PERIODONTOLOGY PERI 323

 FALL 2000

 CASE PRESENTATION AND PROBLEM BASED LEARNING SESSIONS

  Periodontology 2000/2001

 Peri 323

 Course Director:  Dr. John Crawford

The course runs from October 19 through the Spring Semester.

Course Components:

Lectures

The majority of the lectures will be in a case-based format. Each case will be presented in the Dept. of Periodontics treatment planning format.

Time constraints will not allow full discussion of all aspects of the cases so we will generally focus on one or two specific areas in the mouths of the patients.

Each case will be placed on the Department of Periodontics web site for future reference.

There will be material that will not be covered in the lectures but will be included with handouts.  This material will be self-study and will be available on the web.  One half (25 questions) in the final exam will be based on these self-study materials.  

Problem-based discussions

The class will be divided into 4 groups for the problem-based discussions:

GROUP 1 

GROUP 2

GROUP 3

GROUP 4

A dept. faculty member (or Post-doctoral student) will be in charge of each group.
Topics (problems) will be assigned 1 week before each session.
One student in each group will be assigned to summarize the discussion.  The summary must be handed into me (Dr. Crawford) on a floppy disk, not more than one week after the session.  The summary will then be online in Course Info.
A total of 7 hrs unassigned time has been allowed for the extra work needed to prepare for the problem-based sessions and to prepare these summaries.

Laboratories 

There will be 4 laboratory sessions in the Spring semester (2001). 

1.                 Treatment Planning

2.                 Scaling and root planing

3.                 Ultrasonic scaling

4.                 Surgery on the pig jaw

Goals and Objectives

The goals and objectives of the didactic and clinical courses offered by the department of Periodontics fulfill the curriculum guidelines for Periodontics developed by the American Association of Dental Schools in October 1990.

In summary, these are: 

  "To teach the student to diagnose the periodontal status of patients and to recognize the changes that occur in the transition from health to disease.  The student should be able to diagnose, plan treatment, provide therapy and distinguish disease states which require patient referral to periodontists and other health care specialists".  

Periodontology (Peri 323)  is a continuation of your education in periodontology which started with the course Preventive Periodontics (Peri 315).  The specific objectives of Periodontology are different from those of Preventive Periodontics and concentrate on the diagnosis and treatment of periodontal diseases which cause destruction of the periodontium and which may cause premature loss of teeth if not treated.  These diseases are collectively called Periodontitis

Educational goals of the course:

1.         to provide you with the knowledge of the etiology, pathogenesis and clinical features of the various forms of periodontitis.     

2.         to provide you with a knowledge of the rationales and principles of therapy for the various forms of periodontal diseases.

Behavioral goals

1.         the acquisition of knowledge in the biological basis of periodontics on which will be based the clinical skills acquired in the laboratory and clinical courses.  

2.         the acquisition of knowledge of the principles of therapy of different forms of periodontal disease on which will be based the clinical skills acquired in the laboratory and clinical courses.

The faculty of the Department of Periodontics would like to encourage an enthusiasm for Periodontics and a desire to base all dental therapy on the control of the primary etiologic factors of dental diseases.

Specific Behavioral Objectives

 1.         You should be able to describe:

                        a.            the epidemiology of periodontal diseases

                        b.            the principal epidemiological indices (including the ADA case type  
   classification) used to measure the prevalence and severity of periodontal
   diseases.

2.                  You should be able to classify periodontal diseases based on the
            American Association of Periodontology (AAP) classification of 1999.

3.                  You should be able to describe the clinical, radiographic and
            histopathological features of the each of the Periodontal diseases in the 
            AAP classification including:

  gingival inflammation 

    gingival and periodontal pocket formation

    attachment loss and alveolar bone destruction  

4.         You should be able to describe manual probing techniques used for the diagnosis of periodontal diseases and the principal features of the computerized probing technology.

5.         You should be able to describe the Periodontal Screening and Recording (PSR) system for periodontal diseases. 

6.         You should be able to interpret radiographic findings associated with periodontal diseases and occlusal trauma including:

                        i.            severity of bone loss and crown root ratio

                        ii.            patterns of bone loss (angular/horizontal)

                        iii.           changes in crestal and radicular lamina dura

                        iv.            furcation and periapical radiolucencies

                        v.            presence of calculus, caries and defective restorations

                        vi.            root proximity and root resorption

                        vii.           widened periodontal ligament space

                        viii.          other anatomic features such as sinus and mandibular canal 
                                        locations

7.         You should be able to describe the principal features of subtraction radiography and
            digital radiography.

8.         You should be able to use information obtained in the examination of the patient to make a specific diagnosis based on the AAP classification of periodontal diseases.

9.         You should be able to describe the principal clinical features of HIV related periodontal
            diseases.

10.       You should understand the concepts of primary and secondary etiology:

           Primary etiology:

            You should be able to describe:           

a.         the stages of development and composition of human supragingival and
subgingival microbial plaque and their role in disease initiation and progression.

