Fellowship Examination Overview
These study notes are designed for candidates preparing for the Fellowship Examination (FE-2) as offered by Dental Conquer. The notes are anchored to official sources including the GDC Overseas Registration Exam (ORE), RCS England Licence in Dental Surgery (LDS), and GDC Standards for the Dental Team. They provide instructional content across six core subjects, focusing on entry-to-practice knowledge and clinical decision-making. Candidates should verify specific exam dates, fees, and eligibility with the official bodies.
For Dental Conquer practice planning, this module is tracked as 80 questions over about 120 minutes with a listed pass mark of 70%. Treat those numbers as practice baselines and verify the current official format before scheduling.
How This Guide Is Organized
The sections below turn the syllabus into studyable subject blocks. Read a subject first, explain the must-know ideas without notes, then use questions and flashcards to test whether the knowledge holds under pressure.
- Advanced Restorative Dentistry and Biomaterials
- Comprehensive Periodontal Therapy and Implantology
- Endodontic Diagnosis and Microsurgical Techniques
- Oral Medicine, Pathology, and Pharmacotherapeutics
- Pediatric Dentistry and Orthodontic Interception
- Practice Management and Ethical Jurisprudence
Exam Snapshot and Readiness Target
Format: 80 questions, 120 minutes, pass mark 70% (practice baseline; verify official pass mark)
Candidate level: Entry-to-practice for licensure/admission exams
Readiness target: Competent foundation in restorative, periodontal, endodontic, oral medicine, pediatric dentistry, and practice management
Most candidates should budget at least 38+ focused study hours, then adjust upward for unfamiliar clinical systems, regulatory content, or specialty-level case reasoning.
Advanced Restorative Dentistry and Biomaterials
Syllabus Focus
- Direct and indirect restorations
- Biomaterials properties and selection
- Adhesive dentistry
- Aesthetic considerations
- Tooth preparation principles
Key Notes
- Understand the classification of restorative materials: metals, ceramics, composites, and glass ionomers. Each has specific indications based on strength, wear resistance, and aesthetics.
- Adhesive dentistry relies on the hybrid layer formation; etch-and-rinse vs. self-etch systems have different bonding mechanisms and technique sensitivities.
- Indirect restorations (crowns, inlays, onlays) require adequate occlusal reduction (e.g., 1.5-2 mm for all-ceramic crowns) and margin placement considerations (supragingival vs. subgingival).
- Biocompatibility of materials is critical; e.g., resin composites may cause pulpal irritation if placed without adequate liner in deep cavities.
- Caries management includes risk assessment, minimally invasive techniques, and material selection based on lesion depth and location.
Must Know
- Classification of cavity preparations (Black's classification) and modifications for adhesive restorations.
- Properties of dental amalgam: high compressive strength, creep, corrosion, and contraindications (e.g., allergy, aesthetic concerns).
- Ceramic materials: feldspathic, leucite-reinforced, lithium disilicate, and zirconia - indications and cementation protocols.
- Bonding to dentin: smear layer management, wet bonding vs. dry bonding, and the role of primers and adhesives.
Clinical and Exam Application
- When selecting a restorative material for a posterior tooth, consider occlusal load, caries risk, and aesthetic demand. For high caries risk, consider glass ionomer or resin-modified glass ionomer.
- For a fractured cusp, assess remaining tooth structure; if >50% remains, consider direct composite; if less, consider cuspal coverage with an indirect restoration.
- In adhesive cementation of a lithium disilicate crown, use a total-etch adhesive system and a dual-cure resin cement to ensure optimal bond strength.
High-Yield Distinctions
- Amalgam vs. composite: amalgam has better wear resistance and longevity in high-stress areas but lacks adhesion; composite requires strict moisture control.
- Glass ionomer vs. resin composite: glass ionomer releases fluoride and bonds chemically but has lower wear resistance; composite has better aesthetics and polishability.
- Etch-and-rinse vs. self-etch: etch-and-rinse provides stronger bond to enamel but technique-sensitive; self-etch reduces postoperative sensitivity but weaker enamel bond.
