Year Three Courses – D.M.D. Program

Fall

Winter

Oral & Maxillofacial Surgery

  • Course Number:                  1141
  • Credits:                                  2.0
  • Predoctoral Year:                Year 3
  • Semester:                             Fall/ Winter (Sept-Mar)

Lecture Objective

Introduction & Organization of Course: Students are introduced to the definition & scope of the specialty, and informed of the organization, grading system, quizzes, tests, CE, Oral/Written presentations, and reading requirements of the course

Perioperative Management: Classification of diabetes; effects of diabetes on systemic function, medication used in treatment of diabetes‑modes of action, peak, duration, complications; differential diagnosis: diabetic coma vs. insulin shock; the gravid patient‑hormonal and cardiovascular changes; factors in guiding treatment schedule; drug effects on fetus.  Physical and laboratory evaluation of medically compromised patients with liver, adrenal or thyroid disease; effects of steroids on systemic function; patient management.

Definition of hypertension and review of etiologies, laboratory test for evaluation; review of drug therapy used in management; considerations in treatment of cardiac patients‑angina pectoris. Clinical evaluation and management of patient with arrhythmias; interpretation of EKGs and pulses associated with arrhythmias; antiarrhythmic drugs.

Obstructive and restrictive pulmonary diseases and treatment considerations; Rheumatic fever‑etiology, criteria for diagnosis, pathology, treatment; prevention of bacterial endocarditis‑prophylaxis regimens; dental management of patients on anticoagulation therapy‑heparin vs. Coumadin; laboratory evaluation; drug interactions.

Wound Classifications and Sterile Techniques: Wound Classifications, concern of infections, and sterile techniques used in surgery.

Surgical Instruments and Suture materials: Instruments used in outpatient oral and maxillofacial surgery practice; suture materials‑absorbable vs. non-absorbable; consideration for selection.

Flap Design in Oral Surgery: Principles of flap design and types of flaps; anatomical considerations; indications for flap procedures.

Exodontia Techniques: Review of fundamental techniques used in exodontia practice; cardinal forces, hand and chair position, use of elevators, surgical extractions.

Surgical Removal of Impacted Teeth: Classification of impacted teeth ‑mandibular vs. maxillary; theories in regard to etiology and frequency of occurrence; indications for removal of impacted teeth and review of factors indicating non-removal.  Case presentations of surgical removal of impacted teeth‑Interpretation of radiographs, surgical approaches; management of pericoronitis prior to surgery.

Complications Following Odontectomies & Exodontia: Management of complications associated with exodontia‑including hemorrhage swelling and pain; review of routine postoperative care and instructions.  Management of complications following odontectomies‑swelling, infection, delayed healing (dry socket), trismus, altered sensation, displacement of teeth into spaces, sinus or canal fractures.

Management of Infection & Antibiotics in Infection: Case presentations‑management of facial infection involving major facial spaces; Ludwig’s angina and cavernous sinus thrombosis; signs and symptoms, pathways of infection spread, treatment. Review of antibiotics used in the management of facial infections; antibiotic classification, dosage, spectrum, mode of action, side effects; culture and staining techniques; bacterial identification and sensitivities.

Facial Space Infections-Criteria for Hospitalization of Infections: Review of anatomy of fascial spaces, involvement by odontogenic infections, and criteria for specialist referral and hospitalization.

Care of the Hospitalized Patient: Justifications for admission to hospital; types of admissions, hospital notes and orders, consultations‑coordination of specialty services in the management of a traumatized, compromised patient.  . Review of analgesics‑prescription writing, classification, side effects, narcotics and NSAIDs.

Maxillary Sinus: Anatomy, bacteriology and histology of maxillary sinus, clinical and radiographic evaluation of sinusitis; removal of pathology from sinus; patient management and drug therapy; closure of oroantral fistula.

Endodontic Surgery: Indications for apicoectomies; surgical techniques; postoperative management; case presentations.

