Operative Dentistry Viva questions. To help you revise your syllabus for examination.
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Dr. Almas Muhammad Arshad
Dr. Muaaz Amjad
DR. SWARNEET KAKPURE (DEPT OF CONSERVATIVE DENTISTRY AND ENDODONTICS)
THE TOPIC PRESENTED IN SEMINAR COVERS ALMOST ALL THE ASPECTS OF COMPLEX AMALGAM RESTORATIONS INCLUDING PIN RETAINED,SLOT RETAINED AMALGAM RESTORATIONS,CEMENTED,FRICTION LOCKED & SELF THREADING PINS, TMS SYSTEM,AMALGAM FOUNDATIONS ALONG WITH TECHNIQUES OF INSERTION AND MATRIX PLACEMENT.
This document provides an overview of endodontics. It defines endodontics as the branch of dentistry concerned with the morphology, physiology, and pathology of the dental pulp and periradicular tissues. The scope of endodontics includes treating diseases of the pulp, such as pulpal inflammation and infection, through both nonsurgical and surgical root canal treatment and periradicular surgery. Pathogenesis is discussed, noting that while physical and chemical factors can induce inflammation, microbial infection is essential for progression of pulpal and periradicular disease. Routes of canal infection and the focal infection theory are also summarized.
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
This document compares and contrasts microabrasion and macroabrasion techniques for treating tooth discoloration. Microabrasion involves using a paste of hydrochloric acid and pumice or silicon carbide to dissolve and abrade the enamel surface. It is a conservative treatment that removes only superficial stains. Macroabrasion uses diamond or carbide burs to remove defects at a faster rate but with less control than microabrasion. Both techniques can improve the appearance of teeth affected by conditions like fluorosis but microabrasion allows for better control and more conservative removal of tooth structure.
This document provides an overview of endodontic surgery. It begins with a brief history of endodontic surgery dating back over 1500 years. It then discusses the definition, rationale, objectives, and indications for endodontic surgery. The document outlines the classification of endodontic surgery and describes various surgical procedures like periradicular surgery, root-end resection, and root-end filling. It provides details on surgical instruments, treatment planning considerations, and techniques for achieving profound local anesthesia. In summary, the document provides a comprehensive review of the principles and procedures involved in endodontic surgery.
Teeth don’t possess regenerative ability found in most other tissues. Therefore, once enamel & dentin are lost as a result of caries, trauma or wear, restorative material must be used, to reestablish form & function.
Teeth require preparation to receive restoration & these preparations must be based on fundamental principles, which are discussed in this presentation, from which basic criteria can be developed to help predict the success of prosthodontic treatment.
This document discusses the importance of circumferential tie and bevels in dental preparations. It defines different types of bevels such as partial, short, long, full, counter, and hollow ground bevels. It also discusses different extensions used in preparations like flares, skirts, collars, and their indications. The ideal requirements of peripheral margins and factors affecting bevel angle are explained. Bevel placement in teeth with facets and their importance in cast restorations is also summarized.
DR. SWARNEET KAKPURE (DEPT OF CONSERVATIVE DENTISTRY AND ENDODONTICS)
THE TOPIC PRESENTED IN SEMINAR COVERS ALMOST ALL THE ASPECTS OF COMPLEX AMALGAM RESTORATIONS INCLUDING PIN RETAINED,SLOT RETAINED AMALGAM RESTORATIONS,CEMENTED,FRICTION LOCKED & SELF THREADING PINS, TMS SYSTEM,AMALGAM FOUNDATIONS ALONG WITH TECHNIQUES OF INSERTION AND MATRIX PLACEMENT.
This document provides an overview of endodontics. It defines endodontics as the branch of dentistry concerned with the morphology, physiology, and pathology of the dental pulp and periradicular tissues. The scope of endodontics includes treating diseases of the pulp, such as pulpal inflammation and infection, through both nonsurgical and surgical root canal treatment and periradicular surgery. Pathogenesis is discussed, noting that while physical and chemical factors can induce inflammation, microbial infection is essential for progression of pulpal and periradicular disease. Routes of canal infection and the focal infection theory are also summarized.
This presentation specifically deals with the maxillary and mandibular Major connectors used in a cast partial denture. it also mentions the uses, advantages and disadvantages of each,
This document compares and contrasts microabrasion and macroabrasion techniques for treating tooth discoloration. Microabrasion involves using a paste of hydrochloric acid and pumice or silicon carbide to dissolve and abrade the enamel surface. It is a conservative treatment that removes only superficial stains. Macroabrasion uses diamond or carbide burs to remove defects at a faster rate but with less control than microabrasion. Both techniques can improve the appearance of teeth affected by conditions like fluorosis but microabrasion allows for better control and more conservative removal of tooth structure.
This document provides an overview of endodontic surgery. It begins with a brief history of endodontic surgery dating back over 1500 years. It then discusses the definition, rationale, objectives, and indications for endodontic surgery. The document outlines the classification of endodontic surgery and describes various surgical procedures like periradicular surgery, root-end resection, and root-end filling. It provides details on surgical instruments, treatment planning considerations, and techniques for achieving profound local anesthesia. In summary, the document provides a comprehensive review of the principles and procedures involved in endodontic surgery.
Teeth don’t possess regenerative ability found in most other tissues. Therefore, once enamel & dentin are lost as a result of caries, trauma or wear, restorative material must be used, to reestablish form & function.
Teeth require preparation to receive restoration & these preparations must be based on fundamental principles, which are discussed in this presentation, from which basic criteria can be developed to help predict the success of prosthodontic treatment.
