Institute of Dentistry, CMH Lahore Medical College ...

Institute of Dentistry,

CMH Lahore Medical College

Curriculum and study Guide

Third Year BDS

[email protected]

Table of contents

1. Introduction to study guide---------------------------------------------------- 1

2. Mission and vision statement-------------------------------------------------- 2

3. Rationale of curriculum-------------------------------------------------------- 3

4. Introduction to curricular framework-------------------------------------- 3

5. 4 years curricular framework-------------------------------------------------4

6. Curricular map of BDS---------------------------------------------------------5

7. BDS program outcomes-------------------------------------------------------- 6

8. Undergraduate competencies--------------------------------------------------7

9. Coordinator for 3rd year BDS 2019--------------------------------------- 8

10. Student representative----------------------------------------------------------9

11. Clerkship Subjects--------------------------------------------------------------- 10

12. Hours of teaching---------------------------------------------------------------- 10

13. Introduction to Periodontology----------------------------------------- 11

a. Curricular Map of Periodontology -------------------------------------------------- 11

b. Resources -------------------------------------------------------------------------------- ---- 12

• Teaching resources -------------------------------------------------------------------- 12

• Infrastructure resources --------------------------------------------------------------------- 12

• Supporting Staff --------------------------------------------------------------------- 13

c. Teaching and learning strategies----------------------------------------------------------- 13

d. Learning methodologies--------------------------------------------------------------------- 14

e. Curriculum implementation----------------------------------------------------------------- 15

f. Course outline--------------------------------------------------------------------------------- 17

g. Topic and Exam weightage ----------------------------------------------------------------- 18

h. Table of specification for teaching, learning objectives and assessment-------------- 19

i. Learning resources---------------------------------------------------------------------------- 35

j. Other learning resources---------------------------------------------------------------------- 37

k. Summative assessment methods and policies---------------------------------------------- 37

l. Table of specifications for annual examination------------------------------------------- 40

m. Sample MCQs and SEQs--------------------------------------------------------------------- 41

14. Introduction to Oral Pathology ------------------- 45

a. Curricular Map of Orthodontics and Oral pathology---------------------------------- 45

b. Resources ------------------------------------------------------------------------------------ 46

• Teaching resources --------------------------------------------------------------------- 46

• Supporting Staff------------------------------------------------------------------------- 46

• Infrastructure resources --------------------------------------------------------------- 46




f. Course outline -------------------------------------------------------------------------------- 50

g. Table of specification for teaching, learning objectives and assessment-------------- 53

h. Learning resources---------------------------------------------------------------------------- 61

i. Other learning resources---------------------------------------------------------------------- 62

j. Summative assessment methods and policies---------------------------------------------- 63

k. Table of specifications for annual examination-------------------------------------------- 66

l. Sample MCQs and SEQs-------------------------------------------------------------------- 68

15. Introduction to Oral Medicine 70

a. Curricular Map of Oral Medicine ------------------------------------ 70

b. Resources ----------------------------------------------------------------------------------- 71

• Teaching resources --------------------------------------------------------------------- 71

• Infrastructure resources ---------------------------------------------------------------- 71




f. Course Outline -------------------------------------------------------------------------------- 75

g. Table of specification for teaching, learning objectives and assessment-------------- 78

h. Learning resources---------------------------------------------------------------------------- 92

i. Other learning resources---------------------------------------------------------------------- 96

j. Summative assessment methods and policies---------------------------------------------- 97

k. Table of specifications for annual examination-------------------------------------------- 98

l. Sample MCQs and SEQs--------------------------------------------------------------------- 101

16. Introduction to General Medicine------------------------------------ 103

a. Resources --------------------------------------------------------------------------------------- 103

• Teaching resources ------------------------------------------------------------------------ 103

• Infrastructure resources ---------------------------------------------------------------- 103

b. Teaching methodologies---------------------------------------------------------------- 104

c. Learning methodologies-------------------------------------------------------------------- 104

d. Curriculum implementation----------------------------------------------------------------- 106

e. Course Outline ------------------------------------------------------------------------------ 107

f. Table of specification for teaching, learning objectives and assessment ------------- 109

g. Learning resources---------------------------------------------------------------------------- 121

h. Other learning resources---------------------------------------------------------------------- 121

i. Summative assessment methods and policies---------------------------------------------- 122

j. Table of specifications for annual examination-------------------------------------------- 123

k. Sample MCQ and SEQ------------------------------------------------------------------------- 126

17. Introduction to General Surgery------------------------------------ 127

a. Teaching and learning strategies----------------------------------------------------------- 127

b. Learning methodologies-------------- ----------------------------------------------------- 128

c. Curriculum implementation----------------------------------------------------------------- 130

d. Outcomes of the BDS Gen Surgery course------------------------------------------------ 125

e. General Surgery Course Organisation ----------------------------------------------------- 132

f. General Surgery Curriculum Annexures--------------------------------------------- 134

g. Other learning resources---------------------------------------------------------------------- 139

h. Summative assessment methods and policies---------------------------------------------- 140

i. Table of specifications for annual examination-------------------------------------------- 143

1

Introduction to study guide

This study guide book is designed for Dental undergraduates by consolidated effort of all subjects across

the year to provide Dental students of IOD CMH Lahore Medical College a resource material which

would highlight important aspects of curriculum. The study guide aims to promote self-regulated

lifelong learning among students by giving them the control over their learning.

The pervasive curriculum aspects of undergraduates’ competencies, assessment policies and curriculum

coordinators are mapped in his guide book. Horizontal integration across the year better conceptual

understanding while vertical integration promotes clinically relevant understanding. IOD CMH aims

to improve health indicates of society by improvement of students and doctors in preventive health

service provision and health education provision to society through community programs.

The study guide gives an overview of intended course outcomes and objectives in relation to the course

content. The assessment methodology tailored to intuitional strategy is provided.

This study guide has been carefully designed keeping in view PMDC and NUMS curriculum and guide

lining dedicated effort by faculty is done to make this guide tailored to student’s needs. Students

feedback has been seeded and incorporated at all stages during study guide development. Curriculum

is a living dynamic entity. Our aim to improve it by every passing day. This humble effort of all faculty

acts as a guiding light for our dear students.

2

Mission Statement

To provide an excellent learning and teaching environment, inculcating

ethical values and social responsibilities in undergraduate and

postgraduate medical &dental students and nursing and allied health

sciences students to enhance the level of comprehension healthcare in

the Army/Country

Vision Statement

To ensure the development of internationally acclaimed quality

standards and practices for the NUMS Higher Education that benefits

and lives upto the stakeholder’s needs and expectations

3

Rationale of Curriculum The curriculum is designed to address both local and international needs. The curriculum is

focused to prepare students for the international licencing exams and training abroad as well as

empowering them to treat local patients with safety and efficiency. Dentists work as a healer in the

community. A dentist should have evidence based and update knowledge about the epidemiology of

the practicing area. The curriculum of IOD CMH LMC is planned with a collaboration of clinical and

basic sciences faculty in addition to students and family medicine department to ensure that the

prevailing health conditions of the society are treated and dealt with effectively. The emergence of new

techniques in preservation of existing dentition and restoration of the lost dentition and oral structures

has led to changes in the curriculum with more emphasis on new and advanced techniques, procedures

and evolution of new and advanced technology (e.g. CADCAM & Implants).

Introduction to Curricular Framework

This study guide is developed as resource assistance to the students and faculty. The study guide

development process included representation from teaching faculty, management, leadership of college

and students. The study guide is made to achieve and alignment between societies’ needs, institutional

needs, patient needs & student’s needs.

The curriculum implemented is a hybrid type of curriculum which has both horizontal and

vertical integration. Spiral integration is introduced as an adjunct to horizontal and vertical integration.

The curriculum spans over 2 phases

PHASE 1 (Year 1&2): Includes basic sciences Anatomy, physiology, biochemistry, Oral biology and

tooth morphology, Science of dental Materials, Pharmacology and Community Dentistry, Behavioral

Sciences, general pathology, Islamiyat and Pakistan studies. It also includes preclinical Prosthodontics

and operative dentistry.

PHASE 2 (Year 3rd

& Final Year): includes Periodontology, Oral Pathology, Oral Medicine, General

Medicine, General Surgery, Oral Surgery, Prosthodontics, Orthodontics and dental radiology, Operative

Dentistry.

4

4 Years Curricular Framework

BDS SCHEME OF STUDIES

BASIC DENTAL SCIENCES / PRE-

CLINICAL YEAR

CLINICAL YEARS

1st YEAR 2

nd Year 3

rd Year Final Year

Anatomy Science of Dental

Material

Periodontology Prosthodontics

Physiology Gen. Pathology Oral pathology Operative Dentistry

Biochemistry Pharmacology Oral Medicine Oral Surgery

Pak studies & Islamic

Studies

Gen. Medicine Orthodontics and Dental

radiology

Oral Biology Community Dentistry Gen. Surgery

Pre-Prosthodontics Oral Surgery

Pre-Operative Dentistry Prosthodontics

Self-Directed Learning Sessions

5

Curricular Map Of BDS

6

BDS Program Outcomes

At the end of four years dental undergraduate program, the graduates should be able to:

1. Independently assess the patients, order relevant investigations and formulate a treatment plan.

2. Render treatments in the domain of general dental practitioners to their parents in time efficient

and quality-controlled manner.

3. Practice evidence-based dentistry.

4. Modify dental treatments according to patient’s special needs, if any, in the form of medical

conditions, physical or mental disabilities etc

5. Assess and refer the patients with case difficulty indices requiring consultation or treatment by

specialists.

6. Show empathy and respect in their attitude and behavior towards their patients.

7. Maintain high ethical and professional standards in their pursuit of clinical excellence.

8. Draw upon their existing knowledge and update it through continuing education programs.

9. Exercise infection control protocol guidelines laid out by their local health councils.

10. Exercise management qualities to maintain single or multiple unit private practices where

applicable.

11. Work in a team of other health care professionals including dentists, dental assistants, dental

hygienists, laboratory technicians, ceramists and dental nurses etc.

12. Maintain patient records with emphasis on legal and patient confidentiality aspects.

13. Provide basic life support to patients requiring critical care in or outside dental set up.

14. Manage dental emergencies in a dental set up.

15. Demonstrate clear verbal and written communication skills.

7

Undergraduate Competencies

IOD CMH Lahore medical College envisions to produce graduates who are proficient in

following competencies at the end of 4th year

Dental Expertise

Communication

Critical thinking

Management

Scholar

Professionalism

Evidence based practice providing holistic care

Empathetic

Providing Community service

8

Co-ordinators Third Year BDS 2019

Coordinator Name Department Extension

Prof. Dr. Muhammad

Nasir Saleem

Professor

Periodontology 314

Prof. Dr. Sabahat

Javaid

Professor

Oral Pathology 345

Assist Prof.

Dr. Fareed Ahmed

Assistant Professor

Oral Medicine 350

Associate Prof.

Dr Javaid Iqbal

Associate professor

General Medicine 470

Prof. Dr.Imran Daula

Professor

General Surgery 453

9

Class representatives

Name Designation

Saad Khakwani CR 1st Year BDS

Hafiza Eman GR 1st Year BDS

Muhammad Ahsan Fayyaz CR 2nd Year BDS

Alizay Fatima GR 2nd Year BDS

Rehan CR 3rd Year BDS

Arzoo Zulfiqar GR 3rd Year BDS

Ahmad Waheed CR Final Year BDS

Noor Fatima GR Final Year BDS

10

Clerkship Subjects

Following are the core subjects for Third year BDS for which professional examination will be held at

the end of the academic year:

1. Periodontology

2. Oral Pathology

3. Oral Medicine 4. General Medicine

5. General Surgery

Hours of teaching

Subject PMDC

2019

Lecture

hours

Clinical

hours

Self-

Study

hours

Total Teaching

Hours

CMH

Periodontology 175 60 126 0 186

Oral Pathology 150 120 31 0 151

Oral Medicine 125 50 84 0 134

General Medicine 200 72 180 0 252

General Surgery 200 58 175 0

233

Operative Dentistry 100 30 140 70

170

11

INTRODUCTION TO PERIODONTOLOGY

Periodontology is the specialty of dentistry that studies supporting structures of teeth, as well as

diseases and conditions that affect them. The supporting tissues are known as the periodontium, which

includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament.

Curricular Map of Periodontology

https://en.wikipedia.org/wiki/Specialty_(dentistry)

https://en.wikipedia.org/wiki/Dentistry

https://en.wikipedia.org/wiki/Tooth

https://en.wikipedia.org/wiki/Periodontium

https://en.wikipedia.org/wiki/Gingiva

https://en.wikipedia.org/wiki/Alveolar_bone

https://en.wikipedia.org/wiki/Cementum

https://en.wikipedia.org/wiki/Periodontal_ligament

12

Resources

a. Teaching resources

b. Infrastructure resources

Teaching resources

Sr. #. Faculty Name Department as per PM

& DC certificate

Qualification

1 Prof. Dr. Nasir Saleem Professor BDS, FCPS, MSc

2 Dr. Farhan Javed Assistant Professor BDS, MDS

3 Dr. Yousaf Athar Assistant professor BDS, MSc

4 Dr. Daniyal Naeem Dar Registrar BDS

5 Dr. Awrisha Tariq Registrar BDS

6 Dr. Aimen Malik Registrar BDS

7 Dr. Ayesha Tariq Registrar BDS

Infrastructure resources

Sr. #. Infrastructure Resources Quantity

1 Operating Halls 1

2 Dental Units

• Periodontology clinic

20

3 Dental Stools

• Periodontology

20

5 Reception 1

6 Mini Library 1

7 Staff Room 1

8 Dental stores 1

13

Supporting staff

Serial No. Name Designation

1 Najam Ejaz Dental Hygienist

2 Umber Chohan Dental Hygienist

3 Akif Sajid Dental Hygienist

4 Maria Rasheed Dental Hygienist

5 Farooq Ali Dental Assistant

Teaching and Learning Strategies

Multiple educational methods will be used comprising of self-study, interactive lectures, group

discussions, practical, and manual dexterity skill sessions.

(i) Methods for achieving cognitive objectives

• Interactive lectures using audio visual aids on power point presentation

• Group discussions in form of large group and small group

• Collaborative learning

• Self-study and reading from learning resources

(ii) Methods for achieving psychomotor objectives

• Theoretical information provided in lectures

• Clinical demonstrations provided by teaching faculty on models and patients

• Supervised practice on patients

(iii) Methods for achieving affective objectives

• Interaction with peers, group members, teachers, support staff etc.

• Group discussions (small and large)

• Oral presentations by students

14

Learning Methodologies

The following teaching /learning methods are used to promote better understanding:

• Interactive lectures

• Small group discussions

• Practical

• Skill sessions

• Self-directed learning

• Assignments


Interactive lectures

In large group, the lecturer introduces a topic which explains the underlying phenomena through

questions, pictures, exercise, etc. Students are actively involved in the learning process.

Small group discussions

This format helps students to clarify concepts and acquire skills and attitudes. Students exchange

opinions and apply knowledge gained from lectures and self-study. The facilitator role is to ask probing

questions, summarize, or rephrase to help clarify concepts.

Practical

In practical sessions students observe demonstrations from faculty members on proper instrument use

and handling both inside and outside the patients mouth. The students are trained in diagnosing and

treating a periodontal disease as per protocols set by the department.

Skill session

Students are required to practice suturing techniques on inanimate materials.

Self- directed learning

Students' take responsibilities of their own learning through individual study, sharing and discussing

with peers, seeking information from Learning Resource Center, teachers and resource persons within

and outside the college. Students can utilize the time within the college scheduled hours or afterwards

for self-study.

Assignments

Students are given written formative assignments on designated topics. Revision of the topics already

covered by anatomy and physiology departments are given to students as oral presentations.

Oral presentations by students

Students are assigned topics during revision session to enhance their communication skills and group

learning.

15

Curriculum Implementation

Curriculum implementation refers to putting into practice the official document including course

content, objectives, learning and teaching strategies. Implementation process helps the learner to

achieve knowledge, skills and attitudes required of the learning tasks. Learners are a pertinent

component of the implementation process. Implementation occurs when the learner achieves the

intended learning experiences, knowledge, ideas, skills and attitudes which are aimed to make the

learner an effective part of the society. Curriculum implementation also refers to the stage at which

curriculum is put into effect. There has to be an implementing agent as well. Teacher is an important

part of this process and implementation of the curriculum is the way the teacher selects and utilizes

various components of the curriculum. Implementation occurs when the teacher’s formulated course

content, teacher’s personality and teaching and learning environment interact with the learners.

Therefore, curriculum implementation is how the officially planned course of study is translated and

reflected by the teacher into schemes of work, lesson plans, syllabus and resources are effectively

transferred to the learners. Curriculum implementation can be affected by certain factors such as

teachers, learners, learning environment, resource materials and facilities, culture and ideology,

instructional supervision and assessments.

