医院口腔科专科医师规范化培训计划

医院口腔科专科医师规范化 口腔科专科医师培训计划 口腔医学是医学的一个分支，又是相对独立于临床医学的一个一级学科，是以维护、促进口腔健康以及防治口腔器官和口颌系统(包括牙及牙周组织、牙槽骨、唇、颊、舌、腭、咽、面部软组织、颌面诸骨、颞下颌关节、涎腺和相关颈部组织等)疾病为主要内容。口腔疾病综合诊治的范围包括牙体牙髓科、牙周科、儿童口腔科、口腔黏膜科、口腔颌面外科、口腔修复科、口腔正畸科、口腔急诊科常见病的诊断和常见治疗技术的应用。按照《中华人民共和国执业医师法》的规定，口腔医学生在本科毕业后经过1年临床实践和参加执业医师考试取得执业医师资格，即可进行口腔科执业，称为口腔科执业医师，即普通口腔科医师。普通口腔科医师在获得口腔执业资格之后，可继续培训2年，第3年末获得普通口腔专科培训合格证，称为普通口腔专科医师。普通口腔专科医师培训通过为期3年的临床技能训练，结合理论知识学习，使受训者基本理论，基本知识和基本技能进一步提高，可为口腔疾病患者提供涉及多专业的综合性诊治服务和.或实施口腔健康一、二、三级预防保健措施。 一、培训目标 通过理论学习和临床实践，进行口腔医学知识和临床技能的基础培训，提高培训对象对口腔各类常见疾病的认识，使之掌握口腔科常见疾病的诊治原则和操作技能，成为胜任普通口腔科临床工作的口腔医学专门人才。 二、培训方法 理论知识以自学和讨论为主，有部分授课;实践技能通过临床科室轮转进行培训。 分科轮转培训时间分配: 牙体牙髓科?6个月。 牙周科?6个月。 儿童口腔科?3个月。 口腔黏膜科?3个月。 口腔颌面外科?6个月。 口腔修复科?6个月。 口腔正畸科?2个月。 口腔颌面影像科?1个月。 or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil 口腔预防科?1个月。 同时累计参加口腔急诊?2个月。 三、培训内容与要求 (一)口腔预防学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学口腔预防学的理论知识，阅读经典著作及相关文献，或参加选修课学习。 (2)临床技能训练:熟悉或初步掌握龋病与牙周疾病等口腔常见病多发病的流行病学调查、预防保健原则与方法;了解口腔健康教育与问卷调查的基本原则和方法。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 预防性充填(包括非创伤性充20 40 填) 局部涂氟 20 40 菌斑控制示范 10 40 菌斑染色 20 40 儿童口腔健康状况调查 6 10 预防咨询 4 10 针对不同病种和个体的系统保4 10 健 (二)牙体牙髓病学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学牙体牙髓病学理论知识，阅读经典著作及相关文献，参加必修课或选修课的学习。 (2)临床技能训练:掌握牙体牙髓病的正确检查方法和病历写，初步掌握牙体牙髓病科常见病、多发病的病因、发病机制、临床表现、诊断和鉴别诊断、治疗原则和处理方法以及充填的选择与应用要点。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil 龋病治疗: 单面各类型龋洞充填 100 200 复面各类型龋洞充填 80 150 前牙光敏树脂充填 30 50 非龋病治疗 15 30 牙髓和根尖病治疗: 活髓保存治疗 5 15 干髓术 1 3 塑化治疗 30 50 前牙根管治疗 60 100 后牙根管治疗 30 60 根尖手术 5 15 (三)牙周病学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学牙周病学理论知识，阅读经典著作及相关文献，参加必修课或选修课的学习(重点在危因、预防、发展趋势、牙周病与全身病的关系———牙周医学、维护期的重要性)。 (2)临床技能训练:掌握牙周病系统检查、病历书写、诊断及危因评估、针对不同患者的个性化设计及治疗方法、菌斑控制的理论及方法、与患者交流的方法。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 全口龈上洁治 120 (手工洁180 (手工洁 治 >20 ) 治 >30 ) 全口龈下刮治 30 60 松牙固定 10 15 治疗(干扰及食物嵌塞等) 15 30 牙周 - 牙髓联合病变 3 5 牙周脓肿 5 8 常见牙龈病的诊断和治疗( ANUG 、白10 20 血病等) or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil 牙周手术 10 15 牙周检查、诊断及综合治疗设计(系统25 40 治疗病例) 菌斑控制的指导(包括对正畸、修复患20 40 者) 参与牙周病修复治疗 1 2 参与牙周病正畸治疗 1 2 (四)儿童口腔病学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学儿童口腔病学的理论知识，阅读经典著作及相关文献，参加必修课或选修课的学习。 (2)临床技能训练:掌握儿童口腔疾病的正确检查方法和病历书写，初步掌握儿童口腔常见病、多发病的病因、发病机制、临床表现、诊断和鉴别诊断、治疗原则和处理方法。