For Candidates for Certification as a
Diplomate of the
And Their Mentors
Disclaimer
The opinions
expressed in this Guide are solely those of the members of the
DEDICATION
This
edition of the
ACKNOWLEDGEMENTS
We
acknowledge with thanks the following members of the
Dr. M. Lamar Hicks, Editor
Dr. Leif K Bakland Dr. Charles
Jerome
Dr. Gerald N.
Glickman Dr. Keith
V. Krell
Dr. John W. Harrison Dr. Edward J.
Strittmatter, Jr.
The current
Board of Directors of the College of Diplomates (COD) wishes to acknowledge The
We
additionally acknowledge all of the past Directors of the COD who have so
graciously given of their time and talents to ensure that the mission of the
COD is effectively carried out. They include:
Leif K. Bakland Martha
Proctor
Stuart Fountain Cindy
Rauschenberger,
Lamar Hicks Eric
Rivera
John Lundgren James
Simon
Thomas Mork A.
Eddy Skidmore
Carl
The 2007-08 Board of Directors of the
George
Goodis, President
Harold
Goodis, Secretary
Joseph
Dovgan, Treasurer/Website
Debra
Meadows, Pinnacle Editor
André Mickel, Director of Mentoring
Sandra
Madison,
Lastly, the
Board of Directors gratefully acknowledges the contributions and talents of
Susan Hawkinson. Her dedication and efforts on behalf of the
Promoting Board Certification
Board
certification is a privilege and carries with it
a responsibility to maintain the specialty of endodontics as a highly respected
discipline and one that encourages each specialist member to adhere to the
highest standards of practice. The
Introduction to Board Certification
Begins in the Endodontics Program
Endodontic
program directors must imbue to each resident the value of becoming a
Diplomate. Program directors can accomplish this by a number of means. The
first is by inspiring their residents to be life-long students and realize that
their education in the specialty of endodontics is never completed. Board
certification is just the beginning of this life-long process. By taking the
written exam in June of their final year of endodontic training, the resident
probably has the best chance of recalling the information that they have
learned in their program. Directors should strongly encourage that residents
take the written exam while still in their endodontic program. Additionally,
immediately upon graduation, new graduates should be “strongly urged” to
complete the preliminary application to the ABE in a timely manner. The newest
change (April, 2007) in the Boarding process has eliminated the minimum time
requirements for association with the specialty of endodontics. This now means
that a well prepared resident could complete (pass) the written exam in June
and submit their case portfolio in the fall of the same year. If the case
portfolio passes, then the candidate could sit for the Oral examination in the
spring of the following year of graduation.
This most
recent change gives the program directors a new challenge, namely helping the
residents get Board quality cases identified, treated, recalled and written-up.
It is important that program directors assure that all residents receive the
information on Board certification procedures that is sent to each resident by
the
Program
directors should also promote the pursuit of Board certification by all past
residents. It is incumbent that each candidate has sufficient knowledge of all
three phases of the Board certification process. The program directors should
provide comprehensive literature/book reviews to help solidify residents’
knowledge of evidence-based endodontics; ensure that each resident has
sufficient knowledge experience of what is expected in preparation of an ABE
case portfolio; and prepare each resident for the ABE oral exam, by giving
frequent oral exams. If these objectives are met, the candidate should be
well-prepared to pursue Diplomate status.
Every
endodontic program should have a “Board Certification Ambassador” (a program
director, a specific faculty member, or an alumnus of the program), whose job
would be to ensure that the “flame of the Board Certification fire” is
initially lit and remains ablaze.” The Board Certification Ambassador would be
similar in purpose to the AAE Foundation Ambassador.
On-line Mentors
Some Board candidates may not need a full time mentor but
may have a few questions or would like some feedback on a particular topic. The
Mentoring the
Mentors
The COD Board encourages candidates and mentors to attend
the Boardwalk given by the ABE at each AAE Annual Session Meeting. This is an
opportunity to hear, directly from the ABE, about any revisions in the Board
certification process. Additionally, valuable advice is offered by the
participating Board members on preparing and sitting for the different portions
of the examination.
Geographical
Mentors/Board Certification Ambassadors
The COD maintains a listing of mentors through the Board
Certification Ambassador Program. These are Diplomates who are affiliated with
endodontic programs across the country who are willing to serve as mentors to
candidates who would like to have someone in their geographical area provide
one-on-one guidance through the Board process. Any COD member who volunteers to
be a Board Certification Ambassador / mentor must be thoroughly knowledgeable
of the Board certification process so that they can accurately advise the
prospective Diplomate.
The
|
The |
Diplomate
status is a realistic goal for well-prepared candidates who remain zealous in
their pursuit of knowledge and clinical skill as they practice and teach the
specialty of endodontics.
Board
certification in endodontics and the purposes for which it exists transcend
educational background and national considerations. An endodontist pursues
Board certification because being a Diplomate of the American Board of
Endodontic (ABE) makes a very clear and strong statement of the value the
Diplomate places on attaining mastery in the specialty of endodontics,
receiving a most significant acknowledgement of professional achievement, and
being accountable to the public by adhering to the highest standards of
practice that peer review can set. It represents a philosophy of professional
conduct, practice, and sustained achievement that places great worth on being
the best one can be and provides the finest and most comprehensive endodontic
care to a deserving public.
As a mentor
of a candidate for Board certification in endodontics, one has an extraordinary
opportunity to emphasize the meaning and value of attaining Diplomate status.
The mentor also has the opportunity to describe in their own unique way the
enormous satisfaction that is felt on having achieved a singularly commendable
and exceedingly challenging goal after years of preparation, commitment, and
sacrifice.
Once
attained, Board certification cannot be cheapened or tarnished, but continues
to shine brightly and have clear meaning and unmistakable value for those who
succeed in the process. The mentors are entrusted with the responsibility of
perpetuation and improving the specialty of endodontics through the noblest of
pursuits. This manual is written with the express purpose of enabling the
mentor to better carry out this responsibility by being more effective as a
mentor.
“A
The longest
section of the manual is devoted to the development of an acceptable Case
Histories Portfolio. This section includes interpretation of the ABE’s detailed
instructions, identification of areas critical for success, and recommendations
and suggestions for the mentor to use when working with a candidate on a case
report documentation and narrative.
The fourth
section covers preparation for the Oral Examination. It contains valuable
information on what candidates can expect in the oral examination environment,
examples of oral questions, and information on how the exam is conducted. This
section also has some excellent tips, and recommendations from several
Diplomates who have recently completed ABE certification pertaining to methods
that were successful for them in preparing for the oral exam.
Because the
policies, procedures, and philosophy of the ABE are continually updated, the
content of this manual will change over time. Hence, the manual will be a
dynamic document constantly under review and periodically revised. It is
important to realize that what is current today may not be current tomorrow.
The ABE conducts a one and one-half hour information seminar entitled “The
Boardwalk” at the annual session of the American Association of Endodontists.
This seminar covers all aspects of the Board certification process and provides
a forum where the changes in Board policy and procedures are announced. As a
mentor of Board candidates, you and your prospective Diplomate are encouraged
to attend this highly informative session.
The
officers and directors of the
The Board
of Directors of the
|
THE
CONCEPT OF MENTORING |
The word
“mentor is a term that is difficult to define precisely. Despite that, the term
is commonly used today in the educational, professional, and business
communities. Historically the term was personified by Homer in the person (
A
successful mentor of Board candidates possesses three important
characteristics: competence, confidence, and commitment. The competence
arises from having the appropriate knowledge, the experience of having
successfully traveled the road to Board certification and the ability to
command (earn) respect from others. A mentor is competent in the skills
associated with assist functions. These include coaching, counseling,
communicating, instructing, and establishing good interpersonal relations. The
more frequently these skills are used and the more up-to date the knowledge
base, applications and philosophies are in exercising these skills, the more
valuable they become to the mentor and the mentored. A successful mentor is
competent to build on the mentoree’s strengths, to offer constructive criticism
and feedback, and to provide a reliable source of information and resources.
Finally, the mentor is able to promote good judgment.
A mentor
has the confidence to be imaginative, to demonstrate initiative, and to lead
and offer clear direction. The mentor also can deal successfully with another’s
foibles and biases. He/she can set aside self-recognition for the inner
satisfaction and great pride in the achievement of the mentoree.
The best
mentors are the ones who are committed to the investment of time, energy, and
effort in a distinctly different type of working relationship. They are also
committed to sharing personal experiences, knowledge, and skills. They have a
pronounced desire to pass on to a succeeding generation of professionals the
fruits of their own experiences and labors. They are people-oriented and have a
keen interest in seeing others develop their work and succeed in a long,
challenging process.
