competency based evaluation for under graduates · b. removable partial denture (rpd) c. fixed...
TRANSCRIPT
Chhattisgarh Dental college & Research Institute Sundra,
Rajnandgaon – 491441 (C.G.)
Competency Based Evaluation for Under Graduates
Table of Content: Competency Assessment
1. Department of Oral Medicine and Radiology ……………………………………………..1 - 2
a. Pre-clinical Work
b. Case History Recording
c. Intraoral Radiographic Interpretation
d. Extraoral Radiographic Interpretation
2. Department of Oral & Maxillofacial Surgery ……………………………………………..3 - 5
a. Case History Recording
b. Local Anesthesia administration
c. Extraction of tooth
3. Department of Prosthodontics and Crown & Bridge …………………………………….6 - 19
a. Complete Denture construction (CD)
b. Removable Partial Denture (RPD)
c. Fixed Partial Denture (FPD)
4. Department of Pedodontics and Preventive Dentistry …………………………………..20 - 23
a. Case History, diagnosis and treatment plan
b. Behavior management of children
c. Oral prophylaxis
d. Application of Preventive Agents
e. Restoration of cavitated lesions with GIC
f. Extraction of deciduous tooth
5. Department of Conservative Dentistry and Endodontics ……………………………….24 - 25
a. GIC Restorations
b. Silver amalgam restoration
6. Department of Orthodontics ………………………………………………………………26 - 27
a. Case History Recording
b. Impression Making
7. Department of Public Health Dentistry ………………………………………………….. 28 - 30
a. Case History & Index Recording
b. Application of Preventive Agents
8. Department of Periodontics ………………………………………………………………. 31 - 34
a. Case History Recording
b. Hand scaling
DEPARTMENT OF
ORAL MEDICNE AND
RADIOLOGY
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1. Competency Assessment For Preclinical work:
A. Tracing of Radiograph Anatomy
Evaluation Criteria:
a. Is candidate able to clearly trace and label the Radiographic anatomical
landmarks
B. Drug Dosage
Evaluation Criteria:
a. Is the candidate able to know various drugs with proper doses
2. Competency Assessment For Case History
Evaluation Criteria:
a. Is the candidate able to communicate with patient properly
b. Is the candidate following proper examination protocol
c. Is the candidate able to record demographic data
d. Is the candidate able to record chief complaint
e. Is the candidate able to record history of present and past illness, medical history,
past dental history, drug history, personal history, family history
f. Is the candidate able to examine the patient: general examination, extra-oral and
intraoral examination
g. is the candidate able to identify the pathology
h. Is the candidate able to describe the pathology
i. Is the candidate able to arrive at a provisional diagnosis
j. Is the candidate able to give a clinical differential diagnosis
k. Is the candidate able to advice and interpret required investigations
l. Is the candidate able to arrive at a final diagnosis
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m. Is the candidate able to formulate a proper treatment plan
3. Competency Assessment For Intraoral Radiographic Interpretation
Evaluation Criteria:
a. Is the candidate able to identify the radiograph
b. Is the candidate able to identify the teeth seen
c. Is the candidate able to identify the pathology
d. Is the candidate able to describe the pathology
e. Is the candidate able to arrive at radiographic diagnosis
f. Is the candidate able to give a radiographic differential diagnosis
g. Is the candidate able to identify anatomical landmarks
h. Is the candidate able to identify error on the radiograph
4. Competency Assessment For Extraoral Radiographic Interpretation
Evaluation Criteria:
a. Is the candidate able to identify the radiograph
b. Is the candidate able to identify the pathology
c. Is the candidate able to describe the pathology
d. Is the candidate able to arrive at radiographic diagnosis
e. Is the candidate able to give a radiographic differential diagnosis
f. Is the candidate able to identify anatomical landmarks
g. Is the candidate able to identify error on the radiograph
DEPARTMENT OF
ORAL &
MAXILLOFACIAL
SURGERY
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1. Competency Assessment For Case History Recording
Armamentarium and materials: Diagnostic instruments and tweezer.
Evaluation criteria:
A. General Information: Biographical Data including Name, Age, Sex, Address.
B. History: Chief Complaint, History of Chief Complaint, Personal History and
Relevant Medical History
C. Clinical Examination:
a. General Physical Examination are to be recorded, which includes
Palor
Icterus
Cyanosis
Clubbing
Koilonychia
Lymphadenopathy
Edema
and also Vital Signs are recorded such as
Pulse
Blood Pressure
Respiratory Rate
Body Temperature
Oxygen Saturation
b. Extra Oral examination is done
c. Intraoral examination which includes Soft Tissue and Hard Tissue
Examination
D. Diagnosis and Investigations:
a. Is diagnosis correlating with chief complaint and clinical examination
b. Are Relevant Investigations advised based on History and Clinical
examination findings
c. Is radiographic interpretation done properly.
d. Is final diagnosis made in correlation with History, Clinical Examination
and investigations.
e. Is treatment plan drawn up appropriately?
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2. Competency Assessment For Local anesthesia
1. Armamentarium and materials required:Topical anesthetic gel,
Appropriate Local aesthetic solution, disposable syringe with appropriate
length and gauge as per requirement of nerve block.
2. Procedure
a. Doing skin patch test to determine sensitivity/allergic to local
anesthetic solution used for nerve block.
b. Knowing dosage of local anesthetic agent used for giving anesthesia.
c. Operator’s position and patient’s position for specific nerve blocks.
d. Knowledge of which nerve block to be given for extraction of
specific tooth.
e. Knowledge of anatomical landmarks for giving specific nerve block.
f. Knowing technique of giving specific nerve block.
g. Identification of objective and subjective signs and symptoms of
specific nerve block.
h. Identification of specific complications associated with each nerve
blocks.
i. Management of complications after giving nerve blocks.
