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Regulations and Curriculum for Bachelor of Dental Surgery

BDS (Amended upto 2018)

(Deemed to be University under Section 3 of UGC Act, 1956)

(Placed under Category ‘A’ by MHRD, Govt. of India, Accredited with ‘A’ Grade by NAAC)

University Enclave, Deralakatte, Mangaluru – 575 018

Tel: +91-824-2204300/01/02/03, Fax: 91-824-2204305

Website: www.nitte.edu.in E-mail: [email protected]

http://www.nitte.edu.in/

mailto:[email protected]

Regulations and Curriculum - BDS

VISION

To build a humane society through excellence in education and healthcare

MISSION

To develop Nitte (Deemed to be University)

As a centre of excellence imparting quality education, generating competent, skilled manpower to face the scientific and social

challenges with a high degree of credibility, integrity, ethical standards and social concern


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CONTENTS

Notification iii – v

Regulations 1 – 22

Introduction

Definitions

Duration of the Course

Medium of Instruction and Examinations

Maximum Period for completion of the course

Eligibility for Admissions

Admission

Selection of eligible candidates

Withdrawal -Temporary and Permanent

Migration

Conduct and discipline

Graduation Requirements

Convocation

Academic Appeals Board (AAB)

Subjects of Study and Training

Internship Attendance Examinations:

Scheme of Examination, Internal Assessment, University Examination, Criteria for Pass, Carry-over Benefit, Rules for Grace Marks, Re-totalling

Supplementary Examinations

Declaration of Results and Classification

Award of Merit Certificates


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Programme outcomes 23

Curriculum

Human Anatomy, Embryology, Histology and Medical Genetic 24 – 31 Human Physiology 32 – 41 Biochemistry, Nutrition and Dietetics 42 – 50 Dental Anatomy, Embryology and Oral Histology 51 – 58 Pre- Clinical Prosthodontics, Crown and Bridge 59 – 63 Pre-Clinical Conservative Dentistry 64 – 74 Skills and Personality Development 75 – 76 General Pathology 77 – 83 Microbiology 84 – 92 General and Dental Pharmacology and Therapeutics 93 – 97 Dental Materials 98 – 107 Constitution of India 108 – 110 General Medicine 111 – 116 General Surgery 117 – 125 Oral Pathology and Oral Microbiology 126 – 137 Oral Medicine and Radiology 138 – 144 Orthodontics and Dentofacial Orthopedics 145 – 157 Public Health Dentistry 158 – 169 Periodontology 170 – 187 Prosthodontics, Crown and Bridge 188 – 205 Conservative Dentistry and Endodontics 206 – 223 Oral and Maxillofacial Surgery 224 – 241 Pedodontics and Preventive Dentistry 242 - 251 Internship 252 – 258

No. F.9-13/2007-U.3 (A) Government of India

Ministry of Human Resource Development (Department of Higher Education)

U.3(A) Section

Shastri Bhawan, New Delhi, Dated the 4thJune, 2008

NOTIFICATION

1. Whereas the Central Government is empowered under Section 3 of the University Grants Commission (UGC) Act, 1956 to declare, on the advice of the UGC, an institution of higher learning as a deemed-to-be-university;

2. And whereas, a proposal was received in February, 2007 from Nitte Education Trust, Mangalore, Karnataka seeking grant of status of deemed-to-be university in the name of Nitte University under Section 3 of the UGC Act, 1956;

3. And whereas, the University Grants Commission has examined the said proposal and vide its communication bearing No. F.26-10/2007(CPP-I/ DU) dated the 10th March, 2008 has recommended conferment of status of ‘deemed-to-be-university’ in the name and style of Nitte University, Mangalore, Karnataka, comprising A.B. Shetty Memorial Institute of Dental Sciences, Mangalore;

4. Now, therefore, in exercise of the powers conferred by section 3 of the UGC Act, 1956, the central Government, on the advice of the University Grants Commission (UGC), hereby declare that Nitte University, Mangalore, Karnataka, comprising A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, shall be deemed to be a University for the Purposes of the aforesaid Act.

Sd/ (Sunil Kumar)

Joint Secretary to the Government of India

(True Extract of the Notification)

iv

University Grants Commission

Bahadur Shah Zafar Marg New Delhi – 110002

No.F. 26-10/2007(CPP-I) July, 2008

OFFICE MEMORANDUM

1. Whereas the Central Government is empowered under Section 3 of the

University Grants Commission (UGC) Act, 1956 to declare, on the advice of the UGC, an Institution of higher learning as a deemed-to-be-university.

2. And whereas, an application was received from Nitte Education Trust, Mangalore, Karnataka seeking grant of status of deemed-to-be-university in the name of Nitte University under section 3 of the UGC Act, 1956.

3. And whereas, the University Grants Commission have examined the said proposal and vide their communication No.F.26-10/2007 (CPP-1) dated the 10th March, 2008 have recommended conferment of status of ‘deemed-to-be university’ in the name and style of Nitte University, Mangalore, Karnataka comprising A.B. Shetty Memorial Institute of Dental Sciences, Mangalore.

4. Now, therefore, in exercise of the powers conferred by Section 3 of the UGC Act, 1956 the Central Government, on the advice of the University Grants Commission (UGC), vide notification No.F.9-13/2007-U.3(A) dated 4th June, 2008 declared that Nitte University, Mangalore, Karnataka comprising A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore shall be a Deemed to be University for the purposes of the aforesaid Act.

Sd/ (K.P. Singh)

Joint Secretary University Grants Commission

(True Extract of the Notification)

v

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Nitte University (Deemed University under Section 3 of UGC Act, 1956)

(Placed under Category ‘A’ by MHRD, Govt. of India, Accredited with ‘A’ Grade by NAAC)

University Enclave, Deralakatte, Mangalore – 575 018

Tel: +91-824-2204300/01/02/03 Fax: +91-824-2204305

Website: www.nitte.edu.in E-mail: [email protected]

Ref. No. NU/REG/2008-9/48 Date: 15-09-2008

NOTIFICATION

Subject: Regulations and Course Curriculum for Bachelor of Dental Surgery

(BDS) Degree Course

Reference: Minutes of the Academic Council Meeting held on 13th May 2009

In exercise of the powers conferred under Rule R-05 (a) of the Memorandum of Association, the Academic Council has approved the Regulations and Course Curriculum pertaining to the Under Graduate Degree Course in Dental Surgery (BDS) in the A.B. Shetty Memorial Institute of Dental Sciences.

The Regulations and course curriculum shall come into force from the academic year 2008-09.

By Order,

REGISTRAR

http://www.nitte.edu.in/

mailto:[email protected]


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(Deemed to be University under section 3 of UGC Act 1956)

Placed under Category ‘A’ by MHRD, Govt. of India Accredited as ‘A’ Grade University by NAAC

Mangaluru, Karnataka, India

Regulations and Curriculum for Bachelor of Dental Surgery

BDS (Amended upto 2018)

Preamble: A.B. Shetty Memorial Institute of Dental Sciences established in 1985 has been imparting graduate (BDS), Post Graduate (MDS), Certificate in Oral Implantology, Fellowship in Craniofacial Surgery, Diploma in Dental Hygiene, and Diploma in Dental Mechanics education and training. From the academic year 2008-09, A.B. Shetty Memorial Institute of Dental Sciences became a constituent college of Nitte (Deemed to be University). The Regulations for the Bachelor of Dental Surgery (BDS) Degree Course are formulated as under:

1. Introduction:

These regulations shall be called Nitte (Deemed to be University) Regulations for BDS Degree Course and govern the policies and procedures including selection, admission, imparting of instructions, conduct of examinations, evaluation and certification of candidate’s performance and all amendments there to. The regulations shall come into effect for the batch admitted from the academic year 2017-2018 onwards.

This set of regulations shall be binding on all the candidates undergoing the said Degree programmes.

These regulations may be modified from time to time as mandated by the statutes of Nitte (Deemed to be University), and the Dental Council of India (DCI)/ Regulatory Authority of the Government/s.

This set of regulations may evolve and get refined or updated or amended or modified or changed through appropriate approvals from the Academic Council and the Board of Management from time to time and shall be binding on all parties concerned including the Candidates, Faculty, Staff, Departments, and Institution Authorities.


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All disputes arising from this set of regulations shall be addressed to the Board of Management. The decision of the Board of Management (BoM) is final and binding on all parties concerned. Further, any legal disputes arising out of this set of regulations shall be limited to jurisdiction of Courts of Mangalore only.

2. Definitions:

Unless the context otherwise requires

• BoM means Board of Management of Nitte (Deemed to be University) • BoS means Board of Studies (UG and PG) in Dental Sciences • College means A B Shetty Memorial Institute of Dental Sciences • He includes both genders He and She; similarlyhis and /or him, himself

includes her, as well in all cases. • Head of the Institution means the Dean / Principal of the College (A B

Shetty Memorial Institute of Dental Sciences)

• Institution/College means A B Shetty Memorial Institute of Dental Sciences

• Regulations means this set of academic regulations • Regulatory Authority - Authority appointed/constituted by the

central/state government/s to regulate health science education.

• Teaching Hospital means the Hospital attached to the Dental College or any other Hospital owned by, or under the management of, the University

• University means Nitte (Deemed to be University)

3. Duration of the Course: Every candidate shall undergo a period of certified study extending over 4 academic years, from the date of commencement of study for the subjects comprising dental education curriculum to the date of completion of examination which shall be followed by one year of compulsory rotatory internship.

4. Medium of Instruction and Examinations:

The medium of instruction and examination shall be English.


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5. Maximum Period for completion of the course: A candidate who does not pass the BDS Course in all the subjects within a period of 9 years, including one year Compulsory Rotatory paid Internship from the date of admission shall be discharged from the course.

6. Eligibility for Admissions:

No Candidate shall be allowed to be admitted to the Dental Curriculum of first Bachelor of Dental Surgery (BDS) Course until: a. He/ she shall complete the age of 17 years on or before 31st December, of

the year of admission to the BDS course; b. He/she has passed qualifying examination as under:

i. The higher secondary examination or the Indian School Certificate Examination which is equivalent to 10+2 Higher Secondary Examination after a period of 12 years study, the last two years of study comprising of Physics, Chemistry, Biology and Mathematics or any other elective subjects with English at a level not less than the core course for English as prescribed by the National Council for Educational Research and Training after the introduction of the 10+2+3 years educational structure as recommended by the National Committee on Education;

Note: Where the course content is not as prescribed for 10+2 education structure of the National Committee, the candidates will have to undergo a period of one year pre-professional training before admission to the course;

OR ii. The intermediate examination in science of an Indian University/Board

or other recognized examining body with Physics, Chemistry and Biology which shall include a practical test in these subjects and also English as a compulsory subject;

OR iii. The pre-professional/pre-medical examination with Physics, Chemistry

and Biology, after passing either the higher secondary school examination, or the pre-university or an equivalent examination. The pre-professional/ premedical examination shall include a practical test in Physics, Chemistry and Biology and also English as a compulsory subject;

OR


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iv. The first year of the three years degree course of a recognized university, with Physics, Chemistry and Biology including a practical test in three subjects provided the examination is a “University Examination” and candidate has passed 10+2 with English at a level not less than a core course;

OR v. B.Sc examination of an Indian University, provided that he/she has passed

the B.Sc examination with not less than two of the following subjects Physics, Chemistry, Biology (Botany, Zoology) and further that he/she has passed the earlier qualifying examination with the following subjects- Physics, Chemistry, Biology and English.

OR vi. Any other examination which, in scope and standard is found to be

equivalent to the intermediate science examination of an Indian University/Board, taking Physics, Chemistry and Biology including practical test in each of these subjects and English.

Note: Marks obtained in Mathematics are not to be considered for admission to BDS Course.

In case of admission on the basis of qualifying examination as in (b)(i) , in respect of SC/ST candidates the marks obtained in Physics, Chemistry and Biology taken together shall be 40% and must have passing marks in English. Foreign nationals and candidates who have qualified from a foreign university/Board should obtain permission from the Dental Council of India (DCI) and Nitte (Deemed to be University) prior to the admission for equivalence of the qualification

7. Admission :

a. In case of admission on the basis of qualifying examination, a candidate must have passed in the subjects of Physics, Chemistry, Biology and English individually and must have obtained a minimum of 50% marks taken together in Physics, Chemistry, and Biology at the qualifying examination. In respect of candidates belonging to Scheduled Castes, Scheduled Tribes, the marks obtained in Physics, Chemistry and Biology taken together in qualifying examination be 40% instead of 50% as above and must have passing marks in English.

Note: Any student securing admission under NRI/preferential quota, shall also secure the minimum of 50% in the relevant qualifying examination. Admissions under such category shall be made on the basis of a merit list prepared in that behalf.


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8. Selection of eligible candidates: Selection to the BDS Course shall be based on the basis of merit obtained in the National Eligibility cun Entrance Test (NEET) conducted by the Central government or its authorized agency

9. Withdrawal -Temporary and Permanent:

Temporary withdrawal: A candidate who has been admitted to the course may be permitted to

withdraw temporarily for a period of six months or more up to one year on the grounds of prolonged illness, grave calamity in the family etc., provided:

a. He applies stating the reason of withdrawal with supporting documents and endorsement by parent/guardian.

b. The University is satisfied that without counting the period of withdrawal candidate is likely to complete his requirement of the degree within the maximum time specified.

c. There are no outstanding dues to or demands with the college, departments, library, hostel, etc.

The tuition fee for the subsequent year may be collected in advance based on the severity of the case before giving approval for any such temporary withdrawal.

Scholarship holders are bound by the applicable rules pertaining to the scholarship.

The decision of the University regarding withdrawal of a candidate is final and binding..

Permanent withdrawal: A candidate who withdraws his admission before the closing date of

admission for the academic session is eligible for the refund of the deposit only. The fees once paid will not be refunded under any circumstance.

Once the admission for the year is closed, and if a candidate wants to leave the College he will be permitted to do so and take the Transfer Certificate from the College, if required, only after remitting all the tuition fees for the remaining years.


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Those candidates who have received any scholarship/stipend/other forms of assistance from the College and/or University shall repay all such amounts in addition to those mentioned in the clause above.

The decision of the University regarding withdrawal of a candidate is final and binding.

10. Migration:

Migration from one dental college to another is not a right of a student. However, Migration of students from one Dental College to another Dental College in India shall be granted only in exceptional cases to the most deserving among the applicants for good and sufficient reasons and not on routine grounds. There shall be no migration on any ground from a Dental College within the district of Dakshina Kannada. Only in exceptional cases on extreme compassionate grounds*, provided all the following criteria are fulfilled. Routine migrations on other ground shall not be allowed. Both the colleges, i.e. one at which the student is studying at present and

one to which migration is sought, are recognized by the Dental Council of India.

For the purpose of migration, an applicant candidate shall first obtain “No Objection Certificate” from the college where he is studying for the present, the university to which it is affiliated and also from the college to which the migration is sought and the university to which it is affiliated. He shall submit his application for migration within a period of one month of passing (declaration of results) of the first professional BDS examination along with the said “No Objection Certificate” to the Director, Medical Education of the particular state and the Dental Council of India. The Director, Medical Education of the State concerned and the Dental Council of India shall take the final decision and will communicate the same to the applicant student.

The applicant candidate should have passed first professional BDS examination.

The applicant candidate submits his application for migration, complete in all respects, to all authorities concerned within a period of one month of passing (declaration of results) the first professional Bachelor of Dental Surgery (BDS) examination.

The applicant candidate must submit an affidavit stating that he/she will pursue 240 days of prescribed study before appearing at II professional


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Bachelor of Dental Surgery (BDS) examination at the transferee dental college (A. B. Shetty Memorial Institution of Dental Sciences), which should be duly certified by the Registrar of the University in which he/she is seeking transfer. The transfer will be applicable only after receipt of the affidavit by the DCI.

A student who joins A. B. Shetty Memorial Institute of Dental Sciences on migration shall be eligible to appear in the II professional BDS examination only after attaining the minimum attendance in the subjects, lectures, seminars etc. required for appearing in the examination as stipulated by the regulations of Nitte (Deemed to be University).

Note 1: (i) Migration is permitted only in the beginning of II year BDS Course in recognised

Institutions (ii) All applications for migration shall be referred to Dental Council of India by the

college authorities. No Institution/University shall allow migration directly without the prior approval of the Council.

(iii) The Council reserves the right not to entertain any application which is not under the prescribed compassionate grounds and also to take independent decisions where applicant has been allowed to migrate without referring the same to the Council.

Note 2: *Compassionate ground criteria: (i) Death of supporting guardian.

(ii) Disturbed conditions as declared by Government of India in the Dental College area.

11. Conduct and discipline: Candidates shall conduct themselves within and outside the premises of

the Institution in a manner befitting a student of a professional Institution.

As per the order of Honourable Supreme Court of India, ragging in any form is considered as a criminal offence and is banned. Any form of ragging will be severely dealt with.

The following act of omission and/or commission shall constitute gross violation of the code of conduct and are liable to invoke disciplinary measures:

Ragging as defined and described by the Supreme Court of India/ Government

Lack of courtesy and decorum; indecent behaviour anywhere within or outside the campus.

Willful damage or stealthy removal of any property/belongings of the Institute/Hostel or of fellow candidates/citizens.


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Possession, consumption or distribution of alcoholic drinks or any kind of hallucinogenic drugs.

Mutilation or unauthorized possession of library books. Noisy or unseemly behaviour, disturbing studies of fellow candidates. Hacking in computer systems (such as entering into other person‟ s

domain without prior permission, manipulation and/or damage to the computer hardware and software or any other cyber crime etc.)

Plagiarism of any nature. Any other act of gross indiscipline as decided by the Board of

Management, from time to time. Commensurate with the gravity of offense, the punishment may be:

reprimand, fine, expulsion from the hostel, debarment from an examination, disallowing the use of certain facilities of the College, rustication for a specific period or even outright expulsion from the College, or even handing over the case to appropriate law enforcement authorities or the judiciary, as required by the circumstances.

For any offence committed in (i) a hostel (ii) a department or in a classroom and (iii) elsewhere, the Chief Warden, the Head of the Department and / the Head of the Institution, respectively, shall have the authority to reprimand or impose fine.

All cases involving punishment other than reprimand shall be reported to the Vice Chancellor.

Cases of adoption of unfair means and/or any malpractice in an examination shall be reported to the Controller of Examinations for taking appropriate action.

12. Graduation Requirements:

A Candidate shall be declared eligible for the award of the degree if he has: • Fulfilled all Degree Requirements. • No dues to the University, College, Departments, Hostels, Library, etc. • No disciplinary action pending against him. The award of the degree must be recommended by the Academic Council and approved by the Board of Management.


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13. Convocation: Degrees will be awarded in person for the candidates who have graduated during the preceding academic year. Degrees will be awarded in-absentia to such candidates who are unable to attend the convocation. Candidates are required to apply for the convocation along with prescribed fee within the specified date, after having satisfactorily completed all the requirements of the course. Provisional pass certificate will be issued by the University provided the candidate fulfils requirements mentioned in clause (9) above. The provisional certificate will be issued on submission of an application through the college and will be valid until the convocation.

14. Academic Appeals Board (AAB)

There shall be an Academic Appeals Boards constituted by the University Constitution: • Head of the institution of a constituent college - Chairperson (By

seniority) • A Professor from a constituent college - Member (Nominated by the

Vice-Chancellor) • Three faculty members – Members (Nominated by the Vice-

Chancellor) • The Controller of Examinations - Member Secretary

Note: i. The Chairman may co-opt and/or invite more members. ii. Depending on the prevailing circumstances, the senior most member in the Board

shall act as Chairman instead of Chair person. iii. The quorum of each meeting shall be a minimum of four, excluding invitees.

Functions of the Board: • To receive grievance/ complaints in writing from the students regarding

anomaly in award of marks due to bias, victimization, erratic evaluation, etc. and redress the complaints.

• To interact with the concerned teacher and the student separately, before taking the decision.

• The decision of the AAB will be based on simple majority.


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15. Subjects of Study and Training: I Year BDS

No. Subject Lecture Hours

Practical Hours

Total Hours

1 General Human Anatomy including Embryology, Osteology and Histology

100 175 275

2 General Human Physiology Biochemistry

120 70

60 60

180 130

3 Dental Anatomy, Embryology and Oral Histology

105 250 355

4 Dental Materials 20 40 60

5 Pre-clinical Prosthodontics and Crown & Bridge

10 100 110

6 Pre-clinical Conservative Dentistry 10 50 60

7 Skills and Personality development 25 - 25

Total 460 735 1195

II Year BDS No.

Subject

Lecture Hours

Practical Hours

Total Hours

1 General Pathology Microbiology

55 65

55 50

110 115

2 General and Dental Pharmacology & Therapeutics

70 20 90

3 Oral Pathology and Oral Microbiology 25 50 75

4 Dental Materials 60 200 260

5 Pre-clinical Prosthodontics and Crown & Bridge

25 200 225

6 Pre clinical Conservative Dentistry 25 150 175

7 Constitution of India 40 - 40

Total 360 725 1090


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III Year BDS

No.

Subject Lecture

Hours Practical

Hours Clinical Hours

Total Hours

1 General Medicine 60 - 90 150 2 General Surgery 60 - 90 150 3 Oral Pathology and Oral

Microbiology 120 80 - 200

4 Conservative Dentistry and Endodontics

30 - 80 110

5 Oral and Maxillofacial Surgery 20 - 80 100 6 Oral Medicine and Radiology 20 - 80 100 7 Orthodontics and Dentofacial

Orthopedics 20 - 80 100

8 Pedodontics and Preventive Dentistry

20 - 40 60

9 Periodontology 40 - 80 120 10 Prosthodontics and Crown &

Bridge 30 - 80 110

11 Public Health Dentistry 30 - 100 130

Total 450 80 800 1330

IV Year BDS- Part I No.

Subject

Lecture Hours

Clinical Hours

Total Hours

1 Orthodontics and Dentofacial Orthopedics 30 90 120

2 Oral Medicine and Radiology 45 90 135

3 Pedodontics and Preventive Dentistry 15 40 55

4 Periodontology 40 90 130

5 Oral and Maxillofacial Surgery 20 70 90

6 Prosthodontics and Crown & Bridge 30 90 120


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7 Conservative Dentistry and Endodontics 30 90 120

8 Public Health Dentistry 30 100 130

Total 240 660 900

V Year BDS - Part II No.

Subject

Lecture Hours

Clinical Hours

Total Hours

1 Oral and Maxillofacial Surgery 30 120 150

2 Prosthodontics and Crown & Bridge 40 200 240

3 Conservative Dentistry and Endodontics 40 200 240

4 Pedodontics & Preventive Dentistry 30 90 120

Total 140 610 750

16. Internship: Every candidate is required after passing the final year BDS examination

to undergo compulsory rotational internship to the satisfaction of the College authorities and University for a period of 12 months so as to be eligible for the award of the degree of Bachelor of Dental Surgery (BDS) and full registration.

Every candidate on passing all subjects of final year BDS examinations should obtain provisional registration from the Karnataka Medical Council before the commencement of internship. The University shall issue a provisional BDS pass certificate on passing the final examination for the purpose of provisional registration.

The internship shall be completed within 2 years of the date of passing final year BDS examinations

All parts of the internship shall be done in the teaching hospital of the College only.

The State Dental Council will grant provisional registration to the candidate on production of the provisional BDS pass certificate. The provisional registration will be for a period of one year. In the event of the shortage or unsatisfactory work, the period of provisional registration


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and the compulsory rotating internship may be suitably extended by the appropriate authorities.

Full registration shall only be given by the State Dental Council/Dental Council of India on the award of the BDS degree by the University or its declaration that the candidate is eligible for it.

Time distribution

No. Subject Duration

a. Compulsory 1 Oral Medicine and Radiology 1 month

2 Oral and Maxillofacial Surgery 1½ months

3 Prosthodontics and Crown & bridge 1½ months

4 Periodontology 1month

5 Conservative dentistry 1 month

6 Pedodontics and Preventive Dentistry 1 month

7 Oral Pathology and Microbiology 15 days

8 Orthodontics 1 month

9 Public Health Dentistry 3 months

b. Elective (in any one of the dental specialties) 15 days

Total 12 Months

Assessment of Internship: The intern shall maintain a record of work which is to be verified and

certified by the Head of the respective Department. Apart from scrutiny of the record of work, assessment and evaluation of training shall be undertaken by an objective approach using situation tests in knowledge, skills and attitude during and at the end of the training. Based on the record of work and date of evaluation, the Head of the Institution will issue a certificate of satisfactory completion of training, following which the University will award the BDS degree or declare him eligible for it.


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Satisfactory completion shall be determined on the basis of the following:

No. Parameter Score

1 Proficiency of knowledge required for each case 0-5

2 The competency in skills expected to manage each case

0-5 a. competency for performance of self performance

b. of having assisted in procedures and

c. of having observed

3 Responsibility, punctuality, work up of case, involvement in treatment, follow-up reports

0-5

4 Capacity to work in a team (Behaviour with colleagues, nursing staff and relationship with paramedics)

0-5

5 Initiative, participation in discussions, research aptitude 0-5

0: Extremely dissatisfied 3: Somewhat satisfied

1: Very dissatisfied 4: Very Satisfied

2: Somewhat dissatisfied 5: Extremely satisfied

Note: A Score of less than 3 in any of above items will represent unsatisfactory completion of internship

17. Attendance

A candidate pursuing BDS course shall work in the concerned departments of the Institution for the entire period as a full time candidate. No candidate is permitted to run a clinic/laboratory/ work in any laboratory / institution / hospital / nursing home etc., during the period of study (including internship). No candidate should join any other course of study or appear for any other degree examination conducted by this university or any other university in India or abroad during the period of registration (including internship)

Each academic year shall be taken as a unit for the purpose of calculating attendance in every subject, for I to III year. For the IV year each term shall be taken as a unit for the purpose of calculating attendance in every subject.


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75% attendance separately in theory and 75% in Practical/Clinical in a subject is compulsory for appearing at the university examination.

In case of a subject in which there is no examination at the end of the academic year, the percentage of attendance shall not be less than 70%. However, at the time of appearing for the university examinations in the subject, the aggregate percentage of attendance in the subject should satisfy condition (17.3) above.

Note: A candidate who does not fulfil the attendance requirement will have to repeat the year to make up the attendance as required.

18 . Examinations:

There shall be University Examinations at the end of first academic year, second academic year, third academic year and first term and the second term of the fourth academic year. In addition there shall be periodical tests conducted by the College for Internal assessment.

Scheme of Examination Evaluation is based on Formative Evaluation (Internal assessment) and Summative Evaluation I (University examinations)

I Year BDS

No.

Subjects Theory (Marks) Practical (Marks) Subject

Total (Marks) Univ.

Exam Vivavoce I.A Total Univ.

Exam I.A Total

1

Human Anatomy, Embryology and Histology

70

20

10

100

80

20

100

200

2

Human Physiology Biochemistry, Nutrition and Dietetics

70

20

10

100

80

20

100

200

3

Dental Anatomy, Embryology and Oral Histology

70

20

10

100

80

20

100

200

Grand Total 300 300 600

4 Skills and Personality development* - - - - - - - 100

*College exam only


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II Year BDS

No.

Subjects

Theory Practical A + B Written paper

Vivavoce I.A Total (A)

Exercise I.A Record Total (B)

Grand Total

1

a) General Pathology

b) Microbiology

35

35

10

10

05

05

50

50

40

40

05

05

05

05

50

50

200

2

General and Dental Pharmacology and Therapeutics

70

20

10

100

80

10

10

100

200

3 Dental Materials 70 20 10 100 80 10 10 100 200

4

Pre-clinical Conservative Dentistry

-

20

-

20

50

20

10

80

100

5

Pre-clinical Prosthodontics and Crown & Bridge

-

20

-

20

50

10

10

80

100

Grand Total 340

6 Constitution of India*

- - - - - - 100

*College exam only


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III Year BDS

No.

Subjects

Theory (Marks) Practical (Marks) (A+B) Univ. Exam

Vivavoce I.A Total (A)

Univ. Exam

I.A Record Total (B)

Grand Total

1 General Medicine 70 20 10 100 80 10 10 100 200

2 General Surgery 70 20 10 100 80 10 10 100 200

3

Oral Pathology and Oral Microbiology

70

20

10

100

80

10

10

100

200

Grand Total

300

300

IV Year BDS- Part I

No.

Subjects Theory (Marks) Practical (Marks) (A+B)

Univ. Exam

Vivavoce I.A Total Univ. Exam

I.A Record Total Grand Total

1 Public Health Dentistry

70 20 10 100 80 10 10 100 200

2 Periodontology 70 20 10 100 80 10 10 100 200

3

Orthodontics and Dentofacial Orthopedics

70

20

10

100

80

10

10

100

200

4

Oral Medicine and Radiology

70

20

10

100

80

10

10

100

200

Grand Total 400 400


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IV Year BDS- Part II

No.

Subjects Theory (Marks) Practical (Marks) (A+B)

Univ. Exam

Vivavoce I.A Total Univ. Exam

I.A Record Total Grand Total

1

Prosthodontics and Crown & Bridge

70

20

10

100

80

10

10

100

200

2

Conservative Dentistry and Endodontics

70

20

10

100

80

10

10

100

200

3

Oral and Maxiofacial Surgery

70

20

10

100

80

10

10

100

200

4

Pedodontics and Preventive Dentistry

70

20

10

100

80

10

10

100

200

Grand Total 400 400

Internal Assessment: A student should have scored minimum 35% marks in each subject to be eligible to appear for University examination. There shall be atleast three internal assessment examinations including practical examinations. The marks of the best two examinations along with marks obtained in seminars, end-ofposting examinations, case-study, small research projects and home /vacation assignments will be considered, to calculate the internal assessment. The average of the best two examinations will be considered provided he appears for all the three examinations. If he absents himself for any of the examinations, then the average of two will be considered. Ten percent of the total marks in each subject separately for theory and practical/clinical examinations shall be set aside for the internal assessment.

University Examination: A candidate who satisfies all the requirements of attendance, internal assessment progress and conduct shall be eligible to appear for the university examinations. There shall be a University Examination at the end of each academic year in the first three


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years of study and at the end of each term in the fourth year of study. To be eligible to appear for University examination a candidate should fulfill all the following conditions:

a. Undergone satisfactorily the approved course of study in the subject/subjects for the prescribed duration;

b. 75% attendance separately in theory and in practical/clinical, in each subject;

c. Secure at least 35% of total marks fixed for internal assessment separately in theory and practical/clinical in a particular subject; and

d. Fulfilled any other requirement that may be prescribed by the University from time to time.

Criteria for Pass: A candidate shall be declared as pass in a subject if he secures minimum of 50% of marks separately in theory and Practical / clinical examinations in that subject as stipulated below.

a) For pass in Theory, a candidate shall secure 50% marks in aggregate in University theory examination i.e. marks obtained in University written examination, viva voce examination and internal assessment (theory) put together.

b) For pass in Practical / Clinical exam, a candidate shall secure 50% in aggregate in University Practical / Clinical examination and internal assessment (practical/clinical) put together.

Carry-over Benefit i. A candidate who fails in one subject of I year BDS examination is

permitted to go to the second year class. However, he can appear for the Second year examination only after he passes all the First year subjects.

ii. A candidate who fails in one subject of II year BDS examination is permitted to go to the third year class. However, he can appear for the third year examination only after he passes all the second year subjects.


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iii. A candidate who fails in one subject of III year BDS examination is permitted to go to the Fourth year class and is permitted to appear for the Fourth year part-I examination along with Third year examination. However he shall be permitted to appear Fourth year part-II examination only after he passes all the Third year subjects.

iv. A candidate is permitted to go to the Fourth year part-II irrespective of the numbers of subjects failed in Fourth year part-I examination.

Rules for Grace Marks Grace marks upto to a maximum of 5 will be awarded at the discretion of the University provided the candidate has failed in only one subject and passed in all other subjects. There shall be no provision to award grace marks for improvement of class.

18.4 Re-totalling: Re-totalling of marks is permitted for theory papers only. The university, on application within the stipulated time and remittance of a prescribed fee, shall permit a recounting of marks, for the subject (s) applied. The marks obtained after re-totalling will be the final marks awarded.

19. Supplementary Examinations:

Supplementary examination shall be conducted by the university for the benefit of unsuccessful candidates. Supplementary examinations will be conducted within six weeks/six months from the date of announcement of results. • A candidate detained for lack of attendance, internal assessment marks will

be barred from appearing in any one or all course/s for the supplementary examination.

• A candidate dropping from appearance in any or all subjects /courses at regular examination is disallowed from taking dropped subject(s)/course(s) at the supplementary examinations.

• If a candidate submits application for appearing for the examination but does not appear for any of the subjects in the university examination, he can appear for supplementary examination provided other conditions such as attendance requirement, internal assessment marks, etc. are fulfilled.

• A candidate who is promoted to the next higher class as per carry over regulations (except where apex bodies do not permit), if he clears the lower year/semester/phase examinations in the main examination is allowed to appear for the higher class examination during supplementary examinations


21

provided other conditions such as attendance requirement, internal assessment marks, etc. are fulfilled.

A candidate permitted to appear for the supplementary examination can improve his internal assessment marks before he takes the supplementary examination by subjecting himself to internal assessment procedure as practiced in the college.

20. Declaration of Results and Classification:

Class will be awarded only to those candidates who pass the examination in the first attempt.

Class shall be declared at the end of every year and will be on the basis of the aggregate of marks scored in that year.

75% and above - First Class with Distinction 65% and above but less than 75% - First class 50% and above but less than 65% - Second class Candidates who pass the examinations in more than one attempt shall be declared as passed in “Pass” class irrespective of the percentage of marks secured.

An attempt means the appearance of a candidate for one or more courses either in part or full in a particular examination.

A candidate who fails in main examination and passes one or more subjects or all subjects in the supplementary examination is not eligible for award of class or distinction. Passing in supplementary examination by such candidates shall be considered as attempt.

If a candidate submits application for appearing for the regular examination but does not appear for any of the courses/subjects in the regular University examination, he can appear for supplementary examination provided other conditions such as attendance requirement, internal assessment marks, etc. are fulfilled and his appearing in the supplementary examination shall be considered as the first attempt.

Candidates who pass the subjects in the supplementary examinations are not eligible for the award of Gold Medal or Merit Certificate.


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21. Award of Merit Certificates: Merit Certificates shall be awarded on the basis of aggregate marks of I to IV Year examinations.

Only those candidates who have completed the course and fulfilled all the requirements in the minimum number of years prescribed (4 years) and who have passed the examination each year in the first attempt are eligible for the award of merit certificates.

*****


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PROGRAM OUTCOMES

At the end of the program, graduates will be able to...

1. Describe normal and abnormal human structure, development, function and behaviour that is relevant to the practice of Dentistry.

2. Apply basic knowledge of biomedical, technical and clinical sciences for the effective practice of Dentistry.

3. Elicit detailed Dental and relevant Medical history, perform an oral and general physical examination and choose relevant laboratory diagnostic tests for identification of oral disorders, prevention of oral disease and promotion of oral health.

4. Demonstrate the ability to interpret available clinical and laboratory data and effective clinical problem solving, in order to generate differential diagnoses and to manage oral health disorders.

5. Perform and interpret a basic oral radiological examination safely. 6. Plan and administer, safely, appropriate treatments, including surgical

procedures, for common oral disorders in adults as well as children. 7. Identify and manage common medical emergencies encountered in general

dental practice. 8. Identify and refer patients who may require specialist care. 9. Demonstrate knowledge of global and national needs, policies and

regulatory frameworks relevant to oral health. 10. Function effectively as an oral health care team member in health care

settings. 11. Communicate effectively and sensitively with patients, care-givers,

colleagues and the public in a manner that will improve health care outcomes and patient / client satisfaction.

12. Demonstrate the ability to continue refining existing knowledge / skills and acquire new knowledge/skills.

13. Select and pursue an appropriate career pathway that is professionally rewarding and personally fulfilling.

14. Recognize and manage medico-legal, ethical and professional issues in dental practice.

15. Demonstrate and practice integrity, responsibility, respect and selflessness.


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I. HUMAN ANATOMY, EMBRYOLOGY, HISTOLOGY AND MEDICAL GENETICS

Goals The goal is to provide undergraduate dental students comprehensive knowledge of the gross and microscopic structure and development pertaining to head & neck region in detail and rest of the body in brief.

To provide basis for understanding clinical conditions and application of anatomical knowledge in clinical practice.

Objectives Knowledge At the end of the course, the students should be able to: 1. Comprehend the normal disposition, gross features, clinically relevant inter-

relationship, functional and cross sectional anatomy of various structures in the head & neck.

2. Correlate the functions of basic tissues of the body and organs related to head and neck by identifying microscopic and ultra microscopic structure.

3. To understand the principles of sequential development of organs and systems related to head and neck and principals of karyotyping.

4. To understand the appearance of normal skiagrams of head and neck region and principles of newer imaging techniques.

Skills At the end of the course, the student should be able to: 1. Identify, dissect and locate structures of the head and neck region. 2. Identify the basic tissues of the body and organs related to head and neck under

the microscope. 3. To interpret the normal skiagrams of head and neck region. 4. To mark the topography of living anatomy.

Integration From the integrated teaching of other basic sciences, students shall be able to comprehend the regulations and integration of the functions of the organs and systems in the body and thus interpret the anatomical basis of disease process.


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COURSE OUTCOMES

At the end of the course, students will be able to...

CO1: Describe the normal disposition, functional and cross-sectional anatomy of

various structures in the head and neck.

CO2: Explain the microscopic structure of various tissues and organs related to

head and neck.

CO3: Describe the principles and sequential development of the organs and

systems related to head and neck.

CO4: Describe the appearance of normal skiagrams of head and neck region.

CO5: Identify the various structures of the head and neck region.

CO6: Identify the basic tissues of the body and organs related to head and neck

under the microscope.

CO7: Identify the features of normal skiagrams of head and neck region.

CO8: Demonstrate the topography of various structures of head and neck on the

surface of the body.

CO9: Identify the embryology models

I BDS Theory - 100 Hrs. I. Introduction: 10 hrs.

Scope, subdivisions, definitions and interpretation of anatomical terms, planes, anatomical positions, elements of anatomy including fascia, muscles, blood vessels, nerves, joints and lymph vessels.

II. Osteology of Head & Neck: 20 hrs. Skull - exterior - Norma and vault: Interior - Cranial fosse. Individual bones - mandible, maxilla, frontal, parietal, occipital, temporal, zygomatic, ethmoid, sphenoid, vomer, palatine, nasal bones. Cervical vertebrae in general; C 1, C 2 & C 7 in particular Hyoid bone.

III Gross Anatomy of Head and Neck: 30 hrs. a. Scalp - layers, blood supply, nerve supply, lymphatic drainage.


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b. Face - Muscles, blood supply, nerve supply, lymphatic drainage, lacrimal apparatus.

c. Neck - i. Cervical fascia ii. Posterior triangle iii. Anterior triangle - sub mental, digastric, carotid & muscular iv. Midline structures of neck

d. Cranial cavity - meninges; dural folds and sinuses; Hypophysis cerebri. e. Orbit - nerves, vessels, extrinsic muscles of eyeball. f. Parotid region - parotid gland. g. Temporal and infra-temporal fossae - muscles of mastication, Maxillary

artery, maxillary nerve and mandibular nerve. h. Temporo-mandibular joint. i. Submandibular region - submandibular salivary gland. j. Thyroid and parathyroid glands. k. Vessels of head & neck - Carotid, subclavian arteries, Internal jugular vein. l. Mouth, tongue and palate. m. Pharynx. n. Larynx. o. Cervical part of trachea and esophagus. p. Nasal cavity and para nasal air sinuses. q. Lymphatic drainage of head & neck. r. Joints of neck - atlanto - occipital, atlanto-axial.

