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0% found this document useful (0 votes)

131 views213 pages

Restorative - Dentistry - SBRD - 2021 - FD 28 Nov 21 - 0

Restorative_Dentistry_SBRD_2021_FD 28 Nov 21_0

Uploaded by

خالد عسيري

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Restorative Dentistry

Board
Version 1 (2016) Prepared by Curriculum Scientific Group

• Dr.Ali AlYahya, MBBS, Msc.MedEd. FRCSC, FACS

5
COPYRIGHT AND
AMENDMENTS
All rights reserved. © 2021 Saudi Commission for Health Specialties.

This material may not be reproduced, displayed, modified, or distributed

without prior written permission of the copyright holder. No other use is
permitted without prior written permission of the Saudi Commission for
Health Specialties.

Any amendment to this document shall be approved by the Specialty

Scientific Council and the Executive Council of the commission and shall be
considered effective from the date of updating the electronic version of this
curriculum published on the commission website unless a different
implementation date has been mentioned.

For permission, contact the Saudi Commission for Health Specialties, Riyadh,
Kingdom of Saudi Arabia.

Correspondence:

P.O. Box: 94656 Postal Code: 11614

Consolidated Communication Center: 920019393 International Contact Call:

00-966-114179900 Fax: 4800800

Extension: 1322

Website: www.scfhs.org.sa

6
TABLE OF CONTENTS

COPYRIGHT AND AMENDMENTS 6

TABLE OF CONTENTS 7
ACKNOWLEDGEMENTS 9
INTRODUCTION 10
Foreword 10
Rationale and educational objectives of the program 13
General training requirements 14
Program framework 15
Minimum training requirements for SBRD residency 15
Differences between proposed and existing curriculum 16
ABBREVIATIONS 18
OUTCOMES AND COMPETENCIES 21
Clinical Competencies and Learning Outcomes 21
Integration of Disciplines 127
Milestones and continuum of learning 128
TEACHING AND ACADEMIC ACTIVITIES 133
General Principles 133
Core Educational Program 134
Core Specialty Topics 135
Practice- and Work-Based Learning 144
ASSESSMENTS 152
Program-Specific Continuous Assessments 152
Knowledge Domain 153
Behavior Domain 161
Saudi Board Certification Examinations 162

7
REFERENCES 164
APPENDICES 167
Appendix I - CanMEDS alignment criteria with Teaching Activities 167
Appendix II - Clinic-Based Learning Forms 194

8
ACKNOWLEDGEMENTS
First and foremost, we would like to thank Allah, the Almighty, for helping us
to complete this curriculum. We also express our deepest appreciation to the
Saudi Commission for Health Specialty for helping and guiding us in this
curriculum, especially Dr. Saud Orfali and Dr. Reem Al Dhalaan. Their
recommendations and suggestions have been invaluable for this project.

It is also a pleasure to thank the Supervisory Committee and the resident

representative Dr. Mohammed Al Essa, who assisted us in the development
of this curriculum.

We appreciate the valuable contributions and feedback from Dr. Helal Sonbul
while compiling this curriculum. Special thanks are also due to our families
and colleagues for their encouragement and ongoing assistance, which have
been a tremendous support throughout this project.

Finally, we acknowledge and extend our gratitude to the Royal College of

Physicians and Surgeons of Canada for allowing us to benefit from their
expertise in designing a competency-based curriculum. On behalf of the
Saudi Board in Restorative Dentistry, it is a pleasure to be able to utilize and
implement the CanMEDS 2015 competency framework.

9
INTRODUCTION
Foreword
Nowadays, medical and dental schools and institutions are experiencing a
variety of challenges in medical education, which stem from the health care
needs of the society, the patient’s expectations of high-quality and safe care,
new generations of students, a well-developed health care environment, and
new approaches to medical education. To face these important challenges,
postgraduate medical training programs need to modify their practices by
implementing a well-structured and innovative curriculum. Recognizing the
growing demand for this comprehensive, explicit, and innovative health
training curriculum, the SCFHS has adopted the CanMEDS 2015 framework
as a medical education guide in terms of the essential competencies that
residents need for improved patient care and set up the core curriculum of
all training programs, including the SBRD. CanMEDS is an innovative,
competency-based framework that involves the implementation of
outcomes-driven education and assessment to ensure that physicians and
dentists have the knowledge, skills, and attitudes they need for every stage
and role in their career. The framework is based on seven roles that all
physicians and dentists need to embody in order to meet the needs of the
society: medical expert, communicator, collaborator, leader, health advocate,
scholar, and professional. This framework will provide a more personalized
learning experience for residents, who can expect to develop into self-
directed and lifelong learners and provide effective care during their future
practice.

The development of this curriculum was a dynamic, interactive process that

started with the selection of curriculum development committee members
who were qualified medical educators. After reviewing the old curriculum
and conducting several formal and informal interviews with the program
stakeholders, including a resident representative, as well as conducting

10
meetings with curriculum advisory members, the needs were assessed and
the goals, objectives, contents, educational strategies, and assessment
methods of the curriculum were set according to a curriculum template
recommended by the SCFHS, integrating the CanMEDS framework. Finally,
the curriculum’s first version was submitted to the SBRD Scientific
Committee for approval.

The curriculum is intended to be used by SBRD program stakeholders,

including educators, program directors, teachers, trainees, and researchers,
as a guide to learning, training, educational strategy, assessment, and
certification.

To implement the curriculum successfully and help it achieve its potential,

the curriculum developers must ensure that sufficient resources, financial
support, faculty development programs, and administrative strategies have
been developed. These require collaborative work and support from the
SCFHS, program-supervising committees, training centers, program
directors, and contributing tutors or supervisors.

The periodic formative and summative program evaluation should be

conducted by the SBRD Scientific Council to allow for future refinement and
continuous quality improvement of the curriculum.

Finally, in reference to the decree no. 2019003517 issued on 21/9/1440 H by

the Executive Council for Education and Training that stated amendment of
the SBRD program’s duration from 4 years to 3 years, and according to the
recent decree no. 2021000512 issued on 28/6/1442 H, the present updated
version (2021) was reviewed and published.

Definition

SBRD is a program designed to provide didactic, clinical, and hospital training

to upgrade the standards of the dental profession in Saudi Arabia. The
instructions and experiences provided in the SBRD can prepare residents to
be highly qualified restorative dentists who are able to treat restorative cases
which include Operative and Fixed Prosthodontics treatment modalities.

11
History

The prevalence of dental caries is on the rise in a number of nations around

the world. The adult Saudi population has demonstrated a higher prevalence
and greater severity of caries and secular trends over the past decades. This
alarming dental public health problem warrants the immediate attention of
the government and officials in the dental profession.

Unfortunately, current estimates indicate that the World Health Organization

2000 goals are still unmet for Saudi Arabia. Thus, it has been critical to
implicate a program tailored specifically to meet that goal in addition to the
specific demands of the Saudi population, including identifying intervention
targets and improving oral health. From here, the concept of the SBRD was
developed in an effort to prepare qualified restorative specialists to outline
and execute a treatment plan for the prevention and control of dental
diseases, along with dental rehabilitation and maintenance.

The program is the brainchild of Professor Abdullah R. Al-Shammery and

was officially launched in October 1999. The inaugural SBRD commenced
with ten residents in the three major training centers, i.e., King Saud
University in Riyadh, King Abdul-Aziz University in Jeddah, and Dammam
Ministry of Health Dental Center, with a single Regional Training Committee,
and Professor Al-Shammery as the first chairman of the SBRD Scientific
Committee.

Vision

Global leadership in medical education, training, and community services in

the field of restorative dentistry to achieve the vision of Saudi Arabia 2030.

Mission

Building promising competencies with a lifelong ability to learn and provide

a human-centered care in the field of restorative dentistry, using the latest
technology and evidence-based knowledge.

Values
 Professionalism.
 Quality.

12
 Patient safety.
 Human-centered care.
 Cooperation.
 Transparency.
 Empathy.

Goals

The goals of the SBRD are: to supply the community with qualified dental
restorative specialists; to provide a designated training program for dental
restorative specialists and related professions; to maintain an environment
of excellence for residents and apply the measures required for academic
success as well as clinical achievement; to offer the advanced techniques and
modern technology required for oral health research and other related
scientific endeavors, and to provide consulting dental restorative services for
local as well as international agencies.

Rationale and educational objectives of the

program
As a restorative dentistry program, SBRD aims to train and graduate
competent and knowledgeable specialists in restorative dentistry (operative
dentistry, fixed prosthodontics, and esthetics) that are capable of functioning
independently to provide an educational environment that promotes a high
standard of delivery of health care. Specifically, the Saudi Specialty
Certificate in Restorative Dentistry (SSC-[Dent]) program prepares residents
to:

Plan and provide both routine and complex restorative dental care for a wide
variety of patients by applying advanced knowledge and clinical skills.

Acquire competence and confidence in the various restorative clinical

disciplines (operative dentistry, fixed prosthodontics, and implantology) that
are integral components of restorative dentistry.

Reinforce the ability to make judgments in arriving at a diagnosis, planning

treatment, and assessing treatment outcomes.

13
Keep abreast of modern technology, digital dentistry, and practice
management.

Communicate, understand, and function effectively with other health care

professionals and understand the setting of their organizational system.

cquire experience in teaching and research to upgrade clinical knowledge.

At the end of this program, the resident will have acquired the following
competencies and can function effectively in these roles as per CanMEDS
framework competencies:

 Dental expert
 Communicator
 Collaborator
 Leader
 Health advocate
 Scholar
 Professional

General training requirements

 Admission into the program is in accordance with the commission
training rules and regulations.
 Trainees shall abide by the training regulations and obligations
established by the SCFHS, and that of the training center.
 Training is a full-time commitment. Residents shall be enrolled in full-
time, continuous education for the entire duration of the program.
 Training is to be conducted in institutions accredited by the SCHS.
 Training shall be comprehensive and in fulfillment of promotion
requirements and comprehensive patient management.
 Trainees shall be actively involved in patient care with a gradual
progression of responsibility.

14
Program framework
1) Structure of training program

 The SBRD is a program that runs for a period of 3 years.

 Didactic clinical sciences and advanced clinical training are integrated
into the program.
 Documentation of progress in the program and all resident activities
must be maintained by the program director and available for review.
 Comprehensive restorative dental care is divided into two parts: junior
residency (the first 2 years), which is dependent (under supervision),
and senior residency after passing the Part 1 examination (the final
year), which is independent.

2) Supervision of the program

The residency program is supervised by various layers of authority, including

the following:

 The Chairman of the Scientific Council

 The Supervisory shared training Committee in each sector
 Program Director at the Training Center
 Chief resident.
 Program administrator of SBRD

Minimum training requirements for SBRD

residency
The SCFHS requires 3 years of training and completion of the allocated
requirements for eligibility to sit in the SBRD examination:

 Clinical requirements (comprehensive cases, single procedures).

Refer to Appendix II for guidelines on clinical requirements
 Research project
 Community service.
 Participation in teaching activities.

15
 Submission of the universal topics completion certificate (minimum 8
topics)
 Conduct a topic activity selected by the trainee (minimum of 1).

Residents should rotate through more than one training center during their
residency. The approved annual SBRD training Rota policy is:

 The Chairperson of the Sector’s Shared Training Committee should

prepare a Rota annually no more than 3 months before the end of the
current Rota (i.e., in May).
 Residents will be informed of their Rota no less than 3 months before
the end of the current Rota (i.e., in June).
 Each resident will spend no more than 2 years at one training center
regardless of the category of SCHS accreditation.
 Peripheral areas may be exempt and can extend up to 3 years,
provided the center fulfills all requirement supplements but can be a
year in specific cases. The chairperson of the sector’s shared training
committees will evaluate each case independently.
 Each Rota will follow a preset map in accordance with pre-assigned
seats at the training centers.
 Training centers should respect the number of seats assigned and
accredited by the SCHS. The chairperson of supervisory shared
training committee in each sector should be notified of any changes,
and s/he should follow up with each center annually.

Differences between proposed and existing

curriculum
CanMEDS 2015 is a curriculum that utilizes a concept of competency-based
medical education. In this new curriculum:

Educators will be able to:

 Identify the abilities of individual learners at different stages of their

training throughout the program and provide constructive feedback to
improve their knowledge and skills.

16
 Use a range of assessment methods, such as formative, summative,
self, and workplace assessment.

Learners will be able to:

 Provide high-quality care to patients and communities in a safe

environment.
 Continue to update their knowledge and skills.
 Conduct scientific research to support clinical decision-making and
patient management.
 Identify their limits and what they should achieve in each stage of
training.
 Select elective topics in the program.
 Increase their abilities to that expected of a health professional at a
stage of expertise reflecting the milestones concept and a continuum
of learning in CanMEDS 2015.

The inclusion of a preclinical course (transition to discipline stage) is a unique

feature of the new curriculum that will provide residents with the knowledge
and skills essential for starting practice in a dental clinic. Furthermore,
integrating scientific research across all levels will help residents to utilize
the evidence-based dentistry concept in their dental clinic.

17
ABBREVIATIONS
Abbreviation Meaning

AA Academic Activity

Assig. Assignment

BPE Basic Periodontal Assessment

[C] Cognitive Domain

CEC Comprehensive Esthetic Case

CR Centric Relation

CRA Caries Risk Assessment

CE Clinical Encounter

Canadian Medical Education Directions for

CanMEDS
Specialists

CAMBRA Caries Management by Risk Assessment

CBD Case-Based Discussion

DOPS Direct Observation of Procedural Skills

ET Esthetic Technique

EYPT End Year Progress Test

FBD Fixed Partial Denture

HoW Hands-on Workshop

18
Abbreviation Meaning

IDP Interdental Papillae

ILO Intended Learning Outcome

ITER In-Training Evaluation Report

[K] Knowledge Domain

LB Logbook

MCQ Multiple Choice Question

Mini-CEX Mini-Clinical Evaluation Exercise

OSCE Objective Structured Clinical Examination

OP Observable Procedure

[P] Psychomotor Domain

PBC Posterior Bite Collapse

Part 1 Saudi Board Examination Part 1

Part II Saudi Board Examination Part 2

PCC Preclinical Course

PCCT Preclinical Course Test

RD Restorative Dentistry

RDITN Restorative Dentistry Index of Treatment Need

RCT Root Canal Treatment

SDL Self-Directed Learning

19
Abbreviation Meaning

SCFHS Saudi Commission for Health Specialties

SBRD Saudi Board in Restorative Dentistry

Saudi Specialty Certificate in Restorative

SSC-(Dent)
Dentistry

SDL Self-Directed Learning

SOE Structured Oral Examination

TMJ Temporomandibular Joint

VDO Vertical Dimension of Occlusion

WSA Weekly Scientific Activities

WPA Workplace-Based Assessment

20
OUTCOMES AND
COMPETENCIES
Clinical Competencies and Learning Outcomes
Dental Expert

As medical experts, SBRD residents integrate all of the CanMEDS roles,

applying medical knowledge, clinical skills, and professional values in their
provision of high-quality and safe patient-centered care. Being a medical
expert is the central role of the dentist in the CanMEDS framework and
defines the clinical scope of practice for SBRD residents.

21
Key Resident Level
Competen

Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

1.1.Demonstrate a commitment to high-

quality care for their patients [P].

1.2.Integrate the intrinsic role of CanMEDS

into their dentistry practice [C].    CE CE

1.3.Apply knowledge of the clinical and

biomedical sciences relevant to their
discipline [C].

Module 1: Basic Science

Practice This module provides the essential knowledge required in the program, including
Dentistry different topics in anatomy, embryology, oral biology, oral pathology, oral
within microbiology, pharmacology, oral medicine, radiology, and biomaterials. It is
their delivered in a style that facilitates easy learning of the essential facts of basic
1 defined science. Topics within this module include the following:
scope of
● Head and Neck Anatomy*
practice
● Oral Biology*
and
● Oral Radiology*
expertise
● Oral Pathology*
● Dental Pharmacology*
● Basic Material Science*
Main suggested resources:
▪ Essentials of Oral Histology and Embryology: A Clinical Approach, 3rd edition
(Chapters 3 and 5)
▪ Clinically Oriented Anatomy, 7th edition by Moore (Chapters 7 and 9).
 Clinical Anatomy, 10th edition by H. Ellis (Chapters 5 and 6).
▪ Oral Radiology Principles and Interpretation, 7th edition (2013; Chapters 3, 7,
8, 10, and 18).

[C]. CE
2.3.3. Describe the treatment outcome of the CBD
indirect restorations placed [C].
2.3.4. Appraise the caries management and
preventive strategies performed [C].
2.3.5. Perform follow-up and recall
measures on completed cases [P].

Module 3: Applied Dental Biomaterials

This module provides knowledge of the basic science of dental biomaterials,

including their physical, biological, mechanical, and chemical properties. Selection
and manipulation of dental materials and longevity of dental restorations in the
clinic are discussed. Topics within this module include the following:
 Dental Amalgam.
 Composite Resin.*
 Glass Ionomers and Hybrid Ionomers.*
 Intermediate Restorative Materials.
 Dental Cements.
 Ceramics.
 Impression Materials.*
 Gypsum Products.
 Casting Investments.
 Dental Waxes.
 Dental Casting Alloys and Soldering.
 Abrasive and Polishing Materials.

Main suggested resources:

30
Key Resident Level
Competen

Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

 Phillips' Science of Dental Materials, 12th edition by Kenneth J. Anusavice,

Chiayi Shen, and H. Ralph Rawls (2012).
 Craig's Restorative Dental Materials, 14th edition by Ronald L. Sakaguchi, Jack
L. Ferracane, and John M. Powers (2018).
 Applied Dental Materials, 9th edition by John F. McCabe, and Angus W. G. Walls
(2013).
 Additional references are provided by lecturers.
3.1. Dental Amalgam
3.1.1. List different dental amalgam
formulations [K].
3.1.2. Describe the amalgamation reaction
Part I
and related phases [K].
WSA Part
3.1.3. Correlate amalgam manipulation 
SDL II
(trituration, condensation, carving,
EYPT
burnishing, finishing, and polishing)
and the effect on strength,
dimensional change, creep, and
corrosion [C].
3.2. Composite Resin*
3.2.1. Discuss the different components of
dental composites [K]. PCCT
3.2.2 Classify dental composites types Part I
according to their filler contents [K]. Part
 PCC
3.2.3 List the advantages and II
WSA
disadvantages of composite resins EYPT
[K]. CBD
3.2.4. Correlate the properties of different AA
composite formulations with the
indicated clinical application [C].

31
Key Resident Level
Competen

restorations [K].
3.6.8. Discuss the different types of digital
ceramic restoration; explain the
indications, advantages, and
shortcomings of each type [K].
3.6.9. Compare glass and polycrystalline
ceramics [C].
3.6.10. Explain the high fracture toughness of
partially stabilized zircon [K].

3.7. Impression Materials*

3.7.1. Describe the purpose of impression
materials [K].
3.7.2. Classify impression materials [K].
3.7.3. List the requirements for an ideal
impression material [K].
PCCT
3.7.4. List the composition of different types
Part I
of impression materials and the role
Part
of each ingredient [C]. PCC
  II
3.7.5. Describe the appropriate dispensing WSA
EYPT
and mixing of each type of impression
CBD
material [K].
AA
3.7.6. Discuss the disadvantages of
hydrocolloid impression materials
[K].
3.7.7. Discuss the reaction mechanism for
each type of impression material [K].
3.7.8. Compare the properties of

35
Key Resident Level
Competen

Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

hydrocolloid and elastomeric

impression materials [K].
3.7.9. Describe the advantages and
disadvantages of each type of
impression materials [C].
3.7.10. Compare the properties and reactions
of the four major elastomeric
impression materials, and indicate
their clinical applications [C].
3.7.11. Describe the disinfection technique
used for each type [K].
3.7.12. Select appropriate impression
materials based on intended use [C].

3.8. Gypsum Products

3.8.1. Discuss the physical and chemical
characteristics of gypsum products
including model and die materials [K].
3.8.2. Compare the advantages and
disadvantages of the different models Part I
and die materials in terms of Part
WSA
resistance to abrasion, ease of use,  II
SDL
time and equipment needed, and EYPT
other relevant properties [C]. AA
3.8.3. Describe the setting reaction of
gypsum materials and the effect of
different factors on the setting
reaction and physical properties of
the gypsum [C].

36
Key Resident Level
Competen

Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

3.8.4. Describe the factors that influence the

ability of gypsum to reproduce detail
in an impression [C].
3.8.5. Define the properties of strength,
hardness, resistance to abrasion, and
dimensional accuracy, and explain
their importance for gypsum
materials clinically [C].
3.8.6. Describe the manipulation of gypsum
materials [K].
3.8.7. Pour a primary and final impression
with dental stone [P].

3.9. Casting Investments

3.9.1. Classify different types of dental
investments [K].
3.9.2. Explain the setting reaction of dental
Part I
investment including the concepts of
Part
hygroscopic and thermal expansions WSA
 II
[C]. SDL
EYPT
3.9.3. Discuss investments used for all
AA
ceramic and all metal restorations
[K].
3.9.4. Discuss the causes of casting defects
[C].

