WREB 2011 - PATP and Perio/Prosth

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selkie

DMD, Class of 2011
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I noticed there aren't any recent threads covering the PATP and Perio/Prosth portions of the WREB.
I'm taking the PATP this Saturday (!!!) and the Perio/Prosth in a couple weeks, so I was hoping there would be some recent graduates or current students that could share their experience on this?

The PATP examples in the Candidate Guide seem simple enough, any common mistakes or major pitfalls I should know about? Anything specific I should study to be prepared? I'm really nervous, so any help is appreciated!!

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For those of you who don't yet have the Candidate Guide, here's some basic info about the PATP:

Examination Overview
The Patient Assessment and Treatment Planning (PATP) examination is a computer simulation exam administered by Pearson VUE testing centers. The exam uses patient case materials provided by WREB. You are allowed ONE HOUR to assess images and patient information and complete and submit a treatment plan for ONE PATIENT. Prior to beginning the exam, you are allowed up to 15 minutes to complete an instructional tutorial describing how best to navigate the exam.

You will be randomly assigned a patient case file which contains:
- A completed Patient Information form
- A completed Patient Medical History
- A completed Periodontal Examination Record, when appropriate
- Radiographic images of the patient's dentition
- Intraoral and extraoral photographs of the patient
- Clinical findings and caries status
- The PATP section of the Candidate Guide WILL be accessible on screen during exam
- Space for recording your Treatment Plan to be submitted for grading

Treatment Plan
You should only consider the patient inforamation presented. Do not presume any findings exist that are not provided or readily discernable. Not every surface of every tooth will be visible on the radiographs and photographs. Pit and fissure caries cannot be explored and should not be assumed present unless obvious cavitation is noted on the patient photographs, or occlusal caries is discernable on the radiographs.

Patient finances are not to be considered in developing a treatment plan for the patient. Pediatric patients should be considered very cooperative for treatment.

Patient compliance is to be considered good, unless otherwise specifically noted in the patient's Medical and Dental History.

The recommended treatment plan must:
- Appropriately address the patient's chief complaint or concern, if any.
- Include appropriate treatment modifications if there are medical or psychological conditions that effect the delivery of dental care to the patient.
- Recommend additional diagnostic tests or specialist referrals as part of the treatment plan, if indicated.
- Contain a comprehensive appropriately sequenced list of procedures that address the patient's dental needs.
- Include the recommendation of an appropriate periodontal maintenance care interval following completion of active treatment.
- Be sufficiently organized to be readily interpreted by Examiners.
 
These samples of correct Treatment Plans are also found in the Candidate Guide.

Sample 1
Treatment Modifications:
Antibiotic Prophylaxis (Amox. 2g. 1hr. prior to procedure), avoid latex
Periodontal Maintenance Care Interval:
3 months
Sequenced Treatment Plan:
#1 EXT (addressing the patient's immediate complaint)
S/RP UR, UL, LL, LR

#14 RCT (retreatment)
#19 RCT

#20 DO Direct Restoration
#3 MO Direct Restoration
#4 MOD Indirect Restoration

#27 F Direct Restoration
#30 MODF Direct Restoration

#12-14 bridge

#18 crown
#19 crown

#29 EXT Refer for implant placement
#32 Refer to oral surgeon

#29 implant and crown

Sample 2
Treatment Modifications:
Avoid Penicillin, Consultation with oncologist re: timing of treatment
Periodontal Maintenance Care Interval:
6 months
Sequenced Treatment Plan:
Prophy

#9 cosmetic contouring (in lieu of restoration) (addressing the patient's chief complaint)

#2 MO Direct Restoration
#6 DL Direct Restoration

#14 OL Direct Restoration
#15 O Direct Restoration

#31 O Direct Restoration

EXT #'s 1, 16, 17, 32

Refer for orthodontic consultation

Sample 3
Treatment Modifications:
Premedication with Amoxicillin (Amox. 2g. 1hr before each appt.)
Periodontal Maintenance Care Interval:
6 months
Sequenced Treatment Plan:
Prophy and Fluoride

#T MO Direct Restoration, band and loop space maintainer
#S EXT

#A MO Direct Restoration
#B SSC and pulpotomy
#C F Direct Restoration

#I SSC and pulpotomy
#J MO Direct Restoration

#K MO Direct Restoration
#L DO Direct Restoration

Refer for evaluation of posterior cross-bite.
 
