Introduction to Operative Dentistry Part II Dr. Feras Aalam
Clinical procedures for Operative Treatment
Steps in operative/ restorative procedures <ul><li>Evaluate the tooth to be restored </li></ul><ul><li>Obtain local anesth...
Steps in operative/ restorative procedures <ul><li>4.  Prepare the tooth for the restoration </li></ul><ul><ul><ul><ul><ul...
Steps in operative/ restorative procedures <ul><li>7. Burnish, carve or finish the dental material </li></ul><ul><li>8. Ch...
1.   Evaluate the tooth to be restored  Diagnostic phase   <ul><li>a. Clinical examinations </li></ul><ul><ul><li>Percussi...
a. Clinical examination
b. Radiographic examination Panoramic radiograph, OPG Periapical  Bitewing
<ul><li>Full mouth intra oral radiographs </li></ul><ul><li>Bitewings+ periapicals </li></ul>Radiographic examination
c. Vitality test <ul><li>Electric pulp tester(EPT): </li></ul><ul><li>tests the vitalty of the Pulp by passing low electri...
<ul><li>Anesthetic Gel   </li></ul>2.  Obtain local anesthesia Anesthetic solution= carpule  Gauze Syringe  Cotton tip Nee...
2.  Obtain local anesthesia <ul><li>Upper teeth </li></ul><ul><li>Infiltration  </li></ul><ul><li>Lower teeth </li></ul><u...
After local anesthesia Sharping container Cardboard needle cap-holding device makes recapping needles safer
Never leave the patient after local anesthesia
3 . Moisture control  <ul><li>Cotton rolls </li></ul><ul><li>Cotton pellets </li></ul><ul><li>Gauze  </li></ul><ul><li>Den...
A. Cotton rolls  B. Cotton pellets
C. Gauze
D.  Dental Rubber Kit
D.  Dental Rubber dam Rubber e dam over the area to isolate the tooth ,  keep it clean and free of saliva during the  dent...
E.  Saliva ejector
F.  High-volume oral evacuator tip
The difference??
Suction tips  High-volume oral evacuator =high volume suction Saliva ejector = low volume suction
4.  Prepare the tooth for the restoration <ul><li>R otary instruments </li></ul><ul><li>H and instruments </li></ul>
Rotary instruments LOW SPEED HAND PEICE HIGH SPEED HAND PEICE
Burs holder
Hand instruments
5.  Determine the type of dental materials <ul><li>a. Amalgam  </li></ul><ul><li>b. Composite  </li></ul>
c. Glass ionomer <ul><li>Contains Fluoride/ Release Fluoride in the Oral cavity.  </li></ul><ul><li>White /light gray in c...
d. If no time, or deep caries you can apply temporary filling
6. Apply the dental material
Amalgam  <ul><li>A lloy of mercury and one or more other metals.  </li></ul><ul><li>Contents:  </li></ul><ul><ul><li>Silve...
a. Application of amalgam  Amalgamator Amalgam capsule
a. Application of amalgam Amalgam carrier Dappen dish
Application of amalgam <ul><li>Amalgam condenser </li></ul><ul><li>Burnisher </li></ul><ul><li>Matrix </li></ul><ul><li>Re...
APPLICATION OF AMALGAM
Composite  <ul><li>Resin composites </li></ul><ul><li>Bond to the tooth structure by  Bonding agent </li></ul><ul><li>Supe...
Composite kit <ul><li>Shade guide </li></ul><ul><li>Acid etchant </li></ul><ul><li>Bonding material </li></ul><ul><li>Comp...
Composite  <ul><li>Select the shade </li></ul><ul><li>Dry the tooth </li></ul><ul><li>Acid itchant </li></ul><ul><li>Wash ...
Application of Composite  Light cure Dry the tooth Acid itchant
Application of Composite
7.  Burnish, carve or finish the dental material
8 . Check the occlusion of the restoration <ul><li>Articulating paper </li></ul><ul><li>High speed hand piece </li></ul><u...
9.  Finish and polish the restoration <ul><li>Amalgam  </li></ul><ul><li>Composite </li></ul><ul><li>finishing strips  </l...
Before placement of the restorative material <ul><li>Base: placed in deep cavities to provide pulp protection and insulati...
Before placement of the restorative material <ul><li>Cavity base : placed in deep cavities to provide pulp protection and ...
Cavity liners Varnish under Amalgam Dycal under amalgam or  composite
Teeth numbering systems
FDI two-digit tooth numbering system Teeth numbering chart for adult teeth
FDI two-digit tooth numbering system Teeth numbering chart for primary teeth
<ul><li>Tooth #16 : Upper Right 1 st  Molar </li></ul><ul><li>Tooth #46: Lower Right 1 st  Molar </li></ul><ul><li>Tooth #...