3.10. Dental Waxes Part I

WSA
3.10.1. Classify dental waxes and describe  Part
their composition and related SDL II
physical properties [K]. EYPT

37
Key Resident Level
Competen

restorations [C].
3.11.17. Describe different casting
techniques [K].
3.11.18. Explain the causes of casting
defects associated with dental
castings and how to overcome them
[C].
3.12. Abrasive and Polishing Materials
3.12.1. Define finishing, polishing, cutting,
and grinding [K].
3.12.2. List the purpose and principles of
finishing and polishing techniques [K].
3.12.3. Distinguish finishing, polishing, and
cleansing abrasives and techniques,
and recognize common abrasives [K]. Part I
3.12.4. Define abrasion and contrast abrasive Part
WSA
tools or slurries with cutting  II
SDL
instruments. EYPT
3.12.5. Compare two-body and three-body AA
abrasion [C].
3.12.6. Discuss the factors influencing the
rate of abrasion and indicate which
factor is easiest to control clinically
[C].
3.12.7. Describe surface roughness and
gloss [K].

management [C].

Module 5: Operative Dentistry

This module provides essential clinical skills required for residents specializing in
restorative dentistry. It emphasizes the practical aspects of tooth preparation and
selection of appropriate restorative dental materials, based on sound clinical
principles from the best available evidence. Residents discuss common restorative
problems and review their causes and solutions in seminal scientific articles.
Topics within this module include the following:
 Clinical Significance of Dental Anatomy, Histology, and Physiology.*
 Instruments and Equipment for Tooth Preparation.
 Dental Ergonomics.*
 Clinical Application of Amalgam and Amalgam Toxicity.
 Fundamental Concepts of Enamel and Dentin Adhesion.*
 Clinical Application of Resin Composite.*
 Light Curing Units.*
 Clinical Application of Glass Ionomers.*
 Direct Restorative Strategies of Mutilated Teeth.
 Restoration Failures and Repair.
 Controversial Issues in Operative Dentistry.

 Tooth Surface Loss.

 Dental Fluorosis.
 Vital Pulp Therapy.
 Dental Trauma.
 Reactions of Pulpal-Dentin Complex to Caries and Restorative Procedures.
 Biomimetic Approaches in Restorative Dentistry.
 Bioactive Dental Materials in Restorative Dentistry.

46
Key Resident Level
Competen

Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

Main suggested resources:

 Summitt's Fundamentals of Operative Dentistry: A Contemporary Approach,
4th edition by Thomas J. Hilton, Jack L. Ferracane, and James Broome (2013)
 Sturdevant's Art and Science of Operative Dentistry, 6th Edition by Harald O.
Heymann, Jr. Edward J. Swift, and Andre V. Ritter (2012)
 Pashley DH. Dynamics of the pulpo-dentin complex. Crit Rev Oral Biol Med.
1996;7(2):104-33. doi: 10.1177/10454411960070020101. PMID: 8875027.
 Magne, Pascal, and U Belser. Bonded Porcelain Restorations in the Anterior
Dentition: A Biomimetic Approach. Chicago: Quintessence Pub. Co, 2002. Print.
 Opdam N, Frankenberger R, Magne P. From 'Direct Versus Indirect' Toward an
Integrated Restorative Concept in the Posterior Dentition. Oper Dent. 2016
Sep;41(S7):S27-S34. doi: 10.2341/15-126-LIT. Epub 2016 Sep 8. PMID:
26918928.
 Magne P. Composite resins and bonded porcelain: the postamalgam era? J
Calif Dent Assoc. 2006 Feb;34(2):135-47. PMID: 16724469.
 Jefferies SR. Bioactive and biomimetic restorative materials: a comprehensive
review. Part I. J Esthet Restor Dent. 2014 Jan-Feb;26(1):14-26. doi:
10.1111/jerd.12069. Epub 2013 Dec 17. PMID: 24341542.
 Jefferies S. Bioactive and biomimetic restorative materials: a comprehensive
review. Part II. J Esthet Restor Dent. 2014 Jan-Feb;26(1):27-39. doi:
10.1111/jerd.12066. Epub 2013 Dec 17. PMID: 24341442.
5.1. Clinical Significance of Dental Anatomy,
Histology, and Physiology* PCCT
5.1.1. Describe the specific anatomic Part I
features of each tooth that help in  PCC Part
diagnosis and treatment planning [K]. II
5.1.2. Illustrate the physiologic tooth forms EYPT
and contours that affect the

47
Key Resident Level
Competen

Assessment
Instruction
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SN

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are able
to…)

supporting dental and paradental

tissues [K].
5.1.3. Explain the biological principles and
details of the development, structure,
and function of the hard and soft
tissues in the oral cavity [K].
5.2. Instruments and Equipment for Tooth
Preparation
5.2.1. Recognize the different types of
instruments used in the operative
Part I
field [K].
Part
5.2.2. Identify the different materials, parts,
 SDL II
grasp techniques, and motions
EYPT
associated with cavity preparation
CBD
instruments [K].
5.2.3. Justify the use of different types of
instruments according to the clinical
situation [C].
5.3. Dental Ergonomics*
5.3.1. Explain the concept of dental
ergonomics [K].
PCCT
5.3.2. Explain the dental risk factors for
Part I
musculoskeletal disorders [C]. PCC
 Part
5.3.3. Describe the intervention strategies WSA
II
against musculoskeletal disorders [C].
EYPT
5.3.4. Identify the best ergonomic working
position for the dental personnel [C].
5.3.5. Discuss exercises for maintaining a

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to…)

healthy posture [K].

5.4. Clinical Application of Amalgam and

Amalgam Toxicity
5.4.1. Identify the indications of dental
amalgam [K].
5.4.2. Identify the criteria for successful
amalgam restoration [C].
5.4.3. Apply the steps of manipulation and
restoration of posterior teeth using
amalgam [P].
5.4.4. Perform the finishing and polishing
Part I
steps of amalgam restoration [P].
Part
5.4.5. List the American Dental Association
II
recommendations for mercury hygiene  WSA
EYPT
and safety [K].
CBD
5.4.6. Explain the importance and
CE
use of mercury separators in dental
clinics [C].
5.4.7. Critique the toxic effect of amalgam as
reported in the literature [K].
5.4.8. List the precautionary measures for
limiting the exposure to mercury and
mercury vapor during amalgam
removal [K].
5.4.9. Apply precautionary measures of
amalgam hazards in the clinic [P].

5.5. Fundamental Concepts of Enamel and  PCC PCCT

Dentin Adhesion* WSA Part I

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to…)

5.5.1. Indicate the components and Part

classification of bonding agents [K]. II
5.5.2. Describe the properties of bonding EYPT
agents and indicate their clinical CBD
application [C]. CE
5.5.3. Define hybridization [K].
5.5.4. Recognize different factors affecting
the efficacy and durability of dental
adhesives during the bonding
procedure [C].
5.5.5 Describe the manipulation of bonding
agents [C].
5.5.6 Apply dental adhesives for composite
restoration following the standard
protocols [P].

5.6. Clinical Application of Resin Composite*

5.6.1. Explain the indications and
contraindications of composite
PCCT
restorations [K].
Part I
5.6.2. Correlate the material properties with
Part
indications and contraindications [C]. PCC
II
5.6.3. Explain the conservative design for  WSA
EYPT
cavity preparation for anterior and HoW
CBD
posterior composite restoration [K].
CE
5.6.4. Discuss manipulation of layering
DOPS
techniques for composite
restorations [C].
5.6.5. Describe the “C-factor” concept and

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its clinical significance [C].

5.6.6. Highlight the importance of proper
proximal contacts and different
matricing options to achieve it [C].
5.6.7. Describe the various sectional matrix
systems and their clinical application
[C].
5.6.8. Describe finishing and polishing
techniques of composite restorations
[K].
5.6.9. Discuss special considerations in
restoring crowded teeth and their
complications [C].
5.6.10. Restore anterior teeth with composite
restorations [P].
5.6.11. Restore posterior teeth with
composite restorations [P].
5.6.12. Apply the finishing and polishing
steps of composite restoration [P].
5.7. Light Curing Units*
5.7.1. List the different types of light-curing
units [K].
PCCT
5.7.2. List the desirable features of light-
Part I
curing units and their clinical PCC
 Part
significance [C]. WSA
II
5.7.3. Describe the protective equipment
EYPT
required during light-curing composite
restorations [C].
5.7.4. Define irradiance and its clinical

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5.16.1. Explain the effect of various types of II
irritants on the pulp-dentin complex EYPT
[C]. CBD
5.16.2. Correlate clinical symptoms and CE
pulpal inflammation [C].
5.16.3. Identify causes of dentin
hypersensitivity [C].
5.16.4. Desirable management options for
dental hypersensitivity [C].
5.16.5. Recognize pulp-dentin complex’s
reactions to restorative procedures
and materials [C].
5.16.6. Appraise pulp-dentin complex’s
reactions to vital bleaching [C].
5.16.7. Discuss the long-term effects of
crown preparation on pulp vitality [C].
5.16.8. Outline the factors that influence the
quantity of heat generated during
restorative procedures [K].
5.16.9. Discuss the causes of odontoblastic
death during dental procedures [C].
5.16.10. Explain the vibratory phenomenon
and shockwaves [C].
5.16.11. Discuss the effect of dentin
desiccation and how to avoid it [C].
5.16.12. Explain the effect of the presence of
a smear layer on the pulp-dentin
complex [C].

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to…)

5.16.13. Explain the effect of remaining

dentin thickness on pulpal health
[C].
5.16.14. Explain the effect of acid etching on
pulpal health [C].
5.16.15. Identify guidelines to decrease
pulpal injury following tooth
preparation [C].
5.16.16. Discuss crown cementation
dynamics and the effect on the pulp-
dentin complex [C].
5.16.17. Discuss the different methods used
to protect pulp against chemical,
electrical, thermal, and mechanical
irritations [C].
5.17. Biomimetic Approaches in Restorative
Dentistry
5.17.1. Define the concept of biomimetic
dentistry [K].
5.17.2. Identify loss of hard dental tissues [K]. Part I
5.17.3. Recognize the indications and Part
contraindications of biomimetic II
 WSA
approaches [K]. EYPT
5.17.4. List the various dental materials used CBD
in biomimetic dentistry [K]. CE
5.17.5. Describe the techniques of biomimetic
dentistry [C].
5.17.6. Master the clinical application of
biomimetic techniques [P].

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to…)

5.18. Bioactive Dental Materials in

Restorative Dentistry
5.18.1. Recognize the different bioactive
dental materials [C].
5.18.2. Identify the effects of
Part I
bioactive materials on dental
Part
tissues [C].
II
5.18.3. List the clinical conditions requiring  WSA
EYPT
bioactive material use [K].
CBD
CE
5.18.4. List the limitations of bioactive
materials [K].
5.18.5. Master the clinical application of
bioactive materials in various
clinical conditions [P].

Module 6: Esthetics

This module conveys the science and art of dental esthetics. It covers the essential
topics and materials needed to provide excellent esthetics for the patient, including
smile analysis, properties of the color used, shade selection, and different types of
restoration. The resident is also exposed to new technology in smile analysis.
Topics within this module include the following:
 Principles of Light and Color in Dentistry.*
 Conservative Treatment for Vital Discolored Teeth.*
 Conservative Treatment for Non-Vital Discolored Teeth.*
 Esthetic Considerations in Diagnosis and Treatment Planning.*
 Veneers.*
 Indirect Posterior Tooth-Colored Restorations.*
Main suggested resources:

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 Contemporary Fixed Prosthodontics 5th Edition

Chapter 23: Description of Color, Color-Replication Process, and Esthetics
 Summitt's Fundamentals of Operative Dentistry: A Contemporary Approach
– 4th Ed. (2013)
Chapter 3. Esthetic Considerations in Diagnosis and Treatment Planning
Chapter 4. Color and Shade Matching
Chapter 16. Natural Tooth Bleaching
Chapter 19: Esthetic Inlays and Onlays
 Fundamentals of Color: Shade Matching and Communication in Esthetic
Dentistry | Second Edition (2011)
Chapter 1: Color Education and Training Chapter 2: Color Theory
Chapter 3: Elements Affecting Color Chapter 7: Material Selection
 Sturdevant's art and science of operative dentistry 6th edition
Chapter 11: Indirect Tooth-Colored Restorations
Chapter 12: Additional Conservative Esthetic Procedures
 Bonded Porcelain Restorations in the Anterior Dentition: A Biomimetic
Approach
Book by Pascal Magne and U. Belser,
Chapter 2: Natural Oral Esthetics
Chapter 4: Evolution of Indications for Anterior Bonded Porcelain
Restorations
Chapter 5: Initial Treatment Planning and Diagnostic Approach
Chapter 6: Tooth Preparation, Impression and Provisionalization,
Chapter 7: Laboratory procedures
Chapter 8: Try-in and adhesive luting procedures
Chapter 9: Maintenance and Repairs
 Summitt's Fundamentals of Operative Dentistry: A Contemporary Approach
– 4th Ed. (2013)
Chapter 17: Porcelain Veneers

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 The Science and Art of Porcelain Laminate Veneers Galip Gurel 2003.
Chapter 2: Smile Design
Chapter 3: Adhesion
Chapter 7: Atlas of Porcelain Laminate Veneers
Chapter 9: Porcelain Laminate Veneers for Diastema Closure
 Clinical applications of digital dental technology
R Masri, CF Driscoll – 2015
Chapter 4: Digital Application in Operative Dentistry.
 Additional references are provided by lecturers.
6.1. Principles of Light and Color in Dentistry*
6.1.1. Discuss the electromagnetic
radiation, including the components
of daylight with different wavelengths
[K].
6.1.2. List different light sources
(illumination). [K]. PCCT
6.1.3. Define emission, transmission, and Part I
absorption of light [K]. Part
PCC
6.1.4. Discuss fluorescence, opalescence, II
  WSA
translucency and metamerism [K]. EYPT
HoW
6.1.5. Discuss the factors affecting shade AA
matching [C]. SOE
6.1.6. Discuss the dimensions of color with
reference to hue, value, and chroma
[K].
6.1.7. Recognize the recommended protocol
for shade matching [C].
6.1.8. Apply the principles of light and color in
clinical cases during shade selection

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[P].
6.1.9. Select the tooth shade using different
shade guide systems [P].
6.2. Conservative Treatment for Vital
Discolored Teeth*
6.2.1. Recognize types and the nature of tooth
discoloration with reference to
different etiologic factors [C].
6.2.2. Distinguish the types, composition, and
mode of action of tooth bleaching PCCT
agents and techniques (Home vs office) Part I
[C]. Part
6.2.3. Recognize the effects of bleaching PCC II
agents on restorative procedures and   WSA EYPT
materials [C]. HoW AA
6.2.4. Describe the steps of macroabrasion SOE
and microabrasion techniques [C]. CBD
6.2.5. Discuss the clinical steps of resin- CE
infiltration technique [K].
6.2.6. Compare and contrast between
conservative treatment options for
tooth discoloration [C].
6.2.7. Master the different techniques used to
manage discolored teeth [P].
6.3. Conservative Treatment for Non-Vital PCCT
Discolored Teeth* PCC Part I
6.3.1. Analyze measures to prevent tooth   WSA Part
discoloration secondary to HoW II
endodontic treatment [C]. EYPT

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6.3.2. Select the appropriate management AA

and technique according to the cause SOE
of discoloration [C]. CBD
6.3.3. Recognize the potential adverse
effects of internal bleaching and
discuss means of prevention [C].
6.3.4. Describe each step of the internal
‘’walking- bleach’’ technique [K].
6.3.5. Apply non-vital bleaching in indicated
cases [P].
6.4. Esthetic Considerations in Diagnosis and
Treatment Planning*
6.4.1. Recognize esthetic dental problems
according to the etiology [C].
6.4.2. Differentiate between esthetic and
cosmetic considerations [C].
6.4.3. Recognize how to achieve high Part I
esthetic outcomes [C]. Part
6.4.4. List treatment modalities to address II
  WSA
different esthetic and dental EYPT
SDL
problems [K]. AA
6.4.5. Differentiate between all treatment SOE
modalities for esthetic problems [C]. CBD
6.4.6. Describe facial, dento-labial, teeth,
and gingival analysis [K].
6.4.7. Perform a facial and smile analysis
[P].
6.4.8. Recognize the fundamentals of Digital
Smile Design [C].

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to…)

6.5. Veneers*
6.5.1. Review laminate veneers history [K].
6.5.2. Recognize the indications,
contraindications, advantages, and
disadvantages of different types of
direct and indirect esthetic veneers [C].
6.5.3. Recognize pre-operative evaluation
criteria (Analyzing the Smile) [C].
6.5.4. Explain mock-up techniques for veneer
cases [K].
PCCT
6.5.5. Discuss ways of laboratory
Part I
communication [K].
Part
6.5.6. Recognize Aesthetic Pre-recontouring
II
(APR) and Aesthetic Pre-evaluative PCC
   EYPT
Temporaries (APTs) [C]. WSA
AA
6.5.7. Explain different preparation designs HoW
SOE
and technique for composite and
CBD
porcelain veneers [K].
CE
6.5.8. Explain shade selection criteria,
DOPS
impression, and provisionals
techniques [K].
6.5.9. Discuss try-in steps and bonding
techniques [C].
6.5.10. Explain postoperative care [K].
6.5.11. Recognize factors leading to failure
[C].
6.5.12. Prepare indicated teeth for porcelain
veneers using different designs. [P].
6.5.13. Master composite veneer build-up

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using the layering technique [P].

6.4.14. Master porcelain veneers
cementation using resin cement [P].
6.6. Indirect Posterior Tooth-Colored
Restorations*
6.6.1. Differentiate between composite and
indirect ceramic restorations in terms
of physical and mechanical properties
[C].
6.6.2. Justify the use of different materials
and techniques according to the clinical
situation [C]. PCCT
6.6.3. Recognize steps of direct/indirect Part I
technique [K]. Part
6.4.4. Master designs of indirect tooth- PCC II
colored restoration [P].   WSA EYPT
6.4.5. Recognize fundamentals, advantages, SDL AA
and disadvantages of Digital Dentistry HoW SOE
Technology [C]. CBD
6.4.6. Identify indications and limitations of CE
digitally-designed and fabricated DOPS
single-unit restoration and the material
used on the best evidence available [K].
6.4.7. Describe the principles, design, and
intraoral scanning for tooth
preparation by digital technology
(CAD/CAM) [K].
6.4.8. Recognize the steps of complete digital
workflow for patient care in the clinic

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[C].
6.4.9. Perform digitally-designed and
fabricated single-unit restoration [P].
Hands-on Training Session
1. Practice anterior esthetic analysis and
guidelines.
2. Practice composite material properties.
3. Learn different composite layering
CE
techniques, effects and tints.
 HoW OSCE
4. Practice esthetic Class IV composite
SOE
layering techniques, finishing and
polishing.
5. Comprehend tips and tricks for daily
clinical situations and predictable
Esthetic and Functional outcomes.

Module 7: Digital Restorative Dentistry

This module teaches the basic principles of digital dentistry in the restorative
discipline. In this module, residents will be familiar with the major components of
dental computer-aided design (CAD) and computer-assisted manufacturing (CAM)
technologies and their related processes of data or image acquisition; image or
information analysis and manipulation, or computer-assisted manufacturing.
Residents will understand the difference between subtractive and additive dental
CAD/CAM processes and when to use them. They will have an in depth
understanding of the material compositions of currently available materials for
CAD/CAM fabrication. They will also be able to list the criteria for a successful
digital restoration and how to apply these criteria in a clinical situation, when
required. Topics within this module include the following:
 The History of CAD/CAM in Dentistry.

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 Digital Scanning and its Applications.*

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

7.11.6. Discuss principles of guided surgical

implant placement processes, using
digital techniques [K].
7.11.7. Explain the fabrication methods of
CAD/CAM generated implant surgical
guides [K].
7.11.8. Discuss the restorative workflows for
the CAD/CAM design process of
implant supported prostheses [K].
7.11.9. Discuss material choices for
CAD/CAM of implant supported
prostheses [K].
7.11.10. Discuss complications of CAD/CAM
[K].
7.11.11. Discuss the ways in which digital
dental workflow models streamline
the appointments and procedures
associated with dental implant
treatments [C].
Hands-on Training Session
1. Practice intraoral scanning for a single
crown.
2. Practice Intraoral scanning for a single CE
implant supported crown.  HoW OSCE
3. Demonstrate the restorative workflow of SOE
a single restorative crown.
4. Demonstrate the restorative workflow of
a single implant supported crown.

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to…)

5. Perform CBCT interpretation.

6. Demonstrate the superimposition
process of a CBCT and STL files.
7. Design a surgical guide for a guided
implant placement.
8. Practice 3D printing strategies for
different 3D printers.
9. Demonstrate the 3D printing methods
and its applications.
10. Demonstrate the different millings
machines and milling methods.

Module 8: Fixed Prosthodontics

This module imparts essential clinical knowledge and skills. It emphasizes the
practical aspects of fixed prosthodontics, starting with the treatment plan, tooth
preparation, provisionalization, and impression technique, ending with
cementation and management of complications. Topics within this module include
the following:
 Treatment Planning for Single and Multiple Missing Teeth*
 Resin-Bonded FD
 Cantilever FDP
 Pier Abutment
 Prosthetic Treatment of Dentition with Periodontal Disease
 Principles of Tooth Preparation*
 Fluid Control, Soft Tissue Management, and Impression Techniques
 Pontics and the Edentulous Ridge
 Type of Post and Core*
 Provisional Restoration*
 Diagnostic Wax-up*

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disadvantages [K]. II
 WSA
8.8.3 Discuss the indications and EYPT

contraindications for various pontic CBD

designs [C]. AA

8.8.4 Discuss and outline the procedure for

pretreatment assessment of pontic
space [C].