3. Evaluation criteria
a. Is patch test done properly
b. Are anatomical landmarks palpated properly
c. Is technique of giving nerve block properly followed
d. Subjective and objective symptoms identified correctly
e. Identification of complications associated
f. Management of complications
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3. Competency Assessment For Simple Exodontia:
A. Case selection
a. Is there an indication for extraction
b. Is there any contraindication for extraction
c. Is there any relevant Medical History, which requires consultation of
medical colleagues, precautions, premedications or modification of
existing medication which are to be done
B. Armamentarium and materials required: Diagnostic instruments,
Tweezer, periosteal elevator, Appropriate extraction forceps, Dental
Elevator.
C. Procedure
a. Obtaining informed consent from the patients before procedure.
b. Positioning of chair according to the tooth to be extracted.
c. Appropriate Nerve Block, depending on the tooth being extracted.
d. Ascertaining subjective and objective symptoms.
e. Reflection of Flap using periosteal elevator.
f. Extraction of the tooth using appropriate forceps.
g. Inspecting the wound, curettage, if required and toileting of the
wound.
h. Achieving homeostasis and application of pressure pack.
i. Post-extraction instructions and prescription of medication.
D. Evaluation criteria
a. Is case selection done appropriately
b. Is local anaesthesia achieved
c. Is tooth completely extracted.
d. Are post-extraction instructions given
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e. Is Post Extraction instruction given appropriately
f. Are Drugs Prescribed Appropriately
DEPARTMENT OF
PROSTHODONTICS
AND CROWN &
BRIDGE
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1. Competency Assessment For Complete Denture
A. Primary Impression
Instruments and materials required
Mouth mirror Edentulous perforated and non-
perforated impression trays Rubber bowls -2 (large)
Periodontal probe Universal and Adams pliers Spatula (curved)
Divider Impression compound/Alginate Wax knife
Metallic scale Mcintosh sheet BP handle no:3 and BP
blade no:10
T- burnisher Indelible pencil Blow torch/gas torch
PROCEDURE:
Make the patient seat upright and adjust the head rest accordingly.
Select appropriate size stock impression tray and modify the tray as required.
Adjust the chair position.
a. Maxillary impression: Patient’s mouth should be at operator’s elbow level.
- Stand at 7 ‘o’ clock position for tray insertion.
- Move to 12 ‘o’ clock position for further compression and stabilization of the tray.
- Locate posterior vibrating line using T -burnisher and mark with indelible pencil.
- Transfer to the impressions
b. Mandibular impression: Patient’s mouth should be below operator’s shoulder level.
- Stand at 7 ‘o’ clock position to insert, compress and stabilize the tray.
- Support the mandible by thumb finger on both sides.
Use non-perforated stock trays for impression compound. Soften impression compound
in hot water, load the tray and make impression.
Use perforated stock trays for alginate. Mix alginate according to manufacturer
instructions, load the tray and make impression.
Instruct the patient to keep the head down while making maxillary arch impression, to
prevent the material flowing down the pharynx and gagging.
Remove the impression with a snap.
Make simulated functional movements to record border seal areas.
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Evaluate the impression for border extension, frenal attachments, surface details and
any tray exposure.
Wrap the alginate impression in moist gauze till opposing arch impression is made.
Pour the cast for alginate impressions as soon as possible.
Evaluation criteria for primary impression
• Impression tray selection (appropriate size and modification of the tray)
• Manipulation of impression material and loading in the tray
• Tray positioning
• Application of adequate pressure and manipulation of soft tissues during impression
making
• Extension of the impression, adequately recorded denture bearing areas and peripheral seal
areas
• Presence of surface defects (voids or inadequate impression material)
• Tray exposure
• Trimming of excess impression material
• Disinfection of impressions
B. BORDER MOULDING AND FINAL IMPRESSION
Instruments and materials required
Mouth mirror Low fusing (green stick)
compound Lecron carver
Periodontal probe ZOE impression paste Wax knife, wax spatula
T- burnisher Mcintosh sheet Blow torch/gas torch
Indelible pencils Rubber bowls -2 (large) Glass slab
Acrylic trimming burs BP handle no:3 and BP blade
no:10 ZOE mixing spatula
PROCEDURE:
Verify the custom tray in the patient’s mouth and do necessary adjustments.
Ensure 2 mm space between tray border and vestibule in functional position.
Mould the borders using low fusing impression compound/any other suitable material;
clearly define the border seal areas.
Start the border moulding by placing the material segment wise and do simulated functional
movements.
Remove any excess border moulding material inside the tray after each segment of border
moulding.
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Mark anterior and posterior vibrating lines, transfer onto the tray. Place the recording
material between the lines to record adequate posterior palatal seal.
Examine the border molded tray carefully; for adequate extension, retention, stability, and
border thickness filling the vestibule space.
Scrape inner surface of border moulding material, remove wax spacer and make escape
vents in the custom tray.
Make the final impression using zinc oxide eugenol impression paste or rubber base
material.
Remove and evaluate the impression for completeness (devoid of any defects). Don’t
hesitate to remake the impression in case of any defects.
Careful handling of the impression is required to avoid distortion or damage to the tissue
and peripheral areas of impression.
