Universitat Internacional de Catalunya - Barcelona

Advanced Periodontics

• code 09240
• course 3
• term Semester 2
• type OB
• credits 3

Main language of instruction: Spanish

Other languages of instruction: Catalan, English

Head instructor

Dra. Blanca PANIAGUA - bpaniagua@uic.es

Office hours

Wednesdays morning by appointment in bpaniagua@uic.es.

The majority of the population will experience some form of periodontal pathology at some stage during their lives, with this still being the most frequent cause of tooth loss in people over 35. The knowledge of this periodontal pathology, its prevention and treatment, both surgical and non-surgical, is essential for maintaining the health, function, comfort and aesthetics of dentition throughout life. Knowledge of periodontics will allow comprehensive therapy as part of the multidisciplinary treatment that most of our patients require. Without periodontal health, there cannot be health or proper functioning.

Dr José Nart is head of the Periodontics Department, and the lecturer in charge of the subject is Dr. Blanca Paniagua.

Have approved Basic Periodontics.

General objectives of the theoretical programme:

1. To ensure that students are able to identify the different types of periodontal diseases, their aetiology and clinical characteristics, with students being able to perform the diagnosis of periodontal pathologies and to treat initial and moderate forms.

2. To ensure that students are able to re-evaluate cases after the hygiene-causal phase and to decide which patients need surgical treatment as part of their periodontal therapy.

3. To ensure that students understand the different surgical procedures and their possible indications and contraindications.

4. To ensure that students are able to educate and motivate patients during all phases of periodontal treatment and, in particular, during the maintenance phase.

5. To ensure students are able to understand the critical importance of the maintenance phase for the long-term success of periodontal therapy.

6. To ensure that students understand the possible interaction and the effect of the periodontal pathology on the systemic pathology of the patient.

7. To ensure that students understand the scientific method and are able to apply it to periodontics.

• 64 - Undertaking basic oral and dental pathology treatments for patients of all ages. The treatment procedures should be minimally invasive and based on a comprehensive and integrated approach to oral and dental treatment
• 65 - Diagnosing, planning and undertaking, at a general level, multidisciplinary, sequential and integrated treatment of limited complexity for patients of all ages and conditions and patients with special needs (diabetes, hypertension, oncological diseases, transplants, immune-depression, anti-clotting, etc.) or disabilities. Specifically the dentist should be competent in establishing a diagnosis, a prognosis and developing a suitable treatment plan, particularly in terms of orofacial pain, temporo-mandibular disorders, bruxism and other parafunctions; dental and periapical pathology; oral and dental trauma; periodontal and peri-implanted tissue pathologies; pathology of the mandibular bone, of soft oral tissue and annex glands; states of partial or total edentation and planning rehabilitation treatment via dento-muco supported prostheses, or dental impants, dental malpositions or malocculusions and other anatomical or functional alterations of the face or the stomatognathic system and their potential orthodontic, orthopaedic or surgical corrections
• 66 - Taking and interpreting x-rays and other image-based procedures that are important in dental practice
• 68 - Determining and identifying the aesthetic requirements of patients and the possibility of resolving their concerns
• 69 - Identifying patients who require special care, recognising the characteristics and peculiarities of such cases
• 70 - Evaluating motor and sensory oral, mandibular and annex function
• 71 - Undertaking limited procedures for invasive diagnostic techniques using soft tissue (biopsies)
• 72 - Appropriate medical prescriptions, while being aware of their guidelines and warnings, systemic effects and repercussions on other organs
• 73 - Applying loco-regional anaesthetic techniques
• 74 - Preparing and isolating the operatory field
• 75 - Identifying, evaluating and attending to medical emergencies which may arise during clinical practice and apply cardiopulmonary recuscitation techniques; manage severe infections, including pharmaceutical prescriptions and simple surgical aspects
• 76 - Identifying and dealing with any dental emergencies
• 77 - Undertaking medical and surgical treatment for common diseases in soft oral tissue
• 80 - Treating the inflammatory processes of periodontal tissue both pharmacologically and surgically, including supra and subgingival techniques for periodontal instrumentation

