Periodontics I (code 27230) is a compulsory subject, which belongs to module IV (Dental Pathology and Therapeutics), and is taught in Spanish and Basque, during the second semester of the third year of the Degree in Dentistry.

This subject consists of 6 ECTS credits, with a student’s total dedication of 150 hours, divided into 60 classroom hours and 90 non-classroom hours.



Why is this subject important? How important is it for the development of my profession?

Periodontics is the science that studies the diseases that affect the supporting tissues of the teeth and/or their substitutes (dental implants), such as gingival diseases, periodontitis and peri-implant diseases (mucositis, peri-implantitis, apical lesions associated with dental implants…), as well as their treatment.



The aim of the subject is for students to learn about the periodontal and peri-implant supporting tissues and to acquire the necessary skills to establish a diagnosis, a prognosis and a non-surgical approach when facing any periodontal and peri-implant pathology, also knowing its repercussions at both local and systemic levels. Based on this knowledge, the students’ directed, cooperative, and autonomous learning will help them in the analysis and decision-making processes when solving simulated clinical cases, in which diagnostic and therapeutic actions (basic periodontal treatment or non-surgical periodontal treatment will be applied.

Also, the hands-on workshops that are carried out in the laboratory, on simulated anatomical models (periodontal phantoms), will allow the students to avoid mistakes in their clinical practices, which will take place in the following academic years.



Relationship with other subjects:

The development of Periodontics I requires a deep knowledge of the previous subjects studied during the first and second year of Dentistry, such as Anatomy, Cell Biology, Human Histology, Physiology, Microbiology and Immunology, Radiology and Physical Medicine and Dental Prosthesis I. This knowledge is essential to identify, explain and associate the concepts that will be addressed in Periodontics I and, therefore, to be able to apply them properly in the resolution of basic illustrative clinical cases.

Given its basic character, Periodontics I is considered a keystone for other subjects in which clinical practices are carried out, thus requiring an adequate knowledge of the anatomical, clinical and radiographic characteristics of the healthy or diseased periodontal and peri-implant tissues, such as Periodontics II, Dental Prosthesis II and III, Dental Pathology and Therapeutics II, Oral Pathology and Medicine II and Integrated Adult Practice (IAP) I and II, among others. Particularly, the subject Periodontics I is complemented by Periodontics II, which is taught during the first semester of the fourth year, where students will acquire the theoretical knowledge about corrective treatments and supportive periodontal therapy (SPT), as well as the interrelation with other dental disciplines (Orthodontics, Dental Pathology and Therapeutics, Prosthetics...) in the periodontal patient. Also, in this subject, supervised clinical practice on patients will be performed.



Other recommendations:

As new digital tools for teaching are being implemented in this subject, having basic computer skills is recommended, as well as knowledge about presentation softwares (PowerPoint/Keynote) and technical English, since the scientific literature is mostly published in this language.



Professors of the subject:

Ruth Estefanía Fresco (Associate Teacher) (Bilingual)

Aitziber Fernández Jiménez (Assistant Professor) (Bilingual)



Coordinator of the subject: Aitziber Fernández Jiménez



Contact:

Ruth Estefanía Fresco

ruth.estefania@ehu.eus

Office: 1.E.24



Aitziber Fernández Jiménez

aitziber.fernandez@ehu.eus

Office: 1.E.24



https://www.ehu.eus/es/web/graduak/grado-odontologia/profesorado; To know tutoring hours, click on the teacher's name.

Specific competences (C):

C1: The student will be able to establish an appropriate treatment, prognosis and diagnosis of the pathology of peri-implant and periodontal tissues.

C2: The student will be able to establish a multidisciplinary, sequential and integral treatment, with a limited complexity, in patients of all ages and conditions and with special needs (diabetes, hypertension, cancer, transplants, immunodeficiencies, anticoagulants...).

C3: The student will be able to establish a diagnosis and a treatment plan, taking X-rays and interpreting imaging procedures that are relevant to the dental practice.

C4: The student will be able to define and identify the patient's aesthetic conditions to satisfy his concerns.

C5: The student will be able to establish an appropriate periodontal treatment plan, including the application of local anesthesia techniques, non-surgical, pharmacologic and surgical treatment of the inflammatory processes around periodontal and/or peri-implant tissues, such as supra and subgingival periodontal instrumentation techniques (scaling and root planing, tartar removal and debridement). Additionally, the students will be able to manage acute periodontal infections, including the prescription of any appropriate medication and performing simple surgical procedures. They will also be proficient in identifying and addressing dental emergencies, thus providing the patient with suitable dental care.