Evaluation criteria for border moulding and final impression
• Inspection of custom impression tray on the cast and intraorally for adequate space between
tray border and vestibule in functional position
• Simulated functional movements of soft tissues during
• border moulding procedure
• Marking post dam area(posterior palatal seal) using T-burnisher, indelible pencil and
transferring to the tray
• Removal of excess material inside the tray
• Adequate recording of all the peripheral seal areas, verification of retention and stability of
the tray
• Removal of spacer and provision of escape/relief holes
• Mixing of impression material and loading in the tray
• Tray position and simulated functional movements during impression making
• Inspection of final impression borders and surface details (without any defects)
• Disinfection of impressions
C. JAW RELATION RECORDING
Instruments and materials required
Mouth mirror Modelling wax Lecron carver
Straight probe ZOE impression paste Wax knife, wax spatula
Fox plane Acrylic trimming burs Hot plate
Divider Mcintosh sheet Glass plate, glass slab
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Metallic scale Rubber bowls -2 (large) ZOE mixing spatula
PROCEDURE:
Place maxillary occlusal rim and check for retention and stability.
Adjust maxillary occlusal rim- for lip support, lip fullness, nasolabial fold, philtrum and
vermillion border.
Adjust for visibility; 2 mm of maxillary occlusal rim should be visible when the patient
is at rest (depending on the age).
Adjust anterior part of maxillary occlusal rim by asking the patient to say “F” or “V”.
Using Fox’s occlusal plane indicator; adjust the anterior plane making it parallel to inter-
pupillary plane and posterior plane making it parallel to ala-tragus/ Camper’s plane.
Mark the midline considering the tubercle of philtrum/ facial midline as reference.
Mark canine line considering angle of mouth/lateral border of ala of nose as reference.
Stick two triangular pieces of adhesive tape on the tip of the nose and chin. Measure the
vertical dimension at rest (VDR) by Niswonger’s method.
Place mandibular occlusal rim and adjust for esthetics.
Adjust the height of mandibular occlusal rim to the level of dry-wet junction of lower lip,
angle of mouth and posteriorly to half the height of retromolar pad.
Measure vertical dimension at occlusion (VDO). VDO should be 2-4mm less than VDR.
Both the occlusal rims should have bilateral simultaneous contact.
Perform phonetic test. Ask the patient to say “M” and “S” sounds and verify freeway
space and speaking space.
Establish the mandible in centric and record the centric jaw relation using interocclusal
check bite record method.
Mark nick and notch on maxillary occlusal rim and trough on mandibular occlusal rim.
Place bite registration material in trough and ask patient to retrude and close.
Select the artificial teeth according to the guidelines.
Evaluation criteria for Jaw relation recording and teeth selection
• Inspection of temporary denture bases and occlusal rims on the master cast
• Intraoral inspection of temporary denture base (verify border extension, border thickness,
frenal relief, retention, and stability)
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• Inspection of maxillary occlusal rim
Lip fullness, lip support
Occlusal rim height and Incisal visibility
Occlusal plane in relation to Camper’s plane
Mid line, canine line and smile line markings
• Inspection of mandibular occlusal rim
Lip fullness, lip support
Occlusal rim height
Occlusal plane in relation to retromolar pad
Mid line, canine line markings
• Measurement of vertical dimension at rest (VDR)
• Measurement of vertical dimension at occlusion (VDO)
• Provision of adequate freeway space and closest speaking space
• Verification of speech
• Tentative centric bite registration
• Selection of teeth
D. TRY-IN (STAGE OF VERIFICATION)
Instruments and materials required
Mouth mirror Rubber bowls -2 (large) Glass plate
Straight probe Lecron carver Modelling wax
Mcintosh sheet Wax knife, wax spatula
PROCEDURE:
Insert the mandibular waxed-up trial denture followed by maxillary and evaluate for
retention, stability, aesthetics, phonetics and occlusion.
Verify vertical dimension and centric jaw relation established during jaw relation stage.
Verify the shade, size, shape and position of artificial teeth.
Verify the appearance of finished dentures before final processing. Any changes needed
in the denture teeth arrangement can be made at this time.
Obtain consent from patient on approval.
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Evaluation criteria for Try-in
Inspection of mounting on the articulator and teeth arrangement
Intraoral re-verification of temporary denture bases (verify retention, and stability)
Inspection of maxillary trial denture
Lip fullness, lip support
Incisal visibility during rest and speech
Occlusal plane
Mid line, canine line and smile line
Size, shape, shade and position of artificial teeth
Inspection of mandibular trial denture
Lip fullness, lip support
Occlusal plane
Size, shade and position of artificial teeth
Verification of VDO, VDR and freeway space
Verification of centric occlusion
Verification of overjet and overbite
Verification of speech
Obtaining consent from patient
E. DENTURE INSERTION
Instruments and materials required
Mouth mirror Articulating paper Rubber bowls -2 (large)
Straight probe Acrylic trimming burs and
sandpaper Indelible pencil
Articulating paper holder Mcintosh sheet Modelling wax
PROCEDURE:
Verify the tissue surface of denture for frenum relief, over extensions and any other
irregularities and ensure smooth borders.
Do clinical remount to correct occlusal interferences.
Do bite registration at the point of first occlusal contact, mount the dentures on articulator
and do selective grinding.
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Instruct the patient about the use and care of dentures and give a subsequent follow-up
appointment after 24 hours for observation, evaluation and any corrections as necessary.
Post-insertion instructions handouts should be given to the patient.