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are able
to…)

8.9 Type of Post and Core*

8.9.1 List the types of post and core PCCT
according to their use, material
Part I
composition, and technique [K]. Part
8.9.2 State the indications, PCC
 II
contraindications, advantages, and WSA
EYPT
disadvantages of each type [K]. CBD
8.9.3 Describe the techniques used for AA
fabrication, try-in, and cementation
[C].
8.10 Provisional Restoration*
8.10.1 List the types and characteristics of
PCCT
the ideal provisional restoration [K]. Part I
8.10.2 List the types and techniques of Part
construction and cementation [K]. PCC
 II
SDL
EYPT
8.10.3 Discuss critical areas in provisional CBD
restorations that maintain the health AA
and position of the gingiva (marginal
fit, contour, surface finish [C].
8.11 Diagnostic Wax-up* PCCT
8.11.1 State the value and purpose of dental Part I
wax-up [K]. Part
PCC
8.11.2 Describe the steps in diagnostic wax-  II
WSA
up [C]. EYPT
CBD
AA

23. Cement all-ceramic crown with resin
cement (video)

9.12.1 Explain the concept of anterior
guidance [K].
9.12.2 Discuss the function of anterior
guidance [C].
9.12.3 Describe the importance of anterior
guidance over condylar guidance [C].
9.12.4 Discuss the major function of anterior
guidance [C].
9.12.5 Explain the role of anterior guidance
as a control on occlusal posterior
contours [C].
Part
9.12.6 Estimate the effect of anterior
II
guidance on electromyographic
 WSA EYPT
activity in the elevator muscles [K].
CBD
9.12.7 Discuss the four determinants of
AA
anterior form and position [C].
9.12.8 Outline the criteria for the semi-
adjustable articulator used to restore
anterior guidance [C].
9.12.9 Verify the relationship between
anterior and condylar guidance [C].
9.12.10Differentiate between modification
and re- establishment of anterior
guidance [C].
9.12.11Describe the method for
transferring occlusal anterior
guidance to the articulator

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[K].
9.13 Occlusal Stability
9.13.1 Define the concept of stable occlusion
Part I
[K].
Part
9.13.2 List the signs of stable and unstable
II
occlusion [K].  WSA
EYPT
9.13.3 Identify the requirement for occlusal
CBD
stability [K].
AA
9.13.4 Explain the treatment plan required
for unstable occlusion [C].
9.14 Occlusal Equilibration and Selective
Teeth Grinding
9.14.1 Define occlusal equilibration [K].
9.14.2 Explain the importance of Part
occlusal equilibration [C]. II
9.14.3 Identify the selective grinding EYPT
 WSA
concept and its indications [K]. CBD
9.14.4 Describe the technique for a AA
selective grinding procedure CE
[C].
9.14.5 Perform selective grinding in
indicated clinical cases [P].
9.15 Dental Wear
Part
9.15.1 Define dental wear [K].
II
9.15.2 Recognize the types of dental wear
 WSA EYPT
[K].
CBD
9.15.3 Become familiar with the wear index
AA
classification [K].

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to…)

9.15.4 Classify worn dentition according to

location [K].
9.15.5 Verify the effect of wear on occlusion
[K].
9.15.6 Discuss the diagnosis, prevention,
and management of dental wear
problems [C].
9.16 Overview of Full Mouth Rehabilitation
9.16.1 Define full mouth rehabilitation
[K].
9.16.2 Determine the indications of full
mouth rehabilitation [K].
9.16.3 Discuss the various occlusal
concepts and philosophies
pertaining to full mouth
Part
rehabilitation [C].
II
9.16.4 Describe the steps involved in the
EYPT
process of full mouth  WSA
CBD
rehabilitation [C].
AA
9.16.5 Classify the types of deep
CE
overbite and state their etiology
[C].
9.16.6 Identify the methods used to
correct deep overbite problems
[K].
9.16.7 Assess the effect of excess
overjet on occlusion [K].
9.16.8 Decide the appropriate treatment for

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Assessment
Instruction
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R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

extreme overjet problems [C].

9.17 Occlusal Appliances
9.17.1 Define occlusal appliances [K].
Part
9.17.2 List the types of occlusal appliances II
[K]. EYPT
 WSA
Mention the indications and CBD
appropriate selection of occlusal AA
appliances [K]. CE
9.17.3 Describe the fabrication technique of
occlusal appliances [K].
9.18 Criteria For Success of Occlusal Part
Treatment II
9.18.1 Outline the objectives of successful EYPT
 WSA
occlusal treatment [K]. CBD
9.18.2 Describe the testing process for AA
successful occlusal treatment [K]. CE
Hands-on Training Session
1. Make maxillary and mandibular
impressions.
2. Take the bite registration using different
materials.
CE
3. Use the facebow.  HoW
OSCE
4. Pour upper and lower impressions using
dental stone.
5. Check casts for accuracy and trim them.
6. Transfer the relationship of a patient’s
maxillary arch and TMJ to an articulator

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Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

utilizing a facebow.
7. Mount diagnostic casts on a semi-
adjustable articulator.
8. Adjust the setting of the articulator.
9. Mount extracted teeth on alginate
impressions.
10. Pour alginate impressions with
extracted teeth.
11. Analyze occlusion of the previously
mounted casts.
12. Perform diagnostic wax-up. (Laboratory
staff will demonstrate these
procedures)
13. Adjust wax-up for selected cases.

Module 10: Dental Implants

This module provides basic knowledge of dental implants and the skills necessary
for diagnosis and planning treatment. Residents discuss the rationale for dental
implants and the principle of osseointegration as well as the prosthetic
components of implants, including types of dental implant and the concepts of
biomechanics, occlusion of implant restoration, and an implant in the esthetic zone.
Finally, the resident will gain some experience on how to maintain a dental implant.
Topics within this module include the following:
 Historical Overview of Dental Implantology, Types of Dental Implants, and the
Concept of Osseointegration.*
 Biomechanics, Biomaterials, and Surface Treatment of Dental Implants.
 Occlusion of Implant Restoration.
 Patient Selection for an Implant and Planning Treatment.
 Evaluation of Radiographic Images in Patients Considering an Implant.

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10.2.4. List types of surface coating. [K]
10.2.5. Apply the biomechanical principles
in a treatment plan. [P]
10.3. Occlusion of Implant Restoration
10.3.1. Differentiate between implant
occlusion and natural occlusion.
[C]
Part I
10.3.2. Discuss the basics and
Part
consequences of biomechanical WSA
II
overload, bone mechanics, force 
EYPT
directions, and various occlusal
CBD
schemes that contribute to the
AA
success of implant restorations. [C]
SOE
10.3.3. Explain the importance of
controlling the position, angulation,
and occlusal force on the implant. [C]
10.4. Patient Selection for an Implant and
Planning Treatment
10.4.1. Review medical and dental history;
Part I
Recognize local, systemic, and
Part
behavioral risk factors. [C]
II
10.4.2. State the steps in clinical and  WSA
EYPT
radiographic examination and explain
CBD
the surgical and radiographic
AA
methods used to insert stents.
SOE

10.4.3 Develop and apply treatment

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Instruction
cies Enabling Competencies (Residents are able

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SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

strategies. [C]
10.5. Evaluation of Radiographic Images in
Patients Considering an Implant
10.5.1. List the necessary radiographic
information needed. [K]
10.5.2. Describe the types of
radiographic images needed to
obtain the information required
for implant planning. [C] Part I
10.5.3. Describe the importance and Part
sequence of radiographic II
monitoring for implant therapy. WSA EYPT

[C] CE CBD
10.5.4. Describe dental implant image- OSCE
guided surgery. [K] AA
10.5.5. Interpret radiographs obtained by SOE
the cone-beam technique. [C]
10.5.6. Interpret different radiographic
images for single or multiple
implants. [P]
10.5.7. Identify the anatomic landmarks
used to select the correct position
for the implant. [P]
10.6. Treatment Planning for Single-tooth
Implant Restoration Part
10.6.1. Outline the alternative treatments  WSA II
available for single-tooth EYPT
replacement. [K] CBD

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Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

10.6.2. Discuss the contraindications and AA

limitations of a single-tooth implant. SOE
[C]
10.6.3. Explain the orthodontic and occlusal
considerations related to posterior
implant treatment. [C]
10.7. Implant in the Esthetic Zone
10.7.1. Explain the general esthetic
principles and related guidelines;
Discuss esthetic considerations Part
related to maxillary anterior II
implant restoration. [C] EYPT
 WSA
10.7.2. Recognize the role of the biological CBD
width on esthetic implant AA
rehabilitation. [C] SOE
10.7.3. Analyze the clinical considerations
that must be addressed when placing
an implant in the esthetic zone. [C]
10.8. Screw-retained versus Cement-
retained Implant Restoration* PCCT
10.8.1. State the indications for screw- Part I
retained prosthetic restoration; PCC Part
State the indications for cement- WSA II

retained prosthetic restoration; EYPT
Explain the advantages and CBD
disadvantages of screw-retained AA
and cement-retained prosthetic SOE
restoration. [C]

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Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

10.8.2. Select and utilize screw-retained

implant restoration. [C]
10.8.3. Select and utilize cemented-retained
implant restoration. [C]
10.9. Surgical Aspects of Implant Dentistry*
PCCT
10.9.1. Describe the first surgical
Part I
procedure. [K]
PCC Part
10.9.2. Describe the second surgical
WSA II
procedure. [K]  
EYPT
10.9.3. Explain the postoperative
CBD
management. [C]
AA
10.9.4. State the complications that can
SOE
occur after this surgery. [K]
10.10. Prosthetic aspects of Implant
Dentistry*
10.10.1. Explain the steps involved in a
fixed implant prosthesis for PCCT
single-tooth replacement in the Part I
esthetic and posterior zones. [C] Part
10.10.2. Explain the steps involved in a PCC II
fixed implant prosthesis for   WSA EYPT
partially edentulous situations. [C] HoW CBD
10.10.3. Differentiate between AA
prefabricated and customized SOE
healing abutments for soft tissue OSCE
management. [C]
10.10.4. Discuss the types of implant
temporization and techniques

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Instruction
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SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

used. [C]
10.10.5. Compare the different options for
making an impression (closed
versus open tray technique, and
abutment versus fixture level
impressions) [C]
10.10.6. Describe the procedures for bite
registration, abutment selection,
(plan sit), torqueing, and insertion.
[C]
10.10.7. Develop a treatment plan for
complex implant cases. [P]
10.10.8. Describe the process of full mouth
rehabilitation using dental
implants. [C]
10.10.9. Discuss the use of implants for
growing patients. [C]
10.10.10. Make a final impression with a
closed try (at the abutment and
fixture level). [P]
10.10.11. Make a final impression with an
open try at the fixture level. [P]

10.10.12. Immediate Dental Implant Loading Part

State the rationale for immediate II
implant loading. [K]  WSA EYPT
10.10.13. List the guidelines for immediate CBD
loading. [K] AA

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Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

10.10.14. Determine factors that decrease OSCE

the risk of immediate occlusal SOE
loading. [C]
10.10.15. Explain the advantages and
disadvantages of non-functional
immediate loading; Justify the risk
of immediate occlusal loading. [C]
10.11. Implant-natural Tooth Connection
10.11.1. Evaluate the natural abutment
appropriately. [C]
10.11.2. Distinguish biomechanical
differences in movement
Part
between an implant and a
II
natural tooth. [C]
EYPT
10.11.3. Recognize the difference in
 WSA CBD
supporting mechanisms. [C]
AA
10.11.4. State the advantages and
OSCE
disadvantages of connecting a tooth
SOE
to an implant. [K]
10.11.5. Justify the potential risk of
connecting a tooth to an implant.
[C]
10.11.6. Describe the connection method. [C]
10.12. Complications and Management of a Part
Prosthetic Implant II
WSA
10.12.1. Discuss the biological  EYPT
CE
complications, i.e., incident rate, CBD
etiology, and solutions [K]. AA

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Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

10.12.2. Discuss the mechanical OSCE

complications, i.e., incident rate, SOE
etiology, and solutions; Discuss
the esthetic complications, i.e.,
incident rate, etiology, and
solutions. [C]
10.12.3. Estimate and recognize
complications of a prosthetic
implant in a case. [P]
10.13. Treatment Planning for an
Implant-supported Fixed Partial
Denture
Part I
10.13.1. Discuss the prosthetic options;
Part
Classify the prosthetic movements;
II
State the advantages of an implant
EYPT
supported FPD. [C]  WSA
CBD
10.13.2. Describe the preloading and
AA
parameters affecting
OSCE
preloading. [C]
SOE
10.13.3. Identify a passive casting material
and factors influencing fabrication.
[C]
10.14. Maintenance of a Dental Implant Part
10.14.1. Recognize the periodontal aspects II
of a dental implant; Define peri- WSA EYPT

implantitis; Discuss the CE CBD
consequences of peri-implantitis. AA
[C] OSCE

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Key Resident Level
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Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

10.14.2. Explain the hygiene protocol and SOE

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

11.3.4. Describe the procedures used to

correct biologic width violation
(crown lengthening vs orthodontic)
[K].
11.3.5. Compare and contrast between
crown lengthening and orthodontic
procedures [C].
11.3.6. Identify relevant records and
preparatory procedures for cases
indicated for biological width
correction [K].
11.3.7. List types of marginal placement:
supragingival, equigingival,
subgingival [K].

11.3.8. Discuss the margin placement

guideline including reasons for
extending margins subgingivally [C].
11.3.9. Describe the role of marginal fit on
gingival health [K].
11.3.10. Explain the effect of crown contour
(emergence profile, height of
contour, embrasures, and overhang)
on gingival health [C].
11.3.11. Rationalize between restorative
management versus extraction
decision and implant [C].
11.4. Gingival Health and Esthetics WSA Part I

Considerations of Provisional SDL Part

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Key Resident Level
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Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

Restoration II
11.4.1. Explain the effect of different EYPT
provisionals on gingival health [K]. AA
11.4.2. Discuss critical areas in provisional SOE
restoration that maintain the health CBD
and position of the gingiva (marginal
fit, contour, surface finish) [C].
11.4.3. Explain the meaning of emergence
profile and its significance in gingival
esthetics and health [C].
11.4.4. Recognize the role of provisional
restoration to gingival esthetics [C].
11.4.5. Recognize the consequences of faulty
provisional restorations[C].
11.5. Interproximal Embrasures
11.5.1. Explain how to manage
interproximal embrasures (natural
tooth and implant) [C]. Part I
11.5.2. Clarify the relationship between Part
gingival embrasure volume and II
papillary formation [K]. WSA EYPT

11.5.3. Describe the surgical methods used to SDL AA
alter gingival embrasures [C]. SOE
11.5.4. Explain the restorative correction CBD
techniques used for open gingival
embrasures [C].

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Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

Module 12: Scientific Research

This module communicates the principles of scientific research. It is designed to

improve many skills, including scientific thinking, teamwork, and professional
communication skills. Residents will have a chance to conduct a research project
and present their findings in a written or oral format. Topics within this module
include the following:
 Introduction to Scientific Research.*
 Ethics in Scientific Research.*
 Literature Review.*
 Research Problem and Objectives.*
 Introduction to Referencing.*
 Study Design and Research Methodology.*
 Type of Variables, Confounding, Modifiers, Sampling Technique, and Data
Collection, Institutional Review Board (IRB).*
 Questionnaires and Standardized measurement.*
 Qualitative Study Design.*
 Biostatistics.*
 Research Proposal.*
 Discussion.*
 Conclusion, Abstract, Title, Authorship, Acknowledgements, Publication,
Poster Presentation.*
 Research Grants.*
Main suggested resources:
 Gordis Epidemiology, 6th Edition by David D Celentano & Moyses Szklo. (2018)
Introductory Statistics 1st Edition, by Barbara Illowsky, Susan Dean OpenStax.
(2013)
 Additional references are provided by lecturers.

12.1. Introduction to Scientific Research*  PCC

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

12.10.8. Describe how to report the results:

tables, figures, and presenting in
text. [C]
12.10.9. Gain familiarity with the use of the
SPSS program (attend a hands-on
workshop). [P]
12.11. Research Proposal*
12.11.1. Describe the content of the research PCCT
proposal. [K]  PCC Assig
12.11.2. Apply the above-mentioned .
methods of writing. [P]
12.12. Discussion*
12.12.1. Identify the content of the PCCT
discussion section. [K]  PCC Assig
12.12.2. Discuss the methods used to write .
the above discussion. [P]
12.13. Conclusion, Abstract, Title,
Authorship, Acknowledgements,
Publication, Poster Presentation*
12.13.1. Identify the content of the
conclusion. [K]
12.13.2. Identify the content of the abstract. PCCT
[K]  PCC Assig
12.13.3. List the types of titles. [K] .
12.13.4. State how to arrange authorship. [K]
12.13.5. Describe how to write
acknowledgements. [K]
12.13.6. Explain the process of publication.
[C]

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Assessment
Instruction
cies Enabling Competencies (Residents are able

R3 - senior
SN

R1 - junior

R2 - junior
(Residents to…)
are able
to…)

12.13.7. Discuss how to design the poster. [C]

12.14. Research Grants* PCCT

12.14.1. Explain the process of applying for a  PCC Assig
research grant. [C] .
12.15. Critique Articles* PCCT
12.15.1 Discuss the steps in critiquing  PCC Assig
research. [C] .

Communicator

As communicators, SBRD residents form relationships with patients and their

families that facilitate the gathering and sharing of essential information for
effective dental health care.

Resident Level
Key
Competencies

R3 senior
R1 & R2
SN Enabling Competencies (Residents are able to…)

junior
(Residents are
able to…)

1.1 Communicate using a patient-centered approach that

encourages patients’ trust and autonomy and is
Establish characterized by empathy, respect, and compassion.
professional 1.1.1. Apply psychologic and behavioral principles in
therapeutic patient-centered communication.
1 relationships 1.1.2. Take time to talk and listen to dental patients to  
with patients understand them better and improve the clinical
and their relationship.
families

115
Resident Level
Key
Competencies

R3 senior
R1 & R2
SN Enabling Competencies (Residents are able to…)

junior
(Residents are
able to…)

1.1.3 Provide direct and close contact with patients

characterized by honesty and empathy to create a
therapeutic alliance based on trust and respect.

1.2 Optimize the physical environment for the patient’s

comfort, dignity, privacy, engagement, and safety.
 
1.2.1. Show concern about patient privacy and comfort.
1.2.2. Apply all the safety standards needed.

1.3. Recognize when the values, biases, or perspectives of

patients, dentists, or other dental health care
professionals may have an impact on the quality of  

care and modify the approach to the patient

accordingly.
1.1. Respond to a patient’s non-verbal behaviors to
enhance communication.
1.1.1. Recognize and appropriately manage anxious or
 
fearful dental patients.
1.1.2. Recognize and respect the dental patient’s need for
privacy.

1.2. Manage disagreements and emotionally charged

conversations.
1.2.1. Respect each patient’s perspectives, situation,
 
concerns, and values and give alternative treatment
plans.
1.2.2. Break bad news in an empathetic manner.

1.3. Adapt to the unique needs and preferences of each

patient and to his/her clinical conditions and  
circumstances.

Elicit and 2.1. Use patient-centered interviewing skills to gather

2  
synthesize relevant biomedical, dental, and psychological

116
Resident Level
Key
Competencies

R3 senior
R1 & R2
SN Enabling Competencies (Residents are able to…)

junior
(Residents are
able to…)

accurate and information.

Relevant 2.1.1 Encourage and facilitate the dental patient to take
information, the conversational lead and initiate topics in the
incorporating area of their complaints, symptoms, experience,
the worries, values, and preferences.
perspectives of 2.2. Provide a clear structure for and manage the flow of an
 
patients and entire patient encounter.
their families
2.3. Seek and synthesize relevant information from other
sources including the patient’s family, with the
patient’s consent.
2.3.1. Collect the relevant necessary information from the
family, previous dentists, or other dental specialists,  
the patient’s physician (if related to a medical issue),
and other professionals, with the patient’s
permission.
2.3.2. Act professionally when screening for sensitive
information.
3.1 Share information and explanations that are clear,
accurate, and timely, while checking for patient and
Share dental family understanding.
health care 3.1.1 Use language that is easily comprehended and
information matches the patient’s requirements and
3
and plans with expectations.
patients and 3.2 Utilize new technology to facilitate understanding of
their families information and explaining dental treatment plans.
3.3 Disclose harmful patient safety incidents to patients and
their families accurately and appropriately.
Engage 4.1 Facilitate discussion with patients and their families in a
patients and way that is respectful, non-judgmental, and culturally
4
their families safe.
in developing 4.2 Assist patients and their families to identify, access, and

117
Resident Level
Key
Competencies

R3 senior
R1 & R2
SN Enabling Competencies (Residents are able to…)

junior
(Residents are
able to…)

plans that make use of information and communication

reflect the technologies to support their treatment plan, dental care,
patient’s and manage their dental health.
dental health 4.3 Use communication skills and strategies that help patients
care needs and their families to make informed decisions regarding
and goals their dental health.
Document 5.1 Document clinical encounters in an accurate, complete,
and share timely, and accessible manner, in compliance with
written and regulatory and legal requirements.
electronic 5.2 Communicate effectively using a written dental and
information medical health record, electronic dental and medical
about the record, or other digital technology.
clinical 5.3 Share information with patients and others in a manner
encounter to that respects patient privacy and confidentiality and
5
optimize enhances understanding.
clinical
decision-
making,
patient
safety,
confidentialit
y, and privacy

Collaborator

As collaborators, SBRD residents work effectively with other dental health

care professionals to provide safe and high-quality, patient-centered care.

