Learning Outcome and Graduate Attributes

Learning Outcome

and Graduate

Attributes

Chhattisgarh Dental college & Research Institute Sundra,

Rajnandgaon – 491441 (C.G.)

Competency Based Evaluation for Under Graduates

Table of Content: Competency Assessment

1. Department of Oral Medicine and Radiology ……………………………………………..1 - 2

a. Pre-clinical Work

b. Case History Recording

c. Intraoral Radiographic Interpretation

d. Extraoral Radiographic Interpretation

2. Department of Oral & Maxillofacial Surgery ……………………………………………..3 - 5

a. Case History Recording

b. Local Anesthesia administration

c. Extraction of tooth

3. Department of Prosthodontics and Crown & Bridge …………………………………….6 - 19

a. Complete Denture construction (CD)

b. Removable Partial Denture (RPD)

c. Fixed Partial Denture (FPD)

4. Department of Pedodontics and Preventive Dentistry …………………………………..20 - 23

a. Case History, diagnosis and treatment plan

b. Behavior management of children

c. Oral prophylaxis

d. Application of Preventive Agents

e. Restoration of cavitated lesions with GIC

f. Extraction of deciduous tooth

5. Department of Conservative Dentistry and Endodontics ……………………………….24 - 25

a. GIC Restorations

b. Silver amalgam restoration

6. Department of Orthodontics ………………………………………………………………26 - 27


b. Impression Making

7. Department of Public Health Dentistry ………………………………………………….. 28 - 30

a. Case History & Index Recording

b. Application of Preventive Agents

8. Department of Periodontics ………………………………………………………………. 31 - 34


b. Hand scaling

DEPARTMENT OF

ORAL MEDICNE AND

RADIOLOGY

Page | 1

1. Competency Assessment For Preclinical work:

A. Tracing of Radiograph Anatomy

Evaluation Criteria:

a. Is candidate able to clearly trace and label the Radiographic anatomical

landmarks

B. Drug Dosage


a. Is the candidate able to know various drugs with proper doses

2. Competency Assessment For Case History


a. Is the candidate able to communicate with patient properly

b. Is the candidate following proper examination protocol

c. Is the candidate able to record demographic data

d. Is the candidate able to record chief complaint

e. Is the candidate able to record history of present and past illness, medical history,

past dental history, drug history, personal history, family history

f. Is the candidate able to examine the patient: general examination, extra-oral and

intraoral examination

g. is the candidate able to identify the pathology

h. Is the candidate able to describe the pathology

i. Is the candidate able to arrive at a provisional diagnosis

j. Is the candidate able to give a clinical differential diagnosis

k. Is the candidate able to advice and interpret required investigations

l. Is the candidate able to arrive at a final diagnosis

Page | 2

m. Is the candidate able to formulate a proper treatment plan

3. Competency Assessment For Intraoral Radiographic Interpretation


a. Is the candidate able to identify the radiograph

b. Is the candidate able to identify the teeth seen

c. Is the candidate able to identify the pathology

d. Is the candidate able to describe the pathology

e. Is the candidate able to arrive at radiographic diagnosis

f. Is the candidate able to give a radiographic differential diagnosis

g. Is the candidate able to identify anatomical landmarks

h. Is the candidate able to identify error on the radiograph

4. Competency Assessment For Extraoral Radiographic Interpretation


a. Is the candidate able to identify the radiograph

b. Is the candidate able to identify the pathology

c. Is the candidate able to describe the pathology

d. Is the candidate able to arrive at radiographic diagnosis

e. Is the candidate able to give a radiographic differential diagnosis

f. Is the candidate able to identify anatomical landmarks

g. Is the candidate able to identify error on the radiograph

DEPARTMENT OF

ORAL &

MAXILLOFACIAL

SURGERY

Page | 3

1. Competency Assessment For Case History Recording

Armamentarium and materials: Diagnostic instruments and tweezer.

Evaluation criteria:

A. General Information: Biographical Data including Name, Age, Sex, Address.

B. History: Chief Complaint, History of Chief Complaint, Personal History and

Relevant Medical History

C. Clinical Examination:

a. General Physical Examination are to be recorded, which includes

Palor

Icterus

Cyanosis

Clubbing

Koilonychia

Lymphadenopathy

Edema

and also Vital Signs are recorded such as

Pulse

Blood Pressure

Respiratory Rate

Body Temperature

Oxygen Saturation

b. Extra Oral examination is done

c. Intraoral examination which includes Soft Tissue and Hard Tissue

Examination

D. Diagnosis and Investigations:

a. Is diagnosis correlating with chief complaint and clinical examination

b. Are Relevant Investigations advised based on History and Clinical

examination findings

c. Is radiographic interpretation done properly.

d. Is final diagnosis made in correlation with History, Clinical Examination

and investigations.

e. Is treatment plan drawn up appropriately?

Page | 4

2. Competency Assessment For Local anesthesia

1. Armamentarium and materials required:Topical anesthetic gel,

Appropriate Local aesthetic solution, disposable syringe with appropriate

length and gauge as per requirement of nerve block.