IV. Neuro-anatomy: 12 hrs. a. Detailed description of cranial nerves - V, VII, IX, X (in the region of head

and neck) XI, XII including their nuclei of origin, intra and extra cranial courses.

b. Cervical spinal nerves and cervical plexus. c. Autonomic nervous system of head and neck.

V. Embryology: 12 hrs. a. Gametogenesis - spermatogenesis and oogenesis, fertilization implantation,

germ layer formation, fetal membranes and placenta. b. Development of branchial apparatus, pharyngeal arches, pouches and clefts. c. Development of face, jaws, oral cavity, tongue, palate, nasal cavity,

paranasal air sinuses, Salivary glands, thyroid gland, Hypophysis cerebri, Temporomandibular joint.


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VI. Histology: 16 hrs. a. Introduction of cytology and histology. b. Basic tissues - epithelial - simple; compound c. Connective tissue - cells, fibers - collagen, elastic, reticular d. Cartilage - hyaline, elastic, white fibro cartilages, e. Spongy and compact bones f. Muscular tissue - skeletal, cardiac and smooth, g. Nervous tissue - peripheral nerve and ganglia. h. Blood vessels - artery & vein. i. Glands - serous, mucous, mixed salivary glands. j. Lymph node tissue - lymph node, palatine tonsil, thymus & Spleen. k. Skin - hairy and non- hairy l. Endocrine gland - pituitary, thyroid, parathyroid, suprarenal & pancreas. m. Lip, tongue & esophagus n. Trachea and lungs.

Practicals: 175 hrs The following topics are included for examination

Must Know Dissection Topics: 1. Scalp 2. Face including deeper dissection 3. Posterior triangle of neck. 4. Anterior triangles of neck - median region, digastric, carotid triangles. 5. Deep dissection of neck -Thyroid gland, Great vessels of neck. 6. Parotid region. 7. Infra- temporal fossa - Muscles of mastication, Mandibular nerve and its

branches, Maxillary artery and Temporo mandibular joint 8. Sub- mandibular region - gland, hyoglossus and its relations 9. Mouth, palate and pharynx. 10. Nasal cavity and paranasal air sinuses 11. Tongue 12. Larynx


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Surface Anatomy: (to be included in Practicals only) Must Know Superior sagittal sinus; Middle meningeal artery; Pterion; Facial artery; Parotid gland and duct; Facial nerve on face; Common, External, Internal carotid arteries; Palatine tonsil; Vocal cords; Thyroid gland; Spinal accessory nerve. Radiological Anatomy: (Practicals only) Must Know AP & Lateral views of head and neck.

Interpretation of normal radiological anatomy.

Histology Slides: - for Practical exam as Spotters & for Discussion. 1. Epithelium - simple squamous (Mesentry) 2. Epithelium - simple cuboidal (Thyroid) 3. Epithelium - simple columnar (Gallbladder) 4. Epithelium - simple ciliated columnar 5. Epithelium - simple pseudo-stratified ciliated columnar (Trachea) 6. Epithelium - simple compound stratified squamous keratinized (Skin) 7. Epithelium - simple - non-keratinized (Esophagus) 8. Compound - transitional (Urinary bladder) 9. Areolar tissue. 10. Collagen fibres. 11. Elastic fibres. 12. Tendon. 13. Cartilage — hyaline, elastic, white fibrous. 14. Bone - T.S. & L.S. 15. Muscle - skeletal (LS/TS), cardiac, smooth. 16. Blood vessels - large sized artery, medium sized artery, large vein; medium

vein 17. Peripheral nerve & ganglia 18. Serous salivary gland; Mucous Salivary Gland and Mixed Salivary Gland. 19. Lymph node. 20. Palatine tonsil. 21. Thymus 22. Spleen 23. Skin — hairy and non- hairy


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24. Lip; Tooth; Tongue 25. Trachea; Esophagus 26. Lung 27. Thyroid & parathyroid 28. Pituitary 29. Suprarenal gland. 30. Pancreas.

Desirable to Know (to be demonstrated)

1. Ear - external, middle & internal.

2. Spinal cord

3. Brain Stem

4. Cerebellum 5. Cerebral hemispheres - important gyri & sulci of supero-lateral, medial and

inferior surfaces; functional areas - sensory, motor, auditory, visual, gustatory speech & splanchnic areas; blood supply of brain.

6. Cranial nerves in general with functions other than V,VII, IX, and XII.

7. Genetics - definitions, chromosomes, chromosomal aberrations.

8. Anthropology

9. Organs of thorax and abdomen.

10. Extremities - upper & lower limbs

11. Histology of a. Stomach - fundus and pylorus b. Small intestine - duodenum, jejunum & ileum c. Large intestine - colon and appendix d. Liver and gall bladder

Scheme of Examinations : Anatomy A. Theory Total Marks : 100

I. University Written - 70 marks II. Viva Voce - 20 marks III. Internal assessment – 10 marks


30

Distributions of topics and types of question

Contents

Type of Questions and

marks

Marks

Long essay questions from all the chapters of Gross Anatomy including related Embryology and clinical aspects.

Long essay 2x10 marks

20

Short essay questions from all chapters including Histology, Osteology & Embryology

Short essay 10x3 marks

30

MCQ Should be set from all the topics MCQ 20x1 mark

20

Total 70 Marks

B. Practical Total Marks 100 I. Practicals - 80 Marks II. Record - 10 Marks III. Internal Assessment - 10 Marks

Practicals 1. Gross Anatomy - 50 marks I. Spotters - 10x2 marks = 20 marks II. Discussion - 1x20 marks = 20 marks III. Surface Marking - 1x10 marks = 10 marks

2. Histology - 30 marks I. Spotters -10x1 mark = 10 marks II. Slide Discussion -2x10 marks = 20 marks

Recommended Books: 1. Cunninghams Manual of Practical Anatomy, l5thEd , C.J Romans , Oxford

publishers 2. Hand book of General Anatomy, 3rd Edition, B.D.Chaurasia, CBS publishers 3. Human Osteology for Dental students, 1st Ed, Inderbir Singh, Jaypee publishers.


31

Reference Books: 1. Gray’s Anatomy, 40th Ed, Susan Standring, Elsevier Publishers 2. Langman’s Medical Embryology, 1st Ed, Sadler T.W, Williams and Wilkins

Publications 3. Junquira’s Basic Histology, Text and Atlas, 2nd Ed, Anthony Mescher, McGraw

Hill Publications 4. A color Atlas of Human Anatomy, 2nd Ed, McMinn .R.M.H , HutchinsR.T,

Elsevier Publications 5. Grant’s Atlas of Anatomy, 9th Ed, Anne M.r Agur, Williams and Wilkins

Publications 6. DiFore’s Atlas of Histology, 11th Ed, Victor P Eroschenko, Williams and

Wilkins Publications 7. Principles of general Anatomy, 6th Ed, Datta.A.K, Basu KP publications 8. Essentials of Human Anatomy-Part II. 3rd Ed. Datta.A.K, Current Internationals 9. Essentials of Neuro anatomy, 2nd Ed, Datta.A.K, Current Internationals


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II. HUMAN PHYSIOLOGY

Goal: 1. To provide the first year BDS students comprehensive knowledge of normal

functions of the organ systems of the body and their interrelationships. 2. To make them understand the physiological basis of health and disease.

Objectives: A. Knowledge: At the end of the course the student will be able to: 1. Explain the normal functioning of organs and systems. 2. Understand the interrelationships and interactions among various organs and

systems for maintaining Homeostasis. 3. Assess the relative contribution of each organ system towards the maintenance

of constant internal environment. 4. Differentiate between normal and abnormal functioning of organs and systems. 5. Understand physiological basis of pathogenesis and treatment of diseases and

disorders. 6. Apply the physiological basis in the practice of dentistry.

B. Skills: At the end of the course the student shall be able to: 1. Conduct experiments designed for the better understanding of physiological

phenomenon. 2. Interpret experimental and investigative data. 3. Distinguish between normal and abnormal data derived during the practicals or

observed at the laboratory.

C. Integration: At the end of the integrated teaching the student shall acquire an integrated knowledge of organ structure and function and their regulatory mechanism for the maintenance of health.


33

COURSE OUTCOMES


CO1: Explain the normal functioning of organ systems.

CO2: Describe the inter-relationships and interactions among various organs and

systems for maintaining Homeostasis.

CO3: Assess the relative contribution of each organ systems towards the

maintenance of constant internal environment

CO4: Differentiate between normal and abnormal functioning of organs and

systems.

CO5: Explain the physiological basis of pathogenesis and treatment of diseases

and disorders.

CO6: Apply the physiological basis in the practice of dentistry.

CO7: Perform experiments designed for the better understanding of

physiological phenomenon.

CO8: Interpret experimental and investigative data.

CO9: Distinguish between normal and abnormal data derived during the

practicals or observed at the laboratory

CO10: Apply ethical behavior to professional practice.

CO11: Apply effective communication skills while interacting with patients.

I BDS THEORY - TOTAL HOURS-100

I. GENERAL PHYSIOLOGY: Total Hours : 04 1. Homeostasis - Basic concepts 2. Functions of cell organelles 3. Transport across cell membrane - Diffusion, Osmosis, Active transport

- primary & secondary with examples 4. Distribution of total body water normal values.


34

II. MUSCLE NERVE PHYSIOLOGY: Total Hours: 05 1. Membrane potentials: Resting membrane Potential - definition, genesis,

Action potential- phases, ionic basis, properties. 2. Structure and function of nervous tissues; Neuron , Neuroglia.

Nerve fiber — classification, properties and conduction of impulses in myelinated and non myelinated nerve fibers

3. Neuromuscular junction — definition, stucture, sequences of events during transmission at NMJ, Myasthenia gravis.

4. Comparison between skeletal, cardiac & smooth muscles 5. Structure of skeletal muscle, Excitation contraction coupling,

contraction and relaxation. Types of contraction.

III. BLOOD: Total Hours: 15 1. Composition and functions of blood. 2. Plasma proteins; Types and their functions. 3. Erythrocyte sedimentation rate- definition, normal value, significance 4. RBC- Normal count, morphology, blood indices 5. Erythropoiesis- site, stages, factors essential , and regulation 6. Haemoglobin- Normal value, functions, types and fate 7. Anemias- grading, classification, iron deficiency, folic acid deficiency

anemias 8. Leukocytes: Classification, functions, total count, DLC Terminologies

-Leukocytosis, Leukopenia, Leukemia 9. Immunity — Basic mechanism of immunity with referrence to

lymphocytes T- and B lymphocytes 10. Blood plateletes — Morphology, count, functions, thrombocytopenic

purpura. 11. Haemostasis — Steps, Coagulation factors, Intrinsic and Extrinsic

Mechanisms, Haemorrhagic disorders- Haemophilia, purpura. Anticoagulants- Types, mechanism of action, uses

12. Blood groups- Basis of blood grouping , ABO system, Rh grouping. Rh incompatibility — Erythroblastosis foetalis- prevention and treatment

13. Blood transfusion- Indications, precautions, hazards of mismatched blood transfusion, blood bank


35

IV. CARDIO VASCULAR SYSTEM: Total Hours: 13 1. Physiological anatomy of heart, innervation of heart, circulation. 2. Junctional tissues of the heart ,origin and spread of cardiac impulses 3. Cardiac cycle- definition, events, heart sounds 4. Electro cardiogram- Normal ECG, different types of leads,

characteristics of ECG waves. 5. Heart rate- Normal value- variations and regulation. 6. Cardiac output, cardiac index — Definition , normal value,

physiological variations, factors influencing, regulation 7. Arterial blood pressure- definition, normal values, physiological

variation, factors affecting BP, regulation of BP — short term regulation and long term regulation.

V. RESPIRATORY SYSTEM: Total Hours: 10

1. Physiological anatomy of respiratory system. Tracheo-bronchial tree respiratory and non- respiratory functions

2. Mechanism of breathing - Respiratory muscles and their actions, Intrapleural and intrapulmonary pressure during respiratory cycle, Respiratory membrane, surfactant.

3. Lung volumes & Lung capacities, Normal valves, significance, alveolar ventilation.

4. Transportation of oxygen by blood. Oxygen- Hb dissociation curve and factors affecting it.

5. Transportation of carbondioxide 6. Neural regulation of respiration- role of respiratory centers 7. Chemical regulation of respiration, Peripheral and central

chemoreceptors. 8. Hypoxia, Cyanosis, Asphyxia

VI. EXCRETORY SYSTEM : Total Hours: 08

1. Functional anatomy of kidney, Kidney functions, Type of nephrons, Juxta glomerular apparatus.

2. Mechanism of urine formation: Glomerular filtration — GFR, value, determinants, autoregulation, Tubular function - Renal handling of glucose, renal threshold for


36

glucose, Glycosuria, Renal handling of water, obligatory and facultative, role of ADH.

3. Micturition- Innervation of urinary bladder, micturition reflex. 4. Renal function tests- analysis of blood urea and serum creatinne as

markers of renal function.

VII. DIGESTIVE SYSTEM : Total Hours: 08 1. Organization of gastro intestinal tract, innervation. 2. Physiology of salivary secretion — glands, composition, functions and

regulation of secretion. 3. Stomach- functions- Gastric juice —properties, composition, functions

and regulation of secretion. 4. Exocrine pancreas — Pancreatic juice- properties, composition,

functions and regulation of secretion. 5. Liver- functions of liver. Bile- properties, composition, functions and

regulation of secretion. 6. Gallblader — functions- Entero- hepatic circulation 7. Succus entericus — properties, composition, functions and regulation

of secretion. 8. Motor functions of GTT — Mastication, Deglutition, Movements of

small intestine.

VIII. ENDOCRINE SYSTEM : Total Hours: 13 1. Major endocrine glands - Hormone- Definition, classification of action

and regulation of secretion of hormones. 2. Anterior pituitary- Hormones their functions and regulation of

secretion. Disorders related to growth hormone; Dwarfism,Gigantism,Acromegaly

3. Posterior pituitary - Hormones, Actions and regulation of secretion, Milk letdown reflex. Diabetes insipidus.

4. Thyroid gland - Hormones, actions. regulation of secretion. Disorders of thyroid gland- Goitre, Cretinism, myxoedema, Grave’s disease.

5. Adrenal cortex - Hormones Aldosterone - actions and regulation of secretion, Conn’s syndrome. Cortisol- Functions and regulation of secretion. Addison’s disease, Cushing’s Syndrome


37

6. Adrenal medulla - Hormones, actions and regulation of secretion. Phoechromocytoma.

7. Endocrine pancreas - Insulin, Glucogon, Functions and regulation of secretion, Hormonal regulation of blood glucose, Diabetes mellitus

8. Parathyroid gland- Functions, regulation of secretion, Tetany. 9. Regulation of blood calcium. Calcitonin ,Calcitriol and Role of PTH.

IX. NERVOUS SYSTEM : Total Hours: 14

1. Organisation of nervous system 2. Synapse - types, structure and transmission across synapse. 3. Sensory receptors and classification. 4. Sensory pathways - Dorsal column, lateral column, and anterior

column. Pathway for fine touch, temperature, crude touch- Sensory homonculus

5. Physiology of pain. 6. Motor tracts- Pyramidal tracts, corticobulbar and cortico spinal

tracts.origin, course, termination and functions, Motor hormonculus 7. Reflex action, Reflex arc, Classification of reflexes, Stretch and

withdrawal reflexes 8. Functions of Cerebellum and Basal ganglia 9. Functions of Thalamus. 10. Functions of Hypothalamus, Regulation of body temperature. 11. Cerebral cortex- lobes & functions 12. Cerebro spinal fluid- formation, circulation, composition and

functions. Lumbar puncture. 13. Autonomic nervous system- organisation and functions.

X. SPECIAL SENSES : Total Hours: 05

1. Vision —Physiological anatomy of eye ball. Comparison of rods and cones.

2. Visual pathway, visual reflexes, errors of refraction 3. Color vision and color blindness 4. Audition- Physiological anatomy, Auditory pathway, mechanism of

hearing Deafness- Types and tests


38

5. Taste - Taste buds, taste pathway. 6. Olfaction - Receptors, olfactory pathway

XI. REPRODUCTIVE SYSTEM : Total Hours: 05

1. Puberty. 2. Male reproductive system, Spermatogenesis 3. Testosterone functions & regulation of secretion. 4. Female reproductive system- Menstrual cycle- ovarian & uterine

changes, Hormonal influence of menstrual cycle. 5. Functions and regulation of secretion of oestrogen, progesterone. 6. Maternal changes during pregnancy, pregnancy diagnosis test. 7. Physiology of parituration & lactation. 8. Family planning- Physiological basis

PRACTICALS: 60 HOURS Haematology (Procedures to be performed by the students) - 30 Hours

1. Study of microscope and its uses 2. Collection of blood sample and study of haemocytometer 3. Determination of RBC count 4. Haemoglobinometry 5. Calculation of blood indices 6. Determination of WBC count 7. Leishman’s staining and differential leucocyte count 8. Determination of blood groups 9. Determination of bleeding time 10. Determination of clotting time

Human / Clinical Lab (Procedures to be performed on Human Subjects) 20 Hours

1. Clinical examination of radial pulse 2. Blood pressure recording 3. Auscultation of heart sounds 4. Spirometry 5. Examination of cranial nerves


39

6. Demonstration of superficial and deep reflexes

Demonstrations only - 10 Hours 1. Determination of Erythrocyte Sedimentation Rate (ESR) 2. Determination of packed cell volume (PCV) 3. Determination of specific gravity of blood 4. Fragility test for RBC 5. Artificial respiration 6. Demonstration of ECG recording

NOTE: The practical listed as demonstrations are to be shown to the students. These practicals should not be given in the examinations, but questions based upon these may be given in the form of charts, graphs and calculations for interpretation by the students.

Scheme of Examination: Physiology A. Theory Total Marks 50

(i) University Written 35 (ii) Viva Voce 10

(iii) Internal assessment 05

Distribution of topics and types of questions

Contents

Type of questions and marks

Marks

Long essay questions preferably from 1. Blood 2. Cardio vascular system 3. Respiratory system 4. Endocrine system 5. Nervous system

Long essay 01 x 10 marks

10

Short essay questions should be set from all the chapters. (Except the chapter on which a long essay question has been set)

Short essays 5 x 3 marks

15

MCQ should be set from all the topics MCQ 10 x 1 mark 10

Total 35 marks


40

B. Practical Total Marks 50 (i) Practicals 40 (ii) Record 05 (iii) Internal assessment 05

Practicals I. Hematology experiments (Any one of the experiments) - 20 Marks

1. R.B.C. Count 2. W.B.C Count 3. Differential Leukocyte Count 4. Estimation of haemoglobin, Blood indices 5. Blood grouping, Clotting time, Bleeding time

II. Human physiology practicals (Any one of the experiments) - 20 Marks 1. Blood pressure recording 2. Spirometry 3. Examination of cranial nerves 4. Radial pulse examination 5. Demonstration of superficial and deep reflexes

Recommended Text Books (Latest Edition)

1. Text Book of Physiology Author- A.P.Krishna Publishers - Suman Publications, Mangalore.

2. Human Physiology for BDS Author - Prof. A.K.Jain Publishers - Avichal Publishing Company, New Delhi

3. Concise Text Book of Physiology for Dental Students Author- Yogesh Tripathi Publishers - Elsevier, India

4. Essentials of Physiology for Dental Students Authors- K. Sembulingam Prema Sernbulingam Publishers - Jaypee Brothers Medical Publishers, New Delhi


41

Reference Books: 1. Text Book of Medical Physiology

Author - Hall & Guyton Publishers- Saunders, Philadelphia

2. Review of Medical Physiology Author - William F. Ganong Publishers- Mc Graw Hill

3. Concise Medical Physiology Author - Chaudhuri Sujit K. Publishers- New Central Book Agency, Calcutta

Books for Practicals:

1. Manual of Practical Physiology for B.D.S Author - A.K.Jain Publishers- Arya Publication, New Delhi

2. Text Book of Practical Physiology Author - C.L. Ghai Publishers- Jaypee Brothers Medical Publishers, New Delhi


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III. BIOCHEMISTRY, NUTRITION AND DIETETICS

Goals & Objects The knowledge acquired in biochemistry should help the dental student to understand the biochemical basis of life of human system and it should enable the student to apply the knowledge in dental practice. Hence the department would facilitate: 1. To enable students understand the chemistry and metabolism of food stuff and

orient them to apply this knowledge to solve clinical problems.

2. To acquire basic skill for biochemical investigation which could aid them to come to a clinical diagnosis of common disorders.

3. To encourage research activities by allotting short term research problems to students.

Objectives: At the end of the course, the students shall be able to 1. Define the importance of various organic biomolecules, know their functions

and consequences of deviation from the normal.

2. Describe digestion and assimilation of nutrients and consequences of malnutrition.

3. Describe metabolic pathways of various organic biomolecules.

4. Understand basic enzymology and relate enzymes for clinical application.

5. Describe hormones and their role in various metabolism

6. Describe the structural complements. 7. Highlight on clinical biochemistry and also make the students aware of

functional test like LFT, TFT, Serum electrolytes etc.

8. Explain basis of genetics and a brief knowledge of Protein biosynthesis

The students shall acquire a useful core of information which can be retained for a long time: Examples: 1. Basis of gum bleeding in scurvy. 2. Basis of internal bleeding arising due to vitamin K deficiency. 3. Basis of increase in Urea and Creatinine in renal disease


43

4. Reason for normal plasma insulin level in most cases of maturity onset diabetes 5. Knowledge of fluorosis. 6. Knowlegde of Sialochemistry, micronutrient level 7. Antioxidants status in oral cavity

COURSE OUTCOMES


CO1: Enlist and describe the cell organelles with their molecular and functional

organization

CO2: Delineate structure, function and interrelationships of various biomolecules

and consequences of deviation from the normal

CO3: Understand basic enzymology and emphasize on its clinical applications

where in regulation of enzymatic activity is disturbed

CO4: Describe digestion and assimilation of nutrients and consequence of

malnutrition

CO5: Describe and integrate metabolic pathways of various biomolecules with

their regulatory mechanisms

CO6: Explain the biochemical basis of inherited disorders with their associated

sequelae

CO7: Describe mechanisms involved in maintenance of water, electrolyte and acid

base balance and consequences of their imbalances

CO8: Outline the molecular mechanisms of gene expression and regulation, basic

principles of biotechnology and their applications in medicine

CO9: Understand the basic immunology involving molecular concepts of body

defence mechanisms and their applications in medicine

CO10: Continue to learn advancements in biochemistry and apply the same in

medical practice

CO11: Understand different types of Bio –medical waste, their potential risks and

their management


44

Theory Syllabus : Total Teaching 90 Hours

SI No.

Must Know Desirable Know

No. of Hours

1 Introduction to biochemistry and its scope in dentistry

1 hr

2 Carbohydrates 1. Definition, Classification 2. Isomerism 3. Physiologically important

Monosaccharides, Disaccharides & Polysaccharides

4. Homopolysaccharides — Starch, glycogen & cellulose

5. Hetero polysaccharides (Mucopolysaccharides) — Definition, examples and importance.

4 hrs

3 Chemistry of Amino Acids and Proteins: 1. Classification based on structure &

nutritional importance 2. Isoelectric pH Proteins: 3. Definition 4. Classification 5. Functions 6. Denaturation of proteins 7. Biologically important peptides, Plasma

proteins and their separation by electrophoresis

8. Immunoglobulins —Structure and Functions.

9. Hemoglobin and its abnormal forms.

Structural organization of proteins. Collagen - Structure and composition. Muscle protein - actin and myosin

5 hrs


45

4 Chemistry of Lipids:

1. Definition 2. Classification 3. Functions 4. Fatty Acids 5. Neutral Fats -Triacylglycerols (structure

and composition). 6. Phospholipids : composition, examples and

functions. 7. Plasma lipoproteins, Classification &

functions. 8. Cholesterol — structure & derivatives.

Glycolipids 5 hrs

5 Chemistry of Nucleic Acids 1. Nucleosides and biologically important

nucleotides. 2. DNA: Structure and functions. 3. RNA: Types of RNA, Structure and

functions.

Catabolism of Purines & Pyrimidines

4 hrs

6 Vitamins 1. Definition and classification 2. Chemistry, Sources, RDA, metabolic

role and deficiency manifestations of vitamin: A,D,E,K,C, Thiamine, Riboflavin, Niacin, Pyridoxine, Biotin, Folic acid & Cyanocobalamine.

8 hrs

7 Enzymes and Clinical Enzymology: 1. Definition 2. Properties of Enzyme 3. Classification 4. Enzymes Specificity 5. Mechanism of enzyme action : Features

and models of active site 6. Co-enzymes and Co-factors 7. Proenzymes

ELIZA & RIA 6 hrs


46

8. Factors affecting enzyme activity

9. Km value and its importance. 10. Enzyme inhibition: Types and examples. 11. Isoenzymes - definition, examples &

clinical importance 12. Clinical importance of enzymes,

diagnostic, therapeutic & analytical. Glycolipids

8 Physiological Biochemistry 1. Digestion and absorption of carbohydrates,

proteins and lipids 2. Porphyrins 3. Bilirubin metabolism

Electron transport chain, Oxidative phosphorylation respiratory poisons, oxygen toxicity.

6 hrs

9 Carbohydrate Metabolism: 1. Glycolysis : definition, reactions &

energetics; Rapaport - Leubering Cycle,

2. Glycogenesis & Glycogenolysis 3. Glycogen storage diseases. 4. Citric Acid Cycle : Definition, reactions,

energetics & significance. 5. Pentose Phosphate Pathway:

Definition, reactions and significance. 6. Gluconeogensis and Cori’s cycle. 7. Disorders of carbohydrate metabolism. 8. Regulation of Blood Glucose 9. Diabetes mellitus : Classification diagnosis,

metabolic dearrangements and complications.

Fermentation, Biochemical changes during muscular contraction.

8 hrs

10 Lipid Metabolism 1. Beta-oxidation of fatty Acids. 2. Disorders of fattly acid oxidation 3. Formation and utilization of ketone bodies. 4. Causes and consequences of ketosis. 5.Fatty liver and lipotropic factors 6.Cholesterol : Normal value, causes of hyper and hypocholesterolemia

Synthesis of palmitic acid and triglycerides. Risk factors for atherosclerosis (Lipid profile, apolipoproteins, homocysteine and C-reactive protein)

6 hrs


47

11 Protein and amino acid metabolism

1. Transamination and deamination Reactions. 2. Ammonia metabolism: Sources, Transport

& Urea cycle. 3. Decarboxylation reactions. 4. Specialized products synthesized from

glycine, methionine & aromatic amino acids.

5. Metabolic disorders of amino acids: phenyl ketonuria, albinism, Alkaptonuria and Hartnup’s disease

6 hrs

12 Nutrition and Dietics 1. Calorific value of food 2. Respiratory quotient 3. Basal metabolic rate (BMR) 4. Energy requirements of a normal person 5. Nutritional importance of carbohydrates,

proteins & lipids. 6. Dietary fibers 7. Balanced diet 8. Prescribing of a normal diet and diet

for diabetic patient. 9. Protein energy malnutrition 10. Biochemistry of starvation and

obesity

4 hrs

13 Minerals A brief account of Sources, RDA, Biochemical functions & Deficiency manifestations of Calcium, Phosphorus, Iron, Iodine & Fluoride

5 hrs

14 Organ function test 1. Liver function tests, 2. Kidney function tests

Thyroid function tests

3 hrs

15 Acid — Base balance 1. Normal pH of blood 2. Role of buffers, lungs & kidney in acid —

base balance. 3. Acid — base disturbances - acidosis &

alkalosis

Interpretation arterial blood gas analysis

3 hrs


48

16 Molecular Biology and Biotechnology

Brief account of 1. DNA-replication, recombination and repair 2. Transcription and translation 3. Regulation of gene expression.

Application of recombinant DNA technology.

8 hrs

17 Current Topics 1 .Gene therapy 2. Free radicals and antioxidants 3. Importance of tumor markers — CEA,

Alfafetoprotein (AFP), Human chorionic gonadotrophins (HCG), Calcitonin and Prostate Specific Antigen (PSA).

Metabolism of xenobiotics (detoxification)

7 hrs

Mutation and cancer development.

18 Blood Constituents Clinical Chemistry: interpretation and reference levels of glucose, Urea, Creatinine, Uric Acid, Cholesterol, Calcium, Bilirubin, ALT, AST, ALP, Acid phosphatase, Total Proteins, Albumin & A/G ratio.

2 hrs

PRACTICALS: Total hours:60 hrs Part I: Practicals to be performed by students

1. Reactions of Monosaccharides — Glucose and Fructose.

2. Reactions of Disaccharides — Lactose, Maltose, Sucrose.

3. Reactions of Polysaccharides — Starch.

4. Colour reactions of proteins: Albumin, casein.

5. Precipitation reactions of proteins

6. Reactions of urea ,uric acid and creatinine

7. Urine analysis —normal constituents, abnormal or pathological constituents

8. Determination of serum inorganic phosphate.

9. Determination of Creatinine content in urine and calculation of Creatinine clearance

10. Estimation of blood glucose.


49

Part II: Demonstration Practicals: 1. Colorimeter 2. Electrophoresis 3. Chromatography

Part III: 1. Preparation of hemin crystals. 2. Discussion of clinical charts 3. Spotters

TRAINING PROGRAMME FOR UNDERGRADUATES:

Theory classes: 70 hrs Practical/ Demonstration Classes: 60 hrs Tutorials: 10 hrs

Scheme of the Examination for theory:

Contents Types of Questions and Marks

Marks

Metabolism of Carbohydrates, proteins, amino acids, lipids, vitamins, minerals and enzymes

Long Essay 1x10 marks 10

Chemistry of Carbohydrates, proteins, lipids, nucleic acids, nutrition and dietics, organ function test, acid base balance, Physiological Biochemistry, Molecular Biology and Biotechnology, Current Topics.

Short Essay 3x5 marks 15

Chemistry and metabolism of Carbohydrates lipids, proteins, minerals,enzymes,vitamins, nucleic acids chemistry, acid base balance, LFT and RFT

Multiple Choice 10

Total 35 marks Viva voce 10 marks

Theory internal assessment 5 marks


50

Scheme of the Examination for Practicals:


Marks

1) Estimation of blood Glucose 2) Determination of Creatinine in urine 3) Determination of serum inorganic Phosphate

One estimation 15

1) Colour reactions of Carbohydrates and proteins

2) Analysis of Urine - normal and pathological constituents.

15

1. Interpretation of clinical charts 2. Spotters

10

Record 5

Total 45 marks

Practical Internal Assessment 5 marks

Grand Total 50 marks

Recommended Text Books: Biochemistry, Nutrition and Dieties:

1. Text Book of Biochemistry (2011) Vasudevan 2. Text Book of Biochemistry for Dental students Harper 3. Concise Clinical Medical Biochemistry (1993) Pattabhiraman 4. Fundamentals of Biochemistry A.C.Deb. 5. Text Book of Biochemistry (1997) A.V.S Rama Rama Rao

6. Text Book of Medical Biochemistry K.G.Prasannan& Rajan

7. Review of Biochemistry Harper

8. Basic and Applied dental Biochemistry William R.D & Elliot J.C

9. Principles of Biochemistry (2008) Albert Lehminger


51

IV. DENTAL ANATOMY, EMBRYOLOGY AND ORAL HISTOLOGY

Total number of Teaching hours: Theory: 105 Hours; Practical: 250 Hours

Skills: During the course the student is expected to understand and develop skills in: 1. Carving of permanent teeth in wax / Plaster of Paris 2. Microscopic study of oral tissues 3. Identification of Deciduous and Permanent teeth 4. Age estimation by patterns of teeth eruption from plaster casts

Objectives: After the course on Dental Anatomy including Embryology and Oral Histology the student should be able to recognize normal development, morphology, structure and functions of oral tissues and variations in different pathological/ non-pathological states and understand the histological basis of various dental treatment procedures and physiologic ageing process in the dental tissues. The students should be aware of the basic knowledge of various research methodologies.

Theory: 105 Hours

I. Dental Anatomy:

1. Introduction, Dental Anthropology & Comparative Dental Anatomy

3 Hrs 2. Functions of teeth

3. Nomenclature

4. Tooth numbering systems -Different systems and Dental formula

5. Chronology of deciduous and permanent teeth (First evidence of calcification, crown completion, eruption and root completion)

2 Hrs

6. Deciduous teeth — a) Nomenclature, Importance of deciduous teeth Form & function, comparative dental anatomy, fundamental curvature

4 Hrs

7. Gross morphology of deciduous teeth 5 Hrs

8. General differences between deciduous and permanent teeth 3 Hrs


52

9. Morphology of permanent teeth- Chronology, measurements,

description of individual surfaces and variations of each tooth

10. Morphological differences between incisors, premolars & molars of the same arch

9 Hrs

11. Morphological differences between maxillary and mandibular incisors, canines, premolars and molars of the opposite arch

4 Hrs

12. Internal Anatomy of Pulp 1 Hr

13. Occlusion: • Definition, factors influencing occlusion — Basal bone, arch,

individual teeth, external and internal forces and sequence of eruption

• Inclination of individual teeth — Compensatory curves • Centric relation and centric occlusion —protrusive, retrusive and

lateral occlusion • Clinical significance of normal occlusion; Introduction to and

Classification of Malocclusion

4 Hrs

14. Temporo-Mandibular Joint (T.M.J.): - Gross anatomy and articulation, Muscles (Muscles of mastication) Mandibular position and movements; Histology; Clinical considerations with special emphasis on Myofacial Pain Dysfunction Syndrome - (Desirable to Know)

2 Hrs

II. Oral Physiology:

5 Hrs

1. Theories of mineralization

2. Mastication and deglutition

3. Formation of saliva

4. Calcium metabolism, Physiology of speech

III. Oral Embryology and Histology:

1. Development and growth of face and jaws 2 Hrs

2. Development of tooth 6 Hrs

3. Cranial nerves with more emphasis on V, VII and IX nerves 1 Hr


53

4. Blood supply, nerve supply &lymphatic drainage of teeth &

surrounding structure 1 Hr

5. Cell - structure and functions 1 Hr

6. Maxillary sinus - Structure, variations, histology, function and clinical considerations

3 Hrs

7. Salivary Glands - Classification, structure, function, histology, clinical considerations and age changes

4 Hrs

8. Oral Mucous membrane - Definition - General considerations: Functions and classification. - Structure and microscopic appearance of gingiva, palate, lips,

alveolar mucosa, tongue, floor of mouth. - Gingival sulcus and Dento-gingival junction - Clinical considerations and age changes

8 Hrs

9. Enamel: - Physical characteristics, chemical properties and structure - Development - Life cycle of ameloblasts, Amelogenesis and Mineralisation - Clinical considerations - Age changes

8 Hrs

10. Dentin: - Physical characteristics, chemical properties, structure - Types of dentin - Dentin innervation and hypersensitivity - Development - Dentinogenesis and mineralisation - Clinical considerations - Age Changes

6 Hrs

11. Pulp: - Anatomy, structural features, functions, pulp organs - Development - Clinical considerations - Age changes

4 Hrs

12. Cementum: - Physical characteristics, chemical properties, structure - Cementogenesis - Clinical considerations

4 Hrs


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- Age changes

13. Periodontal ligament: - Cells and fibers - Functions - Development - Clinical Considerations - Age Changes

5 Hrs

14. Alveolar bone: - Physical characteristics, chemical properties - Structure - Development - Internal reconstruction - Clinical considerations

5 Hrs

15. Histochemistry of Oral Tissues (Tissue processing) 3 Hrs 16. Theories of eruption and shedding (Physiological tooth movement) 3 Hrs

Practical: 250 Hours

Dental Anatomy: Carving on wax blocks:- a. Cube, rectangle, cone and cylinder b. Individual tooth - Only permanent teeth of both arches Central, Incisors, Lateral, Canines, Premolars and first molars

Histology: List of Histology slides: Development of tooth:

01. Bud stage of tooth development 02. Cap stage of tooth development 03. Early bell stage of tooth development 04. Late bell stage of tooth development 05. Root formation 06. Epithelial rests of Serres

Enamel: 01. Enamel rod 02. Hunter-Schreger Bands 03. Tufts, Lamellae, Spindles 04. Incremental lines of Retzius


55

05. Neonatal line 06. Gnarled Enamel

Dentin: 01. Dentino - Enamel junction 02. Dentinal Tubules/ Primary curvature 03. Incremental lines of Von Ebner 04. Contour lines of Owen 05. Neonatal line 06. Tomes granular layer 07. Interglobular Dentin 08. Secondary Dentin 09. Intra-tubular Dentin 10. Inter-tubular Dentin 11. Dead tracts

Cementum: 01. Cellular cementum 02. Acellular cementum 03. Cemento-enamel junction 04. Sharpey’s fibers

Pulp: 01. Zones of Pulp 02. Pulp stones

Periodontal Ligament: 01. Principle Fibers of Periodontal Ligament

Alveolar Bone: 01. Haversian System 02. Trabeculated Bone 03. Mature And Immature Bone

Salivary Glands: 01. Mucous Gland 02. Serous Gland 03. Mixed Gland

Maxillary Sinus: Sinus Lining (Pseudostratified Ciliated Columnar) (Desirable To Know)


56

Oral Mucous Membrane:

01. Para-Keratinised Epithelium 02. Ortho-Keratinised Epithelium 03. Non Keratinised Epithelium 04. Palate - Posterolateral Zone 05. Tongue -

- Circumvallate Papillae - Fungiform Papillae - Filiform Papillae

06. Dento-Gingival Junction 07. Skin

Temporo-Mandibular Joint (T.M.J.): Histological Section (Desirable To Know)

Desirable to know: Preparation of ground sections, haematoxylin & eosin sections & decalcified section.

Lecture Demonstrations: 01. Identification of Individual teeth

- Deciduous - Permanent

02. Mixed dentition using study models 03. Cross-section & T.S. of mandible and maxilla with teeth present using study

models - Demonstration of preparation of ground section, decalcification - Paraffin section and H & E Staining

Scheme of Examination: I. Theory : 70 Marks Distribution of topics and type of questions


Marks

A. Dental anatomy - one question B. Oral histology - one question

Long essays 2 x 10 marks

20


57

A. Oral histology - four questions- 20 marks B. Dental anatomy - one question – 05 Marks C. Oral physiology - one question – 05 Marks

Short essays 06 x 5 marks

30

A. Multiple choice questions 1 x 20 Marks 20

Total 70

II. Viva Voce : 20 Marks

III. Internal Assessment – Theory : 10 Marks Practical : 10 Marks

IV. Practicals: 90 Marks

1. Carving: 35 marks 1 hour 15 min

2. Spotters: 45 marks (15 x 3 marks) 1 hour 15 min

- Histology and ground section slides

- Tooth identification

- Casts for identification of teeth, numbering system and age assessment

3. Record book: 10 marks (2 records- Dental Anatomy & Dental Histology)

Text books recommended:

SI. No.

Title of the book Author Edition & Year of publication

Publishers

1 Orban’s Oral Histology and Embryology

Orban 13th Ed. 2013 American Publication Ontario, Canada

2 Oral Histology - Development Structure and Functions

A.R.Tencate 7th Ed. 1998 Mosby A. Harcourt Health Science Company


58

3 Dental Anatomy

Physiology and Occlusion

Wheeler’s 1st South Asian Ed. 2015

Prism Book Pvt. Ltd., Bangalore

Reference Books: - Dental Anatomy by Scoot & Simon - Oral Physiology by Lavelle - Oral Physiology by Jenkins - Dental Anatomy by Krauss Questions and terminologies will be taken from recommended text books only.