Evaluation criteria for Complete Denture insertion
Inspection of tissue, polished and occlusal surfaces of denture
Laboratory remount procedure and necessary occlusal corrections
Intraoral inspection of dentures for adequate extension
Retention and stability of dentures
Occlusion – clinical remount procedure and selective grinding to correct
occlusal interferences
Facial appearance
Speech
Instructing the patient about the use and care of dentures (Post insertion instructions)
F. Follow up or Recall:
Instruments and materials required
Mouth mirror Articulating paper Rubber bowls -2 (large)
Straight probe Acrylic trimming burs and
sandpaper Indelible pencil
Articulating paper holder Mcintosh sheet Pressure indicating paste
PROCEDURE:
Verify the occlusion and correct the occlusal interferences if any.
Evaluate the tissues for any ulceration.
Ask for any post-insertion complaints from the patient and correct the dentures as
necessary.
Emphasise on use and care of dentures.
Schedule further recall visits as required.
Evaluation criteria for Recall appointment
Intraoral examination of soft tissues for any irritation from dentures
Careful adjustment of dentures
Correction of occlusion (if required)
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2. Competency Assessment For Removable Partial Denture (RPD)
A. PRIMARY IMPRESSION
INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Divider, Metallic scale(6
inches), T- burnisher, Indelible pencil(H&E pencils), Dentulous perforated impression trays (U
& L 1,2,3,4 sizes), Universal and Adams pliers, Mcintosh sheet, Rubber bowls -2 (large),
Alginate mixing Spatula, BP handle no:3 and BP blade no:10, Blow torch/gas torch.
PROCEDURE:
Make the patient seat upright, adjust the head rest accordingly; adjust the chair position
and operator position (same as for CD impressions)
Select appropriate size stock impression tray and modify the tray as required.
Use impression compound to register edentulous areas in distal extension cases.
Following the alginate impression protocol to make mandibular and maxillary impressions.
Disinfect the impression.
Wrap the first impression in moist gauze and keep the impression with heels unsupported
while opposing arch impression is made and pour the cast as soon as possible.
Evaluation criteria for Primary impression
Impression tray selection (appropriate size and modification of the tray)
Manipulation of Alginate impression material and loading in the tray
Tray positioning
Adequate extension of impression, recording of teeth and edentulous areas
Presence of surface defects (voids, inadequacy of impression materials and exposure of tray)
Evaluation of study models
Surveying of diagnostic models :
Determining path of insertion, Marking undercuts, guide planes
List of mouth preparations
B. MOUTH PREPARATION AND FINAL IMPRESSION
INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Airotor handpiece and diamond
points, T- burnisher, Indelible pencil (H & E pencils), Mcintosh sheet, Rubber bowls -2 (large),
Alginate mixing spatula, BP handle no:3 - 1 and BP blade no:10, Lecron carver, Blow torch/gas
torch, Acrylic trimming burs, Glass slab, ZOE mixing spatula
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PROCEDURE:
Do necessary mouth preparations depending on the partially edentulous situation.
Establish the occlusal plane by enameloplasty of supra erupted teeth.
Establishment of guide planes.
Modification of height of contour.
Verify the custom tray in patient’s mouth and do necessary adjustments (Sectional tray
covering edentulous areas / Full arch tray covering teeth and edentulous areas)
Ensure 2 mm space between tray border and vestibule in functional position.
Do border moulding and final impression using appropriate impression material (rubber
base material / green stick compound for border moulding and zinc oxide eugenol / rubber
base material for final impression). Make the pickup impression with alginate.
Do simulated functional movements during border moulding and final impression.
Remove and evaluate the impression for completeness (devoid of any defects). Don’t
hesitate to remake the impression in case of any defects.
Evaluation criteria for border moulding and final impression for distal extension cases
Inspection of custom impression tray on the cast and intraorally for adequate space between
tray border and vestibule in functional position
Necessary mouth preparations according to the list
Simulated functional movements of soft tissues during border moulding procedure
Marking post dam area (posterior palatal seal) using T- burnisher, indelible pencil and
transferring to the tray
Removal of excess material inside the tray
Adequate recording of all the peripheral seal areas, verification of retention and stability of
the tray
Removal of spacer and provision of escape/relief holes
Mixing of impression material and loading in the tray
Tray position and simulated functional movements during impression making
Inspection of final impression borders and surface details (without any defects)
Disinfection of impressions
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C. JAW RELATION RECORDING
INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Mcintosh sheet, Rubber
bowls big -2, Wax knife, Wax spatula, Hot plate, Lecron carver, Metallic scale, H&E pencils,
Fox plane, Acrylic trimming burs, Glass slab, ZOE mixing spatula.
PROCEDURE:
General observation:
Place maxillary and mandibular occlusal rims and check for extensions, retention and
stability.
Esthetics:
Adjust maxillary occlusal rim for adequate lip support, lip fullness. Check the nasolabial
fold, philtrum and vermillion border.
Adjust for visibility, depending on the age.
Using Fox’s occlusal plane indicator; adjust the anterior plane making it parallel to
interpupillary plane and posterior plane making it parallel to ala-tragus/ Camper’s plane.
Occlusal plane should match with that of remaining teeth
Adjust the height of mandibular occlusal rim to the level of angle of mouth and posteriorly
to half the height of retromolar pad.
Phonetics:
Adjust anterior part of maxillary occlusal rim by asking the patient to say “F” or “V”.
Ask the patient to say “M” and “S” sounds and verify freeway space and speaking space.
Vertical relation - by Niswonger’s method:
Stick two triangular pieces of adhesive tape on the tip of the nose and chin. Measure the
vertical dimension at rest (VDR).
Measure vertical dimension at occlusion (VDO). VDO should be 2-4mm less than VDR.
Both the occlusal rims should have bilateral simultaneous contact.