That which
we do in the mentoring relationship carries out the functions of
mentoring. Dr. B.G. Bibby, a former Director of the
Table 1. Functions of
Mentoring
________________________________________________________________________
Teach Sponsor Encourage Counsel Befriend______________
model protect inspire listen accept
inform support challenge probe relate
confirm promote affirm clarify
prescribe advise
question
To
successfully carry out the mentoring process, we must fulfill each of the
mentoring functions. These functions are accomplished within a support
framework comprised of three categories of factors: Personal, Functional and
Relational. The objectives within the structural framework of Personal Factors
include the need for the mentor to promote confidence building, creativity,
fulfillment of potential, self-development, and a certain amount of
risk-taking. In the Functional category, the mentor must teach, coach, counsel,
support, advise, sponsor, guide and provide resources. Finally, in the
Relational category, the mentor must facilitate mutual trust and sharing.
The rewards reaped by the mentor for
the substantial time and effort that go into the mentoring process are
highlighted by the thrill and pride resulting from seeing one’s protégé
succeed. Of great significance is the opportunity that mentoring provides in
repaying a past debt to his or her mentor for having been competently mentored
at an earlier time. The enjoyment and excitement that one will experience for
nurturing a fellow endodontist through the Board certification process are
sufficient paybacks for the many hours devoted to the effort.
STEPS IN MENTORING A
CANDIDATE
1. Find out which part of the
certification process the candidate is preparing for:
·
Written
Examination
·
Case
History Portfolio
·
Oral
Examination
2. Prepare yourself to help your
candidate by thoroughly reviewing the material that is provided in this
mentoring guide.
3. Go over the details of this
particular examination phase with the candidate: what is expected?
4. Recall and share your own successful
experience in pursuing Board certification- what did you do to prepare?
5. For the written exam, share the
multitude of resources provided in the “
6. For the case histories portfolio,
first be sure that the requirements, in terms of proper cases and categories,
are met. Then go over each case critically: Using the ABE Case History
Portfolio Guidelines is essential. The guidelines are available in a PDF format
on the ABE’s website. Both the mentor and the candidate must use the submission
checklist contained in the guidelines for each and every case. Are the
films/prints/images acceptable? Do dates on images match entries in the text?
.Is the treatment of high quality? Are the cases consistent with the level
expected of a specialist or could a general dentist have done it? Never tell
a candidate that his/her portfolio is going to pass! Only the ABE examiners
can make that decision.
7. For the oral examination, giving the
candidate an opportunity to experience a “mock Board” with you as the examiner
is critical to their success.
8. Enjoy the experience of helping an
endodontic colleague.
|
The ABE
On
The
The purpose
of the ABE is to assure the public that the endodontists it certifies have
demonstrated exceptional knowledge, skill, and expertise in the specialty of
endodontics and to progressively raise the quality of patient care.
Value of Board Certification
To achieve
Diplomate status, an endodontist has shown great inner motivation and
exceptional commitment to continuing professional growth. A Board Certified
endodontist understands the importance of:
o
Achieving
the highest level of knowledge and skill possible
o
Continually
pursuing new knowledge and experience
o
Fully
understanding and applying new research and advances in the practice of
endodontics, and
o
Ensuring
the highest possible quality of care for the patient.
Definitions
|
Prospective Board Candidate:
A student
enrolled in their final year of an advanced education program in endodontics
accredited by the Commission of Dental Accreditation of the
Educationally Qualified Endodontist:
An
endodontist who has successfully completed an advanced education program in
endodontics accredited by the Commission on Dental Accreditation of the
Board Eligible Endodontist:
An
Educationally Qualified Endodontist whose application and credentials have the
approval of the Board.
Board Certified Endodontist:
An
endodontist who has satisfied all requirements of the certification process of
the ABE, has been declared Board Certified by the Directors of the ABE, and
maintains Board Certification. This individual is a Diplomate of the ABE.
Procedures for Certification
|
The ABE
offers two “Tracks” for completing the Board certification requirements. Track
One is the “traditional” track, which has the candidate take the written exam,
submit the case portfolio and then finish the process by sitting for the Oral
exam. Track Two has the candidate submit their case portfolio first, then take
the written and finally sit for the Oral exam.
Changes in
the certification process effective
·
The four-year identification
requirement with the specialty of endodontics is eliminated.
·
The Final Application is due after
Part II, not Part I.
Existing Time Line New Time Line
|
Preliminary Application Submitted Before 2006 |
|
Preliminary Application Submitted 2006 or After |
||
|
Step |
Maximum Time |
|
Step |
Maximum Time |
|
Part I |
3 years |
|
Part I |
3 years |
|
Final
Application |
1 year |
|
Part II |
6 years |
|
Part II |
3 years |
|
Final
Application |
1 year |
|
Part III |
2 years |
|
Part III |
2 years |
|
|
|
|
|
|
|
|
3-10 years |
|
|
1-10 years |
Submitting an Application as a
Student
A student
enrolled in their final year of an
Prospective
Board Candidates have the remaining year following the date of the Written
Examination to submit a Preliminary Application along with a notarized copy of
their endodontic certificate and be declared Board Eligible.
Submitting an
Application as a Educationally Qualified Endodontist
An
Educationally Qualified Endodontist may submit a Preliminary Application along
with verification of their educational qualifications to the ABE upon
completion of his/her advanced endodontic program.
The
Credentials Committee of the ABE will review the Preliminary Application of the
applicant. If it is acceptable, the applicant will be declared Board Eligible
and will be notified by the Secretary of the Board.
Final Application Requirements
Letters of
recommendation from five dentists (at least two must be Board Certified
endodontists) attesting to an applicant’s acceptable ethical and moral standing
in the profession and community is required for approval of the Final
Application.
Recertification:
Applicants
making Preliminary Application on or after
The ABE Certificate:
A
Certificate bearing the seal of the ABE and signatures of the Directors of the
Board shall be awarded to each successful Candidate.
The
Directors of the ABE shall have the power to suspend temporarily, or to revoke
permanently, any certificate issued by the Board on presentation of sufficient
evidence that the person in whose name the certificate is issued has not
fulfilled the requirements of the Board, or has ceased to conduct an ethical
practice according to the American Dental
Association Principles of Ethics and
Code of Professional Conduct. The certificate remains the property of the
ABE and must be surrendered upon revocation. The Diplomate has the right to
appeal the suspension/revocation of certification
The Title – Diplomate,
Diplomates
are permitted to use the following designation, “Diplomate,
|
Examinations Board
Certification requires successful completion of three examinations: o
Written Examination: A four hour examination that tests
a broad range of fields, including anatomy, biochemistry, pathology,
immunology, microbiology, pharmacology, radiology, statistics clinical
endodontics, and related disciplines. The focus of the examination is on the
biomedical sciences and their relationship to the specialty of
endodontics. In preparation the candidate has the opportunity to review
the biologic basis pulp and periradicular pathosis and as well as systemic
disease, diagnosis, and treatment. This permits a consolidation and
correlation of knowledge in the biologic and clinical sciences provided
during their residency program. Often during a training program
students are focused on a discipline based educational process. Board
preparation results in the integration of knowledge from varied disciplines
and often removes the myopic view of patient care. o
Case History Examination: Presentation of a broad range of
treatments from the applicant’s own practice that demonstrate exceptional
knowledge, skills, and expertise in the full scope of the field of
endodontics. The development of a case history portfolio provides the
candidate with an opportunity to demonstrate exceptional skill and expertise
in endodontics. The required clinical procedures requires the
individual to diagnose, treatment plan, and treat wide variety of complex
patients. It increases their confidence level and helps them organize
data, interpret the results, and execute a treatment plan. The required
recall re-enforces the need to confirm the inflammatory process of pulp and
periradicular disease and assess the outcome of treatment. o
Oral Examination: A team of experts question the
applicant about a variety of endodontic diagnosis and treatment situations.
Throughout the extensive interviews, a high level of skill in problem
solving, decision-making, analysis, creativity, and evaluation are required.
The oral examination is designed to evaluate the candidate’s critical
thinking and problem solving abilities. In preparation the candidate
often reviews the dental and endodontic literature. This results in
critical evaluation of treatment procedures and provides justification for
procedures. It is basis for evidence based endodontics.
