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Subject Guide

Dental Prosthetics I

Academic Year: 2016/2017

1. BASIC INFORMATION. ................................................................................................................... 2

2. CONTEXTUAL INFORMATION......................................................................................................... 2

3. SPECIFIC COMPETENCES. ............................................................................................................... 2

C. PROFESSIONAL VALUES, ATTITUDES AND ETHICAL BEHAVIOUR. ....................................................................... 2 D. DENTISTRY SCIENTIFIC FUNDAMENTS. ACQUISITION AND INFORMATION CRITICAL ASSESSMENT. ........................... 3 E. CLINICAL SKILLS: DIAGNOSIS, PROGNOSIS AND DENTAL TREATMENT PLAN. ....................................................... 3 F. CLINICAL SKILLS: DENTAL THERAPEUTICS. .................................................................................................. 4

4. GENERAL COMPETENCES (CROSS-COMPETENCES) ......................................................................... 4

A. BASIC COMPETENCES ............................................................................................................................ 4 B. CROSS COMPETENCES............................................................................................................................ 4

5. CONTENT. ...................................................................................................................................... 5

6. CLASSROOM ACTIVITIES ................................................................................................................ 6

ACTIVITY THAT ENCOURAGES THE USE OF THE SPANISH LANGUAGE: ........................................................................ 7

7. TEACHING METHODOLOGY ........................................................................................................... 7

8. ASSESSMENT PROCEDURE ............................................................................................................. 7

SPECIFIC EVALUATION REGULATIONS ................................................................................................................. 7 A. THEORY BLOCK (40%) .......................................................................................................................... 7

A1. Exam (80% of the block) ................................................................................................................ 7

A2. Lectures post-test (20% of the block) ............................................................................................ 8

B. PRACTICE BLOCK (40%) ........................................................................................................................ 8 B1. Practice activity (90% of the block): ............................................................................................... 8

B2. Practice pre-test (10%) .................................................................................................................. 9

C. PORTFOLIO BLOCK (20%) ...................................................................................................................... 9 C1. Presentation (50% of the block) ..................................................................................................... 9

C2. Word file in English and in Spanish (25% of the block each) .......................................................... 9

D. CRITERIA FOR THE SUBJECT AS A WHOLE (100%) ...................................................................................... 10

9. MATERIALS .................................................................................................................................. 10

10. CHRONOGRAM ....................................................................................................................... 12

A. LECTURES: ........................................................................................................................................ 12 B. PRACTICALS ....................................................................................................................................... 13

11. RECOMMENDED BIBLIOGRAPHY ............................................................................................. 14

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1. Basic information.

Name of the subject: Dental Prosthetics ICode:9999001305Degree: Grade in Dentistry Year: 3rdN. of ECTS credits: 6 N. of hours in the classroom:

4 hours every week: (2 hours of lecture + 2 practice hours)

Regulation requirements: none

Recommended requirements: none

Name of the professor: Pablo González de Villaumbrosia Santa Cruz, Francisco De Sena Espósito, Sergio Giner Garrido

Office hours:Fridays 10:30-12:30

2. Contextual information.

This subject concerns the treatment of the fully edentulous patient, both with conventional complete dentures as well as tooth and implant overdentures.

The first part of the subject will be about general issues concerning edentulous patients and occlusion.

The second part will be about clinical methodologies to treat these patients.

It describes the physiopathology of those patients, as well as the treatment techniques and materials used for treatment.

3. Specific competences.

Specific: CE1, CE2, CE3, CE9, CE10, CE12, CE13, CE14, CE15, CE16, CE17, C19, CE21, CE25, CE26 y CE27.

C. Professional values, attitudes and ethical behaviour.

CE1. Recognise the basic elements of the dental profession, including the ethical principles and legal responsibilities.

CE2. Understand the importance of those principles for the benefit of the patient, society and profession, taking special attention to the professional secret.

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CE3. Identify the patient´s concerns and expectancies, as well as having the ability to have an efficient and clear oral and written communication with the patients, their family, the social media and other professionals.

