Curriculum | Oral & Maxillofacial Surgery | Fourth Year | BDS

SR NO

TOPIC

LEARNING OBJECTIVES
(AT THE END OF THE SESSION THE STUDENT SHOULD BE ABLE TO)

TEACHING GUIDELINES

METHODOLOGY

TIME

• Explain signs and symptoms associated with the need to remove impacted teeth.
• Identify when an impacted tooth requires removal and manage it in a safe manner,  whether an unerupted tooth requires removal, exposure, reimplantation/transplantation, or retention in conjunction with other relevant specialists
• Describe investigations and radiographic interpretation relevant to impacted wisdom teeth
• Describe indications for removal of impacted wisdom teeth, potential complications and how to manage them, relevant pharmacology
• Recognise complications associated with removal (and retention) of impacted teeth (supernumeraries)and deal with complications that may arise.
• Explain why and when to leave a retained root.
• Formulate treatment plan including aftercare.
• Carry out technique under local anaesthesia, sedation or general anaesthesia: carry out steps of procedure safely and correctly, undertake Surgical exposure or transplantation of unerupted tooth, including various techniques of exposure and bone removal, packing and/or bonding of tooth, techniques of tooth splintage, intra-oral suturing techniques.
• Therapeutics of postoperative analgesia prescribed

• General factors, incidence, etiology.
• Classification, indications for removal of lower.
• Assessment: Clinical & radiological.
• Anaesthetic considerations.
• Historical background of techniques
• Surgical procedure.
• Maxillary third molar and Canine impactions, Incidence, Indications for removal, Classification,
• Assessment and Localisation, Surgical Procedure.
• Management of special cases
•  Complication of surgical removal of impacted teeth.

• Didactic lecture
• PPT involving video and pictorial representation.
• Group discussion.
• Project
• Demonstration using skull and mandible.

• Describe the anatomy of oro-facial spaces.
• Identify dental/oral surgical cause for infection (local and/or spreading).
• Explain the microbiology of  head and neck infection.
• Describe Signs and symptoms, Differential diagnosis, Investigations and radiographic interpretation, Methods of medical and surgical management, Potential complications including management of compromised airway.
• Recognize difference between local and spreading infection.
• Recognize systemic sepsis (sepsis syndrome).
• Recognize infection as an early indicator of immunosuppression, e.g. diabetes, immunocompromised states. Institute aftercare and review.
• Recognize when the airway is at risk. Relieve airway or know when to refer. Know when and how to collect samples.
• Manage compromised airway (surgical airway).
• Explain techniques of non- surgical and surgical airway management.
• Formulate treatment plan, recognize the relevance of early involvement of microbiologist.
• Treat/drain infection.
• Carry out technique under local anaesthesia, sedation or general anaesthesia.
• Secure appropriate drains and dressings.

• Introduction.
• Microbiology of odontogenic infections
• Anatomical considerations and fascial spaces
• Spread of Infections.
• Acute dento – alveolar abscess.
• Acute & chronic infections of the Jaws: Cellulitis, Ludwig’s angina, Actinomycosis
• Management of infections -Medical & surgical management Analgesics, Anti inflammatory drugs surgical.
• HepatitisB, H.I.V. infections

• Didactic lecture & PPT involving video and pictorial representation.
• Group discussion.
• Chair side discussion
• Demonstration of facial spaces using skull and mandible.

• Identify dental/oral surgical cause for infection (local and/or spreading).
• Explain the microbiology of  head and neck infection.
• Describe Signs and symptoms, Differential diagnosis, Investigations and radiographic interpretation, Methods of medical and surgical management.
• Recognize difference between local and spreading infection.
• Recognize systemic sepsis (sepsis syndrome).
• Recognize infection as an early indicator of immunosuppression, e.g. diabetes, immunocompromised states. Institute aftercare and review.
• Formulate treatment plan, recognize the relevance of early involvement of microbiologist.
• Treat/drain infection.
• Carry out technique under local anaesthesia, sedation or general anaesthesia.
• Secure appropriate drains and dressings

