Universitat Internacional de Catalunya
Oral Surgical Pathology 1
Other languages of instruction: Catalan, English
Teaching staff
By appointment via e-mail
Lecturer responsible: Dr Jordi Gargallo Albiol
jgargallo@uic.es
Practical session coordinator/lecturer: Dra. Naroa Lozano Carrascal
naroalozano@uic.es
Introduction
The future European dentist will be what he already is in some countries, i.e., “the specialist of diseases of the teeth, mouth, maxilla and other facial structures”.
Oral Medico-Surgical Pathology includes the study of the diagnosis and treatment (surgical and complementary) of diseases, lesions and defects, congenital and acquired, including the functional and aesthetic aspects, of soft and hard tissues of mouth, maxilla and face.
The limits between medicine and oral and maxillofacial medicine are not clearly defined. Our aim is to provide an integrated view of these pathologies and, additionally, to integrate the medical and surgical therapy aspects. We believe these aspects should not be separate neither from a clinical perspective nor from the educational point of view.
Most patients value a comprehensive education in their dentist, which inspires confidence not only in the manual and technical aspects of the treatment but also in the medical training of the dentist.
The dentist is undoubtedly the specialist best prepared for the prevention, diagnosis and medical and surgical treatment of the diseases of the oral and maxillofacial region.
Pre-course requirements
Students must have passed the first and second years of the Dentistry programme, having passed all of the subjects, or have obtained the corresponding official validation of credits.
Objectives
To provide complete theoretical and practical training in pathophysiology, prevention, diagnosis and the treatment of pathologies (congenital and acquired anomalies) of the teeth, oral cavity, maxilla and neighbouring tissues.
Oral and maxillofacial region / oral and craniofacial region
Competences/Learning outcomes of the degree programme
- 10 - Knowing and being able to identify the psychological and physical problems derived from gender violence in order to train students in the prevention, early detection of, care for and rehabilitation of the victims of this type of violence.
- 24 - Recognising situations in which lives are at risk and knowing how to provide basic life-support.
- 35 - Knowing the scientific principles of sterilisation, disinfection and the antiseptics necessary to prevent cross-infection in dental practice
- 43 - Having knowledge of dental biomaterial: in terms of handling, properties, instructions, allergies, biocompatibility, toxicity and eliminating residues as well as their environmental impact
- 44 - Knowing about and being able to use the basic tools and equipment for dental practice
- 48 - Being aware of the effects of tobacco on oral health and participating in measures which help patients who want to give up their smoking habit. Also, knowing about the complex interaction between the environmental, social and behavioural factors related to oral and general health
- 56 - Identifying the signs and behaviour which suggest potential abuse
- 57 - Knowing the general processes of illness, curing and reparing, including infection, inflammation, haemorrhage and clotting, scarring, trauma and alterations in the immune system, degeneration, neoplasia, metabolic alterations and genetic disorders
- 70 - Evaluating motor and sensory oral, mandibular and annex function
- 71 - Undertaking limited procedures for invasive diagnostic techniques using soft tissue (biopsies)
- 74 - Preparing and isolating the operatory field
- 77 - Undertaking medical and surgical treatment for common diseases in soft oral tissue
- 78 - Undertaking simple surgical procedures: the extraction of temporarily and permanently erupted teeth, fractured or retained roots and the uncomplicated surgical extraction of non-erupted teeth and simple procedures for pre-prosthesic surgery
Learning outcomes of the subject
1. A high level of knowledge in oral surgery.
2. Acquisition of the basic principles of oral and maxillofacial surgery.
3. Acquisition by the student of comprehensive knowledge of exodontics and the skills required to resolve its complications.
4. Being able to identify, and knowing how to diagnose and treat, the alterations of dental eruption.
5. Being able to identify, and knowing how to diagnose and treat, infectious pathologies of the oral and maxillofacial region.
6. Knowing and being able to classify maxillary cysts; being able to diagnose and treat them.
7. Knowing the principles and basic information regarding dental implantology, bone biology and the characteristics of implants and the surgical procedures.
- 4.015 - Identify the anatomic and dental structures in panoramic radiographs, periapical and bitewing
- 4.024 - Perform simple extractions of primary molars.
- 4.025 - Perform limited invasive procedures of invasive diagnostic techniques in soft tissue procedures (biopsies)
- 4.027 - Perform simple surgical procedures: removal of temporary and permanent erupted teeth, fractured or retained roots and uncomplicated surgical removal of impacted teeth and simple procedures of pre-prosthetic surgery
- 4.028 - Diagnose, plan and carry out a surgical treatment of limited complexity in patients of all ages and conditions
- 4.029 - Master the bases of basic oral surgery: equipment and instruments, sterility and prevention of infection, techniques of loco-regional anesthesia, surgical field, hemostasis, post-operative cures, pharmacotherapy
- 4.030 - Know how to derive, when necessary, to other professionals or centers, complex treatments or medically compromised patients.