The candidate also moves beyond the role of student and develops skills
permitting them to be independent life-long learners and decision
makers, free of a formalized educational process involving a mentor. Upon
completion of all three examinations, the endodontist earns the Certificate
of the Board and the title “Diplomate of The |
|
Resources for Candidates |
Review Courses
Academic Review of
Endodontology
(Bender, Seltzer, Grossman)
When: September
(2-1/2 days)
Sponsor:
Location:
Lectures given by internationally
known
educators/researchers/clinicians
Topics Covered: Endodontic microbiology and
immunology, management of medically compromised patients, pain, pulp and
periradicular pathology, fascial space infections, trauma, pharmacology, bone
biology, information on the certification process. Recent courses have included
a session sponsored by the
Further Information: 215-456-6620
Review of the Biologic and Clinical Aspects of Endodontology
When: March (3 days)
Sponsor: Division
of Endodontics,
Location:
Lectures given by internationally known
educators/researchers/clinicians
Topics Covered: clinical aspects of endodontic
procedures, management of the medically compromised patient, pharmacology, oral
pathology, histology and physiology of the dentin-pulp complex, local
anesthesia, surgical endodontics. Recent courses have included a session
sponsored by the
Further Information: 313-763-5021
Endodontic Board Review and Scientific Update
When: Mid September
Sponsor:
Lectures are given by
internationally known
educators/researchers/clinicians
Topics Covered: Endodontic microbiology and
immunology, management of medically compromised patients, pain, pulp and
periradicular pathology, fascial space infections, trauma, pharmacology, bone
biology, information on the certification process. Recent courses have included
a session sponsored by the
Further Information: 410-706-7047
Review Manuals and Other Aids
The Endodontic Topical
Guide:
The Endodontic Topical Guide is an index of the Journal of
Endodontics with over 2500 topics and keywords. For example, a topic such as
root canal obturation has a list of over 80 references. The updated versions
have abstracts of JOE articles from volumes 15 through 20. Volumes 21, 22, and
23 updates are also complete with abstracts. For further information, contact
Applied Research Institute, 150 East 200 North, Suite G,
Online Services:
A wide variety of information can be obtained from online
services, including oral pathology tutorials and other study guides. For
example, Grateful Med® allows access to the National Library of Medicine’s
collection of medical and health science information.
Check Websites for the
following groups:
American Association of
Endodontists
American Dental
Association
American Medical
Association
Dental Education
Resources on the Web
Dental Library
Dentistry On-Line
Grateful Med
Healthfinder
HIVDent
Internet Healthcare
Directory
Medscape
Quintessence Publishers
Helpful Hints on the ABE Website lists study
sources that new Diplomates found useful.
Texts, Journals and
Suggested Review Articles
Attention
should be directed to contemporary literature. Key topical areas should be
included such as guided tissue regeneration, wound healing, antibiotic
prophylaxis coverage, management of traumatized teeth and medically compromised
patients. For examples of contemporary literature, please see our literature
guide. Additionally, the following latest editions of these texts may
prove as invaluable resources.
Trowbridge
HO, Emling RC. Inflammation: a review of the process. Quintessence Publishing
Company.
Ingle JI,
Bakland LK. Endodontics.
Malamed SF.
Handbook of local anesthesia. St.Louis: Mosby.
Malamed SF.
Medical emergencies in the dental office. St.Louis: Mosby.
Gutmann JL,
Dumsha T, Lovdahl P, Hovland E. Problem-solving in endodontics.
Seltzer and
Bender’s The Dental Pulp, Hargreaves and Goodis
Arens DE,
Torabinejad M, Chivian N, Rubinstein R. Practical lessons in endodontic
surgery.
Cohen S,
Burns RC. Pathways of the pulp.
Gutmann JL,
Harrison JW. Surgical endodontics.
Little JW,
Falace DA, Miller CS, Rhodus NL. Dental management of the medically compromised
patient.
Andreasen
JO, Andreasen FM. Textbook and color atlas of traumatic injuries to the teeth.
Neidle EA,
Yagiela JA. Pharmacology and therapeutics for dentistry.
Essential
Endodontology, Orstavik and Pitt Ford
● The mentor should advise the candidate to keep current on
the literature with special attention to the following journals: Journal of
Endodontics; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and
Endodontics; International Endodontic Journal; Dental Traumatology.
|
Helpful Hints from the Spring 2007 Diplomate Newsletter |
Eager to
share their success and excitement, every new group of Diplomates offers their
tips and insights to help those who have yet to get through the difficult yet
rewarding Board Certification process. New Diplomates routinely referred to the
various examinations as “fair” and “rewarding.” Their specific observations and
helpful hints are below.
Reading Materials New Diplomates
Recommended
·
Inflammation: A Review of the
Process by Henry O.
Trowbridge and Robert C. Emling
·
Pathways of the Pulp by Stephen Cohen and Kenneth M.
Hargreaves
·
Seltzer and Bender’s Dental Pulp by
·
Dental Management of the Medically
Compromised Patient
by Donald A. Falace and James W. Little
·
Journal of Endodontics, especially the last two to three
years
·
Medically Compromised Patient by J.O. and F.M. Andreasen
·
Essentials of the Traumatic Injuries
to the Teeth by J.O.
and F.M. Andreasen
·
Endodontic Topics at http://www.blackwell-synergy.com/loi/etp
·
ABE
web site
·
·
AAE
web site
Suggested Study Methods
·
Flashcards
·
In
a quiet and secluded study location
·
Review
courses
·
Utilize
a mentor and/or study partner
·
Set
aside time for study and reflection on a regular basis
·
Listen
to CD-ROM’s of CE courses while commuting
Suggested Study Resources
·
ABE
web site
·
Abstracts
published on the
·
PubMed
search
·
ABE
Boardwalk held annually at the AAE’s annual session
·
Local
study groups – organize or join one
Mentors
·
A
common thread among the Candidates is the importance of having at least one
mentor.
·
I encourage all Candidates to seek
out mentors, a most valuable tool that is available to you. If you do not know
anyone that can help you, place a quick call to Dr. Andre Mickel from the
·
I cannot emphasize enough how much
help it was to study with another person. – Dr. Stephen Tsoucaris
·
It is strongly advised to seek out
one or more mentors for each phase of the process. Different
opinions will develop insight into topics and expose areas needing more
investigation. – Dr. Marc Levitan
·
It was extremely beneficial for me
to utilize that experiences of current Diplomates to guide, suggest and
motivate. They served as role models, sounding boards
and examples through the process. – Dr. James Jostes
Review Courses
·
The
value of attending review courses throughout the Board Certification process is
mentioned over and over.
·
Take all the endodontic review
programs that you can. – Dr. Joseph Morelli
·
The Board review courses are great
for the Written and Oral Examination. – Dr. Jaime Silberman
·
A Board review course is
indispensable in helping to put it all together. – Dr. Timothy Kirkpatrick
Residency Program
·
Remember that preparation for the
Board Certification process starts in your residency program. Make the most of
you literature review and case analysis sessions. – Dr. Nooshin Katebzadeh
·
Take the Written Exam while in your
residency program or shortly afterward while the biological principles are
still fresh in your mind. This test is a natural extension of material learned
in residency. – Dr.
John P. Smith IV.
·
Start early during your residency to
gather all the cases that fit each one of the categories in your Portfolio. – Dr. Francisco Banchs
·
Keep all the notes from your
residency, they will be very useful. – Dr. Francisco Banchs
·
There will never be a better time to
take the exam. You have spent the last two – three years
reading, discussing and practicing endodontics, you have all the information you need. – Dr. Randolph
Todd
·
Begin preparation at the start of
your program; prepare and maintain records in the Case
Portfolio format; look for potential cases throughout your program. – Dr.
Khalid Al Fouzan
General Suggestions
·
READ!
o
The
most common suggestion? Read all major texts and current literature – recommendations
ranged from 2-5 years of recent articles.
·
Establish Milestones
o
Develop and adhere to a timeline
that includes progress ‘milestones’ for all three parts of the exam. Your
planning should be tailored to allow for ‘retakes,’ if needed, to avoid
starting all over again. – Dr. Robert A. Caruso
·
Manage Your Time
o
Organization/time management is the
most difficult part of the process. – Dr. Derik P. DeConinck
o
The entire process can, and ideally
should, be completed within five years of graduation. ‘Older’ endodontists can
start and complete the entire process in one year, thus only studying once for
the Boards. – Dr.
Lester J. Quan
o
As in everything that we do,
preparation is the key to success. – Dr. David Rosenbaum
o
Make sure that you review and understand
your deadline set by the ABE for each section. Your
planning should be tailored to allow for “retakes” if needed, to avoid starting
all over again. For any part of the exam, do not, repeat do not wait until the
last minute to prepare. – Dr. Bobby Caruso
·
Get Organized
o
Organize all your academic materials
beginning while in residency. Keep good, organized files of all endodontically
related articles and update constantly. – Dr. Joseph M. Morelli
o
Organize clinical cases according to
ABE’s categories for case presentations. – Dr. Joseph M. Morelli
·
Stay Focused
o
Try to stay focused on the specific
tasks. It is easy to look at all three parts of the exam and become overwhelmed. – Dr. Mickey Zuroff
·
Find Support
o
Don’t travel the road alone. Any or
all of the following – significant other, mentor, fellow candidate – will help
move you along. –
Dr. David M. Kenee
·
Utilize the Helpful Hints
o
I read and tried to remember all the
hints from prior examinees. The best one “Have a conscientious, explicit and
judicious reasoning for everything you do clinically.” – Dr. Lester Quan
Written Examination
·
DO IT ASAP!
o
The
most universal piece of advice was to take the exam as soon as possible.
o
Basic science is very easy to forget
in private practice!