2. Procedure

a. Doing skin patch test to determine sensitivity/allergic to local

anesthetic solution used for nerve block.

b. Knowing dosage of local anesthetic agent used for giving anesthesia.

c. Operator’s position and patient’s position for specific nerve blocks.

d. Knowledge of which nerve block to be given for extraction of

specific tooth.

e. Knowledge of anatomical landmarks for giving specific nerve block.

f. Knowing technique of giving specific nerve block.

g. Identification of objective and subjective signs and symptoms of

specific nerve block.

h. Identification of specific complications associated with each nerve

blocks.

i. Management of complications after giving nerve blocks.

3. Evaluation criteria

a. Is patch test done properly

b. Are anatomical landmarks palpated properly

c. Is technique of giving nerve block properly followed

d. Subjective and objective symptoms identified correctly

e. Identification of complications associated

f. Management of complications

Page | 5

3. Competency Assessment For Simple Exodontia:

A. Case selection

a. Is there an indication for extraction

b. Is there any contraindication for extraction

c. Is there any relevant Medical History, which requires consultation of

medical colleagues, precautions, premedications or modification of

existing medication which are to be done

B. Armamentarium and materials required: Diagnostic instruments,

Tweezer, periosteal elevator, Appropriate extraction forceps, Dental

Elevator.

C. Procedure

a. Obtaining informed consent from the patients before procedure.

b. Positioning of chair according to the tooth to be extracted.

c. Appropriate Nerve Block, depending on the tooth being extracted.

d. Ascertaining subjective and objective symptoms.

e. Reflection of Flap using periosteal elevator.

f. Extraction of the tooth using appropriate forceps.

g. Inspecting the wound, curettage, if required and toileting of the

wound.

h. Achieving homeostasis and application of pressure pack.

i. Post-extraction instructions and prescription of medication.

D. Evaluation criteria

a. Is case selection done appropriately

b. Is local anaesthesia achieved

c. Is tooth completely extracted.

d. Are post-extraction instructions given

Page | 6

e. Is Post Extraction instruction given appropriately

f. Are Drugs Prescribed Appropriately

DEPARTMENT OF

PROSTHODONTICS

AND CROWN &

BRIDGE

Page | 6

1. Competency Assessment For Complete Denture

A. Primary Impression

Instruments and materials required

Mouth mirror Edentulous perforated and non-

perforated impression trays Rubber bowls -2 (large)

Periodontal probe Universal and Adams pliers Spatula (curved)

Divider Impression compound/Alginate Wax knife

Metallic scale Mcintosh sheet BP handle no:3 and BP

blade no:10

T- burnisher Indelible pencil Blow torch/gas torch

PROCEDURE:

Make the patient seat upright and adjust the head rest accordingly.

Select appropriate size stock impression tray and modify the tray as required.

Adjust the chair position.

a. Maxillary impression: Patient’s mouth should be at operator’s elbow level.

- Stand at 7 ‘o’ clock position for tray insertion.

- Move to 12 ‘o’ clock position for further compression and stabilization of the tray.

- Locate posterior vibrating line using T -burnisher and mark with indelible pencil.

- Transfer to the impressions

b. Mandibular impression: Patient’s mouth should be below operator’s shoulder level.

- Stand at 7 ‘o’ clock position to insert, compress and stabilize the tray.

- Support the mandible by thumb finger on both sides.

Use non-perforated stock trays for impression compound. Soften impression compound

in hot water, load the tray and make impression.

Use perforated stock trays for alginate. Mix alginate according to manufacturer

instructions, load the tray and make impression.

Instruct the patient to keep the head down while making maxillary arch impression, to

prevent the material flowing down the pharynx and gagging.

Remove the impression with a snap.

Make simulated functional movements to record border seal areas.

Page | 7

Evaluate the impression for border extension, frenal attachments, surface details and

any tray exposure.

Wrap the alginate impression in moist gauze till opposing arch impression is made.

Pour the cast for alginate impressions as soon as possible.

Evaluation criteria for primary impression

• Impression tray selection (appropriate size and modification of the tray)

• Manipulation of impression material and loading in the tray

• Tray positioning

• Application of adequate pressure and manipulation of soft tissues during impression

making

• Extension of the impression, adequately recorded denture bearing areas and peripheral seal

areas

• Presence of surface defects (voids or inadequate impression material)

• Tray exposure

• Trimming of excess impression material

• Disinfection of impressions

B. BORDER MOULDING AND FINAL IMPRESSION


Mouth mirror Low fusing (green stick)

compound Lecron carver

Periodontal probe ZOE impression paste Wax knife, wax spatula

T- burnisher Mcintosh sheet Blow torch/gas torch

Indelible pencils Rubber bowls -2 (large) Glass slab

Acrylic trimming burs BP handle no:3 and BP blade

no:10 ZOE mixing spatula

PROCEDURE:

Verify the custom tray in the patient’s mouth and do necessary adjustments.

Ensure 2 mm space between tray border and vestibule in functional position.

Mould the borders using low fusing impression compound/any other suitable material;

clearly define the border seal areas.

Start the border moulding by placing the material segment wise and do simulated functional

movements.

Remove any excess border moulding material inside the tray after each segment of border

moulding.

Page | 8

Mark anterior and posterior vibrating lines, transfer onto the tray. Place the recording

material between the lines to record adequate posterior palatal seal.

Examine the border molded tray carefully; for adequate extension, retention, stability, and

border thickness filling the vestibule space.

Scrape inner surface of border moulding material, remove wax spacer and make escape

vents in the custom tray.

Make the final impression using zinc oxide eugenol impression paste or rubber base

material.