CE9. Understand the importance of maintaining and using records information of patient for later analysis, preserving the confidentiality of data.

CE10. Recognize and identify the psychological and physical problems resulting from gender violence, in order to train students in the prevention, early detection, care, and rehabilitation of victims of such violence.

D. Dentistry scientific fundaments. Acquisition and information critical assessment.

CE12. Understand and recognize the structure and normal function of the oral cavity at molecular, cellular, tissue and organ level in the different stages of life.

CE13. Understand and recognize the essential biomaterials sciences for the dental practice and immediate management of possible allergies related to them.

CE14. Recognise the general process of diseases, which include infections, inflammations,

immune system alteration, degeneration, cancer, metabolic alterations and genetic

disorders.

CE15. Be familiar with the general pathological features of diseases and disorders affecting organ systems, specifically those with oral impact.

CE16. Understand the action mechanisms, indications, drug efficiency and other therapeutic procedures, knowing the contraindications, interactions, systemic effects and interactions on other organs, based on the scientific evidence available.

CE17. Understand and recognise the ergonomic and occupational safety principles (including cross-infection control, radiation protection, occupational and biological diseases).

CE19. Knowledge of the scientific method and critical capacity to assess the established knowledge and new information. Be able to formulate hypotheses, collect and critically evaluate information for problem solving, using the scientific method.

E. Clinical skills: Diagnosis, prognosis and dental treatment plan.

CE21. Know how to fulfil a complete oral examination, including the radiological and complementary explorations, and to obtain the clinical references correctly.

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F. Clinical skills: Dental Therapeutics.

CE25. To know and apply the basic treatment of the most common oral and dental diseases in patients of all ages. Therapeutic procedures must be based on the concept of minimally invasive dentistry and in a comprehensive and integrated approach to the dental treatment.

CE26. To know how to plan and carry out multidisciplinary, sequential and integrated limited complexity in patients of all ages and conditions and patients who require special care dental treatments.

CE27. Ask and propose appropriate preventive measurements in every clinical situation.

4. General competences (cross-competences)

Basic competences: CB1, CB2, CB4, CB5

Cross competences: CT1, CT2, CT4, CT5, CT7, CT8, CT9, CT10

A. Basic competences

CB1. Students must prove they have knowledge on a specific field, based on the secondary general education. This knowledge is at a level that, apart from being supported by advanced textbooks, includes aspects that imply knowledge coming from the forefront of its field of study.

CB2. Students are able to apply their knowledge to their professional work or vocation and

prove to have these competences by proposing and defending arguments and by having

the ability to solve problems on their study area.

CB4. Students are able to transmit information, ideas, problems and solutions to a

specialised and non-specialised public.

CB5. Students have developed the learning skills needed to carry out works with a high

level of personal autonomy.

B. Cross competences

CT1. Autonomous learning: Process that enables a person to be in charge of its own development, choosing his path, strategies, tools and the best moment to learn and apply what has been learnt. An autonomous student, at the end, chooses the best strategies to fulfil his learning goals.

CT2. Self-confidence: Ability to value our own results, performances and the conviction to fulfil the challenges that have been laid out.

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CT4. Analysis and synthesis ability: Analysis is the reasoning methods that allow us to split up complicated situations into their components; also assesses other alternatives and perspectives to find out optimal solutions. Synthesis aims to reduce the complexity in order to have a better understanding and problem-solving capacity.

CT5. Ability to apply knowledge into practice: Ability to use the acquired knowledge in the

academic field in situations which are similar to the reality of the profession for which they are

formed. For example, by relating theoretical foundations with their application to real problems

of everyday life, addressing problems and situations close to the professional activity or resolve

issues and / or actual problems.

CT7. Ethical value awareness: Ability to think and act according to the universal principles based on the personal values aimed at his full development related to the commitment of determined social values.

CT8. Information management: Ability to search, choose, analyse and integrate information from different sources.

CT9. Personal relationship values: Positive relationship with others verbally and non-verbally by assertive communication, understanding by this, the ability to express or transmit what is wanted, thought or felt without causing discomfort, attacking or hurting someone’s feelings.

