Curriculum

Home » Oral & Maxillofacial Surgery » Curriculum

III BDS
ORAL AND MAXILLOFACIAL SURGERY
Total Theory Teaching hours: 70 hours
Total Practical’s / Clinicals: 270 hours
III year :20 hours Theory, 70 Clinical hours
IV year: 50 hours Theory, 200 Clinical hours

Lesson No	Topic	Details of the Topic	Duration
1.	Introduction	Definition, Aims & objectives of Oral surgery	1 hour
2.	Diagnosis in oral surgery	History Taking	2 hours
		Clinical Examination
		Investigations
3.	Infection control	Principles of infection control	1 hour
		Cross infection, HIV/AIDS and hepatitis	1 hour
4.	Local Anaesthesia	Neurology of facial pain Historical aspects, definition, types of LA, indications, contraindications, advantage and disadvantage. Local anaesthetic drugs, Classification Ideal requirements of LA solutions, composition and mode of action Choice of particular mode of anaesthesia Complications of LA, prevention and management. Anaesthesia technique- Mandible Anaesthesia technique- Maxilla	5 hours 2 hours 2 hours
5.	Exodontia	Introduction, indications, contra indication	1 hours
		Methods of extraction	1 hours
		Use of instruments and complications –	2 hours
		Prevention and management	2 hours
6.	Medical Emergency		3 hours
7.	Medically Compromised Patients		3 hours
Total			20 hours

Text Books:

Alling John Fetal             Impacted teeth
Peterson L Jetal          Principles of Oral and Maxillofacial Surgery Vol 1,2 & 3 Srinivasan B
Textbook of Oral and Maxillofacial Surgery
Malamed S F                     Handbook of medical emergencies in the dental office
Banks P                     Killey’s fracture of mandible
Banks P                     Killey’s fracture of middle third of the facial skeleton
McGovanda                    The Maxillary sinus and its dental implication
Seward G R et al        Killey and Kays outline of oral surgery Part I
Mc Carthy F M        Essentials of safe dentistry for the medically compromised patients Laskin D M
Oral and Maxillofacial Surgery
Howe G L Howe G L Peterson l J et al
Extraction of teeth
Minor oral surgery
Contemporary Oral and Maxillofacial Surgery
Topazian R G & Goldberg M H     Oral and Maxillofacial infections

Practical and Clinicals hours
III year BDS: 70 clinical hours.
Students are required to learn the following exercises:
Case history taking
Examination of the patient
Recording blood pressure
Use of different instruments in Oral & Maxillofacial surgery
Various local anaesthetic injection techniques on patients

Practical and Clinicals Quota

Year	Clinical exercises	Quota	Category
III year BDS
	Various local anesthetic injection techniques on patients	10 cases	Must do
	Wiring techniques on models	1 exercise	Must do
	Suturing techniques onmodels	1 exercise	Must do

IV BDS
ORAL AND MAXILLOFACIAL SURGERY
IV year BDS Theory: 50 hours

1.	Dento-alveolar surgery	Trans alveolar extraction Impacted teeth: General factors, incidence, etiology Classification and indications Assessment: clinical & radiological Anaesthetic considerations Surgical procedure Impacted maxillary third molar & Impacted Canine	1 hour 4 hours
2.	Endodontic surgery	Introduction, classification, apicectomy, replantation
3.	Infections of the	Introduction, microbiology, anatomy of fascial	4 hours
	oral cavity	spaces, course of odontogenic infections, Spread of infection, classification, clinical features,
		management Dentoalveolar abscess, ludwigs
		angina osteomyelitis and ORN.
		Hepatitis B and HIV
4.	Cystic lesions of jaws	Definition, classification and pathogenesis Diagnosis, clinical features, radiological, aspiration biopsy, use of contrast media and histopathology Management-types of surgical procedures, and complications	3 hours
5.	Oral Implantology	Principles of implantology	2 hours
6.	Ethics		1 hour
7.	Pre-prosthetic surgery	Introduction, aims, classification Corrective procedures – hard & soft tissues Ridge extension	2 hours
		and augmentation procedures
8.	Diseases of maxillary Sinus	Surgical anatomy, Acute & chronic sinusitis	1 hour
		Oro antral fistula & Surgical approach for sinus	1 hour
9.		TMJ disorders	Surgical anatomy	1 hour
			Subluxation & Dislocation	1 hour
			Ankylosis	1 hour
			Myofunctional pain dysfunction syndrome	1 hour
			Internal derangement & Arthritis and other disorders	1 hour
10.		Tumors of the oral Cavity	General considerations, Carcinoma of oral cavity, TNM classification	1 hour
			Non odontogenic benign tumors – lipoma, fibroma, papilloma, ossifying fibroma, myoma etc.	1 hour
			Ameloblastoma	1 hour
			Biopsy – types	1 hour
			Outline of management of squamous cell carcinoma, surgery, radiotherapy, chemotherapy.	1 hour
11.		Fractures of the jaws	General consideration, types of the fractures, etiology, C/F, and general principles. Dento-alveolar #methods of management	1 hour
			Mandibular Fractures – Applied Anatomy, Classification Diagnosis – Clinical and Radiological Features	1 hour
			Management -# of condyle – etiology, classification, clinical features and general principles of management reduction and fixation	1 hour
			Fractures of middle third of the face, Definition of midface, applied surgical anatomy, classification, clinical features and outline of management	2 hours
			Orbital fractures & # of Zygomatic complex	1 hour
			Classification, C/F, indications for treatment, various methods of reduction and fixation.	2 hours
			Complications – delayed union, non-union and malunion.	1 hour
12.		Developmental deformities	Basic forms, prognathism, retrognathism and open bite. Reasons for correction, Outline of surgical methods carried out on maxilla and mandible	4 hour
13.		Salivary gland diseases	Salivary calculi and Infections of the salivary glands its management	1 hour
			Tumours of the salivary gland and management	1 hour
14.		Neurological disorders	Trigeminal neuralgia – definition, etiology, C/F and methods of management including surgery. Glossopharyngeal and Facial paralysis – etiology , clinical features	1 hour
			Nerve injuries – classification, neurorhaphy etc.	1 hour
15.		Cleft lip and cleft palate	Etiology, of the clefts, incidence, classification’s role of dental surgeon in the management of cleft patients. Outline of the closure procedures.	4 hours