118
Key competencies Junior
Senior
SN (Residents are able Enabling competencies (Residents are able to) (R1&R2
(R3)
to) )

1.1 Establish and maintain a positive relationship with

dentists, physicians, and other colleagues in the
 
dental health care professions to support
relationship-centered collaborative care.

1.1.1 Participate in intraprofessional (among dental

colleagues) and interprofessional (among other
 
dental and medical health care professionals)
relationships and teamwork.

1.1.2 Work with other health care professionals and

dental specialists to integrate care at the individual  
and community levels.
Work effectively
with dentists, 1.1.3 Apply the principles of team dynamics.  
physicians, and
1 other colleagues 1.1.4 Engage in continuous intraprofessional and
in the dental interprofessional development to enhance team  
health care performance.
professions 1.2 Negotiate overlapping and shared responsibilities
with dentists and other health care professionals  
during episodic and ongoing care.

1.2.1 Recognize one’s own professional role and

responsibilities and those of others, including
dental assistants, laboratory technicians,  
radiologists, hygienists, and other dental and
medical specialties.

1.3 Engage in respectful shared decision-making with

dentists and other colleagues in the dental health  
care professions.

Work with dentists 2.1 Show respect towards collaborators.  

and other
2.1.1 Encourage the opinions and ideas of other
2 colleagues in the
interprofessional and intraprofessional dental  
dental health care
health care team members.
professions to

119
Key competencies Junior
Senior
SN (Residents are able Enabling competencies (Residents are able to) (R1&R2
(R3)
to) )

promote 2.1.2 Respect the roles and limitations of other

 
understanding, professionals.
manage
2.2 Implement strategies to promote understanding,
differences, and
manage differences, and resolve conflicts in a 
resolve conflicts
manner that supports a collaborative culture.

2.2.1 Value diversity among dental professionals. 

2.2.2 Use constructive negotiation. 

2.2.3 Describe strategies for conflict resolution on the


team.

2.2.4 Give timely and sensitive instructive feedback to

others and respond respectfully and 
professionally to feedback from others.

3.1 Determine when care should be transferred to

Hand over the another dentist or dental health care professional.
 
care of dental
3.1.1 Recognize one’s own limitations and know when to
patients to  
seek help from others.
another dental
health care 3.2 Demonstrate handover of care, using both verbal
3
professional when and written communication, during a patient
 
necessary to transition to a different dental health care
facilitate professional, setting, or stage of care.
continuity of safe
3.2.1 Write appropriate referral and consultation
patient care  
request forms.

Leader

As leaders, SBRD residents engage with others to contribute to the vision of

a high-quality dental health care system and take responsibility for the
delivery of excellent patient care through their activities as clinicians,
administrators, scholars, or teachers.

120
Key competencies
Junior Senior
SN (Residents are able Enabling competencies:(Residents are able to)
(R1&R2) (R3)
to)

1.1 Apply the science of quality improvement to

 
contribute to improving systems of patient care.
Contribute to
improved delivery 1.2 Contribute to a culture that promotes patient
 
of dental health safety.
1
care in teams, 1.3 Analyze patient safety incidents to enhance
 
organizations, and systems of care.
systems
1.4 Use health informatics to improve the quality of
 
patient care and optimize patient safety.
Engage in the 2.1 Allocate dental care resources for optimal patient
 
stewardship of care.
2 dental care
2.2 Apply evidence and management processes to
resources 
achieve cost-appropriate care.
Demonstrate 3.1 Demonstrate leadership skills to enhance dental
 
leadership in care.
3 professional
3.2 Facilitate change in dental health care to enhance
practice 
services and outcomes.
Manage career 4.1 Set priorities and manage time to integrate
 
planning, finances, practice and personal life.
and human
4 4.2 Manage a career and a practice.  
resources
4.3 Implement processes to ensure Improvement in
in a dental practice  
personal practice.

Health Advocate

As health advocates, SBRD residents contribute their expertise and influence

as they work within communities or patient populations to improve dental
health. They work with those they serve to determine and understand needs,
speak on behalf of others when required, and support the mobilization of
resources to affect change.

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Key competencies
Junior Senior
SN Residents are able Enabling competencies Residents are able to:
(R1&R2) (R3)
to:
1.1 Work with patients to address determinants of
Respond to an dental health that affect them and their access to  
individual patient’s necessary dental health services or resources.
dental health needs
1.2 Work with patients and their families to increase
1 by advocating for  
opportunities to adopt healthy dental behaviors.
the patient within
1.3 Incorporate prevention, promotion, and
and beyond the
surveillance of oral health into interactions with  
clinical environment
individual patients.
Respond to the 2.1 Work with a community or population to identify
needs of the the determinants of oral health that affect its  
community or members.
populations served 2.2 Improve clinical practice by applying a process
2 by advocating for of continuous quality improvement to the
system-level  
prevention, promotion, and surveillance of oral
change in a socially health.
accountable
2.3 Contribute to the process of improving oral
manner  
health in the community or population served.

Scholar

As scholars, SBRD residents demonstrate a lifelong commitment to

excellence in practice through continuous learning and by teaching others,
evaluating evidence, and contributing to scholarship.

Key
competencies Junior Senior
SN Enabling competencies (Residents are able to)
(Residents are (R1&R2) (R3)
able to)
LIFELONG 1.1 Develop, implement, monitor, and revise a
LEARNING personal learning plan to enhance professional  
Engage in practice.
1 continuous 1.2 Identify opportunities for learning and
enhancement of improvement by regularly reflecting on and
 
professional assessing personal performance using various
activities through internal and external data sources.

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Key
competencies Junior Senior
SN Enabling competencies (Residents are able to)
(Residents are (R1&R2) (R3)
able to)
ongoing learning 1.3 Engage in collaborative learning to improve
personal practice and contribute to collective  
improvements in practice in an ongoing way.
1.3.1 Learn from and make use of the expertise of
other dentists or dental health care  
professionals.
TEACHER 2.1 Recognize the influence of role modeling and
Teach students, the impact of the formal, informal, and hidden
residents, the curriculum on learners. 
public, and other 2.1.1 Participate in teaching with dental students,
health care interns, residents, or colleagues.
professionals
2.2 Promote a safe learning environment.  
2.3 Ensure patient safety is maintained when
2  
learners are involved.
2.4 Plan and deliver a learning activity.  
2.5 Provide feedback to enhance learning and
 
performance.
2.6 Assess and evaluate learners, teachers, and
programs in an educationally appropriate  
manner.
EVIDENCE- 3.1 Recognize uncertainty in clinical practice and
INFORMED knowledge gaps in clinical and other
 
DECISION-MAKING professional encounters, and generate focused
Integrate best questions that address them.
available evidence 3.2 Identify, select, and navigate pre-appraised
into practice  
resources.
3
3.3 Critically evaluate the integrity, reliability, and
applicability of health-related research and  
literature.
3.4 Integrate evidence into decision-making in
 
clinical practice.

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Key
competencies Junior Senior
SN Enabling competencies (Residents are able to)
(Residents are (R1&R2) (R3)
able to)

RESEARCH 4.1 Demonstrate an understanding of the scientific

Contribute to the principles of research and scholarly inquiry
 
creation and and the role of research evidence in health
dissemination of care.
knowledge and 4.2 Identify ethical principles for research and
practices incorporate them into obtaining informed
applicable to consent, considering potential harms and  
health benefits, and considering vulnerable
4 populations.
4.3 Contribute to the work of a research program.  
4.4 Pose questions amenable to scholarly inquiry
and select appropriate methods to address  
them.
4.5 Summarize and communicate to professional
and lay audiences, including patients and their
 
families, the findings of relevant research and
scholarly inquiry.

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Professional

As professionals, SBRD residents are committed to the dental health and

well-being of individual patients and society through ethical practice, high
personal standards of behavior, accountability to the profession and society,
dentist-led regulation, and maintenance of personal oral health.

Key
Junior
competencies Senior
SN Enabling competencies Residents are able to: (R1&R
Residents are (R3)
1)
able to:
1.1 Exhibit appropriate professional behavior and
relationships in all aspects of practice,
demonstrating honesty, integrity, humility,  
commitment, compassion, respect, altruism, respect
for diversity, and maintenance of confidentiality.
1.1.1 Put patients’ interests before their own or those of
 
any colleague, organization, or business.
1.1.2 Manage information about patients as confidential
 
and use it for the purposes for which it is given.
COMMITMENT TO
1.1.3 Keep information secure at all times.  
PATIENTS
Demonstrate a 1.1.4 In special cases, it may be justified to make
commitment to confidential patient information known without
 
1 patients by consent if it is in the public interest or the patient’s
applying best interests.
practices and 1.1.5 Maintain appropriate boundaries in relationships
adhering to high with patients and without abusing those  
ethical standards relationships.
1.2 Demonstrate a commitment to excellence in all
 
aspects of practice.
1.3 Recognize and respond to ethical issues
 
encountered in practice.
1.3.1 Reject politely any payment, gift, hospitality, and
request to make or accept any referral that may  
affect professional judgment.
1.3.2 Treat patients politely and with respect, in
 
recognition of their dignity and rights as individuals.

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Key
Junior
competencies Senior
SN Enabling competencies Residents are able to: (R1&R
Residents are (R3)
1)
able to:
1.3.3 Recognize and promote the patient’s responsibility
for making decisions about oral and dental  
treatment.
1.3.4 Treat patients fairly and in line with the law.  

1.4 Recognize and manage conflicts of interest.  

1.5 Display professional behavior in the use of

 
technology-enabled communication.
COMMITMENT TO
SOCIETY 2.1 Demonstrate accountability to patients, society, and
Demonstrate a the profession by responding to societal  
commitment to expectations of dentists.
society by
2 recognizing
and
responding to
2.2 Demonstrate a commitment to patient safety and
societal  
quality improvement.
expectations in
oral health
care
COMMITMENT 3.1 Fulfill and adhere to the professional and ethical
TO codes, standards of practice, and laws governing  
PROFESSION dental practice.
Demonstra 3.1.1 Recognize laws and regulations that affect a
te a dentist’s work, premises, equipment, and business,  
commitme
and follow them.
nt to the
3 3.2 Recognize and respond to unprofessional and
profession
by unethical behaviors in dentists and other colleagues  
adhering to in the health care profession.
standards 3.2.1 Treat all team members and other colleagues fairly
 
and and in line with the law without discrimination.
participatin 3.3 Participate in peer assessment and setting of
g in 
standards.

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Key
Junior
competencies Senior
SN Enabling competencies Residents are able to: (R1&R
Residents are (R3)
1)
able to:
dentist-led 3.3.1 Share knowledge and skills effectively with other
regulation team members and colleagues in the interests of 
patients.

COMMITME
4.1 Display self-awareness and manage influences on
NT TO  
personal well-being and professional performance.
SELF
Demonstrate a
commitment 4.2 Manage personal and professional demands for a
4  
to dental sustainable practice throughout life.
health and
well-being to
foster optimal 4.4 Promote a culture that recognizes, supports, and
 
patient care. responds effectively to colleagues in need.

Integration of Disciplines
To simplify the distribution of the learning objectives included in the different
restorative disciplines, the committee reorganized them into integrated
modules that will ensure that the resident covers all the learning objectives
of the restorative specialties. A well-planned curriculum will ultimately
result in a good learning experience for the residents, where the relationship
between modules and learning activities makes sense and the modules can
build upon one another along the learning continuum. These modules are
classified according to the subject theme as:

• Module 1: Basic science

• Module 2: Case Assessment and Treatment Planning

• Module 3: Applied Dental Biomaterial

• Module 4: Cariology

• Module 5: Operative Dentistry

• Module 6: Esthetics

• Module 7: Digital Restorative Dentistry

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• Module 8: Fixed Prosthodontics

• Module 9: Occlusion

• Module 10: Dental Implants

• Module 11: Restorative-Periodontics Interrelationship

• Module 12: Scientific Research

Milestones and continuum of learning

Milestones are a new feature of CanMEDS 2015 (part of the CBD project) and
reflect the abilities expected of a health professional at a certain stage of
expertise. These milestones represent a continuum of learning and training.
This continuum focuses on residency and continuing professional
development after graduation. The CBD continuum approach breaks down
specialist education into a series of integrated stages (see diagram), whereby
residents in the program develop competencies at different stages during
their residency and throughout practice. These stages are:

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Transition to discipline stage: This is a new preparatory stage emphasizing
the clinical knowledge and skills of the resident before entering the clinic.

Foundation of discipline: This stage covers scientific research and basic core
science before moving on to more advanced discipline-specific
competencies.

Core of discipline: This is the main stage, in which the resident covers the
core competencies that make up the majority of the discipline. This starts
with the basic specialty and progresses to become more advanced and
complex during the transition from junior to senior residency.

Continuing professional development: After graduation, dentists progress in

competence to attain expertise during continuing professional development
(learning in practice).

Clinically, residents in the training program will be exposed to different cases

from different training centers. Therefore, their responsibility in the clinic
will increase and progress across the duration of the training period, starting
with clinical examination and making the correct diagnosis through to
devising a treatment plan and appropriate management. Junior residents
have the responsibility of examination, collecting full patient records and
data, making the right diagnosis, and writing a treatment plan. Moreover,
junior residents perform dental procedures in the clinic and provide high-
quality treatment for their patients. The earlier procedures are performed
under the supervision of an assigned specialist and consultant. Senior
residents have greater responsibility for the management of advanced cases,
in addition to teaching junior residents under minimum supervision by a
specialist and consultant. The following table shows the expected continuum
of learning that should be achieved in each level of progression:

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Procedures Junior level Senior level Consultant

Medical expert: Residents show Residents show Dentists in this stage

Comprehensive limited knowledge, knowledge and maintain achieved
dental treatment skills, and broad experience as competences and continue
includes: competencies. specialists in their professional
 Clinical restorative dentistry. development to attain and
examination Residents work in a update more skills within
 Diagnosis dental clinic with Residents work in their scope of practice.
 Treatment plan close supervision. dental clinics without
 Restorative close supervision.
procedures Their attitude is under
 Recall and follow- development. Residents perform
up. dental procedures as
expected of a specialist
in restorative dentistry.

Their attitude develops

as expected of a
specialist in
restorative dentistry.
Communicator Residents can Residents use Dentists demonstrate
actively listen and appropriate non-verbal advanced non-verbal
respond to a patient behaviors to enhance communication skills in
inquiry. communication with difficult situations.
patients.
Residents use Dentists teach others how to
appropriate non- Residents provide use non-verbal
verbal body language information on communication to enhance
communication to diagnosis and dentist-patient rapport.
demonstrate prognosis in a clear,
attentiveness, compassionate, Dentists are role models for
interest, and respectful, and their colleagues.
responsiveness to objective manner.
patients and their
families. Residents facilitate
discussions with
patients and their

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Procedures Junior level Senior level Consultant

families in a respectful
and safe environment.

Collaborator Residents respect the Residents work Dentists contribute to policy

established rules of effectively with discussions related to
their team. dentists and other collaborative care.
colleagues in the
Residents receive and health care Dentists teach, assess, and
appropriately respond professions. utilize a model of
to input from other collaborative care.
health care Residents establish
professionals. and maintain positive Dentists use e-Health tools
and healthy to enhance collaboration in
Residents relationships with health care.
differentiate between dentists and other
task and relationship colleagues in the
issues among health care
health care professions.
professionals.
Leader Residents describe Residents analyze Dentists contribute to the
the process for adverse events and improvement of health care
reporting adverse medical errors to delivery in teams,
events and medical enhance systems of organizations, and systems
errors. care.
Dentists design processes
Residents determine Residents develop that balance standardization
cost discrepancies plans to change areas and variability to reduce
between best practice of wasteful practice medical errors and ensure
and their current within their discipline. patient safety in the delivery
practice. of health care.
Residents evaluate a
problem, set Dentists provide mentorship
priorities, execute and guidance to help others
the plan, and analyze develop leadership and
the results. motivational skills.

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Procedures Junior level Senior level Consultant

Health advocate Residents respond to Residents apply the Dentists collaborate with
an individual patient’s principles of behavior organizations and
health needs by modification during surveillance programs to
advocating for the conversations with identify needs at the
patient within and patients to improve oral population level.
beyond the dental health.
clinical environment. Dentists plan or lead the
Residents participate implementation of a program
Residents analyze a in a process to to improve the oral health of
given patient’s needs improve oral health in the community.
for health services or the community.
resources related to
the scope of their
discipline.

Residents select
appropriate patient
education resources
related to their
discipline.
Professional Residents manage Residents demonstrate Dentists exhibit appropriate
tensions between a commitment to professional behaviors.
societal and dentists’ patients by applying
expectations. best practices and Dentists exhibit honesty,
adhering to high ethical integrity, dedication,
Residents standards. compassion, respect, and
demonstrate an ability altruism.
to regulate tension, Residents demonstrate
emotions, thoughts, a commitment to Dentists serve as role
and behaviors while patients by applying models and teach
maintaining their best practices and professionalism to learners
capacity to perform adhering to high ethical and colleagues.
professional tasks. standards.

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TEACHING AND ACADEMIC
ACTIVITIES
General Principles
Teaching and learning are based on strategies that encourage self-directed
learning, development of a high level of intellectual ability, and integration of
knowledge and skills. Multiple and effective instructional methods will be
offered to help residents achieve their learning objectives in most areas.

Every week, at least 6 hours of formal teaching time should be reserved.

Formal teaching time is planned in advance with an assigned tutor, time slots,
and a venue. Formal teaching time excludes clinical training.

The core educational program includes the following formal teaching and
learning activities:

1. Universal topics
2. Core specialty topics
3. Basic science course
4. Preclinical course (basic specialty topics and practical training)
5. Advanced specialty topics
6. Trainee-selected topics
7. Research and evidence-based topics
8. Educational methods and professional development topics.

The core educational program will be supplemented by other practice-based

and work-based learning such as:

1. Clinic-based learning
2. Comprehensive case presentations
3. Treatment plan sessions/case-based learning

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4. Literature review or Journal Club
5. Self-direct learning
6. Community services
7. Elective modules (special interest module)
8. Supplementary courses and workshops.

Every 4 weeks, at least one hour should be assigned to activities such as

meeting with mentors (refer to mentor guidelines), review of portfolio, or
mini-clinical evaluation exercises.

Core Educational Program

Universal Topics

Introduction and rationale

Universal topics are high-value, interdisciplinary topics of the utmost

importance to the trainee. The reason for delivering the topics centrally is to
ensure that each trainee receives high-quality teaching and develops
essential core knowledge. These topics are common to all dental specialties.

Description

Topics included here must meet one or more of the following criteria:

 Impactful: topics that are common or life-threatening

 Interdisciplinary: topics that are difficult to teach in a single discipline
 Orphan: topics that are poorly represented in the undergraduate
curriculum
 Practical: topics that trainees will encounter in clinical practice.

These topics will be developed and delivered centrally by the commission

through an e-learning platform. A set of preliminary learning outcomes for
each topic will be developed. Content experts, in collaboration with the
central team, may modify the learning outcomes. These topics will be didactic
in nature and will focus on practical aspects of care. These topics have more
content than a workshop and other planned face-to-face interactive sessions.
The suggested duration of each topic is one and a half hour.

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Teaching methods

E- learning

Assessment

 Online formative assessment at the end of each learning unit.

 Combined summative assessment in the form of context-rich MCQ
after completioxn of all topics.
 Alternatively, these topics can be assessed in a summative manner
along with specialty examination

Module Universal topic

Hospital acquired infections

R1
Occupation hazards for health care workers
Safe drug prescribing
R2
Recognition and management of diabetic emergencies
Antibiotics Stewardship Abbreviations
R3 Prescribing drugs in the elderly
Side effects of Chemotherapy and Radiation Therapy

Core Specialty Topics

Preclinical Course

Introduction and rationale

This course is one of the basic preparatory components of the SBRD

curriculum. The main focus is on developing the residents’ skills and
knowledge of the basic principles they need to be proficient in caring for
patients in the field of restorative dentistry. The basic knowledge and
psychomotor skills gained in this course will also provide residents with
increased ability and confidence to acquire additional advanced knowledge
and technical skills in the different disciplines of restorative dentistry. The
course also includes courses in basic science, advanced didactic courses in
basic biomedical and biodental science, and are designed to cover more in-
depth topics that were taught during undergraduate education. This will

135
provide residents with the level of knowledge of the basic sciences required
to ensure that they are competent in their dental specialty.

