The Role of the Manikin Clinic Floor Examiners

Parts II - V: Traditional Format Schedule Candidate Question & Answer Period: It is CRDTS’ preference to conduct the Candidate Q & A in the afternoon (or later) the day before the examination begins. However, in some instances the candidates will be in clinic, on rotation, etc on that day, and it will be necessary to conduct the orientation early in the morning. ©CRDTS,Inc.

Parts II - V: Integrated Format Schedule FIRST PHASE PARTS II & III TIME MANIKIN 8:00 Group A (B) Setup 8:30 8:30 – 12:30 Prosthodontics 1:00 1:00 – 4:00 Endodontics 4:00 EXAM STOPS ©CRDTS,Inc.

Parts II & III: Manikin-based Endodontics & Fixed Prosthodontics Exams CANDIDATES TIME ASSIGNMENT As scheduled in Group Assignment 8:00 A.M. to 8:30 A.M. 8:30 A.M. to 12:30 P.M. 12:30 P.M. to 12:45 P.M. 1:00 P.M. to 4:00 P.M. 4:00 P.M. to 4:15 P.M Part III: Fixed Prosthodontic Examination Set-Up and Starting Checks Fixed Prosthodontic Procedures (4.0 hours) Dismantle and turn in fixed prosthodontic modules Part II: Endodontic Examination Endodontic Examination Procedures (3.0 hours) Dismantle and turn in endodontic modules ©CRDTS,Inc.

FLEX-TIME SCHEDULE Time blocks have been designated for each portion of the manikin procedures: 4 hours for the Prosthodontic Exam 3 hours for the Endodontic Exam Should candidates complete their prosthodontic procedures early, they can take a short break and then begin their endodontic procedures A Clinic Floor Examiner will assign a three-hour start and finish time. Beginning endodontic procedures early does NOT increase the maximum time allowed as indicated above. Each CFE should have a CFE Manikin Flexible Timing Sheet on which they can record and monitor start and finish times for the candidates they are supervising Only available until 12:30 PM Time blocks have been designated for each portion of the manikin procedures: 4 hours for the Prosthodontic Exam 3 hours for the Endodontic Exam Should candidates complete their prosthodontic procedures early, they can take a short break and then begin their endodontic procedures A Clinic Floor Examiner will assign a three-hour start and finish time. Beginning endodontic procedures early does NOT increase the maximum time allowed as indicated above. Each CFE should have a CFE Manikin Flexible Timing Sheet on which they can record and monitor start and finish times for the candidates they are supervising. ©CRDTS,Inc.

CFE Flexible Timing Sheet CFE MANIKIN FLEXIBLE TIMING SHEET CFE Flexible Timing Sheet ©CRDTS,Inc.

EXAMINER RECORDING FORM Accurately record any appropriate penalties on the Examiner Recording Form and confirm it with another Clinic Floor Examiner. Notation of only ONE violation is allowed on each Examiner Recording Form. Applicable Penalties for the Manikin Exam Include: Professional Demeanor Infection Control Improper Operator/Manikin Position Violation of Examination Guidelines Treatment of teeth/surfaces not assigned by examiners The CFE records a grade ONLY when a candidate fails to demonstrate acceptable performance. Applicable Penalties for the Manikin Exam Include: Professional Demeanor Infection Control Improper Operator/Manikin Position Violation of Examination Guidelines Treatment of teeth/surfaces not assigned by examiners When filling out a Recording Form, the CFE writes the candidate ID number, checks the boxes indicating what the candidate is doing at the time the violation occurred, and then marks the appropriate deficiency in the candidate's performance. If the violation is observable by another person, it should be verified by a second CFE. ©CRDTS,Inc.

MANIKIN PROGRESS SHEETS Be sure the Candidate # is in the Upper Right Corner of Progress Sheets Test Site # in Upper Left Corner Test Site # 391 Notes on the candidate’s Progress Sheet should be made in blue or black ink, and examiners should sign all Progress Sheets with their examiner number. ©CRDTS,Inc.