PRACTICAL AND CLINICALS: 200 HOURS

STUDENTS ARE REQUIRED TO LEARN THE FOLLOWING EXERCISES:

Case history taking
Examination of the patient
Recording blood pressure
Use of different instruments in Oral and Maxillofacial surgery
Various local anesthetic injection techniques on patients
Extraction of mobile and firm teeth
Trans-alveolar extraction of root stumps
Surgical removal of simple impacted teeth
Management of dento-alveolar fractures with arch bar fixation, eyelets and inter-maxillary fixations
Training in basic life support skills

PRACTICAL AND CLINICALS QUOTA

Year	Clinical exercises	Quota	Category
IV year BDS
	Extraction of mobile and firm teeth	60 cases	must do
	Trans-alveolar method of extraction with suturing	10 cases	must do
	Surgical removal of Simple impactions	5 cases	Desirable to do
	Management of dento-alveolar fractures with arch bar fixation, eyelets and inter-maxillary fixations	5 cases	Desirable to do
	IM & IV Injection techniques	5 cases	Desirable to do
	Assisting major surgical procedures under general anaesthesia	5 cases	Desirable to do
	Training in Handling medical emergencies, CPR and basic life support		must do

SCHEME OF EXAMINATION

THEORY (UNIVERSITY WRITTEN EXAMINATION) 70 MARKS DISTRIBUTION OF TOPICS AND TYPES OF QUESTIONS

Contents	Type of questions and marks	Marks
a. 1 Question from Local anaesthesia b. 1 Question from Oral surgery	Long Essays 2 x 10 marks	20
a. 5 Questions from Oral surgery b. 1Question from General anesthesia	Short Essays 6 x 5 marks	30
a. 9 Questions from Oral surgery b. 1 Question from Local anaesthesia	Short Answers 2 x 10	20
Local Anaesthesia
Total		70

Internal Assessment- Theory: 10 marks,

Clinicals: 10 marks

Clinicals: 90 Marks
Clinicals in Oral Surgery:

90 Marks (Extraction of firm tooth)

Case History 30 Marks
Local anaesthesia technique 30 marks
Extraction of firm tooth 30 marks

( Maxillary/ Mandibular tooth) and management of the patient

1.Viva voce – 20 marks
2. Theory – 100 marks
3. University written exam – 70
4. Viva voce – 20
5. Internal assessment – 10
6. Total – 100
7. Clinical – 100
8. University exam – 90
9. Internal assessment – 10
10. Total – 100

MASTER OF DENTAL SURGERY
ORAL AND MAXILLOFACIAL SURGERY
Objective:
The training program in Oral and Maxillofacial Surgery is structured to achieve the following four objectives-

Knowledge
Skills
Attitude
Communicative skills and ability

Knowledge:

To have acquired adequate knowledge and understanding of the etiology, patho-physiology and diagnosis, treatment planning of various common oral and Maxillofacial surgical problems both minor and major in nature.
To have understood the general surgical principles like pre- and post-surgical management, particularly evaluation, post-surgical care, fluid and electrolyte management, blood transfusion and post-surgical pain management.
Understanding of basic sciences relevant to practice or oral and maxillofacial surgery.
Able to identify social, cultural, economic, genetic and environmental factors and their relevance to disease process management in the oral and Maxillofacial region.
Essential knowledge of personal hygiene and infection control, prevention of cross infection and safe disposal of hospital waste keeping in view the high prevalence of hepatitis and HIV.

Skill

To obtain proper clinical history, methodical examination of the patient, perform essential diagnostic procedures and order relevant laboratory tests and interpret them and to arrive at a reasonable diagnosis about the surgical condition.
To perform with competence minor oral surgical procedures and common maxillofacial surgery. To treat both surgically and medically (or by other means of the oral and Maxillofacial and the related area).
Capable of providing care for maxillofacial surgery patients.