This document discusses the importance of circumferential tie and bevels in dental preparations. It defines different types of bevels such as partial, short, long, full, counter, and hollow ground bevels. It also discusses different extensions used in preparations like flares, skirts, collars, and their indications. The ideal requirements of peripheral margins and factors affecting bevel angle are explained. Bevel placement in teeth with facets and their importance in cast restorations is also summarized.
Endodontic surgery is performed to address issues like failed root canal treatments, procedural errors, anatomical variations, and biopsies. It involves raising a surgical flap, resecting the root tip, preparing and filling the root end cavity. Potential complications include swelling, pain, nerve damage and infection. A variety of materials can be used for the root end filling including zinc oxide eugenol cements, MTA, composites and glass ionomer cements. The goal is to provide an apical seal to prevent reinfection from microbes remaining in the root canal system.
The document provides information on traumatic injuries to teeth, including concussions, luxations, and fractures. It describes the clinical signs, radiographic findings, and treatment approaches for each type of injury. Concussions involve inflammation of the periodontal ligament without tooth displacement. Luxations occur when a tooth is displaced from its socket, sometimes with alveolar bone fractures. Fractures are classified as enamel fractures, enamel-dentin fractures, enamel-dentin-pulp fractures, or root fractures. Treatment depends on the specific injury but may include repositioning displaced teeth, pulpotomies, root canals, extractions, or orthodontic/surgical repositioning.
The document discusses various aspects of root canal obturation including definitions, purposes, techniques, and materials. Obturation involves filling and sealing the cleaned and shaped root canal using gutta-percha and a sealer. The goals are to achieve a fluid-tight seal, prevent microleakage and reinfection. Common techniques include cold lateral compaction, warm vertical compaction using heat carriers, continuous wave compaction, and thermoplasticized gutta-percha injection. Carrier-based techniques like Thermafil and SimpliFill are also described. Key factors for treatment success include absence of preoperative lesions, void-free fillings, obturation within 2mm of the apex, and adequate coronal restoration
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
This document discusses pin-retained amalgam restorations for teeth with extensive caries or fractures. It describes the advantages as conserving tooth structure and providing increased resistance and retention compared to cast restorations. Potential disadvantages include dentinal microfractures, microleakage, and decreased amalgam strength. Factors that affect pin retention such as pin type, size, orientation, and number are examined. Guidelines for cavity preparation and pin placement based on tooth anatomy and pulp location are provided. Common problems and their solutions are also outlined.
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
This document discusses the posterior palatal seal, including its definition, function, anatomical considerations, techniques for recording it, and potential errors. The key points are:
1. The posterior palatal seal provides retention, stability, and prevention of air leakage for maxillary dentures.
2. It is located along the junction of the hard and soft palate and extends from the pterygoid hamulus on either side.
3. Special techniques like using indelible pencil and having the patient say "AH" are used to identify and record the seal area during impression making.
This document provides an overview of surveying and surveying tools used in the process of designing removable partial dentures (RPDs). It discusses the history and development of surveying, types of surveyors, principles of surveying including survey lines and path of insertion. The document outlines the step-by-step survey process including orienting the cast, tilting, marking survey lines, measuring undercuts, identifying interferences, and tripoding the cast for future reference. Various surveying tools such as the analyzing rod, carbon marker, undercut gauges, and wax trimmers are also described.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Pit and fissure sealants are materials used to protect deep grooves and depressions on teeth from cavities. They are applied to the chewing surfaces of back teeth where plaque and food easily get trapped. Sealants work by creating a physical barrier over the pits and fissures that prevents bacteria from entering and causing decay. Proper application requires cleaning, etching, and drying the tooth surface before precisely applying the sealant material. Sealants should be checked regularly and reapplied when worn down to continue protecting teeth from cavities in the pits and fissures.
The document discusses various techniques for cleaning and shaping the root canal system during endodontic treatment. It describes the objectives and basic principles of root canal preparation, including removing debris and maintaining the original shape of the canal. Several techniques are summarized, such as step-back, crown-down, balanced force, and ultrasonic instrumentation. For each technique, the document outlines the steps and discusses advantages and disadvantages.
This document discusses various types and classifications of posts used in restoring endodontically treated teeth. It describes custom cast posts and prefabricated metallic and non-metallic posts. Metallic posts discussed include stainless steel, titanium, and fiber posts made of carbon, glass or quartz. The advantages and disadvantages of different post types are provided. Active and passive posts as well as parallel and tapered posts are also summarized. The document stresses the importance of a thorough pretreatment evaluation involving endodontic, periodontal, biomechanical and anatomic factors when determining the best post and core treatment strategy.
The document discusses common failures of dental amalgam restorations. It states that while amalgams initially perform well, over time technical issues can lead to fracture, recurrent caries, discoloration and corrosion. Failures are often due to faulty cavity preparation, poor matrix adaptation, or improper amalgam manipulation. Specifically, inadequate extension or retention forms during cavity preparation increase risks of secondary caries and fracture. Contamination or delayed condensation of amalgam can also weaken restorations.
This document discusses extraction techniques for primary and permanent teeth in children. It notes key differences in primary versus permanent teeth that impact extraction, such as root shape and size. Techniques are described for different types of teeth, including use of smaller forceps designed for primary teeth and expanding the socket more due to widely-splayed primary molar roots. Management of buried teeth and potential post-operative complications are also outlined. The importance of pre-operative preparation and instructions for the child and parent are emphasized.
This document discusses provisional restorations, including their definition, purpose, requirements, and fabrication methods. Provisional restorations are interim prostheses used for a limited time after tooth preparation until a permanent restoration can be placed. They protect the prepared tooth, maintain function and aesthetics, and allow the dentist to assess treatment. Ideal provisionals have biologic requirements like pulp protection and positional stability, mechanical requirements like strength and retention, and aesthetic requirements like color matching. They can be custom-made using various resin or metal materials or prefabricated. Direct, indirect, and combined fabrication techniques are described.