Pre-prosthetic Surgery: Clinical evaluation of edentulous ridges‑reasons for alveoplasty; instrumentation and surgical techniques; types ‑interradicular, simple, radical; case presentation. Clinical evaluation of patients for preprosthetic surgery; surgical techniques in performing tuberosity and tori reductions; anatomical considerations.  Indications for vestibuloplasty; surgical principles in performing vestibuloplasty‑maxillary vs. mandibular; grafting procedures; postoperative management; case presentation.

Implant Surgery-Anatomic Considerations: Review of residual ridge classifications, bone densities, implant systems and designs, components. Esthetic considerations.

Pre-implant alveolar reconstruction & Bone Grafting Considerations: Bone grafting biology; Bone graft materials: Bone grafting procedures: block grafting, external & internal sinus lift, ridge augmentation, ridge split, distraction osteogenesis and other advanced techniques.

Radiographic considerations in Implant & Reconstructive Surgery: Anatomical limitation in implant surgery, evaluation of bony anatomy using radiographic studies with emphasis on computed tomographic examinations and interactive CT treatment planning. CT-guided implant surgery

Care of the Traumatized Patient: Considerations in initial treatment of the traumatized patient with multiple facial injuries‑airway management, monitoring, vital signs, laboratory test, fluid replacement, radiographs, physical examination; case presentation.

Facial Fractures: Principles in management of facial fractures –dentoalveolar and mandibular fractures; diagnosis, classifications, methods of stabilization‑unfavorable vs. favorable, edentulous vs. dentulous; case presentations. Maxillary, Le Fort, Zygomaticomaxillary complex, nasal, frontal, NOE fractures and management techniques.

Surgical Correction of Dento-Facial Deformities I – Diagnosis and Treatment Planning: Diagnosis and treatment planning in determination of specific skeletal deficiencies for surgical correction of facial deformities‑interpretation of cephalometric x-ray and model surgery.

Surgical Correction of Dento-Facial Deformities II – Mandibular/Maxillary Considerations: Mandibular considerations in surgical correction of facial deformities; case presentation of surgical techniques‑vertical oblique, sagittal and horizontal osteotomies.  Maxillary considerations in surgical correction of facial deformities‑case presentation of surgical techniques‑Le Fort procedures, midfacial augmentation.

Facial Neuralgia and Paralysis: Signs, symptoms and therapy of facial neuralgias‑tic douloureux, glossopharyngeal, sphenopalatine and atypical neuralgias; Bell’s palsy‑etiology, signs, symptoms, management.

Temporomandibular Joint Surgical Aspects: Anatomy of temporomandibular joint‑review of muscles of mastication; evaluation of function‑radiographic techniques and interpretation ‑tomography, CT scan, conservative therapy. Temporomandibular joint pathology ‑ankylosis, internal derangement, arthritis‑degenerative joint disease‑surgical management of TMJ disorders; case presentation.

Cosmetic Maxillofacial surgery: Facial aging. Surgical procedures: blepharoplasty; rhinoplasty; rhytidectomy; malar, gonial, chin augmentation; neck liposuction. More emphasis on non-invasive procedures: Chemical denervation, facial fillers, laser resurfacing, chemical peels.

Salivary Gland Diseases: Review of salivary gland diseases with emphasis of those that require surgical management.

Emergency Management: Management of medical and surgical emergency cases in the office.

Periodontology II Course

  • Course Number:                  872
  • Credits (Weight):                 1.0
  • Predoctoral Year:                Year 3
  • Semester:                             Fall/Winter (Sep-Mar)                                                        

Course Goals and Objectives

The objectives of this course are to outline therapeutic concerns relative to anatomy, making a diagnosis, determination of etiology, risk factors, wound healing and prognosis with or without treatment. In the context of an evidence based approach to patient treatment, a rationale for therapy is discussed. The program includes the description of non-surgical and surgical therapeutic approaches for the treatment periodontal disease. In addition, techniques for soft and hard tissue site development prior to implant placement as well as therapeutic management of periimplantitis are also presented.

The spectrum of surgical periodontal therapy presented ranges from resective therapy to repair/regenerative procedures. In order to facilitate a clearer understanding of various therapeutic techniques utilized in contemporary Periodontology, the students are exposed to the step by step details of each therapy presented. Biomaterials utilized for various procedures are described as well as the efficacy of the presented biomaterial.