• Introduction
• Microbiology of odontogenic infections
• Anatomical considerations
• Spread of Infections
• Acute dento – alveolar abscess
• Acute & chronic infections of the Jaws
• Management of infections
• Medical & surgical management Analgesics, Anti inflammatory drugs surgical

• Didactic lecture &
• Discussion
•  PPT involving video and pictorial representation
• Group discussion
• OT Visits
• Demonstration of management using skull and mandible

• Describe the anatomy of maxillary sinus
• Identify dental/oral surgical cause for sinusitis(local and/or spreading).
• Describe Signs and symptoms, Differential diagnosis, Investigations and radiographic interpretation, Methods of medical and surgical management, Potential complications including management of sinusitis.
• Recognise difference between local and spreading infection.
• Recognise systemic sepsis.
• Explain techniques of non- surgical and surgical airway management of sinusitis.
• Ability to assess and safely repair an OAF (or remove tooth/root from antrum) and deal with complications that may arise.
• Formulate treatment plan, recognise the relevance of early involvement of microbiologist.
• Treat/drain infection.
• Carry out technique under local anaesthesia, sedation or general anaesthesia.
• Secure appropriate drains and dressings.

• Applied anatomy
•  Acute and chronic sinusitis
• Investigations
• Surgical approach to sinus.
• Removal of tooth or root from the antrum.
• Oroantral fistula and its management.

• Workplace (clinical) experience with appropriate trainers
• Appropriate range of clinical cases for observational and personal treatment.
• Didactic teaching sessions within department.
•  Independent study.
• Involvement in training dental students or in specialist practice
• Use of structured questionnaires
• Exercises in which different conditions and reports are discussed and students asked to derive a diagnosis

• Ability to identify cysts and benign lesions in hard and soft tissue in the oral cavity and jaws.
• Know differential diagnosis and treatment options, when to refer to or confer with other specialists.
• Ability to undertake therapy in a safe manner, and deal with complications that may arise.
• Explain Signs and symptoms, Differential diagnosis of benign and cystic lesions of the jaw.
• Investigations and radiographic interpretation relevant to the management of benign lesions and cysts.
• Pathogenesis of benign and cystic lesions.
• Potential complications.
•  Methods of treatment.
• Be able to decide correct management (biopsy or excise) of jaw cyst/oral hard tissue/soft tissue under  localanaesthetic, general anaesthetic or sedation techniques.

• General features
• Definition
• Classification.
• Pathogenesis
• Signs & symptoms.
• Clinical, radiological & other investigations.
• Surgical management and complications of each type of cyst.

• Workplace (clinical) experience with appropriate trainers
• Problem based learning
• Appropriate range of clinical cases for observational and personal treatment.
• Didactic teaching sessions within department.
•  Independent study.
• Involvement in training dental students or in specialist practice
• Use of structured questionnaires
• Exercises in which different conditions and reports are discussed and students asked to derive a diagnosis

• Ability to identify tumors in hard and soft tissue in the oral cavity and jaws.
• Know differential diagnosis and treatment options, when to refer to or confer with other specialists.
• Ability to undertake therapy in a safe manner, and deal with complications that may arise.
• Explain Signs and symptoms, Differential diagnosis of tumors of the jaw.
• Pathogenesis, Investigations and radiographic interpretation relevant to the management.
• Potential complications.
•  Methods of treatment.

Be able to decide correct management (biopsy or excise) under  localanaesthetic, general anaesthetic or sedation techniques.

• Theories
• Classification
• Management
• Classification
• Etiology, clinical features,radiographic features and management of following tumors: Ameloblastoma, Squamous odontogenic tumour, Calcifying epithelial odontogenic tumour, – Ameloblastic fibroma, fibrodentinoma, Ameloblastic fibrodentinoma, Ameloblastic fibroodontoma, Complex odontoma, compound odontoma, Ameloblastic carcinoma and malignant ameloblastoma. -Odontogenic fibroma (simple and WHOtype), Odontogenic myxoma or myxofibroma, Benign cementoblastoma.

