Curriculum

Periodontology

Fourth Year , BDS

Sr no

TOPIC

Learning objectives

Teaching Guidelines

Time

Methodology

THE PERIODONTAL POCKET Student should be able to understand Classification,
Pathogenesis, Histopathology
Bacterial Invasion
Site Specificity,
Periodontal Abscess,
Lateral Periodontal Cyst
  • Clinical Features
  • Mechanisms of Tissue Destruction Microtopography of Gingival Wall,  Periodontal Pockets as Healing Lesions,
  • Pocket Contents,
  • Root Surface Walls, Periodontal Disease Activity,
  • Pulp Changes Associated with Periodontal Pockets,
  • Relationship of Attachment Loss and Bone Loss to Pocket Depth,
  • Area Between Base of Pocket and Alveolar Bone,
  • Relationship of Pocket to Bone,
1hr Group discussion, model demostration
BONE LOSS & PATTERNS OF BONE DESTRUCTION Student should be able to understand Classifiaction
Clinical features
Radiographic features of bone loss
  • Bone Destruction Caused by Extension of Gingival Inflammation, Radius of Action,
  • Rate of Bone Loss,  Periods of Destruction, Mechanisms of Bone Destruction,
  • Bone Formation in Periodontal Disease,
  • Bone Destruction Caused by Trauma from Occlusion,
  • Bone Destruction Caused by Systemic Disorders,
  • Factors Determining Bone Morphology in Periodontal Disease, Normal Variation in Alveolar Bone,  Exostoses,
  • Trauma from Occlusion, Buttressing Bone Formation,
  • Food Impaction,  Aggressive Periodontitis, Bone Destruction Patterns in Periodontal Disease,
  • Horizontal Bone Loss, Bone Deformities (Osseous Defects),  Vertical or Angular Defects, Osseous Craters,
  • Bulbous Bone Contours, Reversed Architecture, Ledges,
  • Furcation Involvement,
1hr Case presentation,
Radiographic presentations,
discussion
PERIODONTAL RESPONSE TO EXTERNAL FORCES Student should be able to understand Definition, Types of external forces and Clinical features of periodontal response
  • Adaptive Capacity of the Periodontium to Occlusal Forces,
  • Trauma from Occlusion, Acute and Chronic Trauma,
  • Primary and Secondary Trauma from Occlusion, Stages of Tissue Response to Increased Occlusal Forces,
  • Stage I: Injury,
  • Stage II: Repair,
  • Stage III: Adaptive Remodeling of the Periodontium,
  • Effects of Insufficient Occlusal Force,  Reversibility of Traumatic Lesions,  Effects of Excessive Occlusal Forces on Dental Pulp,
  • Influence of Trauma from Occlusion on Progression of Marginal Periodontitis,
  • Clinical and Radiographic Signs of Trauma from Occlusion Alone,
  • Pathologic Tooth Migration,  Pathogenesis,
1hr Small class assignments and discussion
 

CHRONIC PERIODONTITS

 

Student should be able to identify the chronic periodontitis cases clinically & radiogeraphically

 

  • Adaptive Capacity of the Periodontium to Occlusal Forces,
  • Trauma
  • from Occlusion,
  • Acute and Chronic Trauma,
  • Primary and Secondary Trauma from Occlusion, Stages of Tissue Response to Increased Occlusal Forces
  • Stage I: Injury,
  • Stage II: Repair,
  • Stage III: Adaptive Remodeling of the Periodontium,
  • Effects of Insufficient Occlusal Force,  Reversibility of Traumatic Lesions,  Effects of Excessive Occlusal Forces on Dental Pulp,
  • Influence of Trauma from Occlusion on Progression of Marginal Periodontitis,
  • Clinical and Radiographic Signs of Trauma from Occlusion Alone,
  • Pathologic Tooth Migration, Pathogenesis,
 

1hr

 