CT10. Initiative and entrepreneurial spirit: Preference to assume and carry out different tasks. Ability to overcome correctly difficult tasks. Problem anticipation ability, to suggest improvements and carry on with the achievement of a task.

5. Content.

Lesson 1: Dental Prosthetics and Dentistry. General considerations. Types and concepts of dental prosthesis. Relationship between Dental Prosthetics and other branches of science.

Lesson 2: Determinants of occlusal anatomy.

Lesson 3: Dental articulators and facebows: Concept, classification and use. Eccentric records and adjustment of semi-adjustable articulator. Devices to record mandibular movements: axiograph and pantograph.

Lesson 4: The fully edentulous patient. General considerations. Morphological and functional changes. Facial changes.

Lesson 5: Medical history and physical examination of the fully edentulous patient. Topographic anatomy. Concepts in complete dentures: Support, retention and stability.

Lesson 6: Impressions for complete dentures. Anatomical and functional techniques. Clinical procedure. Obtaining of working cast.

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Lesson 7: Record bases and occlusion rims. Functions, properties, materials and manufacturing. Clinical assessment.

Lesson 8: Upper occlusion rim records. Occlusal plane restoration. Record and transfer of cranio-mandibular relationship. Upper cast mounting in the articulator.

Lesson 9: Lower occlusion rim records. Record of vertical dimension of occlusion. Record and transfer of centric relation. Lower cast mounting in the articulator.

Lesson 10: Artificial teeth. Functions, characteristics and properties. Materials and its selection. Arrangement of artificial teeth. Balanced articulation. Waxing of the complete denture.

Lesson 11: Trial denture wax try-in. Clinical evaluation of record base with attached artificial teeth: aesthetic, phonetic and occlusal issues.

Lesson 12: Laboratory technology in complete dentures. Denture bases: functions and properties. Materials and techniques for its manufacturing. Flasking. Polymerization and finishing.

Lesson 13: Remounting and occlusal equilibration of complete dentures. Concept, justification and objectives. Clinical and laboratory techniques.

Lesson 14: Placement of complete dentures. Adjustments. Instructions. Care and maintenance. Periodic check-ups. Relining and adjustments. Breakage and repairs. Failure and complications.

Lesson 15: Immediate dentures. Concept. Advantages and disadvantages. Indications and contraindications. Clinical and laboratory stages.

Lesson 16: Introduction to Implant Dentistry. History, concept, purposes, types of implants. Indications and contraindications.

Lesson 17: Tooth overdentures. Concept, purposes, indications, contraindications, advantages, disadvantages; endodontical, periodontal and restorative considerations, retention systems, directions for use and maintenance.

Lesson 18: Implant overdentures: Concept, types, indications, contraindications, advantages, disadvantages, clinical procedure, parts, type of impressions, laboratory procedure, directions for use and maintenance.

6. Classroom activities

Activity N. of hours Mandatory attendance

Lectures 4,4 ECTS – 110h 50%

Laboratory practices 6,6 ECTS – 165h 50%

Portfolio 0,8 ECTS - 15h 50%

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Case analysis 0,8 ECTS – 15h 50%

Knowledge tests 0,4 ECTS - 10h 100%

Autonomous work and study 14 ECTS – 360 h 0%

Activity that encourages the use of the Spanish Language:

It’s a mandatory activity that promotes the use of Spanish. During all the semester, the main terms of the subject will be told to the student in both Spanish and English. Besides that, the students will have to prepare a presentation of a topic related to the subject and prepare a backup document in Spanish.

7. Teaching methodology

- Master lectures. - Simulation environments. - Clinical cases. - Problem-based learning.

8. Assessment procedure

Evaluation procedure Minimum and maximum grade Knowledge tests 35-45% Laboratory practices 40-50% Portfolio 5-10% Clinical case/problem 5-10%

Specific evaluation regulations

A. Theory Block (40%)

This part will consist of an exam and a series of lectures post-tests.

A1. Exam (80% of the block)

There will be a multiple choice exam. It will consist of 40 questions, and you will have to answer at least 80% of them (32). Every right question adds 1 points, every wrong one -1/3 points and every not-answered question 0 points.