Attitude:

Develop attitude to adopt ethical principles in all aspect of surgical practice, professional honesty and integrity are to be fostered. Surgical care is to be delivered irrespective of the social status, caste, creed or religion of the patient.
Willing to share the knowledge and clinical experience with professional colleagues.
Wiling to adopt new techniques of surgical management developed from time to time based on scientific research which are in the best interest of the patient
Respect patient’s right and privileges, including patients right to information and right to seek a second opinion.
Develop attitude to seek opinion from an allied medical and dental specialist as and when required.

Communication skills:

Develop adequate communication skills particularly with the patients giving them the various options available to manage a particular surgical problem and obtain a true informed consent from them for the most appropriate treatment available at that point of time
Develop the ability to communicate with professional colleagues.
Develop ability to teach undergraduates.

Course content:

The program outline addresses both the knowledge needed in Oral and Maxillofacial Surgery and allied medical specialties in its scope. A minimum of three years of formal training through a graded system of education as specified will equip the trainee with skill and knowledge at its completion to be able to practice basic oral and Maxillofacial surgeon competently and have the ability to intelligently pursue further apprenticeship towards advance Maxillofacial surgery.

The topics are considered as under: –

Basic sciences
Oral and Maxillofacial surgery
Allied specialties

Applied Basic Sciences:

A thorough knowledge both on theory and principles in general and in particular the basic medical subjects as relevant to the practice of maxillofacial surgery. It is desirable to have adequate knowledge in bio-statistics, Epidemiology, research methodology, nutrition and computers.

Anatomy

Development of face, paranasal sinuses and associated structures and their anomalies: surgical anatomy of scalp temple and face, anatomy and its applied aspects of triangles of neck, deep structures of neck, cranial facial bones and its surrounding soft tissues, cranial nerves tongue, temporal and infratemporal region, orbits and its contents, muscles of face and neck, paranasal sinuses, eyelids and nasal septum teeth gums and palate, salivary glands, pharynx, thyroid and parathyroid glands, larynx, trachea and esophagus, congenital abnormality of orofacial regions, general consideration of the structure.

Physiology

Nervous system-physiology of nerve conduction, pain pathway, sympathetic and parasympathetic nervous system, hypothalamus and mechanism of controlling body temperature; Blood-its composition hemostasis, blood dyscrasias and its management, hemorrhage and its control, blood grouping, cross matching, blood component therapy, complications of blood transfusion, blood substitutes, auto transfusion, cell savers; digestive system composition and functions of saliva mastication deglutition, digestion, assimilation, urine formation, normal and abnormal constituents; Respiration control of

ventilation anoxia, asphyxia, artificial respiration, hypoxia – types and management; CVS – cardiac cycle, shock, heart sounds, blood pressure, hypertension; Endocrinology- metabolism of calcium; endocrinal activity and disorder relating to thyroid gland, parathyroid gland, adrenal gland,

pituitary gland, pancreas and gonads; Nutrition- general principles balanced diet. Effect of dietary deficiency, protein energy malnutrition, Kwashiorkor, Marasmus, Nutritional assessment, metabolic responses to stress, need for nutritional support, entrails nutrition, roots of access to GI tract, Parenteral nutrition, Access to central veins, Nutritional support; Fluid and Electrolytic balance/Acid Base metabolism- the body fluid compartment, metabolism of water and electrolytes, factors maintaining hemostasis, causes for treatment of acidosis and alkalosis.

Biochemistry

General principles governing the various biological principles of the body, such as osmotic pressure, electrolytes, dissociation, oxidation, reduction etc; general composition of body, intermediary metabolism, carbohydrate, proteins, lipids, enzymes, vitamins, minerals and antimetabolites.

General Pathology

Inflammation – Acute and chronic inflammation, repair and regeneration, necrosis and gangrene, role of component system in acute inflammation, role of arachidonic acid and its metabolites in acute inflammation, growth factors in acute inflammation role of NSAIDS in inflammation, cellular changes in radiation injury and its manifestation; wound management – Wound healing factors influencing healing; properties if suture materials, appropriate uses of sutures; hemostasis – role of endothelium in thrombogenesis; arterial and venous thrombi, disseminated intravascular coagulation; Hypersensitivity; Shock and pulmonary failure: types of shock, diagnosis, resuscitation, pharmacological support, ARDS and its causes and prevention, ventilation and support, Neoplasm of tumours, Carcinogens and Carcinogenesis, grading and staging of tumours, various laboratory investigation.

General microbiology

Immunity, Hepatitis B and its prophylaxis, Knowledge of organisms, commonly associated with diseases of oral cavity, culture and sensitivity tests, various staining techniques-Smears and cultures, urine analysis and culture.

Oral pathology and microbiology:

Developmental disturbances of oral and para oral structures, regressive changes of teeth, bacterial, viral, mycotic infection of oral cavity, dental caries, diseases of pulp and Periapical tissues, physical and chemical injuries of oral cavity, wide range of pathological lesions of hard and soft tissues of the orofacial regions like the cysts odontogenic infection, benign, malignant neoplasms, salivary gland diseases, maxillary sinus diseases, mucosal diseases, oral aspects of various systemic diseases, role of laboratory investigation in oral surgery.

