Oral & Maxillofacial Surgery
6th year Course Syllabus
Instructors and course information:
The course is taught by the following faculties from the division of Oral & Maxillofacial Surgery.
Name Extension Room Building
Dr. Ahmed Al Yamani 20293 1/1250 Bldg. 12 (M)
Prof. Tarek Al Khateeb
Dean of the Faculty of Dentistry 22034 Dean’s office Bldg. 12 (M) 2nd Level Prof. Ibrahim El Hakim 22367 2/1260 Bldg. 12 (M) 2nd Level
Course director:
E-mail:
Office hours:
Course name: Oral & Maxillofacial Surgery
Department: Oral Maxillofacial Surgery & Rehabilitation Course No.: OMR 611
Semesters: All the academic year Number of hours: 28 hours lectures
84 hours practical Prerequisites:
Attendance is mandatory for both lectures and practical sessions.
Course meeting times and places:
Students should attend a one hour lecture followed by three hours clinical sessions.
Male student’s lectures will be held every Wednesday at building No.10 1st level at 6th year classroom.
Female student’s lectures will be held every Tuesday at the faculty of density female section building No. at 1st level at 6th year classroom.
The one hour lecture will be followed by Clinical sessions (3 hours / week), for female students building No.12 2nd floor at female section, and for male students will take place at building No.12 1st floor at male section.
Course website:
2 Course description:
During the first semester of this course, student will be taught about the Oro-facial infection, pathological and clinical propagation of the different types of facial spaces of infection and how to manage clinically and surgically with each, afterward the course will follow the natural development of the Chronically of infection to develop different types of Cysts and how to diagnose cysts by clinical and radiographic examination and the indication of different modalities of treatment and the indication for each. Tumors of soft & hard tissue, a pathological introduction, clinical & radiological
examination, and types of biopsies & indication of each for the purpose of diagnosis and the way of surgical treatment and reconstruction. Salivary glands affections and its managements.
During the second semester, students will be taught about the Oral and Maxillofacial Trauma, that includes management of the first aid treatment to trauma patients, history taken, clinical and
radiological examination to evaluate the site and degree of facial fractures and injury to the soft tissue as well and how to mange with this patient for the definitive treatment using the different types of reduction and fixation of facial bone fractures and repair of soft tissue injuries. Temporomandibular joint affection, its clinical & radiographic examination, differential diagnosis of the different types of TMJ affection and the conservative and surgical managements. Dental implant, its biological
considerations, different types of implants, clinical implant components, implant prosthetic options, preoperative evaluation of the patient, surgical phase, and complication of implants.
At the end of the course the student will be taught craniofacial deformities & orthognathic surgery;
its causative factors, evaluation of dentofacial deformity patients, pre-surgical treatment phase, surgical treatment, and post-operative phase.
Course content:
Oro-facial infection; its propagation and management.
Odontogenic cysts.
Tumors of the Oro-facial tissues and soft & hard tissue reconstructions.
Salivary glands affections and its management.
Oral & Maxillofacial Trauma.
Temporomandibular joint affection.
Dental implants.
Craniofacial deformities & orthognathic surgery.
3 The practical sessions will follow the lecture immediately in order for the student to apply what they have learned during the lecture. Students will be divided into small groups and a faculty member who will demonstrate different local anesthetic administering techniques will supervise each group then he will closely monitor the student while performing the procedure on their fellow student. The
supervising faculty member before proceeding to the next technique should approve all steps of local anesthesia administration.
All students are expected to adhere strictly to the general clinical rules and regulations including infection control principles.
Course objectives:
Part of the time in the clinical session, students are expected to be able to know and apply the proper clinical and radiological evaluation for a proper diagnosis and treatment plan for each of the clinical presentation of the affections they studied in the contents of the course.
The rest of the clinical session students will have a practice in teeth extraction starting by receiving the patient, adjusting the dental chair, history taken, clinical & radiological examination to decide the indication of extraction. Then students will be able to proceed with the indicated technique for the tooth or teeth for extraction and finally the different methods of extraction (closed or surgical) according to their indication.
Learning resources:
o Recommended text:
• Contemporary Oral & Maxillofacial Surgery by L.G. Peterson et al., Mosby Co.
• Oral infection by Richard G. Topazian.
o The faculty members will provide additional reading material during each lecture.
o Different web sites concerning to each subject in the course.
4 Course requirements and Grading:
Methods of evaluation:
• Two quizzes each at the mid term (Q1, Q2). 10 grades / each.
• Mid-year exam. 40 grades.