Remove and evaluate the impression for completeness (devoid of any defects). Don’t

hesitate to remake the impression in case of any defects.

Careful handling of the impression is required to avoid distortion or damage to the tissue

and peripheral areas of impression.

Evaluation criteria for border moulding and final impression

• Inspection of custom impression tray on the cast and intraorally for adequate space between

tray border and vestibule in functional position

• Simulated functional movements of soft tissues during

• border moulding procedure

• Marking post dam area(posterior palatal seal) using T-burnisher, indelible pencil and

transferring to the tray

• Removal of excess material inside the tray

• Adequate recording of all the peripheral seal areas, verification of retention and stability of

the tray

• Removal of spacer and provision of escape/relief holes

• Mixing of impression material and loading in the tray

• Tray position and simulated functional movements during impression making

• Inspection of final impression borders and surface details (without any defects)

• Disinfection of impressions

C. JAW RELATION RECORDING


Mouth mirror Modelling wax Lecron carver

Straight probe ZOE impression paste Wax knife, wax spatula

Fox plane Acrylic trimming burs Hot plate

Divider Mcintosh sheet Glass plate, glass slab

Page | 9

Metallic scale Rubber bowls -2 (large) ZOE mixing spatula

PROCEDURE:

Place maxillary occlusal rim and check for retention and stability.

Adjust maxillary occlusal rim- for lip support, lip fullness, nasolabial fold, philtrum and

vermillion border.

Adjust for visibility; 2 mm of maxillary occlusal rim should be visible when the patient

is at rest (depending on the age).

Adjust anterior part of maxillary occlusal rim by asking the patient to say “F” or “V”.

Using Fox’s occlusal plane indicator; adjust the anterior plane making it parallel to inter-

pupillary plane and posterior plane making it parallel to ala-tragus/ Camper’s plane.

Mark the midline considering the tubercle of philtrum/ facial midline as reference.

Mark canine line considering angle of mouth/lateral border of ala of nose as reference.

Stick two triangular pieces of adhesive tape on the tip of the nose and chin. Measure the

vertical dimension at rest (VDR) by Niswonger’s method.

Place mandibular occlusal rim and adjust for esthetics.

Adjust the height of mandibular occlusal rim to the level of dry-wet junction of lower lip,

angle of mouth and posteriorly to half the height of retromolar pad.

Measure vertical dimension at occlusion (VDO). VDO should be 2-4mm less than VDR.

Both the occlusal rims should have bilateral simultaneous contact.

Perform phonetic test. Ask the patient to say “M” and “S” sounds and verify freeway

space and speaking space.

Establish the mandible in centric and record the centric jaw relation using interocclusal

check bite record method.

Mark nick and notch on maxillary occlusal rim and trough on mandibular occlusal rim.

Place bite registration material in trough and ask patient to retrude and close.

Select the artificial teeth according to the guidelines.

Evaluation criteria for Jaw relation recording and teeth selection

• Inspection of temporary denture bases and occlusal rims on the master cast

• Intraoral inspection of temporary denture base (verify border extension, border thickness,

frenal relief, retention, and stability)

Page | 10

• Inspection of maxillary occlusal rim

Lip fullness, lip support

Occlusal rim height and Incisal visibility

Occlusal plane in relation to Camper’s plane

Mid line, canine line and smile line markings

• Inspection of mandibular occlusal rim


Occlusal rim height

Occlusal plane in relation to retromolar pad

Mid line, canine line markings

• Measurement of vertical dimension at rest (VDR)

• Measurement of vertical dimension at occlusion (VDO)

• Provision of adequate freeway space and closest speaking space

• Verification of speech

• Tentative centric bite registration

• Selection of teeth

D. TRY-IN (STAGE OF VERIFICATION)


Mouth mirror Rubber bowls -2 (large) Glass plate

Straight probe Lecron carver Modelling wax

Mcintosh sheet Wax knife, wax spatula

PROCEDURE:

Insert the mandibular waxed-up trial denture followed by maxillary and evaluate for

retention, stability, aesthetics, phonetics and occlusion.

Verify vertical dimension and centric jaw relation established during jaw relation stage.

Verify the shade, size, shape and position of artificial teeth.

Verify the appearance of finished dentures before final processing. Any changes needed

in the denture teeth arrangement can be made at this time.

Obtain consent from patient on approval.

Page | 11

Evaluation criteria for Try-in

Inspection of mounting on the articulator and teeth arrangement

Intraoral re-verification of temporary denture bases (verify retention, and stability)

Inspection of maxillary trial denture


Incisal visibility during rest and speech

Occlusal plane

Mid line, canine line and smile line

Size, shape, shade and position of artificial teeth

Inspection of mandibular trial denture


Occlusal plane

Size, shade and position of artificial teeth

Verification of VDO, VDR and freeway space

Verification of centric occlusion

Verification of overjet and overbite

Verification of speech

Obtaining consent from patient

E. DENTURE INSERTION


Mouth mirror Articulating paper Rubber bowls -2 (large)

Straight probe Acrylic trimming burs and

sandpaper Indelible pencil

Articulating paper holder Mcintosh sheet Modelling wax

PROCEDURE:

Verify the tissue surface of denture for frenum relief, over extensions and any other

irregularities and ensure smooth borders.

Do clinical remount to correct occlusal interferences.