59

V. PRE- CLINICAL PROSTHODONTICS, CROWN & BRIDGE

Theory 25 Hours [II BDS]

Topics No.of Hrs.

I. Introduction to Prosthodontics – Scope and Definition A. Masticatory apparatus and function

1. Maxilla and mandible 2. Muscles of mastication and accessory muscles of

mastication 3. Brief anatomy of TMJ 4. Mandibular movements 5. Functions of teeth

1

B. Various branches of Prosthodontics and Prosthesis 1. Scope and limitations 2. Appliances v/s prosthesis 3. Dental prosthesis v/s non-dental appliances

1

C. Effect of loss of teeth 1. On general health 2. On masticatory apparatus 3. Need to replace lost teeth

1

D. Outline of Prosthodontics Types of prosthesis; Requirements of prosthesis

1

II. Introduction to Components of Prosthesis Complete denture prosthesis A. 1. Various surfaces and Components 1

B. Removable partial denture 1. Classification 2. Major and minor connectors 3. Direct retainers and Indirect retainers 4. Rests 5. Denture base 6. Artificial teeth

2


60

C. Fixed partial denture

1. Classification 2. Retainers 3. Pontics 4. connectors

1

III. All Essential Definition and Terminologies from Glossary 1. Model

2. Cast 3. Impression 4. Occlusion rims 5. Temporary denture base 6. Permanent denture base 7. Occlusion 8. Jaw relation — orientation, vertical and centric 9. Christensten’s phenomenon 10. Key of occlusion 11. Balanced occlusion 12. Abutment

1

IV. Introduction to Mouth Preparation

A. Complete dentures 1. General considerations 2. Pre-prosthetic surgery

1

B. Removable partial dentures 1. General considerations 2. Occlusal rest preparation 3. Modifying contours of the abutments 4. Guide planes 5. Elimination of undercuts

1

C. Fixed partial dentures 1. Principles of tooth preparation 2. Retainers in brief

1


61

V. Introduction to all Steps involved in Fabrication of Prosthesis

A. Impression making 1. Definition, requirements and types of impressions 2. Various materials used for making different

impressions 3. Different theories of impression making

1

B. Impression trays Definition, classification, materials, advantages and disadvantages 1. Selection of trays 2. Special trays 3. Spacer design

1

C. Introduction to jaw relation record 1. Definition and type 2. Temporary denture base — indications, advantages,

disadvantages, materials used 3. Occlusion rims — materials, shape, dimensions 4. Clinical procedures of jaw relation recording

2

D. Articulators and face bow 1. Basic outline 2. Need for articulators 3. Definition, classification, parts, advantages,

disadvantages of articulators 4. Definition, classification, parts, advantages,

disadvantages of face bow transfer 5. Demonstration of face bow transfer to an articulator

on a dummy

2

E. Selection of teeth 1. Various guidelines for selection of teeth including

dentogenic concept 2. Arrangement of teeth in detail with various factors of

esthetics, overjet, overbite etc

1

F. Occlusion 1. Balanced occlusion — need and advantages 2. Various factors of balanced occlusion

1


62

G. Try-in procedures

Anterior try-in, Posterior try-in, Waxing, carving, polishing & final try-in

1

H. Processing procedures 1. Flasking 2. Dewaxing 3. Packing 4. Curing 5. Finishing and polishing of acrylic dentures

1

VI. Casting procedures 1. Die preparation

2. Wax pattern 3. Investing 4. Burnout 5. Casting 6. Finishing and polishing

3

Practicals: 300 Hours [I BDS-100 Hours, II BDS-200 Hours]

I BDS: (Must Know) 1. Coloring the anatomic landmarks (maxillary/mandibular edentulous casts) - 1 pair 2. Preparation of special trays - Self cured acrylic (Maxillary / mandibular) - 1 pair

Shellac Special trays (Maxillary/Mandibular) - 1 pair 3. Preparation of temporary, Shellac and permanent denture bases - 1 pair each 4. Preparation of occlusion rims 5. Orientation of occlusion rims on articulator 6. Repair of broken denture - 1 7. Beading and boxing and preparation of cast

II BDS Pre-Clinical Prosthodontics:

- 1 pair

1. Arrangement of teeth for - Class I situation - 10 Class II situation and Class III Situation - 1each

2. Surveying of partially edentulous models and preparing modified master cast, designing with color pencils - desirable to know.

3. Preparing of wax patterns, spruing, casting and finishing (Demonstration) 4. Preparation of plaster models of various preparation of teeth to receive retainers

for FPD 5. Preparation of wax patterns for minimum of 3 unit FPDS and investing, casting

and porcelain facing (Demonstration) Note: Student shall submit one processed denture to present on university practical exam


63

Scheme of Examination (Practical Exam only): Total 100 Marks A. Practical Exercise: [3 hours]: 50 marks

Arrangement of teeth in class I relation, waxing, carving and polishing B. University viva voce : 20 marks C. Internal assessment : 20 marks D. Record book : 10 marks

Recommended text books:

Sl. No.

Title of the book/edition

Author

Publisher

1 Dental Laboratory Procedures (Volume1,2,3)

Morrow, Rudd, Rhoads

Elsevier

2 Prosthodontic Treatment for edentulous patients

Zarb, Hobkirk, Eckert, Jacob.

Elsevier (13th edition)

3 McCracken’s Removable Partial Prosthodontics

Alan B.Carr, David T.Brozon

Elsevier (12th edition)

4 Preclinical manual of Prosthodontics S. Lakshmi Elsevier

5 Fundamentals of Fixed Prosthodontics Herbert T. Shilling burg

Quintessence (4th edition)


64

VI. PRE-CLINICAL CONSERVATIVE DENTISTRY

Aim: The Dental Graduates during training should acquire adequate knowledge necessary skills and attitudes which are required for carrying out all the activities appropriate to dental practice involving the prevention diagnosis and treatment of anomalies and diseases of the teeth, mouth, jaws and associated tissues

Essential Knowledge: Conservative Dentistry and Endodontics covers basic knowledge of all restorative materials and materials associated with Endodontics. It includes the knowledge of dental caries and treatment modalities associated with management of dental caries. Basic knowledge of non-carious and carious lesions of mineralized tissues is essential. Basic knowledge of biological basis of endodontics and management of all endodontic situations, which includes all aspect of diagnosis, treatment planning and treatment modalities are also mandatory. An individual specializing in the restorative dentistry should also have knowledge of allied specialities like Periodontics / Pedodontics & Preventive Dentistry.

Distribution of Teaching Hours

Year Lecture hours Practical hours Total hours

I BDS 5 50 55

II BDS 20 150 170

Theory Class for I BDS

SI. No

Title of The Topic

Contents of The Topic

Duration

Reference Books

1 Introduction Must Know: History of 5 hrs Textbook to conservative dentistry, Scope of of dentistry Conservative Dentistry. Operative Human dentition — Dentistry Incisors, canines, Sturdevant premolars, molar, permanent and deciduous dentition, tooth identification and numbering system.


65

Must Know: Textbook of

Dental Caries, need for restoration, G.V. Black classification, G.J. mount classification. Desirable To Know:

Operative Dentistry Sturdevant

Indications and contra-

indications of direct and

indirect. Esthetic and

metallic restorative

materials.

Practical demonstration for I BDS (50 hrs) • Identification of Equipments and materials • Manipulations of cements

Theory Topics for II BDS : (20 hrs)

SI. No.

Theory Topics

Hrs

Reference

1 Equipment & Armamentarium in the Operatory Hand Instruments in Operative Dentistry Terminology Materials Parts, Nomenclature, classification Description & Application Hand Instrumentation techniques, Sharpening, maintenance, sterilization & Storage Rest, Grasp & Guards Speeds in Dentistry - Historical Evolution and development Classification Speed ranges: indications, Advantages/ disadvantages Rotary Instruments Handpieces: Types, Parts & Design Micromotor Airotor Maintenance / sterilization and disinfection

1 hr

1 hr

The art and science of operative dentistry C.M. Sturdevant

Principles & Practice of Operative dentistry Charbeneau

The art and science of operative dentistry C.M. Sturdevant


66

Burs & Diamond Points : Types, shapes, Uses

Other abrasives Cutting mechanism Hazards with cutting instruments Miscellaneous Equipments Dental Chair : Types, parts, accessories & Attachments Phantom Head Work station and accessories. Phantom Jaw — Types Teeth 1. Extracted natural intact teeth 2. Typhodont teeth

2 Preliminary considerations in Operative Dentistry Pre-op patient & Dental Team considerations: Dental Team Personnel - Dental Auxiliary, Dental Nurse, Dental

Hygienist, Dental technician. Chair side : Position for patient and operator Instrument exchanger (Zones) Magnification & Illumination Pain control: Local anesthesia, analgesia, sedation, Hypnosis. Isolation of Operating Field. Goal and elements - moisture control, retraction and access, tissue protection and harm prevention Types - isolation from moisture Isolation from soft tissues. Moisture control and Isolation techniques: a. Direct Method - Intra oral devices : Rubber dam, cotton rolls,

cellulose wafers, - Extra oral devices : Evacuation systems and

saliva Ejectors b. Indirect methods : Patient’s position Pharmacological agents: Local anesthetics, Anti- sialagogues

2 hrs The art and science of operative dentistry C.M. Sturdevant



67

Rubber dam : Armamentarium, advantages,

disadvantages, indication, contraindication, techniques Other Isolation Technique: Cotton Roll Isolation, Cellulose Wafer, Saliva Ejectors, Throat Shields. Isolation from soft tissues: Soft tissue management in operative dentistry Cross infection control - Introduction, principles of crossinfection

control. - Infectious disease of concern - HIV, HBV,

TB etc. - Classification of infection control

techniques - Sterilization Vs disinfection; Terminology

and definition. Methods of sterilization of instruments, equipments and materials Personal protective barriers. Waste Management : Infectious & Toxic Wastes; Incineration, dental unit Water Lines Contact dermatitis for dental materials Latex Allergy - Glove, rubber dam Mercury Toxicity : Forms of mercury, mercury toxicity, hygiene recommendations for - usage, storage and disposal

3 Tooth Preparation Terminology - cavity preparation / Tooth preparation, definition, objectives Various concepts in tooth preparation, extension for prevention (G.V.Black) Prevention of extension, extension with conviction, minimal intervention, Types of Tooth Preparation Intra - coronal / extra - coronal Biological considerations of tooth preparation Methods of tooth preparation and newer methods of tooth preparation: Mechanical : - Hand & rotary




68

Chemo - mechanical Other: Air abrasion, ultrasonics & Lasers Restoration in Operative Dentistry: Definition, objectives, classification Restorative Materials : Direct & Indirect Additional concepts in operative dentistry Preventive and interceptive operative dentistry - pit and fissure sealants, preventive restorations and role of fluorides Newer concepts in operative dentistry Minimal intervention dentistry : Introduction to minimal intervention dentistry Atraumatic restorative treatment (ART) : Concept, materials and technique Tooth Preparation To Receive Silver Amalgam Principles of cavity preparation for silver amalgam Steps: 1. initial stage 2. Final stage Factors affecting tooth preparation Class I preparation for silver amalgam Nomenclature & Terminology Conservative / Conventional Modification — Occiusolingual, Occiusofacial Extensive

4 Silver amalgam : Material and technical considerations Introduction, definition, terminology Historical Perspective and role of Dr. G.V. Black Classification Material aspect : Composition, manufacture, properties. Technical consideration Dispensing &Proportioning : Minimal Mercury Technique (Eames technique) Trituration, condensation, carving, burnishing, finishing and Polishing. - Low Copper Vs High Copper amalgam

(Gamma 2 phase)

2 hrs


69

- Creep & Delayed expansion: Zinc Free - Amalgam - Tarnish & Corrosion, electro-galvanism

Clinical Considerations : Failure, report & replacement

- Failure of silver amalgam : Marginal ditching, Amalgam blue, Amalgam tattoo

- Controversy : Amalgam wars, mercury concerns

- Amalgam subsitute & alternatives Mercury: Material Aspects : ADA specification, ideal requirements, toxicity, Precaution and Hygiene. Recommendations.

5 Dental caries Definition, Classification & Terminology (Rampant caries, root caries etc) Etiology (Keyes Triad & its modifications), microbiology, Histopathology (Zones of caries), Diagnosis :Techniques & Diagnostic Aids Management : Concepts & Techniques - caries activity/susceptibility tests, role of fluoride

1 hr The art and science of operative dentistry C.M. Sturdevant

Principles & Practice of Operative dentistry Charbeneau Cariology by Newbrun

6 Management of Dental Caries Concepts & Techniques. Various methods of caries removal Deep caries management Vital pulp therapy &Non vital pulp therapy, Infected and affected dentin, Remaining dentinal thickness Provisional & Intermediate restorations Other indications for operative treatment




70

Non-carious destruction and disfigurement of teeth and their management Attrition, abrasion, erosion, Abfraction, Developmental defects. Hypoplasias, traumatic injury, discoloration.

7 Class II Preparation for silver amalgam. 2 hrs The art and Simple : Conservative, conventional

Complex : Modifications of class II : MOD, science of

operative Box, Tunnel, slot dentistry C.M. Modified amalgam restorations Sturdevant and techniques – pin retained and

bonded amalgam. Quadrant dentistry

Principles & Practice

Difference between class II silver amalgam & of Operative Class II composite preparation dentistry Charbeneau

8 Contours and Contacts: 1 hr The art and Tooth form, marginal ridges and embrasures science of Significance of contours and contacts in

operative dentistry operative

dentistry C.M. Occlusion in operative dentistry Sturdevant Ideal occlusion Malocclusion: Classification - Class I, II, III Principles Significance of occlusion in operative dentistry : & Practice Prematurity, trauma from occlusion, surface of Operative texture and marginal finish dentistry Charbeneau

9 Procedures for formulation of contours 1 hr The art and and contacts in operative dentistry

Separators and methods of separation science of

operative Wedges : Description, classification, dentistry C.M. requirements , types, techniques. Sturdevant Matricing :Retainers and Bands for silver amalgam and tooth colored restorative material Principles & Technique Practice of Operative dentistry Charbeneau


71

10 Tooth colored restorative materials (TCRM) Classification Types : Direct & Indirect Direct tooth colored restorative materials Composite resin: Definition, composition, classification Terminology: Bonding adhesion, Etching, conditioning, smear layer, hybrid layer Newer formulations and their indications Pre-operative considerations in cavity preparation: a. shade selection : Colour b. Surface pretreatment : Acid etching, dentin

bonding Bonding agents :Composition, classification Glass lonomer cements Material aspects: Composition & Setting reaction Classification, advantage / disadvantages, beneficial properties, clinical techniques, newer formulations and their indications



Phillips science of dental materials anusavice

11 Cavity preparation for tooth colored restorative material (TCRM) Pre-operative considerations: Shade selection & Isolation etching and bonding. Principles of cavity preparation i. For composite resins ii. For glass ionomer cements Anterior teeth - Class III, IV, V, VI. Posterior teeth - Class I, & II, VI Matricing, restoration including finishing and polishing

1 hr

12 Indirect restorations Types, steps in fabrication Inlays and onlays : Definition, indication/ contra indication, types : metal - casting alloys classification, Properties, composite and ceramic.



72

Cavity preparation for cast inlay - class I,

class II Armamentarium, technique, modifications (eg. Slice preparation) Bevels : Definition, classification, indication Flares : Definition, types, indication Circumferential Tie. Difference between class II silver amalgam and class II inlay preparation.


Phillips science of dental materials anusavice

13 Finishing and Polishing of Restoration Definition, objectives, Benefits, Principles Materials, types of abrasives Procedures for - amalgam, composite, GIC Ceramic, cast metal restorations.

1 hr The art and science of operative dentistry C.M. Sturdevant Phillips sciences of dental materials anusavice

14 Endodontics : Introduction, classification of instruments, materials used in endodontics - sealers, obturation materials, Gutta Percha, Access cavity preparation, Biomechanical preparation and obturation of brief.


Pre-Clinical Exercise: For II B.D.S (150 hrs) I) Preparation of Tooth models in plaster and preparation of cavities and

restoration with modeling wax. a. Incisors - 4 Nos. b. Pre-Molars - 2Nos. c. Molars - 8 Nos. (Upper & Lower)

II) Preparation of Cavities on Typhodont and / or Extracted Natural Teeth


73

Cavities Classification:

Cavity Preparation Restoration

Class I 6 with 2 extensions 4

Class II 5 DO; 5 MO Conventional 8 5 Conservative 4

2 MOD (I Upper molar) 1

(I Lower molar)

Class III 3 All

Class IV 3 All Class V

3 on Anteriors All

2 on Posteriors

Demonstration of Inlay Preparation

Class I 1 To prepare Wax patterns Class II 2+1 MOD To prepare wax patterns

and one to be casted III. Cuspal Preparation : (Demonstration) IV. Endodontic Exercises:

a. Pulp capping: Direct / Indirect on extracted teeth

b. Pulpotomy on extracted posterior teeth

c. Root Canal access cavity opening on Upper Central incisor.(Extracted Tooth)

V Demonstration of Light cure composite and Glass lonomer Restorations. VI Demonstration of Instrumentation and Obturation of root canal. VII Demonstration — Wax pattern, investing, casting, polishing and cementation

of cast restoration. VIII. Demonstration of rubber dam armamentarium and placement

Scheme of Examination for II B.D.S (only Practical Exam) I. University Practicals: 100 Marks

A) Practical Exercise No.1: 10 Marks Spotters: 10 Nos. (Marks :01 Each, Time: 02 Minutes Each)


74

a. Hand instruments used to prepare cavity and restoration b. Identification of Root Canal Instruments

B) Practical Exercise No.2: 40 Marks Preparation of Class TI conventional Cavity for Silver Amalgam in Maxillary or

Mandibular I or II Molar tooth (Typhodont / Natural Tooth) • Cavity Preparation 45 Minutes 20Marks • Lining and Matrix 15 Minutes 10Marks • Filling and carving 5 Minutes 10Marks

C). University Viva –Voce : 20 Marks

D). Internal Assessment : 20 Marks

E). Record book : 10 Marks

Total (A + B + C+D+E) : 100 Marks

Text Books Recommended

SI. No.

Name of the Book & Title

Author

Place of Pubi.

Pubi’s Name

1 Phillips Science of Dental Materials

Anusavice USA Elsevier

2 The Art and Science of Operative Dentistry

Sturdevant USA Mosby

3 Principles & Practice of Operative Dentistry

Charbeneau Bombay Varghese Publication

4 Pathways of the Pulp Stephen Cohen

USA Mosby

5 Text Book of Endodontics Mithra N Hegde

Bangalore EMMEES Publication


75

VII: SKILLS AND PERSONALITY DEVELOPMENT

Personality Development (25 Hours) Objectives: To help the learner to understand and apply empathy and other human values to the care of patients To help the learner to translate learning to further his professional and personal growth

Topics 1. Introduction to ethics in health-care professionals (2Hours ) 2. Self-awareness and Empathy (3 Hours ) 3. Anger management (2 Hours ) 4. Stress Management (4 Hours ) 5. Mind Mapping (2 Hours ) 6. Emotional Intelligence and life skills (4 Hours ) 7. Building self-confidence ,esteem and positive attitude and Personal

effectiveness (6 Hours ) 8. Patient-Doctor relationship and Dealing with patient’s anxiety and stress (2

Hours)

Assessment: Written Examination for 3 Hours at the end of the Academic Year Examination Conducting Authority: College Marks: 100 Marks (no internal assessment). Marks to be submitted to the University and to be noted in the marks card

Books for Reference: 1. First Things First by Stephen R. Covey , A. Roger Merrill , Rebecca R. Merrill,

Free Press, USA 1994 2. The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change

by Stephen R. Covey , Free Press, USA 1999 3. How to Win Friends & Influence People , by Dale Carnegie Simon and

Schuster, USA 1936 4. Wayne Froggratt (1993, 2003) Choose to be happy: Your step-by-step guide,

HarperCollins, Auckland.

5. James W. Kalat (2007) Introduction to Psychology: Eighth edition, Wadworth Publishing.


76

6. Mayer et al. (2004) Emotional Intelligence: Findings and Implications, Lawrence Erlbaum Associates Inc.

7. Kaplan and Sadock’s Synopsis of psychiatry: Tenth Edition 8. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry: Ninth Edition. 9. Medical Ethics for students & Doctors D.J. Borah, Ahuja Publishing House

(2014) 10. Medical Ethics and Law : Tony Hope et al : Churchill Livingstone. 11. Mind Mapping; Scientific Research and Studies, ThinkBuzan Ltd. URL: http://

b701d59276e9340c5b4dba88e5c92710a8d62fc2e3a3b5f53bbb.r7.cf2.rackcdn. com/docs/Mind%20Mapping%20Evidence%20Report.pdf

*****


77

VIII. GENERAL PATHOLOGY

COURSE OUTCOMES


CO1: Describe the normal homeostatic mechanisms and the pathological process in their derangement and the effects on human systems.

CO2: Discuss the concepts of cell injury and pathological and immunological responses produced thereby in different tissues and organs and the body's capacity for healing.

CO3: Demonstrate basic Knowledge and understanding of the immune system in health and disease.

CO4: Explain the etiology, pathogenesis, pathological effects and clinicopathological correlation of common infectious and non-infectious diseases.

CO5: Describe the concept of hemodynamic disorders, thromboembolic disease and shock and their clinical application.

CO6: Describe the concept of neoplasia with reference to the etiology, morphological features, diagnosis and prognosis in different tissues and organs of the body.

CO7: Discuss the epidemiology, gross and microscopic features, clinical presentation and diagnostic techniques associated with different diseases in different organ systems to the extent needed for the understanding of disease processes and their clinical significance.

CO8: Recognise and interpret the common hematological disorders and the investigations, blood banking as well as cytological procedures.

CO9: Perform and interpret the basic bed-side clinical pathology procedures on blood and urine samples.

Total Theory : 55 hrs General Pathology (40 hours) 1. Introduction to pathology, concept of disease, classification of disease,

subdivisions, techniques and advances in pathology. 2. Cellular structure and functions 3. Cell injury- Injured cell / Tissues; Types of injuries and mechanism and cell

responses to injury


78

4. Reversible — Intracellular changes / degeneration / fatty change, Protein and Glycogen accumulations, hyaline change, mucoid change, hydropic change.

5. Disorders of pigmentation. Pathologic calcification. 6. Irreversible changes — Necrosis, Apoptosis, gangrene, Cancrum oris 7. Inflammation — Definition, Classification, aetiology, cardinal signs.

Pathogenesis — Vascular and Cellular events. Exudates. Chemical mediators of Inflammation and Outcomes of Inflammation

8. Healing of wounds. Fracture healing. Factors affecting wound healing, Fracture healing and complications.

9. Immunity and hypersensitivity- definition, types, mechanisms of immunologically mediated tissue injury with examples.

10. Chronic granulomatous diseases. Granulomas- definition, classification, pathogenesis. TB, leprosy, syphilis, actinomycosis and fungal granulomas

11. Infection and infestation – Bacterial - pyogenic infections, typhoid fever. Viral - AIDS, Hepatotropic viruses.

12. Circulatory disturbances - Hyperemia, congestion, haemorrhage, shock, oedema, thrombosis, embolism and infarction. Hypertension

13. Disturbances of Nutrition; Pathogenesis of deficiency diseases with special reference to disorders of vitamins like A, C, D, K and Vitamin B complex

14. DM — etiology, types, pathogenesis, clinical and laboratory diagnosis. Complications and pathogenesis.

15. Cellular growth and differentiation, Regulation. Adaptive disorders of growth- Atrophy, Hypertrophy Hyperplasia, metaplasia. Types and pathologic changes of dysplasia and premalignant lesions

16. Neoplasia — Definition, Nomenclature, classification and characters, spread. Difference between benign and malignant tumors. Aetiology (Carcinogens), Pathogenesis. Molecular basis of Carcinogenesis. Clinical features and laboratory diagnosis. Staging and grading

17. Bone diseases — Osteomyelitis, definition, classification, causes, clinical, radiological and laboratory diagnosis of Acute osteomyelitis. Complications of Chronic Osteomyelitis, TB, Osteoporosis, Hyperparathyroidism, Paget’s disease. Tumors of bone and mandible

Haematology and Clinical Pathology (15 classes) 1. Diseases of blood Investigations on blood - Blood collection, Anticoagulants


79

2. Haemoglobin, Cell counts and indices 3. Peripheral blood smear - Staining. Differential counting, Interpretation and

Reporting 4. Anaemias -Laboratory diagnosis, Investigations or Tests for diagnosis 5. Leukemias, Lymphoma - Laboratory diagnosis, Investigations or Tests for

diagnosis 6. Haemorrhagic disorders - Laboratory diagnosis, Investigations or Tests for

diagnosis 7. Blood Banking - Blood groups, Cross matching, serologic tests, components

service, complications of blood transfusion 8. Urine analysis complete 9. PCV, ESR, reticulocyte count 10. Diseases of oral cavity and salivary gland. Inflammatory conditions, Infection,

Premalignant conditions, oral cancer - squamous cell carcinoma, sialadenitis. Tumors - Pleomorphic adenoma, Warthin tumor, Adenoid Cystic Carcinoma, Muco epidermoid carcinoma

Practicals : Total 55 hrs General Pathology Practicals 1. Introduction and Microscope and Techniques in Pathology, Histopathology,

Cytology, FNAC/ Imprint, Frozen section 2. Histopathology Slides

- Fatty liver - Acute Appendicitis - Granulation tissue - Tuberculous Lymphadenitis - Actinomycosis - Rhinosporidiosis - CVC Liver - CVC Spleen - CVC Lung - Neoplasms

▪ Squamous Papilloma ▪ Pleomorphic Adenoma


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▪ Capillary haemangioma ▪ Cavernous haemangioma ▪ Lipoma ▪ Neurilemmoma (Schwannoma) ▪ Osteochondroma ▪ Osteoclastoma ▪ Osteosarcoma ▪ Squamous cell carcinoma ▪ Basal cell carcinoma ▪ Malignant Melanoma ▪ Adenocarcinorna Colon/ Stomach

Haematology - Microcytic Hypochromic - Dimorphic - Eosinophilia - Acute Myeloid Leukemia - Chronic Myeloid Leukemia

1. Urine Examination

Physical Examination Chemical examination

- Reducing sugar - Ketone bodies - Protein - Blood

2. Haemoglobin estimation, Blood grouping 3. Blood smear staining and Differential cell count, Interpretation and Reporting 4. Instruments 5. Gross Specimens


81

Scheme of Examination I. Theory : 50 Marks A. Written Paper : 35marks B. Viva Voce : 10 Marks C. Internal Assessment : 05 Marks

Distribution of Topics and Type of Questions:

Contents

Type of Questions and Marks

Marks

Question from General Pathology Inflammation, Healing and Repair, Hemodynamic disturbances, Neoplasia, Hematology

Long answer 1x 10 marks

10

Two or three questions from General Pathology Intracellular accumulations, Necrosis, Gangrene, Apoptosis, Amyloidosis, Pathologic calcification, hypersensitivity reactions, infections,Tuberculosis, Leprosy, Syphilis, Shock, Oedema, infarction, Congestion, Hypertension, Diabetes Mellitus, Premalignant Conditions, Neoplasia, Osteomyelitis, Anaemias, Neoplastic Proliferation of WBCs — Leukaemias and Lymphomas, Haemorrhagic disorders, Erythrocyte Sedimentations Rate (ESR), Urine sediment. Two from Haematology; One from Clinical Pathology

Short answer 3x 5 marks

15

MCQ’s10 questions(any of the above topics) 10 x1mark 10

Total 35

II Practical: 50 Marks

A Practicals Exercise : 40 marks B. Internal Assessment : 05 marks C. Record : 05 marks Practical Examination Exercises: - Spotters - Urine Examination


82

- Peripheral smear — DC - Blood grouping/ Hb %

Text Books Recommended:

Sl No

Name of the Book & Title

Author

Edn.

Yr. of Publ.

Publ.’s Name

1. Robbin’s pathologic basis of disease

Cotran & Kumar, Robins

10th

2017

Prism & Saunders

2. De. Gruchy Clinical Haematology in Medical Practice

Frank Firskin Cohn

Chesterman David

Penington Bryan Rush

6th

2013

Oxford University

Press

3. Pathology for dental Students

Harsh Mohan

4th

2011

--

4. Medical Laboratory Technology (Methods and Interpretation)

Dr. Ramnik

Sood

6th

2009

Jaypee Brothers

Reference Books

1. Clinical Diagnosis and Management by Laboratory Methods

Todd, Sanford, John Bernard

Davidson

20th

2001

Veerendar Kumar Arya for

AITBS with Saunders

2. Haematology an illustrated colour text

Martin R. Howard Peter

J Hamilton

4th

2013

Churchill Livingston

USA


83

3. General Pathology

Vol. I & II

Y.M. Bhende and S.G. Deodhare

5th edn.

2007

Popular Prakashan Bombay

4. Colour Atlas of Histopathology

R. C. Curran

4th (Revised)

2000

Harvey Miller


84

IX. MICROBIOLOGY

Aim: • To introduce the students to the exciting world of microbes. • To make the students aware of various branches of microbiology, importance,

significance and contribution of each branch to mankind and other fields of medicine. The objectives of teaching microbiology can be achieved by various teaching techniques such as:

a) Lectures, Assignments ( MCQs & Topic discussion ), Audio visual aids. b) Practical exercises- Demonstrations; Small group discussions. c) Roleplay d) Seminar Presentation

Objectives: At the end of the Microbiology course the student is expected to: 1. Understand the basics of various branches of microbiology and be able to apply

the knowledge relevantly. 2. Apply the knowledge gained in related medical subjects like General Medicine

and General Surgery and Dental subjects like Oral Pathology, Community Dentistry, Periodontics, Oral Surgery, Pedodontics, Conservative Dentistry and Oral Medicine in higher classes.

3. Understand and practice various methods of sterilization and disinfection in Dental clinics.

4. Have a sound understanding of various infectious diseases and lesions in the oral cavity.

A. Skills: 1. Student should have acquired the skill to diagnose and differentiate various oral

lesions. 2. Should be able to select, collect and transport clinical specimens to the

laboratory. 3. Should be able to carry out proper aseptic procedures in the dental clinic.


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A brief syllabus of microbiology is given as follows.

Theory- 65 Hours

1 General Microbiology 16 Hours

2 Immunology 15 Hours

3 Bacteriology 16 Hours

4 Virology 8 Hours

5 Mycology 6 Hours

6 Parasitology 4 Hours

A. General Microbiology: (16 Hours). 1. History: (2 Hours)

a. Louis Pasteur, Robert Koch, Anton Van Leeuwenhoek, Alexander Fleming, Joseph Lister.

b. Introduction- Classification, Prokaryotes, Eukaryotes c. Microscopy- Light, Electron, Dark field, Fluorescent

2. Morphology and Physiology of bacteria: (3 hours) a. Bacterial anatomy in detail- Specific to Cell wall, Cytoplasmic Membrane,

Cytoplasm, Capsule, Flagella, Bacterial Spore, Pili. b. Bacterial Physiology — Generation time, Total count, viable count, Growth

requirements, Nutritional requirements, Environmental factors and Bacterial growth curve.

3. Detail account of Sterilization and Disinfection. (3 Hours) a. Definition of sterilization, classification, physical agents- Heat-(dry heat

and moist heat), Radiation-(ionising and non ionising), Filteration- (Candle, Asbestos, Sintered, Membrane)

b. Definition of disinfection, antiseptics - chemical agents with uses, mode of action, disadvantages, examples and Gaseous sterilants- (formaldehyde gas, ethylene oxide gas, BPL (Betapropiolactone).

4. Culture Media & Culture techniques: (2 Hours) Culture Media - Classification, Definition Composition, sterilisation and uses of following culture media: Nutrient Agar, MacConkey’s agar, Blood Agar, L.J Media, Cary Blair media, Liquid media: Robertson’s cooked meat broth, Thioglycolate broth.


86

Culture techniques - Anaerobic culture methods- McIntosh Fildes Jar, Gas pak system, Anaerobic chamber.

5. Basic knowledge of selection, collection, transport, processing of clinical specimens and identification of bacteria. (1 Hour)

6. Basic genetics and genetic transfer-Transformation, Transduction, Conjugation, Mutation, Sexduction, plasmids and Drug Resistance in bacteria with examples. (2 Hours)

7. Nosocomial infection and hospital waste management. (2 Hours)

B. Immunology: (15 Hours). 1. Infection -Definition, Classification, Source, Mode of transmission and types of

Infectious disease. (1 Hour) 2. Immunity - Definition, Classification, Innate, Acquired, Herd Immunity, Local

Immunity, Premunition, Adaptive immunity. (2 Hours) 3. Cells of Immune Response - T & B lymphocytes, Natural killer cells, antigen

presenting cells, interaction between the cells. 4. The Complement system. (1 Hour) 5. Antigen. (1 Hour) 6. Immunoglobulins - Antibodies - General structure and the role played in defense

mechanism of the body. (1 Hour) 7. Immune response. Hurnoral immune response, cellular immune response.

(1 Hour) 8. Antigen - Antibody reactions - with reference to clinical applications. Define

ELISA Principle, procedures, Uses, Limitations. (2 Hours) 9. Hypersensitivity reactions. (2 Hours) 10. Autoimmune disorders - Basic mechanisms, Principles of auto immune diseases

with examples. (2 Hours) 11. Immunology of Transplantation and Malignancy (HLA, MHC). (2 Hours)

C. Systematic Bacteriology: (16 Hours). General outline: Classification, antigenic structure, pathogenesis, laboratory diagnosis- (Specimen collection, Transportation, Wet mount, Staining & Culture, Treatment, Prevention and Immunoprophylaxis for Corynebacterium diphtheriae, Clostridium tetani, Clostridium perfringens, Clostridium botulinum and Treponema pallidum, E.coli, Salmonella, Shigella,Vibrio cholera.


87

1. Pyogenic cocci — Staphylococcus, Streptococcus, Detailed account of Cariogenic Streptococci. Pneumococcus, Gonococcus, Meningococcus. (5 Hours)

2. Corynebacterium diphtheriae. (1 Hour) 3. Mycobacteria - Tuberculosis and Leprosy. (2 Hours) ‘ 4. Clostridium — Gas gangrene, food poisoning and tetanus. (2 Hours) 5. Non- sporing Anaerobes — in brief about classification and morphology, in

detail about dental pathogens- mechanism of disease production and prevention and Actinomycetes. (1 Hour)

6. Spirochaetes — Treponema pallidum a detailed account of Oral lesions in syphilis and Borrelia vincenti. (2 Hours)

7. Enterobacteriaceae- E.coli, Salmonella, Shigella (2 Hours) 8. Vibrio cholerae (l Hour)

D. Virology: (8 Hours) 1. Introduction: Terminologies, Viral classification, Viral cultivation, Detection

of virus infected cells, Inclusion bodies, Quantification of viruses, Viral multiplication, Modes of transmission of viruses, host — Virus interaction special reference to Interferon. Brief account of Laboratory diagnosis, Chemotherapy and Immuno prophylaxis in general. (2 hours)

2. A few viruses of relevance to dentistry. (5 hours) • Herpes Virus • Hepatitis B virus — brief about other types • Human Imniunodeficiency Virus (HIV) • Mumps Virus; Measles and Rubella Virus, Oncogenic Viruses

E. Mycology: (6 hours)

1. Introduction — Classification of fungi based on morphology, sexual & asexual reproduction, mycotic diseases. Cultivation of Fungi & general principles of laboratory diagnosis of fungal infections. (I hour)

2. Candida albicans- Morphology, pathogenicity and laboratory diagnosis. (1 hour)

3. Cryptococcus neoformans- Morphology, pathogenicity & laboratory diagnosis. (1 hour)


88

4. Briefly on mycotic lesions of oral cavity - Rhinosporidiosis, Sporotrichosis, Histoplasmosis, Coccidioidomycoses, Paracoccidioidomycoses Blastomycosis. (2 hours)

F. Parasitology: (4 hours) 1. Brief introduction- General Characteristics of protozoans and helminths.

Diagnostic procedures: Collection of specimen, methods of examination- (Macroscopic and microscopic), Concentration methods for stool- (Flotation and sedimentation techniques), Demonstration of malarial and filarial parasites. (1 hours)

2. Mode of transmission and life cycle only of the following: (2hours) • Entamoeba histolytica • Plasmodium species • Oral protozoal parasites • Ascaris lumbricoides, Ancylostoma duodenale, Wuchereria bancrofti.

Practicals & Practical Demonstrations: 50 Hours Practical Demonstrations: (18 + 32 Hours) Must Know: 1. Sterilization and disinfection in detail 2. Culture media-Blood agar, chocolate agar, McConkey agar, Nutrient Agar,

Antibiotic Sensitivity plate, L.J. Media, Nutrient Agar with pigmented colonies of Staphylococcus aureus, Nutrient Agar with Pseudomonas aeruginosa, McConkey agar with LF and NLF colonies, Blood agar with beta haemolytic colonies. Liquid Media RCMB, Thioglycolate broth, BHI.

3. Culture methods & Anaerobic Methods 4. Identification of bacteria- Demonstration 5. Microscopy 6. Simple stain 7. Gram Stain 8. Ziehl Neelsen’s stain 9. Lecture Demonstrations- Small group discussions: 16 x 2 = 32 Hours

(Each topic will be discussed through small group discussion followed by lecture demonstration of culture and relevant slides or tests)

• Staphylococcus


89

• Streptococcus • Corynebacteriurn diphtheriae • Treponema pallidum • Clostridiurn tetani • Mycobacterium tuberculosis • Candida • HIV&HBV • Agglutination. • Precipitation. • ELISA. • Hypersensitivity • Sterilization- definition, classification, methods, physical, filtration,

radiation, chemicals used in dental practice, hospital, practice. • Culture media and culture methods. • Microscopy. • Staining methods (Gram, Z-N Staining).

List of Practical Materials Slides for Demonstrations: 1. Staphylococcus 2. Streptococcus 3. P. vivax Schizont 4. P. falciparum Gametocyte 5. AFB 6. Microfilaria 7. Spirochaetes 8. Gram Negative Bacilli 9. Candida 10. Cryptococcus neoformans

Slides for Practical Exercises: (18 Hours) Gram stain - Gram positive cocci: 2 x 1 = 2 Hours

- Gram negative bacilli: 2 x 1 = 2 Hours

- Mixture of any two organisms 2 x 1 = 4 Hours


90

Gram stain of the oral cavity 2 x 1 = 2 Hours Ziehl —Neelson’s stain — Sputum positive for AFB 2 x 2 = 4 Hours Spotters: 2 x 1= 2 Hours

Media for Demonstration: Uninoculated Media: 1. Nutrient agar plate 2. Blood agar plate 3. Chocolate agar plate 4. Mac Conkey agar plate 5. Blood culture bottle 6. Lowenstein Jensen Media slope 7. Sabaraud’s agar slope 8. Robertson’s cooked meat broth 9. Thioglycolate broth 10. BHI

Inoculated Media: 1. Nutrient agar with Staphylococci 2. Alpha Haemolytic Streptococci 3. Blood agar with Beta Haemolytic Streptococci 4. Antibiotic sensitivity plate 5. Nutrient Agar with Pseudomonas aeruginosa 6. MacConkey agar with LF and

NLF colonies.

