CASE WESTERN RESERVE UNIVERSITY by z588ak4

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									                 CASE WESTERN RESERVE UNIVERSITY
                    SCHOOL OF DENTAL MEDICINE
                              2012-3
COURSE TITLES:                    Periodontal Medicine & Case Studies
COURSE NUMBERS:                   COMP 422
DEPARTMENT:                       Periodontics
SEQUENCE YEAR:                    Fourth


CLOCK HOURS:                      16 Hours


CREDIT HOURS:                     1 Credit Hour


COURSE DIRECTOR:                  Dr. Leena Palomo


SUPPORTING INSTRUCTIONAL STAFF:   Senior Perio Residents




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     OFFICE and CONTACT INFO                         1st floor, 216-368-6300




COURSE DESCRIPTION:

Lecture and clinic together in this course enable the student to further apply the knowledge and
skills learned in prior periodontal courses while incorporating the impact of systemic conditions
and multidisciplinary interactions on periodontic endpoints. It focuses on how selective
periodontal treatment can be integrated into a treatment plan considering the parameters
presented by a special situation and introduces students to case specific consideration. Some
examples are treatment related to specific medical problems, pharmacologic interactions,
endodontics, prosthodontics, geriatrics, esthetics, orthodontics and implantology.

COURSE GOALS:

1.      To be able to understand the role of periodontal therapy and its endpoints in the scope
        of various systemic conditions and multidisciplinary dentistry.
2.      To synthesize medical, dental, and lifestyle information in treatment and patient
        management.
3.      To be able to apply principles of periodontal therapy in prosthetic, geriatric, orthodontic,
        and implant treatment situations.

COURSE OBJECTIVES:

At the conclusion of this course, the student will be able to:

1.      Understand how systemic and multidisciplinary conditions impact risk assessment. H.3
2.      Manage periodontal therapy in patients who have systemic disease. R15.2
3.      Understand relationship of periodontal disease to systemic conditions. D.2




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4.     To understand the impact of periodontal infection and inflammation on the systemic
       condition and general health of the patients. D.2
5      Make an initial classification for perio-prosthetic treatment procedures. R.5
6.     Recognize perio procedures outcomes. R.8
7.     Recognize dx and tx complications R.11
8.     Proper sequencing treatment planning integrating dental implants in perio therapy. R.3


Reviewed and revised June 2, 2012

CORE CWRU COMPETENCIES:

This course provides didactic instruction that is designed to furnish foundation knowledge that
is necessary for the development of a number of CWRU School of Dental Medicine
Competencies. The successful completion of this course contributes to the development of the
following competencies:


D.2    Demonstrate knowledge of the interaction and relationship between systemic and oral
       disease (CODA 2-13)

H.3    Apply preventive strategies for patients based on their oral health status and risk
       factors (CODA 2-25c)

R.3    Demonstrate ability to develop optimal and alternative treatment plans which are
       properly sequenced

R.5    Demonstrate clinical skills in the treatment/restoring oral hard and soft tissues to
       form, function, and esthetic standards (CODA 2-25b)

R.8    Evaluate the outcomes of treatment (CODA 2-25n)




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R.11   Recognize, evaluate and manage uncomplicated localized odontogenic infections and
       common post-operative complications (CODA 2-25k)

R15.2 Periodontal disease (CODA 2-25h)




PREREQUISITE: Successful completion of first, second, and third year didactic and clinical
Department of Periodontology requirement.


FORMAT: Lecture, clinic instruction and supervision, consultation with instructors
and patient care

OUTCOME ASSESSMENT:

The students will be assessed via

   1. Mock Board Exam 50%
   2. Senior Surgical Case Report (Oral) 50%



GRADE SCALE:


Didactic and Clinic* >70 = PASS                  < 70 = FAIL


      Grade adjustments will be made to a test if there was an error in calculation or in cases
       where the incorrect answer(s) were keyed.
      Discussions of test items with faculty are always encouraged. Grade changes to
       Summative Evaluations will be made only if accompanied by written (word processor)




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      description of rationale and reference (not just citation). This must be submitted within
      1 week of the returned examination. No more than 5 test items will be reviewed.

