Diploma in Implant Dentistry of the Royal College of Surgeons of Edinburgh (Dip Imp Dent RCSEd) March 2009

Revised with effect from January 2010

Regulations
Contents Page 1. Introduction 2. Purpose of the examination 3. Structure of the examination 4. Entrance requirements 5. Eligibility for the award of the Diploma 6. Application for admission to the examination 7. Results 8. Feedback 9. Limitations on the number of attempts 10. Infringement of the regulations 11. Appeals and complaints 12. Withdrawal from the examination 13. Candidates with special circumstances 14. Exemptions 15. Proof of identity at the examination 16. Diploma certificate 17. Curriculum 18. Appendix A - Learning outcomes

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Introduction

1.1 This document contains the Regulations for the Diploma in Implant Dentistry of the Royal College of Surgeons of Edinburgh. Further information can be obtained from the Examinations Section: Examinations Section The Royal College of Surgeons of Edinburgh 3 Hill Place Edinburgh EH8 9DS Phone +44 0131 527 1600 dental.exams@rcsed.ac.uk www.rcsed.ac.uk 1.2 All parts of the examination are conducted in English. 2. Purpose of the Examination 2.1 The Diploma in Implant Dentistry of the Royal College of Surgeons of Edinburgh is an assessment of core knowledge and competence in the field of implant dentistry. It is intended to test the candidates competency at a level expected of a general practitioner with a particular interest in implant dentistry and will include aspects of minor augmentation. The Diploma is not intended to test the candidates competency or detailed knowledge of the more advanced procedures such as major bone grafting (block onlay grafting), sinus grafting or full arch prosthodontic rehabilitation. Aims To allow the candidate to demonstrate a core knowledge of implant dentistry To allow the candidate to demonstrate a level of competence in the planning and execution of dental implant treatment

3. Structure of the Examination 3.1 The Examination consists of three parts which must all be passed independently. All parts should normally be passed at the same time. For exception please view item 14.2 of these Regulations. The examination will be held in the UK and overseas according to demand. 3.2 Part 1: Written Examination This examination consists of two written papers, each of 90 minutes duration: 3.2.1 Paper 1 consists of multiple choice questions (single best answer type) and extended matching questions. 3.2.2 Paper 2 consists of multiple short answer questions.

3.3 Part 2: Objective Structured Clinical Examination (OSCE) 3.3.1 This examination consists of an Objective Structured Clinical Examination (OSCE) of 90 minutes duration.

3.4 Part 3: Case Presentation and Structured Oral Examination 3.4.1 This examination consists of an assessment of case presentations. Four cases will be submitted for consideration at least one with multiple implants and at least one other with more than 12 months documented follow-up. Cases that were started more than five years before the examination date cannot be submitted. The case presentations must be submitted online by the closing date. There will be a 30 minute structured oral examination which will examine the candidate on selected case presentations. 4. Entrance requirements 4.1 To be eligible to enter for the Diploma examination all candidates must provide certified evidence of: 4.1.1 Possession of a primary dental qualification that is acceptable to the Council of the Royal College of Surgeons of Edinburgh. 4.1.2 Having been working as a qualified dentist for at least three years, including the completion of 36 months full-time postgraduate experience in dentistry (general practice, hospital, community, academic, armed forces). Normally, equivalent part-time experience will be acceptable if gained within a period of six years. 4.2 Submission of a Log Book record of implant-related activity. The Log Book should demonstrate a broad range of activity over a period of at least 12 consecutive months. Activity must be recorded on the standard format record sheet and according to the guidelines recommended in the Guidance for Candidates document. The completed Log Book and summary sheet must be submitted to the College by the closing date. The Log Books will be examined to ensure that a range of experience is demonstrated. Candidates who fail to show this adequately may not be considered as eligible to enter for the Diploma examination. 4.3 Submission of all four of the four completed case presentations before the application to enter the examination can be considered. The procedure for submission is detailed in Section 4 of the Guide to Candidates. 4.4 Submission of the Candidate and Patient Declaration Form (Appendix B). 5. Eligibility for the award of the Diploma 5.1 To be eligible for the award of the Diploma all candidates must provide evidence of having complied with all parts of the Regulations and passed the examination. 6. Application for admission to the examination 6.1 Applications for admission to the examination must be made online through the College website or fully completed on paper and sent to the College with the required certified evidence and accompanied by the full amount of the fee payable for the examination. They must include the Case Presentations and completed Log Book (including summary sheet). 6.2 Applications for the examination must be received by the closing date specified in the examinations calendar. Applications received after the closing date will not normally be processed. 6.3 Postal applications for the examination should be sent to the Examinations Section of the College. For detailed information on submission of case presentations please refer to item 2.3.3 of the Guide to Candidates. Further information regarding the examination can be downloaded from the College Website www.rcsed.ac.uk or obtained from this address:

Examinations Section The Royal College of Surgeons of Edinburgh The Adamson Centre 3 Hill Place Edinburgh EH8 9DS Scotland Telephone No +44 0131 527 1600 dental.exams@rcsed.ac.uk www.rcsed.ac.uk 7. Results 7.1 Results will be posted on the College website and distributed by post. 8. Feedback 8.1 Candidates will be given written feedback on their performance as appropriate and where requested. 9. Limitations on the number of attempts 9.1 There is no limit on the number of times a candidate may apply to sit the Diploma as long as he/she complies with all parts of the Regulations. 10. Infringement of the Regulations 10.1 The College may refuse to admit to the examination, or may not allow to proceed with the examination, any candidate who infringes any of the regulations or who is considered by the examiners to be guilty of behaviour prejudicial to the proper management and conduct of the examination. Examples of such infringements are as follows: 10.1.1 Entry to the examination being attempted by making false claims about eligibility or falsifying entry documentation, including the submission of case presentations or a Log Book containing plagiarized or incorrect content. The College reserves the right to make checks to validate any information or documents supplied by the candidate. 10.1.2 Unfair advantage being sought or obtained: by possession of material during an examination that might give advantage (including electronic communication devices); by plagiarism of any description; by communicating or attempting to communicate with another candidate once the examination has commenced; or by refusing to follow instructions given by examiners or examinations staff regarding the conduct and procedure of the examination; 10.1.3 Removal of, or an attempt, to remove from the examination room, any confidential examination material; 10.1.4 Any attempt to obtain confidential information relating to the examination from an examiner or examination officials; 10.1.5 Passing confidential information on the content of the examination to a third party. 10.2 This list is not exhaustive. Further information can be obtained from the guidelines on suspected malpractice available on the College Website.

11. Appeals and Complaints 11.1 Candidates wishing to lodge an appeal or complaint must do so in accordance with the College Examinations Complaints and Appeals Procedures. The full procedural document can be downloaded from the College website at www.rcsed.ac.uk or obtained from: Examinations Section The Royal College of Surgeons of Edinburgh 3 Hill Place Edinburgh EH8 9DS Telephone No +44 0131 527 1600 dental.exams@rcsed.ac.uk www.rcsed.ac.uk 12. Withdrawal from the examination 12.1 Any candidate who wishes to withdraw an application for admission to any part of the examination must submit a request in writing to the College. A refund of the fee paid may be made (less an administrative fee of 20%), provided that notice of an intention to withdraw is received by the Examinations Section before the closing date by which applications are due, as shown in the examinations calendar. Refunds are not normally made to any candidate who withdraws after the closing date. 12.2 Any candidate who wishes to withdraw an application for admission to any part of the examination on medical grounds and request a refund must submit a request in writing to the College, accompanied by a medical certificate. An application for consideration of a refund on compassionate grounds should be supported by full details, plus a supporting letter from an appropriate professional. Each such application must be submitted to the Examinations Section within 28 days following the date of the candidates programmed examination date. 12.3 The College reserves the right to review admission to the examination on an individual basis in exceptional circumstances. 13. Candidates with Special Circumstances 13.1 Special examination and other assessment arrangements may be made for candidates with permanent or temporary disability. These arrangements are intended to allow candidates to perform to the best of their ability. It is the responsibility of the candidate to notify the Examinations Section when they submit their application of any special circumstances. Applications for special consideration must be supported by written evidence in the form of a medical report from their General Practitioner for medical conditions (an educational psychologist's report is required for requests for extra time because of dyslexia). The policy can be viewed on the College website: www.rcsed.ac.uk 14. Exemptions 14.1 No applications for exemption from any part of the examination will be considered. 14.2 Exemption from Part 3 of the examination (Case Presentations) will only be granted to candidates who fail the Diploma in Implant Dentistry Examination of the Royal College of Surgeons of Edinburgh but obtain a pass mark in Part 3 of the examination. This exemption will normally be restricted to the examination diet immediately following the first unsuccessful attempt.