Transversal competences:

C6: The student will be able to work collaboratively as part of a team in cooperative Periodontology tasks. This includes aiding in clinical tasks, discussing clinical cases, and collaboratively formulating provisional, differential and final diagnoses. Subsequently, they will contribute to developing a comprehensive and multidisciplinary treatment plan for the patient.

C7: The student will be able to develop self-learning skills in periodontics.

C8: The student will be able to develop oral and written communication skills using the appropriate terminology in each context.



Learning outcomes of the subject (LO): The following are the LO that students will demonstrate at the end of the course, correlated with their respective competences.



LO related to competences 1 and 4:

LO1. Identify key elements of Periodontics and Osteointegration, to perform the diagnosis, prevention and treatment of periodontal (PD) and peri-implant (PI) diseases.



LO related to competences 2, 3 and 4:

LO2. Students will be able to correctly perform the clinical history, as well as the exam of the periodontal and peri-implant tissues.

LO3: Students will be able to consistently analyze the signs and symptoms of simulated clinical cases and, based on scientific evidence, reach a differential and a final diagnosis of PD and PI diseases.

LO4: Students will be able to correctly identify and request the necessary complementary tests (radiological, serological and microbiological) for establishing the diagnosis and prognosis of PD and PI diseases.

LO5: Based on the analysis of the data obtained from the different diagnostic tests, the students will be able to correctly establish an individual and general prognosis of PD and PI diseases, as well as a comprehensive treatment plan.



LO related to competence 5:

LO6: Students will be able to correctly perform, in a periodontal simulation model (periodontal phantom), the scaling and root planning techniques, which are the keystone of non-surgical periodontal treatment on patients.



LO related to competence 6:

LO7: Students will be able to collaborate on clinical tasks (periodontal chart and radiographic sequence), to analyze the information about the clinical case and to propose an initial or presumptive diagnosis, a differential diagnosis and a final diagnosis, as well as multidisciplinary and integral treatment plans for the simulated cases.



LO related to competence 7:

LO8: Students will be able to analyze, in an autonomous and collaborative way, the most important scientific information in the field of periodontics, for its implementation in the resolution of specific cases in this area.



LO related to competence 8:

LO9: Students will be able to use appropriate academic terminology and writing in the portfolio and in the final report.

LO10: Students will be able to use appropriate terminology and oral language in the different proposed scenarios (simulated situations between patient and professional dentists).

1. Theoretical content: It shall be provided between weeks 16 and 28, on Thursdays in the pre-established hours of the Faculty. The theoretical contents are divided into five thematic blocks:



(A) Introduction, morphology and functions of the periodontium and the healthy peri-implant tissues:

Lesson 1: Anatomy of the periodontium (2 hours)

Lesson 2.- Similarities and differences between the periodontal and the peri-implant mucosa (1 hour)



(B) Periodontal pathology:

Lesson 3.- Etiology of periodontal diseases. Microbiology: Oral biofilm and calculus (1 hour)

Lesson 4.- Pathogenesis and pathocronology of periodontal diseases (1 hour)

Lesson 5.- Etiology of biological complications around implants: mucositis/peri-implantitis, periapical lesions around implants and soft tissue deficiencies around implants (1 hour)

Lesson 6.- Host-response modifying factors and individual susceptibility (1 hour)

Lesson 7.- Epidemiology of periodontal diseases (1 hour)



(C) Nosological entities and differential diagnosis:

Lesson 8.- Gingivitis: Bacterial plaque-induced and non-plaque-induced gingival inflammation (1 hour)

Lesson 9.- Periodontitis (1) (1 hour)

Lesson 10.- Periodontitis (2) (1 hour)

Lesson 11.- Modifications of the gingival margin: gingival recession (1 hour)

Lesson 12.- Modifications of the gingival margin: gingival enlargement (1 hour)

Lesson 13.- Acute periodontal lesions (1 hour)

Lesson 14.- Occlusal trauma in periodontal and peri-implant tissues (1 hour)

Lesson 15.- Endo-periodontal lesions (1 hour)

Lesson 16.- The relationship between periodontal disease and systemic diseases (1 hour)



(D) Diagnosis, prognosis and treatment plan:

Lesson 17.- Diagnosis of periodontal disease: periodontal assessment (1 hour)

Lesson 18.- Prognosis and periodontal treatment plan. Treatment planning in periodontal patients using dental implants (1 hour)



(E) Basic periodontal treatment:

Lesson 19.- Cause-related periodontal treatment I: Patient’s motivation for the bacterial plaque control. Mechanical and chemical control of the supragingival bacterial plaque (1 hour)

Lesson 20.- Cause-related periodontal treatment II: Scaling and root planing (1 hour)

Lesson 21.- Treatment of biological complications around dental implants (2 hours)



2. Practical Contents: Practical content will be provided between weeks 16 and 29, on Thursdays in the pre-established hours of the Faculty (see schedule and groups).