• Final exam includes:
1. Practical exam: each student have to examine practically by extraction of a tooth, the evaluation includes preparing the clinic considering the measures of infection control, position of the patient on the dental chair, history taken, technique of local anesthesia, and the tooth extraction technique
30 grades.
2. Written exam: includes MCQ, fill in the spaces, Essay in the form of problem solving of different clinical affections.
80 grades.
3. Oral written exam: in the form of clinical or radiological Kodachrom stations. 20 grades.
4. Requirements of 40 extractions of different types of teeth all over the academic year.
10 grades.
Detailed Course Schedule
First topic title:
Oro-facial infection & Apicoectomy.
No. of lectures:
7 Topic contents:
What are infection and its different types?
Different causative factors of infect, and focusing on bacterial cause of infection.
Modes of spread, factors influencing the direction of spread and its anatomical relations to form different types of facial spaces of infection.
Differential diagnosis of the different facial space clinically, and D.D. between soft and bony types of infection.
Management of orofacial infection, when and how?
Management of the offending tooth by amputation of the involved root portion with the infection (Apicoectomy).
Topic objectives:
The student will learn how to diagnose orofacial swelling as a result of infection and differentiate that from any other soft tissue swellings as tumors. After diagnosis of the infection, the student have to know the proper management to deal with the patient with infection, as when he started the surgical management, the timing and type of medication and the principles to evaluate the post-operative management of the causative tooth.
Second topic title:
Surgical Management of Oral Pathologic Lesions (Cyst and Cyst-like lesions of the Jaws and Jaw Tumors).
No. of lectures:
5 Topic contents:
Surgical management of cyst and cyst like lesions of the jaws (Enucleation and Marsupialization).
Definitions of tumors and types of tumors.
Difference of between benign and malignant tumors.
Etiology of maxillofacial tumors.
Methods of diagnosis of maxillofacial tumors:
• History taking
• X-rays types:
Extra-oral radiograph.
Intra-oral radiograph.
CT scan.
MRI.
Radioactive isotopes.
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• Biopsy: types requirement of ideal biopsy:
Techniques of biopsy.
How to submit a biopsy.
How to interpret the biopsy report.
Management of maxillofacial tumors:
• Surgery.
• Radiotherapy.
• Chemotherapy.
• Immunotherapy.
Topic objectives:
To provide student with the basic knowledge of diagnosing oral and maxillofacial tumors that include history taking, methods of diagnosis such as different types of x-rays, different types of biopsy and techniques of biopsy.
Methods of managing oral and maxillofacial tumors with an emphasis on the surgical aspects.
Third topic title:
Salivary Gland Diseases.
No. of lectures:
2 Topic contents:
Affections of the salivary glands:
• Anatomy.
• Classification of Salivary Gland Diseases.
Congenital abnormalities.
Inflammatory diseases.
Diseases due to obstruction.
Salivary gland fistula.
Non neoplastic enlargement.
Cysts of salivary and mucus glands.
Tumors of salivary glands Benign Malignant.
Rare lesions in major gland.
• Etiology of diseases.
• Clinical signs and symptoms.
• Treatment.
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• Sialography.
• Sialadenectomy (removal of the salivary glands, submandibular and parotid).
Topic objectives:
From the material presented in this lesson and from the assigned reading the student will, in written exam:
1. Define mucocele, ranula and explain the pathophysiology of each.
2. Describe the simple surgical approach for each of the above.
3. Describe the etiology, incidence and relative location of salivary duct stones.
4. Describe the technique for conservative removal of salivary duct stones.
5. Identify the etiology and presentation of sialadenitis.
6. Describe the steps in the management of salivary gland infections.
7. List the possibilities in the differential diagnosis of symptomatic and asymptomatic enlargement of the salivary glands.
Fourth topic title:
Oral and Maxillofacial Trauma.
No. of lectures:
6 Topic contents:
• Classification, different types of Etiology, evaluation of facial trauma patient, includes immediate assessment.
Fractured mandible:
Clinical exam (local & general)
Radiographic exam (extra & intra oral views) Signs and symptoms and management
1. Dento-alveolar fracture.
2. Condylar alveolar fracture.
3. Coronoid process fracture.
4. Ramus fracture.
5. Fractures angle of mandible.
6. Fractured body of mandible.
7. Fractured anterior segment of mandible.
Basic surgical treatment.
8. Reduction of fractured segment and its type and indications.
9. Fixation and its different methods, indications, different types of fixation and its indications.
Fractures of the middle third of facial skeleton Surgical anatomy and classifications.