Syllabus
SUBJECT BLOCKS
Block 1: Surgery principles (oral and maxillofacial)
Block 2: Exodontics
Block 3: Alterations of eruption and of dental organogenesis
Block 4: Oral and maxillofacial infectious pathology
Block 5: Cysts of the maxillar bones
Block 6: Basic dental implantology
0. Presentation and introduction to the subject.
-Organisation, theoretical sessions, practical sessions, structure of the classes, projects, evaluation, etc.
Block 1: Surgery principles (oral and maxillofacial)
Introduction to oral medico-surgical pathology
1.1. General surgical pathophysiology
1.2. Responses to surgical aggression
1.3. Post-aggression biological responses of organs (lesion)
1.4. Local response to aggression
1.5. Inflammation-Resolution-Repair-Regeneration
1.6. Lesion-Inflammation-Proliferation-Remodelling
1.7. Growth factors in the process of repair
Diagnosis of the oral medico-surgical pathology
2.1. The clinical history in oral and maxillofacial surgery
2.1.1. Anamnesis
2.1.2. Local, regional and general clinical examination
2.1.3. Complementary tests and examinations
2.2 Pre-operative testing
2.2.1. The healthy patient and the patient with systemic disease
(ASA classification)
2.2.2. The high-risk patient. The medically-compromised patient.
Preparation and work protocol in oral and maxillofacial surgery
3.1. Disinfection: surface, instrumental, personnel.
3.2. Sterilization: instrumental and work flow
3.2. Preparing the surgical field
3.3. Preparation of the patient
3.4. 4-, 6- and 8-handed work in dentistry
3.5. Basic and advanced surgical material and instrumental.
Basic principles of oral and maxillofacial surgery
4.1. Anesthetic technique. Loco-regional anaesthesia. Local anaesthetics.
4.2. Conscious sedation and general anaesthesia
4.3. Basic surgical technique: incision, mucoperiosteal flap,
ostectomy/osteotomy, tissue management, hemostasis, suture
4.4. Types of incisions and flaps in oral surgery
4.5. Types of suture
4.6. Medication and postoperative care in oral and maxillofacial surgery
4.6.1. Analgesics and antiinflammatories
4.6.2. Antibiotic therapy
4.6.3. Oral antiseptics
4.6.4. Instructions, recommendations and postoperative care.
Medical emergencies in oral and maxillofacial surgery
5.1. Types of medical emergencies
5.2. Prevention and treatment of medical emergencies
5.3. Pharmacology, materials and emergency equipment
5.4. Identifying and reducing anxiety in the dental surgery
Block 2: Exodontics
Introduction to exodontics
1.1. Revision of dental anatomy and maxilla: upper and lower maxilla
1.2. Basic instruments and equipment: forceps, elevators, basic surgery instruments. Rotary instruments
1.3. Anaesthetic techniques for dental extraction
2. Indications and contraindications of exodontics 2.1. Indications: Dental and periodontal pathology, pathology of dental eruption, pathologies of the maxilla, requirements of the orthodontic treatment, requirements of the prosthodontic treatment, economic motives-need, etc. 2.2. Contraindications: General or systemic and local.
3. Basic exodontic technique
3.1. Operating times: preparation of the patient. Preparing the surgical field. Anaesthesia. Sindesmotomy. Luxation. Traction. Avulsion. Curettage and revision of the surgical field. Compression of the alveolar bone. Suture. Post-operative instructions.
3.1. Permanent teeth of the upper maxilla
3.2. Permanent teeth of the mandible
3.3. Deciduous teeth.
Complex exodontics
4.1. Dental section techniques
4.2. Exodontics in anticoagulated patients: heparin protocol, dicumarinic protocol, antiplatelet agent protocol, etc.
4.3. Surgical exodontics: elevation of the mucoperiosteal flap, osteoctomy, suture
4.4. Multiple exodontics. Alveolotomy. Alveoloplasty
4.5. Intra-alveolar dressings.
Complications and their prevention
5.1. Intraoperative complications
5.2. Postoperative complications
5.3 Medico-legal aspects of exodontics. Informed consent
Block 3: Alterations of eruption and of dental organogenesis
Alterations of eruption
1.1. Chronology of dental eruption
1.2. Aetiology and frequency of dental eruption alterations.
Pathology of the eruption of third molars
2.1. Indications of extraction, expectant management, therapeutic abstention.
2.2. Surgical technique
2.3. Postoperative care and complications.
Pathology of eruption of included canines
3.1. Indications of extraction, expectant management, therapeutic abstention
3.2. Surgical procedure for extraction of included canines
3.2. Treatments for orthodontic repositioning: direct and indirect fenestration, intramucous and extramucous
3.3. Self-transplant.
Other dental inclusions.