Mark the midline considering facial midline as reference.
Mark canine line considering angle of mouth/lateral border of ala of nose as reference.
Page | 16
Recording the bite:
Situation1: Only few teeth missing. Record the MIP on wax rims by indentations.
Situation 2: Vertical stop present. Maintain the VD and record centric along with
indentations of opposing teeth on the wax rim
Situation 3: Kennedy’s class I in both arches. Establish the VD and centric using inter-
occlusal check bite record method. Indentations of opposing teeth on the wax rim should
also be recorded, when possible.
Select the artificial teeth to match with remaining natural teeth.
Evaluation criteria for jaw relation recording
Temporary denture base inspection (verify border extension, border thickness, frenal relief,
retention, and stability)
Inspection of aesthetics
Lip fullness, lip support
Occlusal rim height and Incisal visibility
Occlusal plane
Mid line, canine line and smile line
Inspection of phonetics
Verification of speech
Vertical dimension
Measurement of vertical dimension at rest (VDR)
Measurement of vertical dimension at occlusion (VDO)
Provision of adequate freeway space
Tentative centric bite registration, wax bite registration marks
Artificial teeth selection
D. TRY-IN (STAGE OF VERIFICATION)
INSTRUMENTS REQUIRED:Mouth mirror, Periodontal probe, Mcintosh sheet, Lecron’s carver,
Wax knife, Wax spatula, Rubber bowls-2 (large), Acrylic trimming burs.
Procedure
Anterior try-in:
Insert the mandibular waxed-up trial denture followed by maxillary
Page | 17
Evaluation of esthetics
Evaluation of phonetics
Posterior try-in
Verify aesthetics
Verify phonetics, speaking space established during jaw relation stage
Verify occlusal contacts
Verify the appearance of finished dentures, gingival carving before final processing. Any
changes needed in the denture teeth arrangement can be made at this time
Obtain consent from patient on approval
Evaluation criteria for Try in:
Temporary denture base inspection (verify retention, and stability)
Anterior try in
Esthetics: Lip fullness, lip support
visibility
Incisal
Mid line, canine line and smile line
Size, shape, shade and position of artificial teeth
Phonetics
Verification of overjet and overbite
Posterior try in
Verification of jaw relations
Esthetics
Phonetics
Occlusal contacts
Obtaining consent from patient
Clasp design and placement
Verification of wax up and carving
E. DENTURE INSERTION
INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Articulating paper holder,
McIntosh sheet, Universal plier, Rubber bowls, Acrylic trimming burs, Occlusal correction burs.
PROCEDURE:
Verify the intaglio surface of denture for frenum relief, over extensions and any other
irregularities (blebs) to ensure smooth borders. Check the clasp location and fit.
Verify the polished surface for roughness, cracks, tag arm exposure
Page | 18
Ensure denture contact with guide planes
Do clinical remount to compensate for polymerization changes
Instruct the patient about the use and care of dentures and give a subsequent follow-up
appointment after 24 hours for observation, evaluation and any corrections as necessary.
Post-insertion instructions handouts should be given to the patient.
Evaluation criteria for RPD insertion
• Finishing and polishing of dentures
• Retention and stability of dentures
• Facial appearance
• Speech
• Occlusion
F. FOLLOW-UP OR RECALL
INSTRUMENTS REQUIRED: Mouth mirror, Periodontal probe, Articulating paper holder,
Macintosh sheet, Universal plier, Rubber bowls, Acrylic trimming burs, Occlusal correction burs.
PROCEDURE:
Record patient’s feelings about the denture.
Evaluate the tissues for any erythema, ulceration.
Verify the occlusion and correct the occlusal interferences if any.
Ask for any post-insertion complaints from the patient and correct the dentures as
necessary.
Emphasise on use and care of dentures and schedule further recall visits as required.
Evaluation criteria for Recall appointment
• Intraoral examination of soft tissues for any irritation from dentures
• Careful adjustment of dentures
• Correction of occlusion (if required)
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3. Competency Assessment For fixed partial denture (FPD)
Instruments and materials required
Mouth mirror Micro-motor Diamond Point burs
Phantom head Micro-motor handpiece
(contra-angle) Chipblower
Laboratory knife with no.
25 blade Inlay wax Mcintosh sheet
PKT waxing instruments Wax heating pot Periodontal probe
No. 7 wax spatula Typodont Jaw set Polishing cloth
Evaluation criteria
• Incisal reduction - 1.5 mm of clearance in maximum intercuspal position and all
excursions
• Facial reduction - 1.2 mm of uniform reduction is achieved
• Biplane labial reduction - apparent incisal and gingival reductions
• Cingulum reduction - 1 mm of reduction present, following cingulum concavity
• Axial taper reduction - Parallel axial wall with minimal taper
• Rounded line angles - all line angles are rounded and smooth
• Shoulder reduction - Rounded shoulder at least 1 mm wide
• Location of finish line - Finish line at gingival margin, clear, smooth, and continuous
• Coping fabrication
• Wax pattern removal and evaluation
Proximal surfaces
Axial surfaces
Occlusal surfaces
• Finishing of margins
• Verification of tooth preparation and carving
DEPARTMENT OF
PEDODONTICS &
PREVENTIVE
DENTISTRY
Page | 20
A. Competency Assessment For Case History Diagnosis And Treatment Plan
Armamentarium and materials required: 2 sets of Diagnostic instruments: Mouth
Mirror, Straight Probe, Twizzer, Explorer,Kidney Tray, Cotton Holder, Waste Reciever
Evaluation criteria:
a. General Information or Demographic Profile:
Record of OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion,
Education, Occupation, Total Income of Family per Month, Percapita Income,
Address, Contact No.
b. History.