Clinical pictures for discussion of salient features of the disease

AGGRESSIVE PERIODONTITS Student should be able to identify the aggressive periodontitis cases clinically & radiogeraphically
  • Localized Aggressive Periodontitis,
  • Historical Background, Clinical Characteristics, Radiographic Findings, Prevalence and Distribution by Age and Gender,
  • Generalized Aggressive Periodontitis,
  • Clinical Characteristics, Radiographic Findings, Prevalence and Distribution by Age and Gender,
  • Risk Factors for Aggressive Periodontitis, Microbiologic Factors, Immunologic Factors, Genetic Factors,  Environmental Factors,
1hr Group discussion,
Case presentation
RADIOGRAPHIC AIDS IN THE DIAGNOSIS OF PERIODONTAL DISEASES Student should be able to take and read various types of radiographs
  • Normal Interdental Bone,
  • Radiographic Techniques,
  • Bone Destruction In Periodontal Disease, Bone Loss,
  • Pattern of Bone Destruction,  Radiographic Appearance of Periodontal Disease, Periodontitis,  Interdental Craters,  Furcation Involvement, Periodontal Abscess, Clinical Probing,  Localized Aggressive Periodontitis,
  • Trauma from Occlusion, Additional Radiographic Criteria (online only),
  • Skeletal Disturbances Manifested in the Jaws (online only),
  • Digital Intraoral Radiography,
  • Advanced Imaging Modalities
1hr Case presentations,
Student interactive session
ADVANCED DIAGNOSTIC TECHNIQUES Student should be able to understand  All techniques available for diagnosis of periodontal diseases
  • Clinical advances
  • Radiographic advancement
  • Microbiological advancements
1hr Hands on demonstration of instruments, problem based learning
RISK ASSESSMENT Student should be able to identify various risk factors associated with periodontitis
  • Definitions,
  • Risk Factors for Periodontal Disease, Tobacco Smoking, Diabetes,
  • Pathogenic Bacteria and Microbial Tooth Deposits,
  • Risk Determinants/Background Characteristics for Periodontal Disease, Genetic Factors,
  • Age,
  • Gender,
  • Socioeconomic Status, Stress,
  • Risk Indicators for Periodontal Disease (online only),
  • Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (online only), Osteoporosis (online only),
  • Infrequent Dental Visits (online only),
  • Risk Markers/Predictors for Periodontal Disease (online only),
  • Previous History of Periodontal Disease (online only),
  • Bleeding on Probing (online only),
  • Clinical Risk Assessment for Periodontal Disease (online only),  Conclusion,
1hr Problem based learning,
Flow chart
DETERMINATION OF PROGNOSIS Student should be able to understand Types of prognosis for periodontal disease
  • Definitions,
  • Types of Prognosis,  Overall Versus Individual Tooth Prognosis,  Factors in Determination of Prognosis,
  • Overall Clinical Factors, Systemic and Environmental Factors, Local Factors,  Prosthetic and Restorative Factors,  Relationship Between Diagnosis and Prognosis, Prognosis for Patients with Gingival Disease, Prognosis for Patients with Periodontitis,  Reevaluation of Prognosis after Phase I Therapy,
 

1hr

 

Student interactive sessions, flow diagrams

THE TREATMENT PLAN

Student should be able to understand various
Phases of treatment plan

  • Master Plan for Total Treatment,
  • Extracting or Preserving a Tooth,
  • Sequence of Therapeutic Procedures, Explaining Treatment Plan to the Patient,
1hr Open textbook reading & discussion
RATIONALE  FOR  PERIODONTAL TREATMENT

Student should be able to understand What Does Periodontal Therapy Accomplish?

  • Local Therapy,
  • Systemic Therapy,  Factors that Affect Healing,
  • Local Factors,
  • Systemic Factors,
  • Healing after Periodontal Therapy, Regeneration,
  • Repair,
  • New Attachment,  Periodontal Reconstruction,
1hr Seminar presentation by students
PERIODONTAL THERAPY IN MEDICALLY COMPROMISED PATIENTS

Student should be able to understand Periodontal treatment in patients suffering from various systemic diseases

  • Cardiovascular Diseases, Hypertension,
  • Ischemic Heart Diseases (online only),  Congestive Heart Failure (online only),
  • Cardiac Pacemakers and Implantable Cardioverter-Defibrillators (online only),
  • Infective Endocarditis, Cerebrovascular Accident (online only), Endocrine Disorders, Diabetes,
  • Thyroid and Parathyroid Disorders (online only), Adrenal Insufficiency (online only),  Hemorrhagic Disorders, Coagulation Disorders, Thrombocytopenic Purpuras,  Nonthrombocytopenic Purpuras,
  • Blood Dyscrasias,  Leukemia,  Agranulocytosis,
  • Renal Diseases (online only),
  • Liver Diseases (online only),
  • Pulmonary Diseases (online only),  Medications and Cancer Therapies,  Bisphosphonates,  Anticoagulant/Antiplatelet Therapy,  Corticosteroids,  Immunosuppression and Chemotherapy,  Radiation Therapy,  Prosthetic Joint Replacement,  Pregnancy (online only), Infectious Diseases (online only),
  • Hepatitis (online only), HIV and AIDS (online only),
  • Tuberculosis (online only),
1hr Interactive quiz between group of students
PERIODONTAL THERAPY IN FEMALE PATIENT

Student should be able to understand Periodontal treatment in female patients suffering from systemic conditions

