The Saudi Specialty Certificate in Restorative Dentistry Program [SSC-(Dent) Resto] Former (SBARD) 2 nd Edition

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1 THE SAUDI COMMISSION FOR HEALTH SPECIALTIES The Saudi Specialty Certificate in Restorative Dentistry Program [SSC-(Dent) Resto] Former (SBARD) 2 nd Edition 1429/2008

2 SAUDI COMMISSION FOR HEALTH SPECIALTIES The Saudi Specialty Certificate in Restorative Dentistry TABLE OF CONTENTS I. Introduction II. Objectives... 3 III. Educational Sponsorship & Setting. 3 IV. Admission Requirements V. Curriculum and Program Duration. 4 a. Basic Science Courses.. 4 b. Didactic Clinical Courses.. 8 c. Advance Restorative Dentistry Clinical Training. 9 VI. Evaluation a. Resident Evaluation...15 b. Program Evaluation VII. Certification..,,,,,. 16 VIII. Summary of SBARD Teaching Hours October 2007/Ramadan

3 I. INTRODUCTION The Saudi Specialty Certificate in Restorative Dentistry [SSC- (Dent) Resto] former SBARD is an advanced educational program in restorative dentistry started October 1999 designed to provide didactic, clinical and hospital training to upgrade the level of dental profession in Saudi Arabia. The instruction and experience provided in SBARD prepare residents to be highly qualified restorative dentists who are able to treat complex restorative cases of the following disciplines; Restorative dentistry, Endodontics and Fixed Prosthodontics. As a result of several meetings, discussions and our intent to strive for perfection, the Advanced Restorative Dentistry Board Committee has produced this 2 nd Edition booklet which contains the admission requirements, curriculum & program duration, method of evaluation, certification & summary of SBARD teaching hours; including the modification of the clinical requirements. II. OBJECTIVE The program is recognized by the Saudi Commission for Health Specialties (SCHS) and eventually qualifies the resident for the rank of specialist then as a consultant. It is a planned sequence of advanced courses in restorative clinical and didactic sciences that leads to the Saudi Specialty Certificate in Restorative Dentistry [SSC-(Dent) Resto]. Its objective is to train and graduate competent, knowledgeable specialist in advanced restorative dentistry (operative dentistry, endodontics and fixed prosthodontics) capable of functioning independently to provide an educational environment that promotes the standard of delivery of health care. Specifically, the SSC-(Dent) Restorative program prepares residents to: * Plan and provide both routine and complex restorative dental care for a wide variety patients applying advanced knowledge and clinical skills. * Acquire competence and confidence in the various restorative clinical discipline (operative dentistry endodontics and fixed prosthodontics and implantology) that are integral components in general dentistry. * Reinforce the ability to make judgments in arriving at diagnosis treatment planning, and assessment of treatment outcomes. * Keep abreast with the modern technology in dentistry and practice management. * Communicate, understand and function effectively with other health care professionals and understand the setting of their organizational system. * Acquire experience in teaching and research to upgrade the clinical knowledge. 2

4 III. EDUCATIONAL SPONSORSHIP AND SETTINGS The sponsor of the Saudi Specialty Certificate in Restorative Dentistry [SSC-(Dent) Resto] is an institution which has an over-all administrative control and responsibility for conducting the program. A governmental or private training center can only be accepted for training after being accredited by the SCHS. The Saudi Specialty Certificate in Restorative Dentistry [SSC-(Dent) Resto] program must be sponsored by a training center and or hospital accredited by the SCHS as either a full recognition procedure is carried out by a committee according to the standard classification and rules set by the SCHS. * A training center must provide a readily accessible facility for dental treatment of all patients. * The training center must provide resources sufficient for resident training. * If a full or partial training center lacks adequate facilities, patient s caseloads, or any other resources needed by the educational program, it must supplement its resources through affiliations with other institutions. Affiliated hospitals or dental departments or centers in which residents receive a substantial portion of their training must be accredited by SCHS. * Residents must be appointed to the house staff of the qualified and accredited staff of the training center and must have equal privileges and responsibilities as residents in other professional educational programs. IV. ADMISSION REQUIREMENTS Dentists with the following qualifications and have complied with the rest of the requirements are eligible for the SSC- (Dent) Restorative: * A Bachelor of Dental Surgery degree (BDS) or the equivalent from a recognized university * Successful completion of rotating internship year in general dentistry (12 months) * Competitive selection examination process including Comprehensive Admission Examination by SCHS * Provision of at least three (3) recommendation letters from consultants as to the suitability of the applicant for training in post-graduate dentistry * Applicant should be registered in the Saudi Commission for Health Specialties as a trainee 3