General objectives

This course is expected:

1. To provide residents with advanced knowledge regarding head and neck

anatomy including the structure and blood supply of the head and neck,
tongue, oropharynx, teeth, masticatory muscles, and the TMJ.
2. To provide residents with advanced knowledge of oral biology, especially
the microstructure and biology of the oral tissues.
3. To provide residents with education in oral radiology including radiation
physics, radiation biology, hazards and protection, advanced imaging
techniques, and diagnostic oral radiology.
4. To enhance residents knowledge of pharmacological agents, especially
those commonly used in treating oral and systemic diseases. Residents
must gain experience in prescribing medication for patients under their
care and must be fully knowledgeable of the indications,
contraindications, and potential adverse reactions of all medications
used.
5. To revise knowledge related to oral pathology including the differential
diagnoses of common oral lesions as well as early screening and
diagnoses of oral cancers.
6. To provide residents with the knowledge related to biomaterials
including materials science and basic physical, mechanical, and chemical
properties of materials utilized in various applications in the oral cavity.
7. Revise the basic principles and current concepts in restorative dentistry.
8. To allow residents to develop a basic knowledge about the principles,
technical steps, indications, and contraindications of the different
procedures and the materials involved in the operative, fixed
prosthodontics, and esthetics disciplines.
9. To allow residents to gain knowledge about dental morphology and
occlusion.
10. Explain and apply the appropriate sequence of clinical investigations.

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11. To teach residents how to use the necessary investigations required to
make a clinical diagnosis and develop a suitable treatment strategy.
12. Explain the basic principles of dynamic diagnosis and management of
caries.
13. To teach residents to recognize the basic periodontal concepts, diseases,
and procedures determining the success of restorative dental practice.
14. To allow residents to identify the main concepts of esthetics and color in
dentistry.
15. To allow residents to identify all the types of dental materials used in
laboratory procedures.
16. To teach residents to explain the main laboratory procedures, be able to
communicate effectively with laboratory technicians, and give correct
instructions to the laboratory during future clinical work.
17. To allow residents to understand the terminology, types, procedures, and
steps involved in making dental implants.
18. Maximize residents’ psychomotor skills in the different operative and
fixed prosthodontics procedures and have residents be ready to
implement them clinically.
19. To teach residents to demonstrate appropriate time management during
laboratory work.
20. To teach residents to demonstrate appropriate patient record-keeping
before commencing clinical procedures.
21. To train residents to recognize personal mistakes and how to avoid and
correct them.
22. To teach residents to communicate professionally with supervisors,
colleagues, and other laboratory staff.
23. To teach residents to be able to correlate the physical, chemical, and
biological properties of restorative materials with teeth and surrounding
soft tissues with regards to different procedures.

Course description

This course is delivered to residents over 7 weeks at the start of the residency
year. It is composed of two integrated sections. The first section introduces
residents to basic knowledge in the different restorative disciplines by

137
covering the basic specialty topics. The content of this section will be
delivered in the form of lectures, resident presentations, and group
discussions. The second section focuses on developing the psychomotor
skills required by residents during their clinical work, in addition to practicing
some diagnostic and laboratory procedures. It is designed to provide hands-
on training in the clinical and laboratory procedures essential for the SBRD
program.

This will be in the form of assigned exercises representing the different

operative and fixed prosthodontic procedures and materials. Reading
assignments will be required of the residents before the session, and
supplementary short lectures or discussions will precede the laboratory
work.

Educational strategy and teaching methods

The preclinical course is based on teaching strategies that encourage

interactive, student-centered approaches, teamwork, and self-directed
learning. The hands-on training sessions will apply the principles of
psychomotor teaching to ensure development of the three phases of
psychomotor skill, i.e., cognitive, developmental, and automated. Various
instructional techniques will be used including:

 Interactive lectures.
 Resident activities (presentations, assignments)
 Group discussions.
 Demonstrations using different aids.
 Close laboratory supervision.
 Training during free time.

Assessment

At the end of this course, all residents will have the Preclinical Course Test
(PCCT) which will cover all lectures with essays, short answers, matching,
and MCQs. The grade of this exam will be 50% of the total grade of this course.
In order to pass the course, the resident must have at least 60 points (out of
100) in the end course exam grade.

138
For both the assignment and the end course exam, the grade will be counted
as a part of R1 academic activities (WSA) by 10% of the equivalent of 2
quizzes. In case the resident fails (with a grade less than 60 points out of 100)
or does not do the final exam, there is no possibility of doing it again. A
remediation plan in the form of a structured oral exam will be planned for the
resident who fails to pass the course within a month after the PCCT. Residents
will not be allowed to start clinical sessions unless the PCCT is passed.

Weekly Scientific Activities

Introduction and rationale

The weekly scientific activity course (delivering the advanced specialty

topics) is a part of the didactic courses required by the SBRD program. The
main focus is on acquiring the advanced knowledge to be integrated with the
clinical skills and attitudes acquired in the clinical training part of this
program and to develop the competencies needed for a successful
professional practice in the field of restorative dentistry.

Educational objectives

 To cover the recommended reading list on advanced topics for each

restorative discipline (operative dentistry, fixed prosthodontics, and
dental implants).
 To help residents acquire experience in researching and critical
analysis of scientific papers.
 To improve the residents’ presentation and discussion skills.
 To prepare for examination.
 To develop independence, self-confidence, and creativity.

Course description

The topics in this course are delivered during the residency program for one
day each week. They provide residents with advanced knowledge about the
different restorative disciplines that challenge the residents depending on
their level of training. It is composed of three parts (weekly scientific activity
wheels). The first part includes the topics that should be covered during R1
residency, the second part includes the topics that should be covered during

139
R2 residency, and the third part includes the topics that should be covered
during R3 residency. The weekly scientific activity day consists of a morning
and an afternoon session. In each session, a different topic will be delivered,
and various educational activities will be undertaken according to the tutor’s
choice. Discussion of the pros and cons, the residents’ activity or interactivity
in lectures, and a literature review will be undertaken during each session.

Teaching strategies and methods

The weekly scientific activity course is based on educational strategies that

encourage interactive, student-centered approaches in an attempt to develop
skills in teamwork, self-directed learning, lifelong learning, and a high level
of intellect. Each tutor will be responsible for selecting and organizing the
educational method that best fits the reviewed topic. These methods can be:

 Student presentations or seminars

 Problem-based learning
 Interactive lectures
 Case-based learning
 Review of the literature (seminars or discussion)
 Guest speakers
 Discussion of pros and cons
 Student assignments
 Cooperative learning (“buzz groups”)
 Workshops

Assessment

 Evaluation of resident’s activities (presentations, literature review,

contribution to discussion)
 Academic Activities (AA) including quizzes.
 Attendance (minimum 85%)

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Research

Introduction and rationale

Research is a systematic process of collecting and analyzing information to

increase understanding of the phenomenon under study (Leedy and Ormond,
2010). In the SBRD program, this process is helpful in generating, integrating,
and applying knowledge gleaned from research in clinical practice.
Conducting scientific research will improve residents’ skills, including their
critical thinking, problem-solving, and decision-making skills. Furthermore,
it creates an innovation-oriented culture and encourages professional
communication skills in residents. Moreover, residents will have the
opportunity to gain more knowledge and experience through a direct
relationship with expert research supervisors.

Course description

This course will provide SBRD residents with the basic skills needed to
approach a scientific research project and complete it successfully.
Moreover, it will provide them with an overview of the application of research
methodology in dentistry. Therefore, this course will cover topics such as:

 The research process

 Study design
 Basics of biostatistics
 Manuscript writing
 Research presentation.

The content of this course will be delivered at the beginning of R1 after the
PCC, utilizing a student-centered concept. Residents will participate in
presenting scientific information by asking, discussing, critiquing, and
justifying scientific issues based on scientific evidence. One specialist
member will attend as a guest to contribute, guide the discussion, and add
valuable comments. A hands-on workshop will be held during this course to
facilitate understanding of the research process.

141
General objectives

1. At the end of the SBRD program, residents will be able to:

2. Identify the basics of scientific research.
3. Explain the meaning of evidence-based dentistry.
4. Use different information sources (PubMed, journals, textbooks,
websites, library…?).
5. Recognize literature that has relevance to the clinical practice.
6. Recognize the ethical principles of scientific research.
7. Explain the study design.
8. Conduct scientific research (e.g. Proposal defense, research
presentations, and poster presentations).
9. Recognize the basics of biostatistics.
10. Present scientific research, topics, and articles with good verbal
communication.
11. Write scientific research manuscripts, which will improve scientific
writing skills.
12. Explain the process of publication.
13. Critically appraise published articles.

Attendance

The total course duration is 6 days (12 sessions). Module attendance is

mandatory with 85% of the total sessions (10 sessions) and this will account
for 5% of the total attendance of weekly scientific activities (WSA) of R1.

Assignment

Residents in groups will submit an assignment after the majority of the

lectures and peer review assessments will be done, and residents will
receive feedback. The grade of this assignment is 50% of the total grade of
this course. In order to pass the course, the resident must have at least 60
points (out of 100) in the assignment grade.

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Scholarly Activities

To encourage residents to perform a scholarly task, a bonus grade will be

given from the weekly scientific activity’s quizzes of R3 as follows: 10% bonus
for poster presentation at a local or national conference, including Resident's
Day. Also, an additional 5% bonus is given if the poster is presented at
international conferences. In case of publication in Scopus or Web of Science-
indexed journals, the bonus will be 25% as total for this academic activity.

Literature Review Sessions

Classical and current dental literature on different topics in restorative

dentistry will be prepared and discussed in the form of a seminar by
residents in the presence of training staff. Residents will be evaluated by the
tutor at the end of the session.

Self-Directed Learning

Self-directed learning (SDL) is an educational experience that is planned and

organized by the resident with or without the help of others. It is used to
augment learning in a particular area or to meet a learning objective.

Educational Methods and Professional Development Topics

Introduction and rationale

The SBRD curriculum has adopted a clear mission and vision that supports
excellence in medical education and employs new educational strategies and
instructional methods. This necessitates the appropriate development of
both SBRD program faculty and residents for better understanding and
applying of the adopted concepts, principles, and required skills of learning,
teaching, managing, communicating, and professional development.

Course description

This course will introduce SBRD residents to the new approaches and
concepts in dental education and provide them with the skills in teaching,
learning, communication, leadership, teamwork, and self-directed learning
needed during their training years and for their future professional education

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and development. The content of this course will be delivered in the form of
lectures and workshops during the first and second years of residency.

Teaching strategies and methods

The medical educational methods and professional development courses are

based on educational strategies that will emphasize interactive student-
centered approaches to encourage self-directed learning, lifelong learning,
problem-solving, and a high level of intellect. Many teaching methods will be
used including:

 Interactive lectures
 Workshops
 Guest speakers
 Resident activities and assignments

Evaluation

 The evaluation will be based on:

 An end of cycle evaluation form
 Attendance and contribution

Practice- and Work-Based Learning

Clinic-Based Learning – General Policies

In the context of providing comprehensive restorative dental care, the

program includes advanced clinical training in operative dentistry, fixed
prosthodontics, and implantology, with an emphasis on diagnostic science
and soft tissue management. There will be a sufficient number and variety of
cases in all three disciplines to ensure an appropriate training ground for
each resident. Residents will be assigned patients who present increasingly
difficult problems and will be given increasingly greater clinical
responsibility as they progress in their advanced training. The resident is
expected to upgrade and increase his/her knowledge, skills, and abilities in
the management of a wide range of complex dental problems and acquire a
specialist’s perspective. Assessment methods used include CBD, multi-

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source feedback or 360, DOPS, a mini clinical evaluation exercise, and a
clinical supervisor’s report. Additional policies include:

1. All assigned comprehensive clinical cases should fulfill the SBRD

Restorative Dentistry Index of Treatment Need – RDITN.
2. All assigned comprehensive clinical cases should involve skills from the
three treatment modalities: Operative Dentistry and Fixed Prosthodontics.
3. Full documentation of each case pre-operatively, including accurate
medical and dental records, during the course of treatment, post-
operatively, with clinical slides, mounted diagnostic casts, and full-mouth
radiographs or Panoramic Radiographs. (follow SBRD treatment plan
protocol in regard to documentation)
4. A definitive treatment plan must be approved by the consultant-in-charge
and a copy must be documented inside the file of the patient.
5. Each patient must sign a consent form prior to initiating treatment, with
approval of the treatment plan (Appendix 3).
6. Residents should only consult assigned SBRD instructors or assigned
consultants in other specialties (according to the consultation schedule)
in the specified centers.
7. It is mandatory to abide by the training center clinical schedule (at least
six sessions per resident).
8. Residents are required to treat at least four patients daily (two patients
per session).
9. The resident must present his/her clinical cases during the monthly case
presentations and treatment planning session in the training center in the
presence of the consultants and other residents (the schedule will be
provided by the training center)
10. Residents must have his/her personal intra-oral camera to take the
appropriate clinical image documentation needed for the program.
11. The resident must complete the minimum number of Comprehensive and
Esthetic Cases to be eligible for promotion and completion of the program.
12. Residents should complete the required number of single requirements
per year to be eligible for promotion and completion of program.

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13. To be eligible for graduation, all residents are required to complete the
minimal number of Comprehensive and Esthetic Cases with the following
RDITN complexity.
14. Cases treated in SBRD clinics should follow the allotted protocol, phases
I–VI.
15. Trainees should fill out SBRD forms for each comprehensive case.
16. Only assigned SBRD instructors with a specified code are permitted to
participate in clinical training, evaluation, and signing the Saudi Board in
Restorative Dentistry Digital Clinical Evaluation System following all
dental procedures.

Clinic-Based Learning – Comprehensive Esthetic Cases (CECs)

Residents are expected to complete a set number of comprehensive esthetic

cases (CECs) throughout the three training years of the program in order to
practice specialty-specific competencies and provide high standards of
comprehensive care augmented by evidence-based diagnosis and
management. Breakdown of numbers and complexity of the cases are
included below.

The minimum criteria for Comprehensive Esthetic Cases (CECs) include the
presence of three primary domains; (the 7-3-1 criteria for short):

1. Minimally-invasive management of carious teeth according to the Caries

Management by Risk Assessment (CAMBRA) model. This should include a
minimum of 7 carious teeth with lesions of scores 1 through 6 according
to the International Caries Detection and Assessment System (ICDAS).
2. Conservative management utilizing indirect restorations. This should
include a minimum of 3 abutment teeth restored with inlays, onlays, or
crowns.
3. Esthetic procedures including a minimum of one of the following Esthetic
Techniques (ETs):
a. Esthetic composite layering of an anterior tooth.
b. Direct composite veneer of an anterior tooth.
c. Diastema closure using direct composite technique (a minimum of 2
adjoining teeth).

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d. Direct cuspal buildup on a posterior tooth (3 surfaces or more
excluding mesio-occluso-distal, MOD, restorations).
e. Porcelain laminate veneers (a minimum of 4 anterior teeth).
f. Anterior implant.

The total number of required CECs for the program is 15 completed cases
(complexity: 7 simple, 5 moderate, and 3 complex cases). Among these 15
cases, the resident must submit at least one case containing each of the
above-mentioned six ETs. In addition, each resident must submit a minimum
of 10 ETs with complete records of all the steps (including pre- and post-
operative photographs, wax-up/mock-up, cavity preparation, and restorative
steps). The minimum number of required ETs is as follows:

» 2 cases: Esthetic composite layering of an anterior tooth.

» 2 cases: Direct composite veneer of an anterior tooth.
» 1 case: Diastema closure using direct composite technique (a minimum of
2 adjoining teeth).
» 2 cases: Direct cuspal buildup on a posterior tooth (3 surfaces or more
excluding mesio-occluso-distal, MOD, restorations).
» 2 cases: Porcelain laminate veneers (a minimum of 4 anterior teeth).
» 1 case: Anterior implant.

Comprehensive Esthetic Cases (CECs)

Level A1 A2 A3

Simple 7 5 3

Moderate 5 3 2

Complex 3 2 1

TOTAL 15 10 6

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Clinic-Based Learning – Cases Complexity Determination
Comprehensive esthetic cases can be categorized into three levels: simple,
moderate, and complex. After the case accepted based on the eligibility
criteria, determining the complexity level of a case depends on many factors
including the number of abutment teeth requiring indirect restorations and
the presence of conditions which complicate the management of the case.
The latter conditions are called complexity modifiers which necessitate
either a multidisciplinary approach, dealing with a difficult case, or the
utilization of additional procedures. In order to determine the case
complexity, the following steps can be followed:

1. Ensure the (7-3-1) case eligibility criteria are met.

2. Perform initial complexity assessment. This is based on the total number
of abutment teeth requiring indirect restorations (inaly, onlay, or crown).
3. Assess the case for additional complexity modifiers. The final complexity
level will be affected by the presence of the following case complexity
modifiers (multiple scenarios form the same category will be counted as
one):
a. Interceptive orthodontics.
b. Esthetic soft tissue management (e.g. osseous crown lengthening or
lip repositioning).
c. Two dental implants.
d. Increasing the vertical dimension of occlusion (VDO).
e. An increase of 5 indirect restorations (inaly, onlay, crown, or veneer).
f. The presence of handling difficulty (e.g. severe limitation of mouth
opening, debilitated patient, or medically-compromised patient).

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4. Final complexity level of the case is determined. Please refer to the follow
chart and the table below.

Comprehensive Esthetic Cases (CECs) Complexity

(after 7-3-1 case eligibility criteria are met)

3 – 5 abutment teeth requiring indirect restoration plus 0 – 1 additional complexity

Simple
modifiers
3 – 5 abutment teeth requiring indirect restoration plus 2 – 3 additional complexity
modifiers
Moderate
6 – 9 abutment teeth requiring indirect restoration plus 0 – 1 additional complexity
modifiers
3 – 5 abutment teeth requiring indirect restoration plus ≥ 4 additional complexity
modifiers
6 – 9 abutment teeth requiring indirect restoration plus ≥ 2 additional complexity
Complex
modifiers

≥ 10 abutment teeth requiring indirect restoration

Clinic-Based Learning – Single Requirements

Additional procedures involving the specialties of the program must be done

according to the annual accomplishment guide (refer to Appendix II).

Case-Based Discussion

R2 and R3 residents should present a comprehensive case managed in their

clinic once a year (CBD). Attendance and contributions from the other
residents to the discussion are mandatory. Each resident will be assessed by
at least three consultants who will complete a special assessment form. R1
residents will present a clinical comprehensive case focusing on case
documentation, diagnosis, and treatment planning.

Treatment Planning Sessions

All treatment plans for comprehensive and special cases should be

presented and discussed locally in the training center and in the presence of
the clinical supervisors and other residents. Case discussion sessions will be
held weekly for the discussion of diagnostic problems, treatment planning,
case presentation, review, and follow-up. As an alternative teaching method,
case-based teaching sessions can be conducted.

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Community Service

Residents have the opportunity to learn by community service in groups. The

most important aspect of this service is helping patients to improve their oral
health. The aim of these activities is to assist residents in identifying and
meeting dental health and social needs in the community. This service can be
done in several ways: volunteering at hospitals or nursing homes, providing
dental health education programs in schools, or participating in programs
run by dental or medical societies.

Elective (special interest) Courses

Towards the end of the training in the program and once the majority of
learning objectives are achieved, senior SBRD residents may choose to
undertake special interest modules, with the approval of the Sector’s Shared
Training Committee and SBRD Scientific Committee. These elective modules
can include an attachment to an overseas institution recognized within the
specialty, as providing superior additional experience within the sphere of
interest of the trainee and a national attachment to an institution recognized
within the specialty, as providing superior additional experience within the
sphere of interest of the trainee.

Supplementary Courses and Workshops

Frequent seminars, workshops, and demonstrations of dental procedures

will be conducted throughout the program. This includes hands-on training in
new dental materials, new dental technology, and modern clinical
procedures, and improving clinical skills.

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ASSESSMENTS
The SBRD program includes two distinct assessment components: Program-
specific continuous assessment supervised by the scientific counsel and
SBRD certification examinations overseen by SCFHS.

Program-Specific Continuous Assessments

Program-specific continuous assessments include a group of assessments
that are directed towards measuring residents’ competencies in three
distinct domains: knowledge, skill, and behavior.

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Program-specific continuous assessments
Level
Assessment Format
R1 R2 R3

I. Knowledge

1. End of Year Progress Test (EYPT)   - MCQs

2. Structured Oral Examination (SOE)   - Oral

3. Case-Based Discussion (CBD)    Oral

  
4. Academic Activity (AA) MCQs
(9) (6) (5)

II. Skill

1. Logbook (LB)    -

2. Observable Procedures (OP) -   DOPS

III. Behavior

1. In-training Evaluation Reports (ITER)    Mini-CEX

Knowledge Domain
End of Year Progress Test

The End of Year Progress Test (EYPT) is a written examination at the end of
each training year (for R1 and R2 only) to ensure that the resident has a
competent level of knowledge for the various topics and concepts provided
throughout the training year via the different teaching and training activities.
The blueprint of EYPT is determined based on topics provided during WSA but
can contain additional topics offered via other learning modalities.

Structured Oral Examination

Structured oral examination (SOE) is used mainly to test the cognitive domain
and is conducted with the aim of evaluating the qualities like depth of
knowledge, ability to discuss and defend one’s decisions, attitudes, alertness,
ability to perform under stress, and professional competence. Residency
level involved: R1 and R2 only.

