KING ABDULAZIZ UNIVERSITY FACULTY OF DENTISTRY ORAL BASIC AND CLINICAL SCIENCES DEPARTMENT

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KING ABDULAZIZ UNIVERSITY FACULTY OF DENTISTRY ORAL BASIC AND CLINICAL SCIENCES DEPARTMENT COURSE: PERIODONTICS PERIO 501 O.B.C.S 545

CONTENTS: COURSE SYLLABUS 1-INSTRUCTOR INFORMATION 2-COURSE DESCRIPTION 3-COURSE OBJECTIVES 4-LEARNING RESOURCES 5-COURSE REQUIREMENTS AND GRADING 6-DETAILED COURSE SCHEDULE

Class information Course Director: Prof. Amal Al- Hessy, building # 9 Female section, office hours Sunday morning. E-mail : aalhessy27@hotmail.com Location : 5 th year class room building # 10 for female and # 9 for Female Periodontics : 501 Faculty members: Staff Members Post.. Ext.# Dr. Ali Al- Ghamdi Head of the Division 21262 Prof. Amal EI-Hessy Course Director 5 th Year 23225 Prof. Mosaad Al-Sherbini Course Director 6 th Year 20013 Prof. Hakem El-Sayed Course Director 4 th Year 22351 Dr. Mohammad Al- Zahrani Assistant Professor 20034 Dr. Nada AlGhorab Assistant Professor 23294 Dr. Hadir Desouky Assistant Professor 23297 Dr. Mamdouh Karima Assistant Professor 20030 Dr. Hind Al-Johani Lecturer 23219 Dr. Dina Al-Tayeb Lecturer 23217 Dr. Ahmad Al- Hassani Dr. Arwa Badahdah Demonstrator Demonstrator

Required Reading: 1- Clinical Periodontology edited by Carranza & Newman 9 th ed. 2- Fundamental of Periodontal Instrumentation and Advanced Root Instrumentation by Jill S. Nield Gebrig 5 th ed, 2004 3- Color Atlas of Dental Medicine 1: Periodontology Edited by K.H.Reteitschak, 3 rd revised edition (Thieme), 2004 4- Color Atlas of Periodontal Surgery: Quintessence Publishing Co. 2004 5- Color Atlas of Periodontal Therapy: Clinical Approaches and Evidence of Success, Quintessence Publishing Co. 1998

PERIODONTICS COURSE OUTLINE (Perio 501) Course Description: Didactic component: Includes a quick review of the classification and pathogenesis of periodontal diseases and a more detailed information on a comprehensive treatment plan and the prognosis of periodontal diseases. The maintenance phase of periodontal disease will be presented and discussed. The relationship between periodontal disease with other clinical disciplines of dentistry and more advanced aspects of the relationship between periodontal diseases and systemic conditions will be presented. The student should be aware of the objectives, indications and contraindications of the various surgical periodontal procedures. The surgical approaches to the management of periodontal diseases will be presented, such that the student will be exposed to the complete spectrum of surgical therapeutic techniques, nevertheless the development of skills in clinical practice will be limited to procedures that are expected to be performed in an integrated comprehensive care general practice. A problem based component was added this year so as to stimulates the student's abilities for critical thinking, evaluation and clinical decision making. Clinical Component: The student should be able to accurately diagnose, plan and deliver routine non-surgical treatment to patients with periodontal diseases as well as accurately interpret and evaluate the results of the treatment rendered. The student should be aware of indications for surgical periodontal procedures as well as the principles which govern each procedure. The student should be able to perform basic diagnostic and therapeutic procedures consistent with the experience gained with the progression of the course. The student should be able to devise the appropriate periodontal maintenance program suitable for each patients. Clinical skills will be limited to procedures that are expected to be performed in an integrated comprehensive care general practice. e.g. basic surgical procedures such as gingivectomy and flap procedures, adjunct procedures e.g. crown lengthening. Emphasis will continue to be placed on gaining mastery of basic techniques of scaling and root planning. It is mandatory that the students should complete at least four cases, with all steps expect for the surgical phase. Grading will be carried out as outlined in the grading system.