2.1 Seminars (S):

S1.- Instrumental used in periodontics (2 hours)

S2.- Motivation and oral hygiene instructions in periodontics. Periodontal assessment (2 hours)

S3.- Radiographic periodontal diagnosis (radiographic series) (2 hours)

S4 and S5.- Clinical case seminars (2 hours per seminar)



2.2.- Laboratory Practices (LP):

LP1, LP2 and LP3.- Clinical Periodontal Assessment: Periodontal chart. Bacterial plaque control. Motivation. Oral hygiene instructions

LP4.- Handling of film holders for taking radiographs with the parallel technique

LP5.- Sharpening of curettes and preparation of the periodontal phantom*

LP6.- Scaling and root planing on periodontal models (phantoms): Columbia 13/14 and Gracey 13/14 curettes*

LP7.- Scaling and root planing on periodontal models (phantoms): Columbia 4R/4L and Gracey 11/12 curettes*

LP8.- Scaling and root planing on periodontal models (phantoms): Gracey 5/6 curette*

LP9.- Scaling and root planing on periodontal models (phantoms): Gracey 7/8 and 9/10 curettes*

LP10.- Scaling and root planing on periodontal models (phantoms): Full quadrant*

LP11.- Scaling and root planing on periodontal models (phantoms): Both maxillae*

LP12.- Scaling and root planing on periodontal models (phantoms): Natural teeth*

* During the development of LP 4-12, each week, the students (in groups of six) will attend the clinical practices of the master's degree in Periodontics and Osteointegration as observers.

In order for students to achieve their learning outcomes (LO), several methodologies will be used, including:



LO1: The acquisition of basic knowledge in Periodontics and Osteointegration for the diagnosis, prevention and treatment of periodontal and peri-implant diseases will be achieved through master classes for the entire group. All the concepts of this subject will be explicitly explained, and the fundamental concepts will be treated interactively. To complete LO1, students will study them in more detail through self-learning (LO8), through basic and deepening bibliography, completing activities in the virtual classroom (eGela) and consolidating knowledge through personalized tutoring.



LO2, 3, 5, 7, 8, 9 and 10: They will be developed through seminars using a methodology based on clinical cases and case problems. Seminars will be held in double sessions and students will be divided into small cooperative groups.



LO2 and 4: They will be developed through Seminars 2 and 3 and Laboratory Practices 1, 2 and 3, scheduled for weeks 18-20.



LO6 and 7: They will be developed through laboratory practices in simulated models (periodontal phantoms), in teams supervised by the tutoring teacher, so that through these LPs they can acquire the practical skills that will be necessary when performing clinical practices in fourth grade.



Application of new technologies as a complementary tool:

Virtual classrooms (e-Gela) will be used as a complement to face-to-face teaching.

• Continuous Assessment System
• Final Assessment System
• Tools and qualification percentages:
  • Multiple-Choice Test (%): 70
  • Realization of Practical Work (exercises, cases or problems) (%): 15
  • Team projects (problem solving, project design)) (%): 15

General aspects of evaluation (continuous and final) applicable to all types of evaluation:



1. Attendance and completion of practical content: Attendance is mandatory, and all practical content must be independently developed and passed, since it allows achieving 75% of the LO of the subject. Thus, non-attendance cannot exceed the limits settled in the regulations and must be duly justified. (UPV/EHU student regulations, November 2016 resolution, (https://www.ehu.eus/documents/3026289/3106907/Reglamento_Alumnado_UPV_EHU.pdf)



2. Plagiarism: No copy or imitation of the work done by third parties may be presented as one's own. Students must know how to cite and use references. The suspicion of plagiarism may cause turning down the work and, consequently, failing the subject.



3. Evaluation system of preference and minimum requirements for passing the subject: Whenever possible, a continuous evaluation will be carried out. In order to pass the subject, the theoretical and practical contents must be passed independently.