Personnel involved in teaching and facilitation

(i) Lectures delivery by:

Dr Nasir Saleem (Professor)

Dr Farhan Javed (Assistant Professor)

Dr Yousaf Athar (Assistant Professor)

(ii) Demonstrators for practical and small group discussion sessions:

Dr Daniyal Naeem Dar

Dr Awrisha Tariq

Dr Aimen Malik

Dr Ayesha Tariq

(iii) Support staff: 5 (4 Dental hygienists, 1 Dental Assistant)

(iv) Computer assistant: 1 as nominated by the college

16

Time frame

Course duration:

• Lectures: 36 weeks

• Clinical rotations: 9 weeks per rotation

Lectures:

• Monday (8:00 to 8:50am)

• Wednesday: (8:50 to 9:40 am)

Practical/ clinical visits:

• Tuesday and Thursday (10:00 to 3:00 pm)

• Friday (10:00 to 3:00 pm) with 1 pm to 2 pm Prayer break

17

Course Outline

Section - 1 The Normal Periodontium, Classification and Epidemiology of periodontal disease.

This section deals with the basic anatomy and physiology of the periodontium and gives an overview

of how to classify patients into different categories of periodontal disease. The incidence, distribution,

and possible control of periodontal diseases and other factors relating to health are also included in this

topic.

Section – 2 Etiology of periodontal disease

This subject includes the role of microbiology in periodontal disease and its interaction with the host

and its response in return. The influence of iatrogenic and systemic factors an dental deposits and how

they contribute towards periodontal disease is also covered here.

Section – 3 Periodontal pathogenesis.

This area deals with the pathogenesis of periodontal pocket, bone loss and explains the detail of the

phases of gingival inflammation.

Section – 4 Periodontal diseases.

This domain discusses in detail the diagnosis, pathogenesis, management and complications of various

periodontal diseases including autoimmune and acute periodontal conditions.

Section – 5 Periodontal Examination, Diagnosis and Therapy

This subject deals with the details of history taking, periodontal investigations and diagnosis. The

instruments, procedures and chemotherapeutic agents used to manage the periodontal diseases non

surgically are also covered under this topic.

Section – 6 Surgical Periodontology

This subject deals with the details of periodontal surgery, which includes the armamentarium,

preparation, techniques, and postoperative healing of curettage, gingivectomy, gingivoplasty and

various flap and bone surgeries. It also includes regenerative and periodontal plastic and esthetic

surgeries.

Section – 7 Dental Implants

This topic involves the basic knowledge of dental implants for students at an undergraduate level

teaching then the basic introduction, rationale, treatment planning and complications of implants.

Section – 8 Supportive Periodontal Care

This subject deals with the explaining management of patient with periodontal disease post-surgical

and non-surgical treatment and maintaining their oral hygiene. Details of patient referral are also

discussed is also covered under this domain.

18

Topic and Exam Weightage

Topic Weightage (%age)

The Normal Peridontium and Classification

and Epidemiology of Periodontal diseases

11

Etiology of Periodontal Disease 11

Periodontal Pathogenesis 11

Periodontal Disease 21

Periodontal Examination, Diagnosis and

Therapy

11

Surgical Periodontology 11

Dental Implants 11

Supportive Periodontal Care 13

Topic

Lecture

Hour

Weightage

(hrs)

Clinical

Hour

Weightage

(hrs)

The Normal Periodontium and Classification

and Epidemiology of Periodontal diseases

6.6 14

Etiology of Periodontal Disease 6.6 14

Periodontal Pathogenesis 6.6 14

Periodontal Disease 12.6 26.5


Therapy

6.6 14

Surgical Periodontology 6.6 14

Dental Implants 6.6 14

Supportive Periodontal Care 7.8 16.5

Total 60 127

19

TOPICS AND

OBJECTIVES

FACULTY

LEARNING

DOMAIN

(CPA)

LEARNING

STRATEGY

ASSESSMENT

Periodontology

Clinical

Viva

OSPE

NUMS

MCQs

NUMS

SEQs

THE NORMAL PERIDONTIUM, CLASSIFICATION AND

EPIDEMIOLOGY OF PERIODONTAL DISEASES

X

3

1

• Explain

development of the

tooth supporting

apparatus

Dr. Yousaf

Athar

C

Interactive

lecture/small

group

discussion

• Explain anatomy

of Periodontium C

Interactive

lecture/small

group

discussion

• Correlate the

microscopic

features and

clinical features of

the periodontium

C

Interactive

lecture/small

group

discussion

• Understand the

nerve and vascular

supply of the

periodontium

C

Interactive

lecture/small

group

discussion

• Explain effects of

Aging on the

normal

peri0dontium

C Interactive

lecture

• Explain gingival

diseases (plaque

and non-plaque

induced gingivitis

and periodontitis

along with

classification

CPA

Interactive

lecture/case-

based

discussion

• Discuss

developmental and

acquired

deformities along

with mucogingival

C

Interactive

lecture/small

group

discussion

20

deformities around

teeth

• Discuss the

definition of

epidemiology.

C

Interactive

lecture/small

group

discussion

• Explain how to

diagnose

periodontal

diseases and

difference between

chronic and

aggressive

periodontitis

C

Interactive

lecture/small

group

discussion

ETIOLOGY OF PERIODONTAL DISEASE X 3 1

PERIODONTAL MICROBIOLOGY

• Discuss diversity

of intraoral

surfaces for

bacterial adhesion

and structure and

composition of

dental plaque

Dr. Yousaf

Athar

C

Interactive

lecture/case-

based

discussion

• Discuss plaque

formation at

ultrastructural level

and growth

dynamics of plaque

C

Interactive

lecture/small

group

discussion

• Discuss different

properties of dental

plaque and

association of

plaque micro-

organisms with

periodontal

diseases

C

Interactive

lecture/ small

group

discussion

• Explain the role of

calculus and other

predisposing

factors

C

Interactive

lecture/case-

based

discussion

21

HOST RESPONSE AND HOST BACTERIAL INTERACTIONS

• Identification of

cells of immunity

and inflammation.

Dr. Yousaf

Athar

C

Interactive

lecture/ small

group

discussion

• Discuss

mechanism of

migration and

functioning of

leucocytes

C

Interactive

lecture/ small

group

discussion

• Discuss different

microbial aspects

of microbial host

interaction and

microbiology and

immunology in

periodontal

diseases

C

Interactive

lecture/ small

group

discussion

• Discuss toll like

receptors and

innate immunity

response

C

Interactive

lecture/ small

group

discussion

• Discuss similarities

between

periodontal

diseases and other

chronic

inflammatory

diseases

C

Interactive

lecture/case-

based

discussion

• Discuss host

response and

potential targets for

host modulation

C

Interactive

lecture/ small

group

discussion

• Explain host

modulatory therapy

C

Interactive

lecture/ small

group

discussion

SYSTEMIC FACTORS

22

• Treatment of

medically

compromised

patients

Dr. Farhan

Javed CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Influence of

systemic disorders

and stress on

periodontium

Dr. Farhan

Javed CPA

Interactive

lecture/case-

based

discussion/

Clinics

IATROGENIC AND OTHER FACTORS

• Overview of factors

predisposing to

periodontal disease

(local and systemic)

Dr. Farhan

Javed CPA

Interactive

lecture/case-

based

discussion/

Clinics

DENTAL DEPOSITS

• Explain origin,

composition,

formation and

mode of

attachment of

calculus

C

Interactive

lecture/ small

group

discussion

• Classify and

differentiate supra

and sub-gingival

calculus

Dr. Yousaf

Athar

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Explain theories of

mineralization C

Interactive

lecture/ small

group

discussion

• Clinical

significance of

calculus CPA

Interactive

lecture/case-

based

discussion/

Clinics

23

• Dental Stains,

Materia Alba,

Dental pellicle

CPA

Interactive

lecture/case-

based

discussion/

Clinics

PERIODONTAL PATHOGENESIS X 3 1

GINGIVAL INFLAMMATION

• Explain in detail

the 4 stages of

gingival

Inflammation

Dr. Yousaf

Athar CPA

Interactive

lecture/case-

based

discussion/

Clinics

PERIODONTAL POCKET

• Define and Classify

Periodontal Pocket

Dr. Farhan

Javed

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Explain the clinical

features,

pathogenesis and

pocket contents CPA

Interactive

lecture/ small

group

discussion/

clinics

• Histopathology of

Soft and hard tissue

wall of the

periodontal pocket C

Interactive

lecture/ small

group

discussion/

clinics

• Treatment options

for periodontal

pocket CPA

Interactive

lecture/case-

based

discussion/

Clinics

BONE LOSS AND PATTERNS OF BONE LOSS

• Bone destruction

patterns in

periodontal disease

Dr. Farhan

Javed CPA

Interactive

lecture/ small

group

24

discussion /

Clinics


caused by trauma

from occlusion

C

Interactive

lecture/ small

group

discussion /

Clinics


caused by systemic

disorders C

Interactive

lecture/ small

group

discussion /

Clinics

• Factors determining

bone morphology

in periodontal

disease

C

Interactive

lecture/ small

group

discussion /

Clinics

PERIODONTAL DISEASES X 4 2

GINGIVITIS

• Explain clinical

findings of

gingivitis including

gingival bleeding on

probing, color

changes, changes in

consistency and

surface texture

Dr. Farhan

Javed

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Explain changes in

position of gingiva

and changes in

gingival contour

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Role of Saliva

CPA

Interactive

lecture/ small

group

discussion /

Clinics

• Explain the

composition,

formation and

methods of

collection of GCF

CPA

Interactive

lecture/ small

group

discussion

25

• Clinical significance

of Sulcular fluid

CPA

Interactive

lecture/case-

based

discussion/

Clinics

ACUTE PERIODONTAL CONDITIONS

• Explain the

clinical features,

microbiology

involved,

diagnosis,

treatment and

complications of

peri-coronitis

Dr. Farhan

Javed

C

Interactive

lecture/case-

based

discussion/

Clinics

• Explain the

clinical features,

microbiology

involved,

diagnosis and

treatment of

Primary Herpetic

Gingivostomatitis

C

Interactive

lecture/case-

based

discussion

• Explain the

etiology, clinical

features,

microbiology

involved,

diagnosis and

treatment of

Necrotizing

ulcerative

Gingivitis

C

Interactive

lecture/case-

based

discussion

DESQUAMATIVE GINGIVITIS

• Diagnosis of

Desquamative

gingivitis

Dr. Farhan

Javed

C Interactive

lecture/case-

26

• Diagnose,

differentiate and

treat Lichen

Planus,

Pemphigoid,

Pemphigus

Vulgaris, Chronic

Ulcerative

Gingivitis, Linear

IgA disease,

Lupus

erythematosus,

Dermatitis

Herpetiformis and

Erythema

Multiforme.

C

C

C

based

discussion

Interactive

lecture/case-

based

discussion

Interactive

lecture/case-

based

discussion

• Drug Eruptions

• Conditions

mimicking

Desquamative

Gingivitis

GINGIVAL ENLARGEMENTS

• Classify Gingival

Enlargements.

Dr. Yousaf

Athar

CPA

Interactive

lecture/case-

based

discussion/

Clinics

C

Interactive

lecture/ small

group

discussion

• Explain the

pathophysiology

of different types

of gingival

enlargements

C

Interactive

lecture/ small

group

discussion

• Explain the

microscopic and

histopathological

features.

27

• Determine a

treatment plan for

all types of

Gingival

Enlargements

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Management

CPA

Interactive

lecture/case-

based

discussion/

Clinics

CHRONIC PERIODONTITIS

• Explain and

Correlate Clinical

and

histopathological

features of

Chronic

Periodontitis

Dr. Farhan

Javed

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Explain the

disease

distribution CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Management of

Chronic

Periodontitis CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Risk factors for

disease

CPA

Interactive

lecture/case-

based

discussion/

Clinics

AGGRESSIVE PERIODONTITIS

• Clinical features,

general

characteristics,

disease

distribution,

background and

management of

aggressive

periodontitis

Dr. Farhan

Javed CPA

Interactive

lecture/case-

based

discussion/

Clinics

28

• Risk factors for

disease

C

Interactive

lecture/case-

based

discussion/

Clinics

NECROTISING ULCERATIVE GINGIVTIS AND PERIODONTITIS

• Etiology, clinical

features,

microbiology

involved,

diagnosis and

treatment of

Necrotizing

Ulcerative

Gingivitis Dr. Farhan

Javed C

Interactive

lecture/case

-based

discussion

Interactive

lecture/case

-based

discussion

• Etiology, clinical

features,

microbiology

involved,

diagnosis and

treatment of

Necrotizing

Ulcerative

Periodontitis

TRAUMA FROM OCCLUSION

• Acute and Chronic

Trauma

Dr. Farhan

Javed

C

Interactive

lecture/case-

based

discussion

• Primary and

Secondary Trauma

C

Interactive

lecture/case-

based

discussion

• Consequences of

trauma

Interactive

lecture/case-

based

discussion

• Tissue Response

of trauma Interactive

lecture/ small

group

discussion

29

• Diagnosis of

Occlusal trauma C

Interactive

lecture/case-

based

discussion

• Occlusal

adjustment C

Interactive

lecture/case-

based

discussion

• Splinting

C

Interactive

lecture/case-

based

discussion

PERIODONTAL MANIFESTATION OF SYSTEMIC DISEASES

• Different systemic

diseases are

discussed with

reference to their

periodontal

manifestations

Dr. Farhan

Javed CPA

Interactive

lecture/case-

based

discussion/

Clinics

PERIODONTAL EXAMINATION DIAGNOSIS AND THERAPY X 3 1

PERIODONTAL EXAMINATION

• History taking

and Diagnosis

Dr. Yousaf

Athar

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Periodontal

screening and

complete

examination of

oral cavity.

CPA

Interactive

lecture/case-

based

discussion/

Clinics

PERIODONTAL DIAGNOSIS

• First and second

visit of patient

Dr. Yousaf

Athar

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Differential

diagnosis along

with laboratory

CPA Interactive

lecture/case-

based

30

aids to clinical

diagnosis

discussion/

Clinics

TREATMENT PLANNING AND PLAQUE CONTROL

• Phases of

periodontal

treatment,

retreatment of

patient in case of

reoccurrence Dr. Yousaf

Athar

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Mechanical

control of dental

plaque CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Motivation,

education and

instruction

Dr. Farhan

Javed

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Interdental

cleaning

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Scaling and root

planning with

advantages and

disadvantages CPA

Interactive

lecture/case-

based

discussion/

Clinics/

Skills

session

• Chemical control

of dental plaque

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Chemotherapeuti

c agents for

topical and

systemic

administration

CPA

Interactive

lecture/case-

based

discussion/

Clinics

INSTRUMENTATION

31

• Manual scaling

instruments

Dr. Yousaf

Athar

CPA

Interactive

lecture/case-

based

discussion/

Clinics/

Skills

session

• Ultrasonic scalers

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Surgical

instruments

CPA

Interactive

lecture/case-

based

discussion/

Clinics

CHEMOTHEURAPEUTIC AGENTS

• Definitions

Dr. Yousaf

Athar

C

Interactive

lecture/case-

based

discussion

• Antibiotics in

Periodontal

Diseases CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Local Drug

Delivery

C

Interactive

lecture/case-

based

discussion/

Clinics

PERIODONTAL THERAPY (NON-SURGICAL)

• Proper history

diagnosis and

examination of

patient Dr. Farhan

Javed

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Complete

periodontal

charting CPA

Interactive

lecture/case-

based

discussion/

32

Clinics/

Skills

session

• Scaling and Root

planning

CPA

Interactive

lecture/case-

based

discussion/

Clinics/

Skills

session

• Follow up

CPA

Interactive

lecture/case-

based

discussion/

Clinics

SURGICAL PERIODONTOLOGY X 3 1

GENERAL PRINCIPLES OF PERIODONTAL SURGERY

• Equipment, Pre op

management,

Anesthesia

Dr. Farhan

Javed

C

Interactive

lecture/case-

based

discussion

• Periodontal

dressings C

Interactive

lecture/case-

based

discussion

• Post op

instructions,

complications and

Management

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Indications and

Contraindications C

Interactive

lecture/case-

based

discussion

SURGICAL PROCEDURES

• Curettage –

Rationale,

indication,

procedure, post

treatment healing

CPA

Interactive

lecture/case-

based

discussion/

Clinics/

33

Dr Farhan

Javed

Dr. Nasir

Saleem

Skills

session

• Gingivectomy –

indication,

contraindications,

procedure, types

C

Interactive

lecture/case-

based

discussion

• Gingivoplasty -

indication,

contraindications,

procedure

C

Interactive

lecture/case-

based

discussion

• Flap surgery –

Classification,

designs, incisions,

suturing, post

treatment healing,

flap techniques,

sutures

C

Interactive

lecture/case-

based

discussion

• Osseous surgery –

Rationale, Factors,

Technique, steps

involved,

armamentarium,

post op

maintenance

C

Interactive

lecture/case-

based

discussion

• Regenerative

Periodontal

Therapy- GTR,

GBR, grafts

C

Interactive

lecture/case-

based

discussion

• Furcation

Involvement –

Anatomy,

Diagnosis, Factors

affecting,

Classification,

Treatment Options,

prognosis

CPA

Interactive

lecture/case-

based

discussion/

Clinics/

Skills

session

• Esthetic and Plastic

Periodontal

Surgery –

objectives, factors

affecting outcome,

techniques to

remove frenum,

deepen vestibule,

C

Interactive

lecture/case-

based

discussion

34

increase attached

gingiva.