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 儿童龋病治疗 药物涂布治疗 30 60 窝沟封闭 60 90 乳前牙充填治疗 30 45 乳磨牙充填治疗 30 40 儿童牙髓和根尖病治疗 乳牙冠髓切断 5 10 乳牙根管治疗 30 50 年轻恒牙根诱导成形 3 5 儿童咬合诱导 丝圈保持器 3 5 儿童前牙外伤处理 3 5 (五)口腔黏膜病学理论知识和临床技能 1.轮转目的 or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil (1)理论知识学习:巩固大学所学口腔黏膜病学的理论知识，阅读经典著作及相关文献，参加必修课或选修课的学习(重点在常见多发的口腔黏膜病)。 (2)临床技能训练: 掌握: 口腔黏膜病的病史采集、检查方法和病历书写，初步掌握口腔黏膜常见病、多发病的病因、发病机制、临床表现、诊断和鉴别诊断、治疗原则和处理方法。复发性溃疡、扁平苔藓、疱疹性口炎、白色念珠菌感染的诊治原则。 熟悉: 慢性唇炎、白斑、天疱疮等疾病的诊治原则。 了解: 某些全身疾病在口腔的表现，如艾滋病、梅毒等。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 复发性口腔溃疡 20 40 扁平苔藓 10 20 疱疹性口炎 3 5 口腔白色念珠菌感染 5 15 慢性唇炎 3 5 白斑 3 5 天疱疮 0 1 其他 10 30 通过小讲课、病例讨论等，加强对罕见病的认识，提高鉴别诊断能力。 (六)口腔颌面外科学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学口腔颌面外科学的理论知识，阅读经典著作及相关文献及相关文献，参加必修课或选修课的学习。 (2)临床技能训练: 掌握: 口腔颌面外科的病史采集、检查方法和病历书写以及各种申请单的正确填写。初步掌握口腔颌面外科常见病、多发病的病因、发病机制、临床表现、诊断和鉴别诊断、治疗原则和处理方法。 熟悉: 口腔颌面外科门诊各项诊疗常规和技术操作常规。 2.临床技能训练量的要求 or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil 完成例数 治疗或操作项目名称 基本要求 较高标准 常见口腔麻醉(传导阻滞、浸润麻醉)200 300 及拔牙 阻生牙、埋伏牙或复杂牙拔除 40 60 牙槽突手术 30 60 各类门诊小手术 30 60 (七)口腔修复学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学口腔修复学的理论知识，阅读经典著作及相关文献，参加必修课或选修课的学习。 (2)临床技能训练: 掌握: 常见修复体的适应证、设计原则及牙体制备的基本要求。 熟悉: 常用修复材料的性能和修复体的制作工序。印模制取、各类修复体戴入及调 等常见问题的处理原则。 了解: 义齿的工艺制作要求。 2.临床技能训练量的要求 治疗或操作项目名称 完成例数 基本要求 较高标准 全口义齿 6 12 单颌总义齿 3 6 可摘局部义齿 30 (含铸造局部义齿 20 (含铸造局部义齿 15 ) 30 ) 烤瓷冠(或全瓷冠) 12 24 烤瓷桥 6 9 后牙铸造冠 15 30 后牙铸造 6 12 桩核(甲)冠 10 15 (八)口腔正畸学理论知识和临床技能 1.轮转目的 or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil (1)理论知识学习:巩固大学所学口腔正畸学的理论知识，阅读经典著作，参加必要的讲座或选修课的学习。 (2)临床技能训练: 1)基本要求:了解错 畸形的病因、分类、诊断和矫治原则;各类矫治器的设计原则及应用。 2)较高标准:在上级医师指导下，熟悉活动矫正器的制作，用活动矫治器矫治简单错 病例1,2例。 在上级医师指导下，进行固定矫治器临床简单操作，包括黏带环、结扎、黏托槽等，用固定矫正器矫治简单错 病例1,2例。 (九)口腔颌面影像学理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学口腔颌面影像学的理论知识，阅读经典著作，参加必修课和选修课的学习。 (2)临床技能训练: 掌握: 常用X线检查片位的正常解剖结构识别及常见颌骨疾病的X线诊断。 了解: 口腔颌面部常见疾病的影像学表现;各类造影检查的操作过程。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 根尖片投照 150 200 阅读常用口腔 X 线片(全景片、华氏>50 >80 位、颧弓切线位、下颌骨正侧位等)、 CT 片 (十)口腔急诊理论知识和临床技能 1.轮转目的 (1)理论知识学习:巩固大学所学口腔医学的理论知识，特别是口腔急症及外伤的理论知识。 (2)临床技能训练: 掌握: 牙体牙髓病、牙周病的急症处理。 熟悉: 儿童口腔病急症处理和口腔颌面部外伤的应急或初步处or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil 理。 了解: 口腔黏膜急症的处理。 2.临床技能训练量的要求 完成例数 治疗或操作项目名称 基本要求 较高标准 牙痛的鉴别诊断及处置 90 150 牙外伤的鉴别诊断及处置 20 40 牙周脓肿的鉴别诊断及处置 15 30 口腔颌面部软硬组织外伤的处置 15 30 口腔颌面部急性炎症的处置 3 10 口腔急性出血的处置 10 20 急性疱疹性口炎的处置 3 6 颞下颌关节脱位的处置 5 10 (十一)口腔病理学理论知识和临床技能 1.