– Dr. Jaime Silberman
o
Twenty years after my residency, I
felt like I was starting from the very beginning of dental school. – Dr. Lester J. Quan
·
Know Your Literature
o
If possible, allow enough time to go
back to the basics and integrate with classic and current literature. – Dr. Claudia I. Holt
Case History Examination
·
FOLLOW DIRECTIONS!
o
The
key suggestion for this examination was to follow instructions very carefully.
o
Details, Details, Details – Life and
the success of your case submissions are all in the
details. – Dr. Randolph Todd
o
Keep an eye on your write-ups;
they are as important as the quality of the cases. – Dr. Francisco Banchs
o
The instructions are very specific
and should be closely followed. – Dr. Steven Card
o
Take advantage of the ABE’s detailed
information about each case. Follow their instructions. –
Dr. Leandro Britto
o
Follow the directions given to a “T”. – Dr. Bart Rizzuto
o
Follow the guidelines, be brief and
do anything you can do make it easier for the Directors to read the cases
quickly! – Dr. Jay
Jacobson
·
Search for Potential Cases
o
Amass 25+ cases and then wean. – Dr. David M. Kenee
o
Look for cases that are not easy to
come by first. –
Dr. Helmut Walsch
o
It is important as you go through
your day-to-day practice that you treat each patient as though they could be a
part of your Portfolio. – Dr. David Rosenbaum
o
Start to identify cases in residency
and create a “follow-up”
log complete with all the necessary
contact data for the patient (including the contact information for a relative
of the patient who might be able to help you locate your patient at a future
time). – Dr. Bobby Caruso
o
Keep a log on a notebook or computer
file of potential Board cases. Anytime you come across a potential Board case,
write the patient’s name, tooth number and reason why you feel it is a Board
case. – Dr. Ariel
Diaz
o
Try to accumulate about two – three
as many cases as needed per category and pick the best for submission. –
Dr. Mark Dinkins
o
Keep track of which categories you
already have a sufficient number of
cases for submission, so that your energy is spent towards finding those
that are more difficult to complete (diagnosis, medically compromised patient
and the molar surgery). – Dr. Francisco Banchs
o
Treat every case as a potential
Board case with appropriate documentation and quality radiographs. – Dr. Timothy Kirkpatrick
·
Radiographs
o
Take all the intra-oral radiographs
and pictures you can. I don’t know how many successful cases I examined when
preparing for this portion of the Board only to find that I didn’t have the
adequate radiographic representation. – Dr. Timothy Bodey
o
During a patient treatment, if you
ever ask yourself the question, Should I expose an x-ray? -you should! That radiograph will be the one that you need to support your case. – Dr. Colleen
Shull
o
Take at least two (preferably three)
pre-op and post-op films. Take working films even if you don’t routinely do so, it strengthens
your cases. – Dr. Ariel A. Diaz
o
Always take high quality radiographs
from multiple angles; you never know if that case may be needed as part of your
Portfolio. – Dr.
Manish Garala
·
Get an Early Start
o
Start early, it’s easier on the
family relationships.
– Dr. David Koelliker
o
Be systematic. It takes time to
organize all the information. – Dr. Jaime J. Silberman
o
When you have cases that qualify, start
writing them up because they take more time than you think to write and edit
them. – Dr.
Katherine Kuntz Jakuc
o
Start case selection early. Every
patient is a possible Board case. – Dr. Geoffrey Okada
o
Keep a folder on your PC desktop
that keeps reminding you everyday to enter interesting cases to follow-up on! – Dr. Jay Jacobson
o
This portion of the Certification
process takes a lot of time, maybe more than you can imagine. Set
aside time to write up your cases, scan your images, etc. – Dr. Anne
Williamson
·
Contact Patients
o
I found the majority of my patients
could be found for follow-up and were quite receptive. – Dr. Bobby. Caruso
o
Keep track of potential Board cases
in each category and recall as soon as possible. – Dr. Claudia I. Holt
o
Make certain your office staff
realizes the importance of the Boards and works hard with you in getting
patients back into the office for necessary recalls. – Dr. David Rosenbaum
o
I found that if I explained to my
patients what I was trying to achieve and made them a part of the process, they
were more than happy to help me by following through with permanent
restorations and coming back for recall appointments. – Dr. Samuel Mesaros
·
Get a Second Opinion
o
Have colleagues and a mentor help
review your cases.
– Dr. Joseph M. Morelli
o
Have a mentor review your cases for
complexity and content. – Dr. Geoffrey Okada
o
Having other review my Portfolio was
an extremely valuable experience. Their suggestions and
advice were priceless. – Dr. Anne Williamson
·
Be Careful
o
The ABE template does not have
grammar and spell check, so you must type and do all editing in Word, correct,
then past into the ABE template. I learned this the hard way! – Dr. Lester J. Quan
o
The worst is a beautiful case with
insufficient documentation. – Dr. Helmut Walsch
o
Make certain that all radiographs
are of excellent quality and are archivable. – Dr. David Rosenbaum
o
When preparing your cases, it’s
important to be obsessive about checking dates; spelling,
and your write-up for organization. Your goal is for the cases to be black and
white. Don’t leave any question marks. – Dr. Lauren Mitchell
·
Proof Read
o
Have dental, but also non-dental
proofreaders. – Dr.
Margot Kusienski
o
Evaluate and grade each case
yourself by following the scoring criteria used by the Directors. – Dr. Tarathorn Sundharagiati
o
Proofread your cases. Have
your mentor proofread your cases. Proofread your cases again. – Dr. Ariel Diaz
Oral Examination
·
RELAX!
o
Despite
initial fears, Candidates found the Oral Examination to be a fair and relaxed
conversation with peers.
o
I found this to be the most
rewarding part of the exam. – Dr. Bobby. Caruso
o
Stay calm, feel relaxed and be
confident of yourself at the time of examination. – Dr. Iejaz Shahid
o
There is no substitute for a good
night’s sleep. –
Dr. David Rosenbaum
o
There were no trick questions or
unanticipated strategies. – Dr. Lester J. Quan
o
Examiners are very fair (and
comprehensive) in their questioning. – Dr. Derik DeConinck.
·
Be Prepared
o
During the week, while I was
treating patients, I would cite the literature that supports what and why I am
doing a particular treatment procedure. Dr. Bobby Caruso
o
Keep updated with current literature
throughout. – Dr.
Helmut Walsch
o
Know all you can about medically
compromised patients.
– Dr. Claudia I. Holt
o
Start organizing early – at least six months before the examination. Whether you study alone,
with a partner or through a mentor, create a schedule that gradually increases
as you near the exam. Starting three months out, I got up an hour early to study. – Dr. David Kenee
o
The Oral Exam is a clinical exam and
as such it requires evidence-based knowledge to
support every procedure you do when you treat a patient. While treating
patients in your practice review every single one of the steps you are taking and support them with
literature. – Dr. Francisco Banchs
o
Pay attention to the 10 areas in
which you are tested.
Know the literature and justify your
clinical decisions with the literature. When you are seeing patients review in
your mind what you are doing and why. – Dr. Ariel Diaz
o
Follow the instructions/tips given
at the review courses, diagnosis, and prognosis. Know the literature to substantiate your answers. Dr. Kimberly
Kochis
o
During a workday in private practice
use each patient case as if it were a Board case. Do this from early diagnosis to final recall. This will be a great
experience in tying together your clinical knowledge and literature reference.
Demonstrate evidence-based treatment. – Dr. Joseph Quevedo
o
We all know where each of our
weaknesses and strengths are. Define your
weaknesses early and challenge them before you sit for the Oral Exam. – Dr.
Shahrokh Shabahang
o
When preparing for the Oral
Examination, remember that the exam can and will encompass more that clinical
endodontics. Special patient management should be as
important in your preparation as is endodontic literature. – Dr. Jay K.
Taylor
·
Practice
o
Have a study partner…hold mock
exams…be both examiner and examinee. – Dr. Helmut Walsch
o
My mentor gave me mock orals. This
was probably the most helpful single thing in preparing for the Orals. – Dr. Joseph M. Morelli
o
Having a mentor provided different
opinions and developed insight into topics and exposed areas needing more
investigation. –
Dr. Marc Levitan
o
Practice orally with a recent
Diplomate. Knowing this info is one thing…..putting it
to words is another. Like anything else in life, PRACTICE!! – Dr. Jason Bergman
o
Have conscientious, explicit and
judicious reasoning for everything you perform in your practice, and provide
the research(s) to support those principles. Practice, practice, practice.
Verbalizing your thoughts is paramount to succeeding, and mock boards are the
best way to do that.
Dr. Anita Aminoshariae
o
Have a colleague or mentors quiz
you, this forces you to verbalize your answers and allows for feedback. Lt. Col. Brian Bergeron
o
Not only is studying important, but
you need to be able to eloquently verbalize that knowledge.
Utilize your mentor to do the mock Oral Exams through the preparation process.
– Dr. Margot Kusienski
o
The Orals require that you organize your thoughts and responses rapidly in front of
some very big names. Practice with someone who makes you feel slightly
intimidated. You will get flustered; the trick is to recover rapidly and move
on to the next question. – Dr. Vincent R. Jones
o
You have to be 200% familiar with
the literature because you do not have much time to organize your thoughts
during the examination. Basically, make the literature pop into your head like
a reflex. – Dr.