The document discusses diseases of the dental pulp. It begins with an introduction to the pulp, including its composition and role in tooth development. It then discusses the pathophysiology of pulpal disease, describing how noxious stimuli can lead to inflammation and necrosis by disrupting blood flow. Several classifications of pulpal diseases are presented, including those based on histopathology, clinical symptoms, and the World Health Organization framework. Etiological agents are explored, such as mechanical trauma, thermal or chemical insults, bacterial invasion, and idiopathic causes. Specific pulpal diseases like reversible and irreversible pulpitis are also mentioned.
The presentation depicts in a very simplified manner the steps of cavity preparation and restoration of class 3 and class 5 composite restoration. It is well supported with illustrations that further provide a better understanding of the topic.
RBBs are resin-bonded bridges that are a minimally invasive option for replacing missing teeth. They are suitable for short spans of missing teeth when the patient is unwilling or unsuitable for surgery. Key factors in determining if a tooth can support an RBB include adequate size, minimal restoration, healthy periodontium, and proper angulation. The bridge design depends on factors like coverage, number of abutments, and framework rigidity. With careful case selection and attention to detail, RBBs can successfully replace missing teeth for select patients.
Fiber reinforced concrete (FRC) is concrete containing fibrous material which increases its structural integrity. This document discusses FRC, including its history, types of fibers used, applications, and mechanical properties. It also provides a case study comparing the effects of straight and hooked steel fibers on properties like workability, strength, and toughness. The study found that hooked fibers had better dispersion and increased flexural strength, toughness, and energy absorption compared to straight fibers. In conclusion, the document provides a detailed overview of FRC and how fiber type and content can influence its mechanical behavior.
Endodontic surgery is performed to address issues like failed root canal treatments, procedural errors, anatomical variations, and biopsies. It involves raising a surgical flap, resecting the root tip, preparing and filling the root end cavity. Potential complications include swelling, pain, nerve damage and infection. A variety of materials can be used for the root end filling including zinc oxide eugenol cements, MTA, composites and glass ionomer cements. The goal is to provide an apical seal to prevent reinfection from microbes remaining in the root canal system.
The document provides information on traumatic injuries to teeth, including concussions, luxations, and fractures. It describes the clinical signs, radiographic findings, and treatment approaches for each type of injury. Concussions involve inflammation of the periodontal ligament without tooth displacement. Luxations occur when a tooth is displaced from its socket, sometimes with alveolar bone fractures. Fractures are classified as enamel fractures, enamel-dentin fractures, enamel-dentin-pulp fractures, or root fractures. Treatment depends on the specific injury but may include repositioning displaced teeth, pulpotomies, root canals, extractions, or orthodontic/surgical repositioning.
The document discusses various aspects of root canal obturation including definitions, purposes, techniques, and materials. Obturation involves filling and sealing the cleaned and shaped root canal using gutta-percha and a sealer. The goals are to achieve a fluid-tight seal, prevent microleakage and reinfection. Common techniques include cold lateral compaction, warm vertical compaction using heat carriers, continuous wave compaction, and thermoplasticized gutta-percha injection. Carrier-based techniques like Thermafil and SimpliFill are also described. Key factors for treatment success include absence of preoperative lesions, void-free fillings, obturation within 2mm of the apex, and adequate coronal restoration
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
This document discusses pin-retained amalgam restorations for teeth with extensive caries or fractures. It describes the advantages as conserving tooth structure and providing increased resistance and retention compared to cast restorations. Potential disadvantages include dentinal microfractures, microleakage, and decreased amalgam strength. Factors that affect pin retention such as pin type, size, orientation, and number are examined. Guidelines for cavity preparation and pin placement based on tooth anatomy and pulp location are provided. Common problems and their solutions are also outlined.
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
This document discusses the posterior palatal seal, including its definition, function, anatomical considerations, techniques for recording it, and potential errors. The key points are:
1. The posterior palatal seal provides retention, stability, and prevention of air leakage for maxillary dentures.
2. It is located along the junction of the hard and soft palate and extends from the pterygoid hamulus on either side.
3. Special techniques like using indelible pencil and having the patient say "AH" are used to identify and record the seal area during impression making.
This document provides an overview of surveying and surveying tools used in the process of designing removable partial dentures (RPDs). It discusses the history and development of surveying, types of surveyors, principles of surveying including survey lines and path of insertion. The document outlines the step-by-step survey process including orienting the cast, tilting, marking survey lines, measuring undercuts, identifying interferences, and tripoding the cast for future reference. Various surveying tools such as the analyzing rod, carbon marker, undercut gauges, and wax trimmers are also described.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Pit and fissure sealants are materials used to protect deep grooves and depressions on teeth from cavities. They are applied to the chewing surfaces of back teeth where plaque and food easily get trapped. Sealants work by creating a physical barrier over the pits and fissures that prevents bacteria from entering and causing decay. Proper application requires cleaning, etching, and drying the tooth surface before precisely applying the sealant material. Sealants should be checked regularly and reapplied when worn down to continue protecting teeth from cavities in the pits and fissures.
The document discusses various techniques for cleaning and shaping the root canal system during endodontic treatment. It describes the objectives and basic principles of root canal preparation, including removing debris and maintaining the original shape of the canal. Several techniques are summarized, such as step-back, crown-down, balanced force, and ultrasonic instrumentation. For each technique, the document outlines the steps and discusses advantages and disadvantages.