掌握龋病、牙周病及牙髓根尖病的病理学表现，了解其发病机制。 2.掌握口腔常见牙源性肿瘤及囊肿、涎腺肿瘤及口腔癌的病理学表现。 3.掌握常见口腔黏膜病的病理学表现、临床特征。 4.掌握口腔组织结构及其发育过程。 5.掌握口腔软组织切片的操作技能、了解各种常见染色的过程及方法。 (十二)掌握口腔科感染控制的理论知识和操作技能 (十三)病例讨论要求 参加多科间病例讨论10次，口腔科综合病例5例(涉及二个以上口腔亚专科疾病的诊断，治疗，例如牙周手术治疗后的修复或正畸治疗及健康维护等)。 (十四)加强心理学、伦理学、法律学理论知识和医德医风的培训，培训医患沟通能力 1.完成1篇病例报告。 2.完成口腔专业英文文献翻译1篇。 or a single tree should be fully in accordance with design drawings to locate, the allowed deviation is 3cm. Group tree planting: shall conform to the design, where the permissible deviations 50cm. Group tree planting site distribution plant: according to general principles of landscape design for 3, 5, 7 for distribution plant, the tree height should be marked on the Center piles. F, tree array of fixed line, must be correct, its line of vertical and horizontal positioning deviation does not exceed 1cm. ? planting holes (pits) excavation. A, planting holes before digging, should take the initiative to understand and hidden laying of underground pipeline to developers and ease of construction. B, point line of the planting hole, slot requirements: (1) the planting hole, slot fixed lines, the design drawings requirements, must be accurate, mark clear. (2) the size of the planting hole, slot, ball diameter according to root, soil and soil conditions may be. Hole must be dug under the vertical, equal to the head at the end, its specification should meet the requirements in the following table: c, planting hole (pit) mining of quality, has a greater impact on plant growth after. In addition to the design and location, according to roots or mud-ball size, soil conditions to determine the point size (should be larger than the root disk, or mud pie 0.25~0.5 m), according to the tree root category to determine points (pit) depth (generally greater root length or thickness of the mud pie 0.2~0.4 meters deep). D, hand-digging planting holes (pits). In fixed-point mark the Center to provide pit (hole) diameter circle on the ground, vertically downward along the circle around the mining to a defined depth. Then pit dug at the end of pine, smoothed. Exposed roots planted seedlings of the pit (point) end of dig in Central make a small mound, Eli root stretch. E, planting soil texture must be loose, protecting water and soil