Hey, Selkie

Thanks for starting this thread. I am planning to take WREB in about 10 months.
I haven't registered or anything but bought the board buster book for WREB since it was only available review book I could find regarding WREB.
I think they cover Prosth/Perio. I have read here somewhere if you studied for part II, you will be fine with computer section of WREB.

Here is the past thread about WREB I had bookmarked before. I hope this helps.

http://forums.studentdoctor.net/showthread.php?t=387927&highlight=WREB

Good luck to you. Come back and share how it went on this thread or PM me.
Thank you!

2Dream
 
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I noticed there aren't any recent threads covering the PATP and Perio/Prosth portions of the WREB.
I'm taking the PATP this Saturday (!!!) and the Perio/Prosth in a couple weeks, so I was hoping there would be some recent graduates or current students that could share their experience on this?

The PATP examples in the Candidate Guide seem simple enough, any common mistakes or major pitfalls I should know about? Anything specific I should study to be prepared? I'm really nervous, so any help is appreciated!!

I think the treatment planning portion is very straightforward. Keep your plan simple but include everything that needs to be there. Address the patient's chief complaint. Order things in the logical sequence.

Don't forget to look for health history issues. Also don't forget to refer out for items that may need a specialists help (OMFS consultation or ortho consultation, etc.). Don't make it harder than it is.

I took the WREB twice, and my second time was the year they included the PATP section. I enjoyed it.
 
Hello!!!!
I am taking the WREB in one month....please an advice would be great....I am reading WREB Buster for the third time, but there's no information about implants...I mean there's one page about it which I think it is not enough since I've heard they are asking overdentures and implants like 15 to 20 questions of it :scared: Anyway, the PATP part it is straight forward as far as I know....PLEASE I accept suggestions of from where and how to study for this test.....Thank you everyone.....:)
 
So I took the PATP last weekend, and it was really very straight-forward! I felt very good about it when I left, and it was so short and sweet. I'm posting this so that you can have the same stress-free experience I did.
So the first thing you should do is breath and relax - this is the kind of thing you've been doing for a couple of years now in your dental school clinic! So much of it will come naturally! The format was just like the examples in the Candidate Guide. So to help you prepare, here's the breakdown of this one hour PATP exam:


  • You show up at least 30 min early for the exam to sign in and be seated. You cannot bring anything in with you, but they supplied me with foam earplugs and the usual noise canceling headset. Also: if you bring someone along for moral support/a ride, they cannot wait for you in the waiting room; they must leave/go out in the hallway/whatever until you are done.

  • Bring two forms of ID (one must be your driver's license). I used my driver's license and a signed ATM/bank credit card. Make sure it is signed on the back. You can also use a Passport as your second ID.