Case Requirements and Grading 1. Continuous assessment 40% * Quiz 15 marks Midterm 30 marks Quiz 15 marks Clinical: (4 completed cases)* 20 marks TOT AL 80 marks 2. Final Examination: (covering the entire course) 60% Written Exam Oral Exam. Clinical Test Case TOTAL 80 marks 20 marks 20 marks 120 marks Over all Grading Guidelines The percentage (%) of total grading system will be used in this course A = Excellent B = Very good C = Good (accepted) D = Marginally accepted F = Unacceptable (failed) 85% or more of total 75% or more of total but less than 85% of total 65% or more of total but less than 75% of total 60% or more of total but less than 65% of total less than 60% of total

First Semester 5 th year Wek Date REMARKS LECTURER Reading* 1. 11/9/2004 26/7/1425 2. 18/9/2004 4/8/1425 3. 25/9/2004 11/8/1425 4. 2/10/2004 18/8/1425 5. 9/10/2004 25/8/1425 6. 16/10/2004 2/9/1425 7. 23/10/2004 9/9/1425 8. 30/10/2004 16/9/1425 9. 20/11/2004 7/10/1425 10. 27/11/2004 14/10/1425 11. 4/12/2004 21/10/1425 12. 11/12/2004 28/10/1425 Orientation Determination of Prognosis Prof. El-Hessy Chapter 33 Objectives and Rationale for Periodontal Prof. El-Sayed Chapter 54 Surgery General principles of periodontal Surgery Prof. El-Sayed Chapter 55 Surgical Anatomy of the Periodontium and Related Structures Dr. Al-Zahrani Chapter 56 Gingivectomy and Gingivoplasty Prof. El-Hessy Chapters 58, 59 The periodontal Flaps Prof. El-Hessy Chapters 60, 61 Suturing Techniques Dr. Al-Johani Chapter 60 Ramadan Vacation Healing after Periodontal surgery Dr. Ghourab Chapters 57, 60 Acute Gingival and Periodontal Infections Dr. Ghourab Chapters (I) 19, 46 Acute Gingival and Periodontal Infections Dr. Ghourab Chapters (II) 27, 45 Influence of Systemic Disease and Prof. El-Sayed Chapter 12 Disorders on the Periodontium (I) Revision *Textbook required :Carranza.Clinical periodontology,9 th ed

Second Semester 5 th year Wek Date REMARKS LECTURER Reading* 1. 5/2/2005 Influence of Systemic Disease and Prof. El-Sayed Chapter 12 25/12/1425 Disorders on the Periodontium (I) 2. 12/2/2005 Periodontal Disease as a Potential Risk Dr. Dina Al-Tayeb Chapter 13 3/1/1426 Factor for Systemic Diseases 3. 19/2/2005 Chemotherapeutic agents in Periodontal Prof. El-Sherbini Chapter 50 10/1/1426 4. 26/2/2005 Other medications in periodontal therapy Prof.El-Sherbini Chapter 50 17/1/1426 5. 5/3/2005 Resective Osseous Surgery Dr. Al-Ghamdi Chapter 62 24/1/1426 6. 12/3/2005 Regenerative Osseous Surgery Dr. Al-Ghamdi Chapter 63 2/2/1426 7. 19/3/2005 9/2/1426 Furcation: The Problem and its Management Dr. M. Karima Chapter 64 8. 26/3/2005 16/2/1426 9. 2/4/2005 23/2/1426 10. 9/4/2005 30/2/1426 11. 16/4/2005 7/3/1426 12. 23/4/2005 14/3/1426 13. 30/4/2005 21/3/1426 14. 7/5/2005 28/3/1426 15. 14/5/2005 6/4/1426 The Periodontic-Endodontic Continuum Dr. Dina Al-Tayeb Chapter 65 Preparation of the Periodontium for Restorative Dentistry Dr. Al-Ghamdi Chapters 74, 75 Interrelationship of Periodontics to Dr. Al-Ghamdi Chapter 53 Orthodontic Treatment Periodontal Plastic and Esthetic Surgery Dr. Al-Zahrani Chapter 66 Periodontal Plastic and Esthetic Surgery Dr. Al-Zahrani Chapter 66 Clinical and Biological Aspects of Dental Implants Dr. Al-Johani Chapters 68, 69 Surgical Aspects of Dental Implants Dr. Al-Johani Chapters 70, 71 Supportive Periodontal Treatment & Dr. Ghorab Chapters Results of Periodontal Treatment 76, 77 *Textbook required :Carranza.Clinical periodontology,9 th ed