• Lecture
• Photo & Video Presentation
• MCQ
• Debate
• Radiographic Illustration of Actual Patients

• Ability to identify extent of trauma, facial fractures and treatment options.
• Know when to refer to or confer with other specialists.
• Ability to undertake surgery in a safe manner.
• Ability to recognize and deal with complications that may arise.
• Describe Aetiology of facial trauma, Priorities of management, Assessment of airway and level of consciousness (Glasgow coma scale), Signs and symptoms of fractures of facial skeleton, Classification of dental trauma and dento-alveolar fractures, Classification of facial fractures,
• Assessment of head injury and cranial nerve function, Aetiology, Interpretation of radiographs, Potential complications.
• Assess and examine a patient with facial trauma.
• Manage airway and treat emergency dento-facial trauma.
• Formulate treatment plan and prioritise management.

• Introduction, Applied Anatomy & types of Fractures.
• Dento Alveolar Fractures.
• Mandibular Fracture:Classification, Clinical features& Diagnosis.
• Preliminary and definitive management.
• Zygomatic Complex Fractures.
• Middle Third Fractures;Classification, Clinical features& Diagnosis.
• Outline of immediate and definitive treatment.
• Orbital Fractures.
• Nasal Fractures.

• Didactic lecture
• PPT involving video and pictorial representation.
• Group discussion.
• Demonstration of management in clinics.
• Radiographic Illustration of Actual Patients
• Tutorials

• Ability to obtain a history.
• Know a differential diagnosis for the development of such conditions, and treatment options.
• Know when to refer to or confer with other specialists.
• Take a history and examine the patient with facial deformity.
• Describe:  Developmental anatomy of facial skeleton and facial musculature,  Classification and assessment of facial deformity, Psychology of facial deformity, Norms of facial proportions, Techniques of cephalometric analysis, Potential complications of surgery.
• Formulate a treatment plan.
• Refer appropriately.
• Provide post-operative care and follow-up.

• Developmental Deformities a) Deformities of the jaws;
• Basic forms of deformities, Prognathism, Retrognathism and apertognathia.
• Reasons
• for surgical correction, Preoperative
• planning.
• Outline
• of various surgical procedure in mandible and maxilla.
• Cleft Lip and Palate: Etiology, Incidence, Timing of Repair, Role of General dental practitioner.

• Didactic lecture
• PBL
• PPT involving video and pictorial representation.
• Group discussion.
• Demonstration of deformity in clinics on patients(Chair side discussion).
• Radiographic analysis and treatment plan formulation based on clinical and radiographic examination actual Patients

• Ability to explain to a patient the hospital process.
• Describe differential diagnosis when appropriate, and treatment options.
• Know when to refer to or confer with other specialists.
• Ability to undertake therapy in a safe manner.
• Ability to recognise and deal with complications that may arise.
• Ability to prescribe safely. Understand the relevance of the patients medical history to prescription of drugs.
• Understand the legislation surrounding the safe prescription of drugs for dental/oral surgical use.
• Know when to refer to or confer with other specialists.
• Describe the process for admission of a patient to hospital, risk factors for the patient’s condition, and understand relevance to in- patient management, how a hospital surgical team works, the roles and responsibilities of team members, especially within the department and within multidisciplinary teams.
• Explain the process for gaining informed consent.
• Describe the principles of consent issues as relating to oral surgery clinical practice and research.
• Explain:- Pharmacology and therapeutics of analgesia, Pharmacology and therapeutics of  antibiotic therapy and drugs to reduce swelling, Pharmacology and therapeutics of emergency drugs.
• Describe indications for provision of local or general anaesthesia or conscious sedation techniques.
• Describe anaesthetic agents, equipment, medicaments and techniques to provide relevant treatment.

• Introduction
• Classification  of emergencies, prevention and their management

a) CardioVascular
b) Respiratory
c) Endocrine disorders
d) Drug allergies and interactions

• Summery

• Didactic,
• Students interactive session
• Simulation using dummy’s
• Student group discussion & seminar
• Role play
• Drill and practice

• Identification of various neurological disorders and Various nerves involved in disorders
• Ability to diagnose nerve injuries(classification, etiology, clinical features, management).
• Effectively diagnose and manage patients with Trigeminal neuralgia
• Effectively diagnose and manage patients with Facial nerve palsy

• Introduction
• Classification of neurological disorders
• Various nerves involved in disorders
• Nerve injuries(classification, etiology, clinical features, management).
• Trigeminal neuralgia(classification, etiology, clinical features, management).
• Facial nerve palsy(classification, etiology, clinical features, management).

