Dr. Gaurav Garg (M.D.S.) Lecturer, College of Dentistry Al Zulfi, MU. Asalaam Alekum Introduction to Operative Dentistry Dr. Gaurav Garg (M.D.S.) Lecturer, College of Dentistry Al Zulfi, MU.

CONTENTS 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)

4. RESTORATION REPLACEMENT OR REPAIR

OPERATIVE PROCEDURES Procedures commonly done are: Direct Restorations Indirect restoration 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 re-establish 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 With diamond or TC burs attached to hand held device called hand piece at high speed (200000-400000 rpm) for gross cutting. With finishing burs attached to slow speed hand piece (30000 – 40000 rpm) or hand cutting instruments for finer adjustments Tungsten carbide Diamond Burs Hatchet Spoon excavator

Terminology in Tooth Preparation F/B D M Understanding the terminology will help dental assistants prepare the correct instruments for a procedure. L Line angles & Point angles Axio-Pulpal line angle 22

CLASSIFICATION OF CARIES G.V. BLACK’S CLASSIFICATION OF CARIES

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

THANK YOU!