COURSE RELATED MATERIAL CONTENTS 1-LECTURES OUTLINES AND OBJECTIVES 2-LECTURES HANDOUTS 3-EXAMPLES OF QUIZZES;MIDYEAR;AND FINAL EXAMS

Course Objectives Lectures Acute gingival & periodontal diseases (I) and (II) (Necrotizing ulcerative gingivitis, Necrotizing ulcerative periodontitis, Acute herpetic gingivostomatitis, Periocoronitis, gingival and periodontal abscess) At the end of the lecture students will learn the following: 1. Etiology 2. Clinical feature and course 3. Histopathology 4. Diagnosis 5. Differential diagnosis 6. Treatment 7- Communicability Influence of systemic diseases & disorders on periodontium After this lecture the students will learn the following:- 1. The effect of nutrition on oral & periodontal tissue 2. The clinical periodontal manifestations of vitamin deficiency ( Fat- soluble & Water soluble vitamin deficiency ) 3. The relationship between endocrine disorders & periodontal disease as : Diabetes mellitus Hyperparathyroidism Sex hormones Corticosteroid hormones 4. The fundamental interrelationships between oral & periodontal tissue and hematological disorders as ( Leukemia Anemia Thrombocytopenia ) 5. The relation between deficiencies in host defense mechanism & destructive periodontal lesions 6. The possible relation between Cardiovascular diseases & the severity of periodontitis

7. Metal intoxication & its effect on the gingival tissue 8. The possible correlation between psychosomatic disorders and the occurrence of periodontal disease Periodontal Disease as a Potential Risk Factor for Systemic Disease 1. Understand the association between periodontal disease and heart disease. 2. Understand the role of disease in diabetes mellitus 3. Understand the effect of periodontal disease on pregnant women 4. Know the association between periodontal disease and respiratory disease 5. Be aware of the importance of patient s education regarding the connection between periodontal and systemic conditions Chemotherapeutic agents in the treatment of periodontal diseases At the end of the lecture students should be able to know the following: 1. Principles for use of antibiotic therapy in periodontics A- specific characteristic of periodontal infection B- limitation of mechanical therapy and if antimicrobial agents can help 2. Systemic administration of antibiotics 3. Single,serial and combination antibiotic therapy 4. Local delivery of antibiotic and, antiseptic agents 5. Clinical applications of systemic and local delivery chemotherapeutic agents for different types of periodontal disease 6. Host modulation agents (Anti-inflammatory agents)

Surgical Phases of Periodontal Therapy A. Objectives of Surgical & Rationale for periodontal surgery At the end of the lecture students should be able to know the following: 1. Goals, objectives & rationale of this phase 2. Comparison between the expected results after non surgical & surgical treatment 3. Indications of periodontal surgery 4. An overview of different modalities of periodontal therapy, according to lesions severity. B.General principles of periodontal surgery At the end of the lecture students will learn the following: 1. The fundamental roles ( general principles ) to be followed, before, during, and after periodontal surgery 2. Management of some critical & emergency situations ; as Syncope excessive bleeding post operative complications 3. Dealing with apprehensive patients 4. Indications for hospital periodontal surgery Gingivectomy At the end of the lecture students should be able to know the following: 1. Indications and contraindications 2. Advantages and disadvantages 3. Surgical gingivectomy 4. Gingivectomy by electrosurgery 5. Laser gingivectomy 6. Gingivectomy by chemosurgery 7. Gingivoplasty