This document discusses various types and classifications of posts used in restoring endodontically treated teeth. It describes custom cast posts and prefabricated metallic and non-metallic posts. Metallic posts discussed include stainless steel, titanium, and fiber posts made of carbon, glass or quartz. The advantages and disadvantages of different post types are provided. Active and passive posts as well as parallel and tapered posts are also summarized. The document stresses the importance of a thorough pretreatment evaluation involving endodontic, periodontal, biomechanical and anatomic factors when determining the best post and core treatment strategy.
The document discusses common failures of dental amalgam restorations. It states that while amalgams initially perform well, over time technical issues can lead to fracture, recurrent caries, discoloration and corrosion. Failures are often due to faulty cavity preparation, poor matrix adaptation, or improper amalgam manipulation. Specifically, inadequate extension or retention forms during cavity preparation increase risks of secondary caries and fracture. Contamination or delayed condensation of amalgam can also weaken restorations.
This document discusses extraction techniques for primary and permanent teeth in children. It notes key differences in primary versus permanent teeth that impact extraction, such as root shape and size. Techniques are described for different types of teeth, including use of smaller forceps designed for primary teeth and expanding the socket more due to widely-splayed primary molar roots. Management of buried teeth and potential post-operative complications are also outlined. The importance of pre-operative preparation and instructions for the child and parent are emphasized.
This document discusses provisional restorations, including their definition, purpose, requirements, and fabrication methods. Provisional restorations are interim prostheses used for a limited time after tooth preparation until a permanent restoration can be placed. They protect the prepared tooth, maintain function and aesthetics, and allow the dentist to assess treatment. Ideal provisionals have biologic requirements like pulp protection and positional stability, mechanical requirements like strength and retention, and aesthetic requirements like color matching. They can be custom-made using various resin or metal materials or prefabricated. Direct, indirect, and combined fabrication techniques are described.
The document discusses diseases of the dental pulp. It begins with an introduction to the pulp, including its composition and role in tooth development. It then discusses the pathophysiology of pulpal disease, describing how noxious stimuli can lead to inflammation and necrosis by disrupting blood flow. Several classifications of pulpal diseases are presented, including those based on histopathology, clinical symptoms, and the World Health Organization framework. Etiological agents are explored, such as mechanical trauma, thermal or chemical insults, bacterial invasion, and idiopathic causes. Specific pulpal diseases like reversible and irreversible pulpitis are also mentioned.
The presentation depicts in a very simplified manner the steps of cavity preparation and restoration of class 3 and class 5 composite restoration. It is well supported with illustrations that further provide a better understanding of the topic.
RBBs are resin-bonded bridges that are a minimally invasive option for replacing missing teeth. They are suitable for short spans of missing teeth when the patient is unwilling or unsuitable for surgery. Key factors in determining if a tooth can support an RBB include adequate size, minimal restoration, healthy periodontium, and proper angulation. The bridge design depends on factors like coverage, number of abutments, and framework rigidity. With careful case selection and attention to detail, RBBs can successfully replace missing teeth for select patients.
Fiber reinforced concrete (FRC) is concrete containing fibrous material which increases its structural integrity. This document discusses FRC, including its history, types of fibers used, applications, and mechanical properties. It also provides a case study comparing the effects of straight and hooked steel fibers on properties like workability, strength, and toughness. The study found that hooked fibers had better dispersion and increased flexural strength, toughness, and energy absorption compared to straight fibers. In conclusion, the document provides a detailed overview of FRC and how fiber type and content can influence its mechanical behavior.
The document discusses fiber reinforced concrete (FRC). It provides a brief history of FRC, noting that fibers were initially asbestos but have since been replaced by steel, glass, and synthetic fibers. The document defines FRC as concrete containing fibers, water, aggregate, and cement. It discusses the types and benefits of fibers, including improved ductility and crack resistance. The document also examines factors that influence FRC properties such as fiber volume, aspect ratio, orientation. It provides examples of FRC applications and concludes that FRC improves energy absorption and can reduce costs compared to conventional concrete.
This presentation gives a brief introduction on FRC's history, definition and why is it used. Types of FRC's and it's applications is explained in detail in later stages.Also, it covers various properties that affects FRC and a Case study in end.
This document discusses restorative and esthetic dentistry. It describes conditions that require restorative treatment like decay, worn tooth structure, and discoloration. It outlines principles of cavity preparation including establishing resistance and retention forms. It also describes components of a typical restorative procedure and different types of dental restorations including class I-V, complex restorations, and direct bonded veneers.
AI and Machine Learning Demystified by Carol Smith at Midwest UX 2017Carol Smith
What is machine learning? Is UX relevant in the age of artificial intelligence (AI)? How can I take advantage of cognitive computing? Get answers to these questions and learn about the implications for your work in this session. Carol will help you understand at a basic level how these systems are built and what is required to get insights from them. Carol will present examples of how machine learning is already being used and explore the ethical challenges inherent in creating AI. You will walk away with an awareness of the weaknesses of AI and the knowledge of how these systems work.
Esthetic crowns in pediatric dentistry.pptxgahanamuthamma
Esthetic crowns are used in pediatric dentistry to restore teeth damaged by decay in a way that preserves function and improves appearance. There are various types of crowns including strip crowns made of composite, pre-veneered stainless steel crowns, polycarbonate crowns, and ceramic crowns. Indications include extensive decay, fractures, discoloration or pulp therapy. Contraindications include non-restorable teeth. Placement involves tooth preparation and selection of an appropriately sized crown, which is then bonded or cemented onto the prepared tooth.