Do bite registration at the point of first occlusal contact, mount the dentures on articulator

and do selective grinding.

Page | 12

Instruct the patient about the use and care of dentures and give a subsequent follow-up

appointment after 24 hours for observation, evaluation and any corrections as necessary.

Post-insertion instructions handouts should be given to the patient.

Evaluation criteria for Complete Denture insertion

Inspection of tissue, polished and occlusal surfaces of denture

Laboratory remount procedure and necessary occlusal corrections

Intraoral inspection of dentures for adequate extension

Retention and stability of dentures

Occlusion – clinical remount procedure and selective grinding to correct

occlusal interferences

Facial appearance

Speech

Instructing the patient about the use and care of dentures (Post insertion instructions)

F. Follow up or Recall:


Mouth mirror Articulating paper Rubber bowls -2 (large)

Straight probe Acrylic trimming burs and

sandpaper Indelible pencil

Articulating paper holder Mcintosh sheet Pressure indicating paste

PROCEDURE:

Verify the occlusion and correct the occlusal interferences if any.

Evaluate the tissues for any ulceration.

Ask for any post-insertion complaints from the patient and correct the dentures as

necessary.

Emphasise on use and care of dentures.

Schedule further recall visits as required.

Evaluation criteria for Recall appointment

Intraoral examination of soft tissues for any irritation from dentures

Careful adjustment of dentures

Correction of occlusion (if required)

Page | 13

2. Competency Assessment For Removable Partial Denture (RPD)

A. PRIMARY IMPRESSION

INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Divider, Metallic scale(6

inches), T- burnisher, Indelible pencil(H&E pencils), Dentulous perforated impression trays (U

& L 1,2,3,4 sizes), Universal and Adams pliers, Mcintosh sheet, Rubber bowls -2 (large),

Alginate mixing Spatula, BP handle no:3 and BP blade no:10, Blow torch/gas torch.

PROCEDURE:

Make the patient seat upright, adjust the head rest accordingly; adjust the chair position

and operator position (same as for CD impressions)

Select appropriate size stock impression tray and modify the tray as required.

Use impression compound to register edentulous areas in distal extension cases.

Following the alginate impression protocol to make mandibular and maxillary impressions.

Disinfect the impression.

Wrap the first impression in moist gauze and keep the impression with heels unsupported

while opposing arch impression is made and pour the cast as soon as possible.

Evaluation criteria for Primary impression

Impression tray selection (appropriate size and modification of the tray)

Manipulation of Alginate impression material and loading in the tray

Tray positioning

Adequate extension of impression, recording of teeth and edentulous areas

Presence of surface defects (voids, inadequacy of impression materials and exposure of tray)

Evaluation of study models

Surveying of diagnostic models :

Determining path of insertion, Marking undercuts, guide planes

List of mouth preparations

B. MOUTH PREPARATION AND FINAL IMPRESSION

INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Airotor handpiece and diamond

points, T- burnisher, Indelible pencil (H & E pencils), Mcintosh sheet, Rubber bowls -2 (large),

Alginate mixing spatula, BP handle no:3 - 1 and BP blade no:10, Lecron carver, Blow torch/gas

torch, Acrylic trimming burs, Glass slab, ZOE mixing spatula

Page | 14

PROCEDURE:

Do necessary mouth preparations depending on the partially edentulous situation.

Establish the occlusal plane by enameloplasty of supra erupted teeth.

Establishment of guide planes.

Modification of height of contour.

Verify the custom tray in patient’s mouth and do necessary adjustments (Sectional tray

covering edentulous areas / Full arch tray covering teeth and edentulous areas)

Ensure 2 mm space between tray border and vestibule in functional position.

Do border moulding and final impression using appropriate impression material (rubber

base material / green stick compound for border moulding and zinc oxide eugenol / rubber

base material for final impression). Make the pickup impression with alginate.

Do simulated functional movements during border moulding and final impression.

Remove and evaluate the impression for completeness (devoid of any defects). Don’t

hesitate to remake the impression in case of any defects.

Evaluation criteria for border moulding and final impression for distal extension cases

Inspection of custom impression tray on the cast and intraorally for adequate space between

tray border and vestibule in functional position

Necessary mouth preparations according to the list

Simulated functional movements of soft tissues during border moulding procedure

Marking post dam area (posterior palatal seal) using T- burnisher, indelible pencil and

transferring to the tray

Removal of excess material inside the tray

Adequate recording of all the peripheral seal areas, verification of retention and stability of

the tray

Removal of spacer and provision of escape/relief holes

Mixing of impression material and loading in the tray

Tray position and simulated functional movements during impression making

Inspection of final impression borders and surface details (without any defects)

Disinfection of impressions

Page | 15

C. JAW RELATION RECORDING

INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Mcintosh sheet, Rubber

bowls big -2, Wax knife, Wax spatula, Hot plate, Lecron carver, Metallic scale, H&E pencils,

Fox plane, Acrylic trimming burs, Glass slab, ZOE mixing spatula.

PROCEDURE:

General observation:

Place maxillary and mandibular occlusal rims and check for extensions, retention and

stability.

Esthetics:

Adjust maxillary occlusal rim for adequate lip support, lip fullness. Check the nasolabial

fold, philtrum and vermillion border.

Adjust for visibility, depending on the age.