PROSTHODONTIC PROCEDURES

PROSTHODONTIC PROCEDURES Tooth #9 –for Ceramic Crown preparation. Fixed Prosthodontic Section - The candidate must prepare #3 for a full cast gold crown, #5 for a porcelain-fused-to-metal crown and #9 for a full ceramic crown. The proper teeth to be treated are printed on the candidate’s Progress Sheet. No equilibration is permitted prior to or during either crown preparation. Defective Teeth: e.g., bubbles in tooth, should be graded without bias, ignoring the defect. Candidates are instructed to ignore the minor “chips” and any color changes. They should prep to the criteria and not to variations. Tooth #5 – for Porcelain-Fused-to-Metal preparation Tooth #3 – for Cast Gold Crown preparation. ©CRDTS,Inc.

Beginning the Prosthodontic Procedures At 8:00 AM, the prosthodontic modules should be distributed. Candidates will be instructed to engrave their candidate number on the lingual surface of the two prosthodontic modules, and then fill the carrier trays with six prosthodontic modules, including the two modules provided by CRDTS. The candidate must then notify the CFE that they are ready to proceed. The CFE must verify that: the correct prosthodontic modules are in place the prosthodontic modules bear CRDTS’ security color (lighter color), the crown preparation modules are engraved with the candidate number the prosthodontic typodont is correctly mounted the occlusion is acceptable. The CFE must sign the Progress Form to indicate that the typodont mounting has been approved. The endodontic modules will remain in the candidate’s box until the Prosthodontic Examination is concluded and the prosthodontic modules have been collected by the CFE. Shortly before 8:00 on the morning of the exam, the CFE’s must distribute the boxes with the candidates’ ID label on it containing their prosthodontic modules. The candidates should be reminded to engrave their candidate number on the lingual surface of all modules. The candidates may mount their prosthodontic modules in the carrier trays and be ready to begin promptly at 8:30. ©CRDTS,Inc.

Anterior Matrix The anterior matrix should extend gingivally to cover the gingival shroud on both facial and lingual surfaces and extend from tooth #’s 7 to 11. The matrix should be sectioned facio-lingually over the center of the prepared tooth which will yield 2 separate pieces; the candidate number will be recorded on both pieces of the matrix.  The examiners will use the anterior matrix to establish incisal and lingual fossa reduction. Candidates are required to construct putty matrix to determine incisal & lingual fossa reduction. However they MUST do so during the examination, not during set up. ©CRDTS,Inc.

Anterior Matrix The matrix should be sectioned facio-lingually over the center of the prepared tooth which will yield 2 separate pieces. ©CRDTS,Inc 13

Posterior Matrix Candidates will fabricate a polyvinyl siloxane (PVS) putty matrix during the exam, prior to the crown preparations. The matrix should extend gingivally to cover the gingival shroud on both buccal and lingual surfaces and include one complete tooth (2nd molar) posterior to the complete cast gold molar preparation and one complete tooth (upper cuspid) anterior to the PFM preparation. The matrix should be sectioned bucco-lingually over the center of each prepared tooth which will yield 3 separate pieces. All three sections must have the cand. # inscribed Candidates are required to construct a putty matrix to determine occlusal wall reduction. However they MUST do so during the examination, not during set up. ©CRDTS,Inc.

Posterior Matrix Incorrect Correct In order to correctly measure the reduction of the occlusal wall, the matrix must be completely seated to its full position. ©CRDTS,Inc. 15

Posterior Matrix These matrices will be used to establish appropriate occlusal reduction, and must be submitted with the examination modules for evaluation. Examiners will use only this matrix when evaluating occlusal reduction. ©CRDTS,Inc.

Concluding the Prosthodontic Procedures When the crown preparations are completed, the candidate must request permission to dismantle the typodont. The CFE must verify that: prior to dismantling the typodont, the CFE must verify that there is no damage to teeth in the contralateral maxillary module the prosthodontic modules bear CRDTS’ security color (lighter color) the candidate number is engraved on the lingual surfaces of the modules and all pieces of the putty matrices the endodontic modules (if present) are removed from the box and the proper prosthodontic modules are placed in the in the candidate’s box the Progress Form is properly identified. the finish time of the Pros Exam is recorded on the box, e.g., P- 11:30 the finish time has been recorded on the Flexible Timing sheet the candidate’s box with the completed prosthodontic modules are picked up to be stored in a central area until the endodontic exam has been completed. When the crown preparations are completed, the candidate must request permission to dismantle the typodont. The CFE must verify that: prior to dismantling the typodont, the CFE must verify that there is no damage to teeth in the contralateral maxillary modules the prosthodontic modules bear CRDTS’ security color (lighter color), the candidate number is engraved on the lingual surfaces of the modules, and the Progress Sheet is properly identified. Ensure prosthodontic modules are placed in properly labeled box and the Progress Sheet returned to the candidate’s packet if the grading is to be done off-site. ©CRDTS,Inc.

