Endodontology MSc

This module is aimed at General Dental Practitioners who undertake root canal treatment as a routine part of their everyday dental practice. This module offers an overview of contemporary endodontic treatments and diagnostic techniques, and commences teaching the requisite practical skills.

Specifically:

1. To explore the historical influences on contemporary root canal techniques.
2. To review the biology of endodontic disease and the evidence base for treatment.
3. To review the diagnosis, treatment and prognosis of endodontic cases.
4. To introduce different filing techniques.

Module content will include:

1. Biology and aetiology of endodontic disease, underpinning evidence and research, critical appraisal and evaluation of evidence, statistical outcomes.
2. History taking, diagnostic techniques, differential diagnosis, treatment planning with patient to obtain valid consent. The use of magnification in diagnosis.
3. Likely outcomes from different pre-operative statuses. Appropriate treatment regimes, referral strategies, the use of published flow charts to assess case complexity.
4. Techniques of filing curved canals using a variety of files, the limitations of these techniques. Technique of balanced force filing to keep instruments centred in the canal, the use of balanced force filing in developing a ‘glide path' in curved canal preparation; efficacy of crown down technique with NiTi versus coronal flaring/glide path and NiTi as finishing instruments, concepts of neutral and positive rake angles in instrument design to vary cutting efficacy; the use of magnification.
5. Tapers and the limitations of producing a tapered preparation with instruments that are not tapered. 
6. Roles of irrigants and lubricants in canal preparation, use of disinfectants in the management of infections.

This module will build on learning achieved in the first two modules (NM7900 and NM7901).

Specifically:

1. To understand the concept of success and failure in endodontics.
2. To highlight the concept of the restoration of the endodontically treated tooth and coronal seal.
3. To highlight the relationship between endodontic and periodontal disease.
4. To understand risk factors for iatrogenic damage and how this can be repaired.

Module content will include:

1. Criteria for success and failure of endodontic treatment, review intervals, future treatment options, tactics to overcome failure.
2. Techniques to include placement amalgam Nayaar cores, techniques that allow for placement of gold posts, gold sectional posts and cores.
3. Techniques and materials needed to remove gutta percha and cements from the root canal system, the potential complexities that retreatment entails when compared with endodontic treatments on virgin teeth.
4. Treatment protocols for tooth bleaching (lightening).
5. Internal and external resorption and its relationship to trauma. Management of trauma and techniques to manage incomplete root formation. Techniques to prevent and/or minimise root resorption.
6. Various techniques of tooth lightening in endodontics.
7. The interrelationship between the endodontic and periodontal apparatus. Contemporary techniques and methods for pulp capping and pulpotomies. The use of ultrasonics for the removal of instruments and posts from root canals, other methods of removing fractured posts from teeth.
8. How to avoid iatrogenic damage and how to repair root canal systems that have suffered procedural misadventures, methods for removal of instruments and posts from root canals, including the use of ultrasonics. Methods of removing fractured posts from teeth.

1. Evaluation of quality of evidence for innovations in endodontics.
2. Exploration and evaluation of a range of new techniques and/or materials for use in endodontics. 
3. Critical review of comparative outcomes.

Examples of topics covered in item 2 include:

• Endodontic imaging; digital radiography, the theory, a critical review of available systems, advantages and disadvantages, 3 D imaging systems and their potential role in contemporary endodontics.
• Active root canal irrigation techniques; the use of active irrigation systems in the chemical debridement of the root canal system; a critical appraisal of theory and methodology.
• Alternative root canal obturation techniques; the roles of synthetic gutta percha type materials to seal the root canal system. Evaluation of new obturation techniques and a critical evaluation of their efficacy.
• Tomorrow's irrigants; evaluation of chemical root canal irrigant solutions that are not yet widely used or accepted for use in the UK.
• Dedicated endodontic computer software, including issues related to management of referral practice, practice logistics, treatment costing, communication techniques and use of IT systems for marketing purposes.
• The single file preparation; a critical evaluation of the potential of a new single file preparation technique.
• The endodontic/implant debate; the comparative outcomes of endodontic treatment vs implant; a critical appraisal of the statistics underlying quoted success rates.

The aims of the module are:

1. To offer students the opportunity to explore and evaluate a range of new techniques and/or materials for use in endodontics.
2. To question the evidence base for innovations in endodontics.

The aims of the module include:

1. To provide a comprehensive introduction to social research with regard to key concepts, approaches, and techniques.
2. To facilitate the preparation of a research proposal for the dissertation.
3. To enable students to identify the strengths and weaknesses of different approaches to their research topic.