DENTAL IMPLANTS X 3 1

• Basic Introduction

and Rationale of

Dental implants

Dr. Farhan

Javed

C

Interactive

lecture/

small group

discussion

• Treatment

Planning C

Interactive

lecture/case-

based

discussion

• Complications

C

Interactive

lecture/case-

based

discussion

SUPPORTIVE PERIODONTAL CARE X 3 1

• Rationale for

supportive

periodontal

treatment

Dr. Yousaf

Athar

C

Interactive

lecture/case

-based

discussion

• Maintenance

Program

CPA

Interactive

lecture/case

-based

discussion/

Clinics

• Classification of

post treatment

patients C

Interactive

lecture/case

-based

discussion

• Referral of patient

to the periodontist

CPA

Interactive

lecture/case

-based

discussion/

Clinics

• Splinting of the

teeth C

Interactive

lecture/case

35

Learning resources

Topics Resources

The Normal Peridontium

Classification of Periodontal Disease and

Epidemiology

• Clinical periodontology by Glickman

• Clinical Periodontology by Manson

• Color Atlas of Clinical Surgical

Periodontology by Strahan & White

• A textbook of clinical periodontology by Jan

Lindhe

• Fundamentals of Periodontics by Thomas G

Wilson, Kenneths Komman

• Periodontology and Periodontics, Modern

Theory and Practice by Sigurd P. Ramford

Major M. Ash

Etiology of Periodontal disease






Lindhe





Major M. Ash

Periodontal Pathogenesis






Lindhe





Major M. Ash

Periodontal Disease • Clinical periodontology by Glickman





Lindhe

36





Major M. Ash


Therapy






Lindhe





Major M. Ash

Surgical Periodontology






Lindhe





Major M. Ash

Dental Implantology






Lindhe





Major M. Ash

Supportive Periodontal Care



• Colour Atlas of Clinical Surgical



Lindhe



37



Major M. Ash

Other Learning Resources

Clinics / Practical Students will be involved in clinical work in the periodontology clinic

Videos Video familiarize the student with the procedures and protocols to assist

patients

Computer

Lab/CSs/DVDs/ Internet

Resources:

To increase the knowledge, students should utilize the available internet

resources and CDs/ DVDs. This will be an additional advantage to increase

learning.

Self-Learning

Self-Learning is scheduled to search for information to solve cases, read

through different resources and discuss among the peers and with the faculty

to clarify the concepts.

Assessment Methods

Internal Assessment

a. Weightage of internal assessment shall be 10 %, each for theory and practical, in BDS

Professional Examination.

b. The Internal Assessment shall comprise of monthly test / PBL / assignments / Clinical tests /

clinical Vivas,etc.

c. The Internal Assessment record shall be kept in the respective department of the College /

Institute and after approval of Principal, a summary as per University registration number shall

be furnished to the Controller of Examinations, at least two weeks before the commencement

of final examination.

d. The result of all the class tests / tools which contribute towards IA will be displayed to the

students during an academic year.

e. The same internal assessment shall be counted both for annual and supplementary

examinations. The students who are relegated, however, can improve the internal assessment

during subsequent year

f. Internal assessment tools of any subject may be changed after the approval of

respective FBS

Annual Examination

a. The weightage of Annual Examination shall be 90%, each for theory and practical, in BDS.

38

Sr.

No

Topic No of MCQs

(25)

(C1=10, C2=7,

C3=8) 01 mark

each

• No. of SAQs/SEQs (09)

05xSAQs/SEQs (C1 &

C2) =7 marks each

• 03xSAQ/SEQs(C3) =7

marks each

• 01xSAQs/SEQs(C3) =9

marks each

1 The Normal Periodontium 03 01

2 Classification of periodontal

disease and epidemiology

3 Etiology of periodontal disease

• Periodontal microbiology

• Host response and host

bacterial interactions

• Iatrogenic and other local

factors

• Systemic factors

• Dental deposits

03

4 Periodontal pathogenesis

• Gingival inflammation

• Periodontal pocket

• Bone loss and patterns of

bone loss

03

01

5 Periodontal diseases

• Gingivitis

• Acute periodontal

conditions

• Desquamative gingivitis

• Chronic enlargement

• Gingival growth

• Chronic periodontitis

• Aggressive periodontitis

• NUP, NUP

• Trauma from occlusion

• Systemic disease with

periodontal manifestation

04

02

6 Periodontal examination, diagnosis

and therapy

• Periodontal examination

• Periodontal diagnosis

• Treatment planning

• Plaque control

• Instrumentation

• Chemotherapeutic agents

• Periodontal therapy (non-

surgical)

03

01

39

b. The examination comprises of a theory paper and practical/clinical examinations as per

PM&DC regulations and the Table of Specifications (TOS) of the University.

c. The gap between two consecutive theory papers shall not be more than two days.

d. The Theory Paper shall be of 3-hours duration, held under the arrangements of the university.

It shall have two parts; MCQs (30%) and SAQs/SEQs (70 %) for the year 2018. It may be

changed after the approval of Academic Council.

e. Allocated time for MCQs for 2019 shall be as under:

25 MCQs - 30 Minutes




f. Each MCQs shall have four distractors

g. The distribution of SAQs/SEQs as well as MCQ difficulty levels for BDS annual examinations

is as under: -

7 Surgical periodontology

• Surgical curettage

• Gingivectomy ,

gingiveoplasty

• Flap surgery

• Osseous surgery ,

regenerative periodontal

therapy , GTR

• Furcation involvement

• Esthetic and plastic

periodontal surgery

03

01

8 Dental implants-basic intro ,

rationale , treatment planning ,

complications

03

01

9 Supportive periodontal care

• Rationale for supportive

periodontal treatment

• Maintenance program

• Classification of post

treatment patients

• Referral of patient to the

periodontist

• Splinting of teeth

03

01

Total 25 (25 marks) 09 (65 marks)

Grand Total 90 Marks

40

Internal assessment calculation (Theory/ Annual)

A B C D F G

Roll No.

Name

All modules/ Pre-Annual Exams or any other exam

Total Marks of internal

assessment out of 10

Total Marks Sum of Marks obtained x 10 / sum of total marks

in all exams

Table of specifications for Annual Professional Exam:

Practical

VIVA

50 marks

Practical / Clinical

40 marks

Total

Examiner 1

Examiner 2

Oral Examination

and Diagnosis

History

Taking

Scaling of teeth

Identification

of Slides and

Instruments

90 Marks

25 Marks

25 Marks

10 Marks

5 Marks

15 Marks

10 Marks

Internal assessment calculation (Practical)

A B C D F G

Roll No.

Name

OSPE/ Practical Class tests throughout the year / Pre

annual Practical Exams or any other exam



Total Marks

Sum of Marks obtained x 10 / sum of total marks

in all exams

41

Multiple Choice Question (MCQs)

• A multiple-choice question (MCQ) consist of a stem that states the question or problem

followed by a set of possible answers that contain an option that is best answer to the

question.

• After reading the questions students should select the appropriate option from the given

possible answers.

• The correct answer carries one mark and incorrect carries zero. There is no negative marking.

Sample MCQ

The tooth supporting tissues are derived from

a) Dental papilla

b) Dental follicle

c) Dental lamina

d) Hertwigs epithelial root sheath e) Enamel knot key: b

Short essay question (SEQs)

• Short essay questions require students to present written answers that are used to asses basic

knowledge of key facts and provide students with an opportunity to demonstrate reasoning and

explain their understanding of the subject.

Sample SEQ

A 29-year-old woman, medically fit and healthy, presented to your clinic with the complaint of food

impaction in upper right jaw. On probing, you find a deep periodontal pocket between tooth # 14 and

15.

a) Classify Periodontal Pockets. (2)

b) Correlate the Clinical and Histo-pathological features of periodontal pocket. (5)

Key: a)

True and false/pseudo pocket

Supra and infra bony pockets

Gingival and periodontal pockets

Simple, compound and complex pockets

b)

42

1 Gingival wall of pocket presents

various degrees of bluish red

discoloration; flaccidity; a smooth,

shiny surface; and pitting on pressure.

The discoloration is caused by circulatory

stagnation; the flaccidity, by destruction of

gingival fibres and surrounding tissues; the

smooth, shiny surface. By atrophy or

epithelium and edema; and the pitting on

pressure, by edema and degeneration

2 Less frequently, gingival wall may be

pink and firm.

In such cases, fibrotic changes predominate

over exudation and degeneration,

particularly in relation to outer surface of

pocket wall. However, despite external

appearance of health, inner wall of pocket

invariably presents some degeneration and is

often ulcerated (see figure 27-15)

3 Bleeding is elicited by gently probing

soft tissue wall of pocket

Ease of bleeding results from increased

vascularity, thinning and degeneration of

epithelium and proximity of engorged

vessels to inner surface

4 When explored with a probe, inner

aspect of pocket is generally painful

Pain on tactile stimulation is caused by

ulceration of inner aspect of pocket wall

5 In many cases, pus may be expressed

by applying digital pressure

Pus occurs in pockets with supportive

inflammation of inner wall

Internal Examiner

He/she shall be Professor and Head of Department who has been involved in teaching of the class being

examined for at least six months. Second preference shall be Associate/Assistant Professor who is

involved in teaching of the class and posted there for one year. Third preference shall be a recognized

Professor of the subject.

External Examiner

He/she shall be a Professor/Associate Professor of a recognized Medical/Dental College or at least an

Assistant Professor with three years teaching experience in the relevant subject.

Conflict of Interest

No person shall serve as an examiner whose close relative (wife, husband, son, daughter, adopted son,

adopted daughter, grand-son, grand-daughter, brother, sister, niece /nephew, son and daughter- in-law

brother and sister- in-law, parental and maternal uncle and aunt etc) is appearing in the examination.

All examiners likely to serve as an examiner shall render a certificate in compliance to this para.

Paper Setting

a. Each College / Institute shall forward a set of two question papers as per TOS along with the

key for each subject to the Controller of Examinations, at least three months in advance of the

annual examination. The question paper as a whole / a question without a comprehensive key

shall not be considered towards final paper setting.

b. The set of question papers shall be prepared by the respective Head of Department (HoD) and

furnished to Controller of Examinations through Head of Institution (HoI)

c. The Controller of Examinations shall approve the faculty for the final paper setting having fair

representation of each college / institute.

43

Paper Assessment

a. The Controller of Examinations shall approve the faculty for the theory paper marking, to be

undertaken in the manner as deemed appropriate.

b. The Examination Directorate shall coordinate directly with the faculty, earmarked for the paper

marking

c. A student who scores 85% and above marks in any subject shall qualify for distinction in that

particular subject.

d. A fraction in aggregate marks of a subject shall be rounded off to whole number. If it is less

than 0.5 then it will be rounded off to the previous whole number while 0.5 or more will be

rounded off to the next whole number.

Practical / Clinical Examinations

a. The Controller of Examiners shall approve the faculty to serve as the internal & external

examiners.

b. The number of external and internal examiners shall be equal.

c. One external & internal examiner each shall be marked for a group of 100 students.

d. Candidates may be divided into groups in the clinical and practical examinations and be

standardized by incorporating clinical exam

e. Practical/clinical examination shall be held after the theory examination of the subject

but in special cases, it may be held before the theory examination with the approval of the

Controller of Examinations. For the purpose of practical/clinical examination, the candidates

may be divided into sub groups by the examiners.

f. The assessment of the practical / clinical examination duly signed by internal & external

examiner shall be furnished to the Controller of Examinations within one week of the

conclusion of examination

Pass Marks

a. Pass marks for all subjects less Islamic / Pakistan Studies, shall be 50 % in theory and practical,

separately.

b. Pass marks for Islamic / Pakistan Studies shall be 33 % which, however, shall not be counted

towards final scoring of the professional examination.

c. No grace marks shall be allowed to any student in any examination.

Declaration of Result.

Every effort shall be made to declare the result of each examination within one month of the last

practical examination or earlier.

Promotion.

No student shall be promoted to the higher classes unless he/she passes all the subjects of the previous

class

Re-Totaling.

Any student may apply to the Controller of Examinations on a prescribed form along with the specified

fee.

44

Supplementary Examination.

The interval between a supplementary examination and the previous professional examination shall not

be more than two months. There shall be no special supplementary examination.

45

INTRODUCTION TO ORAL PATHOLOGY

Oral Pathology is the specialty of dentistry and pathology which deals with the

nature, identification, and management of diseases affecting the oral and

maxillofacial regions. It deals with diagnosis and study of the causes, processes

and effects of diseases affecting the oral and maxillofacial region. The main

method of examination of specimens is by light microscopy.

Curricular Map of Oral Pathology

46

Resources

a. Teaching resources

b. Infrastructure resources

c. Supporting staff

Teaching resources

Sr. #. Faculty Name Department as per PM

& DC certificate Qualification

1 Prof. Dr. Shabahat Javaid Butt Professor MBBS, MPhil

3 Dr. Faiqua Yasser Associate professor BDS, MPhil

4 Dr. Bismah Ahmad Senior Registrar BDS, Mphil

5 Dr. Ayesha Mohammad Rana Registrar BDS

6 Dr. Eesha Najam Registrar BDS

7 Dr. Shan Nafees Registrar BDS

8 Dr Khursand binte Azam Registrar BDS



1

Lecture hall

• Seating Capacity

• Multimedia

• Microphone

• Computer system

1

2

Oral Pathology lab

• Gross Specimens

• Microscope

• Slides

3 Mini library

1

Supporting staff a) Lab assistant

b) Computer operator/lecture hall attendant

47










• Focusing the histological slides on microscope

• Identification of normal histological structures on slides under different magnification

• Drawing and labeling the histological slides on practical notebooks









• Practical

• Skill sessions


• Assignments


48


In large group, the lecturer introduces a topic which explains the underlying phenomena

through questions, pictures, exercise, etc. Students are actively involved in the learning process.


This format helps students to clarify concepts and acquire skills and attitudes. Students

exchange opinions and apply knowledge gained from lectures and self-study. The facilitator

role is to ask probing questions, summarize, or rephrase to help clarify concepts.

Practical

In practical sessions students observe histological slides under microscope or on multimedia

for better understanding of the subject. They are also required to maintain practical manuals in

which they draw and label histological diagrams and different aspects/views of teeth for better

understanding.

Skill session

Students are taught to accurately carve out tooth models from soap for better understanding of

tooth morphology.


Students' take responsibilities of their own learning through individual study, sharing and

discussing with peers, seeking information from Learning Resource Center, teachers and

resource persons within and outside the college. Students can utilize the time within the college

scheduled hours or afterwards for self-study.

Assignments

Students are given written formative assignments on designated topics.


Students are assigned topics during revision session to enhance their communication skills and

group learning.

49


















(i) Lectures delivery by: Prof. Dr. Sahbahat Javaid Butt (Professor)

Dr. Faiqa Yassir (Associate professor)

(ii) Registrar for clinics/practical and small group discussion sessions:

• Dr. Bismah Ahmad (Senior Registrar)

• Dr. Ayesha Mohammad Rana

• Dr. Eesha Najam

• Dr. Shan Nafees

• Dr Khursand binte Azam

(iii) Support staff: 2 as nominated by the medical education department


Time frame

Course duration: 36 weeks

Lectures: Monday (8:50 to 9:40am) (11:40 to 12:00 pm)

Wednesday: (10:00 to 10:50 am) (11:40 to 12:00 pm)

Friday: (8:50 to 9:40 am)

Practical/ clinical visits:

Wednesday: (8:00 to 8:50 am)

Self-study: 5-6 hours per week

50

Course Outline

SECTION I- WHITE LESIONS

Topic weightage: 2.2 %, Time allocation: 3 weeks

Assessment items in Final Exams: 2 MCQS, 0 SEQ/SAQ, 1-OSPE Station

This section introduces students to diagnose the white lesions by correlating the clinical and

histopathological features. By the end of this unit, students will be able to distinguish white

lesions from one another on the basis of etiology, location and keratosis. e.g Candidiasis,

Leukoderma

SECTION II - EPITHELIAL PATHOLOGY

Topic weightage: 10 %, Time allocation: 5 weeks


This section familiarizes students with several key themes and subjects regarding

different types of lesions involving the squamous epithelium. It will include the concepts of

the lesions based on etiology, pathogenesis, clinical features and final diagnosis on

microscopic examination of the biopsy specimens. The aim of this section is to allow students

to develop scientific knowledge, understanding and competence in the area of e.g. Hyperplastic

Epithelial lesions, Benign epithelial lesions, Squamous cell carcinoma and variants

SECTION III - INFECTIONS

Topic weightage: 12.2 %, Time allocation: 10 weeks


The aim of this section is to allow students to develop understanding of infectious diseases.

Students of 3rd year BDS should be able to distinguish between different types of infections

and diagnose bacterial, fungal & viral infections. The students also learn the treatment

modalities of these diseases. e.g. Noma, Tuberculosis, Herpes simplex virus, Varicella Zoster

virus, Candidiasis, Histoplasmosis

SECTION IV - BONE PATHOLOGY

Topic weightage: 9 % , Time allocation : 4 weeks

Assessment items in Final Exams: 1 MCQS, 01SEQ/SAQ, 1-OSPE Station

The section helps the students to develop understanding regarding bone diseases. By the end

of this section, candidates will be able to distinguish different diseases and diagnose them using

clinical, radiographic & microscopic correlation. The students also learn the treatment

modalities of these diseases e.g Fibrous dysplasia, Cemento osseous dysplasia etc.