Common Pitfalls
- Inadequate isolation during composite placement leading to contamination and bond failure.
- Over-reduction of tooth structure for all-ceramic crowns, risking pulpal exposure.
- Using a high-viscosity glass ionomer in a high-stress area without adequate occlusal support.
Review Tasks
- Review the steps of a Class II composite restoration, including matrix band placement and proximal contouring.
- Practice identifying material types from clinical photographs and radiographs.
- Study the chemical composition and setting reactions of dental cements (zinc phosphate, polycarboxylate, glass ionomer, resin).
Comprehensive Periodontal Therapy and Implantology
Syllabus Focus
- Periodontal disease classification
- Non-surgical and surgical therapy
- Implant placement and maintenance
- Peri-implant diseases
- Risk assessment
Key Notes
- Periodontal disease is classified by staging (severity) and grading (risk of progression) according to the 2018 World Workshop classification.
- Non-surgical therapy includes scaling and root planing (SRP) with adjunctive antimicrobials; effectiveness depends on pocket depth and biofilm control.
- Surgical therapy (e.g., flap surgery, bone grafting) is indicated for residual pockets ≥5 mm after SRP, furcation involvement, or for regenerative procedures.
- Implant success depends on bone quality and quantity, primary stability, and prosthetic design. Osseointegration requires a healing period of 3-6 months.
- Peri-implant mucositis and peri-implantitis are inflammatory conditions; treatment involves mechanical debridement, antimicrobials, and possibly surgical intervention.
Must Know
- Periodontal probing: normal sulcus depth ≤3 mm; bleeding on probing indicates inflammation.
- Indices: plaque index, gingival index, bleeding index, and clinical attachment level (CAL).
- Implant components: fixture, abutment, crown; types of implant-abutment connections (external hex, internal hex, conical).
- Contraindications to implant therapy: uncontrolled diabetes, heavy smoking, bisphosphonate therapy (risk of MRONJ), and poor oral hygiene.
Clinical and Exam Application
- For a patient with generalized chronic periodontitis (Stage III, Grade B), initial therapy includes full-mouth SRP with oral hygiene instruction. Reevaluate at 6-8 weeks; if pockets >5 mm persist, consider surgical therapy.
- When placing an implant in the posterior maxilla, assess sinus pneumatization; if insufficient bone height, consider sinus lift procedure.
- For peri-implantitis with bone loss >2 mm, treatment may include mechanical debridement with titanium curettes, chlorhexidine irrigation, and possibly resective or regenerative surgery.
High-Yield Distinctions
- Chronic vs. aggressive periodontitis: chronic has slow progression with local factors; aggressive has rapid attachment loss and familial pattern.
- Gingivitis vs. periodontitis: gingivitis is reversible with no attachment loss; periodontitis involves irreversible attachment loss and bone loss.
- Peri-implant mucositis vs. peri-implantitis: mucositis is reversible inflammation without bone loss; peri-implantitis includes bone loss.
Common Pitfalls
- Failing to assess risk factors (smoking, diabetes) before implant placement, leading to higher failure rates.
- Inadequate maintenance recall for implant patients; peri-implantitis can develop silently.
- Using metal instruments on implant surfaces causing scratches that harbor bacteria.
Review Tasks
- Review the 2018 periodontal classification system and apply it to case scenarios.
- Practice interpreting periodontal charts and radiographs for bone loss patterns.
- Study implant surgical protocols: flap design, osteotomy preparation, and torque values.
Endodontic Diagnosis and Microsurgical Techniques
Syllabus Focus
- Pulpal and periapical diagnosis
- Root canal anatomy
- Cleaning and shaping
- Obturation techniques
- Microsurgical endodontics
Key Notes
- Pulpal diagnosis categories: normal pulp, reversible pulpitis, irreversible pulpitis, pulp necrosis. Periapical diagnosis: normal, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess, chronic apical abscess.
- Root canal anatomy varies by tooth; knowledge of common variations (e.g., MB2 in maxillary molars, C-shaped canals in mandibular molars) is essential.