Using Fox’s occlusal plane indicator; adjust the anterior plane making it parallel to

interpupillary plane and posterior plane making it parallel to ala-tragus/ Camper’s plane.

Occlusal plane should match with that of remaining teeth

Adjust the height of mandibular occlusal rim to the level of angle of mouth and posteriorly

to half the height of retromolar pad.

Phonetics:

Adjust anterior part of maxillary occlusal rim by asking the patient to say “F” or “V”.

Ask the patient to say “M” and “S” sounds and verify freeway space and speaking space.

Vertical relation - by Niswonger’s method:

Stick two triangular pieces of adhesive tape on the tip of the nose and chin. Measure the

vertical dimension at rest (VDR).

Measure vertical dimension at occlusion (VDO). VDO should be 2-4mm less than VDR.

Both the occlusal rims should have bilateral simultaneous contact.

Mark the midline considering facial midline as reference.

Mark canine line considering angle of mouth/lateral border of ala of nose as reference.

Page | 16

Recording the bite:

Situation1: Only few teeth missing. Record the MIP on wax rims by indentations.

Situation 2: Vertical stop present. Maintain the VD and record centric along with

indentations of opposing teeth on the wax rim

Situation 3: Kennedy’s class I in both arches. Establish the VD and centric using inter-

occlusal check bite record method. Indentations of opposing teeth on the wax rim should

also be recorded, when possible.

Select the artificial teeth to match with remaining natural teeth.

Evaluation criteria for jaw relation recording

Temporary denture base inspection (verify border extension, border thickness, frenal relief,

retention, and stability)

Inspection of aesthetics


Occlusal rim height and Incisal visibility

Occlusal plane


Inspection of phonetics

Verification of speech

Vertical dimension

Measurement of vertical dimension at rest (VDR)

Measurement of vertical dimension at occlusion (VDO)

Provision of adequate freeway space

Tentative centric bite registration, wax bite registration marks

Artificial teeth selection

D. TRY-IN (STAGE OF VERIFICATION)

INSTRUMENTS REQUIRED:Mouth mirror, Periodontal probe, Mcintosh sheet, Lecron’s carver,

Wax knife, Wax spatula, Rubber bowls-2 (large), Acrylic trimming burs.

Procedure

Anterior try-in:

Insert the mandibular waxed-up trial denture followed by maxillary

Page | 17

Evaluation of esthetics

Evaluation of phonetics

Posterior try-in

Verify aesthetics

Verify phonetics, speaking space established during jaw relation stage

Verify occlusal contacts

Verify the appearance of finished dentures, gingival carving before final processing. Any

changes needed in the denture teeth arrangement can be made at this time

Obtain consent from patient on approval

Evaluation criteria for Try in:

Temporary denture base inspection (verify retention, and stability)

Anterior try in

Esthetics: Lip fullness, lip support

visibility

Incisal


Size, shape, shade and position of artificial teeth

Phonetics

Verification of overjet and overbite

Posterior try in

Verification of jaw relations

Esthetics

Phonetics

Occlusal contacts

Obtaining consent from patient

Clasp design and placement

Verification of wax up and carving

E. DENTURE INSERTION

INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Articulating paper holder,

McIntosh sheet, Universal plier, Rubber bowls, Acrylic trimming burs, Occlusal correction burs.

PROCEDURE:

Verify the intaglio surface of denture for frenum relief, over extensions and any other

irregularities (blebs) to ensure smooth borders. Check the clasp location and fit.

Verify the polished surface for roughness, cracks, tag arm exposure

Page | 18

Ensure denture contact with guide planes

Do clinical remount to compensate for polymerization changes

Instruct the patient about the use and care of dentures and give a subsequent follow-up

appointment after 24 hours for observation, evaluation and any corrections as necessary.

Post-insertion instructions handouts should be given to the patient.

Evaluation criteria for RPD insertion

• Finishing and polishing of dentures

• Retention and stability of dentures

• Facial appearance

• Speech

• Occlusion

F. FOLLOW-UP OR RECALL

INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Articulating paper holder,

Macintosh sheet, Universal plier, Rubber bowls, Acrylic trimming burs, Occlusal correction burs.

PROCEDURE:

Record patient’s feelings about the denture.

Evaluate the tissues for any erythema, ulceration.

Verify the occlusion and correct the occlusal interferences if any.

Ask for any post-insertion complaints from the patient and correct the dentures as

necessary.

Emphasise on use and care of dentures and schedule further recall visits as required.

Evaluation criteria for Recall appointment

• Intraoral examination of soft tissues for any irritation from dentures

• Careful adjustment of dentures

• Correction of occlusion (if required)

Page | 19

3. Competency Assessment For fixed partial denture (FPD)


Mouth mirror Micro-motor Diamond Point burs

Phantom head Micro-motor handpiece

(contra-angle) Chipblower

Laboratory knife with no.

