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Proper diagnosis is vital for treatment

planning.
DIAGNOSIS:
PREVENTION:
To prevent any recurrence of the
causative disease and their defect.
INTERCEPTION:
Preventing further loss of tooth structure
by stabilizing an active disease process.
PRESERVATION:
Preservation of the vitality and
periodontal support of remaining tooth
structure.
RESTORATION:
Includes restoring form, function,
phonetics, and esthetics.
Purposes of Operative Dentistry


Clinical procedures for Operative Treatment



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Steps in operative/ restorative procedures
• Evaluate the tooth to be restored
• Obtain local anesthesia
• Determine the type of moisture control to be used during the procedure:
• Cotton roll (partial Isolation)
• Dental rubber dam (complete isolation)

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Steps in operative/ restorative procedures
• 4. Prepare the tooth for the restoration
• 5. Determine the type of dental materials
• to be used
• 6. Apply dental material

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Steps in operative/ restorative procedures
• 7. Burnish, carve or finish the dental material
• 8. Check the occlusion of the restoration
• 9. Finish and polish the restoration


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1. Evaluate the tooth to be restored Diagnostic phase
• a. Clinical examinations
• Percussion, pain
• Deep caries
• b. Radiographic examinations
• - Periapical radiograph
• - Bitewing
• c. Vitality test

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a. Clinical examination



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b. Radiographic examination

Panoramic radiograph, OPG



Periapical
Bitewing

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Full mouth intra oral radiographs
Bitewings+ periapicals
Radiographic examination



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c. Vitality test

Electric pulp tester(EPT):

tests the vitalty of the Pulp by passing low electric current throw the tooth  pain
Compare the reading with the opposing or adjacent normal tooth






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Anesthetic Gel

• Anesthetic solution= carpule

Gauze

Syringe

Cotton tip

Needles

Short
Long

local anesthesia kit

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2. Obtain local anesthesia



Upper teeth
Infiltration

• Lower teeth

• Nerve block

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After local anesthesia

Sharping container

Cardboard needle cap-holding device makes recapping needles safer

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Never leave the patient after local anesthesia




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3. Moisture control
• Cotton rolls
• Cotton pellets
• Gauze
• Dental rubber dam
• Saliva ejector
• High-volume oral evacuator tip

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A. Cotton rolls B. Cotton pellets





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C. Gauze






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D. Dental Rubber Kit



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D. Dental Rubber dam
Rubbere dam over the area to isolate the tooth, keep it clean and free of saliva during the dental procedure






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E. Saliva ejector





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F. High-volume oral evacuator tip



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The difference??





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Suction tips

High-volume oral evacuator
=high volume suction
Saliva ejector
= low volume suction

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4. Prepare the tooth for the restoration
Rotary instruments
Hand instruments

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Rotary instruments

LOW SPEED HAND PEICE

HIGH SPEED HAND PEICE




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Burs holder





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Hand instruments










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5. Determine the type of dental materials
a. Amalgam
b. Composite





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c. Glass ionomer
Contains Fluoride/ Release Fluoride in the Oral cavity.
White /light gray in color.
Bond to the tooth structure.

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d. If no time, or deep caries you can apply temporary filling






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6. Apply the dental material

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Amalgam
Alloy of mercury and one or more other metals.
Contents:
Silver
Tin
Copper
Zinc




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a. Application of amalgam

Amalgamator

Amalgam capsule

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a. Application of amalgam

Amalgam carrier

Dappen dish

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Application of amalgam
Amalgam condenser
Burnisher
Matrix
Retainer
Wedge







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APPLICATION OF AMALGAM





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Composite

Resin composites

Bond to the tooth structure by Bonding agent
Superior aesthetic properties and to health concerns about the mercury in dental amalgams
Have found increasing application in the repair and rebuilding of teeth.
Chemical cure or light cure restoration.


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Composite kit
Shade guide
Acid etchant
Bonding material
Composite



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Composite
• Select the shade
• Dry the tooth
• Acid etchant
• Wash
• Dry
• Bonding
• Light cure
• Composite in layers 2mm







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Application of Composite
Light cure

Dry the tooth

Acid itchant







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Application of Composite






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7. Burnish, carve or finish the dental material





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8. Check the occlusion of the restoration

Articulating paper

High speed hand piece
Diamond bur






High point removal

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9. Finish and polish the restoration
Amalgam
Composite finishing strips





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Before placement of the restorative material
Base: placed in deep cavities to provide pulp protection and insulation
Cavity liner: protects the pulp from irritation and encourages healing
Bonding agent: retention of the composite


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Before placement of the restorative material
Cavity base: placed in deep cavities to provide pulp protection and insulation
e.g. Glass ionomer cement
Zink oxide eugenol cement
Cavity liner: protects the pulp from irritation and encourages healing
e.g. Dycal= under amalgam, composite
Varnish= under amalgam ONLY
Bonding agent: retention of the composite

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Varnish under Amalgam

Dycal under amalgam or
composite
Cavity liners

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Teeth numbering systems

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FDI two-digit tooth numbering systemTeeth numbering chart for adult teeth



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FDI two-digit tooth numbering systemTeeth numbering chart for primary teeth



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Tooth #16 : Upper Right 1st Molar
Tooth #46: Lower Right 1st Molar
Tooth #25: Upper Left 2nd Premolar
Tooth #34: Lower Left 1st Premolar
Tooth #11: Upper Right central incisor
Tooth #32:……………
Tooth #23:……………
Tooth #44:…………....
Teeth numbering systemsISO, FDI


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Cavity Classification
Class I
Class II
Class III
Class IV
Class V
Class VI

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Class I





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Class II
Occluso-distal
Occluso-mesial






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Occluso-mesio-distal MOD



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Class III

Class IV

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THANK YOU!