The exam will last 1 hour. Anybody writing anything or having a pen in its hand after the time is over will fail the exam.

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After adding all the points, the grade you need to pass is 50% (20 out of 40 or 50 out of 100).

The exam will have 3 extra questions, apart from the first 40, to act as reserve questions, just in case one of the first 40 has to be discarded.

During the exam no questions will be allowed. If you think one or several of the questions are not clear or are not properly worded, you will have to write your criticism and reasons to contest this question/s at the back of the answers sheet.

The contents you will be asked about in the exam will mainly be the lectures, as well as books and the pdfs documents on Virtual Campus in a lesser degree.

A2. Lectures post-test (20% of the block)

After every lecture, a question will be made about what has been explained that day. Every day’s grade will range from 0 to 2 points, depending on how correct is the answer. It will be 0 is the answer is wrong, 1 if it is partially correct and 2 if it is right.

B. Practice Block (40%)

B1. Practice activity (90% of the block):

You will have a grade for every Practice Module (4 in total). The final grade will be the average of them. Every Module will consist on several practices. You will have the chronogram of the practices on the Virtual Campus.

At the end of every Practice Module there will be a practice exam that will consist of doing from scratch a practice that has been practiced before. Nothing will be allowed to be made ahead of time for these exams.

Every practice exam must be finished before the time provided ends. Not finishing it on time will imply failing the practice.

Not attending a practice will imply failing it too. If the student provides a written prove to his/her professor, he/she will be allowed to retake it at the appropriate time at the end of the semester. Not giving written justification for the absence will make the student lose the right to retake the practice during the ordinary period and will have to retake it during the “Follow-up Period”.

Arriving later than 10 minutes for a practice implies losing the right to do that practice, so it would have to be retaken as any other failed practice.

Up to 2 Practice Modules can be failed, but will have to be retaken at the corresponding time at the end of the semester (see chronogram). If the student fails more than 2 modules, he/she will only be allowed to retake up to two at the end of the semester. The rest of them will have to be retaken during the “Follow-up Period” (Periodo de Seguimiento).

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After the retake time at the end of the semester, the final grade will be the average of the grade of every practice. If any practice has a grade lower than 5 after the retake time, all of them will be considered failed. Every practice has to be passed separately, either during the semester, the retake day at the end of the semester or the “Follow-up Period”.

It´s absolutely mandatory having all the necessary materials for each practice. Not having them will imply failing the practice.

It is not allowed to work in the lab outside of the time given for the practices.

Only the materials for the practice are allowed to be present over the working table. Any personal belongings should be kept into the lockers of the laboratory.

B2. Practice pre-test (10%)

At the beginning of the first day of every Practice Module the students will be asked to answer two questions about that module. The student must have studied thoroughly in advance the description of the practice that is on the Virtual Campus and the related lectures. The grade for every question will range from 0 to 5 points, for a total of 10 points.

The student MUST arrive on time for the pretest of the practice. Arriving late will imply getting a grade of 0 for the pre-test. If the student arrives later than 10 minutes, he/she won’t be allowed to do the practice either, and therefore will fail too.

The final grade for this part of the subject will be the average of all the grades. Having less than 5 will imply failing this part of the subject.

C. Portfolio Block (20%)

C1. Presentation (50% of the block)

The students will do a very short Powerpoint presentation (3 minutes maximum) about a topic related to the subject. The students will do this in pairs, in English and will be assigned the topic by the professor. The intention of this activity is to review as many key aspects of the subject as possible, to consolidate the knowledge acquired during the semester.

The date for the presentation will be available in the chronogram of the subject on the Virtual Campus. That day, apart from doing the presentation, the students will upload the Powerpoint file into the computer of the classroom.

C2. Word file in English and in Spanish (25% of the block each)

The day of the presentation the students will upload two short Word files (2-5 page each, one in English and one in Spanish) with a summary of the topic that has been presented, into the computer of the classroom too. The use of automatic translators will be forbidden (such as Google Translate, etc).