51

SECTION V - CONNECTIVE TISSUE LESIONS

Topic weightage: 2.2 %, Time allocation : 3 weeks


This sections helps students to understand the classification and types of the oral connective

tissue lesions, clinical presentation of connective tissue lesions and diagnosis of lesions with

clinical and microscopic features.

SECTION VI - HAEMATOLOGICAL MALIGNANCIES

Topic weightage: 11 %, Time allocation : 8 weeks


By the end of this section, candidates will be able to distinguish different diseases and diagnose

them using clinical, radiographic & microscopic correlation. The students also learn the

treatment modalities of these malignancies. e.g Hodgkins lymphoma Non Hodgkin lymphoma

SECTION VII - ODONTOGENIC AND NON ODONTOGENIC CYSTS



By the end of this section, students will be able to distinguish different cysts from one

another on the basis of their tissue of origin, nature, expansion and radiographic presentation.

Using the core knowledge will enable them to diagnose cysts using clinical, radiographic &

microscopic evaluation.

SECTION VIII - ODONTOGENIC TUMORS

Topic weightage: 9%, Time allocation : 4 weeks


By the end of this section, students will be able to distinguish different tumors from one

another on the basis of their tissue of origin, nature and radiographic presentation. Using the

core knowledge will enable them to diagnose odontogenic tumors using clinical, radiographic

& microscopic evaluation e.g. Ameloblastoma, Keratocystic odontogenic tumour.

SECTION IX - SALIVARY GLAND PATHOLOGY


52


In this section students will understand basic classification of salivary gland pathology describe

clinical presentation of salivary gland lesions Diagnosis of salivary gland lesions by correlating

clinical and microscopic features.

SECTION X - DENTAL CARIES AND PERIAPICAL DISORDERS

Topic weightage: 2.2 %, Time allocation : 3 weeks


In this section students are taught about the Etiology, Clinical Types, Role of Plaque,

Carbohydrates , Enamel Caries , Dentine Caries , Cementum Caries

SECTION XI - IMMUNE-MEDIATED DISORDERS:

Topic weightage: 10 %, Time allocation : 5 Weeks

Assessment items in Final Exams: 2 MCQS, 1SEQ/SAQ, 2-OSPE Station

In this section students are taught about different immune mediated disorders e.g. Pemphigus

vulgaris, Mucous membrane pemphigoid, Epidermolysis bullosa etc.

SECTION XII - DEVELOPMENTAL DISTURBANCES OF THE ORAL REGION



By the end of this section, candidates will be able to understand the basic classifications and

types of developmental anomalies, understand the congenital defects related to disturbances in

development of oral structures like lips, teeth, palate (hard and soft), tongue, understand the

developmental defects of oral cavity present in different types of syndromes related to genetic

defects in chromosomes

53

Table of specification for teaching, learning objectives and

assessment

At the end of the year students will be able to know:

TOPICS AND OBJECTIVES FACULT

Y

Learning

Domain

(CPA)

LEARNING

STRATEGY ASSESSMENT

Operative Dentistry Clinical viva OSPE NUMS

MCQs

NUM

S

SEQs

1. WHITE LESIONS X 2 0

• Enlist Candidiasis in

Dentistry

Dr. Faiqua

Yasser

C1

Interactive

lecture/small

group

discussion

• Explain the clinical and

histopathological

features of Leukodema,

White Sponge Nevus

Tobacco Pouch

Keratosis

Nicotine Stomatitis,

Actinic Cheilitis

C2

Interactive

lecture/small

group

discussion

• Describe the clinical

and histopathological

features of Submucous

Fibrosis, Hairy

Leukoplakia,

Hairy Tongue,

Geographic Tongue

C2

Interactive

lecture/small

group

discussion

• Discuss Dysplasia in

detail (mild, moderate,

severe, ca-in-situ)

C2

Interactive

lecture/small

group

discussion

• Overview of Lichen

Planus, Leukoplakia,

Speckled Leukoplakia,

PVL, Erythroplakia (red

lesion)

C3

Interactive

lecture/small

practical

• Enlist the recommended

guidelines for

sterilization of dental

operatories and dental

instruments

C2 Interactive

lecture

54

2.EPITHELIAL PATH X 2 1

• Understand basic

classification and types

of oral epithelial lesions

Dr. Faiqua

Yasser

C2

Interactive

lecture/case-

based

discussion

• Describe clinical

presentation of

epithelial lesions C2

Interactive

lecture/small

group

discussion

• Diagnosis of epithelial

lesions by correlating

clinical and microscopic

features of the

following diseases:

• Squamous Cell

Carcinoma ( definition,

risk factors,

pathogenesis)

• SCC Clinical

Presentation, TNM

Classification

• SCC Histopathological

Grading, treatment,

prognosis

• Variants of SCC

(Verrucous, spindle,

basaloid, adenoid,

adenosquamous,

nasopharyngeal)

• Squamous papilloma

• Keratoacanthoma

• Smokers melanosis

• Melanoma

(ABCD,clinical types

only)

C3

Interactive

lecture/case-

based

discussion

2. INFECTIONS X 4 1

• Discuss Different Viral

Infections:

• Herpes simplex virus

• Varicella Zoster virus

• Epstein- barr virus

• Cytomegalovirus

• Human Herpesvirus 8

• Human papilloma

viruses

• Retrovirus (HIV)

Dr. Faiqua

Yasser

C2

Interactive

lecture/practic

al

1

55

• Discuss Different

Bacterial infections and

Granulomatous

disorders

• Noma

• Tuberculosis

• Syphilis

• Actinomycosis

C3

Interactive

lecture/case-

based

discussion

2

• Discuss Different

Fungal Infections

• SUPERFACIAL

FUNGAL

INFECTIONS e.g

Candidiasis

• DEEP FUNGAL

INFECTIONS e.g

Histoplasmosis,

Paracoccidiodomycosi,

Blastomycosis,

Aspergillosis

C2 Interactive

lecture 1

3. BONE PATHOLOGY X 1 1

• Distinguish different

diseases and diagnose

them using clinical,

radiographic &

microscopic correlation.

1. Fibrous dysplasia

2. Cemento osseous

dysplasia

3. Ossifying Fibroma

4. Paget’s disease

5. Hyperparathyroidism

6. Osteopetrosis

7. Osteogenesis

imperfecta

8. Cherubism

9. Cleidocranial

dysplasia

10. BENIGN

TUMOURS:

• Tori

• Osteoblastoma&

osteoid osteoma

• Giant cell lesions

11. MALIGNANT

TUMOURS:

Dr. Faiqua

Yasser

C1

Interactive

lecture/small

group

discussion

56

• Osteogenic sarcoma

• Chondrosarcoma

• Ewing’s sarcoma

4. CONNECTIVE

TISSUE LESIONS X 2 0


classification and types

of oral connective tissue

lesions

Prof.Dr.

Shabahat

Javaid Butt

C2

Interactive

lecture/case-

based

discussion


presentation of

connective tissue

lesions

C3

Interactive

lecture/case-

based

discussion

• Diagnosis of these

lesions by correlating

clinical and microscopic

features of the

following diseases:

• 1- Fibrous tissue lesions

2- Neural tissue

neoplasms

• 3- Muscle tissue

neoplasms

• 4- Adipose and

Vascular tissue

neoplasms

• 5- Osseous and

cartilaginous tissue

neoplasms

C3

Interactive

lecture/practic

al

5. HAEMATOLOGICA-

L MALIGNANCIES X 1 1

• Distinguish different

diseases and diagnose

• them using clinical,

radiographic &

microscopic correlation.

The treatment

modalities of these

malignancies.

1- Hodgkins lymphoma

2- Non Hodgkin

lymphoma

3- Burkitt Lymphoma

4- Multiple Myeloma

5- Plasmacytoma

Prof.Dr.

Shabahat

Javaid Butt

C2

Interactive

lecture/case

based

discussion

57

6- Langerhan cell

histiocytosis

7- Anaemia and

Leukaemia (Oal

presentation only)

6. ODONTOGENIC

AND NON

ODONTOGENIC

CYSTS

X 2 1

• Diagnose cysts using

clinical, radiographic &


• ODONTOGENIC

CYSTS:

1. Periapical cysts

2. Dentigerous cysts

3. Eruption cysts

4. Paradental cysts

5. Lateral periodontal

cysts

6. Gingival cysts of

adult & newborn

7. Glandular

odontogenic cyst

• NON-

ODONTOGENIC

CYSTS:

1. Nasopalatine duct

cysts

2. Nasolabial cysts

3. Globulomaxillary

cyst

4. Median palatal cyst

5. Median mandibular

cyst

6. Palatal cysts of

newborn

7. Dermoid cyst

8. Epidermoid cys

Dr. Faiqua

Yasser

C1

Interactive

lecture/case-

based

discussion

1

1

7. ODONTOGENIC

TUMOURS: X 1 1

• Diagnose odontogenic

tumours using clinical,

radiographic &


Dr. Faiqua

Yasser

C2

Interactive

lecture/case-

based

discussion

58

• EPITHELIAL

ODONTOGENIC

TUMORS:

1. Ameloblastoma

2. Keratocystic

odontogenic tumour

3. Calcifying epithelial

odontogenic tumour

4. Adenomatoid

odontogenic tumou

5. Squamous

odontogenic tumourr

• CONNECTIVE

TISSUE

ODONTOGENIC

TUMOURS

1. Odontogenic fibroma

2. Odontogenic

myxoma

3. Cementoblastoma

4. Ameloblastic

fibroma& fibrodontoma

5. Odontogenic

carcinoma

6. Primary intra osseous

carcinoma

C2

8. SALIVARY GLAND

PATHOLOGY X 2 1


classification of salivary

gland pathology

Dr. Faiqua

Yasser

C2

Interactive

lecture/practic

al


presentation of salivary

gland lesions

1. Reactive Lesions

(mucocele, mucous

retention cyst,

sialolithiasis,

necrotizing

sialometaplasia)

2. Infections (bacterial

sialadenitis)

3. Immune-mediated

diseases

(lymphoepithelial

sialadenitis, Sjogren

syndrome)

C2

Interactive

lecture/practic

al

59

4. Benign tumours

(pleomorphic adenoma,

warthin tumour,

monomorphic adenoma)

5. Malignant tumours

(mucoepidermoid

carcinoma, adenoid

cystic carcinoma, acinic

cell carcinoma,

polymorphous low-

grade adenocarcinoma)

C3

9. DENTAL CARIES

AND PERIAPICAL

DISORDER

X 4 0

• DENTAL CARIES:

1 Aetiology

2 Clinical Types

3 Role of Plaque,

Carbohydrates

4 Enamel Caries

5 Dentine Caries

6 Cementum Caries

• PERIAPICAL

PATHOLOGY:

1. Acute and chronic

periodontitis

2. Chronic apical

periodontitis

3. Periapical abscess

4. Periapical granuloma

5. Acute and chronic

osteomyelitis

6. Cellulitis

Dr.Faiqua

Yasser C2

Interactive

lecture/case-

based

discussion

2

2

10. IMMUNE-

MEDIATED

DISORDERS

X 2 1

• Describe

1.Pemphigus vulgaris

2 Mucous membrane

pemphigoid

3 Epidermolysis bullosa

4 Erythema Multiforme

5 Lichenoid Reactions

Dr. Faiqua

Yasser C3

Interactive

lecture

11. DEVELOPMENTAL

DISTURBANCES OF

ORAL LESIONS

X 2 1

60


classifications and types

of developmental

anomalies

Dr. Faiqua

Yasser

C1

Interactive

lecture/practic

al

• Understand the

congenital defects

related to disturbances

in development of oral

structures like lips,

teeth, palate (hard and

soft), tongue

C2

Interactive

lecture/practic

al

• Understand the

developmental defects

of oral cavity present in

different types of

syndromes related to

genetic defects in

chromosomes

Dr. Faiqua

Yasser

C3

Interactive

lecture/case-

based

discussion

• Developmental

disturbances of oral

region are discussed

under three broad

categories

1- Developmental

disturbances in Teeth

2- Developmental

disturbances in soft

tissue

3- Developmental

disturbances in bone

C1

Interactive

lecture/small

group

discussion

61

Learning Resources

Topics Resources

Oral Pathology

WHITE LESIONS Contemporary oral and maxillofacial pathology.

EPITHELIAL PATHOLOGY Contemporary oral and maxillofacial pathology

DENTAL CARIES

Contemporary oral and maxillofacial pathology

DEVELOPMENTAL DISTURBANCES OF

THE ORAL REGION Contemporary oral and maxillofacial pathology

PERIAPICAL DISORDERS Contemporary oral and maxillofacial pathology

IMMUNE-MEDIATED DISORDERS Cawson's essentials of oral pathology and oral medicine.

SALIVARY GLAND PATHOLOGY Contemporary oral and maxillofacial pathology

VIRAL INFECTIONS

1. Contemporary oral and maxillofacial pathology

2. Cawson's essentials of oral pathology and oral medicine

3. Neville Oral and maxillofacial pathology

FUNGAL INFECTIONS Contemporary oral and maxillofacial pathology

BACTERIAL INFECTIONS +

GRANULOMATOUS DISEASES

Oral and Maxillofacial Pathology 6th Edition Clinical

Pathologic Correlations Authors:

Joseph Regezi ,James Sciubba ,Richard Jordan

ODONTOGENIC TUMOURS



ODONTOGENIC CYSTS



Non-ODONTOGENIC CYSTS Contemporary oral and maxillofacial pathology

BONE PATHOLOGY

Neville Oral and maxillofacial pathology

CONNECTIVE TISSUE LESIONS Neville Oral and maxillofacial pathology

62

HAEMATOLOGICAL Contemporary oral and maxillofacial pathology

MALIGNANCIES (Lymphomas) Contemporary oral and maxillofacial pathology


Hands- on Activities / Practical

Students will be involved in Practical sessions and hands-on activities that

link with the blood module to enhance the learning

Labs

Utilize the lab provides the simulated learning to the specimens and models

available.

Skills Lab

A skills lab provides the simulated learning experience to learn the basic

skills and procedures. This helps patients

Computer


Resources:



learning.

63

Summative Assessment Methods and Policies

Internal Assessment



b. The Internal Assessment shall comprise of monthly test / assignments / class presentation

/ send-ups /class tests / OSPE etc.


Institute and after approval of Principal, a summary as per University registration number

shall be furnished to the Controller of Examinations, at least two weeks before the

commencement of final examination.




examinations. The students who are relegated, however, can improve the internal

assessment during subsequent year

f. Internal assessment tools of any subject may be changed after the approval of respective

FBS

Annual Examination





d. The Theory Paper shall be of 3-hours duration, held under the arrangements of the

university. It shall have two parts; MCQs and SEQs for the year 2019. It may be changed

after the approval of Academic Council.

• Internal Examiner

He/she shall be Professor and Head of Department who has been involved in teaching

of the class being examined for at least six months. Second preference shall be

Associate/Assistant Professor who is involved in teaching of the class and posted there

for one year. Third preference shall be a recognized Professor of the subject.

• External Examiner

He/she shall be a Professor/Associate Professor of a recognized Medical/Dental

College or at least an Assistant Professor with three years teaching experience in the

relevant subject.

• Conflict of Interest

No person shall serve as an examiner whose close relative (wife, husband, son,

daughter, adopted son, adopted daughter, grand-son, grand-daughter, brother, sister,

64

niece /nephew, son and daughter- in-law brother and sister- in-law, parental and

maternal uncle and aunt etc) is appearing in the examination. All examiners likely to

serve as an examiner shall render a certificate in compliance to this para.

• Paper Setting

a. Each College / Institute shall forward a set of two question papers as per TOS along

with the key for each subject to the Controller of Examinations, at least three months

in advance of the annual examination. The question paper as a whole / a question

without a comprehensive key shall not be considered towards final paper setting.

b. The set of question papers shall be prepared by the respective Head of Department

(HoD) and furnished to Controller of Examinations through Head of Institution (HoI)

c. The Controller of Examinations shall approve the faculty for the final paper

settinghaving fair representation of each college / institute

• Paper Assessment

a. The Controller of Examinations shall approve the faculty for the theory paper marking,

to be undertaken in the manner as deemed appropriate.

b. The Examination Directorate shall coordinate directly with the faculty,earmarked for

the paper marking

c. A student who scores 85% and above marks in any subject shall qualify for distinction

in that particular subject.

d. A fraction in aggregate marks of a subject shall be rounded off to whole number. If it

is less than 0.5 then it will be rounded off to the previous whole number while 0.5 or

more will be rounded off to the next whole number.

• Practical Examinations


examiners.


c. One external& internal examiner each shall be marked for a group of 100 students.

d. Candidates may be divided into groups practical examinations and be standardized by

incorporating OSPE stations.

e. Practical examination shall be held after the theory examination of the subject but in

special cases, it may be held before the theory examination with the approval of the

Controller of Examinations. For the purpose of practical/clinical examination, the

candidates may be divided into subgroups by the examiners.

f. The assessment of the practical examination duly signed by internal & external


conclusion of examination.

• Pass Marks

a. Pass marks for all subjects shall be 50 % in theory and practical, separately.

b. No grace marks shall be allowed to any student in any examination.

• Declaration of Result

Every effort shall be made to declare the result of each examination within one month

of the last practical examination or earlier.

• Promotion

65

No student shall be promoted to the higher classes unless he/she passes all the subjects

of the previous class

• Re-totaling

Any student may apply to the Controller of Examinations on a prescribed form along

with the specified fee.