Ming-LI Emily Kuo
o
As you treat your patients throughout
your day ask yourself and write down questions such as, why do I use this
material, procedure or what options exist? What evidence is there to support or
dispute certain options or alternatives? Why is this patient on this or that
drug? What could go wrong and how would I handle it? – Dr. Patrick W. White
o
The Oral is a case-based
question and answer period. The cases are meant to reflect clinical practice.
They have some amount of complexity but are not impossible. After a day at the
office, write down the medical history or case complications encountered.
Review that topic; make note cards, list cures (medications) and complications.
Repetition of disease processes, case types will develop. Repeated review will
prepare you and over time, a breadth of information will be reviewed. – Dr. James Stich
·
Strategies for Taking the Exam
o
When taking the exam it is important
to have an organized way to gather all initial information when the test
starts. It should be practiced in a way to consistently not leave out any
critical information, i.e. medial history, blood pressure, etc. Do not forget
to ask for more information from the examiners as necessary, whether it is a
radiograph(s), or even a clinical picture, if indicated. Try to get the first
part of the exam off to as smooth a start as possible. This will help you to
stay calm and recall information as the exam progresses. Try to find a study
partner and or ask someone qualified to conduct a mock exam. The right strategy
in taking the Oral Exam is as important as what you know. Dr. John M. Lies
o
Try not to get flustered if you
don’t know every answer – you are not supposed to! They are trying to quickly
determine the depth and breadth of your knowledge, so they keep asking
questions until you run out of answers. – Dr. Lester J. Quan
o
My suggestions are: 1) Think through
the questions before answering,
. 2) Answer
only the information asked in the questions, 3) Be succinct but thorough when
answering, 4) Cite literature to correlate with responses whenever possible,
and 5) Candidates will not be able to answer every question. Don’t linger or
focus on questions you cannot answer. Instead, pass on the question and
concentrate on answering the next one! - Dr. Marc
Levitan
o
The approach I had taken for the
Oral Exam was to know and justify everything I do clinically. Be able to
support your statements with the literature. Quiz yourself with a mentor. You
don’t want to be flustered under stress. You need to know things inside and
out. – Dr. Lauren
Mitchell
o
Use literature citations to answer
every question –
Dr. Rory Mortman
|
Mentoring a Candidate for the Written, Case and or Oral Examinations
and Incorporating the approved Diagnostic Terminology |
New
On
PULPAL:
Normal pulp – A clinical diagnostic category in
which the pulp is symptom free and normally responsive to vitality testing.
Reversible pulpitis – A clinical diagnosis based upon
subjective and objective findings indicating that the inflammation should
resolve and the pulp return to normal.
Irreversible pulpitis – A clinical diagnosis based on
subjective and objective findings indicating that the vital inflamed pulp is
incapable of healing.
Additional
descriptions:
Symptomatic
– Lingering thermal pain, spontaneous pain, referred pain
Asymptomatic
– No clinical symptoms but inflammation produced by caries,
caries, excavation, trauma, etc.
Pulp necrosis – A clinical diagnostic category
indicating death of the dental pulp. The pulp is non-responsive to vitality
testing.
Previously Treated – A clinical diagnostic category
indicating that the tooth has been endodontically treated and the canals are
obturated with various filling materials, other that intracanal medicaments.
Previously Initiated Therapy – A clinical diagnostic category
indicating that the tooth has been previously treated by partial endodontic
therapy (e.g. pulpotomy, pulpectomy).
APICAL (PERIAPICAL):
Normal apical tissues – Teeth
with normal periradicular tissues that will not be abnormally sensitive to
percussion or palpation testing. The lamina dura surrounding the root is intact
and the periodontal ligament space is uniform.
Symptomatic apical periodontitis – Inflammation, usually of the
apical periodontium, producing clinical symptoms including painful response to
biting and percussion. It may or may not be associated with an apical
radiolucent area.
Asymptomatic apical periodontitis – Inflammation and destruction of
apical periodontium that is of pulpal origin, appears as an apical radiolucent
area and does not produce clinical symptoms.
Acute apical abscess – An inflammatory reaction to pulpal
infection and necrosis characterized by rapid onset, spontaneous pain,
tenderness of the tooth to pressure, pus formation and swelling of associated
tissues.
Chronic apical abscess – An inflammatory reaction to pulpal
infection and necrosis characterized by gradual onset, little or no discomfort
and the intermittent discharge of pus through an associated sinus tract.
PREPARING FOR THE WRITTEN EXAMINATION |
The Written Examination
The Written
Examination consists of 200 multiple choice questions. It is administered as a
computer-generated exam and candidates can choose from a four-hour morning or
afternoon session on any of the dates during the week the exam is offered. The questions are designed to
test recall, the application of knowledge, interpretation, and problem solving
skills. Subject areas include anatomy, biochemistry, embryology, general and
oral pathology, microanatomy, immunology, inflammation, microbiology,
pharmacology, vascular and neurophysiology, pulpal and periradicular
pathobiology, radiology, oral medicine, biostatistics, clinical endodontics,
dental materials related to endodontics, related dental disciplines, and
classic and current literature. Included in the examination are clinical case
histories, clinical photographs, and radiographs. Questions on the clinical
material require interpretation by the Candidate. Given specific clinical
information, Candidates must determine appropriate diagnostic procedures,
establish a differential diagnosis and definitive diagnosis, determine
appropriate methods for management of the patient, outline methods for
prevention of treatment of a particular condition, outline the sequencing of
procedures, and assess the outcomes of treatment. There is no one single text
or review course that can totally prepare one for the Written Examination.
Because of the contemporary and constantly developing nature of a number of
critical areas, particular study should be directed towards basic concepts of cellular
and molecular biology; inflammation, immunology and virology; management of
medically compromised patients; pharmacology of antibiotics, analgesics, and
local anesthetics to include drug interactions; microbiology to include
anaerobic bacteria and current genus and species identification; differential
diagnosis of radiolucent and radiopaque lesions; pulpal and periradicular
pathosis; wound healing; bone regeneration; and the literature.
|
HOW TO SUCCEED WITH THE CASE HISTORIES PORTFOLIO |
The path to successful completion of the case histories portfolio requirement
is straightforward but rigorous. The cases must be the clinician’s finest effort. In addition to being
high quality, they should demonstrate the broadest scope possible of diagnosis
and treatment in the specialty practice of endodontics. They should convey the
message that a Diplomate of the
Read,
understand and follow all current instructions and guidance published by the
American Board of Endodontists on preparing a case histories portfolio. The
Case History Portfolio Submission Guidelines can be downloaded as a PDF
document on the ABE’s website. Using these guidelines is essential in
preparation of the Case History Portfolio.
GUIDELINES FOR
DEVELOPING AN ACCEPTABLE
CASE HISTORIES
PORTFOLIO
1. Demonstrate mastery in a wide
variety of complex nonsurgical and surgical
cases.
2. Ensure all documentation is complete
and dates are accurate. Have a non-endodontist review the radiograph dates and
clinical entry dates for accuracy. Technical errors tend to detract from the
portfolio because it suggests inattention to detail expected of a Diplomate.
3. Have at least a one-year recall
examination and documentation, longer if possible
4. Use only original high quality
radiographs, or direct digital radiographs. Mixtures of film and digital images
are acceptable.
5. Clearly label supporting
documentation.
6. Justify treatment selection and
annual treatment approaches.
7. Provide definitive clinical
diagnosis and use consistent, approved terminology.
8. Be precise, clear, thorough and
concise.
9. Keep abbreviations to a minimum.
10. Use acceptable grammar and correct
spelling. All entries should be spell checked outside of the document and then
pasted into the final template. The spell-checker feature of Microsoft does not
function in the Case History Report template.
11. Duplicate the entire portfolio.
12. Submit the case histories portfolio
early in the eligibility period.
SELECTION
OF CASES
When
compiling cases for the notebook the candidate should file or store them
alphabetically. It is helpful to arrange them by case type. For example, you
can suggest that the candidate put all potential surgical cases together in one
category. Place hemisections, root amputations, anterior root end resections with
and without root-end fillings, posterior root-end resections with and without
root end fillings, and exploratory surgeries in one section. This will allow a
review of similar cases. Then a decision can be made to select the best cases.
After the
candidate writes a case report, suggest that it be put away for a few days and
then reviewed again. Make any deletions or additions at that time. This
approach will provide a more objective point of view. This can be repeated two
or three times, if necessary.
The Board
specifies the case types and sequencing of the cases in the portfolio. The
order, procedure categories, and the number of cases REQUIRED in EACH category
are listed below (also see Tab 6, Case Histories Portfolio Instructions):
DIAG (1 Case)
Diagnostic
evaluation of the patient (dental or systemic) is the most significant feature
of this case. One year evaluation is required with appropriate images and/or
radiographs.
EMERG (1Case)
These cases must show emergency
treatment procedures in addition to
endodontic
procedures. For example, an incision and drainage, trephination, and
prescription of
medications with the rationale for
their usage fit into this case type.
