RDS 423
King Saud University
College of Dentistry
Department of Restorative Dental Sciences
Division of Endodontics
COURSE OUTLINE
423 RDS
Clinical Endodontics
FOURTH YEAR
Course Director:
Dr. Kholod Almanei (GUC)
E-mail:kalmanei@ksu.edu.sa
Credit Hours: Three (3) credit hours
Academic year 1435-1436H (2014-2015G)
A.Learning outcomes:
Goal:
To train students to perform clinical aspects of endodontic therapy with emphasis on integrating clinical and biological principles. The students will be trained to treat endodontically involved anterior and posterior teeth. In addition, they will be trained to manage endodontic emergencies.
Course Objectives:
At the completion of 423 RDS, students should be able to:
- Be familiar with all endodontic forms used in the clinic.
- Develop a systematic approach to the diagnosis of endodontic pain.
- Organize clinical findings, symptoms and pain history to determine a diagnosis.
- Develop diagnostic tests to determine pulp vitality (cold test, EPT and others).
- Diagnose, plan and deliver routine non-surgical endodontic treatment to patients with pulpal and periradicular disease.
- Clinically record the status of pulpal and periradicular tissues through clinical and radiographic examinations.
- Be familiar with major pulpal and periradicular pathology and their signs and symptoms.
- Develop a differential diagnosis between endodontic and periodontal disease.
- Develop a differential diagnosis between endodontic and non-endodontic disease.
- Take necessary radiographs to interpret osseous changes related to pulpal and periradicular pathology.
- Select or differentiate cases for treatment or referral based on knowledge, experience and difficulty.
- Determine the prognosis for endodontically treated teeth and the possibility of endodontic surgery.
- Identify the need for appropriate adjunctive procedures subsequent to endodontic therapy.
- Refer the case for final restoration.
- Be aware of the value of post-operative follow-up (recall) and the possibility of performing root canal re-treatment
- Course Components:
423 RDS is a Lecture and Clinical course where students have to recognize, diagnose, and treat pulpaly involved teeth. In addition, students have to relate endodontics to various dental disciplines.
| I. Didactics: Topics to be Covered | |||||
| Topic | No of Weeks | Contact hours | |||
| I. The Science of Endodontics: I.1. Clinical diagnostic procedure. I.2. Management of endodontic emergencies. |
2 |
2 |
|||
| II. Endodontic Treatment Procedure: II.1. Endodontic treatment procedure I. II.2. Endodontic treatment procedure II. II.3. Endodontic treatment procedure III. |
3 |
3 |
|||
| III. The Role of Filled Tooth: III.1. Non-surgical retreatment. III.2. Periradicular surgery. |
2 |
2 |
|||
IV. The Role of Endodontics after Dental Traumatic Injuries.
|
1 |
1 |
|||
| V. Endodontology with Interdisciplinary Treatment Approach: V.1. Restoration of endodontically treated tooth. V.2. Endodontic and periodental interrelationships. V.3. Discoloration, bleaching and laser. |
3 |
3 |
|||
VI. Prognosis of Root Canal Therapy
|
1 |
1 |
|||
| VI. Regenerative Endodontics | 1 | 1 | |||
| II. Course Components (hours per year) | |||||
| Lecture | Practical | ||||
| 13 | 90 | ||||
It is expected that each student will: Attend all lectures and clinical sessions. Absences will be looked upon with disfavor and it will be reported to the administration when it reaches 25%.
III. Clinical Requirements
The following minimum requirements must be completed:
a. Two anterior teeth.
b. Two premolars; one with single canal and the other with two canals.
c. Two molars; one upper and one lower molar. Third molar teeth should not be treated.
d. A retreatment case. Tooth should be with 1 or 2 canals. This will be considered as both a retreatment case and one of the above requirements.
e. Two recall cases, with a minimum of 3 months passed from treatment, and they must be restored.
Clinical competency examination:
Complete root canal therapy for single rooted "single-canal" virgin anterior or premolar tooth which has to be done in single visit. The student will select the case and decide the session for examination. The course director and one of 423 RDS clinical instructors will evaluate the case. If the student did not pass the exam, she will have a chance to redo it however, her second evaluation will be out of 15. To pass this course the student should pass this exam. If the student fails to complete her competency exam in single visit three marks from her total evaluation will be deducted and it has to be done in the next visit.
- Virgin = Not endodontically treated before or initiated
N.B:
- 50% of the requirements must be cleaned and shaped by rotary instruments
- Root canal treatment on one upper or lower molar tooth has to be on a virgin tooth.
- No rubber dam isolation = failure.
- No instructor’s permission / sign = 0 + suspension.
- Tracing wrong tooth = 0 + suspension.
- Preventive endodontic therapy and management of deep carious lesions (CARIES CONTROL), and pulpectomy procedures approved by the instructor are considered as part of the endodontic treatment.
- Course Materials
- Required Text
- Principles & Practice of Endodontics 4th ed. by: Walton & Torabinejad.
- Essential References
- Pathways of the pulp 10th ed. By: Hargreaves and Cohen.
- Endodontics 6th ed. by: Ingle, Bakland and Baumgartner.