Periodontal flaps At the end of the lecture students should be able to know the following: 1. Classification of flaps 2. Design of the flap 3. Indications & contraindications 4. Advantages & disadvantages 5. Types of Incisions: - Horizontal incision - Vertical incision Suturing Techniques At the end of the lecture students should be able to know the following: 1. When suturing is needed 2. The different types of sutures material 3. The different techniques of suturing, their application, and indication 4. The different techniques by making a suturing workshop on models after the lecture Resective Osseous Surgery 1. Identify the normal and abnormal alveolar bone morphology 2. Understand different factors which help in the selection of resective osseous surgery 3. Become familiar with different methods and techniques of osseous resective surgery 4. Understand other specific osseous reshaping situations 5. Become familiar with postoperative complications and managements Regenerative Osseous Surgery 1. Become familiar with factors that help in selection of regenerative osseous surgery 2. Understand different regenerative techniques, and advantages and disadvantages of each technique 3. Become familiar with graft materials used for periodontal osseous regeneration 4. Understand the concept of guided tissue and guided bone regeneration 5. Determine when to use bone graft or membrane or both

6. Become familiar with methods used for evaluation of new attachment and bone regeneration 7. Become familiar with factors influencing a successful outcome Furcation, The problem and its management At the end of the lecture students should be able to know the following: 1. Identify the etiologic factors of furcation problems 2. Achieve an accurate diagnosis and classification of furcation defects 3. Recognize the anatomy of the tooth and the bony lesions that might affect the outcome of furcation treatment 4. select an adequate treatment of furcation defects The Periodontic-Endodontic Continuum 1. Understand the classification of pulpal disease 2. Know the classification of peri-raduclar lesions 3. Differentiate between periodontal and pulpal lesions 4. Know the symptoms, diagnosis, prognosis and treatment of combined lesion Surgical Anatomy of the Periodontium and Related Structures 1. Recognize the important anatomical structures when performing periodontal surgery. 2. Understand their clinical implications. 3. Recognize the following structures in the maxilla: Alveolar process, palatine process, zygomatic process, frontal process, incisive canal and papilla, greater palatine foramen, palatal glands, maxillary tuberosity, maxillary sinus and tori 4. Recognize the following structures in the mandible: Mandibular canal, mental foramen, lingual nerve, alveolar process, external oblique ridge, retromolar triangle, mylohyoid ridge and tori Preparation of the Periodontium for Restorative Dentistry 1. Understand biologic, esthetic, restorative, and occlusal considerations in periodontalrestorative interrelationship 2. Become familiar with different surgical procedures used for preparation of the periodontium for restorative dentistry

3. Understand when to use or not use each technique and its limitations 4. Become familiar with pathologic conditions that may occur due to improper restorative procedures Periodontal Plastic and Esthetic Surgery (part 1 & II) 1. Differentiate between the terms mucoginigval surgery and periodontal plastic surgery 2. Identify Periodontal problems related to lack of attached gingiva, shallow vestibule and aberrant frenum 3. Discuss etiological factors of gingival recession 4. Classify gingival recession based on Sullivan and Atkins and Miller classifications 5. Have general idea about different procedures to increase width of attached gingiva, cover exposed roots and to augment and preserve alveolar ridge 6. Understand indications and contraindications of each procedures Clinical and Biological Aspects of Dental Implants 1. Know the different biomaterials of implants 2. Know what is the peri-implant mucosa 3. Explain the implant bone interface 4. Know the clinical management of dental implants, their indication, contraindication 5. Know the various implant systems Surgical Aspects of Dental Implants At the end of the lecture, students should be able to: 1. Know how to select suitable cases for implant cases therapy 2. Know complications of implants and how to maintain implant patients 3. Know the different techniques of endosseous implant surgeries 4. Explain how to diagnose and treat peri-implant disease Interrelationship of Periodontics to Orthodontic Treatment 1- Become familiar with benefits of orthodontics for periodontal patients 2- Understand the concept of using orthodontics for treatment of osseous defects

Course Objectives The students at the end of the course of the 5 th year should be able to : * Diagnose accurately patients with periodontal diseases, plan and deliver routine non surgical treatment as well as accurately evaluate the results of the treatment rendered. * Students differentiate the various indications and contraindications for surgical periodontal procedures as well as the principles which govern each procedures. * The students evaluate the different considerations of periodontal patients with systemic diseases and conditions. * The students should be able to manage periodontal case with other dental involvement as restorative, endodontic and orthodontic treatment.