Chief complaint recorded in patient’s own word, history of present illness, medical,
dental history, family history, history of fluoride, personal history, history of trauma,
history of vaccination, personal habits, oral hygiene practices, dietary habits (24 hrs
diet chart & sweet scores) recorded
c. Clinical Examination.
Extraoral, intraoral, soft tissue and hard tissue recorded
d. Index Recording:
DMFS/defs and OHIS index recorded properly
e. Diagnosis and Investigations.
Diagnosis is correlating with chief complaint and clinical examination?
Is radiographic interpretation done properly?
Is final diagnosis correlating with investigation?
Is treatment plan formulated correctly?
B. Competency Assessment For Oral Prophylaxis
Case selection
Children with poor oral hygiene
Prophylactic pre procedural
Armamentarium and materials required: 2 sets of Diagnostic instruments: Mouth
Mirror, Twizzer, Kidney Tray, Cotton Holder, Waste Reciever, hand scalers
Procedure
Position the dental chair
Perform oral prophylaxis.
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Evaluation criteria:
Proper chair position
Proper arm rest and strokes of instrument
Any plaque or calculus remaining
C. Competency Assessment For Topical Fluoride Application
Case selection
High caries risk children
Children without proximal caries and cavitated lesions in the oral cavity
Special children
In children shortly after periods of tooth eruption
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, Kidney Tray, Cotton Holder,
Waste Reciever, Fluoride application trays or applicator brush and Fluoride gel or
varnish
Procedure for Fluoride gel (Tray technique)
Perform pre-procedural oral prophylaxis.
Position the dental chair upright
Select appropriate sized foam tray and fill one third of the tray with fluoride
gel
Isolate the teeth and insert fluoride trays in oral cavity for 4 min.
Maintain the isolation using suction during procedure
Thoroughly wipe the teeth surfaces after removing the fluoride trays
Instruct the patient not to gargle the mouth with water and eat or drink anything
for at least 30 min.
Evaluation criteria:
Is pre-procedural oral prophylaxis done
Is the tray covering all the teeth surfaces in tray technique
Is isolation properly maintained during procedure
Is fluoride gel thoroughly wiped from tooth surfaces after application
Are post-operative instructions given
D. Competency assessment for pit and fissure sealants
Case selection
Tooth with deep retentive pit and fissures
Page | 22
Stained pit and fissures
Pit and fissures having demineralisation (non-cavitated) confined to enamel
High caries risk patients
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, Kidney Tray, Cotton Holder,
Waste Reciever, Etchant, Dispenser wells, Applicator tip, Pit and fissure sealant,
Curing light, Articulating paper.
Procedure
Thoroughly clean the retentive pit and fissures
Isolate with cotton rolls and acid etch the tooth
Rinse, dry & isolate the tooth with cotton rolls.
Apply the sealant (For mandibular teeth apply distally and allow it to flow
mesially, and for maxillary teeth the converse) and cure
Check for occlusal high points using articulating paper
Evaluation criteria:
Are pit and fissures thoroughly cleaned
Is isolation maintained during the procedure
Is frosty white appearance seen
Are all the pits and fissures sealed without voids
Is the occlusion evaluation done
E. Competency Assessment For Restoration of tooth
Case selection
Primary molars with occlusal caries
Primary molars with proximal caries
Smooth surface caries on primary anteriors
Buccal pit caries on permanent molars
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Straight probe, Twizzer, Kidney Tray,
Cotton Holder, Waste Reciever, Air rotor, diamond burs, Restorative instruments,
Instrument tray, GIC cement, Agate spatula, Varnish/Vaseline, strips, articulating paper
Procedure
Excavate the soft caries using spoon excavator
Page | 23
Remove the infected dentin with air rotor
Rinse, dry & isolate the tooth with cotton
Mix the GIC with agate spatula on paper pad
Restore the teeth with GIC
Check for occlusal high points using articulating paper
Evaluation criteria:
Caries excavation done completely
Is isolation maintained during the procedure
GIC mixing done properly
Restoration done properly covering marginal edge
Is the occlusion evaluation done
F. Competency Assessment for Extraction of tooth
Case selection
Primary tooth with physiologic mobility
Over retained primary tooth
Root stumps of primary tooth
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Straight probe, Twizzer, Kidney Tray,
Cotton Holder, Moon’s probe, extraction forceps.
Procedure
Application of topical anesthesia
Administration of LA (infiltration or nerve block)
Check for subjective or objective symptoms
Retraction of gingiva
Extraction of tooth
Place compress pack
Post extraction instruction
Evaluation criteria:
Proper position of needle insertion
Check the subjective/objective symptoms
Proper retraction of gingival tissue
Tooth removed completely
Post operative instructions given properly
DEPARTMENT OF
CONSERVATIVE
DENTISTRY &
ENDODONTICS
Page | 24
A. Competency Assessment For GIC Restorations
1. Case selection
a. Patient complains of black discoloration
b. food lodgment /cavitation on tooth surface
c. Non Carious Cervical lesions (Cervical abrasions, Erosion and abfractions)
d. Root surface caries.