Pharmacology and therapeutics:

Definition of terminology used, pharmacokinetics and pharma dynamic dosage and mode of administration of drugs, action and fate in the body, drug addiction, tolerance and hypersensitive reactions, drugs acting on CNS, general and local anaesthetics, antibiotics and analgesics, antiseptics, antitubercular, sialagogues, haematinics, anti-diabetic, Vitamins A, B-complex, C, D,E,K Computer science

Use of computers in surgery, components of computer and its use in practice-principles of word processing, spreadsheet function database and presentations; the internet and its use. The value of computer-based systems in biomedical equipment.

ORAL AND MAXILLOFACIAL SURGERY:

Evolution of Maxillofacial surgery.
Diagnosis, history taking, clinical examination, investigations.
Informed consent/medico-legal issues.
Concept of essential drugs and rational use of drugs.
Communication skills with patients- understanding clarity in communication, compassionate explanations and giving emotional support at the time of suffering and bereavement
Principles of surgical audit – understanding the audit of process and outcome.
Methods adopted for the same Basic statistics.
Principles of evidence bases surgery- understanding journal-based literature study; the value of textbook, reference book articles, value of review articles; original articles and their critical assessment, understanding the value of retrospective, prospective, randomized control and blinded studies, understanding the pimples and the meaning of various Bio-statistical tests applied in these studies.
Principles of surgery- developing a surgical diagnosis, basic necessities for surgery, aseptic techniques, incisions, flap designs, tissue handling, homeostasis, dead space management, decontamination and debridement, suturing, edema control, patient general health and nutrition.
Medical emergencies – Prevention and management of altered consciousness, sensitivity reaction, chest discomfort, respiratory difficulty.
Pre-operative workup – Concept of fitness for surgery; basic medical work up; work up in special situation like diabetes renal failure, cardiac and respiratory illness; risk stratification
Surgical sutures, drains
Post-operative care- concept of recovery room care, Airway management, Assessment of Wakefulness, management of cardio vascular instability in this period, Criteria for shifting to the ward, pain management
Wound management- Wound healing, factors influencing healing, basic surgical techniques, Properties of suture materials, appropriate use of sutures.
Surgical Infections – Asepsis and antisepsis, Microbiological principles, Rational use of antibiotics, special infections like Synergistic Gangrene and Diabetic foot infection, Hepatitis and HIV infection and cross infection.
Airway obstruction/management – Anatomy of the airway, principles of keeping the airway patent, mouth to mouth resuscitation, Oropharyngeal airway, endotracheal intubation, Cricothyroidectomy, Tracheostomy.
Anaesthesia – stages of anaesthesia, pharmacology of inhalation, intravenous and regional anaesthetics, muscle relaxants.
Facial pain; Facial palsy and nerve injuries.
Pain control – acute and chronic pain, cancer and non-cancer pain, patient-controlled analgesia
General patient management – competence in physical assessment of patients of surgery, competence in evaluation of patients presenting with acute injury, particularly to maxillofacial region. Competence in the evaluation of
management of patients for anesthesia
Clinical oral surgery – all aspects of dento-alveolar surgery
Pre-prosthetic surgery – A wide range of surgical reconstructive procedures in their hard and soft tissues of the edentulous jaws.
Temporomandibular joint disorders – TMJ disorders and their sequelae need evaluation, assessment and management. It is preferable to be familiar with therapeutic arthroscopic surgery procedures.
Tissue grafting – Understanding of the biological mechanisms involved in auto and heterogeneous tissue grafting.
Reconstructive oral and maxillofacial surgery – hard tissue and so reconstruction.
Anesthesia – Stages of anesthesia, pharmacology of inhalation, intravenous and regional anesthesia, muscle relaxants.
Cyst and tumours of head and neck region and their management – including principles of tumour surgery, giant cell lesion of jaw bones, fibro osseous lesion of jaw lesions. Neurological disorders of maxillofacial region-diagnosis and management of Trigeminal Neuralgia, MPDS, Bell’s palsy, Frey’s Syndrome, Nerve injuries
Maxillofacial trauma – basic principles of treatment, primary care, diagnosis and management of hard and soft tissue injuries, Comprehensive, management including polytrauma patients
Assessment of trauma-multiple injuries patients/closed abdominal and chest injuries/penetrating injuries, pelvic fractures, urological injuries, vascular injuries.
Orthognathic surgery – The trainee must be familiar with the assessment and correcting of jaw deformities
Laser surgery – The application of laser technology in the surgical treatment of lesions amenable to such therapy
Distraction osteogenesis in maxillofacial region.
Cryosurgeries – Principles, the application of cryosurgery in the surgical management of lesions amenable to such surgeries.
Cleft lip and palate surgery- detailed knowledge of the development of the face, head and neck, diagnosis and treatment planning, Current concepts in the management of cleft lip and palate deformity, knowledge of nasal endoscopy and other diagnostic techniques In the evaluation of speech and hearing, concept of multi-disciplinary team management.
Aesthetic facial surgery – detailed knowledge of structures of facial neck including skin and underlying soft tissues, diagnosis and treatment planning of deformities and conditions affecting facial skin, underlying facial muscles, bone, eyelids, external ear etc. surgical management of post acne scaring, face lift, blepharoplasty, otoplasty, facial bone recontouring etc.
Craniofacial surgery – basic knowledge of developmental anomalies of face, head and neck, basics concept in the diagnosis and planning of various head and neck anomalies including facial cleft, craniosynostosis, syndromes, etc., Current concepts in the management of craniofacial anomalies
Head and neck oncology – understanding of the principles of management of head and neck oncology including various pre-cancerous lesions, Experience in the surgical techniques of reconstruction following ablative surgery.
Micro vascular surgery.
Implantology – principles, surgical procedures for insertion of various types of implants.
Maxillofacial radiology/radio diagnosis
Other diagnostic methods and imaging techniques
Allied specialties:

General medicine: General assessment of the patient including children with special emphasis on cardiovascular diseases endocrinal and metabolic respiratory and renal eases, Blood dyscrasias.
General surgery: Principles of general surgery, exposure to common general surgical procedures.

