Transcript Introduction to operative dentistry,lecture, 31-08-2014

Asalaam Alekum
Dr. Gaurav Garg (M.D.S.)
Lecturer, College of Dentistry
Al Zulfi, MU.
CONTENTS
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Definition
Indications for operative treatment
Operative Procedures
Tooth Preparation
G.V.Black’s classification for caries &
restorations
DEFINITION
• Operative dentistry is the art and science of the diagnosis,
treatment, and prognosis of defects of teeth that do not require full
coverage restorations for correction. (1st)
• Such treatment should result in the restoration of proper tooth form,
function, and esthetics while maintaining the physiologic integrity of
the teeth in harmonious relationship with the adjacent hard and soft
tissues, (2nd)
• all of which should enhance the general health and welfare of the
patient.(3rd)
• Operative Dentistry also known as Restorative Dentistry or
Conservative Dentistry
INDICATIONS FOR
OPERATIVE TREATMENT
1. DENTAL CARIES
Cervical Caries
Pit and fissure Caries
Proximal Caries
1. DENTAL CARIES
• DEFINITION:
 “DENTAL CARIES IS AN INFECTIOUS MICROBIOLOGIC
DISEASE OF THE TEETH THAT RESULTS IN LOCALIZED
DISSOLUTION AND DESTRUCTION OF THE CALCIFIED
TISSUES.”(Sturdevent’s art and science of operative dentistry- 5th
edition)
Dental Caries is the most common disease in the world
2. MALFORMED, DISCOLORED, OR
FRACTURED TEETH
Malformed tooth
Discolored teeth
Fractured tooth
3. WEARING OF TEETH (ATTRITION,
ABRASION, EROSION)
Attrition
Abrasion
Erosion
4. RESTORATION REPLACEMENT
OR REPAIR
OPERATIVE PROCEDURES
Procedures commonly done are:
1. Direct Restorations
2. Indirect restoration
3. Veneers
1. DIRECT RESTORATIONS
• Direct Restoration – After tooth
preparation, the restoration is placed in a
moldable stage in the prepared tooth to
recreate normal contours.
1. DIRECT RESTORATIONS
• Amalgam
• Composite resin
• GIC (Glass ionomer cement).
1. DIRECT RESTORATIONS
Advantages :
 Easy to place
 less time consuming
 Cost effective.
Disadvantages :
 Compromised mechanical properties
 Difficult to create contacts & contours
 Prone to contamination with oral fluids
2. INDIRECT RESTORATIONS
• Indirect Restoration- After tooth preparation, it involves
making of impression, pouring of cast, die preparation,
wax pattern, investing, casting, finishing, polishing and
cementing (or luting) of restoration.
• Restoration is fabricated outside and cemented to
prepared tooth
2. INDIRECT RESTORATIONS
• Inlay
• Onlay
• Crowns (base metal,
precious metal, porcelain
fused to metal, or metal
free ceramic)
2. INDIRECT RESTORATIONS
Advantages Provide better mechanical properties and stress
distribution
 Excellent recreation of Contacts & Contours
 No contamination with oral fluids
Disadvantages Time consuming
 Expensive
 More technique sensitive
3. VENEERS
• Material:
Composite resin (Direct/
Indirect)
Porcelain (Indirect)
TOOTH PREPARATION
 Is the mechanical alteration of a defective, injured or
diseased tooth to receive a restorative material that reestablish a healthy state for the tooth, including esthetic
correction where indicated and normal form and function.
TOOTH PREPARATION
• Purpose of Tooth preparation
- To remove carious or diseased portion of tooth and to
avoid further progression or recurrence of it.
- Caries might have progressed in an irregular shape, but
one must prepare the tooth in an appropriate shape to
obtain best mechanical properties of restorative material
TOOTH PREPARATION
• How is Tooth preparation
done
Hatchet
- With finishing burs attached to slow
speed hand piece (30000 – 40000
rpm) or hand cutting instruments
for finer adjustments
Spoon excavator
- With diamond or TC burs attached
to hand held device called hand
piece at high speed (200000400000 rpm) for gross cutting.
Terminology in Tooth
Preparation
F/B
D
M
L
Line angles & Point angles
Axio-Pulpal line angle
References & Suggested
readings
• Sturdevant's art & science of operative dentistry-4th Edition.Theodore M. Roberson, Harald O. Heymann, Edward J. Swift, Jr.
• Principles of operative dentistry (2005)- A.J.E. Qualtrough, J.D.
Satterthwaite, L.A. Morrow and P.A. Brunton.
• Fundamentals of Operative Dentistry- 2nd Edition- Summitt &
Robbins