Instruments: 1. VDRL slide 2. Tuberculin syringe 3. Sterile swab 4. Seitz filter 5. Macintosh fildes jar 6. Widal rack with tubes 7. Microtitre plate 8. Disposable syringe; Surgical gloves 10. Pasteur pipette


91

Specimens: 1. Ascaris lumbricoides 2. Ancylostoma duodenale

Biochemical Reactions: 1. Indole 2. Citrate 3. Urease 4. Triple sugar iron agar 5. Tube Coagulase test

Scheme of Examinations: University theory exam: 50 Marks:

• Written Exam - 35 Marks (Long Question One 10 Marks, Short Note 5 x 3 marks = 15 Marks, MCQ 10 x 1 = 10 Marks)

• Internal assessment - 05 Marks • Viva voce -Microbiology -10 Marks

University Practical exam: 50 Marks:

• Microbiology Exercises 45 Marks • Internal Assessment - 05 Marks

Exercises: • Spotters • Gram staining • Acid Fast Staining

Recommended Books for Regular Reading: 1. Text book of Microbiology - R. Anantha Narayan & C.K. Jayaram Paniker. 7th

edition, Year 2005. 2. Medical Microbiology - David Greenwood et al.15th edition, Year 1997 3. Medical Parasitology - D.R. Arora, B. Arora, 2nd edition. Year 2005. 4. Medical Microbiology - Jawetz, Melnick and Adelberg S. 22nd edition.


92

Books for Further Reading / Reference: 1. Microbiology - Prescott, et al. 2. Microbiology - Bernard D. Davis, et al. 3. Clinical & Pathogenic Microbiology - Barbara J Howard, et al. 4. Mechanisms of Microbial diseases - Moselio Schaechter, et al. 5. Immunology an introduction - Tizard. 6. Immunology 3rd edition - Evan Roitt, et al.


93

X. GENERAL AND DENTAL PHARMACOLOGY AND THERAPEUTICS

GOAL: The broad goal of teaching Pharmacology to undergraduate dental students is to inculcate rational and scientific basis of therapeutics.

OBJECTIVES: 1. KNOWLEDGE :

At the end of the course, the student shall be able to: (1) Describe the pharmacokinetics and pharmacodynamics of essential and

commonly used drugs in dental practice. (2) List the indications, contraindications, interactions, and adverse

reactions of commonly used drugs in dental practice.

2. SKILLS : At the end of the course, the student shall be able to:

(1) Prescribe drug for common dental ailments. (2) Evaluate pharmacy exercises and drug formulations. (3) Identify and comment on certain photographs and pictures. (4) Analyze certain clinical problems and therapeutic exercises. (5) Solve dose and percentage calculation pertaining to dental practice.

COURSE OUTCOMES


CO1: Describe the pharmacokinetics and pharmacodynamics of essential and

commonly used drugs in dental practice.

CO2: List the indications, contraindications, interactions, and adverse reactions of

commonly used drugs in dental practice.

CO3: Prescribe drug for common dental ailments.

CO4: Evaluate pharmacy exercises and drug formulations.

CO5: Identify and comment on certain photographs and pictures.

CO6: Analyze certain clinical problems and therapeutic exercises.

CO7: Solve dose and percentage calculation pertaining to dental practice.


94

Theory class schedule: 90 hours hours

1. General Pharmacology: 10 a. Definition of drug, pharmacology & other related terms 1 b. Nature and source of drugs, drug nomenclature& dosage forms 1 c. Routes of drug administration 2 d. Pharmacokinetics 3 e. Pharmacodynamics including factors affection drug action. 2 f. Adverse drug reactions 1

2. ANS Drugs: 8 a. Introduction to ANS 1 b. Cholinomimetics & anticholinergic drugs 2 c. Skeletal muscle relaxants 1 d. Sympathomimetics & sympathetic blockers 4

3. Drugs acting on CVS and Renal system: 9 a. Antihypertensive drugs 3 b. Antianginal drugs 1 c. Drug for heart failure 2 d. Treatment of shock 1 e. Diuretics and antidiuretics 2

4. Autacoids and drugs used in Respiratory disorders: 4 a. Autacoids – Histamine, prostaglandins, Leukotriene 1 b. Antihistaminics 1 c. Drugs used for cough, bronchial asthma 2

5. CNS drugs: 14 a. Introduction to CNS 1 b. General anaesthetics 2 c. Local anaesthetics 2 d. Sedatives & hypnotics 2 e. Antiepileptic drugs 1 f. Opioid analgesics 2 g. NSAIDs 2 h. Psychotropic drugs 2

6. Drugs acting on Blood: 5 a. Haematinics- Iron preparations, folic acid, vitamin B12 1 b. Coagulants & anticoagulants 2 c. Fibrinolytics, antifibrinolytics and antiplatelet drugs 2


95

7. Drugs used in GIT disorders: 4

a. Drugs used in peptic ulcer 2 b. Antiematics & prokinetics 1 c. Drugs for constipation & diarrhoea 1

8. Hormones &related drugs: 9 a. Pituitary hormones 1 b. Adrenocorticosteroids and their analogues 2 c. Thyroid hormones & antithyroid drugs 1 d. Insulin and oral antidiabetic drugs 2 e. Hormones & drugs affecting calcium homeostasis 2 f. Anabolic steroids and sex steroids 1

9. Chemotherapy: 16 a. Introduction to chemotherapy– general aspects 1 b. Beta-lactam antibiotics

c. Aminoglycosides 2 1

d. Tetracyclines 1 e. Macrolides 1 f. Chloramphenicol and other miscellaneous drugs 1 g. Sulfonamides & quinolones 1 h. Tuberculosis and leprosy 2 i. Anti-malarial drugs 1 j. Anti-amoebic drugs 1 k. Anti-fungal drugs 1 l. Anti-viral drugs 1 m. Anti-helmintics 2 n. Cancer chemotherapy

10 Special Topics a. Vitamins – Vitamin A, D, K and riboflavin, thiamine b. Dental pharmacology – antiseptics, disinfectants, obtundents,

mummifying agents, dentifrices, bleaching agents,dental desensitizers.

c. Chelating agents

5 3 1

1


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Practical class schedule: 30 hours

Introduction - Common equipment used in dispensing pharmacy and their function.

2 hrs

Compounding Exercises : - Mixtures - Emulsions - Solutions ( Mouth washes) - Powders - Paste Ratio calculations Dosage calculations

2 hrs 2 hrs 2 hrs 2 hrs 2 hrs 2 hrs 2 hrs

Prescription writing :- Introduction and medical prescription 4 hrs

Dental prescription with rational 4 hrs

Therapeutic / problem solving exercises 4 hrs

Spotters/ Photograph/ diagrams /Prescription writing 2 hrs

Scheme of Examination: Theory: (20 marks MCQs + 50 marks for Essay = 70 marks)

i. General Pharmacology - 06 marks ii. Autonomic drugs – 10 marks

iii. Drugs acting on CNS – 10 marks iv. Cardiovascular drugs – 06 marks v. Drugs used in respiratory disorders – 04 marks

vi. Autacoids and related drugs – 03 marks vii. Haematinics and drugs affecting coagulation – 04 marks

viii. Drugs acting on GIT disorders – 04 marks ix. Hormones and related drugs – 06 marks x. Chemotherapy – 10 marks

xi. Chelating agents & immunosuppressants – 03 marks xii. Dental Pharmacology – 04 marks

Practical exercises: i. Pharmacy exercises – 2 ii. Percentage & dose calculations - 2


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iii. Prescription writing – 2 iv. Therapeutic problems - 1 v. Spotters (photographs, drugs & diagrams) – 6

Text books recommended for reading and reference:

Author Name of the Book Edn. Publisher

1. R.S Satoskar and S.D Bhandarkar

Pharmacology & Pharmacotherapeutics

Revised 24th

Bombay Popular Prakashan

2. Tripati K.D Essentials of Pharmacology for

Dentistry

3rd Jaypee Bros. Medical Publishers

3. Lawrence D.R Clinical Pharmacology 11th New York Churchill Livingstone

4. Katzung Bertram G. Basic and clinical Pharmacology

13th USA Lange Medical Books

Types of questions & marks allotted: Theory: total marks 100 i. MCQs - 20x1 = 20 marks ii. Long essays - 10x2 = 20 marks iii. Short essays - 3x10 = 30 marks iv. Viva voce = 20 marks v. Internal assessment = 10 marks Practical: total marks 100 i. Pharmacy exercises (2) – 10 marks ii. Percentage & dose calculations (2) – 20 marks

iii. Prescription writing (2) – 20 marks iv. Therapeutic problems (1) – 10 marks v. Spotters – 20 marks

vi. Record book – 10 marks vii. Internal assessment –10 marks

************


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XI. DENTAL MATERIALS

COURSE OUTCOMES


CO1: Acquire knowledge of the composition, properties, manipulative variables,

and uses of restorative, preventive, esthetic and surgical dental materials.

CO2: Develop the ability to use dental materials which will include the

manipulation through laboratory and clinical exercises.

CO3: Interpret the Biocompatibility and type of biological responses that

materials cause and the anatomic aspects of the oral cavity that influence or

modify the biological response to materials

Theory - 80 Hours [I BDS -20 Hours + II BDS -60 Hours]

Topics Hours

1 Introduction Brief history of the development of the science of Dental materials, Aim of studying the subject of dental materials; Scope and requirements of dental materials, Classification of materials, their clinical and laboratory applications

1

2 Structure and behaviour of matter and principles of adhesion Change of state, inter atomic primary bonds, inter atomic secondary bonds, inter atomic bond distance and bonding energy Crystalline and non crystalline structures Diffusion, adhesion and bonding, adhesion to tooth structure

3


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3 Important physical properties applicable to dental materials

Thermal properties-thermal conductivity and co-efficient of thermal expansion. rheological properties-thixotropism, creep, dynamic creep, flow color- dimensions of color — hue, value, chrorna, Munsell system, metamerism, fluorescence, light stress, strain, proportional limit, elastic limit, yield strength, modulus of elasticity, flexibility, resilience, impact, impact strength, permanent deformation, strength, flexure strength, fatigue, toughness, brittleness, ductility, malleability, hardness, abrasion resistance

5

4 Biological considerations in the use of dental materials Requirements of materials with biological compatibility Classification of materials from perspective of biological compatibility Hazards associated with the materials: pH-affecting pulp, polymers causing chemical irritation, mercury toxicity Microleakage, thermal changes, galvanism, toxic effects of materials Biological evaluation for systemic toxicity, skin irritation, mutagenicity and carcinogenicity Disinfection of dental materials for infection control

5

5 Gypsum and gypsum products Gypsum-origin, chemical formula, products manufactured from gypsum Dental plaster, stone, die stone, high strength, high expansion stone Application and manufacturing procedure for each, microscopic and macroscopic structure of each Chemistry of setting, setting reaction, theories of setting, gauging water, microscopic structure of set material Setting time: working and setting time, measurement of setting time and factors controlling setting time Setting expansion, hygroscopic setting expansion - factors affecting each Wet strength, dry strength, factors affecting strength, tensile strength Slurry Care of cast; ADA classification of gypsum products Manipulation including recent methods or advanced methods Disinfection: infection control, methods of use of disinfectant Storage of material and Shelf life

6


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6 IInd BDS

Impression materials Requirements, definition and classification Historical background and development of each impression material Purpose of making impression Desirable properties and application of material Composition Mode of supply Chemistry of setting, setting time, control of setting time advantages, disadvantages, indications manipulation of material, instruments and equipment required- type of impression trays required, adhesion to tray Techniques of impression Storage of impression Recent advances in material and mixing devices Study of properties: working time, setting time, flow, accuracy, strength, flexibility, tear strength, dimensional stability, compatibility with cast and die material, biocompatibility Infection control

5

7 Synthetic resins used in dentistry Historical background and development of material, Denture base materials and their classification, Ideal requirements, Classification of resins Dental resins - requirements, applications, polymerization, polymerization mechanism, stages in addition polymerization, inhibition of polymerization, co- polymerisation, crosslinking, plasticizers, physical properties of polymers Acrylic resins: mode of polymerization- heat activated, chemically activated, light activated; mode of supply, application, composition, polymerization reaction of each, technical considerations, manipulation, physical properties Denture base resins: temporary denture base materials - contents, properties, manipulation, advantages and disadvantages; permanent denture bases - types, composition, properties, technical considerations (flasking, packing, curing, defiasking and processing errors)


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Miscellaneous resins and techniques: repair resins, relining and

rebasing, Short term and long term soft liners, temporary crown and bridge resins, resin impression trays, tray materials, resin teeth, materials in maxillofacial prosthesis, infection control, biological properties and allergic reactions Restorative resins: historical background, resin based restorative materials, composite restorative materials - mode of supply, composition, polymerization mechanisms - light activated, chemically activated, dual cure, polymerization shrinkage, classification of composite resins - application, composition and properties of each, composites for posterior teeth, prosthodontic resins for veneering, biocompatibility - Microleakage, pulpal reaction, pulpal protection, manipulation of composites, techniques of insertion of chemically activated, light activated, dual cure, polymerization, finishing and polishing of restorations, repair of composites Bonding: direct bonding, need for bonding, acid-etch technique, enamel bonding, dentin bonding agents, mode of bonding, bond strength, sandwich technique - indication and procedure Extended applications for composites: resins for restoring eroded teeth, pit and fissure sealing, resin inlay system - direct and indirect, core build-up, orthodontic applications

8

8 Dental waxes including inlay casting wax Introduction and importance of waxes Sources of natural waxes and their chemical nature and Classification Properties - melting range, thermal expansion, mechanical properties, flow and residual stresses, ductility, flow, wax distortion and its causes Manipulation of inlay wax: instruments and equipments required Preformed wax patterns Other waxes: casting wax, processing wax, boxing wax, utility wax, sticky wax, impression wax for corrective impressions, carding wax, bite registration wax - applications, mode of supply & properties

4


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9 Metal and alloys

Structure and behaviour of metals, solidification and microstructure of metals, mechanism of crystallization, classification of alloys, solid solutions, relevant physical and mechanical properties, annealing, heat treatment, Tarnish and corrosion: definition, causes of corrosion, protection against corrosion, corrosion of dental restorations Dental amalgam: history, applications, alloy classification, manufacture of alloy powder, composition, amalgamation, setting reaction, resulting structure, properties, Microleakage, dimensional stability, strength, creep, clinical performance, manipulation, selection of alloy, proportioning, mechanism of trituration, condensation, carving, finishing & polishing, effects of dimensional changes, marginal deterioration, repair of amalgam, mercury toxicity, mercury hygiene Direct filling gold: properties of pure gold, mode of adhesion of gold, classification, manipulation, removal of surface impurities, compaction, physical properties of compacted gold, clinical performance

5

10 Dental casting alloys Historical background, desirable properties of dental casting alloys Alternatives to cast metal technology: direct filling gold, amalgam, mercury free condensable intermetallic compound, CAD CAM process for metal and ceramic inlays, copy milling Classification of casting alloys - by function & description Alloys for crown and bridge, metal ceramic and removable partial dentures : composition, function, constituents, application of each alloy Properties of alloys: melting range, mechanical properties, hardness, elongation, modulus of elasticity, tarnish & corrosion, casting shrinkage compensation of casting shrinkage Biocompatibility: handling hazards, precautions of base metal alloys, casting investments used Heat treatment: softening and hardening heat treatment, recycling of metals, titanium alloys and their applications, properties and advantages, technical considerations in casting, heat sources and furnaces

6


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11 Dental casting investments

Definition, requirements, classification Mode of supply, composition, application, setting mechanism, setting time & factors controlling it Setting expansion, hygroscopic setting expansion, thermal expansion & factors controlling it Technical considerations for casting procedures Preparation of die, wax pattern, spruing, investing, control of shrinkage, wax burn out, heating of invested casting ring Casting and casting defects

5

12 Soldering, welding and brazing Need for joining dental appliances Terms and definitions Solders - definition, ideal requirement, types of solders & their fusion temperatures, applications, mode of supply, composition and selection, properties Fluxes and anti-fluxes - definitions, types, function, commonly used fluxes and their selection Techniques of soldering and brazing - free hand soldering and investment steps and procedure Welding: definition, application, requirements, procedure Laser welding

2

13 Wrought base metal alloys Applications and different alloys used in mainly for orthodontic purpose - stainless steel, cobalt chromium nickel, nickel titanium and beta titanium Properties required for orthodontic alloys, working range, springiness, stiffliess, resilience, formability, ductility, ease of joining, corrosion resistance, biocompatibility Stainless steel - description, type, composition and properties of each type, sensitization and stabilization, mechanical properties- strength, tensile, yield strength, braided & twisted wires, their need cobalt chromium nickel - composition, allocation, properties, heat treatment, physical properties nickel titanium alloys- shape memory, superelasticity titanium alloys - applications, composition, properties, welding, corrosion resistance

2


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14 Dental cements

definitions and ideal requirements of base, liners and luting cements composition, properties, chemistry of setting, manipulation and uses of silicate, silicophosphate, zinc phosphate, zinc polycarboxylate, calcium hydroxide, glass ionomer, modified glass ionomer and resin cements protection of cement, mode of adhesion agents for pulpal protection, modifications and recent advances principles of cementation

6

15 Dental ceramics Historical background and general applications Dental ceramics - definition, classification, application, mode of supply, manufacturing procedure, methods of strengthening Properties of fused ceramics - strength & factors affecting it, modulus of elasticity, surface hardness, wear resistance, thermal properties, specific gravity, chemical stability, esthetic properties, biocompatibility, technical considerations Metal ceramics [PFM]: alloys- types and composition, ceramic - types and composition, metal ceramic bond , bonding using electrodeposition, foil copings, bonded platinum foil, swaged gold alloy foil coping, technical considerations for porcelain and PFM restorations Recent advances- all ceramic restorations, manganese core, injection molded, castable ceramics, glass infiltrated alumina core ceramic, ceramic veneers, inlays, onlays and CAD CAM Chemical attack of ceramic by fluoride

6

16 Abrasive and polishing agents Definition of abrasion and polishing agents Need for abrasion and polishing Types of abrasives — finishing, polishing and cleaning Types of abrasives — diamond, emery, aluminium oxide, garnet, pumice, kieselgurh, Tripoli, rouge, tin oxide, chalk, chromic oxide, sand, carbides, zinc oxide, zirconium silicate Desirable properties of an abrasive, rate of abrasion, size of particle, pressure and speed Grading of abrasive and polishing agents Binders Procedures of polishing Technical considerations — material and procedure used for abrasion and polishing Electrolytic polishing and burnishing

2


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17 Dental implant materials

History Types, Different designs, Biologic properties 3

18 Miscellaneous Infection control Separating media Artificial tooth material Die spacers Tray adhesives Dentifrices Burs Articulating paper Pressure indicating pastes

6

Recommended Text Books: 1. Science of Dental materials. Kenneth J. Anusavice. 11th edition 2. Textbook of Dental materials. Craig, O’Brien. 11th edition

Reference Books 1. Notes on dental materials. EC Coombe. 6th edition 2. Applied dental materials. John F Mc Cabe. 7th edition

Practical Exercises: Note: Demonstration of manipulation of all materials for a batch of not more than 10 students.

Exercises to be done by each student:

I BDS Gypsum products - 40 hours Manipulation and pouring impressions - identifying setting time and working time and working time with reference to proportion, water temperature and spatulation time


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II BDS a. Impression materials - 90 hours

Manipulation and making impression and identifying setting time and defects and preparation of casts, models etc.

b. Self cure and heat cure acrylic resin manipulation and curing - 50 hours c. Cements - manipulation and setting time and working time for luting, base and

restoration consistency - 30 hours d. Silver amalgam — manipulation, trituration, condensation & setting &

working time—30 hours

Scheme of Examinations A. Theory -Written Paper : 70 Marks Practicals : 80 Marks B. Internal Assessment : 10 Marks Internal Assessment : 10 Marks C. Viva- Voce Total : 20 Marks Record Book : 10 Marks Total : 100 Marks Total : 100 Marks

Theory: (70 Marks)

Distribution of topics and type of questions

Contents Type of Questions Marks

Long answer questions ; one each from Prosthodontics & Conservative Dentistry topics

Long answer 2x10

20

Short answer, 3 questions each from Prosthodontics , Conservative & 2 from Orthodontic topics & 2from general topic

Short answer 10x3

30

MCQ s ; 8 questions each from Prosthodontics and Conservative topics and 4 questions from Orthodontic topics

MCQs 20x1

20

Total 70

Practicals: (90 Marks): 1. Exercise No.1: Spotters - Identify and write the composition and two important

uses 20 Numbers — 1 Minute Each-I Mark Each- 20 Marks 2. Exercise No 2: Manipulation Of Impression Materials - 20 Marks Any one of

the following exercise:


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a. Manipulation of impression compound and making impression of maxillary or mandibular arch dies and preparation of cast

b. Manipulation of alginate impression material and making impression of maxillary or mandibular arch dies and preparation of cast

c. Manipulation of ZOE impression material and making impression of thumb/forefinger and preparation of model with base

d. Manipulation of rubber base impression material and making impression of single tooth die/thumb/forefinger and preparation of model with base.

3. Exercise No 3: Manipulation of Acrylic Resin -10 Marks Mixing of heat cure acrylic resin and recording the time taken for all stages

4. Exercise No 4: Manipulation of Dental Cements -20 Marks Manipulation of any one of the following dental cements

a. ZOE [ and filling consistency] b. Zinc phosphate fluting and base consistency] c. Glass ionomer cement type I/II [ and filling consistency] d. Polycarboxylate cement [ luting consistency]

5. Exercise No 5: Manipulation of Silver Amalgam- 10 Marks Trituration of silver amalgam Record: 10 marks


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XII. CONSTITUTION OF INDIA

Total Hours: 40 Hours

SYLLABUS

UNIT – I 14 hours 1. Constitution of India 8 hrs

a. An Introduction to Indian Polity b. Meaning and importance of Constitution c. Making of the Indian constitution – The Constituent Assembly d. Salient features of the Indian Constitution e. Preamble of the Indian Constitution and its significance

2. Fundamental Rights and Directive Principles 6hrs a. Fundamental Rights b. Directive Principles of the State Policy c. Fundamental Duties

UNIT – II 12 hours 1. Government of the Union. 6 hrs

a. The Union Executive- the President and the Vice-President- The Council of Ministers and the Prime Minister

b. The Union Legislature - The Parliament- The Lok Sabha and the Rajya Sabha, Composition, Powers and Functions

c. Important Committees -Privileges d. The Role of the Speaker

2. Government of the States. 5 hrs a. The Governor- The Council of Ministers and the Chief Minister b. The State Legislature- composition powers and functions

3. Democratic decentralization or Panchayath Raj in India 1 hr

UNIT – III 8 hours 1. Federalism in India 5 hrs

a. Federal Features Indian federalism, Centre-State relations- distribution of legislative powers, Administrative and financial relations between the Union and the States


109

b. The Finance Commission, The Planning Commission, National Development Council

c. Military Features 2. The Judiciary 3 hrs

a. The Supreme Court – Organization, Jurisdiction and Role

b. The High Court – Organization, Jurisdiction and Role

c. Judicial Review, Judicial activism, Independence of Judiciary in India

UNIT – IV 6 hours 1. Electoral Process in India – Election Commission, Organization and Functions.

3 hrs 2. Local Governments – Rural and Urban – Organization, Powers and Role. 3 hrs

Books for Reference:

1. D.D. Basu: Introduction to the Constitution of India, S C Sarkar & Sons, Kolkatta

2. M V Pylee: An Introduction to the Constitution of India, Vikas Publishing House Pvt Ltd, 2009

3. Granville Austin: The Indian Constitution. The Cornerstone of a Nation, Oxford University Press, New Delhi, 1966

4. C K Jain (ed): Constitution of India in Precept and Practice, Lok Sabha Secretariat, New Delhi

5. V.N. Shukla: Constitution of India, Jain Book Depot, New Delhi 6. Granville Austin : The working of a Democratic Constitution: The Indian

Experience, New Delhi, Oxford University Press, New Delhi 1999 7. J C Johari: Indian Politics, Vishal Publications, Jalandhar 8. A P Avasthi: Indian Government and Politics, Lakshmi Narain Agarwal,

Agra 9. Anup Chand Kapur: Indian Government and Politics, S. Chand and

Company, New Delhi 10. V D Mahajan: The Constitution of India. S. Chand and Company, New

Delhi. 11. J N Pandey: Constitution Law of India, Allahabad, Central Law Agency,

1998


110

12. J C Johari: The Constitution of India – A Politico-Legal Study- Sterling Publication Pvt. Ltd, New Delhi

13. R C Agrawal: Constitutional Development and national Movement of India, S Chand & Co., New Delhi

14. M Hidayatullah: Democracy in India and the Judicial Process, Metropolitan, New Delhi

15. K C Markandan: Directive Principles in the Indian Constitution, Allied Publishers, Mumbai

16. Bidyut Chakrabarty and Rajendra Kumar Pandey: Indian Government and Politics, SAGE Publications New Delhi

17. India – A Politico-Legal Study- Sterling Publication Pvt. Ltd, New Delhi


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XIII. GENERAL MEDICINE

Goal: The broad goal of teaching dental students in Medicine is to have the knowledge, skills and behavioural attributes to function effectively as a safe and a competent doctor in the out-patient and in-patient settings during dental practice.

Knowledge: At the end of general medicine postings, the student should 1. Have reasonable knowledge of clinical implications of applied basic science,

and knowledge of common medical diseases (general and oral manifestations in particular) of common medical emergencies encountered during dental practice.

2. Be able to translate the pathophysiology into symptoms and signs and carry out • symptom analysis to elicit relevant history, initiate and fine-tune • communication skills in the out patient and in patient settings and be

competent to elicit signs on general examination and systemic examination as relevant to Dental practice.

3. Have knowledge of normal values of common basic lab investigations. 4. Have knowledge of uses and side effects of drugs that are relevant during

Dental practice.

Skills: Should initiate and develop skills of effective communication, know about the bedside behaviour, hospital ethics, conduct oneself to the needs of professionalism as an evolving dentist. At the end of the general medicine postings the student shall acquire reasonable theory knowledge in basic clinical medicine to be acquainted with, and to recognize relevant medical problems such as Diabetes mellitus, Hypertension, bleeding disorders, diseases of the heart, liver, lungs, kidneys, thyroid, HIV disease, common psychiatric ailments, uncooperative patient, precautions and contraindications for anaesthesia, anticoagulant and antithrombotic drugs, antidiabetic — antihypertensive drugs, analgesic drugs etc. The student should be made well aware of the pros and cons of unplanned dental procedures in such patients, and be trained to take appropriate precautions well in advance. The student must develop communication skills to elicit a simple medical history, drug history, drug allergy in areas relevant to dental practice and; acquire skills to elicit


112

& analyse signs during general examination survey to recognise underlying medical diseases so as to refer the patient to the general medicine discipline for further evaluation. • Should be able to record the pulse, temperature, blood pressure, to suspect by

sight and general examination the underlying diseases of the heart, lungs, blood, liver, kidneys etc.

• Should imbibe the skills to be competent enough to handle medical emergencies encountered in dental practice such as anaphylaxis, syncope, seizures, hypotension, hypoglycaemia, cardiac arrest etc.Before the arrival of emergency medical help.

Guidelines: Special emphasis should be given throughout on the importance of various diseases as applicable to dentistry. 1. Special precautions, Contra- indications of anaesthesia and various dental

procedures in different systemic diseases. 2. Oral manifestations of systemic diseases 3. Medical emergencies in dental practice

A Dental student should be taught in such a manner that he/she is able to record the arterial pulse, blood pressure and be capable of suspecting by sight and superficial examination of the body - diseases of the heart, lungs, and kidneys blood etc. He should be capable of handling medical emergencies encountered in dental practice.

COURSE OUTCOMES


CO1: Perform and analyse medical history taking, general physical examination

and systemic examination CO2: Diagnose and manage common infectious diseases with reference to oral

and dental health. CO3: Diagnose and manage common Gastrointestinal (GIT) diseases with

reference to oral and dental health. CO4: Diagnose and manage common cardiovascular diseases with reference to

oral and dental health CO5: Diagnose and manage common respiratory diseases with reference to oral

and dental health


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CO6: Diagnose and manage common hematological diseases with reference to oral and dental health

CO7: Diagnose and manage common renal diseases with reference to oral and dental health

CO8: Diagnose and manage common nutritional diseases with reference to oral and dental health

CO9: Diagnose and manage common neurological diseases with reference to oral and dental health

CO10: Diagnose and manage common endocrine diseases with reference to oral and dental health

CO11: Recognize and differentiate common medical emergencies encountered in general dental practice

CO12: Effectively manage common medical emergencies encountered in general dental practice.

Total Theory :60 hrs Syllabus: Core Topics (Must know) 1. Aims of medicine -Definitions of signs, symptoms, diagnosis, differential

diagnosis treatment & prognosis 2. Infections:

Enteric fever, AIDS, herpes simplex, herpes zoster, syphilis, diphtheria 3. G.I.T

Stomatitis, gingival hyperplasia, dysphagia, acid peptic disease, jaundice, acute and chronic hepatitis, cirrhosis of liver ascites.

4. C.V.S Acute rheumatic fever, rheumatic valvular heart disease, hypertension, ischemic heart disease, infective endocarditis, common arrhythmias, congenital heart disease, congestive cardiac failure

5. R.S. Pneumonia COPD, Pulmonary TB, Bronehial asthma

6. Haematology Anaemias, bleeding and clotting disorders, leukemias, lymphomas, agranulocytosis, splenomegaly, oral manifestations of haematologic disorders, generalized lymphadenopathy.


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7. Renal System Acute nephritis Nephrotic syndrome

8. Nutrition Avitaminosis 9. C.N.S

Facial palsy, facial pain including trigeminal neuralgia, epilepsy, headache including migraine

10. Endocrines Diabetes Mellitus, Acromegaly, Hypothyroidism, Thyrotoxicosis, Calcium metabolism and parathyroids

11. Critical Care Syncope cardiac arrest, CPR shock

Clinical Training: The student must be able to take history do general physical examination (including build nourishment, pulse BP respiration, clubbing, cyanosis, jaundice, lymphadenopathy, oral cavity) and be able to examine C.V.S, R.S. and abdomen and facial nerve Collateral Topics: (Desirable to know) Infectious mononucleosis, Mumps ,Measles, Rubella, Malaria, Diarrhoea, Dysentery, Amoebiasis, Malabsorption, Lung Abscess, Pleural effusion, Pheumothorax, Bronchiectasis, Lung cancers, Renal failure, Balanced diet, PEM Avitaminosis - Meningitis - Examination of comatose patient - Examination of cranial nerves Addison’s disease, Cushing’s syndrome, Acute LVF, ARDS

Clinical: 90 Hours (posting in a general hospital) 1. Five complete cases must be written in a record book before the student takes

the final examination 2. The student must be able to take history, do general physical

examination(including build, nourishment, pulse, BP, temperature, edema, cyanosis, clubbing, jaundice, lymphadenopathy, oral cavity) and be able to examine cardiovascular and respiratory systems,abdomen and the facial nerve and signs of meningeal irritation.


115

Scheme of Examination: I. Theory :100 Marks A. Written Paper: 70 marks

Distribution of Topics and Type of Question:

Content Type of Questions Marks

Essay questions ( structured )

10 marks x 2 questions 10

Short answer questions 3 marks x 10 questions 30

MCQs 1 mark x 20 questions 20

Total 70

B. Viva Voce : 20 Marks C. Internal Assessment — Theory : 10 Marks II. A. Clinicals : 90 Marks Case History : 30 Marks Clinical examination Investigation

: 30 Marks : 10 Marks

Diagnosis & D.D. : 10 Marks Management : 05 Marks Record book : 05 Marks

B. Internal assessment : 10 Marks

Total practical : 100 Marks


116

Recommended Books.

Sl No

Author

Title

Publisher

Edition

1 Fauci, Braunwald

Harrison’s Principles of Internal Medicine

McGraw Hill

19th

2 Colledge,Walker Davidson’s Principle and Practice of Medicine

Churchill Livingstone

22nd

3 Michael Glynn Hutchinson’s Clinical Methods Saunders 23rd 4 S. N. Chugh Text book of Clinical Medicine for

Dental Students Arya -

5 Goldman Textbook of Medicine Elsevier 22nd


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XIV. GENERAL SURGERY

Aims: To acquaint the students with various diseases, which may require surgical expertise and to train the students to analyse the history and be able to do a thorough physical examination of the patient. The diseases related to head and neck region are to be given due importance at the same time other relevant surgical problems are also to be addressed. At the end of one year of study the student should have a good theoretical knowledge of various ailments, and be practically trained to differentiate benign and malignant diseases and be able to decide which patient requires further evaluation.

COURSE OUTCOMES


CO1: Describe atetiology, pathophysiology, principles of diagnosis and management of common surgical problems including emergencies, in adults and children.

CO2: Define indications and methods for fluid and electrolyte replacement therapy including blood transfusion

CO3: Define asepsis, disinfection and sterilization and recommended judicious use of antibiotics

CO4: Describe common malignancies in the country and their management including prevention

CO5: Enumerate different types of anaesthetic agents, their indications, mode of administration, contraindications and side effects.

CO6: Diagnose common surgical conditions both acute and chronic, in adult and children

CO7: Plan various laboratory tests for surgical conditions and interpret the results.

CO8: Identify and manage patients of hemorrhagic, septicaemic and other types of shock

CO9: Maintain patent air-way and resuscitate


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CO10: Manage a critically injured patient, Patient with cardio-respiratory failure, A drowning case

CO11: Provide primary care for a patient of burns

CO12: Acquire principles of operative surgery, including pre-operative, operative and post-operative care and monitoring

CO13: Treat open wounds including preventive measures against tetanus and gas gangrene

CO14: Diagnose neonatal and pediatric surgical emergencies and provide sound primary care before referring the patient to secondary/tertiary centers.

CO15: Identify congenital anomalies and refer them for appropriate management.

Total teaching Hrs Theory:60 hrs History of Surgery: The development of surgery as a speciality over the years, will give the students an opportunity to know the contributions made by various scientists, teachers and investigators. It will also enable the student to understand the relations of various specialties in the practice of modern surgery.

General Principles of Surgery: Introduction to various aspects of surgical principles as related to oro-dental diseases, classification of diseases in general. This will help the student to understand the various diseases and their relevance to routine dental practice

Preparing a patient for Surgery: • To understand the principles involved in preparing a patient for theatre • To be aware of the common problems affecting a patient’s fitness for operation

and the principles of management • To know the steps required when taking informed consent from an adult • To be able to prepare an operating list

• To know the importance of an operation note

Anaesthesia and pain management: • To adequately prepare a patient for anaesthesia • To understand basic anaesthesia • To know and understand the importance of an airway


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• To be familiar with preoperative monitoring • To manage the post-anaesthetic patient • To understand the role of local and regional anaesthesia • To be able to manage the patient in pain Acute life support and critical care: fluid, electrolyte and acid-base balance and blood transfusion: • To appreciate the critical role of fluid balance in Surgery • To understand acid-base balance in relation Surgery • To manage blood loss and restoration of blood volume • To understand ‘shock’ and its management • To be able to resuscitate a hypovolaemic patient • To appreciate multiple organ failure syndrome and systems of organ failure,

multiple organ dysfunction syndrome and systemic inflammatory response syndrome

Nutrition • To understand nutritional requirements in health and how they are influenced

by disease

• To recognize the consequences of malnutrition in surgical patients • To know how to assess nutritional status in surgical patients • To know the indications for an principles of nutritional support • To recognize potential complications of nutritional support

Wounds, tissue repair and scars: • To understand the process of primary wound healing and healing by secondary

intention

• To be able to explain the different management of a ‘tidy’ and ‘untidy’ wound

• To understand the patho-physiology of acute and chronic wounds • To understand the nature of adverse scarring and its treatment

Wound infection: • To know the definition of Koch’s postulates • To appreciate the importance of aseptic technique and of delayed closure in

contaminated wounds

• To be aware of the causes of reduced resistance to infection


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• To understand the factors that determine whether a wound will become infected

• To know the definitions of infected states • To understand the classification of sources of infection and their severity • To be able to describe the management of abscesses • To be able to state the indications for and choice of prophylactic antibiotics • To know what basic precautions to take to avoid nosocomial infections • To understand the characteristics of the common pathogens and their

sensitivities

• To be able to describe the spectrum of commonly used antibiotics

Sterile precautions and theatre safety: • To understand the importance and current status of decontamination of surgical

instruments and equipment in the context of safe surgery • To appreciate the necessity for strict adherence to operating theatre protocols

in order to limit adverse events that are so costly in terms of patient morbidity and hospital medico-legal involvement

• To recognize that satisfactory surgical outcomes after operation require training not only in the technique but also in the use of operating theatre equipment for example electro surgery

• To realize that modern surgery is founded on the control of infection Surgical ethics

• To introduce the moral importance of the concept of autonomy to good surgical practice

• To evaluate the moral and legal boundaries of the doctrine of informed consent • To explain and illustrate some practical difficulties in implementing the

doctrine of informed consent

• To outline good surgical practice on withholding and withdrawing life saving treatment

• To specify the importance and boundaries of confidentiality in good surgical practice

• To indicate why surgical research should be subject to independent evaluation and how to differentiate between such research and minor surgical innovation

• To assess the moral importance of rigorous surgical training and a willingness to criticize fellow surgeons in the face of bad practice


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Burns: • To understand the methods for assessing area and depth of bums • To understand the methods for calculating rate and quantity of fluids to be

given • To appreciate the techniques for treating burns and the patient • To understand the patho-physiology of electrical and chemical burns

Inflammation Soft and hard tissues. Causes of inflammation, varieties, treatment and sequelae.

Infections: Acute and chronic abscess skin infections, cellulitis, carbuncle, and erysepelas. Specific infections such as tetanus, gangrene, syphilis, gonorrhoea, tunerculosis, Actinomycosis, Vincents angina, cancrum oris. Pyaemia, toxaemia and septicaemia

Transmissible Viral Infections: HIV and Hepatitis B with special reference to their prevention and precautions to be taken in treating patients in a carrier state.

Shock and Hemorrhage: Classification, causes, clinical features and management of various types of shock, syncope, Circulatory collapse. Haemorrhage — different types, causes clinical features and management. Blood groups, blood transfusion, precautions and complications of blood and their products. Hemophilias, their transmission clinical features and management especially in relation to minor dental procedures.

Tumors, Ulcers, Cysts, Sinus and Fistulae: Classification, clinical examination and treatment principles in various types of benign and malignant tumours, ulcers, cysts sinus and fistulae.

Diseases of Lymphatic System: Especially those occurring in head and neck region, Special emphasis on identifying diseases such as tubercular infection, lymphomas, leukaemias, metastatic lymph node diseases.

Diseases of the Oral Cavity Infective and malignant diseases of the oral cavity and oropharynx including salivary glands with special emphasis on preventive aspects of premalignant and malignant diseases of the oral cavity.


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Diseases of Larynx, Nasopharynx: Infections and tumours affecting these sites. Indications, procedure and complications of tracheostomy. Nervous System: Surgical problems associated with nervous system with special reference to the principles of peripheral nerve injuries, their regeneration and principles of treatment. Detailed description of afflictions of facial nerve and its management. Trigeminal neuralgia, its presentation and treatment.

Fractures: General principles of fractures, clinical presentation and treatment with additional reference to newer methods of fracture treatment. Special emphasis on fracture healing and rehabilitation.

Principles of Operative Surgery: Principles as applicable to minor surgical procedures including detailed description of asepsis, antiseptics, sterilization, principles of anesthesia and principles of tissue replacement. knowledge of sutures, drains, diathermy, cryosurgery and use of Laser in surgery.

Anomalies of Development of Face: Surgical anatomy and development of face. Cleft lip and cleft palate-principles of management.

Diseases of Thyroid and Parathyroid: Surgical anatomy, pathogenesis, clinical features and management of dysfunction of thyroid and parathyroid glands. Malignant diseases of the thyroid-classification, clinical features and management.

Swellings of the Jaw: Differential diagnosis and management of different types of swellings of the jaw.