  • Puberty,
  • Management,
  • Menses,
  • Periodontal Manifestations,  Management,  Pregnancy,
  • Periodontal Manifestations,
  • Role of Pregnancy Hormones,
  • Maternal Immunoresponse,
  •  Other Oral Manifestations of Pregnancy,
  • Clinical Management,
  • Treatment,
  • Oral Contraceptives,  Management,  Menopause (online only),
  • Oral Changes (online only),
  • Clinical Management (online only),  Conclusion,
1hr Panel discussion
TREATMENT OF AGGRESSIVE AND ATYPICAL FORM OF PERIODONTITIS Student should be able to understand various treatment modalities for Aggressive Periodontitis,
  • Treatment Planning and Restorative Considerations,
  • Periodontal Maintenance, Periodontitis Refractory to Treatment (online only),
  • Necrotizing Ulcerative Periodontitis,  Conclusion,
1hr Discussion of clinical cases
TREATMENT OF ACUTE GINGIVAL DISEASES

Student should be able to understand various treatment modalities for  ANUG, pericoronitis and other acute gingival disease

  • Acute Necrotizing Ulcerative Gingivitis, First Visit,
  • Second Visit & Third Visit,
  • Gingival Changes with Healing,
  • Additional Treatment Considerations,  Persistent or Recurrent Cases,
  • Acute Pericoronitis,  Acute Herpetic Gingivostomatitis,
1hr Discussion of clinical cases
TREATMENT OF PERIODONTAL ABSCESS Student should be able to understand Specific Treatment Approaches for periodontal abscess
  • Classification of Abscesses,
  • Periodontal Abscess, Gingival Abscess,  Pericoronal Abscess, Acute Versus Chronic Abscess,
  • Periodontal Versus Pulpal Abscess,
  • Acute Abscess,
  • Chronic Abscess,
  • Gingival Abscess,
  • Pericoronal Abscess,
1hr Case presentation,problem based learning
PHASE 1 PERIODONTAL THERAPY

Student should be able to understand Periodontal therapy in initial phases

  • Rationale
  • Treatment Sessions
  • Sequence of Procedures
  • Results
  • Healing
  • Decision to Refer for Specialist Treatment
1 hr Small interactive group discussion
 

PLAQUE CONTROL FOR THE PERIODONTAL PATIENT

Student should be able to understand Various modalities for plaque control

  • The Toothbrush
  • Powered Toothbrushes
  • Dentifrices
  • Interdental
  • Cleaning Aids
  • Dental Floss
  • Interdental Cleaning Devices
  • Gingival Massage
  • Oral  Irrigation
1 hr Videos and pictorial discussion
CHEMOTHERAPEAUTIC AGENTS

Student should be able to identify Chemical plaque control agents and their specific uses

  • Prescription Chlorhexidine Rinse
  • Non prescription Essential Oil Rinse
  • Other Products
  • Disclosing Agents
  • Frequency of Plaque
  • Removal
  • Patient Motivation and Education
1 hr Small home assignments to students discussed in class
ADJUNCTIVE ROLE OF ORTHODONTIC THERAPY

Student should be able to understand Ortho- perio interrelationship

  • Benefits of Orthodontic Therapy

 

  • Pre orthodontic Osseous Surgery
  • Orthodontic Treatment of Osseous Defects Advanced Horizontal Bone loss
  • Orthodontic Treatment of Gingival Discrepancies
1 hr Discussion of various cases through photographs and various case presentations
THE PERIODONTIC –ENDODONTIC CONTINUUM

Student should be able to understand Perio-endo interrelationship

  • Biologic Effects of Pulpal Infection on Periodontal Tissues
  • Biologic Effects of Periodontal Infection on Dental Pulp
  • Differential Diagnosis of Pulpal and Periodontal Infection
  • Treatment Considerations of Endodontic-Periodontic Lesion
1 hr Case discussion through pictures and videos
PHASE II PERIODONTAL THERAPY

Student should be able to identify All steps involved in Phase II periodontal therapy

  • Objectives of the Surgical Phase
  • Surgical Pocket Therapy
  • Results of Pocket Therapy,
  • Maintenance,
  • Reevaluation
  • After Phase I Therapy
  • Critical Zones in Pocket Surgery, Indications for Periodontal Surgery
  • Methods of Pocket Therapy
1 hr Problem based learning
GENERAL PRINCIPLES OF PERIODONTAL SURGEY

Student should be able to identify What to be done prior, during and after periodontal surgery

  • Outpatient Surgery
  • Hospital Periodontal Surgery
  • Surgical Instruments
  Photographic presentatation and discussion
GINGIVAL SURGICAL TECHNIQUES

Student should be able to understand Indications for gingival surgeries and how to perform these surgeries

  • Gingival Curettage
  • Gingivectomy
  Case discussions and videos
TREATMENT OF GINGIVAL ENLARGEMENT

Student should be able to understand All treatment modalities available for the treatment of gingival enlargement