Wrong Tooth Treated CRDTS will require candidates provide undamaged teeth for the UL (13-15) module prior to beginning the examination. Prior to dismantling, the CFE will check the UL (13-15) module in the maxillary arch for any damage due to the candidate starting the wrong tooth. If CFE confirms the wrong tooth has been started, the damaged module will be confiscated and CRDTS will provide the candidate with a replacement module. The CFE should note “Wrong Tooth Treated” in the comments section of the Progress Sheet and complete an Examiner Recording Form with “Treatment of teeth/surfaces not approved or assigned by examiners” marked. Prior to dismantling, the CFE will check the UL(13-15) module in the maxillary arch for any damage due to the candidate starting the wrong tooth. ©CRDTS,Inc.

Dismantling Prosthodontic Typodont 391 The CFE must check and make sure that there is no contralateral tooth damage on any other modules prior to authorizing/signing dismantling of the typodont. ©CRDTS,Inc.

Endodontic Procedures Endodontic Section - The candidate will complete a full endodontic treatment on #8 and an access opening on #14 typodont teeth mounted in endodontic modules. The module for endodontic tooth #14 must be etched on the lingual surface with the candidate’s number. The endodontic treatment procedures must be performed under rubber dam, and the dam for each procedure must be removed at the completion of treatment.

Beginning the Endodontic Procedures Prior to issuing the endodontic modules, the CFE’s should verify that all #8 teeth have a visible endodontic canal. The CFE’s will then distribute the endodontic tooth #8 and fully seat the Breakaway Insert containing # 14 into the posterior endodontic module. The CFE must verify that: both endodontic modules are engraved with the candidate number the working length of #8 has been measured the correct endodontic modules have been mounted in the carrier trays The CFE must insert #8 into the typodont and initial the Progress Form. Do not overtighten the set screw, as it may cause the screw mount to come out. If this should happen glue it back in. If tooth #8 should become loose, instruct the candidates to contact the CFE. The candidate must not attempt to dismantle and tighten the screw. The CFE will instruct the candidate to remove the typodont from the mounting. The CFE will then retighten the screw and instruct the candidate set back up and continue treatment. As a general rule, this is a very short process and does not warrant additional time on the examination. ©CRDTS,Inc.

INSERTING #8 Acadental ModuPROTM The candidate can measure the anterior endodontic tooth, place it in the socket, then call a CFE to tighten the set screw with a screw-driver. Do not overtighten the set screw, as it may loosen the mounting. Tooth #8 The CFE must secure endodontic tooth #8 in the module with a set screw and sign the Progress Sheet with their Examiner number and initials. DO NOT OVERTIGHTEN THE SET SCREW; you may loosen the metal sleeve. If the sleeve comes loose and there is not a substitute module available, resecure it with Superglue and allow sufficient time for it to set. DO NOT GLUE THE TOOTH INTO THE SOCKET; it will be impossible to remove and evaluate it. ©CRDTS,Inc.

MODULES FOR ENDODONTIC PROCEDURES Tooth #8 – for Anterior Endodontic procedure. The Posterior Endodontic Module should have the #14 insert in place by the CFE prior to mounting in the typodont. Simply place the insert into the module, seat the insert with positive pressure and it is ready to load into the carrier tray. Tooth #14– for Posterior Endodontic procedure. ©CRDTS,Inc.

TOOTH #8 MEASUREMENT 391 The CFE must check and make sure that the candidate # is recorded in the upper right corner and Test Site in the left corner of the Progress Sheet. The CFE checks the mounting and occlusion of the typodont and signs the Progress Sheet. ©CRDTS,Inc.