Module content will include:

1. Research and professional practice: evidence-based practice, being a critical consumer of research, practice development and research.
2. Key concepts and issues in social research: research topics and research questions, answering questions with data, validity and reliability of data, qualitative and quantitative data, description, exploration, finding connections, formulating and testing hypotheses, populations and sampling, interpretivism and positivism.
3. Research traditions and designs: ethnography, survey, experiment, mixed method, research process.
4. Gathering and analysing data: Observation, questionnaires, interviews. Data analysis and  drawing conclusions.
5. Literature review: searching, locating, reading and summarising, reviewing and critiquing, organising, synthesising, and using the literature.
6. Preparing the research proposal: Identifying research questions or hypothesis for chosen topic. Designing a study to address the question(s). Data gathering and recording, data analysis. Considering alternative approaches: critical analysis of alternative methods of research to the chosen approach.  Knowledge transfer and strategies for dissemination.
7. Ethical frameworks, constraints, data protection, confidentiality and human rights.
8. Preparing an application for ethical approval.

This module aims to build on knowledge and skills gained during the Postgraduate Certificate in Endodontology. It will cover those areas of endodontics that most benefit from the use of enhanced magnification and illumination, such as management of MTA in the repair of perforations, the management of MTA in the closure of open apices cases, location and safe exploration of sclerosed canals, and retrieval of fractured dental instruments from root canals.

Specifically:

• To provide an in-depth evaluation of the history of the dental microscope in endodontology, its indications for use, its advantages and disadvantages.
• To make recommendations on current best practice for its clinical use.

Module content will include:

1. Evaluation of the history of the dental operating microscope, the indications for use of the operating microscope in endodontology. The importance of illumination and magnification in the successful and predictable management of endodontic cases.
2. Inflammation and immunity; a critical review of acute inflammation, chronic inflammation, host immunity and how these processes relate to the endodontic disease process.
3. MTA (Mineral Trioxide Aggregate): its biology and indications for its clinical use in compromised cases. Manipulation of the material in the root canal using the operating microscope.
4. Resorption; a critical appraisal of the processes that lead to the various presentations of root resorption. Its clinical management using MTA and calcium hydroxide.
5. Pulp chamber anatomy; use of the microscope to explore natural pulp chamber anatomy and the application of this knowledge in the prevention of iatrogenic damage.
6. Practical use of the operating microscope including ergonomics of microscope use, siting of microscopes and the use of the microscope in a working team.

The aims of the module are:

1. To provide the student with an opportunity to investigate systematically and in depth a topic of direct relevance to his or her chosen area of application.
2. To enable the student to draw on and contribute to the development of the growing body of applied knowledge and evidence-based practice.

Module content will include:

1. Literature review, knowledge of databases and other sources, searching, locating, reading, summarising, critically appraising, organising and synthesising themes.
2. Identification of potential issues/problems, finding connections, formulation and testing of hypotheses, research designs, research methods, sampling, reliability and validity.
3. Philosophical and methodological underpinnings, critical thinking, problem solving, logical development, data analysis, research design, strengths and limitations.
4. Ethical frameworks, constraints, data protection, ethical approval, human rights, Helsinki declaration.
5. Logical structure, research process, project planning with time frames. Alignment of research design and processes to research question.
6. Interpretation of data, developing insights, validity and reliability, limitations of study. Critical reflection on process, critical thinking skills. Project management and review. 
7. Knowledge transfer, justification of recommendations and conclusions based on findings, strengths and limitations of study, dissemination e.g. seminars, workshops, conferences. Writing for publication.

This module seeks to build on the knowledge and skills acquired in NM7900 Principles of Endodontics.

Specifically:

1. To further develop practitioners' endodontic techniques.
2. To analyse the role of medication in endodontic therapy.

Module content will include:

1. Prevention of endodontic disease.
2. Local anaesthesia, antibiotics and analgesics in endodontics - their roles in controlling pain. Different causes of pain; management of failure of analgesia.
3. The role of intra-canal medicaments and inter-appointment dressings where indicated for different diagnoses. The indications and roles of various root canal irrigants and disinfectants.
4. Anatomy of the apical third of the root canal, vertical and horizontal aspects of canal preparation.
5. Techniques and protocols to produce consistent tapered root canal preparations with various rotary NiTi instruments. Contemporary thermal obturation techniques, including warm vertical condensation, injectable thermo-plasticised technique and thermo-mechanical compaction.
6. Reasons for and methods of obturating the root canal; advantages and disadvantages of different methods.