Neuro – surgery: Evaluation of a patient with head injury, examination of various Neuro-surgical procedures

ENT/Ophthalmology: Examination of ear, nose throat, exposure to ENT surgical procedures, ophthalmic examination and evaluation, exposure to ophthalmic surgical procedures.
Orthopaedic: basic principles of orthopaedic surgery, bone diseases and trauma as relevant to Maxillofacial surgery, interpretation of radiographs, CT, MRI and ultrasound
Anesthesia: Evaluation of patients for GA techniques and management of emergencies, various IV sedation techniques

Academic Clinical programme (applicable for all three years):

Seminars to be presented attended once in a week.

Journal clubs (departmental and interdepartmental) to be conducted once in fifteen days.

Departmental and interdepartmental discussions to be held once in a month.

Minimum 2 scientific papers should be presented.

Every candidate shall maintain a logbook to record his/her work or participate all activities such as journal clubs, seminars, CDE programs etc. this wove scrutinized and certified by the head of the departmental and head of the institute and presented to the university every year

Year by year programme:

I Year

First 6 Months:

Dissection, basic sciences, basic computer sciences, exodontias, seminars on basic selection of dissertation topic, library assignment topic, attending O.T and ward preparation of synopses and its submission within the six months after admission to the university as per calendar of events.

Second six Months (rotation and postings in other department):

Oncology – 2 months
Emergency – 1 month
General medicine- – 15 days
General surgery/anesthesia – 15 days
Ophthalmology -15 days
Neurology -15 days
ENT -15 days

II Year

Minor oral surgery and higher surgical training Submission of library assignment by the end of first term

Examination on minor oral surgical procedures – one paper of three hours duration to be conducted by the college.

III Year

Maxillofacial surgery, submission of dissertation in the first term, i.e., six months before the final examination to the university.

Examination of three hours duration three months before the final examination to be conducted by the college. It is desirable to enter general surgical skills and operative procedure that are observed, assisted or performed in the log book in the format as given by RGUHS in the revised ordinance governing MDS degree course.

Final examination at the end of the third

SL.NO	PROCEDURE	CATEGORY	YEAR	NUMBER
1	Injection I.M and I.V	PI	I, II	50,20
2	Minor suturing and removal of sutures	PI	I	N, A
3	Incision and drainage of an abscess	PI	I	10
4	Surgical extraction	PI	I	15
5	Impacted teeth	PI, PA	I, II	20,10
6	Pre-prosthetic surgery	PI
	a) Corrective procedures b) Ridge extension c) Ridge reconstruction	PI PA A	I I, II II, III	15 3 3
7	OAF closure	PI, PA	I, II	3,2
8	Cyst enucleation	PI, PA	I, II	5,5
9	Mandibular fractures	PI, PA	I, II	10,10
10	Peri-apical surgery	PI, PA	I	5
11	Infection management	PI, PA	I, II	N, A
12	Biopsy procedures	PI	I, II	N, A
13	Removal of salivary calculi	PA	I, II	3,5
14	Benign tumours	PA, A	II, III	3,3
15	Mid face fractures	PA, A	II, III	3,5
16	Implants	PA, A	II, III	5,5
17	Tracheostomy	PA, A	II, III	2,2
18	Skin grafts	PA	III	3,5
19	Orthognathic surgery	PA, A	II, III	3
20	Harvesting bone & cartilage grafts a) Iliac crest b) Rib c) Calvarial d) Fibula	P A A A A,0		3,2,2
21	TMJ surgery	PA, A	II, I	1
22	Jaw resections	PA, A	III, II	3,3
23	Onco-surgery	A,0	III, III	3,3
24	Microvascular anastomosis	A,0	III	5,10
25	Cleft lip and palate	PA, A	II, III	10,15
26	Distraction osteogenesis	A,0	II, III	2,3
27	Rhinoplasty	A,0	III	3,5
28	Access osteotomies and base of skull surgeries	A,0	III	1,3

ORAL AND MAXILLOFACIAL SURGERY

Paper I: Applied Basic Sciences: Applied Anatomy, Physiology, Biochemistry, General and Oral Pathology and Microbiology and Pharmacology

