THE SAUDI BOARD OF ENDODONTICS (SBE) IS FOUNDED IN 2006, THE SBE IS A CERTIFYING BOARD FOR THE SPECIALTY OF ENDODONTICS IN SAUDI ARABIA AND IS ONE OF SEVERAL BOARDS RECOGNIZED BY THE SAUDI COMMISSION FOR HEALTH SPECIALTIES(SCFHS). THE SBE IS SPONSORED BY THE SES.
SSC-Dent (Endo) or SBE
The Saudi Specialty Certificate in Endodontics [SSC-(Dent) Endo] is the branch of dentistry, which is concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Its studies and practice encompass the basic clinical sciences, including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
The program extends for four years and it has been designed to satisfy the needs of those who wish to acquire greater skill, knowledge, and experience in clinical Endodontics, as well as a background in biological sciences. The program includes participation in formal lectures, seminars, book and literature reviews.
SBE Goals and Objectives
1-Develop skillful clinicians capable of delivering advanced or complex endodontic care at a high level of quality and sophistication.
- To provide the residents with a sufficiently large number of diagnostic, non surgical, surgical and post operative evaluation experiences to develop proficiency in the practice of endodontics.
- To prepare the residents to effectively treat and manage medically compromised patients.
- To provide the residents with formal and informal opportunities to present, discuss and defend their clinical cases with endodontic supervisor, other program supervisor and student colleagues during Monthly Case Presentation.
- Establish a sound basis for the practice of endodontics.
- To provide the residents with an in-depth knowledge of relevant basic/biomedical sciences as they relate to the theory and practice of endodontics.
- Develop fundamental research skills and an interest in and understanding of endodontic research in order to evaluate published clinical and scientific papers.
- To train the student in the fundamentals of research methodology, study design, biostatistics, data organization and analysis, scientific writing and presentation.
- To provide the student with the opportunity to conduct and publish research.
- Satisfy the formal clinical requirements necessary to enter the Part II Examination of the Endodontic Program.
- Create the desire and sense of obligation and responsibility to contribute to the perpetuation and growth of endodontics by mentoring teaching.
- To provide the student with the training and opportunity to teach and educate pre and post doctoral students.
III.Educational Sponsorship and Setting
The sponsor of Saudi Specialty Certificate in Endodontic is an institution which has an over-all administrative control and responsibility for conducting the program. A governmental or private training center can only be accepted for training after being accredited by the SCHS. Government or a private training center can be accepted for training after being accredited by the Saudi Commission for Health Specialties (SCHS) as either a full training center or partial training center. A committee according to the standard classification caries out the recognition procedure and rules set by the SCHS as follows:
*A training center must provide a readily accessible facility for dental treatment of all patients.
* The training center must provide resources sufficient for resident
* If a full or partial training center lacks adequate facilities, patient’s caseloads, or any other resources needed by the educational program, it must supplement its resources through affiliations with other institutions. Affiliated hospitals or dental departments or centers in which residents receive a substantial portion of their training must be accredited by SCHS.
* Residents must be appointed to the house staff of the qualified and accredited staff of the training center and must have equal privileges and responsibilities as residents in other professional educational program
Applicants seeking admission into the SSC-Dent (Endo) training program should fulfill the following requirements.
- A bachelor of Dental Surgery degree (BDS) or equivalent from a recognized university.
- Successful completion of an internship year in general dentistry (12 months).
- Competitive selection examination process set by the SSC-Dent (Endo) program.
- Provision of at least three confidential recommendation letters from consultants as to the suitability of the applicant for training which must include a letter from the candidate’s immediate supervisor.
- Letter of no objection from the applicant’s sponsor indicating that the applicant can be in a full time training program for the entire period of 4 years.
- Applicant should be registered in the Saudi Commission for Health Specialties as a trainee.
- Applicants should pay the application and training fees.
- Signed obligation to abide by the rules and regulations of the training program and the SSC-Dent (Endo).
Didactic of Basic Sciences Courses
Oral Pathology (R1)
This course is designed to provide a broad review of the major pathologic processes that affect the oral and maxillofacial areas. Lectures will include acquired and developmental disturbance of the teeth and associated oral structures, benign and malignant tumors of the oral cavity, cysts and tumors of odontogenic origin, diseases of the periodontium, white lesions, pigmented lesions, vesicullo-bullous diseases, spread of oral infection and healing of oral wounds.