• Supplementary Examination

The interval between a supplementary examination and the previous professional

examination shall not be more than two months. There shall be no special

supplementary examination.

• Academic Audit

The Vice Chancellor may get any academic matter deliberated in the manner as deemed

appropriate.

• Issue of Academic Transcript/Detailed Marks Sheet

A student desirous of obtaining Academic Transcript / Detailed Mark Sheet may

apply to Controller of Examinations along with the prescribed fee for each original

copy.

• Withdrawal/Failure

Any student who fails to clear the first Professional in BDS orfirst in four chances,

availed or un-availed, shall be expelled as per PM& DC policy and shall not be eligible

for fresh admission as a fresh candidate in either BDS.

66

Table of specifications for Annual Professional Examination: Theory

Marks of Written Paper

Marks of Int. Asses

= 90

= 10

Time Allowed = 03 hrs

(Including MCQs)

Max Marks = 100 Date:

Pass Marks = 50

25 x MCQs (on separate sheet) (25 Marks) (Time = 30 min) 05 x SAQs/SEQs (C1 & C2) = 07 marks each 03 x SAQs/SEQs (C3) = 07 marks each (65 Marks) (Time = 2hrs 30 min) 01 x SAQs/SEQs (C3) = 09 marks each

S. NO

TOPIC

No. of MCQs (25) (C1=10, C2= 7, C3= 8) 01 mark each

No. of SAQs/SEQs (9)

• 05 x SAQs (C1&C2) = 07 marks each

• 03 x SAQs/SEQs (C3) = 07 marks each


1 WHITE LESIONS 02

2 EPITHELIAL PATHOLOGY 02 01

3 DENTAL CARIES 02

4 DEVELOPMENTAL DISTURBANCES of the ORAL REGION

02 01

5 PERIAPICAL DISORDERS 02 01

6 IMMUNE-MEDIATED DISORDERS 02

7 SALIVARY GLAND PATHOLOGY 02 01

8 VIRAL INFECTIONS 01

01

9 FUNGAL INFECTIONS 01

10 BACTERIAL INFECTIONS + GRANULOMATOUS DISEASES

02

11 ODONTOGENIC TUMOURS 01 01

12 ODONTOGENIC CYSTS 01 01

13 Non-ODONTOGENIC CYSTS 01

14 BONE PATHOLOGY 01 01

15 CONNECTIVE TISSUE LESIONS 02

16 HAEMATOLOGICAL MALIGNANCIES (Lymphomas)

01 01

Total 25 (25 Marks) 09 (65 Marks)

67

A. Internal Assessment Calculation (Theory Annual)

A B C D

Roll No. Name All Modules/ Pre annual Exams or any other exam

Total Marks of internal Assessment out of 10

Total Marks Sum of Marks obtained x 10 / sum of total marks in all exams

Table of Specifications for Annual Professional Exam: Practical

VIVA

50 marks

Practical (OSPE • Draw and label

Task) 40 marks

Total

Examiner I

Examiner 2 OSPE

Total = 15 Stations

Practical

Notebook

25 marks 25 marks 30 marks 10 marks 90 marks

Internal Assessment Calculation (Practical)

A B C D

Roll no. Name OSPE/ PTT/ Class

tests though out the

year/ Pre annual

Exams or any other

exam

Total Marks of

Internal assessment

Out of 10

Total Marks

Sum of Marks

obtained x 10 / sum

of total marks in all

exams

68

Sample MCQs and SEQs


• A multiple choice question (MCQ) consist of a stem that states the question or problem


question.


possible answers.


Sample MCQ

A cyst occurring under the tongue, caused by obstruction of salivary gland duct, is called as:

a) Follicular cyst

b) Dentigerous Cyst

c) Ranula

d) Epidermoid cyst

Key: c



knowledge of key facts and provide students with an opportunity to demonstrate reasoning

and explain their understanding of the subject.

Sample SEQ

Q. A 12 years of boy presented with painless, bilateral symmetrical expansion of mandible,

apparent upward tilt of eyes with cervical lymphadenopathy.

a) What is your diagnosis? (1)

b) Give probable histopathological and radiographical features of your diagnosis? (4)

c) Give D/D of other Giant Cell Lesions in the oral cavity? (2)

Key:

a) Cherubism

b) Histopathological features:

The tissue contains some area in which cellular fibrous connective tissue predominates and other

areas are dominated by immature metaplastic bone with a woven pattern. There is blending of

69

lesional tissue with surrounding normal bone and cortical plates. Multinucleated osteoclast-like giant

cells near bone and within soft fibrous stroma.

Radiographic Features:

The radiologic findings of cherubism are characterized by bilateral relatively symmetric jaw involvement

that is limited to the maxilla and mandible, showing expansile remodeling of the involved bones, thining

of the cortexes, and mixed radiopaque and radiolucent “cotton ball” pattern with a coarse trabecular

pattern.

c) D/D for Giant cell lesions:

1) Central giant cell granuloma

2) Peripheral Giant cell Granuloma

3) Cherubism

4) Aneurysmal bone cyst

5) “Brown tumor” of hyperparathroidim

70

INTRODUCTION TO ORAL MEDICINE

Oral medicine is the discipline of dentistry concerned with the oral health. Diagnosis and management

of medical conditions that affect the oral and maxillofacial region such as; orofacial pain, oral

manifestations of systemic diseases, salivary gland disorders, and the management of medically

compromised patients with oral health issues by non-surgical treatments.

Curricular Map for Oral Medicine

71

Resources a) Teaching resources

b) Infrastructure resources

Teaching resources

Sr. #. Faculty Name Designation as per PM

& DC certificate Qualification

1 Dr. Fareed Ahmad Assistant Professor BDS, MCPS

2 Dr. Muhammad Shairaz Sadiq Assistant Professor BDS, MCPS

3 Dr. Aleena Saeed Registrar BDS

4 Dr. Manal Registrar BDS

5 Dr. Ayesha Noor Registrar BDS



1 Oral Medicine and Diagnosis Dental Hall

1

2

Dental Units

• Oral Medicine

• Diagnosis

2

2

3

Dental Stools

• Oral Medicine

• Diagnosis

2

2

4 Reception 1

5 Mini Library 1

7 Dental equipment and materials

72





















• Practical

• Skill sessions


• Assignments


73






opinions and apply knowledge gained from lectures and self-study. The facilitator role is to ask probing

questions, summarize, or rephrase to help clarify concepts.

Practical


and handling both inside and outside the patient’s mouth. The students are trained in diagnosing and


Skill session






for self-study.

Assignments





learning.

74


















(iv) Lectures delivery by:

Dr Fareed Ahmad (Assistant Professor)

Dr Muhammad Shairaz Sadiq (Assistant Professor)

(ii) Demonstrators for practical and small group discussion sessions:

Dr Mannal Sohail

Dr Ayesha Noor

Dr Bareerah Idrees

(iii) Support staff: 3 (3 Dental Assistants) as nominated by college

Time frame


Lectures: Monday (10:00am to 10:50am), Friday (8:00 am to 8:50am)

Clinical rotation: 6 weeks - Tuesday and Thursday (10:00 am to 3:00 pm), Friday (10:00 am

to 1:00pm)

75

Course Outline

Normal mucosa assessment and investigations

• Histology

• General health status

• Oral examination (including lips oral mucosa floor of the mouth teeth gingival occlusion salivary glands jaw bones)

• Examination of temporomandibular joint

• Laboratory aids

• Analysis treatment planning and patient management

Soft tissue lesions

• White lesions

• Pigmented lesions

• Ulcerative lesions

• Vasculo-bulbous lesions

• Pre-malignant lesions clinical features diagnosis and management

• Disorders of the tongue and lips clinical features, diagnosis and treatment planning

• Diseases of salivary glands xerostomia: clinical features, diagnosis and management

Hard tissue lesions

• Diseases of jaw bones; clinical features diagnosis and management

• Diseases of tempro-mandibular joint; clinical features diagnosis and treatment planning

• Disorders of teeth clinical features diagnosis and treatment

• Focal infection; Significance diagnosis and management of effect cases

• Clinical features diagnosis and treatment of pain

Systemic disorders

• Anaemia

• Leukaemia

• Bleeding disorders

• Patients on anti-coagulant therapy management

76

Overview

A1. History taking A2. Clinical

examination

A3. Investigations A4. Management

A4a. prescribing &

therapeutics

A4b. operative

interventions

B1. Normal

mucosa

assessment

B2. Soft

tissue lesions

B3. Hard

tissue lesions

B4. Systemic

disorders

B5. Pain in

orofacial

region

B6. Medical

emergencies

Histology White lesions Jawbone

diseases

Anaemia Facial pain prevention

General

health status

Pigmented

lesions

TMJ diseases Leukaemia

and leukopenia

Neuropathic

pain

Emergency drugs

and equipment

Mucosa of

lips, floor of

mouth and teeth, gingiva

and occlusion.

Ulcerative

lesions

Disorders of

teeth

Bleeding

disorders

Migraine,

cluster,

tension type headaches

Vesiculo bulbous

lesions

Focal infections

Nutritional deficiencies

Neurological dysfunction

Pre-malignant

and malignant lesions

Endocrine

disturbances

Disorders of

tongue and lips

Renal

diseases

Salivary

glands

diseases

+ No. of MCQs (13)

• (C1=2, C2= 5, C3= 6)

• 01 mark each

* No. of SAQs/SEQs (6)

• 02 x SAQs/SEQs (C1&C2) = 05 marks each

77

• 01 x SAQs/SEQs (C1&C2) = 04 marks each


S.

No

Topic +

MCQs

*SAQs/

SEQs

Weightage

(%)

Weeks

1.

Principles of oral medicine:

assessment and investigation of

patient

1

1

11

4

2.

Infections of gingiva and oral mucosa

3.

Oral ulceration 02

02

31

11

4.

Diseases of lips and tongue

5.

Swellings of face and neck

01

6.

Salivary glands and saliva

7.

Inflammatory overgrowths,

developmental and benign lesions

and oral pigmentation

01

01

18

7

8.

Precancerous lesions and conditions

9.

Oral Carcinoma & Carcinogenesis 01

10.

Muco-cutaneous diseases and

connective tissue disorders

01

11.

Oral manifestation of systemic

diseases

01

01

24

9

12.

Orofacial pain & Psychogenic Pain 01

13.

Temporomandibular disorders 01

14.

Immunity and oral reactions to drug

therapy

01

15.

Disorders of teeth and bone 01

16.

Medical emergencies in dentistry 01 01 16 5

78

TOPICS and

OBJECTIVES

FACULTY

LEARNIN

G DOMAIN

(CPA)

LEARNING

STRATEGY

ASSESSMENT

Oral Medicine

Clinical Viva OSPE NUMS

MCQs

NUMS

SEQs

12. The Oral Mucosa

3

1

• Discuss Normal

oral Mucosa

o Structure

o Function

o Age

changes

Dr.

Muhammad

Shairaz

Sadiq

C

Interactive

lecture/smal

l group

discussion

• Discuss Abnormal

oral mucosa C

Interactive

lecture/smal

l group

discussion

• Oral mucosa in

generalized

disease C

Interactive

lecture/smal

l group

discussion

• Periodontium in

generalized

disease C

Interactive

lecture/smal

l group

discussion

13. Principles of oral medicine: assessment and investigation of

patients

3 1

• Speciality of oral

medicine

Dr.

Muhammad

Shairaz

Sadiq

C Interactive

lecture

• Patient assessment

o History taking

• Examination

CPA

Interactive

lecture/ clinic

visits

• Investigations

o Blood

examination

o Clinical chemistry

o Immunological

tests

o Endocrine

function

o Urinalysis

C

Interactive

lecture/small

group

discussion

79

o Biopsy

o Microbiol

ogical

investigati

ons

• Imaging

techniques

• Discuss how to

form diagnosis C

Interactive

lecture/case-

based

discussion

14. Therapy

• Discuss Principles

of Therapy

Dr.

Muhammad

Shairaz

Sadiq

C

Interactive

lecture

• Discuss topical

therapy

o Covering agents

o Topical

antiseptics

o Topical analgesics

o Topical antibiotics

• Topical

corticosteroids

C

Interactive

lecture/case-

based

discussion

• Discuss Creams

and ointments C

Interactive

lecture/ case

based

discussion

• Discuss systemic

therapy

o Systemic

corticosteroids

o Azathioprine

• Other systemic

drugs used in oral

medicine

C

Interactive

lecture/

Case based

discussion

80

• Discuss

Limitations of

therapy

C

Interactive

lecture/ case

based

discussion

15. Infections of gingivae and oral muosa

• Discuss Bacterial

infections

o Acute necrotizing

ulcerative

gingivitis

o Syphilis

o Gonorrhea

o Non-specific

urethritis

o Tuberculosis

Dr. Fareed

Ahmad

C

Interactive

lecture/ case

based

discussion

• Discuss Fungal

infections

Oral candidiosis C

Interactive

lecture/ case

based

discussion

• Discuss Viral

infections

o Herpes simplex

virus infections

o Varicella zoster

virus infections

o Epstein-Barr virus

infections

o Paramyxovirus

infections

o Human

papillomavirus

infections

o Human

immunodeficiency

virus and AIDS

C

Interactive

lecture/ case

based

discussion

16. Oral Ulceration

• Discuss Traumatic

ulceration

o Aetiology

o Clinical features

o Management

C

Interactive

lecture/case-

based

discussion

81

• Discuss Recurrent

aphthous

stomatitis (RAS)

o Clinical features

o Aetiology of RAS

o Histopathology

and

immunopathogene

sis of RAS

o Systemic

conditions and

RAS like lesions

o Management of

RAS

Dr

Muhammad

Shairaz

Sadiq

C

Interactive

lecture/case-

based

discussion

• Behcet’s disease C

Interactive

lecture

17. Diseases of the lips and tongue and

disturbances of taste and halitosis

• Discuss diseases of

the lips

o Swelling of the lips

o Angular cheilitis

(angular stomatitis,

chelosis, perleche)

o Lip fissures

o Allergic cheilitis

o Actinic cheilitis (solar

keratosis)

o Exfoliative cheilitis

o Perioral dermatitis

o Lick eczema

o Cheilocandidosis

C

Interactive

lecture/ case

based

discussion

• Discuss diseases of

tongue

o Developmental

abnormalities and

morphological

variations

o Tongue fissures

o Coated tongue

o Hairy tongue

o Atrophy of the lingual

epithelium

o Traumatic irritation of

the tongue

Dr. Fareed

Ahmad

C

Interactive

lecture/ case

based

discussion

82

o Enlargement of the

foliate papillae

o Geographic tongue

(erythema migrans,

benign migratory

glossitis), median

rhomboid glossitis

• Discuss disturbances

of taste and halitosis

o Disturbances of taste

C Interactive

lecture/ case

based

discussion

18. Swellings of the face and neck

• Discuss facial

swellings

Differential

diagnosis

Dr.

Muhammad

Shairaz

Sadiq

C

Interactive

lecture/case-

based

discussion

• Discuss Swellings

in the neck C

Interactive

lecture

• Discuss Cervical

lymphadenopathy

o Differential

diagnosis

o Examination of

the lymph nodes

o Inflammatory

causes

• Neoplastic causes

of lymph node

enlargement

C

Interactive

lecture/ case

based

discussion

19. Salivary glands and saliva

• Discuss saliva and

salivary glands

o Saliva

o Salivary glands

Dr. Fareed

Ahmad

C

Interactive

lecture

• Discuss

assessment of the

salivary glands

Examination

o Measurement of

the salivary flow

o Salivary gland

imaging

o Sialochemistry

o Biopsy

CPA

Interactive

lecture/clinica

l session

83

• Discuss salivary

gland diseases

o Sialdenitis

o Sialosis

o Necrotizing

sialometaplasia

o Sarcoidosis

o HIV-associated

salivary gland

disaease

o Salivary gland

tumors

C

Interactive

lecture/ case

based

discussion

20. Inflammatory overgrowths, developmental and benign

lesions, and pigmentation of the oral mucosa

• Inflammatory

overgrowths

o Epulides

o Fibroepithelial

polyp

o Denture

granuloma

o Focal epithelial

hyperplasia

(Heck’s disease)

Dr Fareed

Ahmad

CA

Interactive

lecture/SGD

• Developmental

lesions

o Hamartomas

• Developmental

white lesions

CA

Interactive

lecture/SGD

• Benign neoplasms

• Squamous cell

papilloma CA

Interactive

lecture/SGD

• Miscellaneous

benign conditions

o Traumatic

keratoses

o Nicotinic

stomatitis (pipe

smokers’ palate)

• Leukoedema

CA

Interactive

lecture/SGD

• Pigmentation of

the oral mucosa

o Amalgam tattoos

C

Interactive

lecture/SGD

84

o Melanotic

pigmentation

• Oral melanoma

21. Precancerous Lesions and Conditions

• Precancerous

lesions

o Leukoplakia

o Erythroleukoplaki

a

o Speckled

leukoplakia

o Candidal

leukoplakia

(chronic

hyperplastic

candidosis)

o Malignant

transformation of

precancerous

lesions

o Management of

precancerous

lesions Dr.