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D. Criteria for the subject as a whole (100%)

Every block of the subject (Theory, Practice and Portfolio) must be passed separately with at least a grade of 5 out of 10 in order to pass the whole subject. Any block that is failed will be retaken during the “Follow-up Period” in June-July, keeping the grade for the parts that were passed. If any part remains to be failed after July, the whole subject will have to be repeated next year.

During the “Follow-up Period”, any failed part will have to be passed with a grade of 5 out of 10. Regarding the practices, there will be a time to retake them. It will consist of specific days during which all practices failed will have to be retaken, not existing more days outside of the scheduled ones.

9. Materials

1. Scrubs (pajama for the clinic). 2. Photographs (x2). 3. Mouth mirror. 4. Dental explorer. 5. Dental tweezers. 6. Eye glasses. 7. Aluminum foil. 8. Kavo Protar 5 or 5B, or Artex CP or CR (semi-adjustable articulator and corresponding

face-bow). 9. Articulator mounting plates. 10. Partially dentate typodont (Frasaco®) with complete set of teeth (for the second

semester), with any of these two configurations: 11. Permanent marker. 12. Mechanical pencil. 13. 20 cm transparent standard ruler. 14. 20 cm transparent flexible ruler (optional). 15. Cutter/blades/X-acto blade. 16. Scissors (blade length of 5 cm). 17. Alginate (Ca37 or similar) with water and powder dispensers (very important). 18. Satin white alginate mixing bowl. 19. Alginate spatula: rigid (metallic) with curved tip. 20. Complete set of upper and lower impression trays. Rim-Lock type. 21. Type IV pink plaster (Vel-Mix Stone) 6kg (can be shared). 22. Fast-set plaster (Kerr® Snow-White n.2) 2kg (can be shared). 23. Type IV white plaster (Kerr® Snow-White n.1). 24. Light body silicone (it’s better if you buy the one that comes on cartridges, with pistol,

instead of the one that has to be mixed with a spatula).

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25. Silicone spatula or silicone pistol (depending on what silicone you bought). The pistol can be shared between 4-5 students.

26. Impression silicone adhesive (not adhesive for resin composites). 27. Silicone mixing tips (in case you buy the pistol one). Usually come with the cartridges. 28. 200 cc syringe. 29. 1kg capacity weighing scales. 30. Black rubber plaster mixing bowl. 31. Plaster spatula: rigid and straight. 32. Plaster knife. 33. Spontex wipe. 34. 25x25x10 cm Tupperware. 35. Cast base formers (upper and lower) with slots. 36. Plasticine. 37. Alluwax® wax. Green, without mesh. 38. Moyco® wax (extra-hard wax). 39. Soft wax (e.g: Reus®). 40. Utility Wax® (Diadent). 41. Gas or electrical lamp (alcohol maps are no longer allowed). 42. Stainless steel small saucepan/ladel. 43. Funnel (10 cm in diameter and 1 cm tip). 44. 2 occlusal bite block molds (for occlusion rims) – occlusion rim molds. 45. Petrolatum/petroleum jelly tube (Vaseline®). 46. Two wax knives (one large and one small). 47. Caliper. 48. Venetian plaster spatula (10 cm wide). 49. Plastic Fox plane. 50. Light-curing acrylic resin in plates (can be shared). 51. Small sponge. 52. Rotary instruments: high-speed handpiece and contra-angled handpiece. Standard 4

hole connection (Midwest-4) (for the second semester): 53. Straight handpiece carbide burs for acrylic resin (x2 - bellota type and a thin one) (H-

180-304). 54. High speed handpiece burs: Komet® 837-012, 847-016, 856-016, 858-014, 368-023, 801-

016 (for the second semester). 55. Straight handpiece rubber polishing burs for acrylic resin (2: medium and small grit). 56. One impression coping for closed-tray impressions. For 4.1 platform, external hexagon

implants. 57. One impression coping for open-tray impressions. For 4.1 platform, external hexagon

implants. 58. Two implant replicas of external hexagon implants. Platform 4.1. 59. Screwdriver compatible with those impression copings.