- Oral Microbiology and Immunology (R1-R2)
The purpose of this course is to provide a survey of selected topics in oral microbiology relevant to oral infections and diseases for residents in SSC-(DENT) Endo program; in addition it will cover the principles of immunology and in particular oral immunological processes. The important viral, bacterial and mycotic infections of the oral cavity will be covered together with diseases caused by defect in the immune system. Topics will be included but not limited to:
- Normal microbial flora of the mouth
- Bacterial classification
- Dental caries microbiology
- Periodontal disease microbiology
- Applied Head and Neck Anatomy (R1)
The course should provide the resident with the necessary knowledge of head and neck anatomy, which involves the anatomy of the skull, face, oral and nasal cavities. The course includes the study of muscles, internal organs of head and neck, lymphatic drainage, blood supply, and enervation.
- Advanced Oral Biology (R1)
The purpose of this course is to provide a survey of selected topics in oral biology relevant to oral structures, functions and diseases for residents in SSC-(DENT) Endo Program. Topics will include but not limited to:
- Salivary glands and saliva (morphology, secretion, functions).
- Connective and mineralized tissues (collagen, proteocollagen, bone).
The relationship and response between the above topics and systemic and environmental influences.
- Oral Histology (R1)
Seminars or lectures are designed at the post graduate level on different topics in oral histology.
- Pharmacology (R1, R2 & R3)
The course should provide the resident with the understanding of basic pharmacological principles such as drug action, drug interactions and adverse reactions. Specific drug groups of concern to Endodontics will be emphasized. Proper techniques of prescription writing will be reviewed.
- Dental Ethics (R1)
The prime goal of this course is to promote the resident’s education in dental ethics. This course will cover the related issues ranging from ordinary chairside decision making to HIV/AIDS and ethical practices. This course will guide the residents to an understanding of the essential practice of ethics. The course will highlight on the necessity of awareness of legal process and civil law, forensic dentistry, the practitioner and other related subjects.
- Practice Management (R3-R4)
In this course different aspects of successful practice with emphasis on endodontics will be discussed. The following topics will covered: quality assessment and quality assurance, management of auxiliaries and other office personnel, maintenance and management of patients records, principle of peer review, business management including the understanding of the third party payment and professional practice development, infection control, environmental health management, principles of professional ethics and alternative health care delivery systems.
- Bio Statistics in Dentistry (R2-R3)
Topics covered include variables, frequency distribution, sampling measure of central tendency, variance and measure of dispersion, various statistical tests, analysis and probability.
- Educational Methods (R2)
The residents regardless of their future professional expectations will be exposed to the method of teaching, curriculum development, and instructional objectives, instructional media, audio-visual teaching and learning aids and assessment methods for knowledge, skills and attitude.
- Research Design and Scientific Writing (R2, R3 &R4)
Emphasis will be made on the various methods of research design, in addition to the ethical aspects of research on animals and humans. The resident shall learn to write a protocol for a research project, interpret own research findings, and present research findings, in oral and written form.
- Oral Medicine (R1)
The course will cover several aspects of general patient assessment and management. This will include data collection, analysis, diagnosis, prognosis and treatment planning. Also, it will include brief management of some common oral soft and hard tissue condition, extra-intra, oral swelling, pre-malignant lesions, facial pain and TMJ disorders.
- Advanced Oral and Maxillofacial Radiology (R1-R2)
This course will provide the residents knowledge of radiation physics, radiation biology, hazards and protection, advanced imaging techniques and diagnostic oral radiology.
- Dental Biomaterials (R2)
The topics and seminars in this course will provide the resident with the knowledge necessary to properly select and handling dental materials, which required to render satisfactory treatment to the patient. Although, the manipulative parameters for obtaining maximum performance are continually stressed. In order to develop a basic understanding of biocompatibility, emphasis will be placed on the relationship between the properties of dental materials and their behavior in the pulp and the periapical tissues.
- Dental Informatics (R2)
This course will introduce students to basic of computers and the most common computer applications. Basic computer skills will help students use computer-aided instruction software in the basic and dental sciences. Word processing skills will be useful for assignments that involve writing. Library and literature research skills can contribute in any discipline. Also on using computers in the dental office, it should include topics on components and functions of practice management programs, computer based oral health records, digital imaging. The course should focus on emerging clinical applications that will be vital to the delivery of dental care in the 21st century. The course will deliver education in a rapidly evolving field when students need it most shortly before they graduate.
- Specialty Courses
- Case Presentation
The case presentation will be conducted in the form of a seminar.
The purpose of this seminar is to provide a forum in which clinical experiences can be shared and in which constructive criticism will benefit not only the presenter, but also all in attendance.
Residents’ presentation of clinical cases will serve as the basis for discussion of diagnosis and treatment philosophies and for evaluation of students’ clinical performance.
Residents are required to present cases, which demonstrate a broad spectrum of treatment procedures with justification and thorough documentation. The diversity and complexity must document exceptional skill and expertise in endodontic treatment. Each student should demonstrate a clear and precise understanding of the rationale for a course of treatment, for a differential diagnosis, for alternative approaches to treatment, and of the biological basis for modern endodontic practice. Consultations, as needed to support the presentations, are pre-requisite to cases presented.