Acquired diseases of teeth, Dental materials and Dental radiography in small ...GangaYadav4
This document discusses various dental diseases and conditions seen in small animals including dental caries, calculus, enamel hypoplasia, endodontic disease, tooth fractures, periodontal disease, tooth resorption, luxations, swellings, tumors, and dental materials and radiography. It provides details on the pathogenesis, clinical findings, diagnosis, and treatment of each condition in 2-3 concise sentences. Dental radiography is described as a vital diagnostic tool that requires general anesthesia and uses intraoral film and dental machines to obtain diagnostic images of the teeth and surrounding structures.
This document discusses the construction and design of removable partial dentures (RPDs). It begins by outlining treatment options for edentulous spaces, including fixed bridges, complete dentures, transitional dentures, and implant-supported prosthetics. It then describes the process of constructing an RPD, including taking impressions, designing the framework with saddles, connectors, and retainers, investing and casting the metal framework, setting teeth, and finishing the acrylic. Key aspects like support, retention, and combining RPDs with fixed prosthetics are also summarized.
Basic principles of caries treatment as manifested in cavity preparationSaeed Bajafar
This document discusses the principles of caries treatment and cavity preparation. It outlines how treatment differs based on lesion depth - shallow lesions may remineralize with hygiene, while deep lesions require invasive procedures. Cavity preparation considers lesion location/size, remaining tooth structure, and restorative material. Techniques are described for establishing outline, resistance, retention and convenience forms. Moderate lesions have dentin involvement but not pulp exposure, while deep lesions approximate the pulp. Options for deep caries include temporary fillings, pulp capping or removal. Indirect and direct pulp capping techniques aim to maintain pulp vitality and promote remineralization.
Restoration of endodontically treated teethSanket Pandey
Seminar on restoration of endodontically treated tooth.
Credits to Cohen, Ingle, Respected researchers for their research in this field.
and everyone who previously tried to make a good presentation using the research work.
The document discusses various types of full coverage restorations for primary anterior teeth including stainless steel crowns with composite facings, composite strip crowns, polycarbonate crowns, New Millennium crowns, Kudos crowns, Pedo jacket crowns, and Artglass crowns. It describes the materials, advantages, disadvantages, and placement techniques for each type of crown. Stainless steel crowns with composite facings combine strength, durability and improved aesthetics but take longer to place. Composite strip crowns provide good aesthetics but are technique sensitive. Polycarbonate crowns and Kudos crowns are more durable alternatives that are easier to place than composite strip crowns.
Temporization or Provisional Restorationssuseraf61fb
This document discusses temporization and provisional restorations. It begins by outlining the ideal requirements for provisional restorations, including biological, mechanical, and material requirements. It then classifies provisional restorations based on method of fabrication (custom made vs preformed), type of material used (resin-based vs metal), duration of use (short term vs long term), and technique for fabrication (direct vs indirect vs direct-indirect). Specific materials that can be used are described, like polycarbonate, cellulose acetate, and metals. The direct technique for fabricating an anterior polycarbonate provisional restoration is demonstrated through figures. Limitations of direct provisional restorations are also outlined.
Apexogenesis & apexification in pediatric dentistryDr. Harsh Shah
SDDCH Parbhani
Presented by : Vipul GIratkar
Dept. of Pediatric dentitstry
Guided by . Dr. Rehan Khan
DIscussion regarding apexification and apexogenesis
This document discusses various types of crowns used in pediatric dentistry to restore primary teeth. It begins by introducing the need for aesthetic full coverage restorations in children. It then describes several types of crowns in detail, including their indications, advantages, disadvantages, and placement techniques. The crowns discussed are stainless steel, open-faced steel, polycarbonate, composite strip, pre-veneered steel, and NuSmile crowns. For each type, the document outlines the specific technique for tooth preparation and crown cementation or bonding. The goal of discussing these various crown options is to help pediatric dentists select the best restoration for primary teeth based on factors like aesthetics, durability, and technique sensitivity.
Restoration of endodontically treated teeth.Anish Amin
provides an overview of restoring endodontically treated teeth using posts and cores. It discusses the historical background of posts and describes characteristics of teeth that have undergone endodontic treatment. Key points include that these teeth often have reduced strength and require special considerations for retention and resistance. The document outlines indications for posts and cores, principles of preservation of tooth structure and providing retention and resistance. It also describes methodologies for various steps of the post and core procedure.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
Restoration of endodontically treated teethAnish Amin
Restoration of endodontically treated teeth often requires posts and cores to provide adequate retention and resistance for weakened teeth. Key principles for posts and cores include preserving tooth structure, maximizing retention through post length and design, and providing resistance through features like ferrules. Posts and cores are indicated when there is significant loss of coronal tooth structure and the risk of fracture is high. The amount of remaining tooth structure, presence of a ferrule, and post length and design all influence the success of a post and core restoration.
This document discusses different methods for treating dental caries lesions based on their severity. Shallow lesions can be treated through improved oral hygiene, while deep lesions require more invasive procedures. Treatment options for moderate lesions include removing carious dentin and applying protective medicaments before restoring. For deep lesions, options are emergency treatment, indirect pulp capping by sealing questionable dentin, direct pulp capping for exposed pulps, or endodontic treatment. Both direct and indirect pulp capping aim to preserve the pulp but have varying prognosis depending on the exposure and pulp health.
This document discusses bone grafting techniques used in dentistry. It defines a graft as viable tissue transplanted from a donor site to a host tissue. Bone grafts are classified based on their source and mode of action. Autografts from the patient are considered the gold standard as they are osteogenic, osteoinductive, and osteoconductive. Key steps in the bone grafting procedure are incision, flap design, root debridement, defect debridement, graft material preparation and placement, and suturing. Evaluation methods include clinical measurements, radiographs, surgical re-entry, and histology. Autografts provide the best outcomes but alloplastic grafts and other options are also discussed.