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Method:

 Based on the various topics as per the curriculum prescribed,

questions should be framed under different topics following the
required domains.
 Based on residency level, the questions should be designed and
developed with graded levels of difficulty and different topics of the
examination. Topics need to be categorized as major and minor based
on importance.
 The questions should be subjected to peer review and finalized with
the approval of the head of the Structured Oral Exam Committee
(SOEC).
 Cards are designed with approved questions written on them.
 At the exam, 10 sets of cards should be prepared and laid out on the
table. Each set has two subsets a) direct questions b) applied
questions. In case the student fails to answer any question totally,
he/she will be allowed one to two attempts to select other cards. Each
resident has to successfully answer 2 out of 3 cards chosen. Each card
contains at least 2 questions (for R1, mainly knowledge, and for R2,
knowledge and cognition questions).
 Examiners will use the SOE assessment form to evaluate residents.
 The exam should be held at the end of all scientific activities.
 Residents must pass the exam to be promoted.
 Three examiners will be involved in the exam and they will be selected
by the regional training committee. Program directors should not
evaluate their residents.
 Residents should receive feedback regarding their performance.
 Residents will be considered clear fail when at least two examiners
grade the residents below 60%

Case-Based Discussion

The resident discusses his or her cases with evaluators in a standardized and
structured oral examination. The purpose is to evaluate the resident’s clinical
decision-making and diagnosis, reasoning, treatment plan phases, and how

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they support their management with evidence. The evaluators question the
resident about the care provided in predefined areas– problem definition (i.e.,
diagnosis), clinical thinking (interpretation of findings), management and
maintenance care (treatment and post-op care plans). Evaluation of the case-
based discussion (CBD) abides by the following considerations:

 CBD assessment forms should be used for evaluation of

comprehensive cases only.
 Depending on the level, the assessment for CBD would be different
(see CBD form).
 Residents must pass the exam (>60%) to be promoted.
 Three examiners will be involved in the CBD session and they will be
selected by the regional training committee. Program directors should
not evaluate their residents.
 Residents should receive feedback regarding their performance.
 Residents will be considered clear fail when at least two examiners
grade the residents below 60%.

Academic Activities

The term Academic Activities (AA) can be used interchangeably with quizzes
provided throughout the training year. The number of AA in each training year
is as follows:

 R1: 9 AA (7 quizzes and 2 quizzes counted for PCCT including the

research module assessment).
 R2: 6 quizzes
 R3: 5 quizzes (scholarly research activity bonus is populated in R3’s
AA).

Skills Domain

Logbook

Recording of all cases and single requirements that the resident

accomplishes throughout the training period of the program must be done in
the logbook (LB) based on the Annual Logbook accomplishment Guide (see
appendix). This portfolio must be submitted at the end of each training year

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and will be reviewed and evaluated by the cases reviewing committee. The
logbook is allocated 3,600 points throughout the course of the program with
a breakdown of 900 points for R1; 1,250 points for R2; and 1,450 points for
R3. The LB contains three sections: 1. Single requirements and 2.
Comprehensive esthetic cases (CECs). These sections account for 28, and
72% of the LB grade, respectively. This breakdown is applicable both at the
level of each training year as well as the level of the whole training period of
the program.

1. Single requirements:

Single requirements account for 28% of the total LB grade (300 points for R1
and 350 points for R2 and R3 or 1,000 points throughout the period of the
program). These grades will be distributed over 5 items from the annual
accomplishment guide:

 Operative (400 total points): minimally-invasive procedures as well as

direct restorations, inlays and onlays (1 point per procedure).
 Prosthodontics (300 total points): post/core, crown, non-surgical
management of temporomandibular dysfunction, and implants
procedures (2 points per procedure).
 Esthetics (100 total points): bleaching, diastema closures, and veneers (1
point per procedure).
 Diagnosis and treatment planning (150 total points): Diagnosis and
treatment planning procedures from all disciplines (2 points per
procedure).
 Recall (50 total points): recall procedures at 6 and 12 months post-
treatment (5 points per procedure).

2. Comprehensive esthetic cases:

CECs account for 72% of the total LB grade (600 points for R1; 900 points for
R2; and 1,100 points for R3 or 2,600 points throughout the period of the
program). These points will be distributed over the 15 CECs following the
annual accomplishment guide with simple cases accounting for 100 points
each, moderate cases accounting for 200 points each, and complex cases
accounting for 300 points each.

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Logbook passing criteria

In order for the resident to achieve a passing score for LB for each year, three
conditions must be fulfilled based on each training year (see table below).
Failure of achieving any of these conditions will be considered as an
unacceptable skill performance and the resident must repeat the
corresponding training year:

 For R1:
o Cut-off score (60%) for the overall LB points must be reached (540
points out of 900).
o Cut-off score (60%) for CECs points must be reached (360 points out of
600).
o Cut-off score (60%) for each of the 5 subcomponents (except for recall)
in single requirements must be reached:
 Operative: 78 points out of 130.
 Prosthodontics: 60 points out of 100.
 Esthetics: 18 points out of 30.
 Diagnosis and treatment planning: 24 points out of 40.
 Recall: 0 points.
 For R2:
o Cut-off score (80%) for the cumulative overall LB points must be
reached (1,720 points out of 2,150 points).
o Cut-off score (80%) for cumulative CECs points must be reached (1,200
points out of 1,500).
o Cut-off score (80%) for cumulative points of each of the 5
subcomponents in single requirements must be reached:
 Operative: 216 points out of 270.
 Prosthodontics: 160 points out of 200.
 Esthetics: 56 points out of 70.
 Diagnosis and treatment planning: 72 points out of 90.
 Recall: 16 points out of 20.
 For R3:
o Overall LB points must be reached (3,600 points out of 3,600).

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o All CECs must be completed (2,600 points out of 2,600 accounting for
15 cumulative cases).
o Complete fulfillment (100%) of each of the 5 subcomponents in single
requirements must be reached:
 Operative: 400 points.
 Prosthodontics: 300 points.
 Esthetics: 100 points.
 Diagnosis and treatment planning: 150 points.
 Recall: 50 points.

Logbook Passing Criteria by training year

R1 R2 R3

Cut-off for points 60% 80% 100%

Overall LB points 540 / 900 pt. 1,720 / 2,150 pt. 3,600 / 3,600 pt.

Comprehensive esthetic cases (CECs) 360 / 600 pt. 1,200 / 1,500 pt. 2,600 / 2,600 pt.

Operative
78 / 130 pt. 216 / 270 pt. 400 / 400 pt.
(1 pt. / procedure)
Prosthodontics
60 / 100 pt. 160 / 200 pt. 300 / 300 pt.
(2 pt. / procedure)
Esthetics
Single 18 / 30 pt. 56 / 70 pt. 100 / 100 pt.
(1 pt. / procedure)
requirements
Diagnosis &
treatment planning 24 / 40 pt. 72 / 90 pt. 150 / 150 pt.
(2 pt. / procedure)
Recall
- 16 / 20 pt. 50 / 50 pt.
(5 pt. / procedure)

Logbook grading for promotion criteria

The LB grading in order to determine the passing/failure status of the

resident according to the SCFHS criteria (clear pass, borderline pass,
borderline fail, or clear fail) will be calculated after ensuring the passing
criteria mentioned above (section Logbook passing criteria) are met. After
that, the total LB points (points from single requirements and CECs) earned
by the resident will be used to calculate a percentage which will be compared
to the points allocated for the specific training year (900; 1,250; and 3,600

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points for R1; R2; and R3 respectively. This resulting percentage figure will
be compared to the cut-off scores verified by the SCFHS to determine the
passing status for the LB assessment. For example, if an R1 resident fulfilled
the passing criteria mentioned above by obtaining 400 points in CECs and 210
points in single requirements (90 in operative, 70 in prosthodontics, 20 in
esthetics, and 30 in diagnosis and treatment planning) this means the
resident obtained 610 overall points out of the 900 allocated to R1. Thus, the
resident’s percentage will be (610 × 100) / 900 = 67.78% which falls in the
“Borderline pass” category.

Logbook Single Requirements by Section

Total
Total
number of Point per
Section Procedures types & quantities points for
procedures procedure
section
in section
Treatment plan (15)
Diagnosis and Diet analysis 15) 75 150 pts.
Treatment Caries diagnosis & control (15) procedures 2 pts. (10 pts. /
planning Caries risk assessment (15) (15 cases) case)
Smile analysis (15)
Micro- / Macroabrasion (20)
Enameloplasty / Reshaping (10)
Pit and fissure sealant (35)
Resin-modified glass ionomer (15)
400
Operative Preventive resin restoration (40) 1 pts. 400 pts.
procedures
Amalgam restoration (15)
Anterior composite restoration (110)
Posterior composite restoration (110)
Inlay / Onlay (45)
Post & core (50)
Crown (75) 150
Prosthodontics 2 pts. 300 pts.
Non-surgical management of TMD (10) procedures
Implant fixture (15)
In-office bleaching (10)
At-home bleaching (10) 100
Esthetics 1 pts. 100 pts.
Non-vital bleaching (5) procedures
Anterior diastema closure (pair) (5)

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Logbook Single Requirements by Section

Total
Total
number of Point per
Section Procedures types & quantities points for
procedures procedure
section
in section
Direct composite veneer (20)
Indirect porcelain laminate veneer (50)
10 50 pts.
6 months follow-up (5)
Recall procedures 5 pts. (10 pts. /
1 year follow-up (5)
(5 cases) case)
735
TOTAL - - 1,000 pts.
procedures

Observable Procedures

The primary objective of the Observable Procedures (OP) assessment is to

judge the competency of the resident in performing commonly faced
procedures of the discipline in a standardized manner. It is a method in which
the examiner observes the trainee during a routine procedure on a real
patient and in a real situation where feedback on the procedure is given to the
resident. It is designed to measure the whole aspects of procedural skills and

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it is not procedure-specific. OP will be evaluated based on a Direct
Observation of Procedural Skills (DOPS) format. Four clinical procedures
were selected to be accomplished and fulfilled successfully by the resident
during R2 and R3 training levels:

1- Anterior composite restoration using layering technique.

2- Posterior composite build up restoring at least one missing cusp.
3- Ceramic onlay restoration on a vital tooth.
4- Porcelain laminate veneers for 2 adjacent teeth.

The resident must accomplish two successful procedures competently at the

end of the R2 training level in order to be promoted to the next level. These
procedures should be approved, observed, and evaluated using a special
DOPS form (refer to Appendix II) by two examiners, one of them should be the
program director or any supervisor appointed by the program director. In
each clinical procedure, certain steps are considered critical (marked with a
star in the form) and the resident should perform them competently and
independently. If the resident fails to be competent in these steps and/or
receives a score below 60, the whole procedure is considered incomplete and
the resident has to repeat it after receiving the feedback. At the end of the
clinical encounter, the resident has the right to see the evaluation and the
examiner’s feedback.

Behavior Domain
In-Training Evaluation Report

Evaluation of the behavioral soft skills such as communication and

professionalism is done via utilizing in-training evaluation reports (ITER)
following the general scheme of the Mini-Clinical Evaluation Exercise (Mini-
CEX). ITER will be created by the program directors at least three times every
training year.

Promotion Criteria

In order for the resident to be promoted from the training level to the next,
he/she must successfully pass the minimum number of continuous
assessments for a particular year based on the grading scheme of the SCFHS:

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 R1 and R3: Resident must achieve a score of “Borderline Pass” in all
continuous assessments (6 for R1 and 5 for R3). If the resident
achieves a score of “Borderline Fail,” from a maximum of two
assessments (should not be from the same domain), he/she can be
promoted if a score of “Clear Pass” is given in at least two
assessments, while the rest of the assessments are “Borderline Pass”
level, following the rules and regulation of SCFHS.
 R2: Resident must achieve a score of “Borderline Pass” in all
continuous assessments. If the resident achieves a score of
“Borderline Fail,” in a maximum of three assessments (should not be
from the same domain), he/she can be promoted if a score of “Clear
Pass” in at least three assessments is achieved while the rest of the
assessments are in the “Borderline Pass” level, following the rules
and regulation of SCFHS.
 Residents who fail to achieve the minimum promotion requirements
must repeat the training level.

Description Clear Fail Borderline Fail Borderline Pass Clear Pass

Grade out of 100 < 50% 50 – 59.4% 60 – 69.4% ≥ 70%

Saudi Board Certification Examinations

SBRD certification exams include two parts that the resident needs to pass in
order to be certified to practice restorative dentistry as a consultant. Part 1
consists of a written examination that the resident must undertake and pass
at the first or second training year. Part 2 can be taken at the end of the third
training year and consists of written, OSCE, and SOE sections.

Principles of Restorative Dentistry Examination (Saudi Board

Examination: Part I)

Part I Examination of the Saudi Board Certificate shall cover applied basic
health sciences related to the restorative specialty.

Requirements to take the examination are as follows:

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 Completion of at least nine months of training.
 Valid registration in the Saudi Board Restorative programs.

Final Restorative Dentistry Board Examination (Saudi Board

Examination: Part II)

The final examination of Saudi Board Certificates includes the final written
examination and the final clinical examination. The final clinical examination
consists of the following components: Objective Structured Clinical
Examinations (OSCE) and Structured Oral Examinations (SOE).

Objectives:

 Determine the trainee has sufficient competency related to the

required specialty.
 Determine the eligibility for entering the final clinical examination.
 Determine the ability of the trainee to practice the profession
independently and safely.
 Ensure that the trainee has the necessary clinical competencies
relevant to his/her specialty.

Requirements to take the final clinical/practical examination:

 Passing the final written examination of the Saudi Board Certificate.

 The eligibility of the candidate and the number of attempts to take the
final clinical/practical examination shall be determined in accordance
with the assessment conduct regulations.
 The candidate shall not be allowed to take the final clinical/practical
examination once all allowed attempts have been exhausted.

Refer to the regulations of the Saudi Commission for Health Specialties (

https://www.scfhs.org.sa )

Certification of Training Completion

In order to be eligible to sit for the final specialty examinations, each trainee
is required to obtain a “Certification of Training-Completion.” Based on the
training bylaws and executive policy (please refer to www.scfhs.org.sa),

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trainees will be granted a “Certification of Training-Completion” once the
following criteria are fulfilled:

a. Successful completion of all training rotations.

b. Completion of training requirements as outlined by the scientific council
of specialty.
c. Clearance from SCFHS training affairs that ensures compliance with
tuitions payment and completion of universal topics.

The “Certification of Training-Completion” will be issued and approved by the

Shared Training Committee or its equivalent according to SCFHS policies.

REFERENCES
1) Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical
Education: A Six-Step Approach. Baltimore, MD, USA: Johns Hopkins
University Press; 2009.
2) Dent J, Harden RM. A Practical Guide for Medical Teachers. 3rd ed.
Amsterdam, The Netherlands: Elsevier; 2009.
3) Saudi Commission for Health Specialties. Post Graduate Resident
Training Curriculum Template. Riyadh, Saudi Arabia: Saudi Commission
for Health Specialties;
4) CanMEDS [cited March 1, 2015]. Available from:
http://www.royalcollege.ca/portal/page/portal/rc/public.
5) The Draft CanMEDS 2015. Physician Competency Framework Series IV.
Frank JR, Snell L, Sherbino J, editors. Ottawa, Canada: Royal College of
Physicians and Surgeons of Canada; 2015.
6) The Draft CanMEDS 2015. Milestones Guide. Ottawa, Canada: Royal
College of Physicians and Surgeons of Canada; September 2014.
7) Frank JR, Snell L, Sherbino J editors. CanMEDS 2015. Physician
Competency Framework. Ottawa, Canada: Royal College of Physicians
and Surgeons of Canada; October 2015.
8) AMEE Guides 2015 [cited March 4, 2015]. Available from:
https://www.amee.org/publications.

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9) Wallen RJ, Fraenkel NE. How to Design and Evaluate Research in
Education. 6th ed. New York City, NY, USA: McGraw-Hill Education
Companies; 2006.
10) Creswell JW. Educational Research: Planning, Conducting, and
Evaluating Quantitative and Qualitative Research. 4th ed. New York City,
NY, USA: Pearson College Division; 2012.
11) Saudi Commission for Health Specialties. Introduction to Clinical
Research for Residents. Riyadh, Saudi Arabia: Saudi Commission for
Health Specialties; 2014.
12) Saudi Commission for Health Specialties. General Exam Rules and
Regulations. Vol. 14.0. Riyadh, Saudi Arabia: Saudi Commission for
Health Specialties; 2014.
13) Miller GE. The assessment of clinical skills competence performance.
Acad Med. 1990; 65(9):63-7.
14) Saudi Commission for Health Specialties. The Saudi Specialty
Certificate in Restorative Dentistry Program. 2nd ed. Riyadh, Saudi
Arabia: Saudi Commission for Health Specialties; 2008.
15) General Dental Council. Protecting patients, regulating the dental team.
[Cited September 5, 2015]. Available from: www.gdc-uk.org.
16) The Royal College of Surgeons of England. Restorative Dentistry Index
of Treatment Need Complexity Assessment, England: Clinical
Effectiveness Committee, The Royal College of Surgeons of England.
17) American Dental Association. Caries Risk Assessment Form (Age >6).
American Dental Association, editor. Chicago, IL, USA: American Dental
Association; 2011.
18) American Society of Anesthesiologists. ASA Physical Status
Classification System. American Society of Anesthesiologists:
Schaumburg, IL, USA; October 15, 2014.
19) Michelle Hurlbutt and Douglas Young. A Best Practice Approach to
Caries Management. Journal of Evidence-Based Dental Practice. 2014;
1 4S: 77-86
20) Jonathan L. Ferencz & Nelson R.F.A. Silva. “Fundamentals of CAD/CAM
Dentistry” American College of Prosthodontists, 2019. Apple Books.

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https://books.apple.com/us/book/fundamentals-of-cad-cam-
dentistry/id1451346022.
21) Fundamentals of Fixed Prosthodontics, 4th edition, Herbert T.
Shillinburg.
22) Esthetic Rehabilitation In Fixed Prosthodontics: Esthetic Analysis: A
Systematic Approach To Prosthetic Treatment 1st Edition, Mauro
Fradeani.
23) Hani Nassar et al., Dental follow-up and maintenance index: the
development of a novel multidisciplinary protocol, Heliyon. 2020 May
24;6(5):e03954. doi: 10.1016/j.heliyon.2020.e03954.

166
APPENDICES
Appendix I - CanMEDS alignment criteria with
Teaching Activities
Alignment of Preclinical Course Objectives with CanMEDs Roles

Topics Learning objectives (Residents should be able to) CanMEDS roles

Examination and Lectures and presentations  Medical expert

diagnosis 1. List the steps and skills needed to conduct a patient’s  Communicator
interview and for medical and dental history-taking.  Collaborator
- History-taking 2. Explain factors in the dental, medical, and social history  Leader
- Clinical likely to be relevant to the presenting condition and its  Scholar
examination previous management.  Professional
- Radiographic 3. Describe the relevant biology, anatomy, and physiology of
interpretation normal and abnormal intra-oral and extra-oral structures
and tissues.
Development of 4. List the steps for the examination of the patient and their:
treatment - Oral mucosa and related structures
strategies and - Periodontium
plans - Dental hard tissues
and make the appropriate diagnoses.
Writing referrals 5. Discuss the systemic factors likely to have a bearing on
and consultation the above.
letters 6. Identify all types of dental and medical tests and
investigations needed for the diagnosis.
7. Consolidate all data from the history, symptoms,
examination, and tests to form a final diagnosis.
8. Explain the phases and sequences of writing a treatment
strategy in conjunction with the patient and producing a
plan according to their needs and preferences, including
any future need for revision or modification.

167
Topics Learning objectives (Residents should be able to) CanMEDS roles

9. Explain the importance and procedure involved in using

evidence-based dentistry concepts while writing a
treatment plan.
10. Identify emergency conditions that require immediate
treatment.
11. Recognize components of a consultation and referral
letter.

Hands-on and group discussion session

1. Use and interpret correctly all appropriate investigations
(e.g., radiographic, vitality, hematologic and
microbiologic tests, and appropriately articulated study
casts) to diagnose oral problems.
2. Write down the diagnosis for selected clinical cases
(selected clinical photographs and radiographic films).
3. Write a treatment plan for selected cases.
4. Write consultation letters for selected cases.
5. Write referral letters for selected cases.

Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic principles Lectures and presentations  Medical

and procedures for 1. Recognize the scope and importance of fixed expert
FDP prosthodontic treatment.  Collaborator
2. List types of impression material used.  Leader
- Introduction to 3. Explain the principles and techniques used for making an  Scholar
FDP impression.  Professional
- Impression 4. State the types of bite registration material.
materials 5. Describe the methods used for bite registration.
- Casts 6. List all types of materials used in laboratory work.
- Facebows
7. Discuss the importance and uses of diagnostic casts.
- Articulators
8. Explain the laboratory procedures for the
construction of a cast.

168
Topics Learning objectives (Residents should be able to) CanMEDS roles

- Interocclusal 9. Discuss the purpose of using a facebow.

records, bite 10. Classify the articulators used in dentistry.
registration 11. Name the parts of the articulators.
materials, and 12. Describe the procedure for mounting diagnostic
techniques casts.
- Diagnostic Hands-on training session
casts 1. Make maxillary and mandibular impressions for
residents.
2. Take the bite registration using different materials.
3. Use the facebow on residents.
4. Pour upper and lower impressions using dental stone.
5. Check casts for accuracy and trim them.
6. Transfer the relationship of a patient’s maxillary arch
and TMJ to an articulator by using a facebow.
7. Mount diagnostic casts on semi-adjustable
articulators.
8. Adjust the setting of the articulator.