5 * Applicant should pay the application fees * Signed obligation to abide by the rules and regulations of the training program and the Saudi Specialty Certificate in Restorative Dentistry [SSC-(Dent) Resto] V. CURRICULUM AND PROGRAM DURATION The Saudi Specialty Certificate in Restorative Dentistry [SSC- (Dent) Resto] is a program which extends for a period of four (4) years. The didactic clinical sciences and advanced clinical training are integrated into the program duration. Documentation of the program progress and all resident activities must be maintained by the program director and available for review. A. Basic Science Course Advanced didactic courses in basic biomedical and biodental sciences are designed to cover in depth topics which were given during the under graduate education. These courses include: Anatomy - Oral Biology - Oral Histology - Oral Pathology - Oral Microbiology - Pharmacology- Practice Management Biostatistics - Research Design Methodology and Scientific Writing - Educational Methods Biomaterials - Health Administration. Also requirements of the Saudi Heart Society Program, the Basic life support, Dental Ethics, Infection Control and Evidence Based Dentistry. 1) Anatomy Seminars or lectures are designed at the level of postgraduate studies in Embryology and development of face, cranial nerves, blood supply of the head and neck, structures of the tongue, orpharynx, teeth and masticatory muscles and temporomandibular joint. 2) Oral Biology Seminars or lectures are designed on different topics in advanced Oral Biology especially the microstructure and physiology of oral tissues. 3) Oral Histology Seminars or lectures are designed at the postgraduate level on different topics in oral histology. 4) Oral Pathology Seminars or lectures are designed at the post graduate level in oral pathology, the etiology and pathogenesis of 4

6 oral and paraoral disease at levels beyond those undergraduate studies. 5) Oral Microbiology The course covers the composition of the oral flora and factors influencing its composition. 6) Pharmacology in Dental Clinic Residents will enhance their knowledge of pharmacological agents especially those agents commonly used in treating oral and systemic diseases. They must gain experience in prescribing medications for patients under their care and must be fully knowledgeable of the indications, contra-indications and potential adverse reactions of medications used. 7) Practice Management Course will include the following: - Quality assessment and quality assurance - Management of auxiliaries and other office personnel - Maintenance and management of patient records - Principles of professional ethics - Patient's communication. - Business management, including understanding of third party payment and professional practice development - Infection control - Environmental health management - Alternative health care delivery systems 8) Dental Biomaterials Topics and seminars in Biomaterials to provide the resident with the knowledge necessary to properly select and manipulate various dental material systems used in oral cavity. 9) Biostatistics Combined basic with intermediate level of statistical concepts, definition and methods commonly applied to research or data analysis. Topics covered include variables, frequency distributions, sampling, and measures of central tendency, variance measure of dispersion, various statistical tests, analysis and probability. 10) Educational Methods The resident will learn how to teach and impart knowledge and will therefore be integrated into the supervision and teaching of undergraduate and post-graduate. 5