• Case study
• Photo & Video Presentation of actual patients
• MCQ
• Demonstration on actual patients
• Radiographic Illustration of actual Patients
• PBL

• Recognize clinical features of infections of the salivary glands
• List the relevant information to be elicited during history taking, from patients with salivary gland disorders
• Differentiate on clinical grounds between infection, obstruction, benign and malignant  neoplasms of the salivary glands
• Discuss and ask for relevant investigations to help in the diagnosis of salivary gland disorders
• Evaluate the results of the investigations done for disorders of the salivary glands
• Describe treatment procedures and their indications
• Discuss the potential complications of treatment procedures

Stone retrieval:

• Ability to identify when a salivary duct is blocked and why it is blocked.
• Know when to refer to or confer with other specialists eg radiologist.
• Ability to undertake therapy in a safe manner.
• Ability to recognise and deal with complications that may arise.

Ability to identify a mucous cyst/swelling
Ability to identify a benign lesion from a malignant lesion

• General features
• Investigations in the diagnosis of salivary gland diseases.
• Acute and Chronic infection
• Salivary calculus & its management.
• Tumors of the salivary glands & its management.

• Didactic lecture
• PPT involving video and pictorial representation.
• Group discussion.
• Chair side discussion on patients for clinical evaluation and formulation of diagnosis.
• Radiographic evaluation and diagnosis formulation using specialized diagnostic tests

• Diagnose oral parafunction and other factors in the development of dysfunction of mandibular movements and the TMJs.
• Provide behavioural advice for the management of these problems.
• Construct appropriate occlusal appliances for the diagnosis and treatment of these problems.
• Communicate and work with colleagues on the multidisciplinary management of these problems.
• Monitor and evaluate the effectiveness of treatment regimes.

• Appliedsurgicalanatomyofthe joint.
• DevelopmentoftheTMJ
• Surgicalapproaches  to TM.J
• Radiologicalinvestigations
• HypermobiltyofTMJ;Dislocation-Types,aetiology,clinicalfeaturesandmanagement.
• Hypomobility of TMJ
• Ankylosis: Definition, aetiology, clinical features and management
• Myofacialpaindysfunction syndrome, etiology,clinical features,management-
• Nonsurgicalandsurgical.Internalderangement of the joint.
• InflammatoryDiseases of T.M.
• Joint.Arthroscopy

• Appropriate range of clinical cases for observational and treatment.
• Didactic teaching sessions within department.
• OT Visits
• Demonstration using radiographs, skull and mandible
•  Independent study.
• Involvement in training dental students or in specialist practice
• Use of structured questionnaires
• PBL

• Identification of clinically suspicious lesions
• Ability to identify a benign lesion from a malignant lesion.
• Know differential diagnosis and treatment options.
• Know when to refer to or confer with other specialists.
• Ability to undertake biopsy in a safe manner.
• Ability to recognise and deal with complications that may arise.

• Definition of neoplasia
• Difference between benign and malignant tumors
• General radiographic features of maliganat tumors of the jaws
• Brief discussion of each maligannacy- oral SCC, osteosarcoma, primary intraosseous Ca, metastatic lesion, hematipoietic maliganancies.
• LymphaticSpread.
• TNM Classification,Staging.
• Biopsy-types, Filling of Histopathology requestform
• Outline of management of Squamous Cell Carcinoma: surgery, radiation and chemotherapy
• Roleofdentalsurgeonsinthepreventionandearlydetectionoforalcancer.