25 blade Inlay wax Mcintosh sheet

PKT waxing instruments Wax heating pot Periodontal probe

No. 7 wax spatula Typodont Jaw set Polishing cloth

Evaluation criteria

• Incisal reduction - 1.5 mm of clearance in maximum intercuspal position and all

excursions

• Facial reduction - 1.2 mm of uniform reduction is achieved

• Biplane labial reduction - apparent incisal and gingival reductions

• Cingulum reduction - 1 mm of reduction present, following cingulum concavity

• Axial taper reduction - Parallel axial wall with minimal taper

• Rounded line angles - all line angles are rounded and smooth

• Shoulder reduction - Rounded shoulder at least 1 mm wide

• Location of finish line - Finish line at gingival margin, clear, smooth, and continuous

• Coping fabrication

• Wax pattern removal and evaluation

Proximal surfaces

Axial surfaces

Occlusal surfaces

• Finishing of margins

• Verification of tooth preparation and carving

DEPARTMENT OF

PEDODONTICS &

PREVENTIVE

DENTISTRY

Page | 20

A. Competency Assessment For Case History Diagnosis And Treatment Plan

Armamentarium and materials required: 2 sets of Diagnostic instruments: Mouth

Mirror, Straight Probe, Twizzer, Explorer,Kidney Tray, Cotton Holder, Waste Reciever


a. General Information or Demographic Profile:

Record of OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion,

Education, Occupation, Total Income of Family per Month, Percapita Income,

Address, Contact No.

b. History.

Chief complaint recorded in patient’s own word, history of present illness, medical,

dental history, family history, history of fluoride, personal history, history of trauma,

history of vaccination, personal habits, oral hygiene practices, dietary habits (24 hrs

diet chart & sweet scores) recorded

c. Clinical Examination.

Extraoral, intraoral, soft tissue and hard tissue recorded

d. Index Recording:

DMFS/defs and OHIS index recorded properly

e. Diagnosis and Investigations.

Diagnosis is correlating with chief complaint and clinical examination?

Is radiographic interpretation done properly?

Is final diagnosis correlating with investigation?

Is treatment plan formulated correctly?

B. Competency Assessment For Oral Prophylaxis

Case selection

Children with poor oral hygiene

Prophylactic pre procedural

Armamentarium and materials required: 2 sets of Diagnostic instruments: Mouth

Mirror, Twizzer, Kidney Tray, Cotton Holder, Waste Reciever, hand scalers

Procedure

Position the dental chair

Perform oral prophylaxis.

Page | 21


Proper chair position

Proper arm rest and strokes of instrument

Any plaque or calculus remaining

C. Competency Assessment For Topical Fluoride Application

Case selection

High caries risk children

Children without proximal caries and cavitated lesions in the oral cavity

Special children

In children shortly after periods of tooth eruption

Armamentarium and materials required

2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, Kidney Tray, Cotton Holder,

Waste Reciever, Fluoride application trays or applicator brush and Fluoride gel or

varnish

Procedure for Fluoride gel (Tray technique)

Perform pre-procedural oral prophylaxis.

Position the dental chair upright

Select appropriate sized foam tray and fill one third of the tray with fluoride

gel

Isolate the teeth and insert fluoride trays in oral cavity for 4 min.

Maintain the isolation using suction during procedure

Thoroughly wipe the teeth surfaces after removing the fluoride trays

Instruct the patient not to gargle the mouth with water and eat or drink anything

for at least 30 min.


Is pre-procedural oral prophylaxis done

Is the tray covering all the teeth surfaces in tray technique

Is isolation properly maintained during procedure

Is fluoride gel thoroughly wiped from tooth surfaces after application

Are post-operative instructions given

D. Competency assessment for pit and fissure sealants

Case selection

Tooth with deep retentive pit and fissures

Page | 22

Stained pit and fissures

Pit and fissures having demineralisation (non-cavitated) confined to enamel

High caries risk patients



Waste Reciever, Etchant, Dispenser wells, Applicator tip, Pit and fissure sealant,

Curing light, Articulating paper.

Procedure

Thoroughly clean the retentive pit and fissures

Isolate with cotton rolls and acid etch the tooth

Rinse, dry & isolate the tooth with cotton rolls.

Apply the sealant (For mandibular teeth apply distally and allow it to flow

mesially, and for maxillary teeth the converse) and cure

Check for occlusal high points using articulating paper


Are pit and fissures thoroughly cleaned

Is isolation maintained during the procedure

Is frosty white appearance seen

Are all the pits and fissures sealed without voids

Is the occlusion evaluation done

E. Competency Assessment For Restoration of tooth

Case selection

Primary molars with occlusal caries

Primary molars with proximal caries

Smooth surface caries on primary anteriors

Buccal pit caries on permanent molars


2 sets of Diagnostic instruments: Mouth Mirror, Straight probe, Twizzer, Kidney Tray,

Cotton Holder, Waste Reciever, Air rotor, diamond burs, Restorative instruments,

Instrument tray, GIC cement, Agate spatula, Varnish/Vaseline, strips, articulating paper

Procedure

Excavate the soft caries using spoon excavator

Page | 23

Remove the infected dentin with air rotor

Rinse, dry & isolate the tooth with cotton

Mix the GIC with agate spatula on paper pad

Restore the teeth with GIC



Caries excavation done completely


GIC mixing done properly

Restoration done properly covering marginal edge


F. Competency Assessment for Extraction of tooth

Case selection

Primary tooth with physiologic mobility

Over retained primary tooth

Root stumps of primary tooth


2 sets of Diagnostic instruments: Mouth Mirror, Straight probe, Twizzer, Kidney Tray,

Cotton Holder, Moon’s probe, extraction forceps.