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Pharmacology

  • Course Number: 1139
  • Credits (Weight): 2.0
  • Predoctoral Year: Year 3
  • Semester: Fall/Winter (Sep-Feb)                                                        

Course Goals and Objectives

The goal of this course is to provide the student with a thorough knowledge of the pharmacology of drugs used in dentistry and medicine, concentrating on their mechanisms of action, therapeutic actions and adverse side effects, the potential drug-drug interactions that can arise. Finally, an additional goal is to provide the student with exposure to computerized sources of information regarding new developments in clinical pharmacology so that the information obtained in the course can be continually updated, as well experience in using traditional text, online or handheld drug reference guides to aid in patient management.

The student will be able to demonstrate an understanding of:

  • The pharmacodynamic and pharmacokinetic determinants of drug response.
  • The pharmacology and therapeutic uses of agents that act directly or indirectly on the autonomic nervous system.
  • The concept of selective toxicity as it applies to the application of anti-infective agents for infection control in dentistry.
  • The pharmacology of drugs used to alleviate the various forms of cardiovascular disease and the implications of patient cardiovascular disease in terms of clinical management of the patient and the potential for drug-drug interactions.
    • The actions of pain relief medications ranging from local anesthetics to NSAIDs, to opiate compounds: their appropriate use in dental medicine, and their potential toxicities if used inappropriately.
    • The pharmacology of various oral, IM, IV and inhalation sedative and anesthetic agents available for patient management.
    • The potential for adverse drug interactions that can arise when drugs are used by the dental practitioner in the presence of drugs already being taken by the patient for medical purposes.

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Prosthodontics & Operative Dentistry Course

  • Course Number:  912
  • Credits (Weight): 1.0
  • Predoctoral Year: Year 3
  • Semester: Fall (Sept-Dec)

Course Goals and Objectives

Upon completion of the Prosthodontics and Operative Dentistry Course, the student should be able to:

Demonstrate the ability to integrate and apply concepts in this class to patients’ care and gain “first-hand” knowledge from faculty in the Prosthodontics and Operative Dentistry department.

The YR-3 Prosthodontics and Operative Dentistry Course is a required component of the D.M.D. program. This course provides students with current concepts, materials and techniques, which are commonly used in the today’s prosthodontics and operative dentistry. This course is comprised of 2 sections.

The first section is devoted to the fundamentals of operative dentistry in order to provide students with basic concepts and foundation for the discussion of the diagnosis, treatment planning and sequence of treatment with the patients, practice coordinators and operative dentistry faculty members. Within this first part, students will explore materials and techniques involved in Operative Dentistry, from basic amalgam restorations to ceramic inlays and onlays.

The second section is the combination of fixed prosthodontics with removable (complete and partial) prosthodontics. The sequence of the lectures should allow the student to apply this knowledge to the patient care. The combination of RPD/FPD and Esthetics in Prosthodontics are followed along with how to relate this information to the laboratory technicians. The lectures will discuss the clinical assessment of common problems in prosthodontics and how to troubleshoot such occurrences; the clinical steps associated with the fabrication of complete dentures, with or without a removable partial denture, providing the students with knowledge for diagnosis, treatment planning and actual treatment for such patients. The techniques for advanced cases – such as immediate dentures and overdentures – are discussed, and finally maxillofacial prosthetics is presented as a treatment modality.

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Craniofacial Function II

  • Course Number: 1002
  • Credits: 1.0
  • Predoctoral Year: Year 3
  • Semester: Winter (Feb-Apr)

Course Goals and Objectives

  • The concept of centric relation and centric occlusion (MIP)
  • TMJ and mandibular movements
  • The craniofacial complex anatomy in relation to TMJ and occlusion
  • Applications of occlusal devices for diagnostic and therapeutic purposes
  • Establishing VDO and VDR in different clinical situations
  • Clinical Guidelines for adjusting the restoration to proper occlusion
  • Introduction to full mouth or complex oral rehabilitation process

National Dental Board Part II Preparation:

  • Clinical Case Based Questions
  • TMJ and Occlusion questions
  • CR, CO and Treatment Sequence Questions