Basic principles and Lectures and presentations  Medical expert

procedures for FDP 1. Explain the main principles of occlusion.  Collaborator
2. Discuss the importance of and procedure used for  Leader
- Principles of occlusal analysis.  Scholar
occlusion 3. Discuss the importance and uses of diagnostic wax-up.  Professional
- Occlusal Hands-on training session
analysis 1. Mount extracted teeth on alginate impressions.
- Diagnostic 2. Pour alginate impressions with extracted teeth.
wax-up 3. Analyze occlusion of the previously mounted casts.
4. Perform diagnostic wax-up. (Laboratory staff will
demonstrate these procedures)
5. Adjust wax-up for selected cases.

169
Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic Lectures and presentations  Medical

principles and 1. Recognize the restorative options following expert
procedures of 2. RCT.  Collaborator
FDP 3. State the factors influencing the choice of technique used in  Leader
- Restoration restoring endodontically treated teeth.  Scholar
of 4. Discuss the types of core materials.  Professional
endodontic 5. Lists the steps and instruments used in the preparation of a
ally treated post space.
teeth 6. Discuss the types of post (advantages, disadvantages, and
- Types of indications).
posts and 7. Describe the common mistakes that can be made during the
cores preparation of a post space.
8. Know the types of cement used with a post.
9. Explain the method used to mix dental cement.
Hands-on training session
1. Perform an initial crown preparation.
2. Build up a core with composite and without apost.
3. Prepare a post space using Pesso reamer drills and a
ParaPost system.
4. Cement different posts with different cements.
5. Build up the core with different restorations.
6. Build up a post and core directly on the tooth using resin
(Duralay or Pattern Resin GC)
7. Make impressions for the post space to construct a cast post
and core indirectly.

170
Topics Learning objectives (Residents should be able to) CanMEDS roles

Cariology I Lectures and presentations  Medical expert

- Dynamics of 1. Explain the dynamics of caries.  Collaborator
dental caries 2. Discuss the concept of balance and imbalance with  Leader
- Diagnosis of regards to dental caries.  Scholar
caries 3. Explain the factors affecting the dental caries process.  Professional
4. Introduce the concepts of critical pH, saturation,
demineralization, and remineralization.
5. Justify the appearance of incipient lesions.
6. Demonstrate the optimum method for the
diagnosis of caries.
7. Describe the different clinical presentations of caries.
8. Explain the principles of the International Caries
Detection and Assessment System.
9. Revise the concepts of sensitivity and specificity.
Hands-on training session
1. Online training on the International Caries Detection
and Assessment System.
Cariology II Lectures and presentations  Medical expert
- Caries risk 1. Explain the role of oral bacteria and biofilm in dental  Collaborator
assessment caries.  Leader
and the 2. Explain the effect of fluoride and the formation of  Scholar
CAMBRA fluorapatite.
 Professional
system, Part 3. Explain the role of diet in the development of caries.
1 4. Explain the role of saliva in dental caries.
- Caries risk 5. Summarize the different salivary tests available.
assessment 6. Contrast the different models used to estimate the risk
and the of caries, e.g., CAMBRA.
CAMBRA 7. Explain the principles of CAMBRA.
system, Part 8. Develop preventive and management strategies
2 based on the risk of caries.
Hands-on training session
1. Perform saliva sampling and analysis.
2. Apply a Cariogram and CAMBRA caries risk models on
clinical case scenarios.

171
Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic principles Lectres and presentations  Medical expert

and procedures of 1. Recognize the importance and scope of operative  Collaborator
operative and restorative dentistry.  Leader
esthetics 2. State the main factors that can affect the choice of  Scholar
- Introduction to material and technique to be used.  Professional
operative and 3. List the types, advantages, indications, and
esthetic dentistry contraindications of amalgam, composite, and
- Factors affecting glass ionomer restorations.
operative 4. Explain the basic principles of amalgam and
treatment plan composite preparations and restorations.
- Amalgam, 5. Describe the process of polymerization for
composite, and composites and methods to reduce polymerization
glass ionomer shrinkage and stress.
restorations 6. Describe the technique of matrix application,
- Instruments used incremental placement, and finishing and
in operative polishing for composite resins.
practice 7. Recognize the types of adhesive systems.
- Dental adhesives Hands-on training session
1. Prepare Class II, Class IV, and Class V composite
resin restorations.
2. Apply matrix band and wedge.
3. Restore cavities with composite restorations.
4. Build up a Class IV composite restoration using the
multi-layering technique.
5. Perform a finishing and polishing procedure for
composite restorations.
Basic principles Lectures and presentation  Medical expert
and procedures in 1. Define esthetics and recognize the basic artistic  Collaborator
operative and elements that need to be considered to ensure  Leader
esthetics optimal esthetic results.  Scholar
- Main principles in 2. State the scientific basis of color.  Professional
esthetic, colors, 3. Explain the steps in the color replication process
and shade (shade selection and duplication).
selection 4. Explain the methods used in the main shade guide
systems.

172
Topics Learning objectives (Residents should be able to) CanMEDS roles

- Conservative 5. Recognize the different types and causes of tooth

treatments for discoloration.
discolored teeth 6. Describe the strategies applied in the
- Inlays and onlays management of discolored teeth (bleaching,
- Esthetic veneers microabrasion, and macroabrasion).
7. Describe the techniques, indications, and
contraindications for the restoration of ceramic
inlays and onlays.
8. Describe the types, techniques, indications, and
contraindications for the preparation and
restoration of esthetic veneers, both direct and
indirect.
9. Describe the techniques used for the fabrication
of provisional restorations.

Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic principles and Hands-on training session  Medical

procedures of FDP 1. Use the different types of shade guide systems. expert
- Basic principles 2. Perform inlay cavity preparation.  Collaborator
of treatment 3. Perform onlay cavity preparation.  Leader
planning for 4. Cement onlay porcelain with resin cement.  Scholar
teeth 5. Prepare a tooth for esthetic veneer utilizing a butt  Professional
- Restorations and joint design.
replacement 6. Prepare a tooth for esthetic veneer utilizing a
- Principles of feathered incisal edge design.
tooth 7. Prepare a tooth for esthetic veneer utilizing a
preparation palatal chamfer design.
- Provisional 8. Fabricate provisional restorations for the
restorations preparation of the veneer.
9. Restore a tooth using a composite esthetic veneer.
10. Cement porcelain veneer with resin cement.

173
Topics Learning objectives (Residents should be able to) CanMEDS roles

Lectures and presentations

1. Acquire basic concepts for diagnosis and
treatment planning to restore and replace teeth
and short edentulous spans.
2. Discuss the main principles of crown and bridge
preparation.
3. List the types of provisional restoration.
4. Describe the techniques for constructing
provisional restorations.
Hands-on training session
1. Perform single crown preparations with different
margin designs (mounted teeth).
2. Perform teeth preparation for FPD (mounted
teeth).
3. Fabricate an appropriate provisional
restoration.

174
Topics Learning objectives (Residents should be able to) CanMEDS roles

Periodontal Lectures and presentations  Medical

consideration 1. Recognize the basic concepts used in periodontics. expert
- Basic concepts in 2. List the parts of the gingiva.  Collaborator
Periodontics 3. Differentiate between normal and diseased gingiva.  Leader
- Components of 4. Identify the main classification of periodontal  Scholar
gingiva diseases.  Professional
- Periodontal 5. List the steps of clinical examination and
disease assessment methods to arrive at a periodontal
classification diagnosis (probing depth, bleeding index, clinical
- Periodontal attachment level, radiographic evidence of bone
examination loss, and the presence or absence of signs and
- Periodontic symptoms in the patient).
indices 6. Explain the meaning and importance of biological
- Biological width width.
- Introduction to 7. Name the main periodontal treatment modalities
management used.
- Introduction to 8. Identify the different periodontal surgical therapies
periodontal and their indications.
surgery 9. Discuss the healing period after surgical crown
lengthening.
Hands-on training session
1. Perform complete periodontal examinations on
residents.
2. Observe surgical crown lengthening and
gingivectomy using an electrosurgery machine
(video).
3. Assess the need for periodontal treatment or
surgery (from selected clinical pictures and
radiographs).

175
Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic principles and Lectures and presentations  Medical

procedures for FDP 1. Discuss indications for tissue management. expert
- Tissue 2. Describe the different methods of gingival tissue  Collaborator
management displacement and hemostasis.  Leader
- Final impression 3. Discuss the requirements of an ideal final  Scholar
making impression.  Professional
- Interocclusal 4. Discuss the requirements of an ideal working cast.
record 5. Describe the different materials and techniques
- Working cast and used for a die system.
die 6. List the steps of the Pindex system and die
- Pindex system preparation.
- Die preparation Hands-on training session
1. Make a standard final impression.
2. Pour final impression.
3. Construct proficient working casts with removable
dies.
4. Perform die trimming and determine the finish line
with a red-blue pencil.

Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic principles and Lectures and presentations  Medical

procedures for FDP 1. Explain the steps of wax pattern fabrication. expert
- Wax patterns 2. Explain the laboratory procedures for the  Collaborator
- Investing, casting, construction of cast restorations.  Leader
and finishing and 3. Identify all types of dental laboratory  Scholar
polishing of cast materials.  Professional
restorations 4. Describe the different types of ceramics used.
- Dental alloy 5. Describe the different types of metal alloy used
- Dental porcelain in a porcelain-fused-to-metal prosthesis.
Hands-on training session
 Attend a demonstration by laboratory
production staff on wax-up, investing, casting,
and finishing and polishing cast restorations.

176
Topics Learning objectives (Residents should be able to) CanMEDS roles

Basic principles and Lectures and presentations  Medical

procedures for FDP 1- Recognize the importance and procedure of expert
- Framework designs framework designs for a metal-ceramic  Collaborator
for metal ceramic restoration.  Leader
restoration 2- State the laboratory steps for fabricating  Scholar
- Metal-ceramic metal-ceramic restorations.  Professional
restorations 3- State the laboratory steps for fabricating all-
- All-ceramic ceramic restorations.
restorations Hands-on training session
- Attend a demonstration by laboratory
production staff.
Basic principles and Lectures and presentations  Medical
procedures for FDP 1. Explain the steps of clinical try-in for crowns. expert
- Metal and porcelain 2. State the advantages, disadvantages, and steps  Collaborator
try-in of stain application.  Leader
- Characterization and 3. List the types of luting agents used for  Scholar
glazing cementation.  Professional
- Cementation 4. Explain the correct technique for cementation.
Hands-on training session
1. Apply the try-in steps for metal and porcelain
crowns (demonstration)
2. Use the staining kit for color modification and
characterization (demonstration)
3. Cement porcelain-fused-to-metal crown with
zinc phosphate (video)
4. Cement all-ceramic crown with resin cement
(video)

177
Topics Learning objectives (Residents should be able to) CanMEDS roles

Lectures and presentations  Medical

1. Describe the history and types of dental implants. expert
2. Identify implant terminology.  Collaborator
3. Explain the process for reaching an appropriate  Leader
treatment plan.  Scholar
4. Describe the components of a dental implant.  Professional
5. Describe the steps for the surgical component of
the implant.
6. Recognize the healing period for the surgical
component.
7. Identify the prosthetic components of the implant.
8. Name the types of implant systems.
9. State the types of crown (cemented and screwed
Introduction to types), along with their indications,
Dental implants I contraindications, advantages, and disadvantages.
10. Describe the different techniques for taking an
impression.
11. Explain the meaning and techniques of torqueing.
Hands-on training session
1. Watch the surgical component of an implant (video).
2. Watch the prosthodontics component of an implant
(video).
3. Make a final impression for an implant using the
open tray technique.
4. Make a final impression for an implant using the
closed tray technique.
5. Perform torqueing on the screwed-type crown.
6. Perform torqueing on the abutment.
Dental implants II Workshop

178
Alignment of Research Module Objectives with CanMEDs Roles

Objectives (Residents will be able CanMEDS

Topics Teaching methods
to) Framework roles

Introduction 1. Define research.  Lecture.  Collaborator

to scientific 2. Discuss its importance.  Group discussion.  Leader
research 3. List the types of research.  Workshop.  Scholar
4. Explain the meaning and principles  Professional
of evidence-based dentistry.
5. List the steps of conducting
research.
6. Identify the skills needed to design
and conduct research.
7. Recognize sources of information,
articles, and data.
8. Open an account in PubMed
(workshop).
Ethics in 1. Recognize research ethics (Ethics  Assignment (residents
scientific Training Module: need to submit a
research http://www.pre.ethics.gc.ca/eng/i certificate of ethics by
n dex/) answering questions in
2. Present principles of the the training module
Declaration of Helsinki (ethics) (website: Panel on
3. Present principles of the Belmont Research Ethics).
Report (ethics)  Residents will present
4. Select a research group and/or principles of the
supervisor. Declaration of Helsinki
and Belmont Report in
front of each other.
Literature 1. Describe the meaning of a  Lecture.  Collaborator
review literature review.  Group discussion.  Leader
2. Discuss the importance of a  Residents will review  Scholar
literature review. and critique the  Professional
3. List the steps in conducting a introduction section of a
literature review. selected article in a
4. Apply methods of writing to the group.
introduction section of the  Residents will write the

179
Objectives (Residents will be able CanMEDS
Topics Teaching methods
to) Framework roles

manuscript. introduction section for

5. Critique literature reviews of a literature review of a
published articles. selected topic
(workshop).
Research 1. Define the research problem and  Lecture.  Collaborator
problem and purpose.  Group discussion.  Leader
objectives 2. Explain the importance of the  Residents will review  Scholar
research problem. and critique the  Professional
3. Identify purpose statements, introduction section
research questions, hypotheses, and objectives of the
and objectives selected article in a
4. Formulate a hypothesis. group.
5. Formulate a research objective.  Residents will write the
6. Discuss the process of research objectives for
developing a research question. the selected topic
7. Apply objective methods of (workshop).
writing research.
8. Critique research objectives of
published articles.
Introduction 1. Define a reference and a citation.  Lecture.  Collaborator
to referencing 2. List the different types of  Group discussion.  Leader
referencing styles.  Residents will review  Scholar
3. Understand the meaning of and identify the type of  Professional
plagiarism. references for a
4. Write statements/paragraphs selected article in a
with citations and references. group.
5. Attend an EndNote hands-on  Residents will attend an
workshop. EndNote hands-on
workshop.
 Residents will write
statements or a
paragraph with
citations and
references using the
EndNote program.

180
Objectives (Residents will be able CanMEDS
Topics Teaching methods
to) Framework roles

 Residents will write

statements or a
paragraph with
different referencing
styles.
Study 1. Describe the characteristics of  Lecture.  Collaborator
design/resear quantitative, qualitative, and  Group discussion.  Leader
ch mixed methods research.  Residents will review  Scholar
methodology 2. Explain quantitative study design and critique the  Professional
(research methodology). methods section of a
3. Describe descriptive studies and selected article.
analytical studies.  Residents will identify
4. Describe experimental research, the type of study design
quasi-experimental, and non- used in a selected
experimental quantitative article.
research.
5. Discuss the steps in conducting
experimental research.
6. Explain the meaning and uses of
correlational research.
7. Explain the meaning of causation
and association research.
8. Critique study designs of
published articles.
Types of 1. List the types of variables.  Lecture.  Collaborator
variables, 2. Define confounding and modifier  Group discussion.  Leader
confounding variables.  Residents will review  Scholar
modifiers, 3. List the types of bias found in and critique the  Professional
IRB, sampling research. methods section of a
techniques, 4. Discuss the process of selected article.
and data quantitative data collection.  Residents will identify
collection 5. Explain sampling techniques. types of variables in a
6. Explain how to obtain a sample. selected article.
7. List the types of data collection  Residents will identify
tools (instruments that will be the sampling technique

181
Objectives (Residents will be able CanMEDS
Topics Teaching methods
to) Framework roles

used to collect data). used in a selected

8. Define the different methods of article.
data collection (tests,
questionnaires, interviews, focus
groups, observation).
9. Critique types of variables and
sampling techniques used in
published articles.
Questionnaires 1. Discuss types of questionnaires.  Lecture.  Collaborator
and 2. List the steps of the construction of  Group discussion.  Leader
standardized an instrument (questionnaire).  Residents will review  Scholar
measurement 3. Identify standardized and critique  Professional
measurement and assessment questionnaires
(including scales of measurement, mentioned in a selected
validity, and reliability). article in a group.
4. Discuss methods used to  Residents will
administer tools for data construct a
collection. questionnaire.
 Residents will select a
research topic to be
conducted during the
program.
Qualitative 1. Identify qualitative study design  Lecture.  Collaborator
study design (grounded theory research,  Group discussion  Leader
ethnographic research, narrative  Resident will review  Scholar
research). and critique a  Professional
2. Explain the process of qualitative qualitative study design
data collection. in a selected article in a
3. Discuss how to analyze and group.
interpret qualitative data.  Identify type of
qualitative study design
in a selected article.
Biostatistics I 1. Identify the basics of biostatistics.  Lecture.  Collaborator
2. Explain how to interpret  Group discussion.  Leader
quantitative data.  Residents will review  Scholar

182
Objectives (Residents will be able CanMEDS
Topics Teaching methods
to) Framework roles

3. Explain the data management and critique the  Professional

process. statistical section of the
4. Discuss the process of quantitative selected article in a
data analysis. group.
5. Conduct descriptive analysis.  Residents will discuss a
6. Conduct inferential analysis. descriptive and
inferential analysis of
data.
Biostatistics II 1. Describe how to analyze data.  Lecture.  Collaborator
2. Describe how to present tables,  Group discussion.  Leader
figures, and results.  Scholar
 Professional
3. Attend a hands-on SPSS  Residents will review
workshop. and critique the
statistical section of a
selected article in a
group.
 Residents will discuss a
descriptive and
inferential analysis of
data.
 Residents will enter
research data in the
SPSS program and
analyze it.
 Residents will arrange
data in tables and
figures.
Research 1. Describe the contents of a  Lecture.  Collaborator
proposal research proposal.  Group discussion.  Leader
2. Apply learned writing methods  Residents will complete  Scholar
when writing the proposal. a mini proposal form in  Professional
a group.
 Residents will present
their mini proposal.

183
Objectives (Residents will be able CanMEDS
Topics Teaching methods
to) Framework roles

Discussion 1. Identify the content of the  Lecture.  Collaborator

discussion section.  Group discussion.  Leader
2. Discuss the methods used to write  Residents will review  Scholar
the discussion section. and critique the  Professional
discussion section of a
selected article.
Conclusion 1. Identify the contents of the  Lecture.  Collaborator
- Abstract 2. conclusion.  Group discussion.  Leader
- Title 3. Identify the contents of the  Residents will review  Scholar
- Authorship abstract. and critique the  Professional
Acknowled 4. Know the types of titles. conclusion, abstract,
gements 5. State how to present authorship. and title of a selected
- Publication 6. Describe how to write article in a group.
- Poster acknowledgements.  Design a poster using
7. Explain the process of the PowerPoint
publication. program.
8. Discuss how to design a poster  Discuss the publication
9. presentation. process for a target
journal.
Research 1. Explain the process of applying  Lecture.  Collaborator
grants for a research grant.  Group discussion.  Leader
2. Discuss the steps of critiquing  Residents will review  Scholar
research. and critique some  Professional
selected articles in a
group.
 Residents will use a
checklist to critique the
selected articles.
Presentation 1. Submission of initial draft
of proposal results at The end of R2.
2. Submission of the initial draft of
discussion in the middle of R3.
3. Submission of manuscript at end
of R3.

184
Objectives (Residents will be able CanMEDS
Topics Teaching methods
to) Framework roles

4. Submission of poster at
beginning of R4.
5. Research presentation at
beginning of R4.

Alignment of Educational Methods and Professional Development

Topics with CanMEDs Roles

CanMEDS
Lecture/Workshop Content
competencies
1. New - Challenges and reasons for changes in medical education.  Medical expert
approaches, - Outcome/competency-based education.  Collaborator
concepts, and - Problem-based learning.  Scholar
strategies in - Case-based learning.  Professional
medical - Practice-based learning.
education - Community-based education.
- Patient-centered education.
- Student-centered learning.
- E-learning.
- Evidence-based medicine.
- Active learning.
- Problem-solving and critical thinking.
2. Principles of - Definition of andragogy.  Scholar
adult learning - Principles of adult learning.  Leader
and learning - Differences between pedagogy and andragogy.
styles - Applying principles of adult learning to training.
- Different styles of learning.
3. Teaching - Principles of teaching.  Scholar
methods - Innovative and traditional methods of teaching.  Professional
- Advantages and disadvantages of the different teaching
methods.
4. Educational - Definition and rationale.  Scholar
objectives - Taxonomy of educational objectives.
- How to write educational objectives.