Applied Anatomy

Surgical anatomy of the scalp, temple and face
Anatomy of the triangles of neck and deep structures of the neck
Cranial and facial bones and its surrounding soft tissues with its applied aspects in maxillofacial injuries.
Muscles of head and neck
Arterial supply, venous drainage and lymphatics of head and neck
Congenital abnormalities of the head and neck
Surgical anatomy of the cranial nerves
Anatomy of the tongue and its applied aspects
Surgical anatomy of the temporal and infratemporal regions
Anatomy and its applied aspects of salivary glands, pharynx, thyroid and parathyroid gland, larynx, trachea esophagus
Tooth eruption, morphology, and occlusion.
Surgical anatomy of the nose.
The structure and function of the brain including surgical anatomy of intra cranial venous sinuses.
Autonomous nervous system of head and neck
Functional anatomy of mastication, deglutition, speech, respiration and circulation
Development of face, paranasal sinuses and associated structures and their anomalies
MJ: surgical anatomy and function

Physiology:

1.Nervous system Physiology of nerve conduction, pain pathway, sympathetic and parasympathetic nervous system, hypothalamus and mechanism of controlling body temperature.

Blood

Composition
Haemostasis, various blood dyscrasias and its management of patients with the same
Hemorrhage and its control
Capillary and lymphatic circulation.
Blood grouping, transfusing procedures.

Digestive system

Saliva – composition and functions of saliva
Mastication deglutition, digestion, assimilation
Urine formation, normal and abnormal constituents

Respiration

Control of ventilation anoxia, asphyxia, artificial respiration
Hypoxia – types and management

Cardiovascular System

Cardiac cycle,
Shock
Heart sounds,
Blood pressure,
Hypertension

Endocrinology General endocrinal activity and disorder relating to thyroid gland, Parathyroid gland, adrenal gland, pituitary gland, pancreas and gonads: Metabolism of calcium

Nutrition

General principles balanced diet, effect of dietary deficiency, protein malnutrition, Kwashiorkor, Marasmus.
Fluid and Electrolytic balance in maintaining haemostasis and significance in minor and major surgical procedures.

Biochemistry

General principles governing the various biological activities of the body, such as osmotic pressure, electrolytes, dissociation, oxidation, reduction etc. General composition of the body
Intermediary metabolism
Carbohydrates, proteins, lipids, and their metabolism Nucleoproteins, nucleic acid and nucleotides and their metabolism Enzymes, vitamins and minerals Hormones
Body and other fluids. Metabolism of inorganic elements. Detoxification in the body.

Pathology:

Inflammation-

Repair and regeneration, necrosis and gangrene
Role of component system in acute inflammation,
Role of arachidonic acid and its metabolites in acute inflammation,
Growth factors in acute inflammation
Role of molecular events in cell growth and intercellular signalling cell surface receptors
Role of NSAIDs in inflammation,
Cellular changes in radiation injury and its manifestation.

Haemostasis

Role of endothelium in thrombogenesis,
Arterial and venous thrombi,
Disseminated Intravascular coagulation

Shock:Pathogenesis of haemorrhagic, neurogenic, septic, cardiogenic shock Circulatory disturbances, ischemia hyperaemia, venous congestion, infarction.

Chromosomal abnormalities: Marians Syndrome, Ehler’s Danlos Syndrome, Fragile X- Syndrome

Hypersensitivity: Anaphylaxis, type 2 hypersensitivity, type 3 sensitivity and cell mediated reaction. And its clinical importance, systemic lupus erythematosus. Infection and infective granulomas.

Neoplasia:

Classification of tumours.
Carcinogenesis and carcinogen- chemical, viral and microbial
Grading and staging of cancers, tumour Angiogenesis, Paraneoplastic syndrome, spread of tumours.
Characteristics of benign and malignant tumours.

Others:

Sex linked a gamma globulinemia.
AIDS
Management of immune deficiency patients requiring surgical procedures
De George Syndrome
Ghons complex, post primary pulmonary tuberculosis – pathology and pathogenesis.

Oral Pathology:

Developmental disturbances of oral and Para oral structures
Regressive changes of teeth.
Bacterial, viral and mycotic infections of oral cavity
Dental caries, diseases of pulp and periapical tissues
Physical and chemical injuries of the oral cavity
Oral manifestations of metabolic and endocrinal disturbances
Diseases of jawbones and TMJ
Diseases of blood and blood forming organs in relation to oral cavity
Cysts of the oral cavity
Salivary gland diseases
Role of laboratory investigations in oral surgery.

Microbiology:

Immunity
Knowledge of organisms commonly associated with disease of oral cavity.
Morphology cultural characteristics of strepto, staphylo, pneumo, gono, meningo, Clostridium group of organisms, spirochetes, organisms of TB, leprosy, diphtheria, actinomycosis and moniliasis.
Hepatitis B and its prophylaxis
Culture and sensitivity test
Laboratory determinations
Blood groups, blood matching, RBC and WBC count, bleeding and clotting time etc, smears and cultures,
Urine analysis and cultures.

Applied Pharmacology and Therapeutics:

Definition of terminologies used
Dosage and mode of administration of drugs.
Action and fate of drugs in the body
Drug addiction, tolerance and hypersensitive reactions.
Drugs acting on the CNS
General and local anaesthetics, hypnotics, analeptics, and tranquilizers.
Chemo therapeutics and antibiotics
Analgesics and antipyretics
Antitubercular and antisyphilitic drugs.
Antiseptics, sialagogues and antisialogogues
Haematinics
Antidiabetics
Vitamins A, B-complex, C, D, E, K

MINOR ORAL SURGERY AND TRAUMA

Principles of Surgery: Developing a surgical diagnosis, basic necessities.