- Assignments and Evaluation
| Evaluation | |||
| Assessment | Assessment task | Week due | Proportion of Final Assessment |
| 1 | Quiz #1, 2,3 | 3,6,13 | 5% |
| 2 | Midterm written exam | 9 | 10% |
| 3 | Final written exam | 16 | 20% |
| 4 | Case presentation | Second semester (first 2 clinical sessions) | 5% |
| 5 | Clinical exam | Any clinical session | 20% |
| 6 | Clinical case assessments | Per finished case | 40% |
| Total | 100% | ||
LECTURE SCHEDULE
| Week | Date | Title | Faculty |
| 1 | Aug 31t, 2014 | Introduction | Dr. K. Almanei |
| 2 | Sep 7, 2014 | Clinical diagnostic procedure | Dr. K. Almanei |
| 3 | Sep 14, 2014 | Endodontic treatment procedure I Quiz #1 |
Dr. K. Almanei |
| 4 | Sep 21, 2014 | Endodontic treatment procedure II | Dr. K. Almanei |
| --- | Sep 28 & Oct 5, 2014 | Hajj Vacation | -------------------- |
| 5 | Oct 12, 2014 | Endodontic treatment procedure III | Dr. K. Almanei |
| 6 | Oct 19, 2014 | Restoration of endodontically treated tooth Quiz #2 | Dr. K. Almanei |
| 7 | Oct 26, 2014 | Non-surgical retreatment | Dr. S. Alsubait |
| 8 | Nov 2, 2014 | Management of endodontic emergencies | Dr. H. Balto |
| 9 | Nov 9, 2014 | Midterm Exam | Dr. K. Almanei |
| 10 | Nov 16, 2014 | The Role of Endodontics after Dental Traumatic Injuries | Dr. R. Alsulaimani |
| 11 | Nov 23, 2014 | Periradicular surgery | Dr. S. Alsubait |
| 12 | Nov 30, 2014 | Endodontic and periodental interrelationships | Dr. S. Basoudan |
| 13 | Dec 7, 2014 | Discoloration and bleaching Quiz #3 |
Dr. S. Basoudan |
| 14 | Dec 14, 2014 | Prognosis of Root Canal Therapy | Dr. S. Basoudan |
| 15 | Dec 21, 2014 | Regenerative Endodontics | Dr. K. Almanei |
| 16 | Dec 28, 2014 | Final Exam | -------------------- |
LECTURE OUTLINE AND LEARNING OBJECTIVES
1) Introduction
- Review of objectives and requirements of the course.
- Introduction to all endodontic forms to be used in the clinic.
- Documentation of procedures and treatment.
- Clinical Protocol.
2) Clinical Diagnostic Procedures
- Chief complaint, medical and dental history.
- Examination and testing.
- Pulp test
- Special test
- Radiographic examination and interpretation.
- Root fracture
- Referred pain
- Clinical classification of pulpal and periradicular diseases.
- Treatment planning and case selection.
3) Clinical Endodontics I
- patient preparation.
- preparation of radiographs.
- Preparation for access: Tooth isolation.
4) Clinical Endodontics II
- Access cavity preparation.
- Objective and guidelines for access cavity preparation.
- Mechanical phases of access cavity preparation.
- Error in access cavity preparation.
- Morphology and access cavity preparation for individual teeth.
- Length determination.
- Radiographic
- Electronic apex locator.
5) Clinical Endodontics III
- Cleaning and shaping of root canal system
- Obturation of the cleaned and shaped root canal system
- Temporization of endodontically treated tooth.
6) Restoration of endodontically treated tooth
a) Special features of endodontically treated teeth.
b) Restorative materials and options.
c) Pretreatment evaluation and treatment strategy.
7) Nonsurgical Retreatment
a) Etiology of posttreatment disease.
b) Diagnosis of posttreatment disease.
c) Treatment planning.
d) Nonsurgical endodontic retreatment.
8) Management of Endodontic Emergencies
a) Emergency classifications.
b) Emergency endodontic management.
c) Analgesics and antibiotics.
d) Cracked and fractured teeth.
9) The Role of Endodontics After Dental Traumatic Injuries
a) Classification – World Health Organization.
b) Radiographic examination.
c) Clinical management.
d) Follow-up after dental trauma.
10) Periradicular Surgery
- Indications for periradicular surgery.
- Periradicular surgery.
- Postoperative care.
11) Endodontic and Periodontal Interrelationships
- Influence of pulpal pathologic condition on the periodontium.
- Influence of periodontal inflammation on the pulp.
- Differential diagnosis.
- Treatment alternatives.
12) Discoloration and Bleaching
- Causes of tooth discoloration.
- Contraindications to bleaching.
- Methods of bleaching discolored teeth:
- Veneering discolored teeth.
13) Prognosis of Root Canal Therapy
- Describe the importance of recall.
- Describe modalities used to determine success and failure.
- Factors determine success and failure.
- Identify causes other than endodontic that may lead to failure.
14) Regenerative Endodontics
- Overview of Regenerative Endodontics
- Summary of Basic Research on Regenerative Endodontics
- Clinical Procedures Related to Regenerative Endodontics