- Cleaning and shaping aims to remove pulp tissue, bacteria, and debris while maintaining canal morphology. Use of rotary files with appropriate taper and apical preparation size.
- Obturation should create a fluid-tight seal; gutta-percha with sealer (e.g., AH Plus) is standard. Techniques: cold lateral compaction, warm vertical compaction, carrier-based.
- Microsurgical endodontics (apicoectomy) is indicated when conventional retreatment fails or is not possible; uses ultrasonic tips for root-end preparation and MTA for root-end filling.
Must Know
- Diagnostic tests: percussion, palpation, cold test (e.g., Endo-Ice), electric pulp tester, and radiographic interpretation.
- Working length determination: electronic apex locator and radiograph; confirm 0.5-1 mm short of radiographic apex.
- Irrigation protocols: sodium hypochlorite (0.5-5.25%) as main irrigant, EDTA for smear layer removal, chlorhexidine as final rinse.
- Complications: ledge formation, perforation, instrument separation, and hypochlorite accident.
Clinical and Exam Application
- A patient presents with spontaneous pain and prolonged response to cold; diagnosis is irreversible pulpitis. Treatment: root canal therapy or extraction.
- During retreatment of a maxillary first molar, search for a second mesiobuccal canal (MB2) using an ultrasonic troughing technique and magnification.
- For a tooth with a large periapical lesion that does not heal after retreatment, consider apical microsurgery with root-end resection and MTA filling.
High-Yield Distinctions
- Reversible vs. irreversible pulpitis: reversible has sharp pain to cold that subsides quickly; irreversible has lingering pain.
- Acute apical abscess vs. chronic: acute presents with swelling, pain, and systemic signs; chronic is often asymptomatic with a sinus tract.
- Warm vertical compaction vs. cold lateral: warm provides better adaptation to canal irregularities but more technique-sensitive.
Common Pitfalls
- Incorrect working length leading to over- or under-instrumentation.
- Insufficient irrigation volume or concentration failing to disinfect the canal system.
- Missed canals, especially MB2 in maxillary molars and middle mesial in mandibular molars.
Review Tasks
- Review root canal anatomy diagrams for all teeth, including variations.
- Practice step-by-step root canal treatment on extracted teeth or simulation models.
- Study the indications and steps for endodontic microsurgery.
Oral Medicine, Pathology, and Pharmacotherapeutics
Syllabus Focus
- Oral mucosal diseases
- Oral cancer and premalignancy
- Systemic diseases with oral manifestations
- Pharmacology in dentistry
- Medical emergencies
Key Notes
- Oral mucosal diseases include lichen planus (reticular, erosive), pemphigus vulgaris, and erythema multiforme. Diagnosis often requires biopsy and immunofluorescence.
- Oral cancer risk factors: tobacco, alcohol, HPV (oropharyngeal). Premalignant lesions: leukoplakia, erythroplakia, and oral submucous fibrosis.
- Systemic diseases with oral manifestations: diabetes (periodontitis, xerostomia), HIV (candidiasis, hairy leukoplakia), and autoimmune disorders (Sjögren's syndrome).
- Pharmacology: local anesthetics (lidocaine, articaine), analgesics (NSAIDs, acetaminophen, opioids), antibiotics (amoxicillin, clindamycin), and antifungals (nystatin, fluconazole).
- Medical emergencies: syncope, allergic reaction, hypoglycemia, and cardiac arrest. Management includes basic life support and emergency drugs (epinephrine, glucose, oxygen).
Must Know
- Classification of white lesions: leukoplakia (potentially malignant), lichen planus (immune-mediated), frictional keratosis (benign).
- Red lesions: erythroplakia (high malignant potential), geographic tongue (benign), and erythematous candidiasis.
- Local anesthetic maximum doses: lidocaine 2% with epinephrine 1:100,000 - 7 mg/kg; articaine 4% with epinephrine - 7 mg/kg.
- Antibiotic prophylaxis for infective endocarditis: amoxicillin 2 g PO 1 hour before procedure for at-risk patients (e.g., prosthetic valve, history of endocarditis).