Supernumerary teeth. Mesiodens
Block 4: Oral and maxillofacial infectious pathology
Systemic infections
1.1. Bacteremia, sepsis or septicemia, septic shock
1.2. Focal infection
1.3. Bacteremia and the oral portal of entry
1.4. Prevention of bacterial endocarditis
Local infections
2.1. Dry and suppurative alveolitis
2.3. Osteochemonecrosis of the maxilla: aetiology, action protocols and prevention. Treatment of osteochemonerosis of the maxilla
2.3. Osteomyelitis of the maxilla: aetiology, diagnosis, treatment and preventive measures
Block 5: Cysts of the maxillar bones
1. Classification of maxillar cysts
2. Odontogenic cysts
3. Non-odontogenic cysts
4. Diagnosis and treatment
5. Periapical surgery: indications, contraindications, surgical technique and prognosis of periapical surgery
Block 6: Basic dental implantology
History and foundations of implantology
Anatomy and hystology of the mandibular bone and the upper maxilla applied to implantology
Metabolism and bone physiology, pathophysiology of osteointegration
Surface and design of implants
Biomechanics of dental implants
Pharmacology applied to dental implantology
Diagnostic imaging in dental implantology
7.1. Intraoral radiographs, panoramic extraoral radiographs
7.2. Tomography.
Treatment planning in implantology
8.1. According to the patient: single teeth, partial edentulous, free ends, anterior sector, totally edentulous cases
8.2. According to the prosthesis: fixed or removable
8.3. According to the type of loading: immediate, early or delayed.
Surgical technique step by step: anaesthesia, incisions, flap lifting, bone preparation, implant placement, locking screw or gingiva former, suture and postoperative instructions
- PRACTICES
- TEORETHICAL
- TEMA 13, 14, 15
- TEMA 13, 14, 15
Teaching and learning activities
In person
1. Master classes
Master classes providing the theoretical basic knowledge in schematic form and with a wealth of graphic material. Time (20 minutes) will be dedicated at the end of the theoretical class for questions, clarifications or any broadening of concepts that the student may require (as a short seminar).
2. Preclinical practical sessions
Preclinical practical sessions will take place in the laboratory and in the University Dental Clinic (CUO) by use of phantoms. These practical sessions will make use of the theoretical knowledge acquired as well as instruments and materials, ergonomics, asepsis, patient monitoring, attitude, and anaesthesia, exodontic and suture techniques.
Students will carry out loco-regional anaesthesia, exodontic and suture procedures on phantoms under the supervision of the lecturer.
Evaluation systems and criteria
In person
EVALUATION
It is mandatory to carry a valid official document with a photograph type ID or passport in the exams.
A. THEORETICAL PART: The theoretical content of the subject will include the information transmitted during the online class completed with the content of the recommended bibliography for each topic. The final Theoretical Exam will be multiple-choice questions (4), with a single valid answer. An error in answering a question will subtract 0.25 points.
The theoretical final grade will be complemented by 5% with the verification of the attendance to the classes, the participation, and the answers of the student on-line.
B. PRACTICAL PART: The evaluation of the Pre-clinical Practices will be continuously contemplating the following parameters: Knowledge of the sterile material and technique, ergonomics and handling of the instrument and equipment, techniques of loco-regional anesthesia, exodontics and suturing.
1. The assistance is COMPULSORY. The attendance control of the students will be made to each practice.
2. The ABSENCE of two UNJUSTIFIED practices will be considered suspended practices.
3. The supporting documents must be submitted within 1 week after the absence and can be sent by email to Dr. Naroa Lozano. Under no circumstances will supporting documents be accepted once the internship period has ended.
4. Not be accepted as justifiable, all those absences whose motive can be performed at another time (example: renewal of ID, driving exams ...), or that the proof has been made by a relative of the student.
5. The bad attitude, not bring the material, not pick up the job, be absent before the end of the practice, use of mobile ... are considered FAULTS, two faults will be considered an ABSENCE.
6. The practices represent 30% of the final grade:
20% Final practical exam.