Biopsy: Different types of biopsies routinely used in surgical practice Skills to be developed by the end of teaching is to examine a routine swelling. Ulcer and other related diseases and to perform minor surgical procedures such as draining an abscess, taking a biopsy etc.


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Clinical Training (90 hrs): At the end of III BDS course ,student is expected to – 1. Diagnose and Understand the management of common surgical problems

encountered in general Dental Practice 2. Acquire skills to examine the patient and know about the relevant investigations

& procedures and facilitate the overall management of the case especially applied to the region of Head and Neck.

3. To acquire the knowledge and skills to provide emergency care and to manage surgical complications related to procedures especially of Head and Neck region

General Hospital Posting: 1. Recording of case History and General Physical examination of swellings,

wounds, ulcers, Cellulitis/ abscess, Sinus and Fistulas and other common infectious lesions occurring especially in Head and Neck region

2. Recording of case History and General Physical examination of patients with Fracture of long bones and facilitate the management

3. Recording of case History and General Physical examination of patients with Tumours especially of Head and Neck region and the principles of management

4. Demonstration and understanding of various injection procedures and tissue suture techniques

5. Minor surgical procedures such as draining and abscess, taking a biopsy etc 6. Demonstration and Understanding of Operation Theatre Protocols for asepsis,

instrumentation and other procedures such as scrubbing, Gloving and Draping 7. Demonstration and management of Tracheostomy and other emergency

surgical procedures.

8. Demonstration of General Anaesthetic Protocols and Post operative care

Scheme of Examination I.Theory: 100 Marks A. Written Paper : 70 marks B. Viva voce : 20 Marks C. Internal Assessment : l0 Marks


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Distribution of Topics and Type of Questions:

Topics Type of Questions and

Marks

Marks

• Principles of Surgery, Tissue care, Asepsis and Antisepsis, Theatre Technique, Sterilization, Suture Materials, Diathermy, Laser.

• Wounds - Classification, Clinical Assessment, • Treatment, Complications, Wound Healing • Acute Infections - Non-specific and specific Aerobic

and Anaerobic abscess, Cellulitis, Carbuncle, Erysipelas, Anthrax Gonorrhea, Gas Gangrene, Tetanus, Cancrum Oris, Ludwig’s Angina

• Bacteraemia, Septicemia, Pyaemia, Toxaemia • Hemorrhage - Classification, Emergency • Management, Definitive Treatment, Assessment of

Blood Loss. Syncope, Shock, Cardiac Arrest - Causes, clinical features, Haemodynamic Changes, Emergency Care, Monitoring, Definitive Treatment, Septic Shock (Warm shock), Anaphylaxis.

• Gangrene – Gas Gangrene, Dry Gangrene, Moist • Gangrene • Questions from any topic 20 MCQ’s

Long answer 2x10

Short answer 10x3 marks

20x1 marks

20

30

20

Total 70

II. Practical Exam: 100 marks. A. Clinicals : 90 Marks Long Case - One which includes

• Case History 15 marks • Clinical Examination 25 marks • Suggested investigations 10 marks

• Diagnosis, DD 20 marks • Management 10 marks • Record 10 marks

B. Internal assessment: 10 marks


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Recommended Books:

SI. No.

Author Title Ed Publisher Year of Pubin.

1 Somen Das A Manual on Clinical Surgery

12th Dr. S. Das Calcutta

2016

2 Charles V. Mann

Bailey & Love’s Short Practice of Surgery

27th Oxford University

Press

2018

3 Hamilton Bailey

Hamilton Baileys Demonstrations of Physical signs in Clinical Surgery

19th Butterworth Heinemann

U.K.

2016

Other Books for Reference: 1. Oxford Text Book of Surgery

2. Text Book of Surgery by Devita

3. Surgery by Sebastin

4. Surgery by Somalal

5. Text Book of Surgery by Chatterjee

6. Surgical Anatomy by Lee Mc Gregor

7. Diseases of Eye by Parson

8. Text Book of Ophthalmology by Vasudev Anand Rao

9. E.N.T. Diseases by Mohammed Muqbool

10. E.N.T. Diseases by N.C.Day

11. E.N.T. Diseases by K. K. Ramalingam


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XV. ORAL PATHOLOGY AND ORAL MICROBIOLOGY

Objectives: At the end of the Oral Pathology & Oral Microbiology course, the student should be able to comprehend - 1. The pathological processes that involve the oral cavity and the manifestations

of common diseases, their diagnosis and correlation with other clinical pathological processes

2. The oral manifestations of systemic diseases to help in correlating with systemic physical signs and laboratory findings

3. The principles governing treatment of oral diseases

4. Basic aspects of Forensic Odontology

Skills: During the course the student is expected to understand and develop skills in: 1. Microscopic studies of common lesions affecting the oral tissues through

microscopic slides & projection slides and study of disease processes with the help of surgical specimens

2. Study of teeth anomalies/ polymorphisms with the help of specimens & plaster casts

3. Diagnosing the commonly occurring diseases in the oro-facial region on the basis of clinical, radiological and histological findings.

4. Basic exercises in Forensic odontology such as histological methods of age estimation and appearance of teeth in injuries

COURSE OUTCOMES

At the end of the course students will be able to...

CO1: Describe the pathological processes that involve the oral cavity and the

manifestations of common diseases, their diagnosis and correlation with other clinical pathological processes

CO2: Discuss the oral manifestations of systemic diseases to help in correlating with systemic physical signs and laboratory findings

CO3: Determine the principles governing treatment of oral diseases CO4: Describe the basic aspect of Forensic Odontology


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CO5: Report microscopic studies of common lesions affecting the oral tissues through microscopic slides & projection slides and study of disease processes with the help of surgical specimens

CO6: Discuss teeth anomalies, polymorphisms with the help of specimens & plaster casts.

CO7: Diagnose the commonly occurring diseases in the oro-facial region on the basis of clinical, radiological and histological findings.

CO8: demonstrate basic exercises in Forensic Odontology such as histological methods of age estimation and appearance of teeth in injuries

Total Teaching hours: II BDS - 25 Hours - Theory

50 Hours - Practical III BDS -120 Hours – Theory

- 80 Hours – Practical

Classes to be taken in II BDS Syllabus: 1) Dental Caries (5hrs)

- Theories - Clinical features - Classification - Histopathology - Immunology - Caries activity Tests - Factors Influencing Caries

2) Diseases of the pulp and periapical tissues (4 hrs) a) Diseases of the Dental Pulp

- Pulpitis, Focal reversible pulpitis, Chronic pulpitis, Pulp polyp

b) Diseases of the Periapical tissues - Periapical granuloma, Periapical abscess, Periapical cyst

c) Osteomyelitis - Acute suppurative osteomyelitis, Chronic focal and diffuse

sclerosing Osteomyelitis, Garre’s Osteomyelitis


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3) Regressive alterations of teeth (3 hrs) b) Attrition, Abrasion, Erosion c) Dentinal sclerosis, Dead tracts, Secondary dentin, Pulp calcifications d) Resorption of teeth (internal & external) e) Hypercementosis and Cementicles

4) Healing of Oral Wounds (4 hrs) - Factors affecting the healing of wounds - Biopsy and healing of the biopsy wound, biopsy techniques, processing

of tissues with a brief account of routine stains used - Basic aspects of cytology process - Indications, Staining of cytosmears,

Interpretation of cytosmear - Healing of extraction wound and dry socket - Healing of fracture - Re-Implantation and transplantation of teeth

5) Diseases of Periodontium (4 hrs) - Stains, Calculus, Microbiology of Plaque - Gingivitis, ANUG, Gingival hyperplasia, Periodontitis, aggressive periodontitis

6) Normal Oral Microbial Flora (2 hrs)

7) Defense Mechanisms of the Oral Cavity (2 hrs)

Practicals: 50 hours a. Identification of Hard and Soft Tissue Specimens b. Demonstration of Cytosmear and bacteriology smear

Classes to be taken in III BDS Syllabus: Theory: 120 Hours Must Know 1. Developmental disturbances of oral and para-oral structures: (14 hrs) a) Developmental disturbances of Jaws

- Agnathia, Micrognathia, Facial hemihypertrophy, Facial hemiatrophy b) Development disturbances of lips and palate


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- Congenital lip pits and Commissural pits and fistulas - Double lip, Cleft lip, Cleft palate, Chelitis glandularis, Chelitis

granulomatosa, Hereditary intestinal polyposis, Hereditary melanotic macule

c) Developmental disturbances of Oral Mucosa - Fordyce’s granules - Focal epithelial hyperplasia

d) Developmental disturbances of Gingiva - Fibromatosis gingiva, Retrocuspid papilla

e) Developmental disturbances of Tongue - Macroglossia, Microglossia, Ankyloglossia, Cleft tongue, Fissured

tongue, Median rhomboid glossitis, Benign migratory glossitis, Hairy tongue

f) Development disturbances of Oral lymphoid tissue: - Reactive lymphoid aggregates - Lymphoid hamartoma - Angiolymphoid Hyperplasia - Lympho-epithelial cyst

g) Developmental disturbances of Salivary glands: - Aplasia, Xerostomia, Hyperplasia of the palatal glands, Atresia,

Abberrancy, Stafne’s cyst h) Developmental disturbances in Size of teeth:

- Microdontia, Macrodontia i) Developmental disturbances in the Shape of teeth:

- Fusion, Gemination, Concrescence, Dilaceration, Talon’s cusp, Dens in Dente, Dens Evaginatus, Supernumerary roots, Enameloma

j) Developmental disturbances in Number of teeth - Anodontia, Supernumerary teeth, pre-deciduous and post

permanent dentition k) Developmental disturbances in Structure of teeth

- Amelogenesis imperfecta, Enamel hypoplas ia, Dentinogenesis imperfecta, Dentinal dysplasia, Regional Odontodysplasia, Shell Teeth


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l) Developmental disturbances in Eruption of teeth: - Premature eruptions, Eruption sequestrum, Delayed eruption,

Multiple unerupted teeth, Submerged teeth m) Developmental / Fissural cysts of the Oral cavity

- Median palatal cyst, Naso-alveolar cyst, Palatal cyst of neonates, Thyroglossal duct cyst, Epidermoid and Dermoid cysts, Nasopalatine cyst

2) Benign and Malignant Tumours of the Oral Cavity (26 hrs) a) Benign tumours of epithelial tissue origin

- Papilloma, Keratoacanthoma, Naevus b) Premalignant lesions and conditions c) Malignant tumours of epithelial tissue origin

- Basal cell carcinoma, Epidermoid carcinoma (TNM staging), Verrucous carcinoma, Malignant melanoma

d) Benign tumours of connective tissue origin: - Fibroma, Giant cell fibroma, Peripheral and Central ossifying

fibroma, Lipoma,Haemangioma(different types), Lymphangioma, Chondromyxoma, Osteoma, Osteoid Osteoma, Benign Osteoblastoma, Tori and multipleExostoses

e) Tumour-like lesions of connective tissue origin: - Peripheral and Central giant cell granuloma - Pyogenic granuloma

f) Malignant Tumours of Connective tissue origin: - Fibrosarcoma, Chondrosarcoma, Kaposi’s sarcoma, Ewing’s

sarcoma, Hodgkin’s and Non Hodgkin’s lymphoma, Burkitt’s lymphoma, Multiple myeloma, Solitary plasma cell myeloma

g) Benign Tumours of Muscle tissue origin: - Leiomyoma, Rhabdomyoma, Congenital epulis of newborn,

Granular cell myoblastoma. h) Benign and malignant tumours of Nerve Tissue Origin:

- Neurofibroma, Neurilemmoma, Traumatic neuroma, Melanotic neuroectodermal tumour of infancy, Malignant schwannoma.

i) Metastatic tumours of Jaws and Soft Tissues of Oral Cavity


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3) Disease of the salivary glands (8 hrs) Classification a) Benign tumours

- Pleomorphic adenoma, - Monomorphic adenoma - Warthin’s tumor - Basal cell adenoma - Canalicular adenoma - Necrotizing sialometaplasia

b) Malignant tumors of the salivary glands - Malignant pleomorphic adenoma - Adenoid cystic carcinoma - Acinic Cell carcinoma - Mucoepidermoid carcinoma - Central mucoepidermoid carcinoma - Clear cell carcinoma

c) Non-neoplastic enlargement of Salivary glands:

- Sjogren’s syndrome - Mikulicz’s disease

4) Cysts and Tumours of Odontogenic Origin (7 hrs)

- Introduction and Classification - Primordial cyst, Odontogenic keratocyst, Dentigerous cyst, Dental

lamina cyst of newborn, Gingival cyst of adults, Calcified odontogenic cyst, Radicular cyst

5) Tumours of Odontogenic Origin (l3 hrs)

Classification a) Ectodermal tumours — Ameloblastoma, Calcifying epithelial

odontogenic tumour, Adenomatoid odontogenic tumour b) Mesenchymal tumours — Peripheral and Central odontogenic fibroma,

Odontogenic myxoma, Periapical cemental dentinoma c) Mixed tumours of odontogenic origin — Ameloblasatic fibroma,

Ameloblastic fibro odontoma, Odontoma, Teratoma


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6) Infections of the Oral cavity (13 hrs) a) Bacterial — Scarlet fever, Diphtheria, Tuberculosis, Syphilis,

Actinomycosis, Tetanus, Noma b) Viral — Herpes Simplex, Recurrent Apthous Stomatitis, Bechet’s

syndrome, Reiter’s syndrome, Measles, Mumps, Rubella, Chicken Pox, Herpes Zoster, Cytomegalic inclusion disease, H.I.V. and oral manifestations of AIDS

c) Fungal — Candidiasis, Histoplasmosis, Phycomycosis and Rhinosporidiosis

7) Spread of Oral Infection (3 hrs)

a) Cellulitis, Ludwig’s angina, Intra-cranial complications of dental infection, Maxillary sinusitis, Focal infection and foci of infection (definition, mechanism and significance)

8) Physical and Chemical injuries of the Oral Cavity (6 hrs)

a) Physical injuries of teeth - Bruxism, Ankylosis

b) Physical injuries of bone - Traumatic cyst

c) Physical injuries of soft tissues - Traumatic ulcer, Denture injuries of the mucosa, Mucous

retention phenomena d) Chemical injuries of oral cavity

- Aspirin Burn - Lead, Mercury and Bismuth Poisoning - Acrodynia - Silver - Dilantin sodium enlargement - Tetracycline - Angioneurotic edema - Stomatitis medicamentosa and Nicotina

e) Effects for radiation of bone and oral mucosa


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9) Disease of Bone (7 hrs) - Osteogenesis imperfecta, Infantile cortical hyperostosis,

Cleidocranial dysplasia, Craniofacial dysostosis, Mandibulofacial dysostosis, Pierre Robin syndrome, Marfan’s syndrome, Down’s syndrome, Osteopetrosis, Achondroplasia, Paget’s disease, Fibrous dysplasia, Cherubism, Histiocytosis-X disease

10) Blood Dyscrasias (5 hrs)

- Clinico-Pathological aspects of Anemias, Leukemias, Purpura, Polycythemia Leukopenia, Neutropenia, Agranulocytosis, Infectious Mononucleosis, Hemophilia

11) Diseases of Skin (12 hrs) Hereditary ectodermal dysplasia, Chondroectodermal dysplasia, Lichen planus,

Pemphigus, Benign mucous membrane pemphigoid, Psoriasis, Erythema multiformae, Dyskeratosis congenita, White sponge naevus, Hereditary benign intra-epithelial dyskeratosis, Epidermolysis bullosa, Scleroderma, Lupus erythematoses

12) Forensic Odontology (6 hrs)

Principles of basic Forensic odontology (Pre-clinical Forensic odontology): 1. Introduction, definition, aims and scope 2. Sex and ethnic (racial) differences in tooth morphology and

histological age estimation 3. Determination of sex and blood groups from buccal mucosa saliva 4. Dental DNA methods 5. Bite mark, rugae patterns and lip prints 6. Dental importance of poisons and corrosives 7. Overview of forensic medicine and toxicology

Practicals: I. Identification of Microscopic slides of various oral lesions

1. Pit & Fissure Caries 2. Smooth surface Caries 3. Dental caries - Liquefaction foci 4. Pulp polyp


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5. Periapical granuloma - early cyst formation 6. Odontogenic keratocyst 7. Dentigerous cyst 8. Radicular cyst 9. Cholesterol clefts 10. Cholesterol crystals 11. Calcifying epithelial odontogenic cyst 12. Mucocele 13. Hyperkeratosis 14. Leukoplakia 15. Carcinoma-in-Situ 16. Oral Submucous Fibrosis (H/E) 17. Oral Submucous Fibrosis (VG) 18. Papilloma 19. Fibroma 20. Lipoma 21. Capillary Hemangioma 22. Cavernous Hemangioma 23. Neurilemmoma 24. Poorly differentiated squamous cell carcinoma 25. Moderately differentiated squamous cell carcinoma 26. Well differentiated squamous cell carcinoma 27. Verrucous carcinoma 28. Malignant melanoma 29. Osteosarcoma 30. Pyogenic granuloma 31. Fibrous dysplasia 32. Ossifying fibroma 33. Osteomyelitis 34. Cancellous osteoma 35. Peripheral giant cell granuloma 36. Central giant cell granuloma


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37. Ameloblastoma (follicular) 38. Ameloblastoma (plexiform) 39. Adenomatoid odontogenic tumour 40. Cementifying fibroma 41. Cementoblastoma 42. Compound odontoma 43. Pleomorphic adenoma 44. Warthin’s tumour 45. Mucoepidermoid carcinoma 46. Adenoid cystic carcinoma (PAS) 47. Lichen planus 48. Pemphigus

Scheme of Examination

I. Theory : 100 Marks

Contents Type of Questions and Marks Marks

I. Both questions from Oral Pathology only Long answer (2 x 10 marks) 20

II. a) 4 questions on Oral Pathology b) 2 questions on Oral Microbiology Short answer (6 x 5 marks) 30

A. Multiple choice questions (1 x 20 marks) 20

Total 70

II. Viva Voce : 20 Marks

III. Internal Assessment :

Theory - 10 Marks Practical - 10 Marks


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IV. Practicals : 90 Marks Spotters (Total 15 spotters) 1. Specimen: Identification & Points in Support 5x6 = 30 Marks 2. Slides : Slides, diagrams, labeling & salient features (10 slides) 10x5=50 Marks 3. Record Book: 10 Marks

Questions/terminologies in the question paper will be taken from recommended text books only.

Text Books Recommended:

Name of the Book Author Edn Yr of Publ. Publ.’s Name Place of Publ.

1. Oral pathology clinical pathologic correlation

Regezi & Scuba

2nd 1989 W. B. Saunders Co, USA

2. Text book of Oral pathology

William G. Shafer

8th 1993 S.B. Saunders Co. USA

Other suggested reading:

Name of the Book Author Edn Yr of Publ. Publ.’s Name

Place of Publ. 1. Pathology of

Tumors of the Oral tissues

R.B.Lucas 3rd 1976 Churchill Livingstone, New York

2. Immunology of Oral Disease

Thomas Lehner

3rd 1980 Blackwell Scientific Publ.,

Oxford 3. Oral &

Maxillofacial Pathology

Nevill, Damm Allen,

Bouquot

2nd 2002 Saunders, Pennsylvania

4. Contemporary Oral & Maxillofacial Pathology

J. Philip Sapp

Lewis R. Eversole

2nd 1997 Mosby, Missouri


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5. Colour atlas of Oral

Pathology John Everson & Crispan Scully

- 1995 Mosby-Wolfe, London

6. Oral Diseases in the Tropics

S.R Prabhu Wilson, Duftary

- 1993 Oxford University Press,

Oxford


138

XVI. ORAL MEDICINE AND RADIOLOGY

Aims: 1. To train the students to diagnose the common disorders of oro-facial region by

clinical examination and with the help of such investigations as may be required and medical management of oro-facial disorders with drugs and physical agents.

2. To train the students about the importance, role, use and techniques of radiographs/ digital radiograph and other imaging methods in diagnosis.

3. The principles of the clinical and radiographic aspects of Forensic Odontology.

COURSE OUTCOMES


CO1: Demonstrate comprehensive knowledge of the applied anatomy of the face

and oral cavity, the basic physiologic processes, pathologic processes and

the basics of pharmacologic applications.

CO2: Explain the etiology, epidemiology, clinical presentation and management

protocols of the common disorders of oral and para-oral structures.

CO3: Explain the role of involvement of various systems in relation to dentistry

CO4: Discuss the diagnosis and diagnostic methods, its applications and

limitations in dentistry

CO5: Explain the physics of dental radiology, biologic effects of radiation,

radiation protection measures, principles of intra-oral and extra- oral

radiography, imaging procedures and techniques, indications and limitations

of dental radiography

CO6: Outline the principles, clinical and radiographic aspects of Forensic

odontology.

CO7: Apply the knowledge of medico-legal aspects while handling patients in the

dental clinic


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CO8: Perform thorough physical examination of the various systems, including

the stomatognathic system and identify its normal and abnormal

functioning

CO9: Diagnose and manage diseases affecting the oral and para-oral structures

through evaluation of the patient’s dental and medical history, systemic

examination and investigations of the oral and para-oral tissues

CO10: Explain the oral manifestations of systemic diseases.

CO11: Communicate effectively and empathetically with patients and explain the

disease process, treatment strategies and obtain informed consent.

CO12: Illustrate the diagnostic basis for diseases and conditions in the oral and

para-oral structures.

CO13: Identify the normal conditions and pathologies on a dental radiograph

CO14: Demonstrate a methodological approach and apply principles of

radiographic interpretation in description of lesions.

CO15: Operate imaging equipment, accessory devices and film processing

equipments to produce quality intra-oral radiographs while incorporating

appropriate radiation protection protocols.

CO16: Manage patients with medically compromised conditions

CO17: Apply the principles of an evidence-based approach to learning, clinical and

professional practice and decision making.

CO18: Applying high moral and ethical standards while carrying out clinical and

radiographic examinations

CO19: Demonstrate clinical maturity with a professional attitude towards patients

and colleagues

CO20: Apply a research-oriented attitude through literature search and application

of established evidence in management strategies


140

Total Teaching Hrs: Theory - 65 hrs

The syllabus in Oral Medicine & Radiology is divided into two main parts.

I). Diagnosis, Diagnostic methods and Oral Medicine and

II) Oral Radiology.

Again the part I) is subdivided into three sections.

(A) Diagnostic methods

(B) Diagnosis and differential diagnosis

(C) Oral Medicine & Therapeutics.

Course Content 1. Emphasis should be laid on oral manifestations of systemic diseases and ill-

effects of oral sepsis on general health. 2. To avoid confusion regarding which lesion and to what extent the student

should learn and know, this elaborate syllabus is prepared. As certain lesions come under more than one group, there is repetition.

III BDS Oral Medicine:

Sl.No. Topic Hour

1 Introduction to oral medicine- Definition, Scope and Clinical applications

1 hr

2 Principles of Oral diagnosis - Definitions. - Case history and components, Physical

examination methodologies - General - Extra oral and Neck - Intra oral Formulation of treatment plan

2 hrs

3 Principles, Procedures, and Protocol for Asepsis, Sterilisation, Infection control

1 hr

4 Oral foci of infection and effects on general systemic health 1 hr

5 Cervico-facial lymphadenopathy 1 hr

6 Teeth: Developmental abnormalities, discolouration of teeth 1 hr


141

7 Chair side investigations 1 hr

8 Pulp and periapical diseases and their sequelae 1 hr

9 Diagnosis of caries & periodontal disease 1 hr

III BDS Oral Radiology

1 Introduction to Oral Radiology, Definition and Scope 1 hr

2 Radiation physics - Production of x rays 1 hr

3 Radiographic equipment and accessories including image receptors 1 hr

4 Properties of X rays and Electro physical factors 1 hr

5 Collimation and filtration 1 hr

6 Projection geometry 1 hr

7 Intraoral radiography-principle & technique 1 hr

8 Object localization 1 hr

9 Processing of x ray Films 1 hr

10 Radiographic artefact 1 hr

11 Normal radiographic anatomy of the jaws 1 hr

12 Principles of radiographic interpretation 1 hr

IV BDS Oral Medicine 1 Investigations -Biopsy and Exfoliative cytology,

Hematological,Microbiological, Serological tests 2 hrs

2 White lesion of oral mucosa 2 hrs

3 Red lesions of oral mucosa 1 hr

4 Vesiculobullous lesions 2 hrs

5 Oral ulcers 1 hr

6 Disease of tongue 2 hrs

7 Oral manifestation of AIDS 1 hr


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8 Orofacial pigmentation 1 hr

9 Disease of TMJ 2 hrs

10 Disease of salivary gland 2 hrs

11 Orofacial pain 2 hrs

12 Psychosomatic oral medicine 1 hr

13 Autoimmune diseases of oral cavity 1 hr

14 Oral precancerous lesion & condition 2 hrs

15 Oral Cancer- Etiology, epidemiology, screening, clinical features, staging, diagnosis, management

2 hrs

16 Forensic odontology-Medicolegal aspects of oro-facial injuries 1 hr

17 Age estimation 1 hr

18 Identification of cadavers by dental appliances, Restorations and tissue remnants

1 hr

19 Identification of bite marks, lip prints, palatal rugae 1 hr

20 Management of medical emergencies 2 hrs

21 Bleeding and clotting disorders 1 hr

IV BDS Oral Radiology

1 Radiographic interpretation and diagnosis of caries & periodontitis 1 hr

2 Periapical radioopacities and Periapical radiolucency 2 hrs

3 Biologic effect of radiation 2 hrs

4 Radiation protection 1 hr

5 Fibro osseous disease 1 hr

6 Units of radiation & dosimetry 1 hr

7 Radiographic features of systemic diseases 1 hr

8 Radiographic features of osteodystrophies 1 hr

9 Extra oral radiography 1 hr


143

10 Imaging of Temporomandibular joint 1 hr

11 Imaging of paranasal sinuses 1 hr

12 Trauma radiology 1 hr

13 Digital radiography 1 hr

14 Basics of USG, CT, MRI 1 hr

15 Panoramic radiography 1 hr

16 Nuclear imaging, cephalometric radiography 1 hr

Practicals/Clinicals: Total hrs: 170 hrs 1. Student is trained to arrive at proper diagnosis by following a scientific and

systematic procedure of history taking and examination of the orofacial region. Training is also imparted in management wherever possible. Training also shall be imparted on saliva diagnostic procedures. Training also shall be imparted in various radiographic procedures and interpretation of radiographs.

2. In view of the above each student shall maintain a record of work done, which shall be evaluated for marks at the time of university examination

3. The following is the minimum of prescribed work for recording (a) Recording of detailed case histories of 10 interesting cases and 30 routine

cases (b) Intra-oral radiographs (Periapical, bitewing, occlusal): 25 (c) Saliva diagnostic check as routine procedure

4. Discussion of Clinical and radiographic spotters 5. Demonstration of radiographic accessories 6. Demonstration of Cone Beam Computed Tomography will be given along with

discussion of its applications in dentistry

Scheme of Examination

I. Theory : 100 Marks A. Written Exam : 70 marks B. Viva Voce : 20 Marks C. Internal Assessment : 10 Marks


144

Types of Questions and marks

Type of Questions No.of questions and Marks Total Marks

I. Long answer questions 2 x 10 marks 20

II. Short answer 10 x 3 marks 30

III. Multiple choice questions (MCQ)

20 x 1 marks 20

Total 70

II. Practical/Clinicals : 100 Marks A. Case History and Chairside examination : 50 Marks B. Radiology : 30 Marks C. Record Book : 10 Marks D. Internal Assessment : 10 Marks

Books Recommended: A. Oral Diagnosis, Oral Medicine & Oral Pathology

1. Burkit - Oral Medicine - J.B. Lippincott Company 2. Coleman - Principles of Oral Diagnosis - Mosby Year Book 3. Oral Pathology - Shafers

B. Oral Radiology 1. White & Pharoah - Oral Radiology - Mosby year Book 2. Wood and Goaz — Differential Diagnosis in Oral Medicine

C. Forensic Odontology 1. Derek H.Clark-Practical Forensic Odontology-Butterworth-

Heinemann (1992) 2. C Michael Bowers, Gary Bell-Manual of Forensic Odontology-

Forensic Pr (1995)


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XVII.ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS

Course Objective Undergraduate Programme in Orthodontics is designed to enable the qualifying Dental Surgeon to diagnose, analyze and treat common orthodontic problems by preventive, interceptive and corrective orthodontic procedures. The training programme in Orthodontics is to structure and achieve the following objectives:

Knowledge: • The dynamic interaction of biologic processes and mechanical forces acting on

the stomatognathic system during orthodontic treatment • The etiology, patho-physiology, diagnosis and treatment planning of various

common Orthodontic problems • Various treatment modalities in Orthodontics: preventive, interceptive and

corrective. • Basic sciences relevant to the practice of Orthodontics. • Interaction of social, cultural, economic, genetic and environmental factors and

their relevance to management of oro - facial deformities. • Factors affecting the long-range stability of orthodontic correction and their

management • Personal hygiene and infection control, prevention of cross infection and safe

disposal of hospital waste, keeping in view the high prevalence of Hepatitis and HIV and other highly contagious diseases.

Skills: • To obtain proper clinical history, methodical examination of the patient,

perform essential diagnostic procedures, and interpret them and arrive at a reasonable diagnosis about the Dentofacial deformities.

• To be competent to diagnose, analyze and treat common orthodontic problems by preventive, interceptive and corrective orthodontic procedures.

Attitudes: • Develop an attitude to adopt ethical principles in all aspects of Orthodontic

practice. • Professional honesty and integrity are to be fostered • Treatment care is to be delivered irrespective of the social status, cast, creed or

colleagues.


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• Willingness to share the knowledge and clinical experience with professional colleagues

• Willingness to adopt, after a critical assessment, new methods and techniques of orthodontic management developed from time to time based on scientific research, which are in the best interest of the patient

• Respect patients’ rights and privileges, including patients right to information and right to seek a second opinion

• Develop attitude to seek opinion from allied medical and dental specialists as and when required

Communication Skills: • Develop adequate communication skills particularly with the patients giving

them the various options available to manage a particular Dentofacial problem and to obtain a true informed consent from them for the most appropriate treatment available at that point of time.

• Develop the ability to communicate with professional colleagues, in Orthodontics or other specialities through various media like correspondence, Internet, e-video, conference, etc. To render the best possible treatment.

COURSE OUTCOMES


CO1: Explain the process of normal growth and development of dentition and

associated craniofacial structures.

CO2: Differentiate the abnormality /aberration in the growth process in dental,

skeletal and soft tissues of the craniofacial region and discuss their clinical

implications.

CO3: Define Orthodontics and describe the development, etiology and progress of

different types of malocclusions

CO4: Diagnose the features and classify malocclusion through clinical

examination and the use of appropriate diagnostic aids

CO5: Explain different types of tooth movement, biological reactions involved

and the Bio-mechanical principles of tooth movement


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CO6: Discuss the various materials and their uses in the fabrication of Orthodontic

appliances.

CO7: Describe the aims and objectives of Orthodontic treatment and design the

treatment for various types of malocclusion including preventive,

interceptive and corrective procedures.

CO8: Identify and explain the concepts of growth modulation and appliances for

correction of developing malocclusion

CO9: Describe the principles of Surgical Orthodontics, Interdisciplinary

Orthodontics.

CO10: Recognise and recall the parameters involved in the treatment of adult

orthodontic patients.

CO11: Discuss the principles & guidelines for preventing the relapse of

Orthodontic treatment and fabricate retention appliances

CO12: Recognize the complexity of malocclusions and refer such cases to a

specialist for higher level of care.

CO13: Demonstrate the skills to make upper and lower dental arch impressions,

prepare the study casts, perform model analyses and interpret the results.

CO14: Demonstrate the skills to interpret the radiographic findings based on the

appropriate analytical approach

CO15: Design, fabricate and clinically manage different types of removable

appliances for minor malocclusions.

CO16: Demonstrate effective communication skills for interactions with patients as

well as professional peers

CO17: Recognize the apprehension and psychological status of the patient/parents

having Orthodontic problems

CO18: Instill positive attitude and behavior in patients and parents regarding the

need for Orthodontic intervention

CO19: Employ cross-infection control measures in clinical practice.


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CO20: Practice the principles of Bio-ethics, Medico-legal aspects, public awareness

and community health services.

CO21: Demonstrate the application of recent advances in biomaterials, techniques

and Technology

CO22: Demonstrate the ability to acquire new knowledge/skills and upgrade

existing knowledge/skills

The Orthodontic Curriculum (Theory, Clinicals and Practicals) will be spread over the III and the IV Year Part I of the BDS Course. Total Teaching Hrs -;Theory = 50hrs; Practicals/clinicals = l70 hrs The following basic instructional procedures will be adapted to achieve the above objectives. 1. Introduction, Definition, Historical Background, Aims and Objectives of

Orthodontics and Need for Orthodontic care.

2. Growth and Development: a. Definition

b. Growth spurts and Differential growth

c. Factors influencing growth and Development

d. Methods of measuring growth

e. Growth theories (Genetic, Sicher’s, Scott’s, Moss, Petrovic’s, Multifactorial)

f. Genetic and epigenetic factors in growth

g. Cephalo-caudal gradient in growth.

3. Morphologic Development of Craniofacial Structures a. Methods of bone growth b. Prenatal growth of craniofacial structures c. Postnatal growth and development of: cranial base, maxilla, mandible,

dental arches and occlusion.

4. Functional Development of Dental Arches and Occlusion a. Factors influencing functional development of Dental arches and

occlusion.


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b. Forces of occlusion

c. Wolff’s law of transformation of bone

d. Trajectories of forces

5. Clinical Application of Growth and Development

6. Malocclusion - In General a. Concept of normal occlusion

b. Definition of malocclusion

c. Description of different types of dental, skeletal and functional malocclusion.

7. Classification of Malocclusion Principle, description, advantages and disadvantages of classification of malocclusion by Angle, Simon, Lischer and Ackerman and Proffit Systems

8. Normal and Abnormal Function of Stomatognathic System

9. Etiology of Malocclusion a. Definition, importance, classification, local and general etiological

factors.

b. Etiology of following types of malocclusion:

1) Midline diastema

2) Spacing

3) Crowding

4) Cross-Bite: Anterior/Posterior

5) Class III Malocclusion

6) Class II Malocclusion

7) Deep Bite

8) Open bite

10. Diagnosis and Diagnostic Aids a. Definition, Importance and classification of diagnostic aids.

b. Importance of case history and clinical examination in orthodontics


150

c. Study Models: - Importance and uses - Preparation and preservation of study models. Model analysis: Pont’s, Ashley Howe’s, Bolton, Careys, Moyer’s Mixed Dentition Analysis

d. Importance of intra-oral X-rays in orthodontics

e. Panoramic radiographs: - Principles, Advantages, disadvantages and uses

f. Cephalometrics: Its advantages, disadvantages, uses and limitations

1. Definition

2. Description and use of cephalostat

3. Description and uses of anatomical landmarks lines and angles used in cephalometric analysis

4. Analysis- Steiner’s, Down’s, Tweed’s, Ricket’s-E- line

g. Electromyography and its use in orthodontics

h. Hand-Wrist X-rays and its importance in Orthodontics

11. General Principles in Orthodontic Treatment Planning of Dental and Skeletal Malocciusions

12. Anchorage in Orthodontics - Definition, Classification, Types and Stability. Temporary anchorage devices.

Classification

Advantages and Disadvantages

Indications and Contraindications

Techniques

13. Biomechanical Principles in Orthodontic Tooth Movement a. Different types of tooth movements

b. Tissue response to orthodontic force application

c. Age factor in orthodontic tooth movement

d. Methods of force application

14. Preventive Orthodontics Definition & Different procedures & limitations undertaken in preventive Orthodontics

15. Interceptive Orthodontics a. Definition


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b. Different procedures undertaken in interceptive orthodontics c. Serial extractions: Definition, indications, contra-indications,

techniques, advantages and disadvantages.

d. Role of muscle exercises as an interceptive procedure


152

16. Corrective Orthodontics a. Definition, factors to be considered during treatment planning b. Methods of gaining space in the arch:- Indications, relative merits and

demerits of Proximal stripping, arch expansion and extractions

c. Extractions in Orthodontics - indications and selection of teeth for extraction.

17. Orthodontic Appliances: General a. Requisites for Orthodontic appliances

b. Classification, indications of Removable, Fixed and Functional Appliance

c. Materials used in construction of various orthodontic appliances - use of stainless steel, technical considerations in curing of acrylic, Principles of welding and soldering, fluxes and anti-fluxes.

d. Preliminary knowledge of acid etching and direct bonding.

I. Removable Orthodontic Appliances 1) Components of removable appliances

2) Different types of clasps and their uses

3) Different types of labial bows and their uses 4) Different types of springs and their uses 5) Expansion appliances in orthodontics:

i) Principles ii) Indications for arch expansion iii) Description of expansion appliances and different types and their uses. iv) Rapid maxillary expansion

II. Fixed Orthodontic Appliances 1) Definition, Indications & Contraindications

2) Component Parts and Their Uses

3) Basic Principles of Different Techniques: Edgewise, Begg’s Straight Wire.

III. Extra-oral Appliances 1) Headgears

2) Chin cup


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3) Reverse Pull Headgears

IV. Myofunctional Appliances 1) Definition and principles 2) Muscle exercises and their uses in orthodontics 3) Functional appliances:

Activator, Oral screens, Frankel’s function regulator, Bionator, Twin block Appliance, Lip bumper and Inclined planes.

4) Fixed Functional Appliances Introduction Classification Advantages & Disadvantages Indications and Contra indications

18. Orthodontic Management of Cleft Lip and Palate

19. Principles of Surgical Orthodontics & Brief knowledge of correction of: a. Mandibular and Maxillary Prognathism and Retrognathism b. Skeletal anterior open bite and deep bite ; Cross bite, facial

asymmetry 20. Adult Orthodontics

Principles Indications and contraindications Treatment planning in Adult Orthodontics Retention in Adult Orthodontics

21. Principle, Differential Diagnosis & Methods of Treatment of: 1. Midline diastema, Cross bite; Open bite; Deep bite, Spacing, Crowding

2. Class II - Division 1, Division 2

3. Class III Malocclusion - True and Pseudo Class III

22. Retention and Relapse Definition, Need for retention, Causes of relapse, Methods of retention, Different types of retention devices, Duration of retention, Theories of retention.