• 4.001 - Know the anatomy and histology of the periodontal tissues in health and disease
• 4.002 - Understand the mechanisms of bacterial colonization in the oral cavity and identify their implications for health and periodontal diseases
• 4.003 - - Know the mechanisms of inflammatory and immune response of periodontal tissues against bacteria of dental biofilm
• 4.004 - Understand the main factors associated with periodontal disease, identifying their causes, pathogenesis and risk factors
• 4.005 - Apply diagnostic means and methods available for assessing all patients with periodontal disease
• 4.006 - Obtain the adequate clinical experience in implementing the specific preventive measures against EP and in the implementation of the appropriate therapeutic measures in patients with gingivitis.
• 4.007 - Know the clinical and therapeutic methods that allow the student to make a correct periodontal diagnosis and periodontal treatment planning
• 4.008 - Know the surgical methods for the treatment of the most complex periodontal problems
• 4.009 - Know the main problems that associate periodontal disease with systemic pathology, pathogenesis identifying preventive and therapeutic implications
• 4.010 - Know the main problems associated with peri-implant pathology, knowing the diagnostic and therapeutic methods for its resolution
• 4.011 - – Obtain the adequate clinical experience in the treatment of the most common periodontal problems under supervision
• 4.013 - Perform limited occlusal adjustments under supervision
• 4.014 - Perform periodontal maintenance of simple cases
• 4.015 - Identify the anatomic and dental structures in panoramic radiographs, periapical and bitewing
• 4.019 - Conduct prophylaxis and demonstrations of proper oral hygiene adapted to the patient's age
• 4.029 - Master the bases of basic oral surgery: equipment and instruments, sterility and prevention of infection, techniques of loco-regional anesthesia, surgical field, hemostasis, post-operative cures, pharmacotherapy
• 4.030 - Know how to derive, when necessary, to other professionals or centers, complex treatments or medically compromised patients.
• 4.031 - Differentiate pain according to location
• 4.032 - Differentiate pain according to origin
• 4.033 - Differentiate pain according to duration
• 4.034 - Differentiate pain according to the characteristic of the pain
• 4.117 - Know how to make a proper patient history
• 4.118 - Know how to make a proper oral and practical examination of the patient
• 4.119 - Know how to make a correct facial examination of the patient
• 4.123 - Recognize normal and pathological anatomical structures in a panoramic, periapical and occlusal radiography
• 4.137 - Identify patients requiring a multidisciplinary treatment to achieve therapeutic goals, and be able to work on the treatment.

1. ADVANCED DIAGNOSIS (25/01/2019; Prof. Alberto Monje) 

- Microbiological evaluation (Microbiology and criteria for defining a periodontal pathogen. Socransky complexes and main characteristics of bacteria most closely related to Periodontics (A.a., P.g., T.f., T.d. and F.n.).

- Inborn immune response (inflammatory response) and acquired (cellular and humoral).

- Periodontal prognosis.

2. 2017 CLASIFICATION: PERIODONTAL HEALTH AND GINGIVAL DISEASES AND CONDITIONS (PART 1)(01/02/2019; Dr. Blanca Paniagua)  

3. 2017 CLASIFICATION: PERIODONTITIS (PART 2)(08/02/2019; Dr. Blanca Paniagua)

4. LOCAL CONTRIBUTING FACTORS (15/02/2019; Dr. Blanca Paniagua)

- Anatomic contributing factors:

            - proximal contact relation

            - cervical enamel projections and enamel pearls

            - intermediate bifurcation ridge

            - root anatomy

            - cemental tears

            - accessory canals

            - root proximity

            - adjacent teeth

- Restorative contributing factors:

            - overhanging restorations

            - margin location

            - crown contours

            - pontic form

            - restorative materials

- Orthodontic contributing factors:

            - crowding                                                                       

            - malalignment

            - malocclusion

- Habits as contributing factors:

            - toothbrush and floss trauma

            - mouth breathing and tongue thrust

            - factitial injuries

5. PERIODONTAL TREATMENT

- Periodontal treatment phases. Phase I: scaling and root planning (clinical and microbiological results; limitations) (22/02/2019; Dr. Blanca Paniagua) 

- Chemical oral and dental biofilm control (based on the latest network meta-analysis published by UCM) (01/03/2019; Dr. Lucía Barallat)

- Antibiotics in periodontal therapy (08/03/2019; Dr. Neus Carrió)

- Phase II. Periodontal surgery: principles and practice of periodontal surgery (15/03/2019; Prof. Alberto Monje)

- Phase IV. Supportive Periodontal Therapy (22/03/2019; Dr. Antonio Santos)

6. GUIDED TISSUE AND BONE REGENERATION: BIOLOGY AND PRINCIPLES (29/03/2019 & 05/04/2019; Dr. José Nart)

- Periodontal wound healing

- Concepts in Periodontal Tissue Regeneration 


- Regenerative capacity of bone cells

- Regenerative capacity of gingival connective tissue cells

- Regenerative capacity of periodontal ligament cells

- Role of epithelium in periodontal wound healing

- Root resorption

- Remaining bone in the edentulous ridge

- Classifications of remaining bone

- From an alveolar process to an edentulous ridge:

- Intra‐alveolar processes

- Extra‐alveolar processes 


7. INTERDISCIPLANRY TREATMENT 
 (12/04/2019; Dr. José Nart)

- Orthodontics: tooth movement in the periodontally compromised patient, corticotomies

- Prosthodontics: occlusion, occlusal trauma, tooth mobility and treatment planning in periodontal patient

8. HALITOSIS (26/04/2019; Dr. Antonio Santos) 

9. SYSTEMIC LINK: SYSTEMIC FACTORS IMPACTING THE PERIODONTIUM 

- Diabetes mellitus and Cardiovascular diseases (03/05/2019; Dr. José Nart)

- Adverse pregnancy outcomes and Respiratory diseases (10/05/2019; Dr. Blanca Paniagua)

Master classes by teachers from the Department of Periodontology in a classroom to all the students enrolled in the subject. Such methodology allows the use of audiovisual media to support the content. Likewise, students can interact and participate actively.

The theoretical exam represents 70% to the final grade and the periodontal clinical case 30%. 

The exam will be multiple choice test type with a correction factor of 0.20.

In addition, a periodontal clinical case should be presented by CUO pairs of a patient with gingivitis or periodontitis and the completed phase I (see attached document), which will correspond to 30% of the CUO note. The template can not be modified, since all students must follow the same format.

To pass the subject it is necessary that both parts (theoretical and practical) are approved and the grade of approval will be equal or superior to 5.0.

There is no option to do a written work to pass the subject.

Honors will be given from 9, at the discretion of the faculty.

A PDF with the most relevant concepts of each class will be delivered in Moodle, as well as articles, etc.

We advise students to take notes and check it out with the recommended bibliography.

Class attendance is highly recommended.

Basic Bibliography:

- Lindhe J. Clinical Periodontology and Implant Dentistry 3th ed. Copenhagen Munksgaard, 1998.

- Carranza F. Periodontología Clínica 8th ed. México, Interamericana, Megraw-Hill, 1998.

- Rose lF and Mealey BL. Periodontics: Medicine, Surgery, and Implants. 1st ed. Elsevier, 2004.

Complementary Bibliography:

- Hall W. Decision Making in Periodontology, 3th ed. St. Louis, Mosby-Ycar Book, 1998.

- Nevins M. and Mellonig J. Periodontal Theraphy. Clinical approaches and evidence of success 1st ed. Quintessence Books, 1998.

- Rateitschak M and Wolf H. Atlas de Periodoncia. 2nd ed. Barcelona, Salvat, 1989.

E: exam date | R: revision date | 1: first session | 2: second session:

• E1 24/05/2019 08:00h A01
• E1 24/05/2019 08:00h A02
• R1 05/06/2019 10:00h A09
• E2 28/06/2019 08:00h A13
• R2 03/07/2019 10:00h A08