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10. Chronogram

A. Lectures:

Groups M31 and T32:

Day Lecture

September 7th Subject presentation and Lesson 1: Dental Prosthetics and Dentistry. September 14th Lesson 2: Determinants of occlusal anatomy.

September 21st Lesson 3: Dental articulators and facebows. Lesson 4: The fully edentulous patient.

September 28th Lesson 5: Medical history and physical examination of the fully edentulous patient. Support, retention and stability. Lesson 6: Impressions for complete dentures.

October 5th Lesson 7: Record bases and occlusion rims

October 19th Lesson 8: Upper occlusion rim records. Lesson 9: Lower occlusion rim records.

October 26th Lesson 10: Denture teeth. Lesson 11: Trial placement.

November 2nd Lesson 12: Complete denture manufacturing. November 16th Lesson 13: Remount procedure.

November 23rd Lesson 14: Placement of complete dentures. Lesson 15: Immediate dentures.

November 30th Lesson 16: Tooth overdentures. December 7th Lesson 17: Introduction to Implant Dentistry. December 14th Lesson 18: Implant overdentures: December 21st Presentations and tutorial

January 13th Exam

January 16th Exam revision

Group T31:

Day Lecture

September 9th Subject presentation and Lesson 1: Dental Prosthetics and Dentistry. September 16th Lesson 2: Determinants of occlusal anatomy.

September 24th Lesson 3: Dental articulators and facebows. Lesson 4: The fully edentulous patient.

September 30th Lesson 5: Medical history and physical examination of the fully edentulous patient. Support, retention and stability. Lesson 6: Impressions for complete dentures.

October 7th Lesson 7: Record bases and occlusion rims

October 14th Lesson 8: Upper occlusion rim records. Lesson 9: Lower occlusion rim records.

October 21st Lesson 10: Denture teeth. Lesson 11: Trial placement.

October 28th Lesson 12: Complete denture manufacturing. November 4th Lesson 13: Remount procedure.

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November 11th Lesson 14: Placement of complete dentures. Lesson 15: Immediate dentures.

November 18th Lesson 16: Tooth overdentures. November 25th Lesson 17: Introduction to Implant Dentistry. December 2nd Lesson 18: Implant overdentures. December 9th Presentations

December 16th Tutorial

January 13th Exam

January 16th Exam revision

B. Practicals

Module Day Practice Pretest Assessment

September 12th

Practices presentation No No (only feedback)

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September 19th

Practice n. 1: Impressions for the edentulous patient No No (only feedback)

September26th Practice n. 2: Custom trays manufacturing

Yes (1&2) No (only feedback)

October 3rd Practice n. 3: Impressions with custom trays (part 1) No No (only feedback)

October 10th Assessment of practice n. 2 No Yes (only 1 custom tray)

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October 17th Practice n. 3: Impressions with custom trays (part 2)

Yes (3&4) No (only feedback)

October 24th Practice n. 4: Record bases and occlusion rims manufacturing Yes No (only feedback)

October 31st Assessment of practice n.4 No Yes (1 record base and occlusion rim)

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November 7th Practice n. 5: Upper occlusion rim records

Yes (5&6) No (only feedback)

November 14th Practice n. 6: Lower occlusion rim records No No (only feedback)

November 21st Assessment of practices 5 and 6 Yes (practices 5&6)

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November 28th

Practice n. 7: Preliminary impression for implant overdenture impression Practice n. 8: Custom trays for implant overdentures (assessment)

Yes (8&9) No (only feedback)

December 5th Practice n. 9: Impressions for implant overdentures No No (only feedback)

December 12th Assessment of practice n.9 No Yes (impression for implants and cast)

December 19th Practice retake (up to 1 module)

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11. Recommended bibliography

Jeffrey P. Okeson. Management of Temporomandibular Disorders and

Occlusion. 7th edition. 2012. Imprint: Mosby.

Alfred H. Geering, Martin Kundert. Complete denture and overdenture

prosthetics. 1993.

Zarb. Prosthodontic treatment for edentulous patients. 13th ed. Elsevier.

Bernard Koeck. Complete Dentures. Elsevier.