23. Ethics

Teaching Hours: Theory — Total 50 hours III BDS-20 Hours

1 Introduction, definition, aims and objectives and scope of orthodontics 1 hr

2 Growth and Development 4 hrs

3 Development of dentition and occlusion 2 hrs

4 Diagnostic Aids 4 hrs


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7 Habits 1 hr

8 Genetics 1 hr

9 Serial extraction and space maintainers and space regainers 1 hr

10 Materials used in Orthodontics 1 hr

11 Welding and Soldering 1 hr

IV BDS Part 1-30 Hours

12 Biomechanics 3 hrs

13 Anchorage 3 hrs

14 Retention and Relapse 3 hrs

15 Methods of gaining space and extraction in orthodontics 3 hrs

16 Cleft Lip and cleft palate 3 hrs

17 Functional Appliances 4 hrs

18 Introduction to fixed appliance 3 hrs

19 Surgical Orthodontics 3 hrs

20 Treatment Planning 3 hrs

21 Computers in Orthodontics 2 hrs

III BDS - 80 Hours 1. Basic wire bending exercises

2. Clasps-

a. “C” Clasps on molars, (One with mesial tag, one with distal tag)

b. Jackson’s clasps on molar

c. Triangular clasps

d. Adam’s clasp on molar

e. Adam’s clasp on incisor

f. Adam’s clasp on premolar


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3. Springs

a. Finger spring

b. Single cantilever spring

c. Double cantilever spring

d. Cantilever spring with guard (1 Modification)

e. Springs for mesial movement with guard

f. Spring for distal movement

g. Single closed loop spring

h. Double closed loop spring

4. Canine retractor

a. Helical canine retractor

b. Buccal canine retractor

c. U-loop canine retractor

d. Palatal canine retractor 5. Bows

a. Short labial bow

b. Long labial bow

c. Robert’s retractor

d. Begg’s type

e. Labial bow with reverse loops

Clinical Training during III BDS: • Making of U/L impressions and Study model preparations • Model Analysis • Pont’s Analysis • Ashley Howe’s Analysis • Carey’s Analysis • Bolton’s Analysis • Moyer’s Mixed Dentition Analysis

Clinical Training during IV BDS Part I - 90 Hours: 1) Presentation of 5 Clinical Cases with

1. Detailed Case History


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2. Clinical Examination

3. Model Analysis

4. Space Analysis

5. Diagnosis

6. Treatment Objectives

7. Treatment Plan

8. Design of Appliance 2) Cephalometric Tracing

• Down’s Analysis • Tweed’s Analysis • Steiner’s Analysis

3) Demonstration of Soldering and welding 4) Appliance Design and fabrication 5) Group discussion of any one topic to be presented by each student on rotation

Overall distribution of marks for theory paper (Weightage)

Topic Type of questions Marks

Two questions as indicated in topic wise distribution

Long answer question (LAQ) 2 questions x 10 marks

20

Ten questions as indicated in topic wise distribution

Short answer question (SAQ) 10 questions x 3 marks

30

20 questions equally selected from entire syllabus as indicated in topic wise distribution

Multiple choice questions (MCQ’s) 20 questions x 1 mark

20

Scheme of Examination: I. Theory—100 Marks

A. University Written Exam : 70 Marks B. Viva Voce : 20 Marks C. Internal Assessment : 10 Marks

Type of Questions No. of Questions and Marks Marks Long answer 2 x 10 marks 20


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Short answer 10 x 3 marks 30

Multiple Choice Questions (MCQs) 20 x 1 mark 20

Total 70

II. Practicals / Clinicals -100 Marks A. University Exam: 80 Marks

i. Clinical exam : 25 marks ii. Spotters : 30 marks

iii. Wire bending Exercise : 25 marks B. Internal Assessment : 10 Marks

C. Record book : 10 marks

Recommended Text Books and Reference Books

SI. No

Title of the Book Author Publication

1 Orthodontics: Current Principles & Techniques

T.M. Graber Mosby

2 Handbook of Orthodontics Robert E Moyers Year Book Medical Pub.

3 Orthodontics for Dental Students T.C. White J.H. Gardiner

Macmillan Ind.

4 Removable Orthodontic Appliances

C. Philip Adams W. John S. Kerr

Varghese Pub. House.

5 Contemporary Orthodontics William R Proffit Elsevier


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XVIII. PUBLIC HEALTH DENTISTRY

Total teaching Hrs; Theory: 60 hrs. Clinicals/Practicals: 200 hrs

Goal: To prevent and control oral diseases and promote oral health through organized community efforts.

Knowledge: At the conclusion of the course, the student shall have a knowledge of the basics of public health, preventive dentistry, public health problems in India, Nutrition, Environment and their role in health, basics of dental statistics, epidemiological methods, National Oral Health policy.

Skill and Attitude: At the conclusion of the course, the students shall acquire the skill of identifying health problems affecting the society, conducting health surveys, conducting health education classes and deciding health strategies. Students should develop a positive attitude towards the problems of the society and must take responsibilities in providing health.

Communication abilities: At the conclusion of the course, the student should be able to communicate the needs of the community efficiently, inform the society of all the recent methodologies in preventing the disease.

COURSE OUTCOMES

At the end of the course students will be able to... CO1: Elicit case history, perform Clinical Examination to arrive at a diagnosis

using appropriate diagnostic aids and provide comprehensive Oral health

care to the patients with strict adherence to the Infection control

protocol.


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CO2: Identify Community health/ oral health problems using the knowledge of

Epidemiology and indices to arrive at Community Diagnosis and

communicate the findings to the community.

CO3: Plan, implement and evaluate appropriate Community Oral Health

Programs for Promotion of Oral Health and Prevention of Oral disease at

the Community level for various target groups including school children.

CO4: Develop Health Education aids and impart Health Education using

appropriate methods to various target groups.

CO5: Identify health systems and health policies for delivery of health care

services in India and advocate the need for Oral health policy.

CO6: Develop communication and administration skills to coordinate between

appropriate manpower and resources for delivery of Health/ Oral health

care.

CO7: Sensitize the community towards the various payment plans and public

health/ oral health programs in place for availing health/oral health services.

CO8: Communicate Environmental Health Hazards and associated Health

Outcomes to the Community, Stakeholders and Professional audience

CO9: Adopt practices to prevent Occupational hazards associated with the

practice of dentistry

CO10: Identify and manage Medico legal issues in the practice of dentistry

CO11: Adopt and apply ethical and Moral Standards while carrying out

Epidemiological Researches, Community Oral Health Activities

CO12: Display competency and work efficiently in a 'Team Approach'

CO13: Respect patient’s rights and Privileges including Patient’s right to

information and right to seek a second opinion.

CO14: Strive to maintain the highest professional dignity and honour by adhering

to the guidelines and values set up by the governing bodies of the profession


160

1. Introduction to Dentistry: Definition of Dentistry, History of Dentistry, Scope, Aims and Objectives of

Dentistry, Introduction to Public Health Dentistry.

2. Public Health: i) Health & Disease:- Concepts, Philosophy, Definition and Characteristics.

ii) Public Health:-Definition & Concepts, History of Public Health. iii) General Epidemiology :- Definition, Objectives, Epidemiological

Principles and methods. iv) Environmental Health:- Concepts, Principles, Protection, Sources,

Purification, Environmental sanitation of water, Disposal of waste and role in mass disaster.

v) Health Education:- Definition, Concepts, Principles, Methods, and Health Education Aids

vi) Public Health Administration - Priority, Establishment, Manpower, Private practice management, Hospital management.

vii) Ethics and Jurisprudence: Professional liabilities, negligence, malpractice, consents, evidence, contracts and method of identification in forensic dentistry.

viii) Nutrition in Oral Health and Diseases ix) Behavioural Sciences: Definition of Sociology, Anthropology and

Psychology and their relevance in dental practice and community, Child psychology, Behaviour management.

x) Health Care Delivery System: Centre and State, Oral Health Policy, PrimarHealth Care, National Health Programmes, Health Organizations.

3. Dental Public Health: a. Definition and difference between community and clinical practice. b. Epidemiology of dental diseases:- dental caries, periodontal diseases,

malocclusion, dental fluorosis and oral cancer. c. Survey Procedures: Planning, implementation and evaluation, WHO oral

health survey methods 1997, indices for dental diseases. d. Delivery of Dental Care: Dental auxiliaries, operational and non-

operational, incremental and comprehensive health care, school dental health.

e. Payments for dental care: Methods of payments and dental insurance, government plans.

f. Dentists Act 1948 with amendment, Dental Council of India and State Dental Councils, Composition and responsibilities, Indian Dental Association, Head Office, State and local branches.


161

g. Preventive dentistry: Definition, Levels, role of individual, community and professionals, fluorides in dentistry, plaque control programmes.

h. Pit & Fissure sealants, ART, Dental caries vaccine, Caries activity tests.

4. Research Methodology and Dental Statistics a. Health Information:- Basic knowledge of Computers, MS office, Window

2000, Statistical programmes. b. Research Methodology:- Definition, Types of research, Designing a written

protocol. c. Bio-Statistics:- Introduction, collection of data, presentation of data,

Measures of central tendency, measures of dispersion, Tests of significance, Sampling and sampling techniques-types, errors, bias, blind trials and calibration.

5. Dental Practice Management a. Place and locality b. Premises and layout c. Selection of equipments d. Maintenance of records/accounts/audit

Practicals/Clinical /Field Programme in Community Dentistry: These exercises are designed to help the IV year students to :

1. Understand the community aspects of dentistry. 2. Take up leadership role in solving community oral health program.

Exercises:

a) Collection of statistical data (demographic) on population in India, birth rates, morbidity and mortality, literacy, per capita income.

b) Incidence and prevalence of common oral diseases like dental caries, periodontal disease, oral cancer, fluorosis at national and international levels.

c) Preparation of oral health education material- posters, models slides, lectures, plays, acting/ skits etc.

d) Oral health status assessment of the community using indices and WHO basic oral health survey methods.

e) Exploring and planning, setting of private dental clinics in rural, semi urban and urban locations, availment of finances for dental practices-preparing project report.


162

f) Visit to primary health centre-to acquaint with activities and primary health care delivery.

g) Visit to water purification plant/public health laboratory/ centre for treatment of waste and sewage water.

h) Visit to schools- To assess the oral health status of school children, emergency treatment and health education including possible preventive care at school (tooth brushing technique demonstration and oral rinse program etc)

i) Visit to institution for the care of handicapped, physically, mentally, or medically, compromised patients.

j) Preventive dentistry: In the department, application of pit and fissure sealants, fluoride gel application procedure, A.R.T, Comprehensive health for 5 patients (at least 2 patients).

The college is encouraged to involve in the N.S.S. program for college students for carrying out social work in rural areas. Programme in Community Dentistry: 1. At the college:

Students are posted to the Department to get training in Dental Practice Management

a) Total oral health care approach- In order to enhance the skills of the new graduates in diagnosis, treatment planning, cost of treatment, prevention of oral diseases providing treatment on schedule, recall, maintenance of records etc- at least 10 patients (both children and adults of all types, posting for at least one month).

b) The practice of chair side Preventive Dentistry including Oral Health Education.

2. At the Community Oral Health Care Centre (Adopted by The Dental College in Rural Areas) Graduates are posted for at least one month to familiarize in:

a) Survey methods, Analysis and presentation of Oral Health Assessment of school children and community independently using WHO basic Oral Health survey methods.

b) Participation in rural Oral Health Education Programmes. c) Stay in the village to understand the problems and life in rural areas.


163

3. Desirable: Learning use of computers- at least basic program.

Examination pattern I. Case History with any relevant index a) Oral hygiene index simplified - Green and Vermillion b) Silness and Loe index for plaque c) Loe and Silness index for Gingiva d) CPI e) DMF: T and S, df: t and s f) Dean’s fluorosis index

II. Health Education 1. Make one — Audio visual aid 2. Deliver a health talk

III. Practical work 1. Pit and Fissure Sealant Application 2. Topical Fluoride Application

Teaching Programme - IVBDS Part I

Topics Hours

Introduction of community Dentistry — Aims, Objectives & functions 1 hr

Man and medicine 1 hr

Waste disposal 1 hr

Public Health — Concept of Health & Diseases 2 hrs

Health Education and Health Promotion 2 hrs

Health care delivery system 2 hrs

Environment & Health 4 hrs

Voluntary health Organization 1 hr

Social science & Dentistry 1 hr

Health agencies around the world 1 hr

National health programmes 1 hr

Epidemiology — Principles & Methods, Emporiatrics 3 hrs


164

Research Methodology and Biostatistics 2 hrs

Epidemiology of Dental Caries 2 hrs

Epidemiology of Periodontal Diseases 1 hr

Indices for periodontal diseases 1 hr

Dental Auxiliary 2 hrs

IDA & DCI 1 hr

Finance in Dentistry 2 hrs

Dental Ethics and Jurisprudence 1 hr

Survey Procedures 2 hrs

Planning & evaluation 2 hrs

COPRA 1 hr

Levels of Prevention 1 hr

Dentist Act of India 1 hr

Epidemiology of Oral Cancer 1 hr

Epidemiology of Malocclusion 1 hr

Occupational Hazards & Infection control 2 hrs

Establishing & Managing dental office 1 hr

WHO Oral Health Assesment form 1 hr

Indices for Dental Fluorosis 1 hr

National Oral Health Policy 1 hr

Nutrition in Oral Health and Disease 1 hr

Pit and Fissure Sealants 1 hr

ART 1 hr

Fluorides 4 hrs

Dental Caries vaccine 1 hr

School Dental Health Programs 1 hr

Child Psychology 3 hrs


165

Behaviour Management 2 hrs

Caries activity Tests 1 hr

Plaque Control 2 hrs

Screening 1hr

Mechanical and Chemical Plaque Control 1hr

Scheme of Examination - I. Theory: 100 marks

A. Written Paper 70 marks B. Internal assessment 10 marks C. Viva Voce 20 marks

Distribution of Topics and Type of questions

Particulars No. of questions Marks

Long answer 2 x 10 Marks 20

Short answer 10 x 3 Marks 30

MCQ’S (any Topic) 20 x 1 Mark 20

Total 70

Long answer type:

SI. No. Topics

1 Introduction of Community Dentistry

2 Man and Medicine

3 Waste Disposal

4 Public Health - Concept of Health & Diseases

5 Health Education

6 Health Care Delivery System

7 Environment & Health

8 Voluntary Health Organization

9 Social Science & Dentistry


166

10 Health Agencies around the World

11 National Health Programmes

12 Epidemiology - Principles & Methods

13 Research Methodology

14 Dental Auxiliary

15 Public Health - Concept of Health & Diseases

16 Finance in Dentistry

17 Health Education

18 Dental Ethics and Jurisprudence

19 Environment & Health

20 Survey Procedures

21 COPRA

22 Social Science & Dentistry

23 Levels of Prevention

24 Epidemiology of Oral Cancer

25 Epidemiology - Principles & Methods

26 National Oral Health Policy

27 Pit and Fissure Sealants

28 Fluorides

29 School Dental Health Programs

30 Behaviour Management

31 Caries Activity Tests

32 Plaque Control

Short answer type:

SI. No. Topics

1 Introduction of Community Dentistry - Aims, Objectives & Functions

2 Man and Medicine


167

3 Indices for Periodontal Diseases

4 Waste Disposal

5 IDA & DCI

6 Public Health — Concept of Health & Diseases

7 Finance in Dentistry

8 Health care delivery system

9 Voluntary Health Organization

10 Planning & Evaluation

11 COPRA

12 Health Agencies around the World

13 Dentists Act of India

14 National Health Programmes

15 Epidemiology of Malocclusion

16 Occupational Hazards & Infection Control

17 Establishing & Managing Dental Office

18 WHO Oral Health Assesment form

19 Indices for Dental Fluorosis

20 Nutrition in Oral Health and Disease

21 Research Methodology and Biostatistics

22 Pit and Fissure Sealants

23 ART

24 Fluorides

25 Dental Caries Vaccine

26 School Dental Health Programs

27 Child Psychology

28 Behaviour Management

29 Caries Activity Tests


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II. Practicals: Total marks: 100 A. Clinical Exercises 80 marks B. Internal assessment l0 marks C. Record Book l0 marks

Practical Particulars Marks

Case History 30

Index 1 15

Index2 15

Preventive Procedure 10

Health Talk 10

Total 80

Books Recommended & Reference: 1. Dentistry dental practice and Community by David F. Striffler and Brian A.

Burt, Edn, - 1983, W.B. Saunders Company 2. Principles of Dental Public Health by James Morse Dunning, IV Edition,

1986, Harvard University press 3. Dental Public Health and Community Dentistry Ed by Anthony Jong,

Publication by the C.V. Mosby company 1981 4. Community Oral Health — A system approach by Patricia P. Cormier and

Joyce I. Levy published by Appleton-Century- Crofts/New York, 1981 5. Community Dentistry — A problem oriented approach by P.C. Dental Hand

book series Vol. 8 by Stephen L. Silverman and Ames F. Tryon, Series editor —Alvin F. Gardner, PSG Publishing company Inc. Littleton Massachuseltts, 1980

6. Dental Public Health- An introduction to community dentistry, Edited by Geoffrey L. slack and Brain Burt, Published by John Wrigth and sons Bristol, 1980

7. Oral Health Surveys- Basic Methods, edition, 1997, published by WHO Geneva Available at the regional office New Delhi

8. Preventive Medicine and Hygiene — By Maxcy and Rosenau, Published by Appleton century crofts, 1986


169

9. Preventive Dentistry —by J.O. Forrest published by John Wright and sons Bristol, 1980

10. Preventive Dentistry by Murray, 1997

11. Text book of Preventive and social Medicine by Park and Park, 24th edition

12. Essentials of Public Health Dentistry by Dr. Soben Peter, 6th edition

13. Introduction to Bio-statistics by B.K. Mahajan

14. Research methodology and Bio-Statistics

15. Introduction to statistical methods by Grewal


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XIX. PERIODONTOLOGY

Knowledge: • To have adequate knowledge and understanding of the etiology, patho-

physiology, diagnosis & treatment planning of various periodontal problems.

• To have understood the periodontal surgical principles like pre and post surgical management of periodontal diseases.

• Able to identify social, cultural, economic, genetic, environmental factors and their relevance to disease process management in the periodontal problems.

• Essential knowledge of personal hygiene and infection control, prevention of cross infection and safe disposal of hospital waste keeping in view the high prevalence of infectious disease

Skills: • To obtain proper clinical history, examination of the patient, perform diagnostic

procedures and order essential laboratory tests and interpret them and to arrive at a provisional diagnosis about the periodontal condition.

• To perform with competence various periodontal surgical procedures. To treat both surgically and non- surgically the various periodontal diseases.

Attitude: • Periodontal surgical care is to be delivered irrespective of the social status, caste,

creed or religion of the patient.

• Willing to share the knowledge and clinical experience with professional colleagues.

• Willing to adopt new techniques of periodontal surgical management developed from time to time, based on scientific research which is in the best interest of the patient.

• Respect patient right and privileges, including patients right to information and right to seek a second opinion.

• Develop attitude to seek opinion from an allied medical and dental specialists as and when required.


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Communicative Skills and Ability: • Develop adequate communication skills particularly with the patients giving

them the various options available to manage a particular periodontal surgical problem and obtain a true informed consent from them for the most appropriate treatment available at that point of time.

• Develop the ability to communicate with professional colleagues. • Develop ability to teach undergraduates, present seminars and develop

leadership skills.

COURSE OUTCOMES


CO1: Describe the diverse anatomic and microscopic features of the periodontium and the interrelated functional aspects.

CO1: Explain the etio-pathogenesis of periodontal/peri-implant diseases.

CO2: Demonstrate the ability to recognise and diagnose the various forms of

periodontal/peri-implant diseases.

CO3: Apply the appropriate diagnostic technique to diagnose periodontal

diseases.

CO4: Identify, plan and execute non-surgical and surgical periodontal treatment

procedures based on current scientific evidence to treat systemically healthy

and systemically compromised patients.

CO5: Communicate and demonstrate appropriate measures in the prevention of

periodontal diseases.

CO6: Analyse the role of inter-disciplinary approaches in periodontal/peri-implant

therapy.

CO7: Inculcate a sense of social responsibility and capability to deliver

periodontal healthcare to the underprivileged sections of the society


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Teaching hours: Theory 80 hours

SI. No.

Topic

Expected to know

Hours

01 Introduction Definition of Periodontology, Periodontics Periodontia. Brief historical background and Scope of Periodontics

1

02 Normal Periodontium

In detail • Development of Periodontal tissue, • Micro-structural anatomy and biology of

periodontal tissues, • Gingiva, periodontal ligament, Cementum and

alveolar bone

4

03 Defense mechanism in the oral cavity

• Role of Epithelium • Gingival Crevicular fluid • Saliva • Other defense mechanisms in the oral

environment

1

04 Age changes in teeth and Periodontium

Age changes in periodontal structures & their significance in periodontal diseases. Geriatric dentistry

1

05 Classification of Periodontal diseases

• Need for classification • Scientific basis of classification. • Classification of gingival and Periodontal

diseases as described in World Workshop 1999 • Drawbacks of the earlier classification

1

06 Epidemiology of Periodontal disease

• Definition of index, Incidence, Prevalence, endemic, epidemic and pandemic.

• Classification of indices. (Irreversible & reversible)

• Deficiencies of earlier indices used in Periodontics Detailed understanding of Sillness & Loe Plaque index, Loe and S illness gingival index, CPITN & CPI.

• Prevalence of periodontal diseases in India and Other countries. Public Health significance

2


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07 Diagnosis • Routine procedures, methods of probing types

of probes. (According to case history format) • Halitosis- Etiology and treatment. • Advanced Diagnostic Aids

4

08 Periodontal instrumentation

• Classification of periodontal instruments • principles of periodontal instrumentation • Sonic & ultrasonic instrumentation

2

09 Etiology Periodontal diseases

• Dental Plaque (Bioflim) Definition, Types, composition;

• Formation: Bacterial colonization, Growth& maturation,

• Role of dental plaque in Periodontal disease. Plaque microorganisms in detail Bacteria associated with periodontal diseases. Plaque retentive factors, Materia alba, Food debris,

• Disclosing agents. • Calculus: Definition (Types, composition,

attachment, theories of formation) Role of Dental calculus in disease. • Food impaction: Definition, Types, Etiology,

Hirschfelds classification, Signs, symptoms and Treatment.

• Trauma from occlusion-Definition, Types, Histo pathological changes. Role of trauma from occlusion in periodontal disease. Measures of Management, in brief.

• Habits -Their Periodontal significance. Bruxism & parafunctional habits, Tongue thrusting, mouth breathing, lip biting, occupational habits.

• latrogenic factors. Conservative Dentistry- Restorations. Contact point, marginal ridge, surface roughness, overhanging restorations, interface between restoration and teeth. Prosthodontic Interrelationship-Bridges and other prosthesis, Pontics (types),surface contour, relationship of margins to the Periodontium

9


174

(Theories) Gingival protection theory, muscle

action theory, theory of access to oral hygiene. Orthodontics - Interrelation removable appliance, fixed appliance Retention of plaque, bacterial changes.

• Systemic diseases- Diabetes, Sex hormones, Nutrition (Vitamin C & Proteins) AIDS (HIV) and periodontium, Hemorrhagic disease, Leukemia, Clotting factor disorder. Platelet disorders. PMN disorders

10 Host Response • Mechanism of initiation & progression of Periodontal disease,

• Basic concepts of immunology and inflammation, Defense cells, Mast cells, Neutrophils, macrophages, Lymphocytes, Immunoglobulins, complement, Immune Mechanisms and Cytokines in brief.

• Stages in gingivitis - Initial, early established, advanced Periodontal disease activity continuous paradigm, random burst and asynchronous multiple burst hypothesis

4

11 Gingival Diseases

• Localized & generalized gingivitis. Papillary, marginal and diffused gingivitis.

• Etiology, pathogenesis clinical signs, symptomsand management of-Plaque- associated gingivitis. Systemically aggravated gingivitis (Sex hormones, Drugs and systemic diseases) Necrotizing ulcerative gingivitis

• Desquamative gingivitis associated with Lichenplanus, pemphigoid, pemphigus and other Vesiculo-bullous lesions.

• Allergic gingivitis • Infective gingivitis — Herpetic, bacterial and

candidial and pericoronitis. • Gingival enlargement (Classification and

differential diagnosis)

4


175

12 Extension of inflammation from gingiva

• Mechanism of spread of Inflammation from gingival area to deeper periodontal structures.

• Factors that modify the spread

1

13 Periodontal Pocket

Definition, signs & symptoms Classification, Pathogenesis& histopathology, Root surface changes and contents of the pocket.

2

14 Risk Factors • Definition, Risk factors for periodontal diseases,

• Risk assessment, • Genetic & Environmental risk factors

1

15 Periodontitis • Etiology, Histopathology, Clinical signs & symptoms, diagnosis and treatment of Chronic periodontitis

• Periodontal abscess • Classification, Pathogenesis, Differential

diagnosis and treatment of Furcation involvement Glickman‘s Classification, prognosis and management.

• Aggressive Periodontitis associated with Systemic diseases, Refractory periodontitis.

6

16 Prognosis Definition, types, purpose and factors taken into consideration

1

17 Treatment plan Factors to be considered 1

18 Periodontal treatment of medically compromised Patients

• Different systemic conditions and their effects on the periodontium.

• Management of patients with the various systemic diseases/condition

• Periodontal therapy in female patients (Pregnancy, Puberty, Menopause, Hormone replacement therapy, oral contraceptives

2

19 Periodontal therapy

• General principles of periodontal therapy. Phase I, II, III, IV therapy.

• Definition of periodontal regeneration, repair, new attachment, re-attachment. Plaque control a) Mechanical - Tooth brushes, Inter-dental cleansing aids, Dentifrices

6


176

b) Chemical - Classification and Mechanism of

action of each, Pocket irrigation.

20 Pocket eradication

• Scaling and root planing procedures Indications, Aims and Objectives. Armamentarium — and procedure, healing following root planing.

• Curettage and present concepts- Definition, Indication Aims and Objectives Procedures and Healing

• Gingivectomy, Gingivoplasty including crown lengthening procedure-Definition Indication and contra indication Armamentarium, Procedure and healing.

• Flap Surgery Definition of flap; Types of flap (Design of flap— papilla preservation) Pocket eradication, Indications, armamentarium, surgical procedure and healing

6

21 Osseous surgery • Osseous defects in periodontal disease Definition; Classification of osseous defect and surgery. Resective, additive osseous surgery (Osseous grafts, classification of grafts)- healing;

• Other regenerative procedures root conditioning. Guided tissue regeneration.

3

22 Mucogingival surgery

• Definition; Mucogingival problems, • Etiology & Classification of gingival recession

(P.D.Miller Jr. and Sullivan and Atkins) • Indications, Objectives. • Gingival extension procedures lateral pedicle

graft, free gingival graft, frenectomy and frenotomy, Crow lengthening procedures

3

23 Splints Periodontal splints - purpose, classification- principles of splinting

1

24 Hypersensitivity Causes, theories and management 1


177

25 Implants Definition, Types, Scope, biomaterials used.

• Periodontal considerations such as implant- tissue an implant-bone interface.

• Implant failure • Peri-implantitis and management

1

26 Advanced Surgical techniques

Micro Surgery, Electro Surgery, Cryo Surgery, Laser

1

27 Pharmacothe- rapy

• Periodontal dressing • Antibiotic, anti inflammatory drug, local drug

delivery

2

28 Supportive periodontal therapy

• Definition, Rationale. • Patient Classification • Factors affecting Supportive periodontal

therapy• Implant maintenance

1

29 Endo Perio Lesions

• Pulpo periodontal involvement • Routes of Spread of infection • Simons Classification • Management

1

30 Periodontal Medicine

Effect of Periodontal diseases on Cardiovascular system, respiratory System, Diabetes mellitus, Pre-term low birth weight infants etc

2

31 Infection Control Protocol

Sterilization & variuos aseptic procedures 1

32 Ethics 1

33 Advanced treatment Modalities in Periodontal Therapy

Lasers – Physics, types, applications in Periodontics Photodynamic Therapy – Mechanism of action, Photosensitizers, Advantages and Disadvantages, Applications in treatment of Periodontal and Peri-implant therapy.

1

Tutorial (During Clinical Posting) 1. Infection control

2. Periodontal instruments


178

3. Chair position and principles of instrumentation, Maintenance of instruments

4. Diagnosis of periodontal disease and determination of prognosis


179

5. Radiographic interpretation and lab investigation

6. Motivation of patient — oral hygiene instructions

Desirable to Know 1. Histochemistry of periodontal tissues

2. Masticatory apparatus and functions

3. Immunology- current concepts of host response

4. Applied periodontal microbiology

5. Advanced diagnostic techniques

6. Regeneration

Clinical work and case discussion (III BDS & IV BDS Part I)

25 Detailed Case History And Discussion 50 Hours

50 Oral Prophylaxis 75 Hours

Demonstration of all Surgical Procedures 25 Hours

Maintenance Therapy 20 Hours

Total 170 Hours

Scheme of Examination I. Theory: 100 Marks

a. Written Paper : 70 Marks b. Viva Voce: : 20 Marks c. Internal Assessment : 10 marks

II. Practicals: : 100 Marks a. Clinicals (Case history recording and scaling): 80 Marks b. Record : 10 marks c. Internal Assessment: 10 marks

Teaching hours: Theory 80 hours


180

Topic

Expected to know Long answers

Short answers

MCQ

Introduction Definition of Periodontology, Periodontics Periodontia. Brief historical background and Scope of Periodontics

No Yes Yes

Normal In detail Periodontium • Development of Periopdontal tissue, Yes Yes Yes

• Microstructural anatomy and biology of periodontal tissues, • Gingiva , periodontal ligament , Cementum and alveolar bone

Defense mechanism in the oral cavity

• Role of Epithelium • Gingival Crevicular fluid • Saliva • Other defense mechanisms in the oral

environment

Yes Yes Yes

Age changes in teeth and Periodontium

Age changes in periodontal structures & their significance in periodontal diseases. geriatric dentistry

Yes Yes Yes

Classification of Periodontal diseases

• Need for classification • Scientific basis of classification. • Classification of gingival and Periodontal

diseases as described in World Workshop 1999,

• Drawbacks of the earlier classification

No Yes Yes

Epidemiology of Periodontal disease

• Definition of index, Incidence, Prevalence, endemic, epidemic and pandemic.

• Classification of indices. (Irreversible & reversible)

• Deficiencies of earlier indices used in Periodontics Detailed understanding of Sillness&Loe Plaque index, Loe and Sillness gingival index, CPITN & CPI.

• Prevalence of periodontal diseases in India and Other countries. Public Health significance

Yes Yes Yes

Diagnosis • Routine procedures, methods of probing types of probes. (According to case history format)

Yes Yes Yes


181

• Halitosis- Etiology and treatment.

• Advanced Diagnostic Aids

Periodontal instrumentation

• Classification of periodontal instruments • principles of periodontal instrumentation • Sonic & ultrasonic instrumentation

Yes Yes Yes

Etiology of Periodontal diseases

• Dental Plaque (Biofilm) Definition, Types, composition;

• Formation: Bacterial colonization, Growth& maturation,

• Role of dental plaque in Periodontal disease.Plaque microorganisms in detail Bacteria associated with periodontal diseases.Plaque retentive factors, Materia alba, Food debris,

• Disclosing agents. • Calculus: Definition (Types,

composition, attachment, theories of formation) Role of Dental calculus in disease.

• Food impaction: Definition, Types, Etiology, Hirschfelds classification, Signs, symptoms & sequelae Treatment.

• Trauma from occlusion-Definition, Types, Histopathological changes. Role of trauma from occlusion in periodontal disease. Measures of Management, in brief.

• Habits -Their Periodontal significance. Bruxism & parafunctional habits, Tongue thrusting, mouth breathing, lip biting, occupational habits.

• Iatrogenic factors. Conservative Dentistry- Restorations. Contact point, marginal ridge, surface roughness, overhanging restorations, interface between restoration and teeth. Prosthodontic Interrelationship-Bridges and other prosthesis, Pontics (types),surface contour, relationship of margins to the Periodontium (Theories) Gingival protection theory, muscle action theory, theory of access to oral hygiene. Orthodontics - Interrelation

Yes Yes Yes


182

removable appliance, fixed appliance

Retention of plaque, bacterial changes. • Systemic diseases-Diabetes, Sex

hormones, Nutrition (Vitamin C &Proteins) AIDS and periodontium, Hemorrhagic disease, Leukemia, Clotting factor disorder. Platelet disorders. PMN disorders

Host Response • Mechanism of initiation & progression of Periodontal disease,

• Basic concepts of immunology and inflammation, Defense cells, Mast cells, Neutrophils, macrophages, Lymphocytes, Immunoglobulins, complement, Immune Mechanisms and Cytokines in brief.

• Stages in gingivitis - Initial, early established, advanced Periodontal disease activity continuous paradigm, random burst and asynchronous multiple burst hypothesis.

Yes Yes Yes

Gingival Diseases • Localised& generalized gingivitis. Papillary, marginal and diffused gingivitis.

• Etiology, pathogenesis clinical signs, symptoms and management of-Plaque- associated gingivitis. Systemically aggravated gingivitis (Sex hormones, Drugs and systemic diseases) Necrotizing ulcerative gingivitis

• Desquamative gingivitis associated with Lichen planus, pemphigoid, pemphigus and other Vesiculobullous lesions.

• Allergic gingivitis • Infective gingivitis — Herpetic, bacterial

and candidial and pericoronitis. • Gingival enlargement (Classification and

differential diagnosis)

Yes Yes Yes

Extension of inflammation from gingiva

• Mechanism of spread of Inflammation from gingival area to deeper periodontal structures.

• Factors that modify the spread

No Yes Yes


183

Periodontal Pocket Definition, signs & symptoms

Classification, Pathogenesis& histopathology, Root surface changes and contents of the pocket.

Yes Yes Yes

Risk Factors • Definition, Risk factors for periodontal diseases,

• Risk assessment, • Genetic & Environmental risk factors

Yes Yes Yes

Periodontitis • Etiology, Histopathology, Clinical signs & symptoms, diagnosis and treatment of Chronic periodontitis

• Periodontal abscess • Classification, Pathogenesis, Differential

diagnosis and treatment of Furcation involvement- Glickman’s Classification, prognosis and management.

• Aggressive Periodontitis associated with Systemic diseases, Refractory periodontitis.

Yes Yes Yes

Prognosis Definition, types, purpose and factors taken into consideration

Yes Yes Yes

Treatment plan Factors to be considered No Yes Yes

Periodontal treatment of medically compromised Patients

• Different systemic conditions and their effects on the periodontium.

• Management of patients with the various systemic diseases/condition

• Periodontal therapy in female patients (Pregnancy, Puberty, Menopause, Hormone replacement therapy, oral contraceptives

Yes

Yes

Yes

Periodontaltherapy • General principles of periodontal therapy. Phase I, II III, IV therapy.

• Definition of periodontal regeneration, repair, new attachment, reattachment. Plaque control • Mechanical - Tooth brushes, Inter-

dental cleansing aids, Dentifrices • b) Chemical - Classification and

Mechanism of action of each, Pocket irrigation.

Yes

Yes

Yes


184

Pocket eradication • Scaling and root planing procedures

Indications, Aims and Objectives. Armamentarium - and procedurehealing following root planing.

• Curettage and present concepts- Definition, Indication Aims and Objectives Procedures and Healing

• Gingivectomy / Gingivoplasty including crown lengthening procedure-Definition Indication and contra indication Armamentarium, Procedure and healing.

• Flap Surgery Definition of flap; Types of flap (Design of flap— papilla preservation) Pocket eradication, Indications, armamentarium, surgical procedure and healing

Yes

Yes

Yes

Osseous surgery • Osseous defects in periodontal disease Definition; Classification of osseous defect and surgery. Resective, additive osseous surgery (Osseous grafts, classification of grafts)-healing;

• Other regenerative procedures root conditioning. Guided tissue regeneration.

Yes

Yes

Yes

Mucogingival surgery

• Definition; Mucogingival problems, • Etiology & Classification of gingival

recession (P.D.Miller Jr. and Sullivan and Atkins)

• Indications, Objectives. • Gingival extension procedures lateral

pedicle graft, free gingival graft, frenectomy and frenotomy, Crown lengthening procedures

Yes

Yes

Yes

Splints Periodontal splints - purpose, classification- principles of splinting

No

Yes

Yes

Hyper sensitivity Causes, theories and management No Yes Yes

Implants • Definition, Types, Scope, biomaterials used.

Yes

Yes


185

• Periodontal considerations such as

implant-tissue and implant-bone interface.

• Implant failure • Peri-implantitis and management

Advanced Surgical techniques

Micro Surgery, Electro Surgery, Cryo Surgery, Laser

Yes

Yes

Yes

Pharmacotherapy • Periodntal dressing • Antibiotic, anti inlmmatory drug, local

drug delivery

Yes

Yes

Yes

Supportive periodontal therapy

• Definition, Rationale. • Patient Classification • Factors affecting Supportive periodontal

therapy • Implant maintenance

Yes

Yes

Yes

Endo Perio Lesions • Pulpo periodontal involvement • Routes of Spread of infection • Simons Classification • Management

Yes

Yes

Yes

Periodontal Medicine

Effect of Periodontal diseases on Cardiovascular system, respiratory System, Diabetes mellitus, Pre-term low birth weight infants etc

Yes

Yes

Yes

Infection ContProtocol

Sterilization & variuos aseptic procedures Yes

Yes

Yes

Ethics No Yes Yes

Lasers Laser physics, types, applications in periodontics


186

Topics Type of Questions and

Marks

Total Marks

Gingiva, Periodontal ligament, Role of Occlusion and Periodontal Heath; Trauma from occlusion, Dental plaque & Calculus, Acute infections of Gingiva, Advanced diagnostic Aids, Prognosis & treatment plan, Periodontal Pockets, Classification of Periodontal Diseases , Diagnosis & Prognosis, Surgical Periodontal Therapy Gingivoplasty, Gingivectomy, Flap Surgeries, Resective& Regenerative Osseous surgery, Mucogingival surgery, Antibiotics and Anti- inflammatory Drugs.

Long answer 2 X 10 marks

20

Cementum , Alveolar Bone, Defense Mechanisms of Gingiva, Classification of Periodontal Disease, Plaque and its Hypothesis, Calculus , Plaque Control, Altered Leucocyte Function, Acute Necrotizing Ulcerative Gingivitis , Habits, AIDS and Periodontium, Mechanism of spread of infection , Gingival and Periodontal indices Furcation involvement , Gingival recession , Antibiotics

in Periodontics, Host response , Rationale of periodontal Therapy , Implants, , Supportive Periodontal Therapy

Short answer 10 X 3 marks

30

Questions may be asked from all topics (MCQ) 20X1 mark 20 Total 70

Distribution of Topics and Type of questions :

Recommended Books

SI. No

Author

Title

Edition

Publisher

Year of Publication

1 Standard Book

Clinical Periodontology

11th

SB Saunders Company

2011 Carranza and Newman

Reference Books

1 Carranza and Newman

Clinical Periodontology

10th SB Saunders Company

2007


187

2 Jan Lindhe,

T.Karring, N.P. Lang Clinical

Periodontology & Implant Dentistry

5th Munksgaurd Copenhagen

1997

3 Varma & Nayak R P Current Concept in

Periodontology

2nd Arya Publications

4 Dilip Nayak, Ashita Upoor, Mahesh CP

Text Book of Periodontology & Implantology

1st Elsevier 2010


188

XX. PROSTHODONTICS, CROWN & BRIDGE

COURSE OUTCOMES

At the end of the course, students will be able to... CO1: Apply basic and systemic medical sciences on human anatomy,

embryology, histology, applied in general and particularly to head and neck,

Physiology & Biochemistry, Pathology and Microbiology, virology, health

and diseases of various systems of the body (systemic)

CO2: Apply basic and systemic medical sciences in surgery and medicine,

pharmacology, nutrition, behavioral science, age changes, genetics,

Immunology

CO3: Apply basic and systemic medical sciences in Congenital defects and

syndrome and Anthropology, Bioengineering, Bio-medical and Biological

Principle and applications to Dental material science

CO4: Diagnose and plan treatment for patients requiring a Prosthodontic therapy

CO5: Interpret a radiograph and other investigations for the purpose of diagnosis

and treatment plan

CO6: Evaluate Tooth and tooth surface restorations, Complete Denture

Prosthodontics, Removable partial denture Prosthodontics, Fixed

Prosthodontics and maxillofacial and Craniofacial Prosthodontics, Implants

and implant supported Prosthodontics, T.M.J, and Occlusion. Craniofacial

esthetic, and biomaterials, craniofacial disorders, problems of psychogenic

origin

CO7: Revise on ethics, laws and Jurisprudence and forensic odontology in

Prosthodontics

CO8: Evaluate General health conditions and emergency as related to

Prosthodontics treatment


189

CO9: Identify social, cultural, economic, environmental, educational and

emotional determinants of the patient and consider them in planning the

treatment

CO10: Identify cases, which are outside the area of his specialty/ competence and

refer them to appropriate specialists.