7 11) Research Design, Methodology and Scientific Writing Topics cover scientific theories, definition of terms, research systems and problems, design of experimental research and evaluation of research data. The course is given in a lecture format. A broad spectrum of topics including information retrieval systems, evaluation of published data, scientific expression and terminology will be covered. Residents are introduced to the preparation of scientific papers, writing of manuscripts, writing research proposals, grant applications and viewing of grant application. 12) Oral Medicine and Diagnosis This course will provide a systemic approach to the oral manifestation of systemic diseases like hepatitis, AIDS, blood diseases, cancers and bacterial, viral and mycotic diseases as well as a discussion of common oral lesions stressing on therapeutics. In addition, this course will cover the fundamental diseases process, their clinical characteristic and the application of genetics on dental practice. 13) Dental Radiology This course will provide the residents knowledge of radiation physics, radiation biology, hazards and protection, advanced imaging techniques and diagnostic oral radiology. 14) Basic Life Support (Saudi Heart Society Program Requirements) All residents must be certified in basic life support and should be trained in advanced cardiac life support by the Saudi Heart Society Program. 15) Dental Ethics The prime goal of this course is to promote the resident s education in dental ethics. This course will cover the related issues ranging from ordinary chairside decision making to HIV/AIDS and ethical practices. This course will guide the residents to an understanding of the essential practice of ethics. The course will highlight on the necessity of awareness of legal process and civil law, forensic dentistry, the practitioner and other related subjects. 16) Infection Control Guidelines The course deals with pathological and immunological basis of infectious disease and their methods of 6

8 transmission. The course deals primarily with all the updated standard precautions in dental practice as well as managing patients with infectious diseases. 17) Evidence Based Dentistry This course introduces the residents the key skills required for evidence based practice, question formulation, searching for evidence, and critical appraisal of evidence. B. Didactic Clinical Courses Clinical training will be combined with formal clinical didactic courses that are planned and directed by members of the attending staff and conducted on a weekly basis. Such activities can be implemented in the form of presentations, seminars, lectures, patient case conference, demonstration and laboratory or a combination and must be in coherence with clinical training components. 1.) Dental Book Review in Advance Restorative Dentistry (ARD) Dental Book Review in operative dentistry, endodontics and fixed prosthodontics will be assigned to residents to review and present on a weekly basis. 2) Literature Review in ARD & Journal Club Classical and current dental literature on different topics in restorative dentistry (ARD) will be prepared and discussed in the form of a seminar by residents in the presence of a training staff. 3) Advanced Topics in ARD The didactic program will include a series of teaching lectures devoted to advanced topics in operative, endodontics and fixed prosthodontics. 4) Advanced Case Presentation & Treatment Planning in ARD Formal patient case conferences will be held weekly for discussion of diagnostic problems, treatment planning, case presentation, review and follow up. 5) Workshop and Demonstration Frequent workshop and dental procedure demonstrations will be conducted throughout the program period. This includes hands-on training in new dental materials, modern clinical procedures and/or improving clinical skills. 7

9 6) Laboratory Experience The program will carefully enhance the resident s understanding of laboratory procedure. The resident should develop competency in working laboratory techniques. C. Advanced Restorative Dentistry Clinical Training In the context of providing comprehensive restorative dental care, the program includes advanced clinical training in operative dentistry, endodontics, fixed prosthodontics, and implantology with emphasis on diagnostic science/soft tissue management. There will be a sufficient number and variety of case in all three (3) disciplines to ensure a proper training ground for each resident. The resident is expected to upgrade and increase his/her knowledge and ability in the management of a wide range of dental problems and at the specialist perspective. Residents will, through a formally structured and documented program, provide comprehensive restorative care (as opposed episodic, emergency, referred specialty or one-time care) for a significant number of patients who present complex restorative treatment needs. Full time block assignments to specialty clinics, which discourage continuity of care, will not be the primary source of the resident s clinical experience. The program will be structured to permit the residents to exercise independent judgment beyond that expected in the pre-doctoral curriculum. Residents will be assigned patients who present increasingly difficult problems and will be given increasingly greater clinical responsibility as they progress in their advanced training. 1) Fixed Prosthodontic Training The program will provide a didactic part in fixed prosthodontics, implantology including a clinical component. The part of fixed will comprise of the following: 1.1 Advanced topics in Fixed Prosthodontics (Didactic) - Review tooth anatomy and morphology - The rationale and justification for pre-prosthodontic treatment - To review various pre-prosthodontics treatment modalities, their applications and limitations - To encourage inter-exchange of concepts and ideas among the various dental specialties. - To train the residents various techniques in fixed prosthodontics and their applications, 8