Clinical and Exam Application
- A patient presents with a non-healing ulcer on the lateral border of the tongue for 3 weeks. Perform a biopsy to rule out squamous cell carcinoma.
- For a patient with oral lichen planus, prescribe topical corticosteroids (e.g., clobetasol 0.05% gel) for symptomatic lesions.
- During a dental procedure, a patient becomes pale and loses consciousness. Place in supine position, assess ABCs, and administer oxygen. If hypoglycemia suspected, give oral glucose if conscious.
High-Yield Distinctions
- Leukoplakia vs. oral lichen planus: leukoplakia is a clinical diagnosis with risk of malignant transformation; lichen planus has characteristic Wickham striae and is immune-mediated.
- Herpes simplex vs. aphthous ulcers: herpes is vesicular, contagious, and often on keratinized mucosa; aphthous ulcers are painful, non-contagious, and on non-keratinized mucosa.
- Acute vs. chronic candidiasis: acute pseudomembranous (thrush) presents with white plaques that scrape off; chronic atrophic (denture stomatitis) presents as erythema under dentures.
Common Pitfalls
- Misdiagnosing a traumatic ulcer as malignant without biopsy if it persists beyond 2 weeks.
- Overprescribing antibiotics for viral infections (e.g., herpes) leading to resistance.
- Failing to recognize signs of anaphylaxis (urticaria, wheezing, hypotension) and delaying epinephrine administration.
Review Tasks
- Review the WHO classification of odontogenic tumors and cysts.
- Practice identifying oral lesions from clinical photographs and describing their features.
- Study the dental management of patients on anticoagulants (e.g., warfarin, DOACs) and bisphosphonates.
Pediatric Dentistry and Orthodontic Interception
Syllabus Focus
- Child development and behavior management
- Caries management in children
- Pulp therapy in primary teeth
- Space maintenance and interceptive orthodontics
- Trauma management
Key Notes
- Behavior management techniques: tell-show-do, positive reinforcement, distraction, and protective stabilization. Pharmacological methods include nitrous oxide and conscious sedation.
- Caries risk assessment in children: use tools like Caries-risk Assessment Tool (CAT) and consider diet, fluoride exposure, and oral hygiene.
- Pulp therapy for primary teeth: indirect pulp capping, direct pulp capping, pulpotomy (formocresol, ferric sulfate, MTA), and pulpectomy.
- Space maintenance: indications include premature loss of primary molars; use band-and-loop or lingual arch depending on arch and tooth lost.
- Interceptive orthodontics: manage habits (thumb sucking, tongue thrust), crossbites, and crowding. Serial extraction may be indicated for severe crowding.
Must Know
- Eruption sequence of primary and permanent teeth: primary teeth erupt from 6 months to 2.5 years; permanent teeth from 6 to 12 years.
- Fluoride recommendations: systemic (water fluoridation, supplements) and topical (toothpaste, varnish). Optimal fluoride level in water: 0.7 ppm.
- Trauma classification: Ellis classification for crown fractures (Class I: enamel, Class II: dentin, Class III: pulp).
- Avulsion management: replant immediately, hold by crown, rinse if dirty, and splint for 7-10 days. Prognosis depends on extraoral time and storage medium.
Clinical and Exam Application
- For a 4-year-old with deep caries in a primary molar, perform a pulpotomy using MTA and restore with a stainless steel crown.
- A 7-year-old loses a primary first molar prematurely; place a band-and-loop space maintainer to prevent space loss.
- For a 9-year-old with anterior crossbite due to dental trauma, consider a simple fixed appliance (e.g., 2x4 appliance) to correct the crossbite.
High-Yield Distinctions
- Primary vs. permanent tooth morphology: primary teeth have thinner enamel, larger pulp chambers, and more bulbous crowns.
- Pulpotomy vs. pulpectomy: pulpotomy removes coronal pulp only (indicated for vital pulp); pulpectomy removes all pulp (for necrotic pulp).
- Stainless steel crown vs. composite strip crown: SSC is more durable for primary molars; composite is aesthetic for anterior teeth.
Common Pitfalls
- Underestimating the need for behavior management, leading to uncooperative child and treatment failure.