CO11: Analyse regarding case management involving surgical, interim treatment

etc

CO12: Acquire essential knowledge of personal hygiene, infection control,

prevention of cross infection and safe disposal of waste, keeping in view

the risks of transmission of Hepatitis and HIV

CO13: Examine the patients requiring Prosthodontics therapy, investigate the

patient systemically, analyze the investigation results, radiography,

diagnose the ailment, plan a treatment, communicate it with the patient and

execute it.

CO14: Restore lost functions of Stomatognathic system namely mastication,

speech, appearance and psychological comforts, by understanding

biological, biomedical, bioengineering principles and systemic condition of

the patient to provide a quality health care of the craniofacial region

CO15: Interact with other specialty including medical specialty for a planned team

management of patients for a craniofacial and oral acquired and congenital

defects, Temporomandibular joint syndromes, esthetics, Implant supported

Prosthetics and problems of Psychogenic origin

CO16: Perform clinical and Laboratory procedure with an understanding of

biomaterials, tissue conditions related to the prosthesis and have competent

dexterity and skill for performing clinical and laboratory procedures in

fixed, removable, implant, maxillofacial, TMJ and esthetics Prosthodontics

CO17: Perform Laboratory technique management based on skills and knowledge

of Dental Materials and dental equipment and instrument management


190

CO18: Adopt new methods and techniques in prosthodontics from time to time

based on scientific research, which is in patient's best interest.

CO19: Respect patient's rights and privileges including patients right to information

and right to seek the second opinion

CO20: Develop communication skills, in particular, to explain treatment option

available in management

CO21: Communicate in simple understandable language with the patient and

explain the principles of Prosthodontics to the patient. He should be able to

guide and counsel the patient with regard to various treatment modalities

available

CO22: Develop the ability to communicate with professional colleagues through

various media like Internet, e-mail, video conference, and etc. to render the

best possible treatment

It is suggested that the mentioned topics be dealt with whatever appropriate in the following order so as to cover —

1. Definition 2. Diagnosis [the particular situation, patient selection, treatment planning] 3. Types/classification 4. Materials 5. Methodology — lab/clinical 6. Advantages & disadvantages 7. Indications & contraindications 8. Maintenance phase


191

Theory -110 Hours [III BDS -30 Hours, IVBDS Part I 20hrs; IV BDS Part II- 60 hrs] Complete Denture Prosthesis

SI. No.

Topics

Hours

1 Biomechanics of the edentulous state • Mechanism of tooth support • Mechanism of complete denture support • Masticatory load • Mucosal support • Residual ridge • Psychological effects on retention • Functional and para-functional considerations • Occlusion • Functions — mastication & swallowing • Mandibular movements • Distribution of stresses to the denture supporting tissues • Changes on the morphological face height and the TMJ — face

height centric relation • TMJ changes • Individual behavioural or adaptive response — cosmetic

changes, dietary changes, adaptive & psychological changes, adaptive potential of the patient

2

2 Tissue response to complete denture prosthesis • Soft tissue changes; Soft tissue hyperplasia • Denture stomatitis; Treatment of denture stomatitis; Denture sore

1

3 Effects of aging • Oral changes • Mucosa and skin • Residual bone and the maxillo-mandibular relation • Disuse atrophy; Degenerative changes • Changes in the size of the basal seat • Tongue and taste • Salivary flow and nutritional impairment • Dietary problems • Psychological changes

1

4 Preparing the patient for complete denture prosthesis 1


192

5 Diagnosis & treatment planning for patient with some teeth

remaining • Diagnostic procedures • History and records • Immediate complaints • Systemic evaluation • TMJ disorders • Intra-oral examination • Diagnostic cast • Inter-arch space problems • Radiographs & other investigations • Treatment plan - deciding whether to extract the remaining

teeth, pre extraction record

1

6 Diagnosis of patient with no remaining teeth • Examination charts and records • General observations affecting diagnosis - age, sex, occupation,

ethnic, general health and nutrition, social training, patient complaints, gait, lip support, lip thickness, lip length, lip fullness, profile and contour of features, tone of the facial tissues, vertical face height

• Radiographic examination - advantages of radiographic examination, and intra oral examination - color, resiliency and attachments of the mucosa, abrasions and ulcers, pathoses, maxillary basal seat, torus palatines, mandibular basal seat, arch size, ridge form, ridge relations , arch shape, sagittal profile of the residual ridge, shape of the palatal vault, relation of the hard and soft palate, muscular development, saliva, cheeks and lips, muscle tonus, muscular control, jaw movements, tongue size and position, throat form, gagging

• Mental attitude and classification - House classification, application of House’s classification

1

7 Development of treatment plan • Communication with the patient - nutrition care, nutritional

needs and status of the elderly, impact of wearing dentures on dietary intake, calcium and bone health, vitamin supplementation, nutrition counseling

1

8 Identification and management of the patient with problems 1


193

9 Improving the patient’s denture foundation and ridge relations

• Pre-operative examination • Initial hard tissue and soft tissue procedure • Secondary hard tissue and soft tissue procedure • Non surgical methods • Surgical methods • Congenital deformities • Post operative procedure

10 Articulators • Articulators based on the theory of occlusion • Articulators based on the type of record used for their

adjustments • Selection of articulators for complete dentures

1

11 Principles of retention, support and stability 1

12 Impressions • Muscles of facial expression • Biological considerations for maxillary and mandibular

impression including anatomic landmarks and their interpretation

• Objectives of impression making • Impression materials and Impression techniques • Maxillary and mandibular impression procedures — preliminary

and final impressions • Laboratory steps involved with impression making [beading,

boxing and cast preparation]

2

13 Record bases and occlusion rims • Materials and techniques • Useful guidelines and ideal parameters • Recording and transferring bases and occlusion rims

1

14 Biological consideration in jaw relation and jaw movements - craniomandibular relations • Mandibular movements • Maxillo-mandibular relation including vertical and horizontal

jaw relations; Concept of occlusion

1

15 Relating the patient to the articulator • Face bow- types and uses • Face bow transfer procedure

1


194

16 Recording maxillomandibular relation

• Vertical relation • Centric relation records • Eccentric relation records • Lateral relation records

1

17 Tooth selection and arrangement • Anterior teeth • Posterior teeth • Esthetic and functional harmony

1

18 Relating inclination of the teeth to concept of occlusion • Neutrocentric concept • Balanced occlusal concept

1

19 Trial dentures 1

20 Laboratory procedures • Wax contouring • Investing of dentures • Preparation of mould • Preparing and packing acrylic resin • Processing of dentures • Recovery of dentures • Lab remount procedures • Finishing and polishing the complete dentures • Plaster cast for clinical denture remount procedure

1

21 Denture insertion • Insertion procedures • Clinical errors • Correcting occlusal disharmony • Selective grinding procedures

1

22 Treating problems associated with denture use 1

23 Treating abused tissues 1

24 Relining and rebasing of dentures • Treatment rationale • Diagnosis • Clinical procedure

1


195

25 Immediate complete denture construction procedure

• Indications & contraindications • Delayed and transitional dentures • Treatment planning • Clinical procedures • Subsequent service for immediate dentures

1

26 The single complete denture • Maxillary single dentures • Clinical and laboratory procedure • Subsequent problems with single dentures against natural teeth • Mandibular single dentures • Supplemental prosthodontic procedures for the edentulous

patient

1

27 Overdenture • Indications & contraindications • Selection of abutment teeth • Clinical procedures

1

28 Dental implants in complete denture • Maladaptive denture behaviour • Use of dental implants • Patient considerations • Tissue integration in the edentulous patient

1

Note: 3rd Year - Complete Denture Topics to be covered. 4th Year Part I - Basics of FPD/RPD Topics to be covered. 4th Year Part II - Remaining FPD/RPD Topics; Maxillofacial Prosthodontics, Oral Implantalogy and Esthetics topics to be covered. Removable Partial Denture Prosthesis

SI. No.

Topics

Hours

1 Introduction and scope 1

2 Classification 1

3 Examination, diagnosis and treatment planning 1

4 Components of removable partial denture • Major connectors - Maxillary & Mandibular major connectors

1


196

5 Minor connectors

• Functions; Form and location • Tissue stops

1

6 Rests and rest seats • Interproximal occlusal rest seats • Internal rest seats • Incisal rests and rest seats • Lingual rests on canines and incisors • Possible movements of partial denture • Support for rests

1

7 Direct retainers • Internal attachments • Extra-coronal direct retainers • Relative uniformity of retention • Criteria for selecting a given clasp design • Basic principles of clasp design • Designs of clasp

1

8 Indirect retainers • Denture rotation about an axis • Factors influencing effectiveness of indirect retainers • Auxiliary functions of indirect retainers • Forms of indirect retainers • Auxiliary occlusal rests • Canine rests • Continuous bar retainers and linguo-plates • Modification areas • Rugae support • Denture base considerations • Tooth supported partial denture base

1

9 Distal extension partial denture base • Functions of denture bases • Methods of attaching denture bases • Ideal denture base material • Advantages of metal bases • Need for relining

1


197

10 Stress breakers

• Types of stress breakers • Advantages and disadvantages of stress breakers • Advantages and disadvantages of rigid design • Stress breaking principles

1

11 Principles of removable partial denture design • Biomechanical considerations • Factors influencing design • Essentials of partial denture design • Components of partial denture design

1

12 Surveying • Description of dental surveyor • Purposes of a surveyor • Factors that determine path of placement and removal • Surveying of diagnostic cast • Recording relation of cast to surveyor • Surveying of master cast • Measuring retention and balancing of retention • Influence of survey line in designing of clasps • Blocking out the master cast

1

13 Mouth preparation and master cast 1

14 Impression materials and procedures for removable partial dentures • Rigid materials, Thermoplastic materials, elastic materials • Individual impression trays • Support for the distal extension denture base • Factors influencing the support of distal extension base • Methods for obtaining functional support for distal extension

base

1

15 Preliminary jaw relation and esthetic try in for some anterior replacement teeth

1

16 Laboratory procedures for framework construction 1

17 Fitting the framework 1

18 Completion of the partial denture 1

19 Try in of the partial denture 1

20 Completion of the partial denture 1


198

21 Inserting the removable partial denture 1

22 Post insertion observations 1

23 Temporary acrylic partial dentures • Appearance • Space maintenance • Reestablishing occiusal relationships • Conditioning teeth and residual ridge • Conditioning the patient for wearing a prosthesis

1

24 Immediate removable partial denture 1

25 Removable partial dentures opposing complete dentures 1

26 Repair and additions to removable partial denture • Broken clasp arms • Fractured occlusal rests • Distortion or breakage of other components • Loss of teeth not involved in the support or retention of the

restoration • Other types of repair • Repair by soldering

1

27 Removable partial denture considerations in maxillofacial • Prosthodontics • Maxillofacial Prosthodontics • Intraoral prosthesis design considerations • Maxillary prosthesis • Mandibular prosthesis • Treatment planning • Framework design • Class I resections • Class II resections • Mandibular flange prosthesis

2

Fixed Partial Denture Prosthodontics

Sl.No Topics Hrs

1 Introduction, definitions, contraindications

terminologies, indications and 1

2 Examination, diagnosis, treatment planning and radiological interpretations

1


199

3 Fundamentals of occlusion 1

4 Treatment planning for single tooth restoration 1

5 Treatment planning for the replacement of missing teeth 1

6 Selection and choice of abutment teeth 1

7 Fixed partial denture configuration 1

8 Biomechanical principles of tooth preparation • Preservation of tooth structure • Retention and resistance form • Structural durability of the restoration • Marginal integrity • Preservation of the Periodontium

2

9 Preparation for full veneer crowns • All ceramic crowns • Porcelain fused to metal crowns & Metal crowns

2

10 Preparation for partial veneer crowns • Posterior and anterior three quarters crown • Pin modified three quarter crown • Seven eight crown • Proximal half crowns • Inlay • MOD on-lay

2

11 Preparation modification for extensively damaged teeth 1

12 Endodontically treated teeth 1

13 Fluid control and soft tissue management 1

14 Demonstration and Hands on practicals in soft tissue management of gingival retraction

1

15 Demonsration and Hands on practicals in making of fixed partial denture impressions using elastomeric impression materials

1

16 Demonstration and Hands on practicals on making Provisional restorations

1

17 Demonstration of die preparations 1

18 Wax patterns 1

19 Pontics and edentulous ridges 1

20 Esthetic considerations 1


200

21 Finishing and cementation 1


201

22 Miscellaneous

• Solder joints and other connectors • Preparations for intra-coronal restorations • Preparations for periodontally weakened teeth • The functionally generated path technique • Investing and casting • Resin bonded fixed partial denture • Demonstration and use of CAD/CAM technology in fixed partial

denture

3

Recommended books: 1. Prosthodontic treatment of edentulous patients. Zarb 12th edition

2. Syllabus of complete denture. Heartwell 4th edition

3. Essentials of Complete Denture Prosthodontics. Sheldon Winkler. 2nd Edition.

4. Complete denture prosthetics. Sharry

5. Complete denture. Grant. Heath. Mc Cord

6. Contemporary fixed Prosthodontics. Rosenstiel. 3rd edition

7. Fundamentals of tooth preparation. Shillingburg. 1st edition

8. Theory and practice of fixed Prosthodontics. Tylman 8th edition

9. Modern practice in fixed Prosthodontics. Johnston

10. Fundamentals of fixed Prosthodontics. Shillingburg. 3rd edition

11. Dental crowns and bridges: design and preparation. Bernard G Smith

12. A clinical handbook inlays, crowns and bridges. George F Kantorowicz

13. Mc Crackens removable partial prosthodontics. Mc Giveney Glen P

14. Clinical removable partial prothodontics. Stewart 2nd edition

15. Removable denture prosthodontics. AA Grant, W Johnson, 2nd edition

16. Maxillofacial Prosthodontics. William R. Laney

17. Maxillofacial Prosthodontics. Beumer


202

Esthetic Dentistry

Sl.No Topics Hrs

1 Introduction and scope of aesthetic dentistry 1

2 Anatomy and physiology of smile 1

3 Role of color in aesthetic dentistry 1

4 Simple procedures [rounding of central incisors] 1

5 Bleaching of teeth 1

6 Veneers with various materials 1

7 Preventive and interceptive aesthetics 1

8 Ceramics 2

9 Simple gingival contouring to enhance appearance 1

Recommended books: 1. Esthetic guidelines for restorative dentistry; Scharer & others

2. Esthetics of anterior fixed Prosthodontics; Chiche GJ] & Pinault Alain

3. Esthetic & the treatment of facial form, Vol 28; Mc Namara JA

Oral Implantology

SI. No.

Topics

Hours

1 History of implants, their design and characteristics & osseointegration

1

2 Scope of oral & maxillofacial implantology, terminologies 1

3 A brief introduction to various implant systems in practice 1

4 Bone biology, morphology, classification of bone and its relevance to implant treatment and bone augmentation materials

1

5 Soft tissue considerations in implant dentistry 1


203

6 Diagnosis and treatment planning in implant dentistry 1

7 Pre- surgical preparation of patient 1

8 Demonstration of implant placement in styloform jaws 1

9 First stage surgery — maxilla and mandible 1

10 Healing period and second stage surgery 1

11 Management of surgical complications and failures 1

12 General considerations in Prosthodontic reconstruction & biomechanics

1

13 Prosthodontic components 1

14 Impression procedures and preparation of master cast 1

15 Jaw relation records and construction of supra-structure with special emphasis on occlusion for osseo-integrated prosthesis

1

16 Management of Prosthodontic complications and failures 1

17 Recall and maintenance phase 1

Recommended books: 1. Contemporary implant dentistry. Carl Misch

2. Osseo-integration and occlusal rehabilitation. Hobo S, Ichida E, Garcia LT

3. Tissue integrated prosthesis. Branemark

Clinical Programs: 370 Hours [III BDS-80 Hours, IV BDS part I- 70 Hours, IV BDS part II 220 Hours] 1. Treatment for completely edentulous patients

III year - 1 IV year Part I - 1 IV year Part II - 2

2. Treatment for partially edentulous patients III year - provisional RPD -1 IV year Part I - RPD-1 IV year Part II - RPD -2


204

3. FPD - Teeth preparations to receive various types of crowns on Typhodont Teeth (10)

4. Relining, rebasing, repair — one each

5. Immediate denture -1; single denture -1

6. Obturator - I (On Model)

7. Demonstration of clinical and laboratory procedures for maxillofacial prosthesis and osseo integrated- supported prosthesis

Scheme of Examination: I. Theory - 100 Marks

• Written Paper : 70 Marks • Internal Assessment : 10 Marks • Viva Voce

II. Practicals : 100 Marks

: 20 Marks

• Clinicals : 90 marks • Internal Assessment : 10 Marks

Distribution of topics and type of questions

Topic Type of Questions and Marks

Marks

One question from Complete Denture, one question from Removable Partial Denture/ Fixed Partial Denture

Long answer 2x10 Marks

20

3 questions from CD, 3 From RPD, 2from FPD, 2 from MFP/Esthetics/Implants

Short answer 10x3 Marks

30

MCQs - 8 from CD, 4 from RPD, 4 from FPD, 4 from MFP/Esthetics/Implants

MCQs 20x1 Mark

20

Total 70

II. Clinical Examination - 100 marks A. Practical / Clinicals: 90 Marks B. Internal assessment :10 marks

Exercise No 1: Marks: 10


205

Clinical Case as Spotters - 5 nos. Clinical patients treated with prostheses — complete denture, removable partial denture, fixed partial denture & maxillofacial prosthesis will be kept as spotters. The candidate will pick the lot and examine the patient for a given problem of the patient. The candidate shall examine the patient and identity the problem and treatment plan and methods. Evaluate all diagnosis of the problem and give the treatment plan Diagnosis - 5 marks and Treatment plan -5 marks

Exercise No 2: Marks: 40 Final impression for an edentulous patient — maxillary / mandibular Diagnosis and Treatment Plan — 10 marks Peripheral moulding — 15 marks Impression — 15 marks

Exercise No 3: Marks: 20 Preparation of the tooth to receive all porcelain or metal ceramic crown [on 11 or 21 on typhodont]

Exercise No 4: Marks: 10 Designing on the master cast for an RPD framework (preferably any one of Kennedy’s Classification with Modification) Record Book - Marks: 10


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XXI. CONSERVATIVE DENTISTRY AND ENDODONTICS

Aims and Objectives: The Dental Graduates during training should acquire adequate knowledge necessary skills and attitudes which are required for carrying out all the activities appropriate to dental practice involving the prevention diagnosis and treatment of anomalies and diseases of the teeth, mouth, jaws and associated tissues.

Essential Knowledge Conservative Dentistry and Endodontics covers basic knowledge of all restorative materials and materials associated with Endodontics. It is also recognized that the area of conservative dentistry includes knowledge of dental caries and treatment modalities associated with management of dental caries. Basic and advanced knowledge of non-carious lesions of mineralized tissues and of carious lesions is essential. Basic and advanced knowledge of biological basis of endodontics and management of all endodontic situations, which includes all aspect of diagnosis, treatment planning and treatment modalities are also mandatory. An individual specializing in the restorative dentistry should also have knowledge of allied specialities like Periodontics/ Pedodontics & Preventive Dentistry.

Skills Take proper chair side history, examine the patient and perform essential medical and dental diagnostic procedures and order as well as perform relevant test and interpret them to come to a reasonable diagnosis about the dental conditions in general and conservative dentistry, Endodontics in particular and undertake complete patient monitoring including pre-operative care of the patient. • Perform all levels of restorative work and surgical & non-surgical Endodontics

including Endodontics endosseous implants, as well as EndodonticPeriodontal surgical procedures as a part of multi disciplinary approach to clinical situation.

• Provide basic life saving support services in emergency situations. • Manage acute pulpal & periodontal situations and emergency procedures. • Have a thorough knowledge of Infection Control Measures in dental clinical

environment and laboratories. • Human Values — Ethical practice and communication abilities • Adopt ethical principles in all aspect of restorative and contemporary

Endodontics including non-surgical and surgical Endodontics. • Professional honesty and integrity should be the top priority.


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• Dental care has to be provided regardless of social status, caste, creed, or religion of the patient.

• Develop communication skills in particular, the skill to explain various options available in management and to obtain a true informed consent from the patient.

• Apply high moral and ethical standards while carrying or animal research.

COURSE OUTCOMES


CO1: Acquire adequate knowledge, necessary skill and attitude to carry out dental

practice involving prevention, diagnosis and treatment of anomalies and

diseases of teeth and associated hard and soft tissues

CO2: Apply basic knowledge of anatomy, physiology and biomechanical

properties of teeth, biomaterials and associated tissues for effective practice

of Dentistry

CO3: Demonstrate understanding of the etiology, pathophysiology and clinical

manifestation of diseases of the teeth and adjacent hard and soft tissues.

CO4: Acquire basic knowledge of etiology, biology, prevention, interception and

management of carious and noncarious lesion of teeth.

CO5: Choose various methods to identify the disease process at different stages

and determine the treatment modalities.

CO6: Plan and administer caries prevention, interception and treatment modalities

CO7: Understanding of the etiology, pathophysiology and clinical manifestation

of diseases of the teeth and adjacent hard and soft tissues

CO8: Define and classify diseases of teeth and adjacent tissues and plan out the

treatment preferences

CO9: Communicate effectively and sensitively with patients and public to bring

about satisfaction and trust

CO10: Identify and manage common anomalies of shape, size and number of teeth


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CO11: Perform and interpret basic diagnostic procedures for teeth and perioral

tissues

CO12: Demonstrate basic knowledge of the biological basis of Endodontics and

management of various Endodontic situations including diagnosis,

treatment planning and treatment modalities

CO13: Identify and refer patients requiring specialist care

CO14: Perform basic diagnostic procedure for caries assessment, prevention and

treatment with the knowledge of physiological systems.

CO15: Analyze occlusion, factors affecting and physiology of occlusion with

emphasis on trauma from occlusion and occlusal correction.

Distribution of Teaching hours

Year

Lecture hours

Practical Hours

Total Hours

I BDS Pre-clinical conservative 5 50 55

II BDS Pre-clinical conservative 20 150 170

III BDS 30 80 110

IV BDS Part I 20 80 100

IV BDS Part II 60 220 280

Total 135 580 715


209

Allotment of Theory Topics for III BDS

SI. No.

Topics

Hours

1 Clinical Operative Dentistry &Endodontics:- Introduction, Definition, Scope Diagnosis, Case Selection & Treatment Planning Case History & Patient assessment Diagnosis: Definition, Aim, and Types: Differential, Provisional & Final Diagnosis; Diagnostic Investigations: a) Clinical investigations: Objective & Subjective b) Radiographic Investigations: Indication, Types (IOPA,

Bitewing, & OPG), Radiographic Techniques(Paralleling, Bisecting Angle,

Clarks Rule), RVG(Radio-Visuo-Graphy) Diagnosis Of Dental Caries: Methods & Aids- Caries Detector Dyes Pulpal Diagnostic tests: a) Pulp Sensitivity Tests: Thermal tests: Hot & Cold Tests; their

limitations Electric Pulp Test(EPT): Interpretation of Results b) Pulp Vitality Tests: Pulse Oximetry & Laser Doppler Flowmetry

Other tests: Test Cavity , Trans Illumination Diagnosis of Emergencies:- Restorative & Endodontic Treatment Planning: Phases Informed Consent, Record Keeping, Medico Legal Considerations

4

2 Biological Considerations in Operative Dentistry: Dentin-Pulp Complex Dental Pulp Biology: Development, Components, Physiology - Pulpal reaction / response to various materials and procedures. - Age Related Changes: Degeneration, Calcification Diseases of The Pulp: Causes, Differential Diagnosis, Management & prevention

- Pulpitis: Acute/Chronic; Reversible! Irreversible, Dentin: Development, Composition, Microstructure, Properties, Function Types- Primary Secondary, Tertiary/Reparative, Reactionary, Sclerotic

3


210

3 Discoloration of teeth

- Etiology, Types / classification Management : Laminate Veneers, Bleaching (Vital & Non-vital ) & Crowns Tooth Whitening modalities Vital : Night Guard vital bleaching (NGVB) Non-vital: Walking bleach, superoxol, Carbamide Peroxide In-office bleaching /Power bleaching

2

4 Pulp Therapy: Vital Pulp Therapy & Non-Vital Pulp therapy: Definition, Description & Classification Pulp Capping: Definition, Types: Direct & Indirect Indication, Contraindications, Limitations Factors Affecting Pulp Capping, Case Selection - Infected & Affected Dentin - Pulpotomy Vs Pulpectomy - Apexogenesis Vs Apexification Pulp Capping Agents: Calcium Hydroxide: Material / Technical & Clinical Considerations Zinc Oxide Eugenol, MTA & Other Pulp Capping Agents

3

5 Dentin Sensitivity & Hypersensitivity: - Theories, Etio-Pathology, Management & Prevention - Hydrodynamic Theory (Short Note) - Management of oro-facial pain in endodontics

3

6 Infection Control — as related to Conservative Dentistry & Endodontics - Introduction, Principles of Cross Infection Control, - Infectious disease Of Concern-HIV, HBV, TB etc - Classification Of Infection Control Techniques - Sterilization Vs Disinfection: Terminology & Definition Methods of Disinfection: For Operatory, Equipments & Materials Methods of Sterilization of instruments, Equipments & Materials. - Moist Heat Sterilization: Autoclaves

3


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- Chair-side Sterilizers: Hot Glass Bead Salt Sterilizer

- Chemical Agents: Gluteraldehyde - Gas Sterilization: Ethylene Oxide - Personal Protective barriers Waste Management: Infectious & Toxic Wastes; Incineration, Dental Unit Water Lines Contact Dermatitis For Dental materials; Latex Allergy- Glove, Rubber Dam .Mercury Toxicity: Forms of Mercury, Mercury Toxicity, - Hygiene Recommendations For - Usage, Storage & Disposal

7 Glass lonomer Cement Based Restoratives Technical Aspects: Dispensing & Manipulation, Matrices, Surface Protection, Finishing & Polishing procedures - Sandwich (Bilayered Restoration): Material & Technique - Modified Glass Ionomers: i) Metal modified Glass ionorner: Miracle Mix, Cermet ii) Light Cured Glass Jonomer: Material & Technical Aspects iii) Resin Modified Glass ionomer (RMGIC) iv) Compomer (PMCR -Polyacid Modified Composite Resins) Recent Advances & Newer Modifications in Glass lonomer Cements Type IX & Type VII

2

8 Adhesive Dentistry & Esthetic Tooth Colored Restoratives: Introduction:- Terminology: Adhesion & Cohesion: Definition & Types, Esthetics: Definition, Principles, Golden proportion Properties - Indication & Contraindication; Advantages & Disadvantages Limitations & Drawbacks Pre Operative Considerations: Isolation (Rubber Dam) - Shade Selection: Color matching, - Surface Pretreatment (Etching & Bonding)

4


212

Acid Etching: Definition, Purpose, Material & Techniques Used

Etching Patterns , Etching Vs Conditioning (For GIC) Bonding Agents: Enamel / Dentin Bonding systems - Brief History Of Development, Classification Material &

Technical Aspects - Recent Advances & Newer Bonding Systems. Eg; Self Etching

Primers Smear Layer: Definition, Description, Components & Clinical Significance Micro leakage: Definition, Causes, Methods to study/detect Micro leakage Composite Resin Systems:Definition , Brief History Of Development, Material Aspects: Composition (Initiators, Activators, Photo-initiators) Fillers in Composite Resins: Type, Particle Size Properties: Abrasion/wear Resistance, Strength, Polymerization Shrinkage, Biocompatibility Posterior Composites: Material Aspects Recent Advances & Newer Composites - Packable , Micro-filled, Nano filled

9 Gingival Tissue Management in Operative Dentistry: - Indication, Methods & Materials - Gingival Retraction Cords, - Merocel, Expasyl

2

10 Revision classes 6

III B.D.S. Clinical / Practical Work

Work to be done Minimum

I. Case history records 5

II. Deep caries management exercise : Pulp capping 20

III. Amalgam restorations a) Class I and Class II (including Buccal & lingual extension)

20 Class I and 5 Class II


213

Allotment of Theory Topics for IV BDS

SI. No.

Topics

Hours

1 Endodontics Definition, Aim & Scope of Endodontics

1

2 3

Magnification and Illumination Application of rubber dam in Dentistry Course Outcome 1) Knowledge by taking Lecture Definition Advantages of magnification and Illumination Anatomy of Loupes Uses of Loupes Misconception of Magnification Ergonomics Rubber Dam Isolation Advantages of isolation with rubber dam Parts of rubber dam 2) Skill Development Preclinical demonstration of use of loupes Uses of loupes under supervision Correction of posture Application of magnification and illumination in conservative dentistry Application of rubber dam 3) Attitude Improves the precision, quality of procedure and ergonomics


214

4 Disease of Pulp & Periapical tissues and their management Etiology Patho-physiology Management Pulp Disease Pulpitis : Reversible & Irreversible Pulp Necrosis Periapical diseases: Periradicular Periodontitis Periradicular abscess Phoenix abscess, Periapical Granuloma & Cyst, Apical Periodontitis Calcification : Causes, Types-Dystropic, Pulp stones (True & False)

3

5 Rationale of Endodontics & Principles Fish’s theory (Zones of Infection) Kronfeld’s Mountain Pass Theory

2

6 Clinical Diagnostic methods: Case history recording in endodontics Clinical examination using various diagnostic tools / aids Diagnostic Aids: Pulp Tests: Pulp Sensitivity : Thermal & Electric Pulp Test (EPT) Pulp Vitality Tests : Pulse Oximetry, Laser Doppler Flowmetry

3

7 Diagnosis & Management of Orofacial Pain in Endodontics - Causes , Types Pharmacologic Management of Pulpal & Periapical Pain Management of Endodontic Pain Emergency Non-Odontogenic tooth pain; referred pain, Phantom Pain, MPDS

1


215

8 Case Selection & Treatment Planning in Endodontics:

Indications and contra indications of Endodontics therapy Factors influencing : Local & Systemic Factors, Treatment of vital / Non-vital pulp Inflamed pulp

2

9 Endodontic Pre-operative Considerations: a. Preparation of Operatory: Infection Control b. Patient Preparation Treatment Planning & Case Presentation Informed Consent Radiation Safety & ALARA Principles Pre-medication : Antibiotics, Analgesics, Anti-Anxiety Local Anesthesia: Agents, Techniques : Infiltration, Blocks, Supplemental c. Endodontic Radiography Principles, Techniques & Radiographic interpretation d. Preparation for Access: Tooth Isolation : Principles & Rationale, Armamentarium, Methods & Aids in Rubber Dam Placement

3

10 Armamentarium & Sterilization Endodontic Instruments: General Classification, Hand Instruments: Standardization of hand / engine driven instruments, Broaches Reamers K-Files & H-Files Spreaders & Pluggers Gates-Glidden & Peeso Reamer Nickel Titanium Rotary Endodontic Systems: Profile, ProTaper Newer Rotary Endodontic Systems Ultrasonic (Endodontic) sonic instruments Maintenanace: Sterilization & Storage of Endodontic Instruments Glass Bead / Hot Bead Sterilizer, Autoclave, Gluteraldehyde, Ethylene Oxide

3


216

11 Microbiology in Endodontics

Pathways of infection Microbial flora of root canal (infected & Non-vital pulp) Various culture tests/techniques, culture media, interpretation Antibiotics in Endodontics; Selection of antibiotics in endodontics: Principles, antibiotic sensitivity Antibiotic Prophylaxis : AMA recommendations Complications: Abscess, space infection & Cellulitis; management

3

12 Tooth Morphology & Access cavity preparation: a. Root canal anatomy: Components of the root canal system. - Applied anatomy of the pulp space (internal anatomy) - Variations in root canal configuration: Vertucci’s classification Lateral & Accessory Canals Apical Foramen, Apical Delta b. Access cavity preparation: - Objectives & Guidelines (Principles) - Isolation with rubber dam : Purpose & Advantage - Mechanical phase of access cavity preparation Armamentaria: Magnification & Illumination Endodontic Handpieces & Access Burs Endodontic Explorers & Ultrasonic tips Access cavity preparations Anterior & Posterior Special / challenging cases : calcified, Heavily restored teeth Errors in Access cavity preparation Morphology & Access cavity preparation for individual teethoutline

3


217

13 Preparation of Pulp space:

Shaping and Cleaning: Objectives : Biologic & Mechanical Principles, concept: Biomechanical Vs Chemo-mechanical Techniques : Apico-coronal, Corono-Apical Hybrid Techniques Step-Back & Crown — Down Technique Recapitulation, Apical matrix. Hand Instrumentation Vs Rotary Instrumentation Errors in Preparation of Pulp space: Types : Zipping, Ledging, Transportation of apical foramen, perforation Perforation : Causes, types, diagnosis, management Separation of Instruments: Cause, Management & Prevention

3

14 Intra canal irrigants and medicaments in endodontics. Normal saline Hydrogen Peroxide Sodium Hypochlorite Chlorhexidine lodides Other irrigants : Mixture of tetracycline and Detergent (MTAD) Polyantibiotic Paste EDTA : RC-Prep./Glyde Calcium Hydroxide & Mineral Trioxide Aggregate (MTA)

3

15 Determination of working length / methods Anatomy of apical root Rationale of determination of working length Radiographic methods : Various methods : Ingle’s, Grossmans Electronic methods : Apex Locators : Rationale, Principles, Types, Limitations, Newer systems.

3


218

16 Root canal obturation

Coronal & Apical Seal Objectives & Ideal Root canal filling Obturation materials - Classification, Ideal requirements & Description Root canal sealers Ideal requirements, composition and properties. Types : Zinc oxide & Eugenol, Glass lonomer, Calcium Hydroxide, Resin & Medicated Sealers. Core materials : Silver points, Gutta Percha: Materials aspects Resilion & Custom Cones Obturation systems: Carrier or Core based gutta percha Injectable Thermoplasticized Gutta Percha (ITGP) Thermafil, Obtura, Inject-R Various Techniques of root canal obturation Conventional : Lateral & Vertical, Sectional condensation Recent Techniques

3

17 Endodontic Emergencies Definition, Classification, Etiology and Principles of management Pre-operative Emergencies Operative Emergencies - Sodium Hypochlorite& Hydrogen Peroxide Accident - Cause, Management Prevention Post-operative emergencies: Fracture of Tooth/ Root

2

18 Traumatic Injuries of Teeth - Causes (Briefly) Ellis classification & Management Fracture of Teeth Crown Fracture: Cause, Types, Management, Prevention Crown - Root Fracture Root fracture Cause, types, management, prevention Luxation Injuries Avulsed teeth : Cause, Management & Prevention Replantation : Indications / contra indications Extra oral time, Hank’s Balanced Salt Solution Splinting

3


219

19 Discoloration of teeth

Etiology, Types / classification Management : Laminate Veneers, Bleaching (Vital & Non-vital ) & Crowns, Tooth Whitening modalities , Vital : Night Guard vital bleaching (NGVB), Non-vital : Walking bleach, superoxol, Carbamide Peroxide, In-office bleaching /Power bleaching

3

20 Endodontics - Periodontics , Intercommunication pathways, differential diagnosis , Interrelation - classification & Management

2

21 Pediatric Endodontics : - Primary & Young Permanent Teeth: Anatomical considerations : Internal Anatomy - Open immature Apex, Blunderbuss Canals Pulp Therapy , Vital Pulp Therapy , Pulpotomy : Definition, Indication / Contraindication ,Types (Formocresol/Calcium Hydroxide/Gluteraldehyde) , Apexogenesis : Description, Rationale, Technique , Non-vital pulp therapy, Pulpectomy, Apexification : Description, Rationale, Technique, Apexogenesis Vs. Apexification, Geriatric Endodontics : endodontics considerations in elderly patients

4

22 Resorption Definition, types / classification Cervical resorption : Cause, diagnosis, management Root resorption - classification, etiology and management

2

23 Surgical endodontics case selection - indication / contra indications factors affecting case selection : Local and systemic Incision and drainage, trephination

4

Various flap designs for peri-radicular surgeries Leubke - Oschenbein, Semilunar Root End Surgeries - Apical curettage / apicoectomy Root end / retrograde filling - materials and techniques Root resection & Hemi section, Bicuspidization, reimplantation, Intentional reimplantation, transplantation Endodontic microsurgery : Principles, advantage, surgical Loupes and microscopes. Endodontic endosseous implants


220

24 Restoration of endodontically treated teeth

Changes in endodontically treated teeth Treatment planning for endodontically treated teeth Access restoration : Purpose, ideal requirements, types / classification Post & Core system : Post space preparation, Ferrule Basic components : Post : Custom made, Pre fabricated posts Core : Types and materials used Coronal coverage: Final & Provisional restoration

4

25 Success and failure in endodontics Factors affecting, causes of failure, management Retreatment in endodontics. i. Non-surgical retreatment: Material, methods and techniques Removal of: Gutta Percha: Solvents, techniques Silver points : Retrieval — aids and methods Separated instruments: Causes, techniques, masseran kit ii. Surgical retreatment : Indications, methods

2

26 Single visit endodontics Rationale, indications / contra indications Case selection : Factors affecting, treatment planning - Single visit Vs Multiple visit

2

27 Minimal Intervention Dentistry 2

28 Regenerative Endodontics 1

29 Saliva Check and its clinical importance 2

30 Esthetic Dentistry 2

31 Lasers 1

32 Microscopes in restorative & Endodontics 2

33 Photography in restorative Dentistry 1

34 Occlusal consideration in Operative Dentistry 2

35 Ergonomics 1

36 Practice Management 2


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lV B.D.S. WORK DONE STATEMENT Clinical Demonstration 1. Diagnostic Aids — Vitality tests

2. Access opening and rubber dam applications

3. Working length estimations — electronic apex locators

4. Endodontic Instruments

5. Biomechanical preparation including rotary endodontics

6. Obturation technique and materials

7. Endodontic surgery

8. Post endodontic restorations including post and core

9. Composite restorations — inlays

10. Laboratory fabrications of ceramic and metal ceramic crowns.

Clinical Section - Practical Work:

Work to be done Minimum

I. Case history records

II. Deep caries management exercise : Pulp capping

III. Amalgam restorations a) Class I

(including Buccal & lingual extension) b) Class II

(MO/DO & MOD)

20

25

IV Tooth Colored Restorations a) Glass lonomer & Composite restorations

15

V. Endodontic exercises Root Canal Treatment (Anterior tooth)

Minimum one case


222

Scheme of Examination: I. Theory examination : 100 marks

A. written Paper : 70 marks B. Viva-Voce : 20 marks

C. Internal Assessment : 10 marks

Distribution of Topics and Type of Questions

Type of Questions Marks allotted Total Marks

Long answer type One long Essay each from Conservative Topic and from Endodontics topic

1 x 10 = 10 marks I x 10 = 10 marks

20 Marks

Short answer type Three questions each from Conservative & Endodontics topics

5x3 marks = 15 marks 5x3 marks = 15marks

30 Marks

MCQ questions From Conservative topics From Endodontics topics

10x1mark=10marks 10x1mark=10marks

20 Marks

II. Practical: 100 marks A. Clinicals : 80 marks B. Internal Assessment : 10 marks C. Record book : 10 marks

Details of marks distribution of the practical/clinical examination I. Case History: 10 marks II. Spotters : 20 marks III. Preparation of Class II cavity for amalgam Or Class II cavity preparation for

composite in posterior teeth. Exercise 1: 50 marks

• Class II Silver Analyan cavity preparation 25 marks • Base and Matrix placement 10 marks • Restoration and Polishing 15 marks

Or Exercise 2:

• Class II composite cavity preparation 25 marks


223

• Etching and Matrix placement 10 marks • Restoration and Polishing 15 marks

Recommended Books:

Name of the Book & Title Author Publisher’s Name

1. Phillips Sciences of Dental Materials Anusavice Elsevier

2. The Art and Science of Operative Dentistry

Sturdevant Mosby

3. Principles & Practice of Operative Dentistry

Charbeneau Varghese Publication

4. Pathways of the Pulp Stephen Cohen

Mosby

5. Endodontic Practice Grossman Varghese Publication

6. Text Book of Endodontics Mithra N Hegde

EMMEES Publication


224

XXII. ORAL AND MAXILLOFACIAL SURGERY

Introduction Oral and Maxillofacial surgery is a speciality of dentistry concerned with the diagnosis and surgical treatment of congenital and acquired diseases, dysfunctions, defects or injuries of the mouth, jaws, face, neck and adjacent craniofacial regions. The Oral and Maxillofacial Surgeons lead the way for communication between Dentistry and Medicine that improved human health by attending facial trauma, Orthognathic surgery, craniofacial surgery and tumors in addition treating developmental deformities of the face and the jaws.. Surgery of course is not merely about performing an operation; it is about careful history taking, meticulous examination and careful investigations to reach a diagnosis. Only then can the management strategies be discussed with the patient.