Surgery, Aseptic Technique, Incisions, Flap Design Tissue handling, Haemostasis dead space management, decontamination and debridement, Suturing, Oedema control, patient general health and nutrition.

Medical Emergencies: prevention and management of altered consciousness (syncope, orthostatic hypotension, seizures, diabetes mellitus, adrenal insufficiency hypersensitivity reactions, chest discomfort, and respiratory difficulty.

Examination and Diagnosis: clinical history, physical and radiographic, clinical and laboratory diagnosis, oral manifestations of systemic diseases, implications systemic diseases in surgical patients.
Haemorrhage and Shock: applied physiology, clinical abnormalities coagulation, extra vascular hemorrhage, and haemorrhagic lesions, management secondary hemorrhage, shock.
Exodontia: principles of extraction, indications and contraindications, types of extraction, complications and their management, principles of elevators and elevators used in oral surgery.
Impaction: surgical anatomy, classification, indications and contraindications, diagnosis, procedures, complications and their management.
Surgical Aids to Eruption of Teeth: surgical exposure of unerupted teeth, surgical repositioning of partially erupted teeth.
Transplantation of Teeth
Surgical Endodontics: indications and contraindications, diagnosis, procedures of peri radicular surgery
Procedures to improve Alveolar soft tissues: requirements, types (alveoloplasty, tuberosity reduction, mylohyoid ridge reduction, genial reduction, removal of exostosis, vestibuloplasty)
Procedures to Improve Alveolar soft Tissues: hypermobile tissues- operative / sclerosing method, epulis fissuratum, frenectomy and frenotomy.
Infection of Head and Neck: Odontogenic and non-Odontogenic infections, factors affecting spread of infection, diagnosis ad differential diagnosis, management of facial space infections, Ludwig angina, cavernous sinus thrombosis.
Chronic Infections of the Jaws: Osteomyelitis (types, etiology, pathogenesis, management), osteoradionecrosis
Maxillary Sinus: maxillary sinusitis – types, pathology, treatment, closure of Oro – antral fistula. Caldwell- Luc operation
Cysts of the Orofacial region: classification, diagnosis, management of OKC, dentigerous, radicular non-Odontogenic, ranula
Neurological Disorders of the maxillofacial region: diagnosis and management of trigeminal neuralgia, MPDS, bell’s palsy, Frey’s syndrome, nerve injuries.
Implantology: definition, classification, indications and contraindications, advantages and disadvantages, surgical procedure.
Anesthesia

Local Anesthesia: classification of local anaesthetic drugs, modes of action indications and contra indications, advantages and disadvantages, techniques, complications and their management.
General Anesthesia: classification, stages of GA, mechanism of action, indications, and contra indications, advantages and disadvantages, post anaesthetic complications and emergencies, anaesthetic for dental proceduresin children, pre medication, conscious sedation, legal aspects for GA

Trauma
Surgical Anatomy of head and Neck
Etiology of Injury
Basic Principles of Treatment
Primary Care: resuscitation, establishment of airway, management of hemorrhage, management of head injuries and admission to hospital.
Diagnosis: clinical, radiological
Soft Tissue Injury of Face and Scalp: classification and management of soft tissue wounds, injuries to structure requiring special treatment.
Dento Alveolar Fractures: examination and diagnosis, classification, treatment, prevention.
Mandibular Fractures: classification, examination and diagnosis, general principles of treatment, complications and their management.
Fracture of Zygomatic Complex: classification, examination and diagnosis, general principles of treatment, complications and their management.
Orbital Fractures: blow out fractures
Nasal Fractures
Fractures of Middle third of the Facial Skeleton: emergency care, fractured maxilla, and treatment of le fort I, II, III, fractures of Naso-orbito-ethmoidal region.
Ophthalmic Injuries: minor injuries, non-perforating injuries, perforating injuries, retrobulbar hemorrhage, and traumatic optic neuropathy.
Traumatic Injuries to Frontal sinus: diagnosis, classification, treatment
Maxillofacial injuries in Geriatric and paediatric patients.
Gunshot wounds and War Injuries
Osseointegration in Maxillofacial Reconstruction
Metabolic response to Trauma: neuro endocrine responses, inflammatory and clinical implications.
Healing of Traumatic Injuries: soft tissues, bone, cartilage, response of peripheral nerve to injury
Nutritional Consideration following Trauma
Tracheostomy: indications and contraindications, procedure, complications and their management.