Classification <ul><li>Class I </li></ul><ul><li>Class II </li></ul><ul><li>Class III </li></ul><ul><li>Class IV </li></ul...
Class I
Class II <ul><li>Occluso-distal </li></ul><ul><li>Occluso-mesial </li></ul>
Occluso-mesio-dista l   MOD
Class III Class IV
Class V Composite, Glass ionomer, amalgam
Introduction to operative dentistry,part2
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  • Bitewing+ periapical
  • Cardboard needle cap-holding device makes recapping needles safer
  • Amalgam capsules
  • Dappen dish r
  • Shade selection, Light cure
  • Varnish under Amalgam Dycal under composite
  • Introduction to operative dentistry,part2

    1. 1. Introduction to Operative Dentistry Part II Dr. Feras Aalam
    2. 2. Clinical procedures for Operative Treatment
    3. 3. Steps in operative/ restorative procedures <ul><li>Evaluate the tooth to be restored </li></ul><ul><li>Obtain local anesthesia </li></ul><ul><li>Determine the type of moisture control to be used during the procedure: </li></ul><ul><ul><li>Cotton roll (partial Isolation) </li></ul></ul><ul><ul><li>Dental rubber dam (complete isolation) </li></ul></ul>
    4. 4. Steps in operative/ restorative procedures <ul><li>4. Prepare the tooth for the restoration </li></ul><ul><ul><ul><ul><ul><li>rotary instruments </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>hand instruments </li></ul></ul></ul></ul></ul><ul><li>5. Determine the type of dental materials to be used </li></ul><ul><li>6. Apply dental material </li></ul>
    5. 5. Steps in operative/ restorative procedures <ul><li>7. Burnish, carve or finish the dental material </li></ul><ul><li>8. Check the occlusion of the restoration </li></ul><ul><li>9. Finish and polish the restoration </li></ul>
    6. 6. 1. Evaluate the tooth to be restored Diagnostic phase <ul><li>a. Clinical examinations </li></ul><ul><ul><li>Percussion, pain </li></ul></ul><ul><ul><li>Deep caries </li></ul></ul><ul><li>b. Radiographic examinations </li></ul><ul><li>- Periapical radiograph </li></ul><ul><li>- Bitewing </li></ul><ul><li>c. Vitality test </li></ul>
    7. 7. a. Clinical examination
    8. 8. b. Radiographic examination Panoramic radiograph, OPG Periapical Bitewing
    9. 9. <ul><li>Full mouth intra oral radiographs </li></ul><ul><li>Bitewings+ periapicals </li></ul>Radiographic examination
    10. 10. c. Vitality test <ul><li>Electric pulp tester(EPT): </li></ul><ul><li>tests the vitalty of the Pulp by passing low electric current throw the tooth  pain </li></ul><ul><li>Compare the reading with the opposing or adjacent normal tooth </li></ul>
    11. 11. <ul><li>Anesthetic Gel </li></ul>2. Obtain local anesthesia Anesthetic solution= carpule Gauze Syringe Cotton tip Needles Short Long local anesthesia kit
    12. 12. 2. Obtain local anesthesia <ul><li>Upper teeth </li></ul><ul><li>Infiltration </li></ul><ul><li>Lower teeth </li></ul><ul><li>Nerve block </li></ul>
    13. 13. After local anesthesia Sharping container Cardboard needle cap-holding device makes recapping needles safer
    14. 14. Never leave the patient after local anesthesia
    15. 15. 3 . Moisture control <ul><li>Cotton rolls </li></ul><ul><li>Cotton pellets </li></ul><ul><li>Gauze </li></ul><ul><li>Dental rubber dam </li></ul><ul><li>Saliva ejector </li></ul><ul><li>High-volume oral evacuator tip </li></ul>
    16. 16. A. Cotton rolls B. Cotton pellets
    17. 17. C. Gauze
    18. 18.
    19. 19. D. Dental Rubber Kit
    20. 20. D. Dental Rubber dam Rubber e dam over the area to isolate the tooth , keep it clean and free of saliva during the dental procedure
    21. 21. E. Saliva ejector
    22. 22. F. High-volume oral evacuator tip
    23. 23. The difference??
    24. 24. Suction tips High-volume oral evacuator =high volume suction Saliva ejector = low volume suction
    25. 25. 4. Prepare the tooth for the restoration <ul><li>R otary instruments </li></ul><ul><li>H and instruments </li></ul>
    26. 26. Rotary instruments LOW SPEED HAND PEICE HIGH SPEED HAND PEICE
    27. 27.