10 contra- indications and different types of articulators and articulation. - To have sound foundation in basis concept of color science and its clinical implication on the esthetic result of fixed prosthodontics treatment. - Residents will be exposed to the occlusion and correction of occlusal disharmony - The resident should understand the retention and resistance concept in FPD (geometry and design) - Clinical techniques in impression making, gingival retraction, provisional restoration and cementation for FPD. - To know how to deal with casting and soldering procedure, accuracy of dies, marginal fit. - To familiarize the resident with types of dental implant and the biological aspects of osseointegration - To enable the resident to select suitable edentulous and partially edentulous cases for implant treatment, plan and prescribe the appropriate therapy. - Residents are expected to know the prosthetic procedures and be familiar with all the component related to prosthetic phase. 1.2 Journal Club and Literature Review in Fixed Prosthodontics and Implantology (Classical and Current) 1.3 Fixed Prosthodontic Clinical Requirements Residents will be required to complete successfully. (See Table I) 9

11 TABLE I FIXED PROSTHODONTIC CLINICAL REQUIREMENTS PROCEDURE REQUIREMENTS COMMENTS Anterior PFM Units 40* Posterio r Units Posterior PFM Units Posterior Full Metal Units 90* A minimum of 5 metal units Full Ceramic Units Anterior Full Ceramic Posterior Full Ceramic 10* Resin Bonded Bridge Metallic Non- Metallic Anterior Posterior Anterior Posterior -* Implant supported Prosthesis Single tooth Implant Supported Restoration Implant Supported Fixed Partial Denture 2 1 Non Surgical Treatment of TMJ 2 Direct Technique Post and Core Indirect Technique Tooth Colored 30 (*)-code applicable to crown, pontic and retainer. 10

12 2) Endodontic Training The program will provide didactic and clinical experience in endodontics. The program compromises of the following courses: 2.1 Endodontic Laboratory Courses (by using extracted human teeth) -To practice access opening - To be conversant with working length - To learn and practice different techniques of obturation - To manage retreatment cases 2.2 Advanced Topics in Endodontics (Didactic) - Review of root canal anatomy morphology - Review pulp histology and physiology - Diagnosis of pulp pathosis - Diagnosis of periradicular pathosis - Microbiology of the root canal - Endodontic surgery - Endodontic Radiography - Management of Endodontic Complications 2.3 Journal Club & Literature Review in Endodontics (to cover all aspects of endodontics) 2.4 Endodontic Clinical Requirements (See table-ii) TABLE II ENDODONTIC CLINICAL REQUIREMENTS PROCEDURE REQUIREMENTS COMMENTS Anterior Premolar Molar Maxillary Anterior RCT 50 Mandibular Anterior RCT Maxillary Premolar RCT 60 Mandibular Premolar RCT Maxillary Molar RCT Mandibular Molar RCT 100 TO TAL ; 210 RCT Endodontic Surgery Anterior Endo Surgery 10 Evaluated per tooth not per root. Posterior Endo Surgery Root Canal Retreatment Anterior Retreatment Premolar Retreatment Molar Re-treatment 20 A minimum requirement of 10 Molar Retreatment cases Non Vital Bleaching Office Walk in 5 11

13 3) Operative/Esthetic Dentistry Training The operative dentistry training includes operative plus esthetic in restorative dentistry and will cover the following topics: 3.1 Advanced Operative Dentistry Seminar Courses are intended to provide residents with in-depth knowledge of the various aspects of operative dentistry in the scope of clinical techniques and recent material. Selected books and classical journal articles in operative and esthetic dentistry are reviewed. 3.2 Cariology Lectures and seminars in basic scientific and clinical aspects of dental caries and the new trends to control caries. 3.3 Dental Morphology and Occlusion Provide didactic and laboratory background of importance in restorations of teeth. Basic topics in dental morphology. 3.4 Operative/Esthetic Dentistry: Restorative Clinical Requirements (See Table-III) 12

