Dental Hygiene

Activity type

Scienze dell' igiene dentale

SSD

MED/28

Year

2nd year

Semester

1st semester

CFU

2

Hours distribution

20 classroom hours

Lecturers

UMBERTO ROMEO

Activity type

Scienze dell' igiene dentale

SSD

MED/50

Year

2nd year

Semester

1st semester

CFU

2

Hours distribution

20 classroom hours

Lecturers

MATTEO SACCUCCI

Activity type

Scienze interdisciplinari cliniche

SSD

MED/36

Year

2nd year

Semester

1st semester

CFU

2

Hours distribution

20 classroom hours

Lecturers

DANIELA MESSINEO

The course aims to provide the knowledge related to the special odontostomatological pathology, deepening the different pathologies of odontostomatological interest and the aspects related to the semeiotics and monitoring of the oral cavity.
He also wants to provide basic knowledge on radiology, with particular reference to radiological examinations commonly used in dentistry.
At the end of the course the student will have to recognize, at the level of the oral cavity and radiological examinations, clinical signs of local and systemic pathologies as well as the morphological-functional aspects typical of odontostomatological health.

1. Knowledge and understanding
At the end of the course, students will be expected to:
• Understand the fundamental concepts of pathogenicity, etiology, and mechanisms of onset of the main diseases of the oral cavity.
• Understand the inflammatory, degenerative, dysplastic, and neoplastic processes affecting oral and perioral tissues, and recognize their clinical manifestations and implications in the professional practice of dental hygienists.
• Know the correlations between oral and systemic diseases, and the role of dental hygienists in the prevention and monitoring of pathological conditions.
• Know the physical principles, indications, limitations, and appropriateness of radiological methods in dentistry (intraoral, OPT, CBCT, MR/HFUS basics), including the principles of radiation protection (ALARA/ALADA-IP) and image quality criteria (QA/QC).
• Know the main dental-periodontal radiological patterns, radiographic staging criteria, and bone defects, as well as radiological indications for surgery (periapical lesions, inclusions, supernumerary teeth, paranasal sinuses).
• Understand the basics of structured radiological reporting, dose management, pediatric protocols, and digital workflow (DICOM/PACS).
• Understand the principles of clinical monitoring: definition, classification, self-assessment scales (VAS, NRS, VRS), and key indicators for monitoring the oral cavity, including risk factors, tumor markers, and infectious disease markers.
• Knowledge of semiological techniques (medical history, physical and instrumental semeiotics), including conventional radiology, cytological and culture sampling, vital staining, and chemiluminescence/autofluorescence techniques.
• Understand the role of monitoring in the primary, secondary, and tertiary prevention of mucosal diseases, oral cancer, infections, periodontal diseases, and implant complications.

2. Ability to apply knowledge and understanding
At the end of the course, students will be able to:
• Apply the knowledge acquired to recognize and interpret the signs and symptoms of the main oral diseases.
• Use radiological methods appropriately according to the clinical question, applying the principles of radiation protection and ensuring diagnostic appropriateness.
• Recognize radiographic and clinical patterns to contribute to the multidisciplinary diagnostic process.
• Conduct targeted medical histories, objective examinations, and correctly use semiological techniques for the early detection of pathological alterations.
• Apply indicators and assessment scales for monitoring periodontal, implant, and oncological risk.
• Use monitoring as a primary, secondary, and tertiary prevention tool, integrating clinical, radiological, and laboratory information for patient management.
3. Independent judgment
Students must be able to:
• Critically analyze clinical and radiological pictures, distinguishing between inflammatory, degenerative, dysplastic, neoplastic, and infectious conditions.
• Assess the quality and adequacy of radiological investigations, identifying artifacts, technical errors, and warning signs (“red flags”).
• Formulate reasoned judgments on the appropriateness of further diagnostic investigations and referral to a specialist.
• Evaluate and interpret risk indicators and clinical markers to guide operational and preventive decisions.
• Judge the effectiveness of monitoring protocols and therapeutic strategies, including the evaluation of surgical healing and periodontal or implant stability.
4. Communication skills
Students must be able to:
• Communicate clearly, effectively, and technically correctly with the dental team and the patient.
• Use technical and scientific terminology correctly to describe clinical and radiological conditions.
• Discuss clinical cases in a structured manner, arguing diagnostic and operational choices.
• Use checklists, structured reports, and standardized forms to support interdisciplinary communication.
• Promote proper oral health behaviors and adherence to preventive programs through accessible and professional language.5. Learning skills
5. Learning skills
Students must:
• Demonstrate the ability to independently update their knowledge by consulting guidelines, scientific texts, and evidence-based sources.
• Integrate theory and practice through clinical training, real-life case studies, and simulations.
• Develop a critical and reflective approach to learning, useful for improving their professional practice.
• Become familiar with digital tools and standardized clinical protocols to optimize monitoring and prevention.
• Maintain and expand diagnostic and preventive skills over time, adapting them to scientific and technological advances.