- Failing to assess for non-nutritive sucking habits that may cause open bite or crossbite.
- Incorrectly diagnosing a tooth as non-vital when it is a normal exfoliation.
Review Tasks
- Review the AAPD guidelines on pulp therapy for primary teeth.
- Practice space maintainer design and indications for different scenarios.
- Study the management of dental trauma using the IADT guidelines.
Practice Management and Ethical Jurisprudence
Syllabus Focus
- Dental practice regulations
- Ethical principles and GDC standards
- Consent and confidentiality
- Complaints handling
- Health and safety
Key Notes
- GDC Standards for the Dental Team outline nine principles: put patients' interests first, communicate effectively, obtain valid consent, maintain and develop knowledge and skills, etc.
- Consent must be informed, voluntary, and specific. For minors, parental consent is required; for adults lacking capacity, follow Mental Capacity Act.
- Confidentiality: patient information must be kept secure; disclosure only with consent or when required by law (e.g., child protection, public health).
- Complaints handling: have a written complaints procedure, acknowledge within 3 days, investigate, and respond within 10 working days (NHS) or as per practice policy.
- Health and safety: COSHH regulations, infection control (HTM 01-05), radiation protection (IR(ME)R), and waste disposal.
Must Know
- GDC Standards principle 1: put patients' interests first - includes treating with dignity, respecting choices, and providing care in a safe environment.
- Valid consent: patient must have capacity, be given sufficient information (risks, benefits, alternatives), and consent freely without coercion.
- Dental records: must be accurate, contemporaneous, and stored securely. Include medical history, treatment plan, consent, and notes of each visit.
- Regulatory bodies: GDC (UK), CQC (England), NHS (for NHS patients). Know the roles and reporting requirements.
Clinical and Exam Application
- Before extracting a tooth, explain the risks (e.g., dry socket, nerve injury) and alternatives (e.g., root canal treatment). Document the discussion and obtain written consent.
- If a patient complains about a failed restoration, follow the practice complaints procedure: listen, apologize if appropriate, offer to review, and arrange corrective treatment if needed.
- When treating a child, ensure parent/guardian is present and consents. For a Gillick-competent child, involve them in decision-making.
High-Yield Distinctions
- GDC Standards vs. CQC regulations: GDC sets professional standards for individuals; CQC regulates practice premises and services.
- NHS vs. private practice: NHS has specific contracts and patient charge bands; private practice has more flexibility in fees and treatment options.
- Dental negligence vs. breach of GDC standards: negligence is a legal claim; breach of standards may lead to fitness to practise proceedings.
Common Pitfalls
- Failing to obtain written consent for invasive procedures, leading to legal issues.
- Inadequate record-keeping, e.g., not recording verbal consent or treatment discussions.
- Not following infection control protocols, risking cross-infection and regulatory action.
Review Tasks
- Read the GDC Standards for the Dental Team document in full.
- Practice writing a consent form for a common procedure (e.g., extraction).
- Review the steps for handling a patient complaint according to GDC guidance.
How To Use These Notes With Practice Questions
Do not jump straight from reading to a full mock. Work by subject first: review the key notes, make a short recall sheet from memory, then answer a focused question set. After each miss, decide whether the problem was missing knowledge, poor clinical sequencing, weak source-rule recall, or a distractor you failed to eliminate.
Dental Conquer's question bank, flashcards, mind maps, and spaced review tools are most useful after this instruction layer because they reveal which parts of the notes are not yet retrievable.
Final Review Checklist
- Revisit the GDC Standards for the Dental Team and ensure you can apply each principle to clinical scenarios.
- Review the 2018 periodontal classification and be able to stage and grade cases.
- Practice interpreting radiographs for caries, periodontal bone loss, and periapical pathology.
- Memorize local anesthetic maximum doses and management of medical emergencies.
- Understand the differences between primary and permanent tooth treatment approaches.
- Be familiar with the complaints handling process and record-keeping requirements.
Official Sources and Further Reading
Use these sources as the final authority for format, eligibility, rules, and exam updates. Study notes are a preparation layer, not a replacement for official candidate guidance.