Procedure

Application of topical anesthesia

Administration of LA (infiltration or nerve block)

Check for subjective or objective symptoms

Retraction of gingiva

Extraction of tooth

Place compress pack

Post extraction instruction


Proper position of needle insertion

Check the subjective/objective symptoms

Proper retraction of gingival tissue

Tooth removed completely

Post operative instructions given properly

DEPARTMENT OF

CONSERVATIVE

DENTISTRY &

ENDODONTICS

Page | 24

A. Competency Assessment For GIC Restorations

1. Case selection

a. Patient complains of black discoloration

b. food lodgment /cavitation on tooth surface

c. Non Carious Cervical lesions (Cervical abrasions, Erosion and abfractions)

d. Root surface caries.

2. Armamentarium & Materials required

a. Diagnostic instruments - mouth mirror, straight probe, explorer, Tweezers, cotton rolls, cotton

holder.

b. Excavation instruments - spoon excavator, hatchet, burs and airotor

c. Condensers - cement spatula, plastic filling instruments, condensers, & carvers, articulating

paper, matrix band and retainer, wedges

d. Isolation – cotton rolls and saliva ejectors

e. Pulp protection cements, GIC

3. Procedure of application

a. Cavity preparation if needed) / conditioning

b. Isolation

c. Pulp protection

d. Application of matricing (when needed)

e. Manipulation of GIC

f. Placement of GIC

g. Checking for high points


a. Able to select the case properly.

b. Clinical & radiographic evaluation of tooth

c. Isolation

d. Under/ overfilling/ Craze & crack lines

Page | 25

B. Competency Assessment For Silver amalgam restorations

1. Case selection

a. Patient complains of black discoloration

b. food lodgment

c. Cavitation on tooth surface

2. Armamentarium & Materials required

a. Diagnostic instruments - mouth mirror, straight probe, explorer, Tweezers, cotton rolls,

cotton holder.

b. Excavation instruments - spoon excavator, hatchet, burs and airotor

c. Condensers - cement spatula, amalgam carrier, plastic filling instruments, condensers,

burnishers & carvers, mortar, pestle, amalgam squeeze cloth, articulating paper, matrix bands,

retainers, wedges.

d. Isolation – cotton rolls and saliva ejectors

e. Pulp protection cements, silver alloy & mercury.

3. Procedure of application

a. Cavity preparation

b. Isolation

c. Pulp protection

d. Application of matricing (when needed)

e. Manipulation of silver amalgam

f. Placement of silver amalgam into the cavity, condensing, burnishing & carving

g. Checking for high points


a. Proper case selection & Clinical & radiographic evaluation of tooth

b. Isolation

c. Under/ Overfilling

DEPARTMENT OF

ORTHODONTICS &

DENTOFACIAL

ORTHOPAEDICS

Page | 26

A. Competency Assessment For Case History, Diagnosis And Treatment Plan

Armamentarium and materials required: 2 sets of Diagnostic instruments: Mouth Mirror,

Straight Probe, Twizzer, Explorer, Kidney Tray, Cotton Holder, Waste Receiver



Record of OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion,


Address, Contact No.

b. History.

Chief complaint recorded in patient’s own word, history of present illness, medical,

dental history, family history, history of fluoride,personal history, history of trauma,

history of vaccination,personal habits, oral hygiene practices recorded


Extraoral, intraoral, soft tissue and hard tissue and functional examination

d. Malocclusion Recording:

Identification of Malocclusion in Sagittal plane.

Identification of Malocclusion in Vertical plane.

Identification of Malocclusion in Transverse plane


Diagnosis is correlating with chief complaint and clinical examination?



Is treatment plan formulated correctly?

B. Competency Assessment For Impression Making

Armamentarium and materials required:Mouth mirror, Probe, Rubber Bowls, AlginateMixing

Spatula, Dentulous perforated impression trays (U & L 1,2,3,4 sizes), Mcintosh sheet and

Alginate Impression Material & water

Procedure:

Make the patient seat upright, adjust the head rest accordingly; adjust the chair position

and operator position for impression making.

Select appropriate size impression tray and modify the tray asrequired.

Page | 27

Ask the Patient to gargle followed by air drying the occlusal surfaces to remove debris

and saliva.

Alginate impression material is used for impression making. Mix the powder with water

asper the instructions of manufacturer in a clean rubber bowl.

Cold water can be used if longer working time is desired.

The alginate mixture should be creamy in consistency and should not have lumps in it.

The material is than loaded in to the impression tray with the spatula, the surface is

smoothened with wet gloved finger.

For Maxillary impression 11 0'clock position and for mandibular impression 7 0’clock

position is ideal.

Place the loaded tray by retracting the patient’s lips on one side with a mouth

mirror/gloved finger and on the other side by rotating the tray into the mouth.

Once set, remove the impression with a firm quick snap.

Wash the impression with running tap water and then disinfect it with 1% sodium

hypochlorite solution.

The impression should be quickly poured using dental stone and vibrator as per

manufacturer’s instructions.

Remove the cast immediately after adequate set.

Evaluation Criteria for Impression:

Impression tray selection (appropriate size and modification of the tray)

Manipulation of Alginate impression material and loading in the tray

Tray positioning

Adequate extension of impression, recording of teeth, frenum and sulcus areas

Presence of surface defects (voids, inadequacy of impression materials and exposure of

tray)

Evaluation of study models

DEPARTMENT OF

PUBLIC HEALTH

DENTISTRY

Page | 28

A. Competency Assessment For case history & index recording

Armamentarium and materials required:

2 sets of Diagnostic instruments: Mouth Mirror, Periodontal Probe, Twizzer, Kidney

Tray, Cotton Holder, Waste Reciever



Is OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion, Education

Occupation, Total Income of Family per Month, Percapita Income, Address, Contact

No. Recorded?

b. History.