  • They will take your fingerprints electronically and inform you that you must sign in/out this way if you need any bathroom breaks during the exam.
  • Once you're seated, do go through the tutorial. It just saves you time and confusion, and the 15 minutes allotted for the tutorial are not taken out of your one hour exam time.
  • When you begin the exam, you'll be given all the patient's info in the format shown in the 2011 Candidate Guide (Health History, Dental History, Pictures, Radiographs, etc.). These are arranged into tabs, and at the bottom of the screen are three text boxes just as shown in the 2011 Candidate Guide). This will all be very clear to you if you go through the tutorial before beginning.
  • First text box: Treatment modifications (special considerations): This is where you input things like "do not prescribe penicillin", or "avoid latex", or "instruct patient to bring asthma inhaler/nitroglycerin/etc to each appt", or "premedicate with XXX". This is very common sense, just acknowledge any needs you normally would.
  • Second text box: Recommended Maintenance Care Interval: Are you recommending 3 month recalls for your patient? Remember: Once an SRP patient, always a perio-maintencance patient. Can the patient get by with the basic 6 month recall?It's a simple two-word answer: "X months".
  • Third text box: Sequenced Treatment Plan: This is where you provide a treatment plan, making sure it is in the proper sequence!!!
Quick review of sequencing:
-First: Any emergency care - Pulpotomies, Extractions, etc to get the pt out of pain. If the patient isn't in pain, then you'll want to try and address their Chief Concern/Complaint first. This might involve smoothing sharp surfaces of fractured restorations until you can prep a crown/re-restore/etc.
-Second: As with any patient you'd see at your dental school clinic, you want to begin by cleaning the teeth. Specify adult prophy/child prophy + fluoride/SRPs-which quadrants. You do not have to specify OHI (Oral Health Information/Education)- this is assumed. You do have to specifically mention fluoride as this is not assumed. All of this is in the 2011 Candidate Guide which you will recieve once you register for WREB.
-Now sequence Tx needs: As I am not yet a dentist or educator, you should of course double check all of the info I offer (I have personally found a good deal of false info posted on these forums, so be aware!). Information on proper sequencing is not specified in the 2011 Candidate Guide (which is mailed to you once you register for the WREB), but it is obviously beneficial to review and clarify with faculty at your respective dental schools.
Tx is properly (according to me) sequenced as follows:
-Oral Surgery: Extract all non-restorable teeth
-Endo: Complete all RCTs at this point (note that you do not crown these teeth until the very end of tx- this gives you time to be sure that they do not "flare up" in the meantime).
-Operative: For children, Tx plan operative needs one quadrant at a time, rather than how you would treat adults. This includes extractions and all other needs. Again: Treat One Quadrant at a Time. If you get a Pedo patient and need to Tx plan a space maintainer post-extractions: I do not know whether or not you have to specify which type of space maintainer, or simply state "space maintainer". For adults: In general, you want to restore posterior/most decayed teeth first. If you are doing two restorations at once, do not restore two opposing teeth at the same time! With opposing quadrants numb, how can you ensure correct occlusion?
After all direct and indirect restorations are completed, you can now prep any crowns (and implant crowns) the patient needs. Makes sense: have you ever prepped a crown on someone with a mouth full of caries? Nope. Do the crowns last. Even if they represent the deepest caries.
- Prosth: Any FPDs/RPDs/Full Dentures as needed. Note: When Tx planning an RPD (as I did), you must specify three things: which #teeth are being replaced by the RPD, which #teeth have rest seats (and where), which #teeth have clasps (where/what type). Review all of this in the 2011 Candidate Guide. Seriously! It's only a couple pages and you'll feel so much better after you read it for yourself!
-Misc: Note any referals you will need as well: "Refer to Oral Surgeon for extraction of impacted third molar #XX", or "Refer to Oral Surgeon for biopsy of ...", or "Refer to Periodontist for evaluation of cyst-like raised area buccal of implant #XX", or "Refer to Endodontist for RCT of #XX". Put these referrals in your treatment plan at the appropriate times (not at the end just because this is where I mentioned them!).

Above all: Rememer folks: This is just one of five parts of your WREB Examination. It is possible to fail this portion and still pass the WREB, although I highly doubt you will fail the PATP.
Also
: If you reivew pg 80-81 of the 2011 Candidate Guide, you will note that your treatment plan has to actually cause harm/overtreat the patient in order for you to fail even a portion. If you fail any portions, there's still a (very) good chance you'll pass the rest, and therefore pass the PATP, so don't worry!!
******This exam is meant to weed out candidates who would obviously cause harm to patients! The Examiners recognize that there are multiple ways to approach a treatment plan. Don't obsess over reading the Examiners' minds! Just present a properly sequenced treatment plan that does not harm or over-treat the patient! You are going to pass.
 
Hello, I am having extreme difficulty passing the written portion of the WREB, I have already passed the Nerb. Anybody have any old exams questions, materials, where to look. Thank! Taking it in 4 weeks
 
Hi: I took the wreb exam on Dec /2012 and I failed the PErio and Prosth written portion, Do you have any questions or material that can help me to pass?
I really would appreaciate your help,
Thank you:)
 
Hi, I just took my Patp Exam for Wrebs. I wrote everything according to the guide in proper sequence, and addressed chief complaint properly.however there was an tooth that needed an endo( not related to chief complaint ) that i missed. How bad will that affect my score
 
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