Dublin Dental University Hospital

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Trinity College Dublin

Oral Surgery

The Dublin Dental University Hospital /TCD in an accord with the Irish Committee for Surgical Training in Dentistry and the Dental Council offer a Doctorate Course in Oral Surgery.  This is one of the 2 Dental Specialties presently recognized by the Department of Health (Oral Surgery / Orthodontics).

This is a three year full time, taught course based in the Dublin Dental University Hospital , involving supervised hands-on clinical skills (assessment / surgical) and a founding in research leading to a D. Dent. Ch. Thesis level.  It is a busy course, requiring dedication, hard-work and academic stamina.  The required clinical and research standard is high.  The basis of the surgical training is in dentoalveolar surgery, implantology, intraoral bone grafting, conscious dental sedation, mucosal biopsy and a significant exposure to oral medicine, other dental disciplines and oral /maxillofacial surgery.

Applicants must have a dental degree, registrable with the Dental Council in Ireland, have achieved the standard of the MFD RCSI / FFD (OS/OM) or equivalent and preferably have some oral surgery / oral and maxillofacial experience.  Experience in audit, research and presentations to Learned Societies are considered an advantage.  Exposure and an understanding of basic ATLS principles and OMFS trauma are an advantage

Candidates interested in the course are encouraged to visit and meet the trainers.

Trainers:

1. Prof Leo F A Stassen Programme Director. Consultant Oral and Maxillofacial Surgeon

2. Dr. Claire Healy Consultant / Senior Lecturer Oral Medicine

3. Dr. Ioannis Polyzois Consultant / Senior Lecturer Periodontology

4. Dr Mary Clarke Lecturer Dental Sedation / Specialist Oral Surgeon

5. Dr. Mary Collins Lecturer / Specialist Oral Surgeon

6. Dr. Veronica Fisher Lecturer / Specialist Oral Surgeon

Taught postgraduate Course in Oral Surgery

Module                           Title:         ECTS:
  1 Core Course          15
  2 Surgical diagnosis and treatment planning          15
  3 Clinical oral pathology and microbiology          15
  4 Applied surgical anatomy/surgical technique          10
  5 Literature review (journal club)          15
  6 Conscious Sedation            5
  7 Clinical Oral Surgery          110
  8 Research            90
Total          275

 

Module 1– CORE COURSE  (See attached documentation generic to all the Taught Courses) ECTS 15

Module 2

Module title: SURGICAL DIAGNOSIS AND TREATMENT PLANNING ECTS: 15

Learning outcomes:

To obtain knowledge in relation to the importance of:-

History taking

Relevant Medical History

Medical and Dental Emergencies

Cross Infection Control

Medico-legal Considerations

Module 3

Module title: CLINICAL ORAL PATHOLOGY & MICROBIOLOGY ECTS: 15

Learning outcomes:

To obtain knowledge in relation to the management and treatment of:-

Surgical anatomy

Dento-facial infections

Odontogenic cysts

Premalignancy & Malignancy of Oral Cavity

Diseases of Bone

Salivary Gland Disease

Module 4

Module title: APPLIED SURGICAL ANATOMY/Surgical Technique   ECTS: 10

Learning outcomes:

The student on the completion of the course on surgical anatomy should be able to:

Demonstrate mastery of the knowledge of anatomy of the vasculature of the mandible, maxilla and adjacent facial structure and the application of this information to haemorrhage control and other intra-operative and post-operative haemorrhage complications.

Discuss pain of the facial area in terms of nerve innovation and possible anatomically related causes of various types of pain.

Tract the progress of infections emanating from the oral cavity to the various facial structures and facial planes of the head and neck and discuss the anatomic consequences of infection extension.  Demonstrate plans for expedient and effective treatment based upon anatomic aspects of the spread of the infection.

Discuss the possible anatomic complications of venepuncture of the arm and the anatomy of the nerves and associated vasculature, both venous and arterial, of the antecubital fossa.

Discuss the clinical significance of principles of microscopic and macroscopic bone healing and bone repair involved in the alveolar process adjacent to teeth and to titanium implants and osseous repair following other types of surgical procedures.

Discuss the anatomic aspects of surgical techniques of oro-antral and oro-nasal fistulas and surgical techniques of fistula closing.

Relate the anatomy of the head and neck to various aspects of craniofacial anomalies and the management of associated clinical defects.

In relation to Surgical Technique, to obtain knowledge in relation to the surgical management of:-

Dental extractions and their complications

Surgical removal of roots, supernumeraries and impacted teeth

Management of dento alveolar trauma

Management of facial trauma

Preprosthetic surgery

Implant surgery

Sinus disease

To obtain an understanding in relation to the management and surgical options in relation to:-

Neoplastic disease

Surgical aspects of TMJ disorders

Surgical correction of facial deformity

Module 5

Module title:  Literature Review (JournalClub) ECTS: 15

Module 6

Module title:CONSCIOUS SEDATION   ECTS: 5

Learning outcomes:

To be capable of giving adequate sedation to a patient while adhering to the Dental Council’s Guidelines.

Module 7

Module title: CLINICAL ORAL SURGERY   ECTS: 110

Learning outcomes:

To obtain a detailed knowledge of anatomy of the head and neck relevant to the practice of oral surgery.

To have a sound understanding of how to communicate with patients and in particular the behavioural sciences.

To understand the importance of history taking not only relating to the presenting complaint but also in relation to the patients medical status social factors and dental status.

To be capable of competent examination of the patient

To understand the scientific basis and application of those tests which supplement a diagnosis, e.g. x-rays, blood investigations etc.

To understand the principles of sterilisation and their application to oral surgery practice

To be capable of managing dental and medical emergencies which may occur during the practice of oral surgery.