COURSE REQUIREMENTS:

Clinical Requirements

 A.   SENIOR SURGICAL CASE REPORT (SURGERY MUST BE COMPLETED)

      One surgical case report must be prepared by the student prior to the Oral
      Examination. The written notes should follow the same format as the 3 rd year case
      report. Case Report MUST meet the following specifications:

         1. Case Type: FULL CASE (including initial therapy, re-evaluation, surgical
            therapy, post-op management, and assessment of results).

             Localized or generalized mild, moderate, or severe periodontitis with periodontal
             pockets and radiographic bone loss must be present in patient. Cases that
             require surgery such as crown lengthening, ridge augmentation prior to
             restorative/prosthetic treatment, or implant therapy may also be used.

         2. Report must be an original periodontal case diagnosed, treated and compiled by
            the student during his/her third or fourth year of dental school.

         3. Charting:

             Comprehensive charting is required at pre-treatment, re-evaluation (if it is a
             scaling and root planing case), and one year post-treatment (if surgical
             treatment was performed). The consultation for the treatment plan and all the
             necessary procedures (e.g., scaling and root planing, surgery, etc.) and the date
             of the completion of the treatment must be documented in the Daily Treatment
             Record and signed by a periodontics instructor. Determine and record probing
             depths, bleeding on probing and gingival margin position. An O’Leary Plaque
             Control Record to determine the presence of plaque and the patient’s oral




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            hygiene must be included.

        4. Radiographs:

            Complete dental radiographs, including posterior bitewings, are required before
            treatment. All radiographs must be of diagnostic quality, reproducing with proper
            contrast and density the teeth and alveolar bone in anatomically correct
            relationships. All teeth and implants, including third molars, must be shown in
            their entirety in at least one radiograph. All occluding posterior teeth must be
            shown on bite wing radiographs. All radiographs must be placed in suitable
            mounts.


            SURGICAL CASE APPROVAL—Surgery must be completed

            The Senior Perio Case Approval Form is available at the perio desk and must be
            signed by full-time periodontics faculty when your case selection is made. This
            must be completed by end of first semester.

B.   EVALUATION OF ORAL EXAMINATION—See Grading Sheet

     Each student will be asked to orally present the above case he/she has treated to a
     preceptor or restorative faculty and a periodontics instructor. A written outline should
     be used as a guide for the oral presentation. A copy of the Daily Treatment Record and
     the Case Approval Form must be turned in to the instructor before the case is
     presented.

            Oral presentations will commence the LAST WEEK OF CLINIC 2013. The
            patient used for this exercise should NOT be the same one used for the written
            Junior Case Report. NOTE: You must bring your Junior Case Report to this
            presentation.

            Students should be thoroughly familiar with all aspects of their cases and should
            be prepared to discuss them in their entirety. Evaluation of the student’s
            knowledge of




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              clinical situations, alternate choices of therapy, recognition and management of
              other clinical medical, dental and lifestyle conditions and hypothetical situations
              will also be part of the examination.

              An average score of 70% will be required to pass the examination.

 C.    ONE PERIODONTAL SURGICAL PROCEDURE

To receive credit, the student must do all the pre-op work-up on the patient. This will
      include an assessment of medical/dental historic considerations, examination,
      periodontal treatment plan, oral hygiene instruction, monitoring of plaque control to be
      sure that it is satisfactory, prophy and/or scaling and root planing, plus re-evaluation.
      Select a patient who needs a localized surgical procedure that can be done in a single
      appointment. Some examples are: moderate periodontitis involving 2 or 3 adjacent
      teeth, or a crown-lengthening procedure involving either a single tooth or 2 adjacent
      teeth.