    28. 28. Burs holder
    29. 29. Hand instruments
    30. 30. 5. Determine the type of dental materials <ul><li>a. Amalgam </li></ul><ul><li>b. Composite </li></ul>
    31. 31. c. Glass ionomer <ul><li>Contains Fluoride/ Release Fluoride in the Oral cavity. </li></ul><ul><li>White /light gray in color. </li></ul><ul><li>Bond to the tooth structure. </li></ul>
    32. 32. d. If no time, or deep caries you can apply temporary filling
    33. 33. 6. Apply the dental material
    34. 34. Amalgam <ul><li>A lloy of mercury and one or more other metals. </li></ul><ul><li>Contents: </li></ul><ul><ul><li>Silver </li></ul></ul><ul><ul><li>Tin </li></ul></ul><ul><ul><li>C opper </li></ul></ul><ul><ul><li>Z inc </li></ul></ul>
    35. 35. a. Application of amalgam Amalgamator Amalgam capsule
    36. 36. a. Application of amalgam Amalgam carrier Dappen dish
    37. 37. Application of amalgam <ul><li>Amalgam condenser </li></ul><ul><li>Burnisher </li></ul><ul><li>Matrix </li></ul><ul><li>Retainer </li></ul><ul><li>Wedge </li></ul>
    38. 38. APPLICATION OF AMALGAM
    39. 39. Composite <ul><li>Resin composites </li></ul><ul><li>Bond to the tooth structure by Bonding agent </li></ul><ul><li>Superior aesthetic properties and to health concerns about the mercury in dental amalgams </li></ul><ul><li>Have found increasing application in the repair and rebuilding of teeth. </li></ul><ul><li>Chemical cure or light cure restoration. </li></ul>
    40. 40. Composite kit <ul><li>Shade guide </li></ul><ul><li>Acid etchant </li></ul><ul><li>Bonding material </li></ul><ul><li>Composite </li></ul>
    41. 41. Composite <ul><li>Select the shade </li></ul><ul><li>Dry the tooth </li></ul><ul><li>Acid itchant </li></ul><ul><li>Wash </li></ul><ul><li>Dry </li></ul><ul><li>Bonding </li></ul><ul><li>Light cure </li></ul><ul><li>Composite in layers 2mm </li></ul>
    42. 42. Application of Composite Light cure Dry the tooth Acid itchant
    43. 43. Application of Composite
    44. 44. 7. Burnish, carve or finish the dental material
    45. 45. 8 . Check the occlusion of the restoration <ul><li>Articulating paper </li></ul><ul><li>High speed hand piece </li></ul><ul><li>Diamond bur </li></ul>High point removal
    46. 46. 9. Finish and polish the restoration <ul><li>Amalgam </li></ul><ul><li>Composite </li></ul><ul><li>finishing strips </li></ul>
    47. 47.
    48. 48. Before placement of the restorative material <ul><li>Base: placed in deep cavities to provide pulp protection and insulation </li></ul><ul><li>Cavity liner: protects the pulp from irritation and encourages healing </li></ul><ul><li>Bonding agent: retention of the composite </li></ul>
    49. 49. Before placement of the restorative material <ul><li>Cavity base : placed in deep cavities to provide pulp protection and insulation </li></ul><ul><li>e.g. Glass ionomer cement </li></ul><ul><li>Zink oxide eugenol cement </li></ul><ul><li>Cavity liner : protects the pulp from irritation and encourages healing </li></ul><ul><li>e.g. Dycal= under amalgam, composite </li></ul><ul><li>Varnish= under amalgam ONLY </li></ul><ul><li>Bonding agent : retention of the composite </li></ul>
    50. 50. Cavity liners Varnish under Amalgam Dycal under amalgam or composite
    51. 51. Teeth numbering systems
    52. 52. FDI two-digit tooth numbering system Teeth numbering chart for adult teeth
    53. 53. FDI two-digit tooth numbering system Teeth numbering chart for primary teeth
    54. 54. <ul><li>Tooth #16 : Upper Right 1 st Molar </li></ul><ul><li>Tooth #46: Lower Right 1 st Molar </li></ul><ul><li>Tooth #25: Upper Left 2 nd Premolar </li></ul><ul><li>Tooth #34: Lower Left 1 st Premolar </li></ul><ul><li>Tooth #11: Upper Right central incisor </li></ul><ul><li>Tooth #32:…………… </li></ul><ul><li>Tooth #23:…………… </li></ul><ul><li>Tooth #44:………….... </li></ul>Teeth numbering systems ISO, FDI
    55. 55. Classification <ul><li>Class I </li></ul><ul><li>Class II </li></ul><ul><li>Class III </li></ul><ul><li>Class IV </li></ul><ul><li>Class V </li></ul><ul><li>Class VI </li></ul>
    56. 56. Class I
    57. 57. Class II <ul><li>Occluso-distal </li></ul><ul><li>Occluso-mesial </li></ul>
    58. 58. Occluso-mesio-dista l MOD
    59. 59. Class III Class IV
    60. 60. Class V Composite, Glass ionomer, amalgam
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