MAXILLOFACIAL SURGERY

Salivary gland
Sialography
Salivary fistula and management
Diseases of salivary gland – developmental disturbances, cysts, inflammation and sialolithiasis
Mucocele and Ranula
Tumours of salivary gland and their management
Staging of salivary gland tumours
Parotidectomy
Temporomandibular Joint
Etiology, history signs, symptoms, examination and diagnosis of temporomandibular joint disorders
Ankylosis and management of the same with different treatment modalities
MPDS and management
Condylectomy – different procedures
various approaches to TMJ
Recurrent dislocations – Etiology and Management
Oncology
Biopsy
Management of pre-malignant tumours of head and neck region
Benign and Malignant tumours of Head and Neck region
Staging of oral cancer and tumour markers
Management of oral cancer
Radial Neck dissection
Modes of spread of tumour
Diagnosis and management of tumours of nasal, paranasal, neck, tongue, cheek, maxilla and mandible
Radiation therapy in maxillofacial regions.
Lateral neck swellings
Orthognathic surgery
Diagnosis and treatment planning
Cephalometric analysis
Model surgery
Maxillary and mandibular repositioning procedures
Segmental osteotomies
Management of apertognathia
Genioplasty
Distraction osteogenesis
Cysts and tumour of orofacial region
Odontogenic and non-Odontogenic tumours and their management
Giant lesions of jawbone
Fibro osseous lesions of jawbone
Cysts of jaw
Laser surgery
The application of laser technology in surgical treatment of lesions Cryosurgery
Principles, applications of cryosurgery in surgical management of Cleft lip and palate surgery
Detailed knowledge of the development of the face, head and neck
Diagnosis and treatment planning
Current concepts in the management of cleft lip and palate deformity
Knowledge of Naso endoscopy and other diagnostic techniques in the evaluation of speech and hearing
Concept of multidisciplinary team management
Aesthetic facial surgery
Detailed knowledge of the structures of the face and neck including skin a underlying soft tissue
Diagnosis and treatment planning of deformities and conditions affecting facial skin
Underlying facial muscles, bone. Eyelids external ear
Surgical management of post acne scarring, facelift, blepharoplasty, otoplasty, facial bone recontouring, etc
Craniofacial surgery
Basic knowledge of developmental anomalies of the face, head and neck
Basic concepts in the diagnosis and planning of various head and neck anomalies including facial clefts, craniosynostosis, syndromes, etc.
Current concept in the management of Craniofacial anomalies

Monitoring Learning Progress

It is essential to monitor the learning progress to each candidate through continuous appraisal and regular assessment. It not only helps teachers to evaluate students, but also students to evaluate themselves. The monitoring to be done by the staff of the department based on participation of students in various teaching / learning activities. It may be structured and assessment be done using checklists that assess various aspects.

Checklists are given in Section IV

UNIVERSITY SCHEME OF EXAMINATION

M.D.S. Degree examinations in any branch of study shall consist of dissertation, written paper (Theory)

Part I at the end of Ist year and Part II at the end of 3 years Practical/Clinical and Viva voce.

Theory: Part-I: Basic Sciences Paper – 100 Marks

Part-II: Paper-I, Paper-II & Paper-III – 300 Marks (100 Marks for each Paper)

Written examination shall consist of Basic Sciences (Part-I) of three hours duration shall be conducted at the end of First year of MDS course. Part-II Examination shall be conducted at the end of Third year of MDS course.

Part-I: Applied Basic Sciences: Applied Anatomy, embryology, growth and development Genetics, Immunology, anthropology, Physiology, nutrition & Biochemistry, Pathology & Microbiology, virology, Applied pharmacology, Research Methodology and bio statistics. Applied Dental anatomy & histology, Oral pathology & oral Microbiology, Adult and geriatric psychology. Applied dental materials.

Part-II Examination shall consist of Paper-I, Paper-II and Paper-III, each of three hours duration.

Paper-I & Paper-II shall consist of two long answer questions carrying 25 marks each and five questions carrying 10 marks each.

Paper-III will be on Essays. In Paper-III three Questions will be given and student has to answer any two questions. Each question carries 50 marks. Questions on recent advances may be asked in any or all the papers.

Distribution of topics for each paper will be as follows:

DISTRIBUTION OF MARKS:

Theory:

(1) Part I University Examination (100 Marks): –

There shall be 10 questions of 10 marks each (Total of 100 Marks)

(2) Part II (3 papers of 100 Marks): –

(i) Paper-I: 2 long essay questions of 25 marks each and 5 short essays of 10 marks each. (Total of 100 Marks)

(ii) Paper-II: 2 long essay questions of 25 marks each and 5 short essays of 10 marks each. (Total of 100 Marks)

(iii) Paper III: 2 out of 3 essay questions (50 x 2 = 100 Marks)

Practical and Clinical Examination: 200 Marks

Viva-voce and Pedagogy: 100 Marks

Practical / Clinical Examination: 200 Marks.

Minor Oral Surgery -100 Marks

Each candidate is required to perform the minor oral surgical procedures under local anaesthesia. The minor surgical cases may include removal of impacted lower third molar, cyst enucleation, any similar procedure where students can exhibit their professional skills in raising the flap, removing the bone and suturing the wound.

One long case – 60 marks
Two short cases – 20 marks each

Viva Voce: 100 Marks

Viva-voce examination: 80 marks

All examiners will conduct viva-voce conjointly on candidate’s comprehension, analytical approach, expression, interpretation of data and communication skills. It includes all components of course contents. It includes presentation and discussion on dissertation also.

Pedagogy Exercise: 20 marks

A topic be given to each candidate in the beginning of clinical examination. He/she is asked make a presentation on the topic for 8-10 minutes.