Muhammad

Shairaz

Sadiq

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Precancerous

conditions

o Oral submucous

fibrosis (OSF)

o Sidropenic

dysplagia

o Lichen planus

• Other

precancerous

conditions

CPA

Interactive

lecture/case-

based

discussion/

Clinics

• Oral carcinoma

and

carcinogenesis

o Aetiological

factors for oral

squamous cell

carcinoma

o Clinical features

and diagnosis of

oral carcinoma

o Staging systems

for oral carcinoma

CPA

Interactive

lecture/case-

based

discussion/

Clinics

85

o The management

of oral carcinoma

o Prevention of oral

carcinoma

• Oral carcinoma as

a genetic disease

22. Mucocutaneous disease and connective tissue disorders

• Mucocutaneous

disease

Dr Fareed

Ahmad

C Interactive

lecture

• Lichen planus and

lichenoid

reactions

CPA

Interactive

lecture/case

based

discussions/

clinical

session

• Immunobulbous

diseases

o Pemphigus

o Pemphigoid

o Dermatitis

herpetiformis

• Linear IgA

disease

CA

Interactive

lecture/case-

based

discussion

• Epidermolysis

bullosa C

Interactive

lecture

• Erythema

multiforme

CA Interactive

lecture/SGD

• Idiopathic oral

blood blisters

(Angina bullosa

Haemorrhagica)

CA Interactive

lecture/smal

l group

discussion

• Connective tissue

diseases

o Lupus

erythematosus

o Morphoea and

systemic sclerosis

o Mixed connective

tissue disease

CA Interactive

lecture/smal

l group

discussion

23. Gastrointestinal diseases

• Coeliac disease

(glutensensitive

enteropathy)

C Interactive

lecture

86

o Oral manifestation

of celiac disease

Dr

Muhammad

Shairaz

Sadiq

• Inflammatory

bowel disease

(IBD)

o Crohn’s disease

o Oral Crohn’s

disease

o Orofacial

granulomatosis

o Ulcerative colitis

• Stomatosis and

inflammatory

bowel disease

CA

Interactive

lecture/smal

l group

discussion

• Gastro

oesophageal

reflux disorder

(GORD)

CA Interactive

lecture/smal

l group

discussion

24. Blood and nutrition, endocrine disturbances, and renal

disease

• Disorders of the

blood

o Anaemias

o Oral signs and

symtopms in

anaemia

o Management of

patients with

anaemias and

haematinic

deficiencies

o Leukemia

o Leukopenia

o Myelodysplastic

syndrome

o Platelet

abnormalities

o The selection of

patients for

haematological

examination

Dr

Muhammad

Shairaz

Sadiq

C Interactive

lecture

• Disorders of

nutrition

o Nutritional

deficiencies

• Scurvy

C Interactive

lecture/case-

based

discussion

87

• Endocrine

disturbances

o Normal endocrine

changes

o Adrenocortical

diseases

o Thyroid disease

• Diabetic mellitus

CA Interactive

lecture/smal

l group

discussion

• Renal disease

o Chronic renal

failure

o Renal patients

undergoing

dialysis

• Renal transplant

patients

CA Interactive

lecture/smal

l group

discussion

25. Immunodeficiency, hypersensitivity,

autoimmunity and oral reactions to drug

therapy

• Immunodeficienc

y

Dr

Muhammad

Shairaz

Sadiq

C Interactive

lecture

• Hypersensitivity C Interactive

lecture

• Angioedema CA Interactive

lecture/smal

l group

discussion

• C1 esterase

inhibitor

deficiency

C Interactive

lecture

• Autoimmunity CA Interactive

lecture/smal

l group

discussion

• Oral reactions to

drug therapy

o Spectrum of

adverse reactions

o Oral reactions o

antibiotics

o Oral reactions to

steroids

o Drug therapy and

periodontal tissues

CA Interactive

lecture/smal

l group

discussion

88

o Fixed drug

eruptions

26. Facial Pain and neurological disturbances

• Facial pain: an

overview

o The nerve supply

o the face

o The evaluation of

facial pain

Dr Fareed

Ahmad

Dr Fareed

Ahmad

C Interactive

lecture/case-

based

• Neuropathic pain

o Trigeminal

neuralgia

o Glossopharyngeal

neuralgia

o Postherpetic

neuralgia

o Neuropathic pain

secondary to other

conditions

C Interactive

lecture/case-

based

discussion

• Migraine CA Interactive

lecture/clini

cal sessions

/small group

discussion

• Cluster headaches

(periodic

migrainous

neuralgia/

migrainous

neuralgia)

CA Interactive

lecture/smal

l group

discussion

• Tension type

headache

CA Interactive

lecture/smal

l group

discussion

• Facial Pain:

miscellaneous

conditions

o Giant cell arteritis

(temporal

arteritis/cranial

arerirtis)

o Auriculotemporal

syndrome (Frey’s

syndrome)

CA Interactive

lecture/clini

cal sessions

/small group

discussion

89

• Neurological

disturbances

o Facial nerve

deficits

o Anaesthesia and

paraesthesia

o Bell’s palsy

o multiple sclerosis

o Extrapyramidal

syndromes

Interactive

lecture/clini

cal sessions

/small group

discussion

27. Temporomandibular disorders

• Investigation of

the

stomatognathic

system

o History

o Examination

o Imaging

o Arthroscopy

CA Interactive

lecture/smal

l group

discussion

• Temporomandibul

ar pain and

dysfunction

syndrome

(TMPDS)

o Management

Dr Fareed

Ahmad

C Interactive

lecture

• Internal

derangement

o Disc displacement

with reduction

o Disc displacement

without reduction

CA Interactive

lecture/smal

l group

discussion

• Rheumatoid

arthritis

CA Interactive

lecture/case-

based

discussion

• Osteoarthrosis

(osteoarthritis)

C Interactive

lecture/

case-based

discussion

90

• Masseteric

Hypertrophy

C Interactive

lecture /

case-based

discussion

• Tumors CPA Interactive

lecture/smal

l group

discussion/c

ase-based

discussion

28. Psychogenic orofacial problems

• Chronic orofacial

pain

o Atypical facial

pain

o Atypical

odontalgia

o Oral dysaesthesia

(Burning mouth

syndrome)

o Management of

chronic orofacial

pain

Dr Fareed

Ahmad

CPA Interactive

lecture/

small group

discussion

• Disturbances in

taste and

salivation

C Interactive

lecture/case-

based

discussion

• Dysmorphophobia C Interactive

lecture/case-

based

discussion

• Self-injurious

behavior

C Interactive

lecture/case-

based

discussion

• Eating disorders C Interactive

lecture/case-

based

discussion

• Drugs and

Alcohol

C Interactive

lecture/case-

91

based

discussion

29. Disorders of teeth and bone

• Disorders of teeth

o Hypodontia

o Variation in

eruption

o Variation in size

of teeth

o Non carious tooth

surface loss

o Discoloration of

the teeth

o Disturbances of

the structure and

enamel and

dentine

Dr

Muhammad

Shairaz

Sadiq

C Interactive

lecture/case-

based

discussion

• Disorders of bone

o Inherited and

development

disturbances

o Metabolic and

endocrine

disturbances

o Disorders of

unknown

aetiology paget’s

disease

C Interactive

lecture/smal

l group

discussion

30. Medical emergencies in dentistry

• The prevention of

medical

emergencies

Dr Fareed

Ahmad

CA Interactive

lecture/smal

l group

discussion

/role plays

• Administration of

drugs

o Routes of

administration of

drugs

CA Interactive

lecture/smal

l group

discussion/

role plays

• Emergency drugs

and equipment

CA Interactive

lecture/smal

l group

92

Learning resources

Topic Resources

The Oral Mucosa Tyldesley's Oral Medicine, 5th Edition, by Anne

Field & Lesley Longman.

Oral and Maxillofacial Medicine, the Basis of

Diagnosis and Treatment, 2nd Edition, by

Crispian Scully.

Medical Problems in Dentistry, 6th Edition, by

Crispian Scully.

A Clinical guide to Oral Medicine by P J

Lamely & M A O Lewis.

Principles of oral medicine: assessment and

investigation of patients

Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Therapy Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



discussion/

role plays

• Management of

emergencies

CAP Interactive

lecture/smal

l group

discussion/

role plays

93

Infections of gingivae and oral mucosa Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Oral Ulceration Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Diseases of the lips and tongue and disturbances

of taste and halitosis





Crispian Scully.


Crispian Scully.



Swellings of the face and neck Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Salivary glands and saliva Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.

94



Inflammatory overgrowths, developmental and

benign lesions, and pigmentation of the oral

mucosa





Crispian Scully.


Crispian Scully.



Precancerous lesions and conditions. Oral

carcinoma and carcinogenesis





Crispian Scully.


Crispian Scully.



Mucocutaneous disease and connective tissue

disorders





Crispian Scully.


Crispian Scully.



Gastrointestinal diseases Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Blood and nutrition, endocrine disturbances, and

renal disease



95



Crispian Scully.


Crispian Scully.



Immunodeficiency, hypersensitivity,

autoimmunity and oral reactions to drug therapy





Crispian Scully.


Crispian Scully.



Facial Pain and neurological disturbances Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Temporomandibular disorders Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Psychogenic orofacial problems Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



96

Disorders of teeth and bone Tyldesley's Oral Medicine, 5th Edition, by Anne




Crispian Scully.


Crispian Scully.



Medical emergencies in dentistry Tyldesley's Oral Medicine, 5th Edition, by Anne


Contemporary Oral and Maxillofacial surgery

6th Edition by James R. Hupp, Edward Ellis III,

Myron R. Tucker


Clinics / Practical Students will be involved in clinical work in the clinics of Oral Medicine and

diagnosis

Videos Videos to familiarize the students with the procedures and protocols to assess

patients.

Computer


Resources:



learning.

Self-Learning

Self-Learning is scheduled to search for information to solve cases, read



97

Assessment methods

Internal Assessment (IA)




clinical vivas etc











respective FBS

Annual Examination









i. 25 MCQs - 30 Minutes

ii. 30 MCQs - 40 Minutes

iii. 40 MCQs - 50 Minutes

iv. 45 MCQs - 60 Minutes



is as under: -

98

Total Marks = 50 Total Time Allowed = 2 hours

Marks of Written Paper = 45

Marks of Int. Asses = 05

(Including MCQs)

13 x MCQs (on separate sheet)

(13 Marks) (Time = 20 min)

02 x SAQs/SEQs (C1 & C2) = 05 marks

each

01 x SAQs/SEQs (C1 & C2) = 04 marks

each

03 x SAQs/SEQs (C3) = 06 marks each (32 Marks) (Time = 1hrs 40 min)

S. No Topic No. of MCQs (13)

(C1=2, C2= 5, C3= 6)

01 mark each

No. of SAQs/SEQs (6)

• 02 x SAQs/SEQs (C1&C2)

= 05 marks each

• 01 x SAQs/SEQs (C1&C2)

= 04 marks each

• 03 x SAQs/SEQs (C3) = 06

marks each

1. Principles of oral medicine: assessment and

investigation of patient

01 01

2. Infections of gingiva and oral mucosa

3. Oral ulceration 02

02 4. Diseases of lips and tongue

5. Swellings of face and neck 01

6. Salivary glands and saliva

7. Inflammatory overgrowths, developmental and

benign lesions and oral pigmentation

01

01 8. Precancerous lesions and conditions

9. Oral Carcinoma & Carcinogenesis 01

10. Muco-cutaneous diseases and connective tissue

disorders

01

11. Oral manifestation of systemic diseases 01

01

12. Orofacial pain & Psychogenic Pain 01

13. Temporomandibular disorders 01

14. Immunity and oral reactions to drug therapy 01

15. Disorders of teeth and bone 01

16. Medical emergencies in dentistry 01 01

Total 13 (13 Marks) 06 (32 Marks)

99

Internal Assessment Calculation (Theory Annual)

A B C D

Roll No. Name All Modules/

Pre annual Exams or any other exam

Total

Marks of internal

Assessment out of 05

Total Marks Sum of Marks obtained x 05 / sum of

total marks in all exams

Table of specifications for Annual Professional Exam: Practical Clinical Assessment

Total = 50

OSPE = 20

VIVA = 20

Logbook = 05

Internal Assessment = 05

OSPE (20 Marks)

Stations Marks Time

Static Stations 5 5×2=10 2 min each station

Interactive Stations 2 2×5=10 5 min each station

Internal Assessment Calculation (Practical)

A B C D

Roll No. Name OSPE/ Practical Class tests though out the

year/ Pre annual Practical Exams or any

other exam


assessment Out of 05

Total Marks Sum of Marks obtained x 05 / sum of total

marks in all exams

Internal Examiner


examined for at least six months. Second preference shall be Associate/Assistant Professor who is

involved in teaching of the class and posted there for one year. Third preference shall be a recognized

Professor of the subject.

100

External Examiner








Paper Setting

a. Each College / Institute shall forward a set of two question papers as per TOS along with

the key for each subject to the Controller of Examinations, at least three months in advance

of the annual examination. The question paper as a whole / a question without a

comprehensive key shall not be considered towards final paper setting.

b. The set of question papers shall be prepared by the respective Head of Department (HoD)

and furnished to Controller of Examinations through Head of Institution (HoI)

c. The Controller of Examinations shall approve the faculty for the final paper setting having

fair representation of each college / institute.

Paper Assessment

a. The Controller of Examinations shall approve the faculty for the theory paper marking, to be

undertaken in the manner as deemed appropriate.

b. The Examination Directorate shall coordinate directly with the faculty, earmarked for the paper

marking

c. A student who scores 85% and above marks in any subject shall qualify for distinction in that

particular subject.

d. A fraction in aggregate marks of a subject shall be rounded off to whole number. If it is less

than 0.5 then it will be rounded off to the previous whole number while 0.5 or more will be

rounded off to the next whole number.



examiners.







Controller of Examinations. For the purpose of practical/clinical examination, the candidates

may be divided into sub groups by the examiners.




101

Pass Marks

a. Pass marks for all subjects less Islamic / Pakistan Studies, shall be 50 % in theory and practical,

separately.

b. Pass marks for Islamic / Pakistan Studies shall be 33 % which, however shall not be counted






Promotion.


class

Re-Totaling.

Any student may apply to the Controller of Examinations on a prescribed form along with the

specified fee.


The interval between a supplementary examination and the previous professional examination

shall not be more than two months. There shall be no special supplementary examination.

Sample MCQ

A 22 years female presented to the oral medicine department with eruptions on face (butterfly

pattern) and fever. Intra-oral examination revealed superficial erosions and erythematous patches

on the mucosa. Which of the following investigations you would suggest her?

A. Haemoglobin, CBC and serum B12

B. Liver function tests

C. Microbiological sampling of mucosal sites

D. Serum Anti ds-DNA

KEY: D

Sample SEQ/SAQ

A young boy belonging to poor socio-economic status visits the diagnostic department of your

hospital with crater-like ulceration of gingiva & mal-odor.

a. What is your provisional diagnosis? (1)

102

b. What are the predisposing factors of this condition? (2)

c. How would you manage his condition? (3)

KEY:

a. Acute Necrotizing Ulcerative Gingivitis

b. Predisposing Factors

* Local irritation

* Poor oral hygiene

* Stress

* Nutritional deficiency

* Blood dyscrasias

* HIV

* Immunosuppression

* Intense smoking

c. Management

• Identification and elimination of predisposing factor

• Good oral hygiene

• Antiseptic/Antibacterial Mouthwashes/Gel

• Topical analgesics

• Systemic antibiotics

• Metronidazole

– 200 mg TDS for 3 days (drug of Choice)

• Systemic Analgesics

• Subgingival plaque control

• Debridement of necrotic gingival tissue

• Ultrasonic scaling

• Home care

103

INTRODUCTION TO GENERAL MEDICINE

The BDS undergraduate students learn General Surgery during third year of the

program and are evaluated in the Third Professional BDS Examination

Resources d. Teaching resources

e. Infrastructure resources

Teaching resources

Sr. #. Faculty Name Department as per PM &

DC certificate Qualification

1 Dr. Javed Iqbal HOD-Associate Professor MBBS, FCPS

2 Dr. Ashfaq Zia Assistant Professor MBBS, FCPS

3 Dr. Raja Yasser Shahbaz Assistant Professor MBBS, FCPS



1 Lecture hall 1

2 Opd

2

3 Medical wards

4 80 BEDDED

5 Class rooms 1

6 Mini Library 1

104





















• Practical

• Skill sessions


• Assignments


105






opinions and apply knowledge gained from lectures and self-study. The facilitator role is to ask

probing questions, summarize, or rephrase to help clarify concepts.

Practical


and handling both inside and outside the patients mouth. The students are trained in diagnosing and


Skill session






for self-study.

Assignments





learning.

106


















(v) Lectures delivery by:

Sr. #. Faculty Name Department as per PM &

DC certificate Qualification

1 Dr. Javed Iqbal Associate Professor MBBS, FCPS

2 Dr. Ashfaq Zia Assistant Professor MBBS, FCPS

3 Dr. Raja Yasser Shahbaz Assistant Professor MBBS, FCPS


Time frame


Lectures: Tuesday (8:50 to 9:50 am), Thursday (8:50 to 9:50 am)

Clinical rotataion:9 weeks - Monday and Wednesday (12:00 am to 3:00 pm),

107

Course Outline

Outline of Clinical Teaching in the Subject of Medicine

3rd year BDS 2018-2019

1st Rotation • History taking and GPE

• Symptomatology and history taking pertaining to CVS +

respiratory system

• Clinical examination of CVS and respiratory system

2nd Rotation • Symptomatology and history taking pertaining to GIT

• Clinical examination of GIT

• Nomenclature symptomatology and history taking pertaining to

CNS and musculoskeletal system

• Clinical examination of CNS and musculoskeletal system

3rd Rotation • Revision of clinical methods

• Case discussion of common clinical conditions

4th Rotation • Revision of clinical methods

• Case discussion of common clinical conditions

108

Course Objectives

This program aims to ensure that the dental graduates will make the bio-psycho-social care of medical

patients their first concern by applying their knowledge and skills in a competent and ethical manner

and using their ability to provide leadership to analyze complex and uncertain situations.