4. Final evaluation (requirements): If a student refuses the continuous evaluation and requests a single final test, he/she must confirm his/her attendance in advance (at least 3 weeks before the test). If failing to do so, or not showing up the day of the exam will automatically result in failing the subject in both the ordinary and the extraordinary call.



Evaluation with 100% face-to-face teaching.



-Continuous evaluation. The evaluation will consist of:



1. Theoretical test: (70% of the final result)



The exam will be a multiple-choice test, with 4 confounders and only one valid answer:

-Correct answers will be worth 1 point.

-Unanswered questions will be worth 0 points.

-Wrong answers will have a value of -0.5 points.



A minimum of 5 points over 10 will have to be obtained in the written test in order to add this result to the rest of the evaluation and thus be able to pass the subject.



2. Continuous evaluation of the activities of the Seminars and Laboratory Practices, using the following tools:



2.1. The individual's digital portfolio, consisting of the individual portfolio and six items, corresponding to the activities carried out in Seminars 1-5 and in LP 1-3 (15%). The evaluation criteria are described in the Student's Guide.



2.2. A checklist to assess the student’s competences in the laboratory, which will be completed through direct observation during LP 4-12 (15%). The evaluation criteria are specified in the Student's Guide.



-Final evaluation. Students who request so, may choose a final test, with a theoretical and a practical part, as follows:



1. Theoretical content: (70% of the final result)

The exam will be a multiple-choice test, with 4 confounders and a single valid answer, with 0.50 negative points for the wrong answers.



2. Practical content: (30% of the final result)



2.1. For the evaluation of the practical contents of the seminars, a clinical case shall be solved (10% of the practical result).



2.2. Complete periodontal exploration (periodontal chart and periodontal radiographic series) (15% of the practical result)



2.3. Practical analysis of the instrumental used in seminars and laboratory practices (15% of the practical result)



2.4. Root planing and scaling in periodontal simulation models (60% of the practical result)



In order to pass the subject, both theoretical and practical contents must be independently passed, with a minimum of 5 points over 10 in the written test and 7 over 10 in the practical test.



If, for epidemiological reasons, a face-to-face evaluation would NOT be possible, a final assessment will be made according to such conditions.



-Evaluation of semi-face-to-face education derived from the aforementioned epidemiological situation:

Continuous evaluation of all the face-to-face and the telematic teaching activities, considering the general evaluation criteria.



1. Evaluation of the theoretical content (70%): A written or oral test will be conducted via eGela.



2. Evaluation of the practical content (30%): Through the individual digital portfolio and the continuous evaluation via checklist of the face-to-face laboratory practices and seminars.



In order to pass the subject, a minimum of 5 points over 10 must be obtained in the written test, in order to add this result to the rest of the evaluation.

As in the ordinary call, the same percentages are maintained in this call: 70% theoretical content and 30% practical content.



Since attendance to seminars and laboratory practices is compulsory, if the evaluation is positive, this result will be kept even for students who have failed the ordinary call, so that they will only have to do a written theoretical test.



The criteria mentioned in the ordinary call are also maintained regarding a possible epidemiological emergency.



-Final evaluation: All students who request it, according to the UPV/EHU student regulations (https://www.ehu.eus/es/web/graduak/normativa/evaluacion-del-alumnado-en-las-titulaciones-oficiales-de-grado) may choose a final evaluation, which will consist of a written final test and a practical test, in the same way as in the regular call.

To refuse both ordinary and extraordinary calls, it will be enough not attending the exam.

Seminars:
-University Manual: "Guía práctica de periodoncia". ISBN: 978-84-1319-549-0 (digital). Link: https://web-argitalpena.adm.ehu.es/listaproductos.asp?IdProducts=UMEPD235490
-Material for seminars provided by the Faculty of Medicine and Nursing
-Device with Internet connection: laptop/tablet/mobile phone

Laboratory practices:
-University manual: "Guía práctica de periodoncia" and teaching materials
-Lab coat or clinical pyjamas
-Lab material provided by the Faculty of Medicine and Nursing
-Periodontal simulation model provided by the Faculty of Medicine and Nursing
-Transparent nail polish (to be carried by the student)

Basic bibliography

-Aguirre-Zorzano LA, Estefanía-Fresco R, García-De-La-Fuente AM. (2017). "Diagnóstico periodontal: conceptos básicos". EHU.OCW 2017; https://ocw.ehu.eus/course/view.php?id=433