RCT fixed expert 23-24pptx.pdf second partEl Sayed Omar
The document discusses several factors that are important for restoring endodontically treated teeth, including the need for full coverage restorations, use of posts, and biologic width considerations. It notes that adequate coronal restoration is equally as important as endodontic treatment. Factors like tooth type, structure loss, and occlusal stresses determine need for full coverage restorations. Post length, diameter, and ferrule effect are important principles for restoring teeth with posts. Techniques for managing severely damaged teeth like crown lengthening and orthodontic extrusion are also covered.
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This document discusses factors to consider when restoring endodontically treated teeth, including whether to use posts and cores. It notes that some studies found teeth without posts were more resistant to fracture. It then defines dowels/posts and cores, and outlines considerations for the choice of restorative technique, including tooth type, remaining structure, and endodontic, periodontal and prosthetic factors. It discusses factors that affect retention of prefabricated post restorations like post length, diameter, design and luting agents.
This document discusses different types of root resorption, including internal, external, inflammatory, and replacement resorption. It provides details on the definition, causes, mechanisms, diagnostic methods and treatment approaches for each type. The key types discussed are internal infection-related resorption, where necrotic infected pulp tissue triggers the resorption process, and external cervical resorption, which is often linked to trauma, restorations or orthodontic treatment. Diagnosis involves radiographs and vitality testing, while treatment focuses on removing resorptive tissue, root canal therapy if needed, and restoration.
This presentation is an overview of Hemolytic anemia with respect to enzyme deficiencies. The inheritance pattern, clinical manifestations, symptoms complications, diagnosis and management of different types of enzyme deficiencies such as G6PD and Pyruvate Kinase have been discussed in detail.
Rheumatology MCQs Practice questions with explanationDr. Almas A
Topic: Rheumatology
Exam type: MCQs Practice questions
Q. A 26-year-old female presented to ER with dry cough and shortness of breath and often complains of chest pain. Chest x-ray shows bilateral hilar lymphadenopathy. Which of the following will indicate that the patient suffers from sarcoidosis?
Q: A 50-year-old female presents to ER with dyspnea on exertion and orthopnea, red painful eyes. She complains of chronic dull pain in the gluteal region for the last 5 years and stiffness in the lower back that wakes her up in the morning. X-ray spine reveals squaring of vertebrae with bone spur formation. On MRI sacroiliitis is seen. Which of the following is the most likely diagnosis?
Q: A 60-year-old female presents in OPD with knee joint stiffness in the morning and increases with activity and decreases on rest. She also complains about a crackling noise on joint movement. X-ray shows narrowing of the joint space and osteophytes. Which of the following treatments is recommended in this patient?
Q: A 70-year-old female presented to ER with swelling of knee joint and severe pain. Arthrocentesis revealed rhomboid-shaped crystals that stained deeply blue with H&E stain, and show weak positive birefringence on light microscopy. X-ray reveals chondrocalcinosis. Which of the following statements is true?
Q: A 40-year-old female comes to OPD with dry eyes and dyspareunia for the last 6 months. She also complains of cough and fatigue with joint pains. On examination, her parotid gland was enlarged and laboratory tests revealed anti-Ro antibodies are positive. Which of the following tests is recommended to this patient?
Laboratory waste disposal steps are important to be followed. we cannot drain the laboratory waste directly into the drain, or it can cause corrosive damage to the drain system and the sewerage. Alkali waste requires proper neutralization for proper disposal
The correct disposal of acid waste includes the following steps. Pouring direct into the sink in the laboratory will cause corrosive damage. Thus these steps need to be followed when disposing acid waste.
what are the steps you need to follow when you get a needle stick injury in the lab, while handling needles or any sharp instruments. We should deal with each needle stick injury as it is contaminated by any infectious disease like hepatitis, AIDS or others.
This document discusses the estimation of serum total cholesterol levels through a colorimetric enzymatic method. Cholesterol is esterified in the sample and oxidized to produce hydrogen peroxide which reacts with phenol and 4-aminophenazone in the presence of peroxidase to form a colored compound (quinoamine). The absorbance is read at 540nm and used to calculate cholesterol concentration compared to a standard. Elevated cholesterol is a risk factor for coronary artery disease and atherosclerosis.
This document summarizes the components and significance of a complete blood count (CBC). A CBC provides important information about red blood cells, white blood cells, platelets, and their parameters such as hematocrit, hemoglobin, and counts. Abnormal CBC results can indicate various disorders including anemia, infection, inflammation, and cancer. The CBC establishes normal ranges for blood cells which vary by age, gender, and altitude.
Estimation of Serum Protien by Biuret methodDr. Almas A
This document describes the Biuret method for estimating total serum protein levels. The Biuret method involves mixing serum samples with a Biuret reagent containing copper sulfate, sodium hydroxide, and potassium iodide. This causes a violet color complex to form between copper ions and peptide bonds in proteins, with intensity proportional to protein amount. By comparing absorbance of samples to a protein standard of known concentration, total protein levels are calculated. Normal protein levels are 6-8 g/dL but can increase or decrease in various physiological and pathological conditions.
This document provides information on the functions, properties, and importance of lipids. It begins by discussing the structure of lipids and classification of fatty acids. It then covers various chemical properties of lipids including hydrolysis, saponification, hydrogenation, and rancidity. Physical properties such as hydrophobicity and melting points are also described. The functions of saturated, unsaturated, and essential lipids are outlined. Finally, the structural, clinical, and disease importance of lipids is summarized, highlighting their roles in cell membranes, energy storage, insulation, and brain injury/lipidosis.