11 Local clinical examination.
Management of various types of fractures of mid-facial skeleton
(LeFort І, ІІ, and ІІІ fracture), fracture of the Zygomatic complex, orbital fractures and nasal bone fractures.
The management of each type of fracture will include:
Signs and symptoms and clinical examination both extra-oral and intra-oral.
Topic objectives:
Objectives of facial fractures lectures:
At the end of the series of facial fractures, on written examination the student will:
1. List signs of facial bone fractures.
2. Describe the evaluation process in facial trauma.
3. Define: compound, comminuted, simple, greenstick fractures.
4. List advantages of early immobilization.
5. List methods of immobilization.
6. List goals of fracture treatment.
7. List possible complications of fracture treatment.
8. List locations of mandibular fractures.
9. Define:
a. Horizontally favorable fractures.
b. Horizontally unfavorable fractures.
c. Vertically favorable fractures.
d. Vertically unfavorable fractures.
10. List methods of reducing mandibular fracture.
11. Describe factors leading to choice of open vs. close reduction.
12 12. List sign and symptoms of condylar fracture.
13. List muscle groups and describe their effect on fractures of the mandible.
14. Describe location of LeFort І, ІІ and ІІІ fractures.
15. Describe treatment of LeFort І, ІІ and ІІІ fractures.
16. Describe location of a ZMC fracture and the bones affected.
17. Describe ocular changes in ZMC fracture.
18. List signs of ZMC fracture.
19. Describe treatment of ZMC fracture.
20. List complications of ZMC fracture.
Fifth topic title:
Temporomandibular joint orders and disorders.
No. of lectures:
3 Topic contents:
Components of the temporomandibular joint.
Myofacial pain dysfunction syndrome.
Internal derangement of the T.M.J.:
• Diagnosis, conservative treatment and surgical treatment.
Arthritis of the T.M.J.:
• Types, etiology, signs and symptoms and treatment.
Ankylosis:
• Etiology.
• Clinical findings.
• Radiographic findings.
• Treatment: surgical techniques.
Dislocation of the T.M.J.:
• Subluxation.
• Causes of dislocation.
• Clinical features.
14 Treatment:
• Immediate (emergency).
• Conservative treatment.
• Surgical treatment.
Topic objectives:
1. Describe the anatomy of the T.M.J., including architecture, muscles, ligaments, nerve and vascular supply, and proximity to vital structures.
2. Discuss the steps in the differential diagnosis of T.M.J. pain.
3. Discuss the etiology of pain dysfunction syndrome.
4. Discuss the pathophysiology and symptoms of "T.M.J. pain dysfunction syndrome" and differentiate from "internal derangement" of T.M.J.
5. Discuss the progressive steps in the management of T.M.J. pain dysfunction syndrome.
6. List the types of T.M.J. arthritis and differentiate the various types as to pathophysiology, etiology and presentation.
7. Discuss the management of each type of arthritis.
8. Describe the Preauricular and Risdon surgical approaches to the T.M.J.
9. Describe the pathophysiology and signs and symptoms of T.M.J. dislocation.
10. Describe the mechanism of reducing acute T.M.J. dislocation.
11. Identify the surgical procedures available for treating chronic T.M.J. hypermobility.
12. Differentiate and describe the etiology and presentation of ankylosis, fibrosis and muscle contracture arthroscopic and "open joint" techniques.
13. Describe the surgical and physiotherapeutic approaches in dealing with fibrosis and muscle contracture causing mandibular hypomobility.
Sixth topic title:
Contemporary Implant Dentistry.
No. of lectures:
2 Topic contents:
Biological considerations for Osteointegration.
Types of dental implants.
Clinical implant components.
Implant prosthetic options.
Pre-operative evaluation of implant patient.
Surgical phase treatment planning.
Stage І surgery implant placement.
Complications of stage ІІ surgery.
Implant uncovering stage ІІ surgery.
Advanced surgical techniques.
Topic objectives:
From the material gained from lectures, the student will be able to discuss management of the atrophic maxillary and mandibular alveolar ridges by endosteal dental implants.
Seventh topic title:
Correction of dentofacial deformities.
No. of lectures:
3 Topic contents:
Causes of dentofacial deformity.
Evaluation of dentofacial deformity patients.
Pre-surgical treatment phase.
Surgical treatment phase.
Post surgical treatment phase.
Topic objectives:
From the material gained from lectures, the students will be able to list the types of dentofacial deformities as well as the surgical procedures that can be performed for correction of maxillary and mandibular growth discrepancies.