-Aguirre-Zorzano L.A., Estefanía-Fresco R., Fernández-Jiménez A., García-De-La-Fuente AM. "Tratamiento periodontal no-quirúrgico". EHU.OCW 2018; https://ocw.ehu.eus/course/view.php?id=470

-Aguirre Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-la-Fuente AM. "Enfermedades periodontales y periimplantarias: nuevas claves diagnósticas". EHU.OCW 2022; https://ocw.ehu.eus/course/view.php?id=585

-Berglundh et al.(2021). Lindhe´s Clinical Periodontology and Implant Dentistry. 7th edition, ed. Wiley Blackwell, Munksgaard

-Chambrone L. & Ávila Ortíz G. (2022). Tissues: Critical Issues in Periodontal and Implant-related Plastic and Reconstructive Surgery. Quintessence Publishing Company, Incorporated, 2022. ISBN: 0867159634

-García de la Fuente, Ana María, Estefanía Fresco, Ruth, Fernández Jiménez, Aitziber, Aguirre Zorzano, Luis Antonio. (2023). University Manual: "Guía práctica de periodoncia". ISBN: 978-84-1319-549-0 (digital). Link: https://web-argitalpena.adm.ehu.es/listaproductos.asp?IdProducts=UMEPD235490

-Genco et al. (1993). Periodoncia Contemporánea. Interamericana-McGraw-Hill. México

-Laskaris & Scully (2012). Periodontal manifestations of local and systemic diseases: colour atlas and text. Springer Science & Business Media. https://link.springer.com/book/10.1007/978-3-642-55596-1

-Levi et al. (2015). Non-Surgical Control of Periodontal Diseases: A Comprehensive Handbook. Springer

-Palmer & Floid (2021). Periodontology. Springer

-Pattison, G. L. (1985). Instrumentación Periodontal. 1ed. Buenos Aires, Panamericana

-Rateitschack KH, Rateitschack Pluss EM, Wolf HF (1991). Atlas de Periodoncia. 2ª Ed Salvat. Barcelona

-Sato N. (2002). Cirugía periodontal: Atlas clínico. Ed Quintessence S.L. Barcelona

-Zuhr O. & Hürzeler M. (2012). Plastic-Esthetic Periodontal and Implant Surgery. A microsurgical aproach. Quintessence Publishing



Learning material in video (EHUTB) in Spanish:

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M.(2018). Higiene interdental. https://ehutb.ehu.eus/video/5af05e17f82b2b1b738b4994

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M.(2018). Técnica de Bass modificada. https://ehutb.ehu.eus/video/5af004aef82b2bcd718b49a6

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M.(2018). Técnica de Stillman modificada. https://ehutb.ehu.eus/video/5af05c4bf82b2b1b738b4991

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M.(2018). Control de placa bacteriana.https://ehutb.ehu.eus/video/5af0606ff82b2b296c8b462e

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M.(2018). Instrumental para realizar el tratamiento periodontal no quirúrgico. https://ehutb.ehu.eus/video/5af06304f82b2b316c8b463e

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M.(2018). Raspado y alisado radicular (RAR) realizado por un operador zurdo. https://ehutb.ehu.eus/video/5af06945f82b2b2f6c8b464a

-Aguirre-Zorzano LA, Estefanía-Fresco R, Fernández-Jiménez A, García-De-La-Fuente A M. (2018). Raspado y alisado radicular (RAR) realizado por un operador diestro. https://ehutb.ehu.eus/video/5af062ebf82b2bc8718b49f4

In-depth bibliography

Scientific journals (in English):
-Periodontology 2000

-Journal Clinical of Periodontology

-Clinical Oral Implant Research

-Journal of Periodontology

-International Journal of Periodontics and Restorative Dentistry

-Journal of Periodontal Research …

Databases:
-PubMed; https://www.ncbi.nlm.nih.gov/pubmed/
-ISI Web of Knowlegde; https://www.recursoscientificos.fecyt.es/
-Scopus; https://www.recursoscientificos.fecyt.es/
-Cochrane Library; https://www.cochranelibrary.com/

Journals

Scientific journals (in Spanish):

-Periodoncia Clínica (Replaces the magazine “Periodoncia y Osteointegración”) http://www.sepa.es/web_update/periodoncia-clinica-presentacion/

-Periodoncia y Osteointegración: http://www.sepa.es/web_update/po-home/

Web addresses

Sociedad Española de Periodoncia (SEPA): http://www.sepa.es/

European Federation of Periodontology (EFP): https://www.efp.org/

American Academy of Periodontics (AAP): https://www.perio.org/