15. Proof of Identity at the Examination 15.1 Candidates must bring their passports to each part of the examination. Exceptionally, candidates who are not in a position to provide a passport must produce an official document that includes their name, signature and a current photograph e.g. current photographic driving licence. 15.2 For the purposes of visual identification, any candidate sitting the examination may be required to remove any clothing and/or other item which covers all, or part of, the candidates face. The College will observe sensitivity in the visual identification of candidates. 16. Diploma Certificate 16.1 A candidate who passes the examination shall be entitled to the designation of Diplomate in Implant Dentistry of the Royal College of Surgeons of Edinburgh (Dip Imp Dent RCSEd) and shall receive a Diploma bearing the Seal of the College signed by the President, Dean and Convener and Secretary to the College. The form of the Diploma shall be as follows: The President and Fellows of the Royal College of Surgeons of Edinburgh hereby grant the Diploma in Implant Dentistry to . who has passed the necessary examination The ceremonies for the presentation of diplomas are normally held four times a year. 17. Curriculum 17.1 The curriculum for the Examination is defined by the Learning Outcomes. 18. Learning Outcomes (Appendix A) 18.1 The list is intended not to be prescriptive but to give candidates a guide to the topics that may be included. 18.2 It is important to note that the examination is not a specialist examination and that the level of knowledge expected in any area will not exceed that which would be expected of a dentist who has three years experience of clinical dental practice together with a particular interest in implant dentistry.

Appendix A Aims and Learning Outcomes for the Diploma in Implant Dentistry, The Royal College of Surgeons of Edinburgh The Diploma in Implant Dentistry of the Royal College of Surgeons of Edinburgh is an assessment of core knowledge and competence in the field of implant dentistry. It is intended to test the candidates competency at a level expected of a general practitioner with a particular interest in implant dentistry and will include aspects of minor augmentation. The diploma is not intended to test the candidates competency or detailed knowledge of the more advanced procedures such as major bone grafting (block onlay grafting), sinus grafting or full arch prosthodontic rehabilitation. Aims To allow the candidate to demonstrate a core knowledge of implant dentistry To allow the candidate to demonstrate a level of competence in the planning and execution of dental implant treatment

Learning Outcomes What the Candidate is able to do 1. Clinical Assessment Skills For the patient presenting with an established or anticipated need for tooth replacement, the candidate should be able to:

Elicit and record a comprehensive medical and dental history Understand the relevance of the case history to the individual case Complete a thorough extra-oral and intra-oral examination, including detailed assessment of the teeth, restorations, periodontal tissues, oral mucosa, residual alveolar ridges and aesthetic requirements Assess the occlusion and its relevance in relation to the treatment proposed Recognise the need for appropriate further investigations. Be able to request and interpret appropriate investigations and write a report of the findings Collate and interpret the information gathered in the history and examination process and arrive at the correct diagnoses Arrive at a considered prognosis for the remaining dentition Communicate clearly to the patient, both verbally and in writing, the findings of the examination, the diagnosis and treatment options Show an awareness of the evidence base relating to the different options considered including dental implants Produce a treatment plan considering all options for tooth replacement and the preventive, functional, aesthetic, psychological and financial requirements of the patient Understand the interface between implant dentistry and other clinical disciplines Understanding the differences between fixed and removable implant prostheses Evaluate the options of both fixed and removable implant prostheses Understand the current evidence in relation to the different types of implant placement techniques Consider and recommend the timing of implant placement and restoration Obtain valid consent for the proposed treatment Provide or refer for appropriate allied treatment.

Re-evaluate the clinical situation prior to implant therapy Recognise and refer cases of a complexity that are beyond the scope of their competence

2. Practical Procedures For the patient requiring implant therapy, the candidate should be able to: Obtain all records necessary to mount and evaluate study casts and prescribe diagnostic wax-ups Demonstrate an understanding of the use of the diagnostic wax-up in the construction of radiographic and surgical guides Order fabrication of appropriate radiographic templates Prescribe and interpret appropriate radiographs Plan in detail the placement of implants Demonstrate the transfer of planning information to the surgical procedure via the use of appropriate guides Select the appropriate form of anaesthesia and manage patient anxiety Maintain infection control and follow an appropriate aseptic surgical protocol Design appropriate mucoperiosteal flaps Understand the different types of bone defects and how to manage these Understand the different types of grafting materials and barriers used for minor augmentation and their application to implant treatment Carry out surgical implant placement which may involve minor local augmentation procedures for the repair of small dehiscence and fenestration defects Understand the principles of soft tissue handling and wound closure Provide postoperative care and advice, including the prescription of analgesia and antibiotics as appropriate Demonstrate an understanding of the management of intra-operative and peri-operative complications Assess the outcome of implant placement with respect to the treatment plan Understand the following treatment with respect to restoring dental implants o Provisional restorations o Abutment selection o Impression techniques o Jaw registration o Laboratory prescription o Try in and adjustment o Final prosthesis delivery/fit Carry out the following treatment with respect to restoring dental implants o Provisional restorations o Abutment selection o Impression techniques o Jaw registration o Laboratory prescription o Try in and adjustment o Final prosthesis delivery/fit Plan and implement an appropriate maintenance and re-evaluation programme Demonstrate an understanding of the management of complications during restorative treatment and throughout the maintenance programme

3. The scientific basis of implant dentistry The candidate should be able to demonstrate knowledge of: Clinical Implant Dentistry Anatomy o Detailed knowledge of the mandible, maxilla and related structures Pathology o Hard and soft tissue disease affecting implant treatment Bio-mechanics o Bone and implant components o Implant design and surfaces Physiology and Histology o Wound healing o Bone physiology and osseointegration o Soft tissue integration Applied Dental materials o Implant component materials o Impression materials o Restorative materials Applied Pharmacology o Local anaesthetics, analgesics and antibiotics Radiology o Dental imaging techniques o Regulations relating to ionising radiation

4. Appropriate attitudes to professional and clinical practice The candidate should demonstrate the ability to: Reflect on their clinical practice Maintain good clinical records Understand the importance of informed consent Reflect on their professional and clinical standards Locate and evaluate the scientific literature and the evidence base relevant to implant dentistry Analyse personal needs in respect of continuing professional development and life-long learning

NOTE: These Regulations are under continual review therefore it is recommended that candidates keep in regular contact with the College to ensure that they have the most upto-date information. The Examinations Section will be able to advise you: Examinations Section The Royal College of Surgeons of Edinburgh The Adamson Centre 3 Hill Place Edinburgh EH8 9DS Scotland Telephone No +44 0131 527 1600 dental.exams@rcsed.ac.uk www.rcsed.ac.uk