MED COMP (1 Case)
These cases must show endodontic
management of a medically compromised patient.
This requires MODIFICATION of
treatment timing or procedures. Simply recognizing
and/or documenting a medical problem
does not meet the criteria, nor does
prescribing
prophylactic antibiotic coverage or
treating patients with common medical conditions.
Patients on anticoagulant therapy or
those receiving chemotherapy or radiation
treatments may fulfill this category
if your treatment has to be modified in some way.
NS RCT
(5 Cases)
These cases
must demonstrate difficult nonsurgical root canal therapy. This includes
teeth with calcified canals, curved and/or long canal systems, unusual anatomy,
etc. These FIVE nonsurgical cases MUST include at least one maxillary molar and one mandibular molar.
RETX (2
Cases)
These cases
must include nonsurgical retreatment of previously endodontically treated
teeth. At least one case MUST be a molar.
These cases
must demonstrate surgical root canal treatment. A posterior (molar) surgery
with root-end resection and root-end fillings MUST be included.
OTHER (3
Cases)
The cases presented in this category
are cases that do not qualify for the previous 12 cases. The three Other cases must be different from each other and may include, but are
not limited to the following: trauma
(management of traumatic injuries and their sequelae, such as crown/root
fractures, luxations, avulsions, open apices, resorptions, etc.); perforations,
hemisections, root amputations, endodontic endosseous implants, replants,
transplants, endo-perio, endo-pedo, endo-ortho, removal of separated
instrument, decompression and vital pulp therapy (including apexogenesis).
Osseointegrated implants are not acceptable. No more than one case from each
category is permissible.
As the
candidate prepares the case histories portfolio, remind him/her that the goal
is to present the highest quality endodontic care possible. The portfolio is
the only means by which the candidate can communicate to the examiners the
excellence of his or her abilities as an endodontic clinician. In preparing the
cases for submission to the Board, strict attention to detail will give the
candidate the best chance to successfully complete this phase of the Board
certification process.
SUGGESTIONS FOR THE PREPARATION OF
A CASE HISTORIES PORTFOLIO
The
case histories portfolio is a direct reflection of the candidate’s skills as a
practitioner. Only the highest quality cases should be submitted to the Board
for review. Preparation of the case history reports is time consuming and
possibly the most demanding of the Board requirements. All case histories need
to have complete documentation, proper diagnosis and treatment, and recall
documentation. Without exception, excellent quality radiographs should be the
standard. Selected photographic 2x3 slides are highly recommended to document
unusual or complex procedures. The portfolio should portray the abilities of
the clinician and clearly communicate to the Board that the quality of the
candidates work is the reason why Diplomate status should be awarded. It is the
exclamation point that sets this specialist practitioner apart and justifies
Board certification. The case histories portfolio MUST demonstrate the broad
range of the candidate’s endodontic abilities and MUST be their best!!!
Although
reasons for failure of the case portfolios are varied, the more common problems
are poor case selection, poor documentation and poor quality radiographs.
The
Board provides the candidate with a Case History Evaluation Form that serves as
a table of contents to identify and classify the cases in the portfolio. The
fifteen cases must be placed in the proper order and include all of the
required categories. The Board requires that each case be reported as one
category only and focus only on one tooth, even if multiple procedures were
performed and multiple teeth were involved. Furthermore, even though a case is
complex (multiple categories, multiple teeth), it cannot be used more than once
in the portfolio. You can assist the candidate in determining the predominant
category for each case and tooth to be reported.
Example:
(from the case history evaluation form)
A B C
|
Patient No. |
Tooth No. |
Operation Performed |
|
1 |
23 |
DIAG |
|
2 |
15 |
EMERG |
|
3 |
2 |
MED COMP |
|
4 |
3 |
NS RCT |
|
5 |
32 |
NS RCT |
|
6 |
31 |
NS RCT |
|
7 |
17 |
NS RCT |
|
8 |
8 |
NS RCT |
|
9 |
19 |
RETX |
|
10 |
7 |
RETX |
|
11 |
19 |
SCRT |
|
12 |
13 |
SCRT |
|
13 |
15 |
OTHER |
|
14 |
19 |
OTHER |
|
15 |
30 |
OTHER |
If the
candidate decides to use abbreviations in the portfolio in addition to the ones
required by the Board, they should be listed on a separate sheet of paper and
placed at the front of the portfolio. It is best to remember that many
abbreviations have been used for so long or are so commonplace in endodontics
and dentistry that they can be categorized as boilerplate. Abbreviations such
as MB, ML, PDL, PRM, BP, Ca (OH )2 , IRM and those specified by the
Board such as NS RCT and S RCT fall into this category. These abbreviations should not be included on a front-page listing.
Abbreviations such as NKDA (no known drug allergies) or RAS (right arm sitting)
that are not universal in the use or are outside common usage in Endodontics should be included in the front-page
list. In general, abbreviations should be kept to a minimum because the
examiners have to refer the list several times when they review the cases.
To avoid confusion,
recommend to the candidate that he/she should be as brief as possible in their
write-ups without compromising thoroughness. If the candidate deviates from
standard diagnostic terminology (not a good idea), especially in pulpal and
periradicular diagnosis, the terms and a brief definition should be included on
the page with the list of abbreviations. Stress to the candidate the importance
of using the approved ABE Terminology. The terminology or nomenclature should
be consistent throughout the portfolio.
Avoid
phrases such as “within normal limits.”
Explain what normal is, e.g., “The probing depths were 1-2 mm with no
bleeding on probing” rather than “WNL.”
As the
candidate prepares the cases, remind him/her that a thorough and accurate
representation of the way the cases were treated is the goal. Make every effort
to limit the narrative to the spaces provided on the form. The examiners have
many cases to review, so verbosity is verboten. Be PRECISE and CONCISE.
The case
history report form used for case submission may be downloaded from the ABE
website at www.aae.org/certBoard.com
Instructions for the
Case History Report Form and Addendum Page
To Create the Case History Report
Template
1.
Open
the Case History Report Form Template
Click on File then
click on Save As
Save in Desktop –
leaving the filename as is – click Save
Click File then Close – then close out of Word
2.
On
your desktop screen you will have an icon for the Case History Report Template. This template is now ready to be
used to create your fifteen Case History Report Forms.
To Create Case History Report Forms
1.
Double-click
on the Case History Template Icon
Click yes to open as read only
Click File – click on Save As
If you receive the Before you Save prompt, click on Don’t Save As Suggested Format. Change the file name appropriate
to the case report you are making (you will use this template to create each
Case History Report Form Case 1 through Case 15). Save as a Word Document.
Use this procedure to create your 15
Case History Report Forms.
General Instructions
Tool Bar
Be sure the
Form Toolbar is locked. When the Form Toolbar is locked, the other symbols (abl
– the check box – etc., are grayed out). The form will not work properly if the
Form Toolbar is not locked. If the Form Tool Bar is not visible – click on View – then Toolbars - then Forms.
Tab Button
Use the Tab
button to navigate from one section to another.
Select Buttons –
Please note the following
information regarding the Procedure Category
In the Patient
Sex and Procedure Category click on select pull-down menu box
– then click on the appropriate response. Use the pull-down menu for all
Procedure Categories. In addition, the OTHER category has a text box below the
Select pull-down box to describe the type of OTHER treatment (i.e.,
Apexification, Root Amputation, and Intentional Replantation).
B.
Procedure Category: OTHER
_______ Type the subcategory in this text box
(tab through it for the remaining cases)
Spell Check
The Case
History Evaluation Form does not provide the functionality of “spell check.” A
work-a-round solution is to type your report in a Word document and then copy
the text and paste it into the appropriate section in the form. Please remember
that “spell check” is a great tool, but it is the responsibility of the writer
to present an error free report. Please proof read your report for content and
then re-proof your report strictly for spelling errors.
Allowed Space
While
typing a report on this form, you will be restricted to the allowed space for
each section of the form. If you exceed the limits of the space, what you type
will not appear on the form. The form has been created to allow you to enter
information up to the end of each section. However, due to capital letters,
lower case letters and spaces being different sizes, you may find that you are
stopped before reaching the end of the last line. Do not try to change this or
the font to squeeze the typing into the form. The lines will not accommodate
any font other than Arial, regular, size 10. Continue your report on the
Addendum Page.
Changes
Creating
each Case History Report from the template will allow you to make changes and
additions to the form as needed. When you need to make a change to your created
Case Form – open the form and click no when asked if you want to open as
Read Only and then enter your changes
and save before closing the document.
Addendum Page
The two
pages of the form should accommodate most case reports. However, for an
occasional case, you may need more room. Use the Addendum page for this. When
you have exceeded the limits of the current section you are working on, you
will no longer be able to enter information. Use the backspace to allow enough
room to enter “See Addendum Page” at the end of that particular section. Scroll
down to the Addendum page; indicate the area you are continuing, i.e. “C.
Medical History continued:” then continue with your narrative of that area. All
areas continued for a case can be on the same Addendum page. Using an Addendum
page for every case, or using more than 2 Addendum pages for any case, probably
indicates a need to edit your narrative to make it brief and concise.