Is Chief complaint recorded in patient’s own word, Is history of present illness,

medical, dental history, family history, personal history (personal habits, habits related

to oral cavity, oral hygiene practices, dietry habits (24 hrs diet chart & sweet scores)

recorded?


Is extraoral, intraoral, hard tissue, periodontal status recorded?

d. Index Recording: Is Index pertinent to patient condition recorded and scores are

given?


Is diagnosis correlating with chief complaint and clinical examination?



Is comprehensive treatment plan formulated correctly?

B. Competency Assessment For topical fluoride application

Case selection

High caries risk children

Page | 29

Children without proximal caries and cavitated lesions in the oral cavity

Special children

In children shortly after periods of tooth eruption



Waste Reciever, Fluoride application trays or applicator brush and Fluoride gel or

varnish

Procedure for Fluoride gel (Tray technique)



Select appropriate sized foam tray and fill one third of the tray with fluoride gel

Isolate the teeth and insert fluoride trays in oral cavity for 4 min.

Maintain the isolation using suction during procedure

Thoroughly wipe the teeth surfaces after removing the fluoride trays

Instruct the patient not to gargle the mouth with water and eat or drink anything for

atleast 30 min.



Is the tray covering all the teeth surfaces in tray technique

Is isolation properly maintained during procedure

Is fluoride gel thoroughly wiped from tooth surfaces after application

Are post-operative instructions given

C. Competency Assessment For pit and fissure sealants

Case selection

Tooth with deep retentive pit and fissures

Stained pit and fissures

Pit and fissures having demineralisation (non-cavitated) confined to enamel

Page | 30

High caries risk patients



Waste Reciever, Etchant, Dispenser wells, Applicator tip, Pit and fissure sealant, Curing

light, Articulating paper.

Procedure

Thoroughly clean the retentive pit and fissures

Isolate with cotton rolls and acid etch the tooth

Rinse, dry & isolate the tooth with cotton rolls.

Apply the sealant (For mandibular teeth apply distally and allow it to flow mesially,

and for maxillary teeth the converse) and cure



Are pit and fissures thoroughly cleaned


Is frosty white appearance seen

Are all the pits and fissures sealed without voids


DEPARTMENT OF

PERIODONTICS &

IMPLANTOLOGY

Page | 31

A. Competency Assessment For case history recording

Armamentarium and materials required:

2 sets of Diagnostic instruments: Mouth Mirror, Periodontal Probe, WILLIAMS PROBE

Twizzer, Kidney Tray, Cotton Holder, Waste Reciever



Is OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion,


Address, Contact No. Recorded?

b. History.

Is Chief complaint recorded in patient’s own word, Is history of present illness,

medical, dental history, family history, personal history (personal habits, habits

related to oral cavity, oral hygiene practices, dietry habits (24 hrs diet chart &

sweet scores) recorded?


Is extraoral, intraoral, hard tissue (dental status, occlusion) recorded?

Is gingival status recorded?

Is periodontal status recorded?

Is mucogingival problems recorded?

d. Investigations Adviced. : Is proper investigation ( laboratory of radiographic )

adviced pertinent to patient condition ?


Is diagnosis correlating with chief complaint and clinical examination?

Page | 32



Is comprehensive treatment plan formulated correctly?

f. Prognosis.

Is Overall prognosis and Individual prognosis recorded correctly pertaining to patients

clinical and radiographic condition.?

g. Treatment Plan.

Is treatment plan suggested to the patient under following headings?

Preliminary phase

Phase I (etiotropic phase)

Phase II(surgical phase)

Phase III(restorative phase)

Phase IV( maintenance phase)

Page | 33

B. Competency Assessment For hand scaling procedure

Case selection

Patients with gingivitis

Patients with periodontitis

Patients presenting with any other periodontal disease

Patients with synergistic disease( endo –perio lesion, ortho-perio interrelationships)

involving multidisciplinary approach


2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, , Probe, Williams Periodontal

Probe, Kidney Tray, Cotton Holder, Waste Receiver,

2 sets of periodontal instruments: set of 3 supragingival scalers

A brushing model with toothbrush/ pair of diagnostic cast and toothbrush

Procedure for hand scaling



Maintain proper operator position

Proper use of hand grasp

Proper use of finger rests

Proper use of strokes

Proper accessibility and visibility

Proper isolation: A clean operating field is maintained during scaling.

Type of illumination and vision ( direct/ indirect) used

Page | 34



Is the operator chair positioned properly

Are general principles of instrumentation followed

Is the finger rest used appropriate according to the arch/quadrant worked upon

Is the hand grasp used appropriate according to the arch/quadrant worked upon

Is The stroke used for removal of calculus effective and appropriate

Is there any flecks of supragingival or sungingival calculus seen on any surface

of tooth

Are stains completely removed from all the surfaces of tooth

Are post-operative oral hygiene instructions given

Is proper brushing technique advised and demonstrated to the patient according

to the patients age and clinical picture

Learning Outcome and Graduate Attributes

Documents

Transcript of Learning Outcome and Graduate Attributes