                        b.         the classification of the specific microorganisms and the morphologic form  of
microorgansims associated with periodontal diseases.

c.                  Virulence factors associated with periodontal pathogenic bacteria.

d.                  The organization of microbial plaque into biofilms  

Secondary etiology:

              You should be able to describe:                   

                        a.         the formation, composition, modes of attachment, mechanisms of mineralization,
and pathologic potential of supragingival and subgingival calculus and altered
cementum.

                        b.         the significance of carious lesions, overhanging restorations, rough margins,
crown contours, tooth position and open contacts on the etiology of periodontal
diseases.

                        c.         the role of occlusal trauma in periodontal diseases:

11.       You should be able to describe the major features of the immunopathology (host response) of periodontal diseases.

12.       You should be able to describe factors that may modify the host response to  periodontal disease, such as genetic factors, systemic diseases,  emotional stress, tobacco usage, age and substance abuse.

13.             You should be able to discuss the current understanding of the relationship of
            periodontal disease to systemic conditions and diseases such as pregnancy,
            cardiovascular disease, lung disease and diabetes.  

14.       You should be able to:

             a.            describe the information necessary to develop a periodontal treatment plan
                            (patient history, clinical findings, etiologic factors, diagnosis, prognosis, and
                            the patient's dental health goals and needs).

             b.            describe the rationales and objectives of the following phases of therapy:

                                                i.   initial therapy

                                                ii.  reevaluation

                                                iii. surgical phase

                                                Iv. surgical reevaluation

                                                iv. supportive periodontal treatment

              c.            describe how significant medical history findings influence periodontal
                             treatment planning and discuss precautions necessary during therapy.

              d.            recognize those cases which require referral to periodontists or other
                             health-care providers

              e.            integrate periodontal treatment with other dental treatment needs

              f.            describe the major goals in the treatment of occlusal trauma

              g.            describe local and systemic pharmaco-therapeutics used in periodontal
 therapy for:

                                    i.             pain and anxiety control

                                    ii.            tooth sensitivity

                                    iii.           chemical plaque control

                                    iv.           pre-procedural rinse

                                    v.             control of infections

                                    vi.            postoperative management

                                    vii.           therapy of periodontal diseases

                h.           describe instruments, rationale and objectives of scaling and root planing
with manual and ultrasonic instruments.

                i.            describe methods of correcting plaque retention areas (secondary etiologic 
                               factors)           

                j.            list and describe the anatomical features to consider in planning periodontal surgery.

                k.           describe indications, contraindications, objectives, and techniques for periodontal surgical procedures, including:

                                     i.            gingivectomy

                                    ii.            periodontal flaps

                                    iii.            mucogingival surgery

                                    iv.            treatment of osseous defects including the concepts and new
    advances in regenerative techniques.

             l.            describe the principal suturing techniques used in periodontal surgery and
                           their functions

             m.          describe the rationale for the use of periodontal dressings and  the technique for their placement.

             n.           describe the postoperative instructions to be given after periodontal surgery.

             o.                    describe postoperative emergencies and procedures for their management.
                      

             p.                   describe the principal concepts of wound healing as they relate to periodontal tissues

             q.         define and describe dental implants with regard to their:

                                    i.            indications and contraindications

                                    ii.            physical properties

                                    iii.            design

                                    iv.            interface with soft and hard tissues

                                    v.            maintenance

           r.          describe methods for evaluating the effectiveness of the different phases of
                        therapy

           s.          describe the rationale for supportive periodontal treatment (maintenance).

           t.           list the procedures employed in supportive periodontal treatment.

           u.                     describe criteria for modifying a supportive periodontal treatment program to
                         meet individual patient needs.

Competencies

The competencies addressed in this course are the following:

Competency 1

Decision making supported by foundational knowledge and evidence-based rationales.

Competency 6

Diagnosing oral and dental diseases/abnormalities.

Competency 7

Developing a  treatment plan and treatment alternatives.

Competency 12

Identifying patient a with increased risk factors for oral diseases.

Competency 20

Controlling primary and secondary etiologic factors of periodontal disease.

Exams, Quizzes etc.

 There will be 2 multiple choice exams with 50 questions in each exam – one midterm and one final. 

• Three of the four labs will be graded (the Ultrasonic scaling lab will not be graded)
• Summaries of problem-based learning will be pass/fail. A failing grade will be assigned if the summary is inadequate or if it not handed in within 1 week of the PBL session.
• There will be 5 unannounced quizzes in the lectures.  You may miss one quiz without penalty

Grades

Midterm                      30%

Final                            30%

Laboratories              20%

Quizzes                      20%

Grade cut off points  

                        A --            90 and above

                        B --            84-89

                        C --            77-83

                        D --            70-76

                        E --            below 70  

To receive an A in the course, your aggregate score for the midterm plus final exams must be 90 or above. 

If you receive a failing grade in your PBL summary or fail to hand in your summary within one week of the session, 3 percentage points (approximately one half a grade) will be deducted from your aggregate score. 

If you score below 76% for the course you must arrange with Dr. Crawford to go over the midterm and final exams. 

If you score under 70% you must go over the exams and sit another exam. If you pass this exam your grade will be adjusted to a D.   

Dr. Crawford is available in room 465B on most days during the course.
He can be reached at 996-1266 or by e-mail:  jimmy@uic.edu