The periodontium and pulp are two most important entities of the tooth, infection from one can travel towards other by different pathways. Neglect of either one can lead to failure. This presentation will help you learn clear steps towards diagnosis and treatment planning of such lesions
Hepatitis B and C infection and it's clinical implication in Dental practice, how to management patients of hepatitis and what clinical features patients with hepatitis show in oral cavity.
This document discusses pharmacogenetics and personalized medicine. It provides examples of genetic variations that can alter drug response, such as variations in receptors, enzymes, and metabolic pathways. Slow or deficient metabolism of drugs by enzymes like cytochromes and pseudocholinesterases can cause toxic drug accumulation. Genetic testing can help identify variations to optimize drug therapy for each individual and minimize adverse reactions. Personalized medicine uses pharmacogenetics to tailor treatments based on a person's genetic profile.
CEPHALOSPORINS (First Genertaion)
Introduction:
First discovered in 1945
A class of Beta Lactam Antibiotics
Are derivatives of 7-aminocephalosporanic acid
They were first isolated from Cephalosporium acremonium (fungus)
Structure:
Are Beta-lactam compounds
In which the beta-lactam ring is fused to a 6-membered dihydrothiazine ring, thus forming the cephem nucleus.
Mechanism of action:
They are Bactericidal agents by cell lysis.
Bind to the Penicillin-binding proteins (PBPs) on the bacterial cell membrane and inhibit cell wall synthesis.
Inhibit Peptidoglycan synthesis by inhibiting the transpeptidation reaction – failure of cross-linking of peptidoglycan.
Mechanism of resistance
Acquired resitance to cephalosporins could be due to:
Alternation of the PBPs (target protiens)
Impermeability to the antibiotic thus preventing it to reach it’s site of action.
Production of Beta lactamases by many bacteria that inactivate the drug.
Resistance developed by penicilinase produced by staphylococci (less than penicillin)
Classification of cephalosporins:
Based on their spectrum of activity, Cephalosporins can be broadly categorized into four generations.
1st Generation (Cefazolin, Cephalexin)
2nd Generation (Cefotetan, Cefoxitin)
3rd Generation (Cefoperazone, Cefixime)
4th Genertaion (Cefepime)
First Generation drugs:
Also called Narrow spectrum Cephalosporins
Include;
ORAL:
CEPHALEXIN
CEFADROXIL
CEPHRADINE
PARENTERAL:
CEFAZOLIN (prototype)
CEPHAPIRIN
Anti-baterial spectrum:
First generation cephalosporins are very active against gram positive cocci which include:
Pneumococci
Streptococci
staphylococci.
Against gram negative bacilli
E. coli
Klebsiella
Proteus
Active against most penicillin-susceptible anaerobes found in the oral cavity,
except those belonging to the Bacteroides fragilis (that are Gram-negative bacillus bacterium species, and an obligate anaerobe of the gut ) group.
Clinical uses:
For dental surgical prophylaxis (Cephalexin and Cefazolin)
Skin and bone infections (Cefazolin)
Pharyngitis
Tonsilitis
Otitis
Pneumonia
UTI
Skin infections
Toxicity:
Diarrhea
Nausea
Vomiting
Abdominal discomfort
Headache
Fever
Rashes
Pruritis
Urticaria
Serum sickness like reaction
Disturbance in liver enzymes
Transient Hepatitis
Cholestatic jaundice
Eosinaphilia
Blood disorders
Antibiotic associated colitis (rare)
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
4. • In the crown:
o Temporary enamel restoration
o Permanent dentin restoration
o Deep or large carious lesions
o Deep cervical or radicular lesions
o Pulp capping
o Pulpotomy…..
• In the root:
o root and furcation perforations
o internal/external resorptions
o Apexification
o Retrograde surgical filling.
5. ZnO 75%
Gutta percha 25%
Types:
• Standardized type: follows same ISO
classification as endodontic files
• Non-standardized: have a greater taper than
the standard ISO type
6. Use:
Root canal Irrigant
Root canal Medicament
Advantages:
broad spectrum antimicrobial properties 2% equals to 5%
NAOCL in sense of antibacterial action
synergic affect when used with NAOCL
Disadvantage:
can’t dissolve orgainc and inorganic components of pulp
12. • K FILE:
• triangular or square cross section
•Advantages:
• More flexible and don’t fracture
•Disadvantages:
1- Less cutting efficiency
2- Extrusion of debris periapically
• H FILE:
• has flutes that resemble successive triangles..
• Advantage: They have superior cutting efficiency
• Disadvantage is they are not flexible and fracture
easily
13. • Used to extirpate PULP
• Removal of cotton and paper points
14. • Small flame shaped
• Used in conventional hand piece
• Used for :
1- enlarging canal orifice (/coronal 3rd)
2- to remove lingual shoulder in Anteriors
15. • To remove GP during post preparation
• Small flame-shaped cutting instrument
• used in the conventional handpiece
16. • Small flexible instrument
• Placement of material into the canal
• Fits into the conventional slow handpiece
17.
18. • Loss of working length
• Ledging and stripping
• Perforations
19. • ZIP: Apical portion transportation of a canal
• ELBOW: Rotating the instrument in curved
canal can produce a biomechanical defect.
How to avoid these
1- never rotate instrument in curved canal
2- Always pre curve the small size instruments
26. • Tofflemire Universal
• Ivory Bands
• Pilodent – for composites
• Automatrix – difficuilt to contour
27. • When the tooth structure is prepared with a
bur or instruments, residual organic and
inorganic components form a smear layer that
is composed of hydroxyapatite and denatured
collagen.