       It is required that the planned surgical procedure be reviewed and signed as acceptable
       by a periodontal instructor. The Senior Surgery Case Approval Form is available at the
       perio desk. This should be done at the re-evaluation appointment after satisfactory
       initial therapy. Assistance for the procedure will be provided by a graduate periodontics
       resident. The student will also manage post-op and follow-up appointments as are
       needed. Students are encouraged to do more than one surgical procedure so as to get
       as much clinical experience as possible. The student must make all appointments with
       the periodontal clinic secretary at the perio desk.

 D.    15 POINTS OF SCALING AND ROOT PLANING AND 4 POINTS PERIO
       MAINTENANCE

       You will NOT be required to complete a specific number of patients with scaling and
       root planing, so that patients would be treated according to their needs. Treatment is
       considered maintenance if scaling has been done over the last year. Maintenance
       does not require reevaluation.

       Each quadrant of scaling and root planing will be graded on a scale of 1 to 4, 1 being




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       unacceptable and 4 being excellent. Each grade you obtain will be equivalent to the
       same number of points. Each student needs 15 points minimum of SC/RP and 4 points
       minimum of maintenance. You must have a periodontal treatment plan signed by a
       periodontal instructor and recorded on the periodontal examination form before starting
       a scaling and root planing procedure. NOTE: CREDIT WILL NOT BE GIVEN FOR
       THE SCALING AND ROOT PLANING PROCEDURES UNLESS THE RE-
       EVALUATION IS PROPERLY DONE AND DOCUMENTED ON THE PERIODONTAL
       EXAMINATION FORM.

       ONE (1) COMPETENCY EXAMINATION IN SCALING AND ROOT PLANING (not
       included in 19 points) in the Mock Board format. Only perio full-time faculty can
       supervise the exam.

       Please note:

       Use the S/RP competency exam form available in the clinic.
       Prerequisite: You should have at least 19 points before taking the exam.


 E.    ONE (1) PERIODONTAL SURGICAL ASSIST. Credit can be obtained under the two
       categories:

       1. Assisting as needed in the perio clinic, not necessarily for your patient.

       2. Assisting in your patient’s surgery.


GRADE SCALE

The *clinical course grade will be expressed as a letter grade as Pass/No Pass based on
percentage obtained on summative exams. 70% required to Pass.

All clinical requirements must be completed by the last regularly scheduled session of clinic. A
0.50 point penalty (on a 4.0 scale) will be deducted from the grade if all requirements are not




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completed on time. Students are to notify front desk of the Periodontal Clinic in writing, when
the deficiency in requirement is anticipated at least one month prior to the deadline. This would
enable us to assist the student in timely manner.

Students are required to take ALL tests including Mock Board on the days indicated in the
syllabus. In accordance with school policy, absences are:
1.     Excused – in case of illness documentation from the treating physician must be
       presented. A new test will be administered. Format and time will be at the discretion of
       the faculty.
2.     Unexcused – when a student fails to give notification o an absence which can be
       predicted to be absolutely unavoidable, or fails to present an appropriate excuse. In
       most cases, an unexcused absence would result in a zero score for the particular test.


COURSE DEFICIENCY POLICY:


1. Remediation will be required of all students earning an "F" grade (didactic).

REMEDIATION:
Students who do not attain a passing score will be required to remediate by taking another oral
exam within one week from the scheduled oral presentation.

After the midterm examination, students with a No Pass performance are to report to the course
director’s office. At this meeting, the students are directed and advised to solve any difficulties
with the course. The final course grades are submitted to the registrar and the Student Services
Office. Performances of the failed students are evaluated by the Student Standing and
Promotion Committee. The course director submits a written evaluation of the student’s
performance if requested by the committee. Then the committee makes a recommendation on
the format of remediation with an approval of the course director. The remediation varies from a
repeat of the course to the additional self-study, depending on the need of the individual student.




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ATTENDANCE POLICY:


Attendance in class is expected. Failure to attend class with subsequent failure of the exams
does not warrant remediation. In accordance with school policy, students who habitually fail to
attend class will be denied tutoring through CWRU School of Dental Medicine.



Required TEXTS:

Rose, Mealey, Genco Cohen. Periodontics Medicine, Surgery and Implants Elesevier
Mosby. 2004.




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