To be competent at the management of extracting roots, uncovering submerged teeth and complicated dental extractions.

To understand the principles and techniques related to surgical endodontics.

To be able to manage dento-alveolar trauma and uncomplicated mandible fractures.

To carry out tissue integrated implant surgery.

To undertake bone and soft tiisue augmentation of the jaws prior to implant placement, inc. sinus lifts, nerve lateralisation and intra-oral bone grafting (harvesting)

To diagnose and appropriately manage disorders of structures immediately adjacent to the oral cavity including the maxillary sinus, the salivary glands and the jaw bones.

To recognise benign and malignant disease of the oral cavity and jaw and understand the appropriate management.

To be able to diagnose and manage facial pain including disorders of the TMJ.

To understand and manage, in appropriate consultation, the oral manifestations and complications of systemic diseases.

To be able to diagnose, participate in treatment planning and refer for appropriate treatment patients who have abnormalities or deformities of the jaw.

1.         The surgical removal of roots and buried or impacted teeth

Recognising the various anatomical relationships that pose clinical   difficulty in the removal of or which lead to complications following the surgical removal of roots and teeth

Deciding, on the basis of the history, examination, radiographic evidence, and special tests when it is advisable to surgically remove impacted teeth or to pursue a more conservative treatment

Being aware of the potential consequences of surgical removal of roots and impacted teeth both in the short and long term i.e. Complications – oro-antral fistulae, fracture of the tuberosities, haemorrhage, trismus, pain etc. and the correction of these complications.

 2.       Exposure of unerupted teeth

Deciding, with the help of an orthodontic consultation when appropriate, whether surgical exposure of a tooth can result in it being brought into a favourable position within the arch

Providing anchorage in order to reposition the tooth

Deciding, on the basis of the history, examination and special tests whether it is advisable to surgically expose, remove or monitor unerupted teeth

 3.      Reimplantation of teeth

Deciding, on the basis of the history examination and special tests whether it is advisable to reimplant the tooth

Replacing, repositioning and stabilising implanted teeth

  4.     Surgical Endodontics

knowing when it is appropriate to carry out surgical endodontics rather than pursue a more conservative treatment completing surgical endodontics successfully

 5.     Treatment of salivary gland diseases

Utilising appropriate special tests for the diagnosis of salivary gland diseases

The management of salivary gland diseases with appropriate referral if necessary

 6.     Premalignancy and Malignancy of the Oral Cavity

Recognising and prioritising lesions requiring a biopsy

Complying with the needs of the pathologist with respect to both the technical and diagnostic aspects of a specimen adequate for diagnosis

Carrying out effectively incisional and excisional biopsies(benign disease) of oral tissue, when appropriate

7.     Pre-prosthetic surgery

Liaison with other dentists in the assessment of benefit to the patient of all preprosthetic surgical techniques

Carrying out hard and soft tissue preparation to facilitate successful restorative procedures

8.     Tissue integrated implant surgery

Assessment of benefit to the patient of tissue integrated implants

Interpretation of techniques necessary for the appropriate selection of site for placement of implants

Effectively carrying out currently accepted surgical techniques for successful implants

The use of bone augmentation techniques in the areas of inadequate bone for implant placement including taking of bone from an acceptable oral donor site

9.      Management and treatment of fractures facial trauma and facial skeleton

The clinical and radiographic diagnosis of fractures

The reduction and fixation of dento alveolar and uncomplicated fractures of the mandible and maxilla.

10.    Congenital and acquired anomalies of the jaws and tempro-mandibular joint

Diagnosis and investigation of congenital and acquired anomalies of the jaws and tempero-mandibular joint utilising appropriate clinical and radiological investigations

Recognising, diagnosing congenital and acquired anomalies of the jaws and working with the dentofacial deformity team to faciliate their management

Module  8

Module title: RESEARCH   ECTS: 90

Learning outcomes:

At the end of the course, the student will be able to:

Critically evaluate the scientific literature

Understand the scientific method

Know how to make an application to a Research Ethics Committee

Undertake a piece of research from protocol design to report writing

Assessment 

There will be written examinations at the end of the first year.  The examination at the end of the first year will be based upon the 3 core units (Biomedical Science, Oral & Related Systemic Disease and Applied Scientific Method) of didactic learning in the first year and also on the specialist course.  There will be 4 x 3 hour papers at the end of the first year.

Paper 1 – Biomedical Science

Paper 2 – Applied Scientific Method

Paper 3 – Oral & Related Systemic Disease

Paper 4 – Specialist Paper in Oral Surgery

There will be written examinations at the end of the second year.  The examination at the end of the second year will  a 1 x 3 hour paper to assess background knowledge in the specialist area of oral surgery under the headings outlined in the modules above and 1 x 3 hour paper on Behavioural Science.  There is a viva voce x 1 hour, review of a scientific paper (read) x ½ hour and a preliminary review of the Thesis (presenation and oral) x ½ hour.  There is a clinical practical exam based on a surgical procedure.  The student will not rise to the next year of the course unless these examinations are passed.

At the end of the third year there will be 1 x 3 hour papers in Oral Surgery (evidence based questions).  There is a viva voce x 1 ½ hours and a practical examination carried out under local anaesthesia and sedation, assessing the full implications of the case (consent, radiographs, sedation, surgery and aftercare).

  1. Research thesis (Oral Surgery). D.Dent.Ch
  2. Clinical logbook
  3. The Oral surgery programme is reviewed every 5 years by the  ICSTD.
  4. The trainees undergo an assessment by the ICSTD every year to   ensure satisfactory progress.
  5. Formal recognition of the D.Dent.Ch is through Trinity College  Dublin.
  6. Trainees are encouraged / advised to sit the Specialty Oral Surgery FFD(os) of the RCSI after successful completion of their three year training

 LFAS 2011