In order to understand the course content and achieve the learning objectives, students must have a basic knowledge of biology, histology, chemistry, and anatomy before beginning the teaching activities included in the course module.

1. Oral mucosal diseases:
• Anatomical and dysembryogenic variants
• Infectious pathogenesis
• Bacterial etiology
• Viral etiology
• Mycotic etiology
• Pigmented lesions (melanotic and non-melanotic lesions)
• Connective tissue lesions (fibrous, vascular, neural lesions)
• Inflammatory with autoimmune pathogenesis
• Potentially malignant epithelial disorders
• Risk factors for oral cavity carcinoma
• Diagnosis of oral cavity tissues
• Drug-related osteonecrosis of the jaws
• Jaw cysts

2. Dental tissue disorders:
• Dental lamina abnormalities
• Odontogenic inflammation

3. Semiological techniques for dental-periodontal and oral mucosa monitoring:
• Medical history: the general method of collecting medical history; types of questions and medical history.
• Physical semiology: objective examination of the oral mucosa and dental-periodontal examination.
• Instrumental semeiotics: conventional dental radiology, sampling for cytological examination; biopsy; sampling for culture and antibiogram; oral and oropharyngeal swabs; vital staining; detection techniques using a light source (chemiluminescence and autofluorescence).
• Monitoring as a tool for preventing oral mucosal diseases:
• monitoring in the primary, secondary, and tertiary prevention of oral cancer; monitoring in the primary, secondary, and tertiary prevention of infectious diseases.
• Monitoring of a therapeutic program.
• Periodontal monitoring and periodontal risk assessment.
• Implant monitoring and implant risk assessment.
• Monitoring of surgical wound healing.

4. Radiological techniques
• Methods: intraoral (paralleling), OPT/cephalometry, CBCT; MR/HFUS overview.
• Image quality, artifacts, QA/QC; roles of hygienist, TSRM, radiologist.
• Radiation protection: ICRP, Legislative Decree 101/2020; ALARA/ALADA-IP appropriateness.
• Radiological patterns in the oral cavity/periodontium; radiographic staging; bone defects.
• Imaging for surgery: periapical lesions, inclusions, supernumerary teeth, paranasal sinuses.
• CBCT: indications/limitations, parameters, voxels, artifacts, dosimetry; reporting principles.
• TMJ and salivary glands: when to indicate imaging; red flags.
• TMJ and salivary glands: when to indicate imaging; red flags.
• Reporting and communication: OPT/intraoral/CBCT checklists; examples of structured reports.
• Case studies: guided reading, recurring errors, group discussion.
• Dose management, pediatric protocols, digital workflow (DICOM/PACS).

