Module I and II: “Beginning With The End In Mind” *
(The subject matter, hours and method of presentation are listed for each topic – Due to the nature of teaching introduced there may be more than one subject discussed in each presentation. Hence the subjects may appear more than once)
The Expanding Scope of Implant Dentistry – An introduction about the objectives of the course
(Treatment Plan – 5 Hours Lecture)
- To provide an overview of the discipline of implant dentistry as it relates to the mainstream practice of dentistry.
- To emphasize the necessity of considering implant dentistry as an adjunct to overall patient treatment planning rather than focusing on corporate-driven concepts
- The students will be able to consider implant dentistry as proven mainstream dental therapy.
- Be able to identify the discipline as part of their scope of treatment
Examples of Cases where the patients’ needs and desires could not have been met without implants – The State of the Art
(Root Forms, Plate Forms, Grafts – 5 Hours Lecture)
- To illustrate the end result of various cases that have been successfully treated
- To provide basic reports of cases from simple predictable situations to varying advanced levels
(* Stephen Covey –“Seven Habits of Highly Effective People”)
- Display examples of significant changes in the quality of life produced through the benefits of implant dentistry
- This will instill confidence among participants that they too can perform such predictable cases
- They will be able to have a perspective early on in the course as to identify the various approaches that practitioners could take and have an overall understanding of the multimodal approach.
Evolution of Modern Implant Dentistry
(History – 5 Hours Lecture)
- To provide a chronological sequence of events that have led to the professional acceptance of implants as part of mainstream dentistry.
- To emphasize the importance of understanding previous designs and configurations and their pitfalls
- To provide an overview of the corporate strategies that changed the pratice of implant dentistry
- To elaborate on regulatory standards that govern the sale and distribution of dental implants
- The current state of the art
- This presentation will enable the participants to compare the present implants systems as they are being constantly modified and help them in deciding if there may be any validity in the changes.
- They will also understand that their pratice would have to be patient centered rather than become a “one implant system” practice.
Introduction to Case-Based Learning format
(Pedagogy – 2 Hours Lecture)
- A central purpose is to foster analytic or critical thinking, which will also develop students’ confidence and skill in dealing successfully with unanticipated issues under practical constraints.
- Another key purpose is to transfer much of the responsibility for learning from the teacher to the student, whose role shifts from passive absorption to active construction of meaning. The teacher challenges students to be prepared to discuss various aspects of the material, to set priorities for learning and to acquire information as it is needed to deal with the problem at hand. Cases help students learn multi-level concepts and their application to practical situations. A good case discussion can be lively, exciting and involving for learners. It emphasizes synergistic collaborative learning, in which the group product exceeds the sum of learners’ individual contributions because it results partly from the interaction among them.
- Finally, the case method communicates the important value of good questions in situations where there are few single right answers.
- stimulate dialogue among learners rather than lecture;
- permit self-discovery by learners rather than impose their expertise;
- serve as resources to learners rather than final authorities
- be able to clearly define a problem
- develop clearly stated solutions that fit the problem and its inherent conditions, based upon information and clearly explicated reasoning
Introduction To Diagnosis And Treatment planning
(Diagnosis and Treatment Plan – 5 Hours Lecture)
- To help understand the diagnostic and treatment modalities necessary to properly treat patients requiring implant dentistry
- To meet the patient before meeting the mouth ( determining the patient’s needs, desires, motivations and goals ).
- To provide an organized approach to examination, taking records, patient evaluation, obtain appropriate tests and radiographs and formulate a clinical decision-making tree ( vertical treatment planning)
- To recognize and incorporate an interdisciplinary approach to treatment planning.
The participants will be able:
- to provide the medical evaluation of implant patients
- to diagnose and incorporate criteria for recognition of basic predictable cases as opposed to more complex forms of treatment
- to understand the indication and contraindications for implant modalities and therapies
- to learn how to determine whether they should treat or refer a case based on their degree of training and experience.
- incorporate DeVans’ axiom “ preserve what remains rather than meticulously replace what is missing “.
- will be able to consider comprehensive treatment planning
Demonstration Of Placement Of Endosseous Implants (Live) – Review Of Pre And Post -Op Instructions and Medications
(Demonstration – Root Forms – 5 Hours
Plate Forms – 5 Hours)
(Begin Case-Based Learning Format)
Example: 56 year old Asian male presents for restoration of missing mandibular posterior teeth.
Chief Complaint: “ I cannot chew properly. My partials are loose and I am not happy with them. I wish there is a way to hold my teeth so that I can have a fixed solution. I am tired of my partial dentures”
A routine examination is performed, review of patients study casts and radiographs is done. The patient has been diagnosed with mild to moderate atrophy of the edentulous areas of his left posterior mandible and well formed residual ridges on the right posterior quadrant.
Diagnosis: Kennedy Class I partial edentulism
Misch-Judy Classification of available bone discussed
Treatment Plan: A clinical decision tree is worked out with the participants and a treament plan for implants has been arrived at. Alternate plans provided even though patient wants only fixed options. The participants are encouraged to present options and discuss alternatives.
Definitive Plan: Root form implants on the right side and plate/blade form implant(s) joined with natural co-abutments on the left side. Adequate interocclusal space exists on both sides . (The definitive recommended plan and all alternate plans of treatment are presented.
Case Presentation: The definitive recommended plan and all alternative plans of treatment are presented. Informed Consent is obtained.
- To introduce patient interviewing and interactive case presentation
- To demonstrate the clinical setting of inserting dental implants
- To review the sterilization and clean room protocols
- To review radiographic and pre-surgical planning
- To review the implant insertion sequencing
- To provide an indepth live demonstration of the actual surgical sequencing and protocol for endosseous dental implants – root form and plate/blade form.
- To review the basic anatomy directly relevant to the procedures.
- The learner will be able to have some clinical background knowledge that will be relevant when discussing the applied basic science, such as anatomy, course materials.
- They will be excited early on in the course as to what more to expect since they had first hand exposure to real life experiences.
- They will return to their offices looking at their own patients with a broader perspective
- They will return enthused for the future modules.
- The student will be able to better understand the nature and validity of suggested treatment options
- Students will be able to search the pre-treatment files of their patients for similar cases (that they treated differently) and bring them for student and faculty discussion for reinforcement and review.
(24 Hour – Post Op) – Introduction to Immunology and Wound Healing
( Immunology – 5 Hours Lecture )
Example Case Scenario: 52 year old female with post-menopausal disturbances had two endosseous implants placed in her mandible two weeks ago and presents for a post-operative evaluation: Patient has also been diagnosed with NIDDM (type II diabetes). She feels that one of her implants that was placed in an extraction socket may be moving slightly.
- to teach basic principles of wound healing
- day by day sequence of osseous healing around dental implants
- soft tissue healing around implants – submerged and non submerged
- healing sequence of one stage and two stage implants
- clinical discussions and case sequencing that effect healing rate and quality
- The students will be able to understand the pathophysiology of bone healing in extraction sockets.
- The students will learn the basic wound healing mechanism that is initiated following insertion of dental implants and correlate it with functioning and non-functioning implants.
- They will be able to apply immunological principles that govern wound healing to the systemic conditions that may impair normal responses.