Backup Copies
As an
additional safeguard, make backup copies of this file and of any reports you
write.
Printing
The margins
have been made wide enough on this form to accommodate any inkjet or laser
printer.
Assembling the Case History Report
Notebook
Place your
completed Case History Report form in a plastic protector front to back. The
Addendum page should be placed in a plastic sheet protector and be placed
behind the appropriate Case History Report form in the notebook.
Be certain the candidate removes or blacks out the names of
schools, institutions, laboratories, oral pathologists and any other
identifying features to ensure anonymity.
Case History Report
Form
The
following information relates directly to the preparation of the case history
form. As a mentor you can offer the candidate many reminders and suggestions
for each section of the Case History Report Form that will enhance the quality
of the report and the portfolio.
A. Tooth #: Use the 1-32
system. One tooth number only must be used per case.
B. Procedures:
Use the
dropdown list in the form to select the procedure category. For “Other” cases
explain the type of case in the Other Subcategory area of the form.
Chief Complaint: This is self-explanatory. It should be in the
patient’s own words.
C. Medical History:
If “the patient is
in good health,” state it that way. In addition, it is
very
important to report the blood pressure for each patient. If the
blood
pressure was abnormal, the candidate should describe how
the patient was managed. For example, “BP 188/110.
Pressure
monitored for three successive days with no change.
Patient
referred to his physician for evaluation and
treatment.
If
the patient was on a medication, be sure to list the drug,
dosage, frequency and duration of administration.
Describe what
this medication does for the patient. For example,
“Sandimmune is
a cyclosporine and a cyclic polypeptide
immunosuppressant
agent.”
If
the medication impacted upon the management of the patient,
report
how. If it didn’t have an impact, state that it didn’t.
If a medical condition required any alteration of the
treatment plan,
state
what the modification was. Explain how any treatment was altered to accommodate a medical
condition.
Did the patient require pre-op or
post op antibiotics. Which antibiotics were selected and why? Was it an
American Heart Association recommendation or a physician recommendation?
Remember to include the dosage and number. Have lab reports, radiation reports;
and MRI, CAT scan, or bone scan results available. Include these as attachments
to the case report if they influenced diagnosis or treatment. All vital signs
must be recorded.
D. Dental History: This should tell the story behind
the referral. State who the
referral
came from: general practitioner, specialist, and physician.
Report the treatment that was provided before the
specialist saw
the patient, such as non-surgical root canal therapy
or pulpotomy,
and the time since the last treatment. Report the
signs and
symptoms at the time of the referral and then at the
time the
specialist first saw the patient. Have the candidate
include such
things as a history of trauma, caries, carious
exposure,
mechanical exposure, restorations and pulp capping
procedures.
If the referring practitioner obtained a microbiological
culture,
include this in the report.
E. Clinical
Evaluation: (Diagnostic Procedures)
Exam:
Describe the condition of the tissues. For probing depths,
list the
measurements,
e.g., 1-2 mm. Report any sinus tracts, their
location
and how they were traced, e.g., gutta-percha point, silver
point,
wire. Report the results of the overall exam including cancer
screening,
soft, and hard tissue exam, e.g. mandibular tori. If
photographs
were taken at this time, indicate this and include a
2x3 photographic slide or digital photo.
Tests: Identify the teeth involved (by
number and the results of
endodontic diagnostic tests such as
percussion, palpation,
electric
pulp test (record the scale), cold or heat. Report the
results
of any traced sinus tracts. It is important to indicate
whether
the sensation from the heat or cold lingers or disappears
rapidly. This differentiates a
reversible pulpitis from an irreversible
pulpitis. Also indicate whether the
response was delayed or
immediate.
A table can be used to arrange the results of
diagnostic tests for easy review by the examiners.
The meaning of
symbols used in the table of test results can be
explained on the
cover sheet.
Example:
TESTS
|
Tooth
# |
6 |
7 |
8 |
9 |
10 |
11 |
|
|
|
|
|
|
|
|
|
Percussion |
- |
- |
+ |
- |
- |
- |
|
Palpation |
- |
- |
+ |
- |
- |
- |
|
Mobility |
0 |
0 |
1+ |
0 |
0 |
0 |
|
Cold |
+ |
+ |
- |
+ |
+ |
+ |
|
EPT |
28/80 |
24/80 |
80/80 |
26/80 |
25/80 |
27/80 |
|
Heat |
+ |
+ |
+ |
+ |
+ |
+ |
|
Transil. |
n/a |
n/a |
n/a |
n/a |
n/a |
n/a |
|
Biting |
- |
- |
- |
- |
- |
- |
|
Sinus
Tract |
- |
- |
- |
- |
- |
- |
Radiographic Interpretation: Describe the appearance of the
periodontal ligament, lamina dura and surrounding bone. Report any
abnormalities within the bone or in the periradicular area. If the radicular
portion of the tooth is altered, for instance an immature apex or dilacerated root,
state this. Besides interpreting the radiograph, be certain to examine the
quality of the radiograph. This is critical. The quality of the radiograph
must be excellent. It should be as parallel to the occlusal plane as
possible, properly exposed and processed, and have no fixer stains, cone cuts,
elongation or foreshortening. Besides a straight-on exposure, there should be
an altered angle or shift shot exposure of pre-op, working and post-op films,
especially for posterior teeth. The same guidelines for excellent quality apply
to xeroradiographs and radiovisiography films. Remember, the quality of the
radiograph is critical. It is a main source of information for the examiners.
F. Pretreatment Diagnosis: There
must be a pulpal diagnosis and a periradicular
diagnosis. Terminology must be
consistent throughout the portfolio and acceptable to the
G. Treatment Plan:
Emergency: If there was an emergency procedure,
explain what was done,
e.g., pulp cap, pulpotomy, and
trephination.
Definitive:
Include the primary treatment, e.g.
NS RCT
Alternative:
The next best treatment: e.g.,
extraction
Restorative:
Although this part of the treatment plan is just a recommendation
to the referring dentist, it is best
to put down what the best
treatment
would be, not necessarily the most affordable.
Prognosis: Ensure the candidate uses favorable,
questionable, and unfavorable for the prognosis. This is the system the Board
requires. Explain briefly why the prognosis is appropriate based on what
factors are present or absent.
H. Clinical Procedures: (Treatment
Record)
The treatment record should be very
comprehensive, yet PRECISE and CONCISE.
It is a chronological record of all treatment rendered. It
begins with the initial referral and any emergency treatment rendered. The
blood pressure should be recorded at the initial appointment. State that the
medical history was reviewed and note any abnormalities. Explain how
abnormalities were handled. If any other consultations were required, state
this, e.g., referring dentist, prosthodontist, periodontist. Include a copy of
the consult, if appropriate.
Give a brief description of the proposed treatment and any
complications that might be encountered. Be explicit that informed consent was
obtained. For example: “Treatment options were reviewed. The plan included
calcium hydroxide to promote apexification. It was explained that this
procedure may take a year or longer. If an adequate apical seal could not be
accomplished, SRCT would be an alternative. The treatment plan was accepted and
potential complications acknowledged.” If a candidate is treating a patient
under the age of 18, he/she must be certain to have written consent, from a
parent or a guardian, to treat the patient. The adult must fully understand the
treatment and potential complications.
Include dosages and amounts of local anesthetic
administered, e.g., local anesthesia (LA) (36 mg. of 2% lidocaine HCL with .018
mg. of 1:100.000 epinephrine).
It is preferable to use milligram dosages of anesthetic in
addition to a concentration notation such as 1:100,000 epinephrine.
Consultation with physician colleagues requires amounts of a drug, including
local anesthetics, to be communicated in metric terms. In addition, maximum
dosages for individual patients are calculated on the basis of a patient’s
weight in metric units (mgs/kgs).
Record any untoward reactions to treatment procedures, e.g.,
“After injection the pulse rate increased and the patient became faint. The
patient was placed in a supine position and O2 administered at 6
liters per minute until she returned to normal.” If a patient has a reaction to
an antibiotic or any other drug, it should be reported along with the treatment
rendered.
Be sure to record the type and concentration of irrigant,
working lengths, type and method of instrumentation, canal obturation materials
and any other medicaments used. Be specific. Make sure all the data is arranged
in an orderly, neat, clear and precise manner. Remember, the candidate’s goal
is to present a detailed report of the case. Make any appropriate comments on
clinical appearance as well as radiographic changes. Include appropriate 2x3
photographic color slides or digital photographs, especially with surgical
cases.
Be certain all conventional and/or digital radiographs,
photographic slides and /or digital photographs and other pertinent materials
are clearly labeled and dated, and that the dates of all materials correspond
to the dates in the narrative.
If biopsies were obtained or bacteriological cultures taken,
include a copy of the results with the case report form. The Board does not
require original copies of the pathology or microbiology reports. A copy of the
original will suffice.