14 TABLE-III RESTORATIVE CLINICAL REQUIREMENTS PROCEDURE REQUIREMENTS COMMENTS Caries Control - - Should be done in management of CC Vital Bleaching Office Bleaching Home Bleaching Macro/Micro- Abrasion 30 Arches - Evaluated per arch with a minimum of four teeth - A minimum of four teeth per arch Amalgam Restoration Single Surface 2 surface (Proximal) Total Per Tooth; not per surface - A minimum of 75 (Proximal) Buildup Direct Composite Restoration Posterior Composite Anterior Composite Single Surface & PRR 2 surface ( Proximal) Single surface 2 surface Direct Composite Veneer Porcelain Veneer Total Indirect Restoration Ceramic & Metallic Inlay/Olay Total 20 Post & Core (non-casted) Total 20 -It should be evaluated as either build up or post and core Glass Ionomer Restoration One Surface Restoration 2 Surface Restoration - -Amalgam or Composite 13

15 4) Comprehensive Cases Candidates must have five (5) completed comprehensive cases per year; whereby, each case should involve all three (3) disciplines, (operative dentistry, endodontics and fixed prosthodontics). A total of twenty (20) completed comprehensive cases will be required for the duration of the entire 4-year program. 4-1) Comprehensive Case Classification The cases maybe classified as the following: Simple Case Moderate Case Complex Case Note: Further details will be provided in the SBARD Complexity Code Manual A. Resident Evaluation IV. EVALUATION A periodic formal evaluation of the student during their residency program will be implemented. This is to determine whether they are meeting the qualitative and quantitative standards aimed for the program. 1) Didactic Evaluation To determine whether the quantitative requirements of the program are being fulfilled, a record of each resident s clinical and didactic activities must be taken and kept for review as part of each resident s evaluation. The records must include the following information. - Nature and length of each off-service rotation and documentation of the resident s attendance. - Number of patients to whom comprehensive care was delivered. - Number and type of procedures the residents performs on patients. - Nature and extent of inpatient dental care provided by the resident. - Lectures, seminars and conferences attended. - All resident s documentation and evaluation reports must be kept in the resident s permanent files. Evaluation outcomes must be provided to the resident in writing. 14

16 2) Clinical Evaluation B. Program Evaluation The scientific committee must regularly evaluate the degree to which the program goals are being met. VII. CERTIFICATION The successful candidate will be awarded a Certificate in the Saudi Specialty in Advanced Restorative Dentistry upon completion of all the academic requirements as well as the final board examination. 15

17 VII. SUMMARY OF SBARD TEACHING HOURS Name of Course No. of Teaching Hours 1 st Year No. of Teaching Hours 2 nd Year No. of Teaching Hours 3 rd Year No. of Teaching Hours 4 th Year Total In every Course % in the program BASIC SCIENCE COURSE 1 Anatomy Oral Biology Oral Histology Oral Pathology Oral Microbiology Pharmacology Practice Management 8 Dental Biomaterial Biostatistics Educational Methods 11 Research Design Methodology & Scientific Writing 12 Oral Medicine & Diagnosis 13 Dental Radiology Basic Life Support Dental Ethics Infection Control Guidance Evidence Based Dentistry

18 DIDACTIC OF CLINICAL SPECIALTY 18 Adv. Topics in Restorative Adv. Topics in Endodontics Adv. Topics in Prosthodontics Adv. Topics in Oral Medicine/Diagnosis 22 Adv. Topics in Esthetic Dentistry Adv. Topics in Implant Dentistry Adv. Topics in Preventive Dentistry Adv. Topics in Public Health Lit. Review in ARD& Journal Club/Literature Review 27 Case presentation and TX Planning in ARD Dental Book Review in ARD Clinical 29 ARD Clinical Rota Research 30 ARD Clinical Rota Community 31 Community Project TOTAL % 17

19 For more information, please contact: SAUDI COMMISSION FOR HEALTH SPECIALTIES Tel. No.: Ext.: 1552 Fax No.: Ext Website: 18

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