• When primer and bonding agent are applied
on the etched dentin they form resin-dentin
interdiffusion zone called hybrid layer.
36. • Should have a continuous tapering, conical shape,
with the narrowest cross-sectional diameter apically
and the widest diameter coronally.
• The walls should taper evenly towards the apex and
should be confluent with the access cavity.
• To give the prepared root canal the "quality of flow;'
i.e, a shape that permits plasticized gutta-percha to
flow against the walls without impedance.
• Should keep the apical foramen as small as
practical.
• Should clean and shape the canal without
transporting the apical foramen.
37. • Iodoform paste
– (zinc oxide and iodoform mixture)
– bactericidal and nonirritant
• ZnO Eugenol paste (without catalyst)
why catalyst not used… > to increase working
time……..
• Material should be resorbable, nonirritant and
radioopaque.
• Why GP not used? – Not degraded
38. • Abutment for space maintainer
• Bruxism
• Caries involving 3 or more surfaces
• Developmental defects like Dentinogenesis
imperfecta and enamel hypoplasia
• Extensive caries in class 2 involving cusps
• Following pulp therapy to avoid fracture of
weekend tooth
• Handicapped children
39. • Stain less steel crowns
• Nickel based crowns (ni-chromium 3M)
40. • The process of inducing the development of
root and apex closure in an immature
permanent tooth with open apex.
• Calcific Root-End closure.
• Types:
1. Multiple Step(CaOH)
2. Single Step (MTA)
41. • Physiological process
• Formation of apex in vital young permanent
tooth with appropriate vital pulp therapy
• MAINTAIN PULP VITALITY
• Includes :
1- Direct pulp capping
2- Indirect pulp capping
3- Pulpotomy/Partial Pulpotomy
42. • Since gallium amalgam expands after trituration, it
provides better marginal seal than silver amalgam….
• Setting time is less than silver mercury amalgam,
therefore can be finished and polished after one hour..
• Most of the physical and mechanical properties of
gallium alloy are similar to high copper mercury
amalgam.
So better marginal seal, less setting time and same
mechanical properties………
43. • A ferrule, is defined as a circumferential area
of axial dentin superior to preparation bevel
should have a height of 1.5mm to 2.5mm
45. • Leave the tooth in place
• Clean with saline and chlorohexidiene
• Suture the lacerated gingiva
• Determine position of the tooth both clinically and
radiographically.
• Apply a flexible splint for 2 weeks
• Antibiotics adminstration for 7 days
• Initiate root canal in transplanted tooth after 10 days with
closed apex
• Open apex in growing children can be waited for pulp
revasculrization and in adult cases open apex closed with
MTA
46. • Apply local anesthesia
• Rinse the area with saline or chlorohexidine
• Reposition the tooth using digital pressure or
forcep.
• Reposition the displaced bone both facially
and lingually
• Suture the gingiva if lacerated
• Splint with wire or acrylic for 4 months.
47. • BV Rupture → Blood into Dentin →
Breakdown of blood (Hemin, Hematin,
Hemosiderin) → Pinkish brown discoloration
49. • Radiographic Apex : Apex of tooth determined
radiographically
• Anatomic Apex: apex of tooth determined
morphologically. At the CDJ.
• Difference can be 1.5 – 3 mm because of
cementum deposition with age.
50. • From a Coronal refrence point to the point
where cleaning and shaping or obturation
ends
• Refrence point:
– Anteriors → Incisal Edge
– Anteriors with broken edges → Smoothen the edge
– Posteriors → Cusp Tip
51. Pulp sensibility Test
MOA:
Ionic shift in the dentinal tubules Local depolariztion in
Delta A fibers
Tells if the tooth is Vital or Non-Vital
52. • False Positive
➢ Gangrenous necrotic pulp
➢ Partially necortic pulp in multi-rooted
• False Negative
➢ Recent Trauma
➢ Extensive pulpal calcification
➢ Fibrotic pulp
➢ Extensive restorations with base
➢ Pt on sedatives
54. Based on Shape (Parallel, Tapered, Parallel and
Tapered)
Based on surface characteristic ( Active, Passive)
Based on Method of fabrication:
• Custom
• PreFabricated (Metal, Zirconia, Fiber-post)
Which one causes most internal stresses..+ Fracture :
Metal, Active, Tapered
55. Tooth has incompletely cracked but no part of
the tooth has yet broken off.
Diagnosed with:
Bite Test
Biting on Tooth Sloth
(Pain on releasing of biting force)
Pain on biting Symptomatic apical periodontitis
56. Conventional tooth prep:
• Specific walls, floor, angulation.
• Amalgum
Modified:
• Does not require specific wall forms, angulation, Walls and floor
• Composite
57. Shape and form of cavity is such that it prevents the
displacement or removal of restoration by tipping and
lifting forces
Occlusal covergence
Adhesive systems
Beveling/flaring cavity margin for composite
58. “Shape and placement of preparation walls and cavity is
such that it enables to tooth structure AND THE
RESTORATION to withstand the forces of mastication
without getting fractured”
Box like cavity
Flat floor
Rounded line angles
Adequate thickness of material
Preservation of cusps and marginal ridges
Reduction of cusp for capping
67. 1.Bisecting Angle - Used in Endo
a.Xray beam is at right angle to long axis of tooth
2.Parallex
a.For curved roots in upper anteriors
b.Not recomended for Endo though
c.Superimposition of zygomatic process
68. • Right angle to the dentin surface
• Vertical in the cuspal region
• Deciduous Horizontal cervically
• Permenant Oblique cervically