10% The correct development of the different practices: attendance, participation, interest, use of the complete personal protective equipment ... The student who has a lack of unjustified attendance will be qualified with a 0 in this section.
7. The value of the final exam will be 20% of the final grade.
8. The exam will consist of 4-5 questions that will be chosen randomly, from a template of questions that the professors of practices will have made about the different practices carried out.
9. Each question will be scored with: 0 (poor), 1 (good) or 2 (excellent). Then proceed to make the average, about 20 points.
C. In order to pass the subject, it is essential to approve the practices and the theoretical exam individually (the pass is 50% of the exam score: 10 out of 20 in the practical and 25 out of 50 in the theoretical one).
FINAL EVALUATION
The evaluation of each student will be carried out as follows:
Theoretical final examination: 70%
Practical sessions: 30%
Total: 100 points
FINAL SCORE: 100p/1000= 5 (pass)
Bibliography and resources
Hupp JR, Ellis E, Tucker E. Contemporary Oral and Maxillofacial Surgery.5 Th. ed. Philadelphia:Ed. Mosby.; 2008.
Michael Miloro. Peterson's Principles of Oral and Maxillofacial Surgery, Ed BC Decker
Neville. Oral and Maxillofacial Pathology, Ed Saunders
Sailer, Pajarola. Oral Surgery for the General Dentist. Ed Thieme
Sapp JP, Eversole LR, Wysocki GP. Contemporary Oral and Maxillofacial Pathology 2 nd ed. Philadelphia: Mosby-Elsevier; 2004.
2. Bibliografia de consulta
Atari M, Barajas M, Hernández-Alfaro F, Gil C, Fabregat M, Ferrés-Padró E, Giner L,Casals N. Isolation of pluripotent stem cells from human third molar dental pulp. Histol Histopathol 2011;26:1057-70.
Cawson RA, Odell EW. Cawson fundamenteos de medicina y patología oral.Barcelona: Elsevier; 2009.
Díaz Carandell A, Hernando Chaure A, Ferrés Padró E. Protocolo de actuación ante situaciones de emergencia médica en la CUO. Clínica Universitaria de Odontología. Guía Clínica de aplicación en la CUO Departament de Patologia Mèdico-Quirúrgica i Implantologia Oral. Facultat d’Odontologia. Universitat Internacional de Catalunya;2008.
Gutiérrez J L, Vicente Bagán J, Bascones A, Llamas R, Llena J, Morales A. Documento
de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos
dentales. Rev Esp Cir Oral y Maxilofac 2006;28:151-181.
Hernando Chaure A, Ferrés Padró E. Cirugía oral electiva en pacientes bajo terapia anticoagulante y antiagregante plaquetario. Guía Clínica de aplicación en la CUO. Dpartamento de Patologia Mèdico-Quirúrgica e Implantologia Oral. Facultad de Odontologia.Universitat Internacional de Catalunya;2006.
Kirk RM. Técnicas quirúrgicas básicas. 5a ed. Barcelona: Ed. Elsevier;2003.
Maestre Vera JR. Treatment options in odontogenic infection. Med Oral Patol Oral Cir
Bucal 2004;9 Suppl:25-31;19-24.
Maestre Vera J R, Gómez-Lus Centelles M L. Antimicrobial prophylaxis in oral surgery and
dental procedures. Med Oral Patol Oral Cir Bucal 2007;12:E44-52.
Malamed S.F. Handbook of local anesthesia 5ª ed. Philadelphia: Mosby-Elsevier;2005.
Prats Armengol J, Ferrés Padró E. Estudio comparativo entre las técnicas del bloqueo anestésico de la tercera rama del trigémino (Convencional, de Gow-Gates y de Akinosi) en 120 exodoncias quirúrgicas de terceros molares inferiores.Quintessence 1999; 12:167-174.
Sailer HF, Pajarola GF. Atlas de cirugía oral.Ed. Masson. Barcelona;1997.
Scully C. Oral and Maxillofacial Medicine. The basis of diagnostic and treatment 2nd ed. Edinburgh: Churchill Livingstone-Elsevier; 2008.
Jorba, J. Asepsia en odontología. Normativa homologada
por el colegio oficial de odontólogos y estomatólogos de
Cataluña y Baleares. COEC
Stapff, KH. Recomendations for surface desinfection (3)
Quintessence J. 1991 Aug 21 ( 8) p 739‐43 .
Evaluation period
- E1 20/12/2024 A02 08:00h
- E1 20/12/2024 A01 08:00h
- E1 20/12/2024 A03 08:00h
- R1 21/01/2025 A05 17:00h