Calendar of Activities
The schedule of meetings and assignments will be distributed before the commencement of the course Evaluation
The following categories will be evaluated:
- Diagnostic approach
- Clinical approach
- Rationale of therapy and mechanism oF repair
- Background literature
The supervisors will observe and evaluate the case presented, the quality of the student’s response, familiarity, experience, and the manner of presentation, confidence and authority.
Endodontic Literature Review
The purpose of this course is to review the current literature for articles pertaining to Endodontics in a seminar format.
- Pulp Biology
This course covers the biologic basis of pulp therapy based on classic and current scientific literature, embryology, physiology, and microanatomy of the dental pulp and related structures. The course also explores prevention, etiology, diagnosis and treatment using scientific principles. Students are taught biologic rationale for treatment from extensive literature review.
The course reviews the normal and diseased pulp and its relationship to periapical tissues. Emphasis is placed on pulpal, neural and vascular supply; pulpal defense mechanisms; injury, aging, and retrogressive changes and pulp’s response, healing and repair potential of periapical tissues; and histopathology of periapical lesions. Clinical sign and symptoms are correlated with histopathology whenever possible. Pulpal reactions to irritants are emphasized along with associated diagnostic and therapeutic procedures.
- Book Review
The objective of this course is to review current techniques and philosophies of endodontic practice as presented in current Endodontic textbooks. The texts recommended are:
- Pathways of the Pulpby Cohen and Burns
- Endodonticby Ingle
- Textbook and Color Atlas of Traumatic Injuries to the Teethby Andreasen J. and Andreasen F.
- Surgical Endodonticsby Gutmann and Harrison
- Essential Endodontology(Prevention and treatment of apical periodontitis) by Orstavik and Pittford:
- Endodontology (Biological consideration In Endodontic procedure) by Seltzer.
The course will have a weekly seminar format in the large training centre. The assignments must be handed on paper. Candidate will edit answers to the questions as his/her assigned text presents the material.
Evaluation will depend upon candidate effort, participation in oral and written presentations. In addition, an essay type of examination will be held at the end of each half year.
- Describe the clinical and radiographic features of traumatized teeth and supporting tissues including the following:
- Enamel fractures
- Crown fractures without pulp exposure
- Crown fractures with pulp exposure
- Crown root fracture
- Root fracture
- Tooth luxation (concussion, subluxation, lateral luxation, intrusive luxation).
- Describe and diagnose possible short and long-term responses of the pulp, peri-radicular tissues and hard tissues to the traumatic injuries listed above.
- Apply relevant diagnostic tests and procedures for patients with dental injuries and interpret the findings.
- Describe the differences in the treatment strategies for traumatic dental injuries in primary and permanent dentitions.
- Identify the criteria for success or failure of various treatment modalities.
- Describe and use appropriate treatment strategies (immediate and follow-up) for various traumatic injuries primary and permanent dentitions.
Diagnosis and Treatment Planning
Define and differentiate subjective and objective findings as well as interpret the significance of these findings in identifying diseases of the pulp and peri-radicular tissues.
- Describe and interpret radiographic findings that may indicate pulpal and periapical pathosis.
- Recognize and describe conditions for which root canal treatment is indicated and contra-indicated.
- Recognize and diagnose when it is appropriate to plan adjunctive endodontic treatments such as vital. pulp therapy, bleaching, root amputation, endodontic surgery, intentional re-implantation, auto-transplantation, hemisection, apexification, endodontic endosseous implants, orthodontic extrusion and re-treatments.
- Identify problems that may necessitate treatment modifications including operative complications, cracked tooth, periodontal problems, isolation difficulties, restorability, strategic value, patient management, medical complications, abnormal root or pulp anatomy, impact trauma and restricted opening.
Endodontic Instruments/Instrumentation and Sterilization
- Identify, select and arrange in an orderly fashion instruments required for each endodontic procedure.
- Describe common disinfection and sterilization techniques used in Endodontics.
- Monitor the thoroughness of sterilization and disinfection of all items and spaces used in his/her daily clinical practice.
- Use correctly all instruments in the standard endodontic pack.
- Clean and sterilize correctly every instrument used in endodontic practice.
- Recognize how to prevent avoidable deterioration of endodontic instruments like files and broaches.
- Use high-quality magnification (combination of light and magnification) for appropriate cases.
- Apply modern treatment devices and modalities including surgical operating microscopy and fibre-optic endoscopy, to the management of suitable cases.
Cleaning and Shaping
- State reasons and describe situations for enlarging the cervical portion of the root canal before performing straight-line access.
- Explain how to minimized preparation errors in small curved canals.
- Describe techniques for negotiating severely curved, “blocked”, or constricted canals.