ENDODONTIC EXAMINATION Separate rubber dams must be applied for #8 and #14. Circulate throughout the clinic at all times during the endodontic examination. Make periodic announcements during the day advising candidates of time restraints and procedures. If no canal or pulp chamber are present, note it on the Progress Form and the candidate will be given a score of Minimally Acceptable Note the defect on Candidate box Separate rubber dams must be applied for #8 and #14. In order to avoid avulsion, the endodontic tooth should NOT be clamped. Rotary instruments are permissible for the endodontic exercise. The candidate has been advised to notify the CFE if a broken endodontic file cannot be retrieved from the canal. If it’s feasible, the candidate may leave the endo file in the canal, obturate and submit the treatment for evaluation. For the endodontic exam, if the CFE is positive that the candidate is in the correct location with no canal orifice present, then a note is made on the progress sheet and the candidate is given a score of ACC (Minimally Acceptable). The CFE will note the defect on the candidate box should sectioning or additional documentation be required at a later date. ©CRDTS,Inc.

Concluding the Endodontic Examination When the endodontic treatment has been completed, the candidate must request permission to dismantle the typodont. The CFE must collect both endodontic modules and verify that: prior to dismantling the typodont, the CFE must verify that there is no damage to teeth in the contralateral maxillary module both of the endodontic modules bear CRDTS’ security color (lighter color), candidate number is engraved on the lingual surface of both endodontic modules the correct endodontic modules have been placed in the candidate’s box ( box retrieved from the central location/cart prior to check out) the Progress Form is properly identified. the finish time of the Endo Exam has been recorded on the candidate’s box, e.g., E- 3:30 the finish time is transferred to the Flexible Timing sheet The CFE will not remove #8; it will remain in the anterior endodontic module provided by CRDTS. The candidate will remove the module with # 8 and the module with #14, and turn them in along with the Progress Form. The CFE must verify the correct module has been turned in and initial the endodontic Progress Form. The candidate must then clean their operatory and leave the clinic area. When the endodontic treatment has been completed, the candidate must request permission to dismantle the typodont. The CFE must verify that: the endodontic modules with #’s 8 & 14 bear CRDTS’ security color (lighter color), the candidate number is engraved on the lingual surface of the modules there is no damage to teeth in contralateral posterior module the Progress Sheet is properly identified Candidate will remove both endodontic modules with #8 and #14 in place. Ensure endodontic modules are placed in properly labeled box and the evaluation forms should be returned to the candidate’s packet if the grading is to be done off-site. If grading is being done on-site, the box with modules and the Progress Form must be taken to the grading area If grading is being done on-site, the endodontic material and any forms should be taken to the Evaluation Station. If the grading is being done off-site, the Progress Form and any penalty forms should be filed/kept together; the endodontic modules for #8 and #14 should be checked and placed in the candidate’s labeled box along with the other modules; then the box containing both endodontic and prosthodontic modules must be taped shut and returned to the trunk. ©CRDTS,Inc.

Packing up modules – place matrix back on modules to pack in bags/boxes

Dismantling Endodontic Typodont 391 The CFE must check and make sure that there is no contralateral tooth damage on any other modules prior to authorizing/signing dismantling of the typodont. ©CRDTS,Inc.

Wrong Tooth Treated CRDTS will require candidates provide undamaged teeth for the UR(2-6) module prior to beginning the examination. Prior to dismantling, the CFE will check the UR(2-6) module in the maxillary arch for any damage due to the candidate starting the wrong tooth. If CFE confirms the wrong tooth has been started, the damaged module will be confiscated and CRDTS will provide the candidate with a replacement module. The CFE should note “Wrong Tooth Treated” in the comments section of the Progress Sheet and complete an Examiner Recording Form with “Treatment of teeth/surfaces not approved or assigned by examiners” marked. Prior to dismantling, the CFE will check the UR(2-6) module in the maxillary arch for any damage due to the candidate starting the wrong tooth. ©CRDTS,Inc

PEER EVALUATION & FEEDBACK FORMS It is the responsibility of all Examiners to complete the Peer Evaluation, Expense & Feedback Forms online. It is the responsibility of all Clinic Floor Examiners to complete the Peer Evaluation Forms with his/her evaluation of the performance of each team member. ©CRDTS,Inc.

IMPORTANT POINTS TO REMEMBER Report for your assignment on time. Review Manual/Examiner materials thoroughly. Be sure to have all essential materials and supplies for conducting the Manikin Examination. Avoid unnecessary conversation with Candidates. Never teach, instruct or give personal opinions. Always maintain an air of professionalism in the clinic as well as in the school proper. Be a good team member. Maintain security of all examination materials. Should an occasion arise that prohibits you from accepting an assignment, notify the Central Office as soon as possible. Unauthorized early departure, by an Examiner, is strictly prohibited. ©CRDTS,Inc.