2. Armamentarium & Materials required
a. Diagnostic instruments - mouth mirror, straight probe, explorer, Tweezers, cotton rolls, cotton
holder.
b. Excavation instruments - spoon excavator, hatchet, burs and airotor
c. Condensers - cement spatula, plastic filling instruments, condensers, & carvers, articulating
paper, matrix band and retainer, wedges
d. Isolation – cotton rolls and saliva ejectors
e. Pulp protection cements, GIC
3. Procedure of application
a. Cavity preparation if needed) / conditioning
b. Isolation
c. Pulp protection
d. Application of matricing (when needed)
e. Manipulation of GIC
f. Placement of GIC
g. Checking for high points
4. Evaluation criteria
a. Able to select the case properly.
b. Clinical & radiographic evaluation of tooth
c. Isolation
d. Under/ overfilling/ Craze & crack lines
Page | 25
B. Competency Assessment For Silver amalgam restorations
1. Case selection
a. Patient complains of black discoloration
b. food lodgment
c. Cavitation on tooth surface
2. Armamentarium & Materials required
a. Diagnostic instruments - mouth mirror, straight probe, explorer, Tweezers, cotton rolls,
cotton holder.
b. Excavation instruments - spoon excavator, hatchet, burs and airotor
c. Condensers - cement spatula, amalgam carrier, plastic filling instruments, condensers,
burnishers & carvers, mortar, pestle, amalgam squeeze cloth, articulating paper, matrix bands,
retainers, wedges.
d. Isolation – cotton rolls and saliva ejectors
e. Pulp protection cements, silver alloy & mercury.
3. Procedure of application
a. Cavity preparation
b. Isolation
c. Pulp protection
d. Application of matricing (when needed)
e. Manipulation of silver amalgam
f. Placement of silver amalgam into the cavity, condensing, burnishing & carving
g. Checking for high points
4. Evaluation criteria
a. Proper case selection & Clinical & radiographic evaluation of tooth
b. Isolation
c. Under/ Overfilling
DEPARTMENT OF
ORTHODONTICS &
DENTOFACIAL
ORTHOPAEDICS
Page | 26
A. Competency Assessment For Case History, Diagnosis And Treatment Plan
Armamentarium and materials required: 2 sets of Diagnostic instruments: Mouth Mirror,
Straight Probe, Twizzer, Explorer, Kidney Tray, Cotton Holder, Waste Receiver
Evaluation criteria:
a. General Information or Demographic Profile:
Record of OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion,
Education, Occupation, Total Income of Family per Month, Percapita Income,
Address, Contact No.
b. History.
Chief complaint recorded in patient’s own word, history of present illness, medical,
dental history, family history, history of fluoride,personal history, history of trauma,
history of vaccination,personal habits, oral hygiene practices recorded
c. Clinical Examination.
Extraoral, intraoral, soft tissue and hard tissue and functional examination
d. Malocclusion Recording:
Identification of Malocclusion in Sagittal plane.
Identification of Malocclusion in Vertical plane.
Identification of Malocclusion in Transverse plane
e. Diagnosis and Investigations.
Diagnosis is correlating with chief complaint and clinical examination?
Is radiographic interpretation done properly?
Is final diagnosis correlating with investigation?
Is treatment plan formulated correctly?
B. Competency Assessment For Impression Making
Armamentarium and materials required:Mouth mirror, Probe, Rubber Bowls, AlginateMixing
Spatula, Dentulous perforated impression trays (U & L 1,2,3,4 sizes), Mcintosh sheet and
Alginate Impression Material & water
Procedure:
Make the patient seat upright, adjust the head rest accordingly; adjust the chair position
and operator position for impression making.
Select appropriate size impression tray and modify the tray asrequired.
Page | 27
Ask the Patient to gargle followed by air drying the occlusal surfaces to remove debris
and saliva.
Alginate impression material is used for impression making. Mix the powder with water
asper the instructions of manufacturer in a clean rubber bowl.
Cold water can be used if longer working time is desired.
The alginate mixture should be creamy in consistency and should not have lumps in it.
The material is than loaded in to the impression tray with the spatula, the surface is
smoothened with wet gloved finger.
For Maxillary impression 11 0'clock position and for mandibular impression 7 0’clock
position is ideal.
Place the loaded tray by retracting the patient’s lips on one side with a mouth
mirror/gloved finger and on the other side by rotating the tray into the mouth.
Once set, remove the impression with a firm quick snap.
Wash the impression with running tap water and then disinfect it with 1% sodium
hypochlorite solution.
The impression should be quickly poured using dental stone and vibrator as per
manufacturer’s instructions.
Remove the cast immediately after adequate set.
Evaluation Criteria for Impression:
Impression tray selection (appropriate size and modification of the tray)
Manipulation of Alginate impression material and loading in the tray
Tray positioning
Adequate extension of impression, recording of teeth, frenum and sulcus areas
Presence of surface defects (voids, inadequacy of impression materials and exposure of
tray)
Evaluation of study models
DEPARTMENT OF
PUBLIC HEALTH
DENTISTRY
Page | 28
A. Competency Assessment For case history & index recording
Armamentarium and materials required:
2 sets of Diagnostic instruments: Mouth Mirror, Periodontal Probe, Twizzer, Kidney
Tray, Cotton Holder, Waste Reciever
Evaluation criteria:
a. General Information or Demographic Profile:
Is OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion, Education
Occupation, Total Income of Family per Month, Percapita Income, Address, Contact
No. Recorded?
b. History.
Is Chief complaint recorded in patient’s own word, Is history of present illness,
medical, dental history, family history, personal history (personal habits, habits related
to oral cavity, oral hygiene practices, dietry habits (24 hrs diet chart & sweet scores)
recorded?
c. Clinical Examination.
Is extraoral, intraoral, hard tissue, periodontal status recorded?
d. Index Recording: Is Index pertinent to patient condition recorded and scores are
given?
e. Diagnosis and Investigations.