- Describe in general, the principles application of ultrasonic devices in cleaning and shaping.
- Discuss the properties and role of chelating and decalcifying agents.
- Discuss the properties and role of intra-canal, inter-appointment medicaments.
- Describe techniques, step by step, for standardized and flaring including hand and engine driven instruments (Step-back and/or crown-down) preparations.
- Describe techniques for shaping canals that are irregular, such as round, oval, hourglass, bowling-pin, kidney-bean, or ribbon-shaped.
- Obturation Recognize the indications and contra-indications for root canal obliteration as well as list the clinical criteria for the ideal obturating material.
- Define and carry out the various condensation and root canal obturation techniques.
- Residents will be exposed to other new techniques in obturation.
- Evaluate residents will be exposed to other new techniques in obturation. The quality of root canal obturation.
- Recognize indications and contra-indications for endodontic surgery especially when compared with non-surgical root canal therapy.
- Provide complete pre-surgical planning and assessment for patients’ under-going endodontic surgery procedures.
- Carry out various endodontic surgery procedures.
- Evaluate the prognosis and implement post-operative care (short and long-term follow-up) for every treated case.
- Endodontic Microsurgery
- Recognize the indications and contra-indications for microsurgery.
- Evaluate patients and make adequate preparation for microsurgery.
- Provide necessary post-operative and long-term follow-up care.
- Describe indications and contra-indications for endodontic treatment in children.
- Evaluate and manage pediatric patients with endodontic problems of their permanent teeth.
- Carry out all types of routine endodontic treatment, including vital and non-vital pulp therapy, in both anterior and posterior permanent teeth.
- Provide necessary post-operative and long-term follow-up care.
- Recognize and diagnose all form of endodontic emergencies.
- Establish a feasible treatment plan for every case.
- Provide effective and comprehensive treatment (immediate, short and long-term) for all forms of endodontic emergencies.
- Describe appropriate long-term follow-up strategies for all treated cases.
Periodontal – Endodontic Considerations
- Describe and recognize the effects of pulpal disease and endodontic procedures on the periodontium.
- Describe and recognize the effects of periodontal disease and procedures on the pulp.
- Differentiate between gingival sulcus defects which will respond to root canal treatment and those requiring periodontal therapy.
- Provide relevant and effective treatment according to diagnostic findings.
- Identify and refer patients with complex problems to appropriate centers
- Introducing the resident to the single tooth implant procedure as an alternative treatment.
Preparation for Restoration and Temporization
- Describe the role of restoration in the longevity of endodontically treated teeth.
- Explain the importance of the coronal seal and of the factors contributing to loss of tooth strength.
- Identify restorative options prior to starting root canal treatment.
- Recognize the advantages and disadvantages of direct and indirect restorations.
- Outline post-operative risks to the un-restored tooth.
- Discuss the rationale for immediate restoration and itemize indications for delaying final restoration.
- Carry out temporization of damaged teeth (both short and long-term basis).
- Apply common post systems and other core materials as part of endodontic treatment.
The pre-clinical course is offered during the first month of the Program. The course has a laboratory/lecture format.
It is designed to develop proficiency in a variety of endodontic instrumentation and obturation techniques before the candidate applies them in the clinical session.
Each first year student will demonstrate the complete instrumentation and obturation of the following extracted teeth:
- Two (maxillary and mandibular) central incisors
- Maxillary first bicuspid (2 root)
- Mandibular first molar
- Maxillary first molar
The following clinical procedures should be done by each student: before graduation
|Clinical Procedure||Number of Cases|
|Non-surgical Endodontics:||50 anterior teeth.50 pre-molar teeth200 upper and lower molar100 re-treatment cases|
Surgical Endodontics 40 cases including more than 10 molar teeth. Traumatic and Emergency Treated teeth 25 cases Bleaching of Endodontically Treated teeth5 casesRecall of the Finished cases50% of the cases
It is mandatory to use rubber dam for safety and avoiding cross infection. A resident who fails to apply the RD will face a strong disciplinary action.
The above requirements are expected to be finished according to the following:
- 70 teeth at the end of the 1st year.
- 130 teeth at the end of the 2nd
- 100 teeth at the end of the 3rd
- 100 teeth at the end of the 4th
An annual comprehensive oral and written examination on basic science and various prosthetic subjects will be held at the end of each year.
- Part I exam (Promotion Exam) is to be held after the first year and the approval of the program scientific committee.
- Part II exam (Graduation Exam) this exam will be held after the completion of 4 years training and fulfilling of the clinical requirements and the approval of the program scientific committee.
- Program Evaluation
The scientific committee must regularly evaluate the degree which the program goals are being met.
The successful candidate will be awarded a Certificate in the Saudi Specialty of Endodontics upon completion of all the academic and clinical requirements as well as the final specialty examination.