GENERAL OUTCOMES OF THE BDS GENERAL MEDICINE COURSE:

The General outcomes of this course are:

1. Development of the graduate as a scholar and a scientist; 2. Development of the graduate as a practitioner; and

3. Development of the graduate as a professional.

SPECIFIC OUTCOMES OF THE BDS GENERAL MEDICINE COURSE:

At the completion of this course the BDS graduate will be able to:

1. Apply biomedical scientific principles, method and knowledge to clinical practice.

2. Apply the principles, method and knowledge of population health and the improvement of health and healthcare to clinical practice.

3. Apply scientific method and approaches to medical research.

4. Carry out a consultation with a medical patient.

5. Diagnose and suggest management of common General Medical conditions relevant to Dental practice.

6. Communicate effectively with patients and colleagues in a medical context.

7. Provide immediate care in medical emergencies relevant to Dental practice. 8. Prescribe drugs safely, effectively and economically.

9. Carry out common practical procedures involved in general care of medical patients safely

and effectively. 10. Use information effectively in a medical context.

11. Behave according to ethical and legal principles.

12. Reflect, learn and teach others.

13. Learn and work effectively within a multi-professional team. 14. Protect patients and improve care.

ANNEX-A: TOPICAL DETAILS OF THEORY COMPONENT MODULES

109

TOPIC AND OBJECTIVES

FACULTY

LEARNIN

G

DOMAIN

LEARNI

NG

STRATE

GY

Lectures /

Ward

Demonstr

ations

ASSESSMENT

General Medicine

Written

Test

MCQS/S

EQS

Ward

Test

Viva OSPE Midterm

Exam

Send Up

Exam

Feed

Back

from

Faculty

and

Student

s

Counse

ling

• Acute chest

pain differential

diagnosis and

management

principles

All

Faculty

J

Interact

ive

lecture/

small

group

discuss

ion

• Ischemic Heart

Disease

J

Interact

ive

lecture/

small

group

discuss

ion

• Hypertension

J

Interact

ive

lecture/

small

group

discuss

ion

• Rheumatic

fever

J

Interact

ive

lecture/

small

group

discuss

ion

• Enteric fever

J

Interact

ive

lecture

• Dengue fever J

Interact

ive

lecture/

110

based

discuss

ion

• Malaria

J

Interact

ive

lecture/

small

group

discuss

ion

• HIV/AIDS and

other STDS

J

Interact

ive

lecture/

small

group

discuss

ion

• Infective

endocarditis

J

Interact

ive

lecture/

small

group

discuss

ion

• Fungal

infections

diagnosis and

treatment

J

Interact

ive

lecture/

small

group

discuss

ion

• Acute hepatitis

J

Interact

ive

lecture/

small

group

discuss

ion

• Acid peptic

disease

J

Interact

ive

lecture/

small

group

111

discuss

ion

• Chronic

hepatitis

J

Interact

ive

lecture/

small

group

discuss

ion

Cirrhosis of liver

J

Interact

ive

lecture/

small

group

discuss

ion

• Liver Disease

and Dentistry

J

Interact

ive

lecture/

small

group

discuss

ion

• Ascites

diagnosis and

management

J

Interact

ive

lecture/

small

group

discuss

ion

• Pneumonia

J

Interact

ive

lecture/

small

group

discuss

ion

• Bronchial

asthma

J

Interact

ive

lecture/

small

group

112

discuss

ion

• Tuberculosis

J

Interact

ive

lecture/

small

group

discuss

ion

• COPD

J

Interact

ive

lecture/

small

group

discuss

ion

• Meningitis and

Encephalitis

J

Interact

ive

lecture/

small

group

discuss

ion

• Cerebrovascula

r accident

J

Interact

ive

lecture/

small

group

discuss

ion

• Epilepsy

J

Interact

ive

lecture/

small

group

discuss

ion

• Clotting

disorders

(Hemophilia,

Von-Willibrand

J

Interact

ive

lecture/

small

group

113

discuss

ion

• Bleeding

Disorders

(ITP,DIC

J

Interact

ive

lecture/

small

group

discuss

ion

•

J

Interact

ive

lecture/

small

group

discuss

ion

• Anemia

classification ,

diagnosis and

treatment

J

Interact

ive

lecture/

small

group

discuss

ion

• Nephrotic

syndrome

J

Interact

ive

lecture/

small

group

discuss

ion

• Acute renal

failure

• Chronic renal

failure

J

Interact

ive

lecture/

small

group

discuss

ion

• Hyperthyroidis

m and

• Hypothyroidis

m.

• Parathyroid

disorders

J

Interact

ive

lecture/

small

group

114

Clinical Teaching Schedule

3rd

Year BDS Institute of Dentistry 2018-19

Morning Clinical Teaching Schedule

(Mondays, Wednesdays) Timings: (12:00pm to 03:00pm)

The assigned students will be divided into two batches

discuss

ion

• Diabetes

mellitus Type 1

• Diabetes

mellitus Type 2

J

Interact

ive

lecture/

small

group

discuss

ion

• Osteoporosis

J

Interact

ive

lecture/

small

group

discuss

ion

• RA

J

Interact

ive

lecture/

small

group

discuss

ion

• SLE

J

Interact

ive

lecture/

small

group

discuss

ion

115

Batch 1 Lt. Col. Muhammad Farooq (Mondays, Wednesdays) (12:00pm to 01:30pm)

Batch 2 Lt. Col. Muhammad Farooq (Mondays, Wednesdays) (01:30pm to 03:00pm)

Batch 2 Dr. Muhammad Siddique (Mondays, Wednesdays) (12:00pm to 01:30pm)

Batch 1 Dr. Muhammad Siddique (Mondays, Wednesdays) (01:30pm to 03:00pm)

3rd Year BDS Institute of Dentistry 2018-19

Afternoon Clinical Teaching Schedule Timings: 03:00pm to 05:00pm

Day Teaching Schedule

Mondays

• Batch I Self Learning: Practice History Taking and Clinical Skills

• Batch II Self Learning: Practice History Taking and Clinical Skills

Wednesdays

• Batch II Self Learning: Practice History Taking and Clinical Skills

• Batch I Self Learning: Practice History Taking and Clinical Skills

➢ Attendance is compulsory

GENERAL MEDICINE

(Bedside)

(Third Year BDS)

INTRODUCTION

116

The subject of general Medicine at undergraduate level enables the students to learn the clinical

medicine and application of the knowledge in clinical dental practice.

The course curriculum is designed to give the students a touch of the major areas of General

Medicine while keeping in mind the limitations and time constrains of the BDS curriculum.

This practice will ensure patient safety and better understanding of the correlations of the

disease with other dental pathologies. The practical component of the course involves

structured ward rotations and patient interaction for better learning.

SECTION I CARDIOVASCULAR SYSTEM

This section introduces students to the brief overview of different types of diseases related to

cardiovascular system.

Aims

The section aims to provide basic background knowledge regarding important diseases of


Learning outcomes

By the end of a unit, candidates will be able to:

1. Understand differential diagnosis of acute chest pain and its principles of management.

2. Understand spectrum of ischemic heart disease and its management.

3. Understand the etiology, diagnosis and guidelines of management of hypertension.

4. Understand the etiology, diagnosis and treatment of rheumatic fever.

5. Describe the pathophysiology, etiology, investigations and management of cardiac

failure.

SECTION II INECTIONS

This section familiarizes students with common infections causing patients to seek medical

advise and overview of its principles of management.

Aims

117

The aim of this section is to allow students to develop knowledge, understanding and

competence in identification of various common infections.

Learning outcomes


1. Identify and discuss the common causes of clinical presentation of fever like enteric

fever, dengue fever and malaria.

2. Identify and discuss the infections like HIV/AIDS and other STDs.

3. Describe the infectious agents of infective endocarditis and its diagnosis, investigations

and management.

4. Describe the important fungal infections, their diagnosis, investigations and treatment.

SECTION III GASTROINTESTINAL SYSTEM

This section introduces students to the different types of diseases related to gastrointestinal

system.

Aims


gastrointestinal system.

Learning outcomes


1. Describe the etiology, clinical features, investigations and management of acute

hepatitis..

2. Explain the causes of chronic hepatitis and cirrhosis of liver and its management.

3. Understand the clinical implications of the liver diseases in dental procedures.

4. Explain the diagnosis and management of ascites.

5. Describe the pathophysiology of the acid peptic disease and its appropriate

investigations and management.

118

SECTION IV RESPIRATORY SYSTEM

This section introduces students to the key themes of different systemic diseases related to


Aims

The section aims to provide basic scientific knowledge and understanding regarding important

diseases of respiratory system.

Learning outcomes


1. Explain the risk factors of pneumonia, its classifications, investigations and appropriate

treatment..

2. Understand the etiology, diagnosis and guidelines of management of bronchial asthma.

3. Understand the etiology, diagnosis and treatment tuberculosis.

4. Describe the pathophysiology, etiology, investigations and management of chronic

obstructive pulmonary disease.

SECTION V NERVOUS SYSTEM


nervous system.

Aims


nervous system.

Learning outcomes


119

1. Understand the etiology, diagnosis and guidelines of management of meningitis and

encephalitis.

2. Understand the etiology, diagnosis and management of cerebrovascular accident.

3. Describe the classification, etiology, investigations and management of epilepsy.

SECTION VI HAEMATOLOGY

This section familiarizes students with common hematological disorders causing patients to

seek medical advice and overview of its principles of management.

Aims

The aim of this section is to allow students to develop knowledge, understanding and

competence in identification of hematological disorders.

Learning outcomes


1. Identify and discuss the common clotting disorders like hemophilia and Von-

Willibrand disease.

2. Identify and discuss the diseases like immune thrombocytopenic pupura and

disseminated intravascular coagulation.

3. Describe the classification of anemia and its diagnosis, investigations and management.

SECTION VII NEPHROLOGY


renal system.

Aims

The section aims to provide basic background knowledge regarding important diseases of renal

system.

Learning outcomes


120

1. Understand the etiology, diagnosis and management of nephrotic syndrome.

2. Describe the classification, etiology, investigations and management of acute and

chronic renal failure.

SECTION VIII ENDOCRINOLOGY

This section introduces students to the different types of diseases related to endocrinology.

Aims


endocrinology.

Learning outcomes


1. Describe the etiology, clinical features, investigations and treatment of hypothyroidism,

hyperthyroidism and parathyroid disorders.

2. Describe the pathophysiology, classification of diabetes mellitus and its appropriate

investigations and management.

SECTION IX BONES AND MUSCLES


musculoskeletal system.

Aims


musculoskeletal system.

Learning outcomes


1. Understand the etiology, diagnosis and guidelines of management of osteoporosis.

121

2. Understand the etiology, diagnosis and management of systemic lupus erythematosus.

3. Describe the etiology, investigations and management of rheumatoid arthritis.

Learning Resources

1. Davidson text book of medicine

2. P.J kumar text book of medicine

3. Current medical diagnosis and treatment

4. Oxford pocket book of medicine

5. Hutchison clinical book

6. McLeod clinical book

7. Viva in medicine

OTHER LEARNING RESOURCES

Clinics / Practical Students will be involved in clinical work in the periodontology clinic

Videos Video familiarize the student with the procedures and protocols to assist

patients

Computer


Resources:



learning.

Self Learning

Self Learning is scheduled to search for information to solve cases, read



122

ASSESSMENT METHODS:

Internal Assessment



b. The Internal Assessment shall comprise of monthly test / PBL / assignments / Clinical

tests / clinical vivasetc


Institute and after approval of Principal, a summary as per University registration number

shall be furnished to the Controller of Examinations, at least two weeks before the

commencement of final examination.




examinations. The students who are relegated, however, can improve the internal

assessment during subsequent year


respective FBS

Annual Examination



PM&DC regulations and the Table of Specifications(TOS) of the University.












is as under: -

123

Ser. Subject

Theory Practical

Grand

total MCQs PBQs/SAQs Int

Assess

Sub

Total

Oral

&

pract

Int

Assess

Sub

total

2. Gen

Medicine 45 45 10 100 90 10 100 200

Internal assessment calculation (Theory/ Annual)

A B C D F G

Roll No. Name All modules/ Pre Annual Exams or any other exam Total Marks of internal


Total Marks Sum of Marks obtained x 10 / sum of total marks

in all exams


• A multiple choice question (MCQ) consist of a stem that states the question or problem


question.


possible answers.




knowledge of key facts and provide students with an opportunity to demonstrate reasoning

and explain their understanding of the subject.

Internal Examiner


examined for at least six months and has delivered 50% of the total lectures. Second preference shall

124

be Associate/Assistant Professor who is involved in teaching of the class and posted there for one year.

Third preference shall be a recognized Professor of the subject.

External Examiner








Paper Setting









Paper Assessment

a. The Controller of Examinations shall approve the faculty for the theory paper marking, to

be undertaken in the manner as deemed appropriate.

b. The Examination Directorate shall coordinate directly with the faculty, earmarked for the

paper marking

c. A student who scores 85% and above marks in any subject shall qualify for distinction in

that particular subject.

d. A fraction in aggregate marks of a subject shall be rounded off to whole number. If it is

less than 0.5 then it will be rounded off to the previous whole number while 0.5 or more

will be rounded off to the next whole number.



examiners.








candidates may be divided into sub groups by the examiners.




126

Pass Marks

a. Pass marks for all subjects less Islamic / Pakistan Studies, shall be 50 % in theory and

practical, separately.







Promotion.


class

Re-Totaling.


specified fee.


The interval between a supplementary examination and the previous professional examination

shall not be more than two months. There shall be no special supplementary examination.

127

SEQ SAMPLE

A 28 years old female presented in outpatient department with 3 days history of fever, haemoptysis and left

sided pleuritic chest pain. Examination revealed dull percussion and inspiratory crackles in left mid chest.

Her TLC is 14300 per ml.

a) What is the diagnosis? 1.5

b) How will you investigate this patient? 02

c) How will you manage this patient 03

MCQ SAMPLE

A 55-year-old female came to hospital with fever, pain abdomen, reversal of sleep cycle, drowsiness

and abdominal distension of 10 days. She was operated 30 years ago for perforated duodenal ulcer and

was transfused 3 units of blood at a local private hospital. She was febrile, drowsy and having ascites,

splenomegaly and generalized abdominal tenderness. What is the diagnosis?

a) Perforated duodenal ulcer

b) Spontaneous bacterial peritonitis

c) Acute hepatitis

d) Acute Pancreatitis

128

INTRODUCTION TO GENERAL SURGERY

INTRODUCTION:

General surgery is the science and art of treating injury, deformity, and disease using operative

procedures. General surgery is frequently performed to alleviate suffering when this is unlikely through

medication alone. Surgical operative procedures may range from minor procedures performed in a

physician's office, to more complicated operations requiring a medical team in a hospital setting. The

BDS undergraduate students learn General Surgery during third year of the program and are evaluated

in the Third Professional BDS Examination.







• Hands on demonstrations

• Tutorials

• Journal club




• Diagnosis and treatment planning

• Patient handling

129

• Clinical skills





• Case presentation


The following teaching / learning methods are used to promote better understanding:

• Interactive Lectures

• Hospital / Clinic visits

• Small Group Discussion

• Case- Based Learning

• Clinical rotations (CR)

• Skills session

• E- Learning

• Self- Directed Study

INTERACTIVE LECTURES

In large group, the lecturer introduces a topic or common clinical conditions and explains the underlying

phenomena through questions, pictures, videos of patients, interviews, exercise etc. students are actively

involved in the learning process.

HOSPITAL VISITS:

In small groups, students observe patients with signs and symptoms in hospital or clinical settings. This

helps students to relate knowledge of basic and clinical science of the relevant module.

SMALL GROUP DISCUSSION (SGD)

This format helps students to clarify concepts acquire skills or attitudes. Sessions are structured with

the help of specific exercise such as patient case, interviews or discussion topics. Students exchange

opinions and apply knowledge gained from lectures, tutorials and self-study. The facilitator role is to

ask probing questions, summarize, or rephrase to help clarify concepts.

CASE- BASED LEARNING

A small group discussion format where learning is focused around a series of questions based on a

clinical scenario. Students’ discuss and answer the questions applying relevant knowledge gained in

clinical and basic health sciences during the module.

130

Clinical Rotations (CR)

Clinical rotations for clinical subjects like Operative Dentistry, Orthodontics, Prosthodontics and Oral

Surgery are scheduled for student learning.

SKILLS SESSION

Skills relevant to respective module are observed and practiced where applicable in skills laboratory or

Department of Physiotherapy.

SELF DIRECTED STUDY

Students’ assume responsibilities of their own learning through individual study, sharing and discussing

with peer, seeking information from Learning Resource center, teachers and resource persons within

and outside the college. Students can utilize the time within the college scheduled hours of self- study.