185
CanMEDS
Lecture/Workshop Content
competencies
5. Problem- - Definition and rationale.  Scholar
based - Steps of practice-based learning.  Leader
learning - Roles of group members.
6. Self-directed - Definition and rationale.  Collaborator
learning - Principles of SDL.  Scholar
- Steps of SDL.  Professional
- Advantages of SDL.
- Perception of SDL.
7. Group - Definition of group dynamics and behavior that affects the  Collaborator
dynamics and group process.  Professional
teamwork - Stage of group development.
- Functions and ground rules in group work.
- Nature of teamwork.
- Steps for creating an effective team.
- Importance of teamwork in education and health care.
8. Assessment - - Definition of assessment.  Scholar

and new - Summative and formative assessments.

methods of - Extended matching items versus MCQ.
assessment - Objective structured clinical and practical examinations.
- Portfolio.
- Work-based assessments.
9. Feedback and - Definition of feedback and self-reflection.  Scholar
self-reflection - The importance and effect of feedback and self-reflection  Collaborator
on learning outcomes.  Professional
10. Presentation - Rationale for and basic components of an oral presentation.  Collaborator
skills - Steps for preparing and creating effective presentations.  Scholar
- Manage the presentation environment.  Professional
- Use visual aids and support materials.
- Understand and overcome fear and anxiety of public
speaking and gaining confidence and control.
- Balancing verbal and non-verbal messages to engage
listeners.
- Maximizing vocal delivery.
- Body language tips and techniques.
- Interacting with and handling questions from the audience.

186
CanMEDS
Lecture/Workshop Content
competencies
11. Study and - The process of studying.  Scholar
learning skills - The importance of study skills.
- Effective learning/study skills.
12. Writing skills - The importance of and types of writing.  Scholar
- Strategies to improve writing.
- Essential steps and process for writing assignments.
- Definition of plagiarism.
- Strategies that minimize the potential for plagiarism.
13. Leadership - Concept of leadership and the importance of leadership  Collaborator
skills skills.  Professional
- Differences between a leader and a manager.  Leader
- Skills of an effective leader.
- Techniques for dealing with conflict.
- Aspects of leadership in health care.
14. Communicatio - Meaning and relevance of communication skills in health  Collaborator
n skills and sciences education and training.  Communicator
professionalis - Importance of effective communication skills in practice.  Professional
m - Communication skills in the context of health sciences
education.
- Definition and elements of professionalism.
- Competencies needed for dentists as communicators and
professionals according to the CanMEDS competency
framework.
15. Workshop - Definition and importance of workshops.  Collaborator
design - Workshops as an educational and developmental tool.  Leader
- Essential steps for designing an effective workshop.  Professional
16. Time - Definition and advantages of time management.  Professional
management - Steps and skills needed to manage time.  Medical expert
- Implementation of time management in practice.
17. Faculty - Definition and principles of faculty development and their  Scholar
development rationale.  Professional
- Effects of faculty development interventions on knowledge,
attitudes, and skills of health care professionals and the
institutions in which they work

187
CanMEDS
Lecture/Workshop Content
competencies
18. Program - Definition and principles of program evaluation.  Scholar
evaluation - Purpose of program evaluation in education.  Leader
- Evaluation according to Bloom’s taxonomy of educational
objectives.
- Relevance of evaluation to the learning process.
19. Dental practice - Business management, including third-party payment and  Leader
management professional practice development.  Professional
- Management of auxiliaries and other office personnel.  Communicator
- Maintenance and management of patient records.  Collaborator
- Book-keeping/accounting.
- Office design and arrangement and placement of
equipment.
- - New technology in practice.

Alignment of Clinic-Based Learning with CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies
- Elicit a detailed medical and dental history using patient-  Dental expert
centered interviewing skills.  Communicator
- Carry out a thorough and appropriate assessment and  Collaborator
examination of oral and extra-oral structures of a patient  Scholar
and make appropriate diagnoses.  Health
- Complete a thorough examination of any existing advocate
restoration, RCT, prostheses, implants, and related tissues  Professional
and structures, evaluating the biological and esthetic
Clinical- based
quality of each.
learning
- Conduct a periodontal examination, charting, and diagnosis.
- Use and interpret correctly all appropriate investigations.
- Use evidence-based decision-making.
- Use all clinical examination, history, and investigation
findings to develop alternative and effective treatment
strategies.
- Develop communication skills by deciding the treatment
strategy in conjunction with the patient and producing a

188
CanMEDS
Activity Objective (Residents will be trained to)
competencies
plan according to their needs and preferences.
- Work with other health professionals to develop an effective
treatment plan and provide high-quality, safe, and patient-
centered care.
- Write consultation and referral letters.
- Advise patients on preventive methods.
- Manage emergencies and traumatic injuries.
- Master skills of all restorative procedures (operative,
prosthodontic, and esthetic)
- Provide restorative, conservative, and esthetic treatment
using different materials and techniques
- Provide an appropriate periodontal restorative treatment
plan and management.
- Provide all types of fixed prosthodontic therapy using the
appropriate techniques, materials, and technologies
available for all types of fixed dental prostheses and
restorations.
- Diagnose and manage significant occlusal conditions and
disorders.
- Diagnose oral parafunction and other factors in the
development of dysfunction of mandibular movements and
the TMJ, and provide behavioral advice for management of
these problems.
- Diagnose, generate an appropriate treatment plan, and
provide the best treatment methods for the different
occlusal problems.
- Construct appropriate occlusal appliances for the
treatment of these problems.
- Provide full mouth rehabilitation treatment following all
recommended steps.
- Provide dental implant therapy in multiple clinical
circumstances.

- Liaise appropriately with dental technicians with respect to

necessary laboratory requirements.

189
CanMEDS
Activity Objective (Residents will be trained to)
competencies
- Use conscious sedation techniques in conjunction with
appropriate specialists.
- Recognize the importance of working with a team of health
professionals in patient management.
- Apply ethical and humanistic principles in clinical care.
- Supervise junior residents or undergraduate students (for
seniors).
- Improve collaboration skills by receiving instructions and
feedback from supervisor or colleagues.

Alignment of Case-Based Discussion with CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies
Presentation - Present a comprehensive case with a detailed history,  Dental expert
of advanced examination, and description of the investigation tools used.  Scholar
cases - Recognize social, systemic, and oral factors that influence the
treatment plan and prognosis.
- Present the consultation reports and outline their influence on
the treatment strategy.
- Formulate an appropriate differential diagnosis and alternative
treatment plans.
- Incorporate evidence into the treatment plan, techniques, and
selection of materials.
- Follow the ideal sequence in patient management.
- Document comprehensive cases following the recommended
format.
- Present follow-up of a patient’s case.
- Expose other residents to different cases and treatment
modalities.
- Improve presentation skills by regularly seeking feedback on
presentations.

190
Alignment of Treatment Planning Sessions with CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies
Treatment - Develop competence in short presentations on comprehensive  Dental expert
plan sessions cases.  Scholar
- Formulate a correct diagnosis based on history, clinical
examination, investigations, and consultation.
- Develop the best treatment strategy after discussing the case
with supervisors.
- Expose other residents to dental cases with different problems
and treatment strategies.

Case-based - Develop skills in analytical thinking and reflective judgment by  Dental expert
learning reading and discussing complex, real-life scenarios.  Scholar
- Formulate a correct diagnosis based on history and  Leader
investigations.  Collaborative
- Develop the best treatment strategy after discussing the case.
- Students are encouraged to interact with each other in team
projects.
- Explore educational sources beyond the required textbooks.

Alignment of Literature Review Sessions with CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies
Literature - Present the summarized assigned or selected articles to other  Scholar
review and residents and consultants.  Medical expert
Journal Club - Review literature related to restorative dentistry to improve  Health
decision-making and patient care. advocate
- Acquire knowledge about the different types of studies and
methodologies.
- Critically appraise the published articles.
- Keep up to date with the literature.
- Recognize classical and current published articles and case
reports impacting the practice of restorative dentistry.
- Identify areas of controversy in areas of restorative dentistry
disciplines.

191
Alignment of Self-Directed Learning Activities with CanMEDs
Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies
Self-directed - Take responsibility for personal learning above and beyond  Dental expert
learning responding to instruction.  Scholar
 Professional
- Develop independence, confidence, and awareness of available
resources.
- Predict personal learning needs and objectives.
- Develop searching and reading skills using relevant journals
and books.
- Develop an interest in further learning beyond the essential
core curriculum.
- Develop lifelong learning skills.
- Encourage critical thinking skills.
- Maintain a personal portfolio.

Alignment of Community Service Activities with CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies
Community - Participate in local organizations that benefit the community as a  Medical expert
service whole.  Communicator
- Demonstrate respect for all people regardless of culture and  Collaborator
socioeconomic background.  Health
- Develop experience in volunteering activities. advocate
- Encourage residents to interact with each other in a community  Professional
project.  Leader
- Become active members of the community when they have their
own practices.
- Assess the needs of a community.

192
Alignment of Elective Courses with CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies

Elective - Select modules they expect to find interesting and  Medical expert
(special encouraging intrinsic motivation and a deeper approach to  Communicator
interest)  Collaborator
learning.
 Professional
module - Gain additional experience within the sphere of interest of
the trainee from units and staff locally or abroad.

Alignment of Supplementary Courses and Workshops with

CanMEDs Roles

CanMEDS
Activity Objective (Residents will be trained to)
competencies

Supplementar - Keep up to date with the latest advances in restorative  Medical expert
y courses, dentistry materials and techniques.  Scholar
workshops, - Identify and practice modern clinical procedures.
and guest - Benefit from the experience and knowledge of local and
speaker international speakers.
lectures - Acquire knowledge and skills in advanced areas of
restorative dentistry.

193
Appendix II - Clinic-Based Learning Forms
Academic Schedule Example

Training Year General Schedule

Month R1 R2 R3

October Orientation Clinical Training Clinical Training

Preclinical Course Academic Instruction Academic Instruction
November
Research Module
December Clinical Training
Academic Instruction
January

February

March

April

May

June

July

August

September

194
Training Week General Schedule

Day AM PM

Treatment
Clinical
Sunday planning Clinical training
training
session

Monday Clinical training Clinical training

Tuesday Clinical training Clinical training

Weekly Scientific Activities
Weekly Scientific Activities
(Interactive lectures/resident’s
(Interactive lectures/resident’s
Wednesday presentations/literature
presentations/literature
review/guest
review/guest speakers/workshops)
speakers/workshops)

Clinical training Clinical training

Supplementary or professional Supplementary or professional
Thursday development courses, lectures, and development courses, lectures,
workshops and workshops
Community service Community service

Saudi Board in Restorative Dentistry

Annual Logbook Accomplishment Guide

Resident’s Name: Level: R1 R2 R3

Date: Category: A1 A2 A3

Training Center: Region: 1st 2nd 3rd 4th 5th

195
Minimum Number of
requirements per finished
3 year
Section/Procedure Code year procedures Remarks
Requirements
R1 R2 R3 R1 R2 R3

I. Diagnosis and Treatment planning

A1 15 4 9 15
- Treatment plan TX-1 A2 10 4 10
A3 6 6
A1 15 4 9 15
- Diet analysis TX-2 A2 10 4 10
A3 6 6
- Caries A1 15 4 9 15
diagnosis & TX-3 A2 10 4 10
control A3 6 6

- Caries risk A1 15 4 9 15
TX-4 A2 10 4 10
assessment A3 6 6
A1 15 4 9 15
- Smile analysis TX-5 A2 10 4 10
A3 6 6
II. Operative

- Micro- / A1 20 5 10 20
O-4 A2 15 5 15
Macroabrasion A3 10 10
- Enameloplasty A1 10 2 5 10
O-5 A2 8 3 8
/ Reshaping A3 5 5
- Pit and fissure A1 35 10 20 35
OP-3 A2 25 10 25
sealant A3 20 20
- Resin-modified A1 15 5 10 15
OP-4 A2 10 5 10
glass ionomer A3 5 5
- Preventive A1 40 10 25 40
resin O-15 A2 30 15 30
restoration A3 20 20
- Amalgam
restoration A1 15 5 10 15
O-6 A2 10 5 10
- Class II A3 5 5
O-8
- Build-up
- Anterior
composite A1 110 40 70 110 Minimum of 15
restoration O-9 A2 70 40 70 from each
- Class II, IV, V O-11 A3 50 50 procedure
- Build-up

196
Minimum Number of
requirements per finished
3 year
Section/Procedure Code year procedures Remarks
Requirements
R1 R2 R3 R1 R2 R3
- Posterior
composite Minimum of 15
A1 110 40 70 110
from each
restoration O-10 A2 70 40 70
procedure
- Class I, II, V, VI O-13 A3 50 50
except class IV
- Build-up
- Inlay / Onlay A1 45 5 20 45
- Metal A2 30 10 30
O-18
- Ceramic A3 20 20
O-17

III. Prosthodontics

- Post & core

- Prefabricated
post & core P-1
metal A1 50 10 30 50
Minimum of 5
A2 30 15 30
- Prefabricated P-2 cast post &
A3 20 20
core
post & core
esthetic P-3
- Cast post & core
- Crown Minimal
- Porcelain- P-4 A1 75 15 40 75 anterior
A2 55 25 55 A1: 35
fused-metal P-5 A3 40 40 A2: 25
- All ceramic A3: 20
- Non-surgical A1 10 2 5 10
management of P-7 A2 5 2 5
TMD A3 3 3
A1 15 - 7 15
- Implant fixture P-6 A2 12 5 12
A3 8 8
IV. Esthetics
- In-office A1 10 2 5 10
O-1 A2 7 3 7
bleaching A3 5 5
- At-home A1 10 2 5 10
O-2 A2 6 3 7
bleaching A3 4 5
- Non-vital A1 5 1 3 5
O-3 A2 4 2 4
bleaching A3 3 3
- Anterior A1 5 1 3 5
diastema O-12 A2 3 1 3
closure (pair) A3 2 2

197
Minimum Number of
requirements per finished
3 year
Section/Procedure Code year procedures Remarks
Requirements
R1 R2 R3 R1 R2 R3
- Direct A1 20 5 10 20
composite O-19 A2 15 5 15
veneer A3 10 10
- Indirect A1 50 15 35 50
porcelain O-20 A2 40 15 40
veneer A3 30 30

V. Recall

- 6 months A1 5 - 2 5
RC-1 A2 3 1 3
follow-up ECE A3 2 2
- 1 year follow- A1 5 - 2 5
RC-2 A2 3 1 3
upECE A3 2 2
VI. Comprehensive Esthetic Cases (CECs)
- Simple (100 Minimum
CEC-S number of
points/case)
CECs / year
- Moderate (200 CEC-
depends on
points/case) M A1 15 4 9 15
the
A2 10 4 10
A3 6 6 corresponding
- Complex (300 points rather
CEC-C than the
points/case)
actual number
of cases

198
RDITN/Medical Assessment

ASA 1 A normal healthy patient

ASA 2 A patient with mild systemic disease without substantive functional limitations

ASA 3 A patient with severe systemic disease with substantive functional limitations
ASA 4 A patient with severe systemic disease that is a constant threat to life

ASA 5 A moribund patient who is not expected to survive without the operation

ASA 6 A patient declared brain-dead and whose organs are being removed for donation purposes

Simple medical history Complex medical history

ASA 1–2 ASA 3–5

Medical history that significantly affects clinical management and
outcome/need for premedication.

RDITN/Periodontal Assessment

Basic periodontal examination

0 No bleeding or pocketing detected

1 Bleeding on probing - no pocketing exceeding 3.5 mm

2 Plaque retentive factors present - no pocketing exceeding 3.5 mm

3 Pockets 3.5 mm to 5.5 mm in depth (color-coded area partially visible)

4 Pockets > 5.5 mm in depth

199
CAMBRA Form

200
Case Approval Form

CASE APPROVAL FORM

Resident’s name:
Resident’s no.:
Date: Case no.:

Fully Partially Not

A. Appropriate documentation
Performed Performed Performed

1. Medical and dental history

2. Chief complaint

3. Dental charting

Extra-oral examination: Face, lymph

4.
nodes, TMJ, muscles
Intra-oral examination: Teeth, mouth
5.
opening, periodontium, mucosa, tongue
Clinical test for suspected teeth: thermal
6.
percussion, palpation, bite

7. Preoperative orthopantomogram

8. Preoperative 20 cm

9. Intra-oral pictures, 5 views before treatment

10. Mounted diagnostic casts

11. Diagnostic wax-up

12. Diagnosis

13. Treatment plan

201
Case Report Evaluation Form

CASE REPORT EVALUATION FORM

Name: Resident year:

R1 R2
Training center:
R3 R4

Non-applicable (0)
Below average (2)
Region:

Poor (1) Poor (1)

Very good (4)
Excellent (5)
Central Eastern Western

Average (3)
POINTS OF EVALUATION

1 Abstract      

Clinical case documentation:

 Appropriate documentation of critical informative data:
patient gender, age, medical/dental history, chief complaint,
2 medications prescribed, previous procedures, or any      

appliances constructed.
 All critical diagnostic tests, examinations, or procedures
have been recorded.

3 Appropriate treatment plan      

Successful in declaring the various treatment options

4      
(alternative treatment plans)

5 Quality of treatment rendered      

202
Mini-CEX Form

Trainee name SCFSH #

Residency level Date

Brief summary of case:

CASE NEW FOLLOW-UP

COMPLEXITY LOW MODERATE HIGH

DATA GATHERING THERAPY OTHERS

FOCUS DIAGNOSIS COUNSELING

SCORE FOR STAGE OF TRAINING

Criteria 1 Satisfactory Superior

1 2 3 4 5 6 7 8 9

Posture

History-taking

Physical

Communication

Critical judgment

Humanistic

Organization and

Overall clinical care

Suggestions for development:

Evaluator’s Name:
Signature:

203
DESCRIPTION OF CRITERIA

Sitting posture on the chair/operative position and

Posture
gaining access/positioning the patient

Facilitates patient’s narrative; uses appropriate

questions to obtain accurate, adequate information
History-taking
effectively; responds to verbal and nonverbal cues
appropriately

Follows an efficient, logical sequence; examinations

are appropriate for clinical problems; provides
Physical examination skills
patients with explanations; is sensitive to patients’
comfort and modesty

Explores patients’ perspectives; jargon-free speech;

open and honest; empathetic; agreement on
Communication skills
management
plans and therapies with patients
Forms appropriate diagnoses and suitable
management plans; orders selectively and performs
Critical judgment
appropriately
diagnostic studies; considers risks and benefits

Shows respect, compassion, and empathy;

establishes trust; attends to patient’s comfort and
Humanistic
needs; respects confidentiality; behaves in an ethical
quality/professionalism
manner; is aware of legal frameworks and his or her
own limitations

Organization and efficiency Prioritizes; is timely and succinct; summarizes

204
CBD Form

205
DOPS Form

206
DOPS Form

207
Smile Analysis Form

208
209
210
ITER

211
Treatment Plan Phases

PHASE I PHASE II PHASE III PHASE IV PHASE V PHASE VI

PRE-
PREVENTIVE OPERATIVE ENDODONTIC PROSTHODON PROSTHODONTIC RECALL AND
PHASE PHASE PHASE TIC SURGICAL PHASE MAINTENANCE
PHASE
This consists Objectives – Objectives – A. Cases A.Fabricatio Establish
of two parts: eliminate eliminate that n and recall and
emergency caries, restore infection, require delivery of maintenance
management function, eliminate extensive definitive plan
and restore secondary prosthodo prosthesis according to
stabilization esthetics, periodontal ntic : the Caries
maintain involvement, managem - Crowns/fixe Risk
healthy reassessment ent- d partial Assessment
Emergency:
periodontium, of restorability alteration dentures and
To manage
and restore of teeth, of vertical - Implant- complexity
any dental
the dentition to assessment of dimensio supported of treatment
emergency to
a maintainable appropriate n/plane of prosthesis received
control a
level treatment occlusion - Occlusal
patient’s appliance
A. Establish a modality per or
symptoms B. Fabricatio
definite case, and esthetic
considera n of
operative outcome.
1. Medical tions restoratio
treatment
history require ns
plan A. Establish a
2. Acute additional postponed
B. Restore all definitive
infection pre- to Phase V
carious endodontic
management, treatment such as
teeth with treatment
acute pain steps: porcelain
permanent plan
management, veneers or
restorations B. Management
esthetic - Final onlays
C.Bleaching of vital pulp
emergencies evaluation of constructe
performed (prevention
occlusion, d to
prior to of pulp
mounted correct
Stabilization: placement of damage,
diagnostic anterior
Objectives – to definitive reversible or
casts guidance,
control the restorations irreversible)
- Occlusal or alter
disease D. Assessment C. Management
analysis the
process, and of traumatic
- Diagnostic occlusal
educate the preparation injuries
wax-up plane
patient, and of teeth.
- Fabrication
establish a

212
PHASE I PHASE II PHASE III PHASE IV PHASE V PHASE VI

PRE-
PREVENTIVE OPERATIVE ENDODONTIC PROSTHODON PROSTHODONTIC RECALL AND
PHASE PHASE PHASE TIC SURGICAL PHASE MAINTENANCE
PHASE
patient-doctor of
relationship provisional
s,
A. Diagnosis templates,
and risk and
assessmen surgical
t stents
B. Restoratio
n of
1. Diagnosis endodonti
- Medical cally
history treated
- Dental teeth,
history post, and
- Diet history cores
- Radiographic
evaluation
- Soft/hard
tissue
evaluation
- Dental
consultation
s
(periodontic
orthodontic,
surge
- Other
necessary
diagnostics
(pulp vitality
tests,
cephalometri
c analysis,
smile
analysis,

213

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