The candidate should have emphasized the importance of the
recall to the patient at the end of the treatment. Be sure to include this in
the procedure section. Have the candidate indicate whether a six month recall
was recommended. If there was a need for more frequent recalls, state why this
was appropriate.
I. Post Operative Evaluations (1 year minimum)
For recalls, report any radiographic or clinical changes. If
the recall was performed by someone else, state this fact. If there have been
restorative changes since the endodontic treatment was completed, describe what
they were. Although a one year follow-up is the minimum requirement, the longer
a case is followed the better. Recall radiographs need to be of the highest
quality. Appropriate 2x3 photographic slides or digital clinical photos can be
included to demonstrate any clinical observations.
Remember, the recall examination is not a cursory exam. It
is a thorough radiographic and clinical examination that elucidates as
completely as possible the current state or condition of the tooth and the patient.
The recall report should convey to the examiner the results of the thorough
clinical exam and the interpretation of those results.
AMERICAN BOARD OF
ENDODONTICS
CASE HISTORY
EVALUATION FORM
Candidate Number: ________ Prefix
#: Date Received:
Examiner: Date Mailed:
CANDIDATE USE ONLY:
TYPE the Following:
Enter your Candidate Number above
Type the Tooth Number opposite the
Required Procedure in column three
EXAMINER'S USE ONLY:
Enter evaluation scores as indicated for each of the three
categories.
Excellent 3
Acceptable 2
Deficient 1
Unacceptable 0
|
Case No. |
Required Procedures |
Tooth No. |
Clinical Evaluation, Diagnosis, Treatment Plan |
Treatment, Post Treatment Evaluation |
Complexity |
|
1. |
DIAG |
|
|
|
|
|
2. |
EMERG |
|
|
|
|
|
3. |
MED COMP |
|
|
|
|
|
4. |
NS RCT |
|
|
|
|
|
5. |
NS RCT |
|
|
|
|
|
6. |
NS RCT |
|
|
|
|
|
7. |
NS RCT |
|
|
|
|
|
8. |
NS RCT |
|
|
|
|
|
9. |
RETX |
|
|
|
|
|
10. |
RETX |
|
|
|
|
|
11. |
|
|
|
|
|
|
12. |
|
|
|
|
|
|
13. |
OTHER |
|
|
|
|
|
14. |
OTHER |
|
|
|
|
|
Case Submission Dates May 1 October 1 Portfolios
are accepted for review twice a year – May 1st and October 1st
(portfolios must be received in the Central Office on or before the
current submission date (listed above) to be included in that examination
review cycle). Notebooks received after the current submission date will not
be reviewed until the next submission date provided the candidate’s
eligibility has not expired. |
Portfolio Preparation
Detailed instructions and materials
for the Case History Portfolio are sent from the headquarters office.
Candidates are required to submit documentation of fifteen specific cases (as
outlined in the Case History Evaluation Form) from their specialty practice of
endodontics that demonstrate a broad spectrum of diagnostic, treatment, and
evaluative procedures, and the ability to manage complex clinical
problems at a specialist’s level. The diversity and complexity of the cases
must thoroughly document exceptional knowledge, skill, and expertise in the
specialty of endodontics. Each case should contribute added dimension to the
portfolio. The portfolio should also demonstrate that the Candidate is
practicing the full scope of the specialty of endodontics.
Narrative
The narrative documentation must computer-generated.
It is essential that the narrative
include proper and consistent diagnostic terms, acceptable grammar, and correct
spelling. Data should be arranged in a neat and orderly fashion in proper
alphabetical or numerical sequence. The narrative reports must be complete and
prepared according to instructions. Failure to follow instructions is a
frequent reason for failure. A cover sheet describing routine policies and
procedures and defining abbreviations is permitted. The use of abbreviations is
acceptable but should be limited, especially when sufficient space is available
on the Case History Report Form.
Medical histories for all cases
should document previous and present illnesses, allergies, and medications the
patient is taking. Alterations in your normal treatment regimen should be
explained and justified. Biopsy reports of surgically excised tissue must be included.
It is also recommended that
Candidates be specific in providing clinical diagnoses. Most cases require a
pulpal and a periapical/periradicular diagnosis and both must be provided.
Signs and symptoms are not acceptable as clinical diagnoses. The ABE approved
terminology should be used.
All supportive or supplemental
materials must be masked to prevent identification of the candidate,
institution(s), geographic location, and patient’s name (e.g., pathology
reports, medical lab reports, kodachromes, and photos).
Radiographs
Radiographs/images must be placed in
the order of sequence they were taken. Radiographic/image documentation must be
original and of high quality. Copies of radiographs/images are not permitted. The
case number, Candidate number and all X-ray dates need to be indicated on the
X-ray mount form. Patient names cannot be listed.
It is strongly suggested that a
sufficient number of diagnostic quality radiographs/images be presented for
each case. Proper film/sensor placement, use of altered angulations to permit
visualization of superimposed structures such as canals or roots, and adequate
processing are essential. Xeroradiographs/digital images are acceptable as long
as the above criteria are met. Interim treatment radiographs/images are
suggested but not required. All treated canals must be visible on at least one
postoperative radiograph/image.
Digital
Images
Guidelines for Submission of
Digital Images
Quality and
image clarity of digital images are dependent upon three primary factors:
o
Quality and type of paper,
o
Quality and type of printer,
o
And overall resolution.
Digital
images submitted must be of high diagnostic value, and therefore,
must follow the same guidelines used for evaluation of standard radiographs.
A high-grade paper such as document
quality paper or photo-quality paper (glossy type) provides exceptional
resolution and is required. Thermal
paper, thermal printers, and normal copy paper are not acceptable.
High
quality ink jet printers in conjunction with document or photo quality paper
have proven to be excellent choices for digital images
The individual size of a digital
image should be minimally equivalent to a 2x3 size film but no larger than 5”
by 7”. Images larger than 5” by 7” tend to lose their clarity and detail.
Images can be printed onto 8 ½” x 11” document or photo quality paper or
individually mounted on standard copy paper so long as the mounting medium does
not interfere with the respective image. All digital images must be void of any
identifying information and must be properly dated and coded by case number and
protected with a transparent plastic cover.
Laboratory
and Biopsy Reports
Photocopies of laboratory and biopsy
reports are acceptable. All supplemental reports must be masked to prevent
identification of the Candidate, institution(s), geographic location, and
patient’s name. All information must be in English, if the original document is
not in English, a notarized translation as well as a copy of the original
document must be included.
Recall
Clinical evaluations and recall
radiographs (one year minimum from the date treatment is completed) are
required for each case. The required
one‑year recall must be from the time definitive endodontics was
completed. Cases requiring calcium hydroxide therapy require a one-year
radiograph recall examination following completion (obturation) of root canal
treatment. Cases in the diagnostic category must have an one‑year follow‑up
evaluation regardless of whether endodontic treatment was instituted. The
recall evaluation must include a comprehensive narrative including comments on
any change in the original condition.
Is the Case Complex Enough for Submission
The following requirements are the
basis for scoring
Excellent
Required
the highest level of knowledge and technical skill.
Required
the highest level of patient management.
Treatment
consultations were required.
The
treatment sequence was a critical component.
Acceptable
High
technical skill required.
Adequate patient
management.
Treatment
sequence important but not critical.
Deficient
Routine
diagnostic and technical difficulty requiring average skills.
Unacceptable
The
knowledge and technical skills required were within the scope of the general
dentist.
Reviewing
the Case History Portfolio before submission
It is strongly suggested that prior to submission a thorough
review is completed. Common errors are inconsistent dates. Compare the
dates on the front and back of the Case History Report form, biopsy reports,
radiographs and/or digital images for consistency with each case.
Guidelines for Submission of the
Case History Portfolio
Before
submitting your notebook, try using the following guide to thoroughly review
your notebook, case by case. This can also be performed by someone that is not
a dentist !
Check List
Tooth Identification:
Are the teeth properly identified?
Procedure(s):
Is the
procedure properly recorded?
Is the
subcategory completed for the three “Other” cases?
Chief Complaint:
Is the patient’s chief complaint noted prior
to treatment?
Medical History
Was the
patient’s history or medication record considered?
Is the medical
history adequate?
Is it
documented that appropriate medical consultations were obtained?
Were dental
procedures appropriately modified to meet medical problems?
Are all
medications documented (include dosages, frequency of dosing and the condition
for which the drug is being given)?
Are vital
signs recorded?
Dental History
Is the dental
history comprehensive – does it provide a thorough synopsis of the patient’s
dental history, including symptoms pertinent to the endodontic treatment
Clinical Evaluation (Diagnostic Procedures):
Were the patient’s chief complaint, clinical
signs and symptoms, and general dental condition recorded?
Were reasonable and proper diagnostic tests
and examinations performed?
Were pre-treatment radiographs adequate?
Were radiographic interpretations consistent
with films presented?
Pre-treatment:
Were pulpal and periapical diagnoses
consistent with medical, dental histories and results of diagnostic tests?
Were all essential diagnostic procedures
properly interpreted?