Scope The scope of oral and maxillofacial surgery depends on the qualifications and capabilities of the person. There is a definite distinction in the case selection for an undergraduate, trained in oral surgery and a postgraduate trained in oral and maxiliofacial surgery and for cases that require multidisciplinary approach. It deals with treatment of following conditions: • Simple and complicated cysts and tumors of the jaws. • Fractures of the facial bones • TMJ disorders ; Dentofacial deformities • Salivary gland diseases • Oro-facial infections • Precancerous conditions and lesions; Detection and management of oral cancer.

Objectives 1. Knowledge & understanding:

• Apply the knowledge gained in the related medical subjects like pathology, microbiology and general medicine in the management of patients with oral surgical problems.

• Diagnose, manage and treat patients with oral surgical problems. • Gain knowledge of a range of surgical treatments. • Be able to decide the requirement of a patient to refer to specialist

opinion or treatment. • Understand the principles of in-patient management.


225

• Understand the management of major oral surgical procedures and principles involved in patient management.

• Know the ethical issues and have communication ability.

2. Skills: • A graduate should have acquired the skill to examine any patient with

an oral surgical problem in an orderly manner. • Should be competent in the extraction of teeth • Should be able to carry out certain minor oral surgical procedures under

L.A. like frenectomy, alveolar procedures and biopsy etc. • Ability to assess, prevent and manage various complications during and

after surgery. • Able to provide primary care and manage medical emergencies in the

dental office. • Understand the management of major oral surgical problems and

principles involved in inpatient management

Curriculum: The undergraduate curriculum in Oral & Maxillofacial Surgery is designed on its objectives to expose students to the speciality and help them develop the knowledge, skills, and values to become competent in performing minor oral surgery. The educational programmes rest on 2 Central elements

i. A rigorous didatetic programme that combines lectures with small group learning

ii. A clinical programme that imparts proficiency on the basis of Oral surgical procedures The curriculum provides the students with a solid foundation that they will use in the future clinical application.

COURSE OUTCOMES


CO1: Recognize the scientific principles needed for the provision of Oral

Maxillofacial surgical care and prevention of cross infection

CO2: Provide appropriate knowledge, understanding, intellectual skills, practical

skills and attitude to practice oral surgery in selected cases

CO3: Differentiate between normal and abnormal oral and dental tissue


226

CO4: Diagnose and differentiate diseases and pains of the oro facial complex and

head and neck

CO5: Elicit patient history and evaluate to determine the treatment plan and refer

to appropriate specialists for opinion

CO6: Perform competently Extraction of teeth with proper follow-up care,

prescription of medications and recall

CO7: Diagnose and provide treatment for basic minor oral surgical condition

CO8: Provide Diagnosis and treatment competently to the medically

compromized patient and manage medical emergency if any

CO9: Apply didactic and clinical knowledge in diagnosis of major oral surgical

situations

Oral Surgery, Local Anesthesia and General Anesthesia Teaching hours Theory: 70 Hours (III BDS: 20 hours, IV BDS Part I: 20 Hours IV BDS Part II: 30 hrs) III BDS I. Introduction : 2Hours

a) Definition,history, Introduction, Objectives and scope.

b) History taking, examination of the patients, investigations & diagnosis.

II. Anesthesia

a) Local Anesthesia (L.A.) 4 Hours

b) Neurology of facial pain

c) Historical aspects, definition, types of L.A, Indications and Contra Indication, advantage & disadvantage.

d) Local anesthetic drugs, Classification. Ideal requirements of L.A, composition & action.

e) Factors to be considered in the choice of particular mode of anesthesia.

f) Complication of L.A, its prevention and management.


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Anesthesia of mandible 2Hours

a) Anatomical consideration, infiltration, mental nerve block, buccal & inferior dental nerve block.

Anesthesia of Maxilla 2Hours a) Anatomical considerations, infiltration, infra orbital, posterior

superior alveolar, nasopalatine, greater palatine & maxillary nerve block.

b) Extra oral blocks- Indications & Technique.

General Anesthesia (G.A.) 3 Hours

a) History of G.A.

b) Indications of G.A., in oral surgery

c) Pre- anesthetic evaluation of the patient.

d) Pre- medication.

e) Types of G.A., including I.V. Sedation.; Stages of G.A., common G.A agents.

f) Complications during and after anesthesia.

g) Post anesthetic care of the patients. III. Asepsis, Sterilization, Cross Infection & Disinfection 2 Hours

a) Definitions. b) Terminologies.

c) General considerations.

d) Effective measures in infection control.

e) Problems encountered in asepsis and infection control.

IV. Exodontia 4 Hours

a) General Considerations.

b) Indications & Contraindications.

c) Methods of Extractions:

- Principles of forceps extraction.

- Indications, Principles and surgical procedure of Trans- alveolar extraction.

d) Principles and use of elevators.


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e) Complications of exodontia and management.

IV BDS

I. Impacted teeth - 2Hours

a) General factors, incidence, etiology, Classification, indication for removal of impacted molars

b) Assessment: Clinical & radiological.

c) Anesthetic considerations and surgical procedure.

d) Maxillary third molar and canine impactions, Incidence, Indication for removal, Classification, Assessment & Localization, Surgical Procedure.

e) Complication of surgical removal of impacted teeth sent to Endodontics.

II. Endodontic surgery - 1 Hour

a) Introduction b) Classification

c) Apicoectomy

d) Replantation. III. Pre- Prosthetic surgery - 3 Hours

a) Introduction, Aims of pre-prosthetic Surgery, Classification.

b) Corrective procedures- hard and soft tissues.

c) Sulcus extension procedures.

d) Ridge reconstruction or augmentation procedures.

IV. Principles of Implantology - 2 Hours

V. Infection of oral cavity- 5 Hours

a) Introduction.

b) Microbiology of odontogenic infections.

c) Anatomical considerations and facial spaces.

d) Spread of Infections.


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e) Acute dento-alveolar abscess.

f) Actue & chronic infections of the jaws: Cellulitis, Ludwig’s angina, Actinomycosis, Osteomyelitis, Osteo-radionecrosis.

g) Management of infections:

- Medical- Antibiotics, Analgesics, Anti- inflammatory drugs - Surgical.

h) Hepatitis-B, & H.I.V. infections.

VI. Maxillary Sinus diseases - 2 Hours

a) Applied anatomy, acute and chronic sinusitis, surgical approach to sinus.

b) Removal of tooth or root from the antrum.

c) Oro- antral fistula and its management.

VII. Cystic lesion of the jaws - 3Hours

a) General features, definition, Classification.

b) Pathogenesis, signs & symptoms.

c) Clinical, radiological & other investigations.

d) Surgical management and complication of each type of cyst.

VIII. Disorders of Temporo Mandibular joint - 4Hours

a) Applied anatomy. b) Sub-luxation & dislocation of the T.M.Joint.

c) Pain dysfunction syndrome.

d) Ankylosis of the joints & management.

e) Infections of the T.M.Joint.

IX. Diseases of Salivary Glands - 3Hours

a) General features, Investigations in the diagnosis of salivary gland diseases.

b) Acute and chronic infection.

c) Salivary calculus & its management.


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d) Tumors of the salivary glands & its management.

X. Neurogenic Disorders - 2 Hours

a) Nerve Injuries.

b) Trigeminal neuralgia.

c) Glossopharyngeal & facial paralysis.

d) Facial nerve palsy

XI. Fractures of the jaws - 7 Hours

Introduction, applied anatomy & types of Fractures.

a) Dento alveolar fractures.

b) Mandibular fractures:

- Classification.

- Clinical features & diagnosis - Preliminary and definitive management.

c) Zygomatic complex fractures

d) Middle Third fractures: - Classification. - Clinical features & diagnosis.

- Outline of immediate and definitive treatment.

e) Orbital fractures

f) Nasal fractures

-Advances in Maxillofacial fracture fixation XII. Developmental deformities - 4Hours

a) Deformities of the jaws:

- Basic forms of deformities, prognathism, retrognathism and apertognathia.

- Reasons for surgical correction, Pre-operative planning. - Outline of various surgical procedure in mandible and maxilla.

b) Cleft Lip and Palate:

- Etiology, Incidence, Timing of Repair.


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- Role of General dental practitioner.

XIII. Emergencies in Dental Practices - 3 Hours

A) Primary care of Medical emergencies in Dental Practice

a) Cardio- vascular disorders.

b) Respiratory disorders.

c) Endocrine disorders.

d) Drug allergies and interactions.

B) Simulation assisted Management of Medical emergencies – Introduction and Protocol

C) Tracheostomy.

XIV. Oral surgical considerations - 4 Hours

a) Systemic diseases and Patients with medically compromised conditions.

b) Immuno compromised conditions, Geriatric patients.

c) Pregnant woman.

XV. Tumors of the Oral Cavity - 4 Hours

a) General considerations

b) Non-odontogenic benign tumors (fibroma, papiloma, lipoma, ossifying fibroma, myxoma)

c) Ameloblastoma

d) Carcinoma of the oral cavity

e) Biopsy

f) TNM classification

g) Outline of management of carcinoma

h) Role of dental surgeons in early detection and prevention of oral cancer

XVI. Recent Advances – 2 hours

a) Lasers

b) Piezosurgery


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c) Cryosurgery

d) Stem Cell and Tissue Regeneration CLINICALS : 270 Hours

III B.D.S Students are required to learn the following:

1. Case history taking.

2. Examination of the patient.


233

3. Recording blood pressure.

4. Various anesthetic injection techniques.

5. Use of different instrument in oral surgery.

6. Extraction of mobile teeth.

7. Wiring techniques on models- orange peel/glove.

IV BDS

SI. No.

Procedure

Number of cases

Category

1 Closed methods of extractions 75 Must Do

2 Open method of extraction with suturing. 5 Must Do

3 Seminar presentation under Staff Guidance 1 Must Do

4 Major case history taking. Desirable to Do

5 Wiring and Arch bar fixation 1 Must Do

6 Posting in Rural Centre with Staff during dept. posting

Desirable to do

7 Assisting in major surgical procedures under GA

Desirable to Do

8 Handling medical emergencies, C.P.R training and Basic life support demonstration

Must Do

INTERNSHIP

15 days of night duty/ observation of major cases in operation theatre ( Elective)

Student should undergo Training in Simulation assisted management of Medical Emergencies

CLINICAL DISCUSSION TOPICS: Principles of surgery 1. Developing a surgical diagnosis: It depends upon

• Chief complaint • History of present illness • Identification of various signs and symptoms


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• Laboratory investigations and imaging examinations 2. Adequate visibility:

• Adequate access and Adequate light • Clean surgical field

3. Aseptic techniques


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4. Painless surgery 5. Incisions and flap designs 6. Tissue handling 7. Hemostasis 8. Drainage and debridement 9. Closure of wounds 10. Postoperative care Surgical anatomy

• Sensory innervations of head and neck • Arterial supply and venous drainage of head and neck • Lymphatics of head and neck • Fascial planes and spaces • Fascial layers • Fascial spaces • Maxillary sinus • Impacted maxillary, mandibular 3rd molar anatomy etc.

Diagnosis in oral surgery 1. History taking

• Personal details, History of present illness, Past medical history, Drug history, Family history, Past dental history, Social history

2. Clinical examination • Inspection • Palpation • Percussion • Auscultation

3. Provisional diagnosis 4. Investigations 5. Definitive diagnosis Medical emergencies Hypersensitivity reactions Respiratory difficulties

• Asthma • Hyperventilation • Chronic Obstructive Pulmonary Disease


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• Foreign body aspiration • Gastric contents aspiration

Cardiovascular problems • Angina pectoris • Myocardial Infarction • Stroke • Coronary artery bypass grafting • Coronary angioplasty • Dysrrhythmias • Infective endocarditis • Congestive cardiac failure

Renal problems

• Renal dialysis • Hypertension

Hepatic disorders

• Impaired liver function Endocrinal abnormalities

• Diabetes Mellitus • Adrenal insufficiency • Hypothyroidism • Hyperthyroidism

Hematological problems • Hereditary coagulopathies • Therapeutic anticoagulants

Altered consciousness • Vasovagal syncope • Orthostatic hypotension • Seizures • LA toxicity

Pregnancy Anesthesia and pain control Local anesthesia

• Introduction and Classification


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• Concept of LA and Ideal requirements; Mode of action of LA • Theories of LA ;Types of LA and Complications of LA • Methods of induction • Local infiltration, Field block, Nerve block • Factors in selecting the method of induction • Techniques of maxillary anesthesia- Local infiltration, Infra-orbital,

Posterior superior alveolar, Greater palatine, Naso-palatine, Maxillary nerve blocks.

• Techniques of mandibular anesthesia- Inferior alveolar nerve block, Gow-gates nerve block, Vazirani-Akinosi nerve block, Lingual, Long buccal, Mental, Incisive nerve blocks.

General anesthesia • Concept of GA • Indications • Pre anesthetic evaluation • Pre anesthetic medication • Commonly used agents • Complications during and after GA • IV sedation • Mode of action • Technique • Cardio-Pulmonary Resuscitation • Emergency drugs • Tracheostomy

Pain • Definition • Classification • Neurophysiology • Pain theories • Pain pathways • Biochemical mediators of pain • Dual nature of pain

Methods of pain control 1. Removing the cause 2. Blocking the pathway of painful impulses


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3. Raising the pain threshold 4. Preventing pain reaction by cortical depression 5. Using psychosomatic methods

Principles of exodontia • Pain and anxiety control • Presurgical medical assessment • Indications for removal of teeth • Contraindications for removal of teeth • Clinical evaluation of teeth for removal • Radiographic examination of teeth for removal • Patient and surgeon preparation • Chair position for forceps extraction • Mechanical principles involved in tooth extraction

1. Lever principle 2. Wedge principle 3. Wheel and axle principle

• Principles of forceps use • Procedure for closed extraction • Specific technique for removal of each tooth • Post extraction care of tooth socket

Sutures and suturing techniques • Materials; Requisites for suture materials, Classification, Biological

response of body to suture materials; Suture needles; Principles of suturing

• Knot tying Square knot; Surgeon’s knot; Granny’s knot, Interrupted suture, Continuous suture, Horizontal mattress suture, Vertical mattress suture, Figure of eight suture

• Suture removal Impacted teeth

• Incidence; Definition Etiology Indications Classification • Assessment- both clinical & radiological, Surgical procedures

Complications during and after removal Prevention and management


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Complications of exodontias: Fracture of Root tip, Alveolar bone, Maxillary tuberosity, Adjacent or opposing tooth, Dislocation of Adjacent tooth, TMJ, Root into maxillary antrum or soft tissues, Postoperative hemorrhage, Damage to Gums, Lower lip, Inferior alveolar nerve, Lingual nerve, Tongue & floor of mouth. Collapse in dental chair-Syncope, Respiratory arrest, Cardiac arrest.

Biopsy techniques (DEMONSTRATION / OBSERVATION OF PROCEDURE) Oral cytology- Exfoliative cytology; Oral brush biopsy Aspiration biopsy- FNAC; Punch biopsy Incision biopsy and Excision biopsy Procedure: Anesthesia and Tissue stabilization and Haemostasis Incision, Handling of tissue, Identification of surgical margins, Specimen care surgical closure, Biopsy data sheet

Cysts of jaws (DEMONSTRATION I OBSERVATION OF PROCEDURE) Definition, Classification, Pathogenesis, Clinical presentation, Radiographic examination, Aspiration Biopsy and histopathology, Use of contrast media Management, Type; Rationale; Indications; Procedures; Complications

Scheme of Examination I. Theory: 100 marks

A. Written Paper : 70 marks B. Viva Voce : 20 Marks C. Internal Assessment : 10 Marks

Distribution of Topics and Type of questions

Contents Type of questions and Marks

Marks

1. One question from Local anesthesia 2. One question from Oral surgery

Long answer 1x10 Marks 1x10 Marks

10 10

8 questions from Oral surgery 01 question each from General anesthesia, and medically compromised patients

Short answer 10x3 Marks

30


240

MCQ’s any topic 20x1 20

Total 70

II. Practical Examination: 100 Marks.

A. Clinical Exercises : 80 marks B. Internal assessment : 10 marks C. Record Book : 10 marks

1. Case history, examination of the patient, presentation of the case history: 30 Marks.

2. Local anesthesia technique: 10 Marks 3. Extraction of firm molar and management of patient: 40 Marks

Recommended Text Books: Sr. No.

Title of Book Author Edition/Year Publisher

1 Local anesthesia & Pain control in dental practice

Monheim’s 1st / 1984 Mosby

2 Handbook of Local Anesthesia Stanley Malamed

5th / 2004 Mosby

3 Oral & Maxillofacial Surgery Daniel Laskin 1st / 1980 & 2nd volm

Mosby

4 Principles of Oral & Maxillofacial Surgery

Peterson 2nd / 2004 B C Decker

5 Outline of Oral surgery Killey & Kay 2nd / 1992 Wright

6 Fractures of Mandible Killey & Kay 3rd / 1988 Wright

7 Extraction of Teeth Jeffrey Howe 3rd / 1990 Varghese


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Recommended Text Books:

1 Textbook of Oral & Maxillofacial Surgery

Kruger 6th Ed / 1984 Mosby

2 Oral & Maxillofacial Infections

Topazian 4th Ed / 2002 Saunders

3 Principles of Oral & Maxillofacial Surgery

U J Moore 5th Ed / 2001 Blackwell

4 Textbook of Oral & Maxillofacial Surgery

Neelima Malik 2nd / 2008 Jaypee


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XXIII. PEDIATRIC & PREVENTIVE DENTISTRY

Statement of Intent: The intent of Pedodontics & Preventive Dentistry course, as a part of the BDS curriculum at the faculty of dentistry, NITTE deemed to be university is to educate and train students to adopt the principles of Paediatric dentistry in providing oral health care for children from infancy to adolescence and special children with high degree of credibility, integrity, ethical standards and social concern.

Knowledge: At the end of the course, the students: Will be able to demonstrate the principles of pediatric and preventive dentistry right from birth to adolescence, including those with special health care needs. Shall be able to prevent and intercept developing dental health problems in the child, including malocclusions.

Skills: At the end of the course, the students:

• Shall be able to obtain detailed case history, do a methodological examination of the child patient, perform essential diagnostic procedures and interpret them, arrive at a reasonable diagnosis and formulate a comprehensive treatment plan and treat appropriately.

• Will be able to provide highest quality of dental care to all children, including those with special care needs

• Will be able to manage the disabled children effectively and efficiently, tailored to the need of individual requirement and conditions

• Will be able to prevent decal decay & restore the lost tooth structure to maintain harmony between both hard and soft tissues of the oral cavity

• Shall be able to diagnose early developing malocclusion and prevent or intercept them.

• Counsel the parents with regards to various treatment modalities available and apply the best suited option for the child, including different facets of preventive dentistry.


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Attitudes: At the end of the course, the students:

• Will develop a positive attitude to adopt ethical principles in all aspects of Pedodontic practice. Will be able to provide good oral health care to the child and nurture them into good citizens for tomorrow.

• Will develop a professional attitude and adopt ethical principles in all aspects of Pedodontic practice.

• Will be able to deliver treatment without any prejudice and bias, irrespective of the social status, cast, creed, and religion of the patients.

• Will be humble and be willing to share the knowledge and clinical experience with fellow professional colleagues.

• Shall seek the kind opinion of allied medical and dental specialties, as and when required.

• Will adapt, after a critical assessment, advanced methods and techniques of Pedodontic management developed based on scientific research, which are in the best interest of the dentist, child and parent.

• Shall respect the child patients’ rights and privileges, including their right to information, right to seek a second opinion and confidentiality.

COURSE OUTCOMES


CO1: Demonstrate the principles of pediatric and preventive dentistry right from

birth to adolescence, including those with special health care needs

CO2: Elicit detailed case history, do a methodological examination of the child patient, perform essential diagnostic procedures and interpret them, arrive at a reasonable diagnosis and formulate a comprehensive treatment plan and treat appropriately.

CO3: Identify a child’s developmental status through the understanding of the normal sequence of development and variations produced by intrinsic or extrinsic forces

CO4: Relate the current concept of caries and its underlying causative factors in a child, and to implement timely, effective health care services.


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CO5: Prevent decay & restore the lost tooth structure to maintain harmony

between both hard and soft tissues of the oral cavity

CO6: Describe and manipulate various restorative materials used in children, semi-permanent restorations, and esthetic crowns along with recent advances

CO7: Counsel the parents with regards to various treatment modalities available and apply the best-suited option for the child, including different facets of preventive dentistry.

CO8: Recognize external anatomy, physiology and morphology of teeth and their dimensions to aid in the identification and treatment of primary and permanent dentition

CO9: Diagnose, prevent and intercept developing dental health problems in the child, including malocclusions.

CO10: Demonstrate various radiographic techniques used in children and recognize radiographic features of dental diseases

CO11: Relate to the child’s development in terms of psychological, social, cognitive and physical parameters, and detect any deviation in these patterns that may interfere with the treatment process

CO12: Display pharmacological and non-pharmacological management techniques, which can be incorporated in children while managing different conditions in order to train a child to accept dentistry

CO13: Identify morphology of primary and permanent root canal, pulpal and periapical diseases and perform pulp therapy techniques

CO14: Apply anatomical, physiological, psychological factors specifically related to a child in the management of facial hard and soft tissue injuries

CO15: Master asepsis and sterilization in dental procedures along with exodontia and LA techniques

CO16: Explain minor oral surgical procedures commonly done in children.

CO17: Describe salient features of gingiva and periodontium in primary dentition and summarize management of common gingival and periodontal diseases in children

CO18: Provide appropriate dental care to all children, including those with special care needs


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CO19: Demonstrate the management of disabled children effectively and

efficiently, tailored to the need of individual requirement and conditions

CO20: Manage any medical or dental emergencies and display the ability to handle them under unforeseen circumstances

CO21: Identify victims of child abuse and neglect; document and report the same and help manage these patients and their families

CO22: Explain the genetic basis of dental diseases

CO23: Demonstrate a professional attitude and adopt ethical principles in all aspects of Pedodontic practice

CO24: Deliver treatment without any prejudice and bias, irrespective of the social status, cast, creed, and religion of the patients

CO25: Display humility and willingness to share knowledge and clinical experience with fellow professional colleagues.

CO26: Seek the kind opinion of allied medical and dental specialties, as and when required.

CO27: Employ, after a critical assessment, advanced methods and techniques of Pedodontic management developed based on scientific research, which are in the best interest of the dentist, child and parent

CO28: Demonstrate respect for the child patients’ rights and privileges, including their right to information, right to seek a second opinion and confidentiality.

Teaching Hours: Theory classes: 65 hours (III year –20 hrs, IV year – 45 hrs)

Clinical working hours – 170 (III year – 40 hrs, IV Year – 130 hrs)

Theory - Syllabus

No. III B.D.S. – 20 Hours Time

1. Introduction to Pediatric and Preventive Dentistry - Definition, Scope, Objectives and Importance

1 hour

2. Growth and Development of Craniofacial Structures - Importance of study - Prenatal and Postnatal factors in growth and development - Theories of growth and development - Development of maxilla and mandible and related age changes

3 hours


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3. Development of Occlusion from Birth through adolescence 3 hours

4. Dental Anatomy and Histology - Development of teeth and associated structures - Eruption and shedding of teeth; Teething disorders and its

management - Chronology of Eruption of teeth - Differences between deciduous and permanent teeth - Development of dentitions from birth to adolescence - Importance of first permanent molar

3 hours

5. Dental Radiology Related to Pedodontics 1 hours

6. Dental Surgical Procedures in Children - Indications and contraindications of extractions of primary and

permanent teeth - Knowledge of local and general anesthesia - Minor surgical procedures

2 hours

7. Dental Caries - Historical Background - Definition, etiology and pathogenesis

3 hours

- Caries Pattern in primary, young permanent and permanent teeth in children

- Rampant caries, early childhood caries and extensive caries Definition, etiology, pathogenesis, clinical features, complications and management

- Role of diet and nutrition in dental caries - Dietary modification and diet counseling.

- Caries activity tests, caries prediction, caries susceptibility and their clinical applications.

8. Gingival and Periodontal Diseases in Children - Normal gingiva and periodontium in children - Definition, etiology, pathogenesis - Prevention and management of gingival and periodontal

diseases

2 hours


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IV B.D.S. – 45 Hours

9. Child Psychology - Definition - Theories of Child Psychology - Psychological development of child through adolescence - Principles of psychological growth and development while

managing child patient - Dental fear and its management - Factors effecting child’s Psychology and its clinical

application.

3 hours

10. Behaviour Management. - Definition - Types of behaviour encountered in the dental clinic - Non-Pharmacological and Pharmacological methods of

behaviour management

3 hours

11. Pediatric Operative Dentistry - Principles of pediatric operative dentistry - Modifications required for cavity preparation in primary and

young permanent teeth - Various Isolation Techniques - Restoration of primary and young permanent teeth. - Restorative materials used in pediatric dentistry.

3 hours

12. Pediatric Endodontics - Principles and diagnosis - Classification of pulpal pathology in primary and permanent

teeth - Management of pulpal pathology in primary and young

permanent teeth

3 hours

13. Traumatic Injuries in Children - Classification and importance - Sequelae and reaction of teeth to trauma - Management of traumatized teeth

3 hours


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14. Preventive and Interceptive Orthodontics.

- Definition - Problems encountered during primary & mixed dentition

phases; their management - Serial extractions - Space Management

3 hours

15. Oral Habits in Children - Definition, Etiology and Classification - Clinical features; Management and prevention

3 hours

16. Dental Care of Children with Special Care Needs - Definition, Etiology, Classification, Behavioural and clinical

features and Management of children with - Physically handicapping conditions - Mentally compromising conditions - Medically compromising conditions - Genetic disorders

2 hours

17. Congenital Abnormalities in Children - Definition, Classification and clinical features and

Management

2 hours

18. Dental Emergencies in Children and their Management 2 hours

19. Dental Materials used in Pediatric Dentistry 1 hours

20. Preventive Dentistry - Definition - Principles and scope - Types of Prevention& Different Preventive measures

1 hour

21. Dental Health Education and School Dental Health Programme

2 hours

22. Fluorides - Historical background - Systemic and topical Fluorides & Mechanism of action - Toxicity and Management - Defluoridation Techniques

2 hours

23. Case History Recording - Outlines of Principles of examination, diagnosis and treatment

planning

3 hours

24. Setting up of Pedodontic Clinic 1 hour


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25. Ethics 1 hour

26. Infant Oral Health care 1 hour

27. Sports Dentistry 1 hour

28. Forensic Dentistry 1 hour

29. Child Abuse 1 hour

30. Revision Classes 1 hour Clinical work for students: (3rd year – 40 hours; 4th year – 130

hours) Quota 170 hours

1. Fabrication of appliances • Hawley’s Appliance • Habit breaking appliance • Oral screen • Space maintainer

1 each

2. Presentation of minor seminar and major seminar 1 each

3. Participate in a school dental health programme 1

4. Case history recording and treatment planning 20

5 Oral prophylaxis 20

6 Restoration (silver amalgam, glass ionomer, composite restoration) - Non invasive - Invasive

45 25 20

7 Topical fluoride application 10

8 Extraction 25

9 Clinical Demonstration 1. Pulp therapy and Stainless steel crown for primary teeth 2. Fixed space maintainers, regainers and eruption guiding

appliance

1 each

Scheme of Examination: I. Theory: 100 Marks

• Theory (Written) Examination : 70 Marks • Viva Voce : 20 Marks • Internal Assessment : 10 Marks

Total : 100 Marks


250

II. Clinical Examination: 100 Marks • Clinical Exercises : 80 Marks (Case Presentation – 30, Clinical work - 50)

• Internal assessment : 10 Marks • Record Book : 10 Marks

Clinical Exercises with Mark Distribution Marks

Exercise I 1. Case Presentation a. Clinical Examination and recording of Long

Case History b. Diagnosis, Treatment planning & Management

2. Clinical Case with any one of the following

exercises Oral Prophylaxis & Fluoride Application

a. Management of child b. Oral Prophylaxis c. Topical Fluoride Application d. Post operative Instructions

Restoration of Tooth

a. Management of child b. Cavity Preparation c. Isolation, lining, Matrix, Band

Application d. Filling, Carving & Finishing e. Post operative Instructions

Extraction of tooth

a. Management of child b. Local Anesthesia c. Extraction d. Prescription e. Post operative Instructions

30 15

15

Exercise III Record Book presentation 10


251

Text Books and Reference Books:

Sl No.

Title Author Edn Year Publishers

1 Dentistry for the child and adolescence

McDonald IX 2011 Elsevier

2 Clinical Pedodontics Finn IV 2003 W.B Saunders company, USA

3 Pediatric dentistry infancy through adolescence

Pinkham IV 2005 W.B Saunders company, USA

4 Textbook of pediatric dentistry

Braham II 1990 CBS Publishers

5 Clinical use of fluorides Stephen H Wei

I 1985 Lea and Febiger

6 Understanding Dental caries Niki foruk I 1985 Karger

7 Behaviour management Wright II 1987 Wright Bristol

8 Traumatic Injuries Andreason II 2000 Mosby

9 Pediatric dental medicine Forrester IV 1981 Elsevier

10 Pediatric operative dentistry D B Kennedy

IV 1996 Wright

11 Pediatric dentistry for clinicians

Shobha Tandon

II 2008 Paras medical Publishers

12 Pediatric dentistry Damle II 2002 Arya medi publishing house

13 Principles and practices of Pedodontics

Arathi Rao II 2006 Jaypee brothers medical publishers

14 Pediatric dentistry Muthu & Sivakumar

I 2009 Elsevier


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INTERNSHIP:

1. General Guidelines: Every candidate is required, after passing the final BDS examination to

undergo compulsory rotational internship to the satisfaction ofthe College and University authorities for a period of 12 months so as to be eligible for the award of the degree of Bachelor of Dental Surgery (BDS) and registration at the DCI.

It shall be task oriented training. The interns should participate in various Institutional and field programmes and be given due responsibility to perform the activities in all departments of the Dental College and associated institutions.

To facilitate achievement of basic skills and attitude, training in following areas shall be provided to all dental graduates.

i) History taking, examination, diagnosis, charting and recording treatment plan of cases.

ii) Presentation cases in a group of seminar iii) Care and sterilization of instruments used. iv) Performance and interpretation of essential laboratory tests and

other relevant investigations. v) Data analysis and inference

vi) Proper use of antibiotics, anti inflammatory and other drugs as well as other therapeutic modalities

vii) Education of patients, their relatives and community on all aspects of dental health care while working in the institution as also in the field. viii) Communication aimed at inspiring hope, confidence and optimism.

ix) Legal rights of patients and obligations of dental graduate under forensic jurisprudence

x) Emphasis shall be on chair side teaching, small group teaching and discussions, tutorials, Seminars, ward posting, laboratory posting, field visits and self learning.

The Internship shall be compulsory and rotating as per the regulations prescribed for the purpose


253

2. Curriculum for Internship Programme Time Schedule: The compulsory rotating Dental Internship shall include training in Oral Medicine & Radiology, Oral & Maxillofacial Surgery, Prosthodontics, Periodontics, Conservative Dentistry, Pedodontics, Oral Pathology & Microbiology, Orthodontics and Public Health Dentistry.

A. Oral Medicine & Radiology: (1 month) The interns shall

perform the following: i. Standardized examination of patients -25 cases ii. Exposure to clinical, pathological laboratory procedures and biopsy 5

cases iii. Effective training in taking of radiographs (Intra-oral, Extra oral,

cephalogram) 1 iv. Effective management of cases in wards- 2 cases

B. Oral and Maxillofacial Surgery (l 1/2 months)

i. The Intern shall perform the following procedures:

a. Extractions - 50

b. Surgical extractions - 2

c. Impactions - 2

d. Simple Intra Maxillary Fixation - 1

e. Cysts enucleations - 1

f. Incision and drainage - 2

g. Alveoloplasty, Biopsies & Frenectomies etc. - 3

ii. The Intern shall perform the following on Cancer Patients: 1. Maintain file work 2. Do extractions for radiotherapy cases 3. Perform biopsies 4. Observe varied causes of oral cancers

iii. The Intern shall have 15 days posting in emergency services of a dental/ general hospital with extended responsibilities in emergency dental care in the wards. During this period he shall attend to all emergencies under the direct supervision of Oral surgeon during any operation.


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Emergencies: Toothache; Trigeminal neuralgia; Bleeding from mouth due to trauma, post extraction, bleeding disorder or hemophilia; Airway obstruction due to fracture mandible and maxilla, dislocation of mandible, syncope vaso-vagal attacks. Ludwig’s angina, tooth fracture, post inter-Maxillary fixation under general Anesthesia. Work in I.C.U with particular reference to resuscitation procedures. Conduct tutorials on medico-legal aspects including reporting on actual cases coming to casualty. He should have visits to law courts.

C. Prosthodontics, Crown and Bridge: (1 1/2 months)

The Intern shall make: Complete denture (upper &lower) 2

Removable partial denture 4

Fixed Partial denture I

Planned Partial denture I Miscellaneous-like reline/over denture/repairs of maxillofacial Prosthesis I Learning use if face bow and Semi anatomic articulator technique I Crowns Introduction of implants

D. Periodontics: (1 month)

i. The Intern shall perform the following procedures: Prophylaxis 15 cases Flap Operation 2 cases Root Planning 1 case Curettage 1 case Gingivectomy 1 case Perio-Endo cases 1 case

ii. During his one week posting in the community health centers, the intern shall educate the public on prevention of periodontal diseases.

E. Conservative Dentistry and Endodontics (1 month)

The intern shall perform the following procedure independently or under the guidance of supervisors. Restoration of extensively mutilated teeth 5 cases Inlay and On-lay preparations 1 case


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Use of tooth colored restorative materials 4 cases Treatment of discolored vital and non-vital teeth 1 case Management of dento-alveolar fracture 1 case Management of pulp-less, single-rooted teeth without pen-apical lesion

4 cases

Management of acute dento-alveolar infections 2 cases Management of pulp-less, single rooted teeth with peripheral lesion 1 case Non surgical management of traumatized teeth during formative period

F. Pedodontics and Preventive Dentistry (1 month)

The intern shall perform the following: Topical application of fluorides including varnish 5 cases Restorative procedures on deciduous carious teeth 10 cases Pulpotomy 2 cases Pulpectomy 2 cases Fabrication and insertion of space maintainers 1 case Oral habit breaking appliances 1 case

G. Oral Pathology and Microbiology: (15 days) The interns shall perform the following: History recording and clinical examination 5 cases Blood Urine and Sputum examination 5 cases Exfoliative cytology and smears study 2 cases Biopsy laboratory procedure and reporting 1 cases

H. Orthodontics and Dentofacial Orthopedics :(1 month)

i. The interns shall observe the following procedures during their posting in Orthodontics: Detailed diagnostic procedures for 5 patients Laboratory techniques including wire bending for removable appliances, soldering and processing of myo-functional appliances. Treatment of plan options and decisions Making of bands, bonding procedures and wire insertions. Use of extra oral anchorage and observation of force values. Retainers


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Observe handling of patients with oral habits causing malocciusions ii. He shall do the following laboratory work:

1. Wire bending for removable appliances and space maintainers including Welding and heat treatment procedures 5 cases

2. Soldering exercises, banding and bonding procedures 2 cases

3. Cold cure and heat cure acrylisation of simple Orthodontic appliances 5 cases

I. Public Health Dentistry: (3months)

The Intern shall conduct health education session for individuals and groups on oral health, public health, nutrition, behavioural sciences, environmental health, preventive dentistry and epidemiology They shall conduct a short term epidemiology survey in the community or in the alternate participate in the planning and methodology. They shall arrange effective demonstrations of • Preventive and interceptive procedures for prevalent dental diseases

• Mouth rinsing and other oral hygiene demonstrations 5 cases • Tooth bushing techniques

Conduction of oral health education programmes at

• School setting 5 cases • Community Setting 5 cases • Adult education programmes 5 cases

• Preparation of Health Education materials 5 No.s • Exposure to team concept and National Health care systems

• Observation of functioning of health infrastructure • Observation of functioning of health care team including multipurpose

workers male and female, health educators and other workers. • Observation of at least one National Health programme. • Observation of interlink ages of delivery of oral health care with Primary

Health care.

3. Elective Posting (15 Days) The intern shall be posted for 15 days in any of the dental departments of their choice mentioned in the foregoing.


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4. A Research oriented / epidemiological study guided by a PG teacher has to be carried out and the study report has to be submitted to the institution by every intern before the completion of the internship.

5. Assessment of Internship: The intern shall maintain a record of work which is to be verified and

certified by the Head of Each department. Apart from scrutiny of the record of work, assessment and evaluation of training shall be undertaken by an objective approach using situation tests in knowledge, skills and attitude during and at the end ofposting in each department. Based on the record of work and evaluation, the Head of the Institution shall issue a certificate of satisfactory completion oftraining, following which the University shall declare him eligible for the award of BDS degree.

Satisfactory completion shall be determined on the basis of the following:

No. Parameter Score

1 Proficiency of knowledge required for each case 1 - 4

2 The competency in skills expected to manage each case a. competency for performance of self performance, b. of having assisted in procedures and c. of having observed

1 - 4

3 Responsibility, punctuality, work up of case, involvement in reatment, follow-up reports

1 - 4

4 Capacity to work in a team (Behaviour with colleagues, nursing staff and relationship with paramedics)

1 - 4

5 Initiative, participation in discussions, research aptitude 1 - 4

6 Participation in Community and Social service programmes 1 - 4

Score: 1: Very dissatisfied (less than 30%) 2: Dissatisfied (Between 30-50%) 3: Satisfied (Between 50-70%) 4: Very Satisfied (more than 70%)

Note: A Score of less than 3 in any of above items will represent unsatisfactory completion

of internship

5. Rural Service: During the rural services, the internee shall participate in


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1. Community Health Monitoring programmes and services which include Preventive. Diagnostic and corrective procedures to create educational awareness about dental hygiene and diseases

2. Conduction of Oral Health Education Programs at: (a) School Setting - 5 (b) Community setting - 5 (c) Adult Education Programme - 5

3. Lectures to create awareness and education in public forums about the harmful effects of tobacco consumption and the predisposition to oral cancer – two lectures per student.

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Documents

Regulations and Curriculum for Bachelor of Dental Surgery BDS › naac › 2019 › CRITERIA1 › 1.1.1 › ... · Regulations and Curriculum for Bachelor of Dental Surgery BDS (Amended