Is diagnosis correlating with chief complaint and clinical examination?
Is radiographic interpretation done properly?
Is final diagnosis correlating with investigation?
Is comprehensive treatment plan formulated correctly?
B. Competency Assessment For topical fluoride application
Case selection
High caries risk children
Page | 29
Children without proximal caries and cavitated lesions in the oral cavity
Special children
In children shortly after periods of tooth eruption
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, Kidney Tray, Cotton Holder,
Waste Reciever, Fluoride application trays or applicator brush and Fluoride gel or
varnish
Procedure for Fluoride gel (Tray technique)
Perform pre-procedural oral prophylaxis.
Position the dental chair upright
Select appropriate sized foam tray and fill one third of the tray with fluoride gel
Isolate the teeth and insert fluoride trays in oral cavity for 4 min.
Maintain the isolation using suction during procedure
Thoroughly wipe the teeth surfaces after removing the fluoride trays
Instruct the patient not to gargle the mouth with water and eat or drink anything for
atleast 30 min.
Evaluation criteria:
Is pre-procedural oral prophylaxis done
Is the tray covering all the teeth surfaces in tray technique
Is isolation properly maintained during procedure
Is fluoride gel thoroughly wiped from tooth surfaces after application
Are post-operative instructions given
C. Competency Assessment For pit and fissure sealants
Case selection
Tooth with deep retentive pit and fissures
Stained pit and fissures
Pit and fissures having demineralisation (non-cavitated) confined to enamel
Page | 30
High caries risk patients
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, Kidney Tray, Cotton Holder,
Waste Reciever, Etchant, Dispenser wells, Applicator tip, Pit and fissure sealant, Curing
light, Articulating paper.
Procedure
Thoroughly clean the retentive pit and fissures
Isolate with cotton rolls and acid etch the tooth
Rinse, dry & isolate the tooth with cotton rolls.
Apply the sealant (For mandibular teeth apply distally and allow it to flow mesially,
and for maxillary teeth the converse) and cure
Check for occlusal high points using articulating paper
Evaluation criteria:
Are pit and fissures thoroughly cleaned
Is isolation maintained during the procedure
Is frosty white appearance seen
Are all the pits and fissures sealed without voids
Is the occlusion evaluation done
DEPARTMENT OF
PERIODONTICS &
IMPLANTOLOGY
Page | 31
A. Competency Assessment For case history recording
Armamentarium and materials required:
2 sets of Diagnostic instruments: Mouth Mirror, Periodontal Probe, WILLIAMS PROBE
Twizzer, Kidney Tray, Cotton Holder, Waste Reciever
Evaluation criteria:
a. General Information or Demographic Profile:
Is OPD NO, Date, Name, Age, Sex, Date of Birth, Place of Birth, Religion,
Education, Occupation, Total Income of Family per Month, Percapita Income,
Address, Contact No. Recorded?
b. History.
Is Chief complaint recorded in patient’s own word, Is history of present illness,
medical, dental history, family history, personal history (personal habits, habits
related to oral cavity, oral hygiene practices, dietry habits (24 hrs diet chart &
sweet scores) recorded?
c. Clinical Examination.
Is extraoral, intraoral, hard tissue (dental status, occlusion) recorded?
Is gingival status recorded?
Is periodontal status recorded?
Is mucogingival problems recorded?
d. Investigations Adviced. : Is proper investigation ( laboratory of radiographic )
adviced pertinent to patient condition ?
e. Diagnosis and Investigations.
Is diagnosis correlating with chief complaint and clinical examination?
Page | 32
Is radiographic interpretation done properly?
Is final diagnosis correlating with investigation?
Is comprehensive treatment plan formulated correctly?
f. Prognosis.
Is Overall prognosis and Individual prognosis recorded correctly pertaining to patients
clinical and radiographic condition.?
g. Treatment Plan.
Is treatment plan suggested to the patient under following headings?
Preliminary phase
Phase I (etiotropic phase)
Phase II(surgical phase)
Phase III(restorative phase)
Phase IV( maintenance phase)
Page | 33
B. Competency Assessment For hand scaling procedure
Case selection
Patients with gingivitis
Patients with periodontitis
Patients presenting with any other periodontal disease
Patients with synergistic disease( endo –perio lesion, ortho-perio interrelationships)
involving multidisciplinary approach
Armamentarium and materials required
2 sets of Diagnostic instruments: Mouth Mirror, Twizzer, , Probe, Williams Periodontal
Probe, Kidney Tray, Cotton Holder, Waste Receiver,
2 sets of periodontal instruments: set of 3 supragingival scalers
A brushing model with toothbrush/ pair of diagnostic cast and toothbrush
Procedure for hand scaling
Perform pre-procedural oral prophylaxis.
Position the dental chair upright
Maintain proper operator position
Proper use of hand grasp
Proper use of finger rests
Proper use of strokes
Proper accessibility and visibility
Proper isolation: A clean operating field is maintained during scaling.
Type of illumination and vision ( direct/ indirect) used
Page | 34
Evaluation criteria:
Is pre-procedural oral prophylaxis done
Is the operator chair positioned properly
Are general principles of instrumentation followed
Is the finger rest used appropriate according to the arch/quadrant worked upon
Is the hand grasp used appropriate according to the arch/quadrant worked upon
Is The stroke used for removal of calculus effective and appropriate
Is there any flecks of supragingival or sungingival calculus seen on any surface
of tooth
Are stains completely removed from all the surfaces of tooth
Are post-operative oral hygiene instructions given
Is proper brushing technique advised and demonstrated to the patient according
to the patients age and clinical picture