  • Chronic Inflammatory Enlargement
  • Periodontal and Gingival Abscesses
  • Drug-Associated Gingival Enlargement
  • Leukemic Gingival Enlargement
  • Gingival Enlargement in Pregnancy
  • Gingival Enlargement in Puberty
  • Recurrence of Gingival Enlargement
  Case discussions and videos
THE PERIODONTAL FLAP

Student should be able to understand Definition, classification,sutures, healing after flap

  • Classification of Flaps
  • Design
  • Incisions
  • Elevation of the Flap
  • Suturing Techniques
  • Types of Sutures
  • Healing after Flap Surgery
1 hr Problem based learning, case presentation
THE FLAP TECHNIQUE FOR POCKET  THERAPY

Student should be able to understand Various surgical techniques for periodontal defects

  • Overview
  • Technique for Access and Pocket Depth Reduction/Elimination Incisions
  • Reconstructive Techniques
  • Flaps for Reconstructive Surgery
  • Distal Molar Surgery
1 hr Case discussions and videos
RESECTIVE OSSEOUS SURGERY

Student should be able to identify Various steps involved in respective osseous surgery and their rationale

  • Selection of Treatment Technique
  • Rationale
  • Factors in Selection of Resective Osseous Surgery
  • Examination and Treatment Planning
  • Methods of Resective Osseous Surgery
  • Osseous Resection Technique
  • Placement and Closure
  • Postoperative Maintenance
  • Specific Osseous Reshaping Situations
1 hr Videos depicting the surgical technique and discussion
RECONSTRUCTIVE PERIODONTAL SURGERY

Student should be able to understand Various surgical techniques used for regenerative surgery

  • Evaluation of New Attachment and Periodontal Reconstruction
  • Reconstructive Surgical Techniques
1 hr Case discussion, photographic demonstration and videos
FURCATION INVOLVEMENT & TREATMENT

Atudents ahould be able to tell the Definition, classification,  clinical features, radiographic features of furcation involvement

  • Etiologic Factors
  • Diagnosis and Classification of Furcation Defects
  • Local Anatomic Factors
  • Anatomy of the Bony Lesion
  • Indices of Furcation Involvement
  • Treatment
  • Nonsurgical Therapy
  • Surgical Therapy
1 hr Case discussion, photographic demonstration and videos
PERIODONTAL PLASTIC & ESTHETIC SURGERY

Student should be able to understand Various surgical techniques for correction gingival defects,
Classification of flaps for root coverage

  • Terminology
  • Objectives
  • Etiology of Marginal Tissue Recession
  • Factors That Affect Surgical Outcome
  • Techniques to Increase Attached Gingiva
  • Techniques to Deepen The Vestibule
  • Techniques to Remove the Frenum
  • Techniques to Improve Esthetics
  • Tissue Engineering
  • Criteria for Selection of Techniques
  • Surgical Techniques
  • Tissue Engineering Alternatives for Muco gingival Procedures
1 hr Case discussion, photographic demonstration and videos
RECENT ADVANCES IN SURGICAL TECHNOLOGY

Student should be able to identify Various new equipments used in surgical procedures

  • Microsurgery
  • Magnification Systems
  • Periodontal Microsurgery,
  • Microsurgical Instruments
  • Ergonomics
  • Lasers in Periodontics
1hr Pictorial and hands on demonstration
PERIODONTAL RESTORATIVE INTERRELATION
SHIPS

Student should be able to perform Various treatment used to correct restorative defects

  • Biologic Considerations
  • Esthetic Tissue Management
  • Occlusal Considerations in Restorative Therapy
  • Special Restorative Considerations
1 hr Photographic presentations and discussions
PERIODONTAL SPLINTS

Patient should be able to identify cases requiring splinting and perform splinting

  • Types of Splints
  • Clinical Implications

 

 

1 hr Case discussion, photographic demonstration and videos
SUPPORTIVE PERIODONTAL TREATMENT

Student should be able to perform steps involved in SPT

  • Rationale For Supportive Periodontal Treatment
  • Maintenance Program
  • Classification of Posttreatment Patients
  • Referral of Patients to the Periodontist
  • Tests for Disease Activity
  • Maintenance for Dental Implant Patients
1 hr Textbook reading and discussion
DENTAL IMPLANTS

Student should be able to understand Basic concepts of implantology both clinical and surgical,
Implant surgery procedure

  • Periimplant Anatomy, Biology, and Function
  • Clinical Evaluation of the Implant Patient
  • Diagnostic Imaging for the Implant Patient
  • Standard Implant Surgical Procedures

 

  • Advanced Implant Surgical Procedures
  • Technologic Advances in Implant Surgery
  • Implant-Related Complications and Failures
1 hr Case discussion, photographic demonstration and videos