E- LEARNING

E-Learning is a strategy by which learning occurs through the utilization of electronic media, typically

the Internet. The basic aspects of medical professionalism and ethics will be addressed through and E-

Learning course.

131


















Curriculum delivery by: Dr. Muhammad Imran Hameed Daula (Professor of Surgery)

Dr. Fahim Anwer Rao (Associate Professor of Surgery)

Dr. Brig. (R) Anwaar-ul-Haq, (Professor of ENT)

Time frame


Lectures: Monday: (1050 to 1150 hours)

Wednesday: (1200 to 1500 hours)

Clinical teaching / visits: Monday: (1200 to 1500 hours)

Wednesday: (1200 to 1500 hours)

Self-study: 6 hours per week

OVERVIEW OF GENERAL SURGERY CURRICULUM

AIM OF THE BDS GENERAL SURGERY COURSE:

132

This program aims to ensure that the dental graduates will make the bio-psycho-social care of surgical

patients their first concern by applying their knowledge and skills in a competent and ethical manner

and using their ability to provide leadership to analyze complex and uncertain situations.

GENERAL OUTCOMES OF THE BDS GENERAL SURGERY COURSE:

The General outcomes of this course are:

1. Development of the graduate as a scholar and a scientist;

2. Development of the graduate as a practitioner; and

3. Development of the graduate as a professional.

SPECIFIC OUTCOMES OF THE BDS GENERAL SURGERY COURSE:

At the completion of this course the BDS graduate will be able to:

1. Apply biomedical scientific principles, method and knowledge to clinical practice.

2. Apply the principles, method and knowledge of population health and the improvement of health and healthcare to clinical practice.

3. Apply scientific method and approaches to medical research.

4. Carry out a consultation with a surgical patient.

5. Diagnose and suggest management of common General Surgical conditions relevant to Dental practice.

6. Communicate effectively with patients and colleagues in a medical context.

7. Provide immediate care in surgical emergencies relevant to Dental practice. 8. Prescribe drugs safely, effectively and economically.

9. Carry out common practical procedures involved in general care of surgical patients

safely and effectively. 10. Use information effectively in a medical context.

11. Behave according to ethical and legal principles.

12. Reflect, learn and teach others.

13. Learn and work effectively within a multi-professional team. 14. Protect patients and improve care.

133

GENERAL SURGERY COURSE ORGANISATION

PMDC Course minimum requirements

200 teaching hours (50 Theory, 150 Clinical)

Proposed Course Duration 30 weeks minimum (excluding scheduled holidays)

Course Components 1. Theory component

2. Clinical component

Theory Component sub-

divided into fiveNon-

integrated modules (Details as per ANNEX-

A)

1. Principles of Surgery (Surgical Physiology, Pathophysiology,

Infection Control, Pre and Post-Operative Care of the Surgical

patient) 2. Trauma and its management

3. Common Surgical disorders relevant to Dental practice

4. Anesthesia and its Risks 5. Ethics and Professionalism in Clinical practice

Mode of Information

Transfer (MIT) for

Theory Component

1. Minimum of 02 lectures OR 02 Small Group Discussions of

one-hour duration per week (Minimum 02 hours / week)

2. Student presentations

Clinical Component

(Details as per ANNEX-B, C and D)

1. Learning of Clinical Skills (ANNEX-B) at the bedside or in

the clinical skills laboratory 2. Learning of Clinical Skills (ANNEX-C) through workshops

3. Observation of surgical procedures (ANNEX-D) in the

operating room, emergency department and surgical ward. A

log book should be maintained for skills and procedures mentioned in ANNEX-D

Mode of Information

Transfer (MIT) for Clinical Component

Minimum of 02 Clinical sessions based in General Surgery ward /

Clinical Skills laboratory per week. Each session should be at least of 02 hours and 30 minutes duration (Minimum 05 hours / week)

Assessment Plan of

Theory Component

1. Written assessment at the end of each module comprising 50

Multiple Choice Questions (MCQs) 2. Midterm Examination at the end of Module 2 (replacing the

end of Module 2 written assessment). Details as per ANNEX-

C 3. Final Term Examination at least four weeks prior to

University Professional Examination. Details as per ANNEX-

D

4. A total of 05 written assessments for the theory component are to be carried out during each academic year

Assessment Plan of

Clinical Component

1. Two OSPE / Clinical Examination of Short Cases clinical

assessments to be conducted during clinical teaching sessions over an academic year in addition to Clinical assessments

carried out during Mid and Final Term examinations

134

2. OSPE / Clinical Examination of Short Cases as part of Midterm and End Term Examinations. Details as per

ANNEX-C and D

3. A total of 04 OSPE / Clinical Examination for the clinical

component are to be carried out during each academic year

Feedback to Students 1. Regular FORMATIVE Student Feedback & Counseling

Sessions (SFCS) to be conducted after each Theory / Clinical

component assessment

2. Specific FORMATIVE Student Feedback & Counseling Sessions (SFCS) to be arranged by the Head of Department

(HoD) as and when required during the academic year

Internal Assessment 1. 10 marks will be allocated for Internal Assessment 2. Marks obtained by a student in ALL the Theory and Clinical

assessments during the academic year will be totaled and

divided by the grand total of all the assessments. The

percentage of the final figure from 10 will be awarded as internal assessment

3. If a student has been exempted from an assessment (Theory or

Clinical) the result of the same will NOT be included while calculating internal assessment

4. If a student is absent from an assessment (Theory or Clinical)

he / she will be awarded zero marks for the same while calculating internal assessment

Pre requisite to Course

delivery

1. The HoD will ensure that ‘Learning Outcomes’ (LOs) are

developed for each of the topics included in the Theory and

Clinical Module. These LOs will be taken into account while developing assessments

2. The HoD will ensure that the type and frequency of MITs for

each of the topics included in the Theory and Clinical Module are decided

Course Evaluation and

Improvement Cycle

3. HoD will convene a meeting of the faculty at the end of each

module, clinical rotation and the complete course

4. Faculty will provide informal feedback for each of the above mentioned periods

5. Students will provide formal feedback in written form for

each of the above mentioned periods 6. The meeting will review the course delivery and its progress

and identify areas of weakness along with recommendations

to bring improvements. These will be authorized by the HoD

7. Minutes of all such meetings will be recorded 8. Issues relating to course delivery and administration may be

addressed based on the recommendations of the HoD on as

and when required basis 9. A final course evaluation meeting will be conducted at the end

of each academic session

Recommended books and

resources

1. Bailey and Love’s Sort Practice of Surgery – 26th edition

2. An Introduction to the Symptoms & Signs of Surgical Disease by Norman S Browse

3. A Manual on Clinical Surgery by S. DAS

4. Clinical Methods in General Surgery by Hamilton & Bailey

135

GENERAL SURGERY CURRICULUM ANNEXURES

ANNEX-A: TOPICAL DETAILS OF THEORY COMPONENT MODULES

S NO TOPIC

MODULE 1: PRINCIPLES OF SURGERY

1. Body’s response to trauma and stress

2. Shock, Pathology, Types and management

3. Wound Healing & its complications

4. Types of Wound closure

5. Wound Infection / Surgical Site Infection

6. Cross infection control in the clinical environment

7. Blood transfusion in surgical patients

8. Colloids and Crystalloids used in surgical patients

9. Common fluid & electrolyte disorders in surgical patients

10. Common acid base disorders in surgical patients

11. Nutritional management of surgical patients

12. Risk assessment in surgery

13. Pre-operative preparation of Surgical patients

14. Post-operative care of Surgical patients

15. Principles of Minimal Access Surgery

16. Application of invasive and non-invasive diagnostic modalities in surgical practice

MODULE 2: TRAUMA AND ITS MANAGEMENT

17. Trauma Management based on ATLS protocol

18. Head injury

19. Cervical spine injury

20. Maxillofacial trauma

21. Neck trauma

22. Chest trauma and its management, Thoracotomy / Use of Chest drains

23. Hemorrhage its types and management

24. Burns

MODULE 3: COMMON SURGICAL DISORDERS RELEVANT TO DENTAL PRACTICE

25. Benign disorders of the Thyroid gland

26. Malignancies of Thyroid gland

27. Thyroidectomy & its complications

28. Disorders of the Parathyroid gland and their surgical management

136

29. Differential diagnosis & diagnostic approach to neck swellings

30. Cervical lymphadenopathy

31. Neck dissections& its types

32. Oral cancer and precancerous conditions (Carcinoma tongue and lip)

33. Skin malignancies (Squamous and Basal celled carcinoma, Malignant Melanoma)

34. Carcinoma Larynx

35. Tracheostomy, indications, care and complications

36. Benign and Malignant disorders of the Salivary glands

37. Benign disorders of the Oesophagus / Dysphagia

38. Malignant disorders of the Oesophagus / Oesophagectomy

39. Skin grafts, flaps, basics of reconstructive surgery

40. Surgical drains (NG tube, Foley catheter, Chest drain)

41. Principles of Surgical anastomosis

42. Cellulitis, Carbuncle, Abscess

43. Tetanus, Gas gangrene, Necrotizing fasciitis

44. Parasitic infections – Surgical aspects of Amoebiasis and Hydatid disease

45. General introduction to fractures, their healing and complications

46. Osteomyelitis

47. Common benign skin swellings (Lipoma, Epidermoid and Dermoid cysts)

48. Cleft lip and palate

49. Surgical biopsy and its types

MODULE 4: ANESTHESIA AND ITS RISKS

50. General anesthesia and its complications

51. Regional anesthesia (Spinal and Epidural anesthesia) and its complications

52. Local anesthesia and its complications

MODULE 5: ETHICS AND PROFESSIONALISM IN CLINICAL PRACTICE

53. Introduction to Clinical Ethics and Professionalism

54. Maintaining Quality of care

55. Evidence Based Medicine

56. Patient safety in the clinical environment

57. Professionalism in clinical practice

58. Maintaining ethics and professionalism in Clinical research

59. Occupational hazards in the clinical environment

137

ANNEX-B: TOPICAL DETAILS OF CLINICAL SKILLS TO BE LEARNED AT THE

BEDSIDE OR IN THE CLINICAL SKILLS LABORATORY

S NO TOPIC

1. Clinical history taking

2. General physical examination of a patient

3. Systemic physical examination of a patient with special emphasis on chest examination

4. Formulating a diagnosis and treatment plan for a patient

5. Clinical examination of a swelling

6. Clinical examination of an ulcer

7. Clinical examination of a patient with cervical lymphadenopathy

8. Clinical examination of a parotid swelling

9. Clinical examination of a submandibular gland swelling

10. Clinical examination of facial and trigeminal cranial nerve lesions

11. Clinical examination of a patient with oral lesion suspected to be malignant

12. Clinical examination of a goiter

13. Examination of a branchial cyst / fistula, thyroglossal cyst, cystic hygroma

14.

Identification and uses of:

a. Common surgical instruments

b. Chest drain with under water seal. c. Common drains (NG tube, foley catheter)

d. Commonly used surgical sutures

e. Commonly used intravenous cannulas, central venous catheters, LP needles, intra-venous fluids

f. Instruments used for airway management (guedel’s airway,

endotracheal tube, cricothyroidotomy / tracheostomy tube.

g. Diathermy machine h. General anesthesia apparatus

15. Identification of radiologic anatomy in a normal Chest X ray

16.

Identification of following pathologies on X ray:

a. Pleural effusion. b. Pneumothorax

c. Cervical spine injury

17. Identification of typical presentations of extra-dural, sub-dural intracranial hematomas

and sub-arachnoid hemorrhage on CT scan

18. Introduction to protocols of operation theatre, ward work, patient clerking and out-

patient clinics

138

ANNEX-C: TOPICAL DETAILS OF CLINICAL SKILLS TO BE LEARNED THROUGH

WORKSHOPS

S NO TOPIC

1. Intravenous access

2. Introduction to basic surgical skills

3. Antisepsis, cross infection control and gowning up in the operating room

4. Primary Trauma Care based on the ATLS protocol

5. Clinical communication (Role modeling) with special emphasis on counseling and

taking written informed consent

139

ANNEX-D: TOPICAL DETAILS OF CLINICAL SKILLS AND SURGICAL

PROCEDURES TO BE OBSERVED (O) OR PERFORMED (P) IN THE OPERATING

ROOM (OR), EMERGENCY DEPARTMENT AND SURGICAL WARD (LOG BOOK TO

BE MAINTAINED FOR THESE SKILLS / PROCEDURES)

S NO TOPIC

1. Collection of samples of blood, urine, sputum, pus swab (P)

2. Administration of drugs by intramuscular and intravenous routes (P)

3. Wound care and dressings (P)

4. Skin suturing and suture removal (P)

5. Needle biopsies, aspiration of localized fluids (P)

6. Pre-operative preparations, sterilization, and disinfection techniques in the OR (O)

7. Incision and drainage of an abscess (O)

8. Excision of soft tissue lumps (O)

9. Thyroidectomy (O)

10. Excision of a major salivary gland (Parotidectomy, sub-mandibular excision) (O)

11. Application of skin graft (O)

12. Administration of General anesthesia (O)

13. Administration of Spinal and Epidural anesthesia (O)

14. Application of POP cast to a long bone fracture (O)

KEY FOR COMPETENCY LEVEL OF PROCEDURES TO BE PERFORMED (TO BE

MENTIONED IN LOG BOOK):

1- Observer Status

2- Assistant

3- Performed under supervision

4- Performed under indirect supervision

5- Performed independently

140

OTHER LEARNING RESOURCES

Hands- on Activities / Practical

Students will be involved in Practical sessions and hands-on activities that

link with the blood module to enhance the learning

Labs

Utilize the lab provides the simulated learning to the specimens and models

available.

Skills Lab

A skills lab provides the simulated learning experience to learn the basic

skills and procedures. This helps patients

Videos

Video familiarize the student with the procedures and protocols to assist

patients

Computer


Resources:


resources and CDs / DVDs. This will be an additional advantage to increase

learning.

Self Directed Learning

Self Directed Learning is scheduled to search for information to solve cases,

read through different resources and discuss among the peers and with the

faculty to clarify the concepts.

141

Summative assessment methods and policies:

Internal Assessment




clinical viva etc.











respective FBS

Annual Examination














Internal Examiner


examined for at least six months and has delivered 50% of the total lectures. Second preference shall

be Associate/Assistant Professor who is involved in teaching of the class and posted there for one year.

Third preference shall be a recognized Professor of the subject.

External Examiner




142





Paper Setting









Paper Assessment

a. The Controller of Examinations shall approve the faculty for the theory paper marking, to

be undertaken in the manner as deemed appropriate.

b. The Examination Directorate shall coordinate directly with the faculty, earmarked for the

paper marking

c. A student who scores 85% and above marks in any subject shall qualify for distinction in

that particular subject.

d. A fraction in aggregate marks of a subject shall be rounded off to whole number. If it is

less than 0.5 then it will be rounded off to the previous whole number while 0.5 or more

will be rounded off to the next whole number.



examiners.








candidates may be divided into sub groups by the examiners.




Pass Marks

a. Pass marks for all subjects less Islamic / Pakistan Studies, shall be 50 % in theory and

practical, separately.




143




Promotion.


class

Re-Totaling.


specified fee.


The interval between a supplementary examination and the previous professional examination shall

not be more than two months. There shall be no special supplementary examination.

144

Table of Specification (TOS) for Third Professional

BDS Examination

General Surgery

Table of Specifications for Annual Professional Examination: Theory

Marks of Written Paper = 90 Time Allowed = 03 hrs

Marks of Int. Asses = 10 (Including MCQs)

Max Marks = 100 Date: _____________

Pass Marks = 50

Part A

45 x MCQs (on separate sheet) (Time = 55 min) (45 Marks)

Part B

Q. No. 1 PBQ (05 Marks)

Q. No. 2 PBQ (05 Marks)

Q. No. 3,4,5,6,7,8,9 SAQ (05 Marks Each)

TOPIC MCQs PBQ/SAQ

Principles of surgery 9 2

Trauma and its management 9 2

Common Surgical Disorders

Relevant To Dental Practice 9 2

Anesthesia And Its Risks 9 2

Ethics And Professionalism In

Clinical Practice 9 1

Total 45 (45 Marks) 09 (05 Marks Each)

145

Internal Assessment calculation (Theory Annual)

Table of Specifications for Annual Professional Exam: Practical

VIVA

50 marks PRACTICAL TOTAL

Examiner 1 Examiner 2 OSCE

10 stations of

3 marks each

Short Case 1 Short Case 2

15 15 30 15 15 90

Internal Assessment calculation (Practical)

A B C D F

Roll No. Name Periodical/

Clinical exam

Pre-annual

exams

90 marks

Total Marks

E= D x05/90 C+E

Out of 05 Out of 05 10 Marks

Award List for Professional Examination

S/N Roll

No.

Name Theory IA Total Practical IA Total

Grand

Total

Remarks

(90) (10) (100) (90) (10) (100) (200) Pass/Fail

A B C E H

Roll No. Name Total Marks obtained in 2

terms exams

(1+2)=(50+50)

Pre-annual

exams

90 marks

Total

Marks of internal

Assessment out of 10

D+F

D= (C x 05)/ 100 F= E x05/90

Out of 05 Out of 05 Out of 10

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