• Lecture
• Integration with Dept. of OMR & PCD
• Lecture
• Integration with Dept. of O.Path
• Video presentation
• OT Postings
• Discussion of latest treatment modalities using presentations

• Discuss the normal development of the lip, nose, primary and secondary palate
• Describe the development of the cleft lip and palate
• State the factors that cause cleft deformities
• Diagnose and classify cleft lip and palate
• Describe the deformity in cleft lip and palate patients
• Discuss the problems of the cleft patient
• Discuss the management of the cleft patient
• State the principles and techniques of cleft lip and palate repair
• State the reasoning and timing of cleft lip and palate repair
• Discuss Alveolar bone grafting in cleft lip and palate patients
• State the time table and sequence of treatment for cleft lip and palate repair

• Introduction
• Normal development of the lip, nose, and palate
• Development of the cleft lip and palate
• State the factors that cause cleft deformities
• Diagnose and classify cleft lip and palate
• Describe the deformity in cleft lip and palate patients
• Problems of the cleft patient
• Management of the cleft patient
• Principles and techniques of cleft lip and palate repair
• Timing of cleft lip and palate repair
• Alveolar bone grafting in cleft lip and palate patients
• Time table and sequence of treatment for cleft lip and palate repair

• Workplace (clinical) experience with appropriate trainers
• Appropriate range of clinical cases for observational and personal treatment.
• Didactic teaching sessions within department.
• OT Visits
• Involvement in training dental students or in specialist practice
• Use of structured questionnaires

• Identify patients requiring pre-prosthetic surgery
• Decision making for type of surgery to be conducted
• Alternatives to preprosthetic surgery

• Introduction,
• Aims of  PreProsthetic
• Surgery,
• Classification.
• Corrective procedures – hard and soft tissues.
• Sulcus extension procedures.
• Ridge reconstruction or augmentation procedures.

• PBL
• Didactic lecture & PPT involving video and pictorial representation.
• Group discussion.
• Demonstartion of of management using skull and mandible.

• Knowledge and skills to use dental

implants to replace missing dentition and oral tissues.

• Ability to identify which treatment option is best for  the patient.
• Know when to refer to or confer with other specialists e.g. restorative specialist.
• Ability to undertake surgical treatment in a safe manner. Ability to recognise and deal with complications that may arise.

• History taking and examination
• Formulation of  treatment plan.
• Insertion of implants
• Bone harvesting and augmentation
• Soft tissue procedures or guided bone regeneration
• Post-operative care and follow-up
• Show a high degree of skills in the choice and execution of appropriate techniques for all stages of the surgical implant placement.
• Construct surgical and radiographic guides to aid planning of number, position and angulation of fixtures.

• Didactic teaching sessions within department.
• Workplace (clinical) experience with appropriate trainers
• Appropriate range of clinical cases for observational and personal treatment.
• Independent study.
• Involvement in training dental students or in specialist practice
• Use of structured questionnaires

• Ability to identify which treatment option is best for  the patient.
• Know when to refer to or confer with other specialists e.g. restorative specialist.
• Ability to undertake surgical treatment in a safe manner. Ability to recognise and deal with complications that may arise.

• Introduction
• Classification
• Etiology
• Apicoectomy
• Reimplantation

• Workplace (clinical)
• experience with appropriate trainers including attendance at appropriate clinics eg restorative clinic.
• Appropriate range of.clinical cases for observational and personal treatment.
• Attendance at didactic teaching sessions within department.
• Attendance at suitable courses. Attendance at suitable meetings.
• Independent study.
• Involvement in specialist dental practice.

• Hospital in-patient care
• Ability to explain to a patient the hospital process.
• Describe differential diagnosis when appropriate, and treatment options.
• Know when to refer to or confer with other specialists.
• Ability to undertake therapy in a safe manner.
• Ability to recognise and deal with complications that may arise.
• Ability to prescribe safely.
• Understand the relevance of the patients medical history to prescribe drugs.
• Understand the legislation surrounding the safe prescription of drugs for dental/oral surgical use.
• Know when to refer to or confer with other specialists.
• Management of the medically at-risk patient
• Hospital discharge and  follow-up

• Systemic diseases.
• Patients with medically compromised conditions
• Immuno compromised conditions
• Geriatric patients
• Pregnant woman

• Didactic,
• Seminar,
• Students Interactive Session
• &
• Case Presentation
• Problem based learning