RSD 810 Fundamentals of Operative Dentistry RSD 814 Preclinical Restorative Dentistry Course Director: Carla Rodriguez DMD Assistant Director: Susan Bishop DMD

In this course you will gain an understanding of the basic concepts of the carious disease process, it’s affect on the dentition, and how we as operators correct or restore the affected dentition.

We will explore rationale for appropriate materials selection depending upon the health, risk status and concerns of the patient. Esthetic concepts will be discussed so that patient needs may be addressed.

Necessary nomenclature will be introduced so that communication can be accomplished.

Finally, we will thoroughly progress through the processes of tooth preparation and restoration of the carious lesion as it presents in the clinical setting.

Faculty: Dr. Rowida Abdalla Dr. Elizangela Bertoli Dr. Susan Bishop Dr. Eric Demann Dr. Richard Mitchell* Dr. Hiroko Nagaoka Dr. Martha Rice Dr. Carla Rodriguez Dr. Lina Sharab *lecture only

Susan Bishop, D.M.D. Lecture Syllabus

Susan Bishop, D.M.D. Lab Syllabus

$64 dollars on Amazon $84 dollars on Amazon, 62 rental on Kindle Canvas Lecture

If you work better with headphones the course director kindly asks that you wear only one in the lab. This will prevent missed words of wisdom and instruction. “It’s on you”. Lecture Lab You will be held accountable for all information included in lecture and lab documents presented during class and made available on Canvas.

Lecture

Requests for accommodation for written exams must be made to the course director at the beginning of the course. A letter from the Disability Resource Center, documenting the right for accommodation must be filed with the Office of Academic Affairs.

Lab

See full copy syllabus for specific information. Lecture

Lab

Daily Project Sheet

Lecture

Lab

Lecture Lab At a Glance Daily sheets

Life is a work in progress— This is a guideline only, not the final draft Draft of Spring Syllabus RSD 810/814

Operative Dentistry is the art and science of the maintenance and restoration of the natural dentition in an optimum state of health, function, and esthetics.

A thorough understanding of the histology, physiology, and occlusal interactions of the dentition and supporting tissues is essential for this process.

The form of a tooth and its contour and contact relationships with adjacent and opposing teeth are major determinants of muscle function in mastication, esthetics, speech, and protection.

The relationships of form to function are especially noteworthy when considering the shape of the dental arch, proximal contacts, occlusal contacts, and mandibular movement.

The operator should be protected, from head to toe. The operator should be protected, from head to toe. Personal Protective Equipment

Best clinical detection: *Visual *Tactile *Radiographic Clean and dry Adequate lighting magnification Clinical Exam-develop the problem list

After identifying caries lesions you will determine which material is best suited for restoration based on risk factors, size location, and occlusion.

Mere detection of the caries lesion is not enough information for us to determine a reasonable treatment plan of action. What will the “intervention” be? When will we “restore”? How will we restore? Is the lesion : active and non-cavitated? active and cavitated? inactive and non-cavitated? inactive and cavitated? a filling? a filling with active caries? a filling with inactive caries? HOW RAPIDLY IS IT PROGRESSING? CAN IT BE ARRESTED? What is the periodontal status? What is the caries risk assessment?

Periodontal considerations: Gingival and periodontal health is measured clinically by measuring presence of bacterial product, loss of attachment, pocket depth, mobility, bleeding on probing, etc. Is the periodontal health such that the dentition should be restored?

Isolation to prevent contamination Keeping instruments clean and orderly helps efficiency

This preclinical Operative study will prepare the dental student for “direct” restorative procedures. Observing anatomical guidelines and functional harmony allows for excellent restoration of dentition.

These are the supplies and instruments you will need to successfully complete the sealant procedure. oils, fluoride Phosphoric acid sealant varnish

Procedure for Class I Composite 1.Anesthesia delivered. 2. Dental dam isolation 3. Clean tooth with oil-free cleanser 4. Using the appropriate bur on the high speed handpiece, enter carious area and remove defective enamel only. 5. Stop, wash, assess. 6. Judiciously remove any remaining carious enamel. 7. Stop, wash, assess. 8. Using the slow speed handpiece and a large round bur, remove infected dentin from the entire fissure system. A spoon excavator or explorer may be used to check for the presence of carious dentin material. 9. Wash thoroughly, and dry. Etch for 15 seconds with 37% Phosphoric Acid. (apply first to enamel, then dentin) 10. Rinse and dry thoroughly. Enamel should be frosty, but do not desiccate dentin. 11. Apply a drop of Concepsis to the dentinal surface, leave 60 sec. Suction dry but do not desiccate 13. Apply a thin layer of Optibond Primer to dentin, leave 60 sec, then gently dry thoroughly to evaporate solvent. Dentin should glisten. 14. Apply thin layer of Optibond Adhesive and cure for 20 sec. 16. Apply Filtek Supreme Ultra no thicker than 2mm. into the void created by tooth removal. Cure each increment for 20 sec. 17. Seal margins with PermaSeal or Sealant. Cure 30 sec. 18. Rinse, rub with alcohol dampened cotton roll to remove air inhibited layer 19. Check Occlusion 20. Polish with rubber point By the end of the course this will be second nature!

For Instance: Which direct operative material is appropriate? AmalgamComposite Heavy occlusionMinor occlusion Root surfaceEsthetic area Unable to isolateIsolate able Easyto fill, hard to prepEasy to prep, hard to fill CheapSolvent patient

Composite Restoration: (Preparation includes contact area) Apply a thin layer of Filtek A1 Enamel into the putty matrix, then firmly seat the Matrix and light cure for 20 sec. Using opaque material create dentinal anatomy and cure. Cover with enamel material, sculpt and cure. A tiny amount of Wetting resin may be used to help in the sculpting process. Next semester we will introduce complex esthetic direct restorations.

Today in D611 we will identify Operative instruments and supplies from your student kits. Work with your professors to sort and organize these so that your lab time will be well spent.