In order to complete the exam, it is recommended that students study the theory in depth from the beginning of the course in order to encourage continuity and diligence in their studies from the outset.
The following books are recommended for consultation and further study:


Oral Pathology. Clinical-Pathological Correlations. With online expansion
Joseph A. Regezi, James J. Sciubba, Richard C. Jordan 2018
Publisher: Antonio Delfino Editore ISBN 8872875870

Carranza's Clinical Periodontology, 11th Edition 2011
Newman, Takei, Klokkevold, Carranza Elsevier ISBN 9781437704167


- Annibali S, Pippi R. Physical semeiotics in dentistry. Antonio Delfino Editore, Rome 2002. ISBN 9788872877036

- Pippi R. Semiological techniques for monitoring the oral cavity. Edizioni Universitarie Romane 2015. ISBN 9788860223821

• National/society guidelines on dose optimization and CBCT use; radiation protection regulations
(ICRP; Legislative Decree 101/2020).

The professor delivers lectures in a traditional manner, using audiovisual aids and following the lesson schedule published on the Cds website.

Pursuant to Article 5 of the teaching regulations for the dental hygiene course, students are required to attend CLID teaching and professional training activities. Attendance is verified by teachers using signature sheets/roll calls on updated lists provided by the teaching secretariat in accordance with the provisions of the CCLID, as indicated by the president's office. Proof of attendance at the compulsory teaching activities of a course is required for students to take the relevant exam.

The methods of assessing learning are designed to ensure consistency between the expected learning outcomes and the assessment methods, allowing for the objective and transparent assessment of the knowledge, skills, and abilities developed by the student during the course.
1. Number and type of tests
The final assessment of the course is based on:
• An individual oral exam, the only test that contributes to the overall assessment.2. Objectives of the exam
The oral exam aims to assess:
• Knowledge and understanding of the fundamental concepts of pathogenicity, etiology, and mechanisms of onset of oral diseases, as well as radiological methods and radiation protection (Dublin Descriptor 1 – Bloom: knowledge and understanding).
• Ability to apply knowledge and understanding, with particular attention to the interpretation of clinical signs and symptoms and radiological patterns (Descriptor 2 – Bloom: application).
• Independent judgment in recognizing pathological alterations, evaluating the quality of radiological investigations, and identifying any clinical-diagnostic “red flags” (Descriptor 3 – Bloom: analysis and evaluation).
• Communication skills in presenting content using appropriate technical and scientific language and in discussing clinical and radiological cases (Descriptor 4 – Bloom: synthesis and communication).
• Learning skills, assessing the ability to critically rework content and integrate theoretical and practical knowledge (Descriptor 5 – Bloom: metacognition and autonomous learning).
3. Administration method
• Period: at the end of the teaching period, during the regular exam session.
• Approximate duration: 20–30 minutes per candidate.
• Test structure: interview consisting of theoretical and clinical-application questions, with possible discussion of cases and radiological reports.

4. Type of exam and evaluation criteria
The oral exam evaluates mastery of content and skills according to the following criteria:
• Mastery of theoretical content (0–10 points);
• Ability to apply knowledge and clinical reasoning (0–8 points);
• Independent judgment and critical analysis skills (0–7 points);
• Clarity of presentation and appropriate technical-scientific language (0–5 points).
5. Final assessment of the exam result
• Grade expressed in thirtieths.
• To pass the exam, students must achieve a minimum passing grade in each criterion.
• The overall assessment takes into account the breadth of knowledge, the ability to apply it consistently, independent judgment, and effective communication.
6. Reasons for choosing the assessment method
The oral exam allows for an integrated assessment of all cognitive levels of Bloom's taxonomy:
• it allows for the exploration of knowledge and theoretical understanding;
• it assesses application and clinical reasoning skills;
• it allows for the assessment of independent judgment, communication skills, and learning abilities;
• it guarantees flexibility in exploring specific areas and in modulating the level of questions based on the skills required by the professional profile.

What are the risk factors for oral cancer?
What are the classifications of odontogenic inflammation?
What is used to determine the presence of oral candidiasis?
• ALARA/ALADA-IP principles and a practical example of optimization in CBCT.
• Two radiographic signs to distinguish root cysts from granulomas.

Module: SPECIAL ODONTOSTOMATOLOGICAL PATHOLOGY
N/D
Module: SEMEIOTICS AND MONITORING TECHNIQUES
N/D
Module: SPECIAL ODONTOSTOMATOLOGICAL RADIOLOGY
N/D