GOOD MORNING

DR PRITI D DESAI ASSOCIATE PROFESSOR CONSERVATIVE ND ENDODONTIC DENTISTRY GURUNANAK INSTITUTE OFDENTAL SCIENCE AND RESEARCH, PANIHATI KOLKATA-127

DENTISTRY Dentistry is branch of medical science which deals with diagnosis ,treatment plane, prognosis and prevention of disease of the teeth

Conservative Dentistry Conservative dentistry is branch of dentistry which deals with the diagnosis, treatment plan ,prognosis, and prevention of disease of hard structure of teeth(enamel dentin ,cementum), restoring them to their own form ,function and esthetics there by maintaining the stomatognathic system.

Tooth Tooth is mineralized organs in the mouth that are used to pronounce letters and mostly to chew on food. Two sets of teeth comes in human life Primary dentition - total 20 teeth are present Permanent t dentition - total 32 teeth are present

Function of teeth are- Mastication, Esthetic (appearance) Phonetics(speech)

Teeth are divided in to four quadrant

Primary dentition- milk teeth or deciduous teeth Central incisor Lateral incisor Canine First molar Second molar These five set of teeth comes in each quadrant upper right, upper left Lower right, lower left

Primary teeth and their approximate appearance in mouth Upper Jaw Central incisors – 7½ months Lateral incisors – 9 months Cuspid – 18 months Primary or first molars – 14 months Lower Jaw Central incisors – 6 months Lateral incisors – 7 months Cuspid – 16 months Primary or first molars – 12 months

Permanent dentition central incisor lateral incisor Canine First premolar Second premolar First Molar Second molar Third molar These eight teeth as set of teeth comes in each quadrant

Permanent teeth and their approximate appearance in mouth Upper Jaw Central incisors – 7-8 years Lateral incisors – 8-9 years Cuspid – 11-12 years First premolars – 10-11 years Second premolars – 10-12 years First molars – 6-7 years Second molars – 12-13 years Third molars – 17-21 years

Permanent teeth and their approximate appearance in mouth Lower Jaw Central incisors – 6-7 years Lateral incisors – 7-8 years Cuspid – 9-10 years First premolars – 10-12 years Second premolars – 11-12 years First molars – 6-7 years Second molars – 11-13 years Third molars – 17-21 years

Permanent dentition

Primary & Permanent dentition

Anatomy of tooth Two portion Crown –portion seen inside mouth Root-portion remain in bone Neck - marks the boundary between the root and the crown

Structure of tooth Enamel Dentin Cementum Pulp

DEJ CEJ The line of union between enamel and dentin is known as dentino-enamel junction (DEJ) The line of union between cementum and enamel is known as cemento-enamel junction (CEJ) Both are clinically very important during cavity preparation and restorative procedure.

Dentino-enamel junction - DEJ Cemento-enamel junction - CEJ

Central Incisor

Lateral Incisor

Canine

First Premolar

Second Premolar

First Molar

Second Molar

Third Molar

Tooth notation system There are different tooth numbering system for naming a specific tooth. Three most common system used are – FDI(world federation notation) Universal numbering system Zsigmondy palmer notation FDI system used world wide and universal is used widely in USA.

Tooth notation system Two categories 1-those having similar notation for the teeth in each segment 2-Those having a different notation for the teeth in each segment

Tooth notation Most system divide the mouth in to four quadrant and dental arch is expressed by cross. Four quadrant denote as follows Upper Right Upper Left R L Lower Right Lower Left

Sometimes it is simplified to denote Upper Right As Upper Left As Lower Right As Lower Lest As

Tooth Notation

System having similar notation for the teeth in each segment Zsigmondy system-palmer’s notation here central incisor of each segment is given no 1 and the numbers then run in distal direction Permanent dentition. 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 E D C B A A B C D E e d c b a a b c d e E D C B A A B C D E e d c b a a b c d e

Primary Dentition E D C B A A B C D E e d c b a a b c d e e d c b a a b c d e

Other system not use number PERMANENT TEETH M3M2M1P1P2C I2I1 I1I2CP1P2M1M2M3 PRIMARY TEETH dM2dM1dCdI2dI1 dI1dI2dCdM1dM2

Having a different notation for the teeth in each segment -- UNIVERSAL SYSTEM Universal system was given by American dental association in 1968.this system is most popular in united states. the universal system uses a unique letter or number for each tooth. Advantage – unique letter or number for each tooth avoiding confusion. Disadvantage - difficult to remember each letter or number of tooth

UNIVERSAL SYSTEM -Having a different notation for the teeth in each segment PERMANENT TEETH 1 2 3 4 5 6 7 8 9 10 11 121 3 14 15 16 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 PRIMERY TEETH A B C D E F G H I J T S R Q P O N M L K

Universal system -has also a variant employing the letter d for deciduous teeth PRIMARY TEETH D1 D2 D3 D4 D5 D6 D7 D8 D9 D10 D20 D19 D18 D17 D16 D15 D14 D13 D12 D11

ARMY SYSTEM -Having a different notation for the teeth in each segment PERMANENT TEETH 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 16 15 14 13 12 11 10 9 9 10 11 1213141516 PRIMARY TEETH E D C B A A B C D E J I H G F F G H I J

FDI SYSTEM (FERATION DENTAIRE INTERNATIONALE(FDI) IN THIS SYSTEN TWO DIGIT ARE ACCEPTED -Having a different notation for the teeth in each segment – First introduced in 1971 which later adopted by ADA (1996).this system is commonly practiced in european countries and cnada and now it is gaining popularity in India also.

FDI system System is known as two digit numbering system in which First number represent tooth quadrant and Second number represent a the number of tooth from the midline of the face. Both digit pronounced separately while communication. e.g. 46 is not forty six but four six

FDI SYSTEM (FERATION DENTAIRE INTERNATIONALE(FDI) IN THIS SYSTEN TWO DIGIT ARE ACCEPTED – Having a different notation for the teeth in each segment PERMANET TEETH 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

FDI SYSTEM (FERATION DENTAIRE INTERNATIONALE(FDI) IN THIS SYSTEN TWO DIGIT ARE ACCEPTED PRIMARY TEETH 55 54 53 52 51 61 62 63 64 65 85 84 83 82 81 71 72 73 74 75

Out of existing system for noting the dentition there is no system which is full proof The safest method is to write full description of the teeth e.g. upper left first permanent molar, lower right first primary molar

Tooth All the parts of the body get repaired by physiologic process when it get damaged but when tooth structure is get damaged it is not repaired by itself especially hard structure of tooth. so tooth is not repairable tissue of the body so it require replacement of tooth structure when ever there is loss of tooth structure. Loss of tooth structure occurs due to various disease of teeth

Disease Of The Teeth Caries Attrition Abrasion Erosion Abfraction Fracture of tooth Discoloration of teeth Hypoplasia of tooth Hypo calcification of tooth Abnormal form of tooth– peg shape lateral, taurodontism

Caries - is multifactorial microbial infectious disease of hard structure of tooth characterized by demineralization of inorganic substance and destruction of organic substance of the tooth

Caries of Tooth

ATTRITION – is defined as physiologic continuous process resulting in loss of tooth structure from direct frictional forces between contacting teeth. it occurs in both occlusal and proximal surfaces.

ABRASION – is refers to the loss of tooth substance induced by mechanical wear other than that of mastication

EROSION – is defined as a loss of tooth substance by a chemical process that does not involve known bacterial action

ABFRACTION – are micro fracture s which appears in the enamel as cervical area of tooth flexes under heavy loads.

FRACTURE OF TOOTH – of tooth occurs due to traumatic injuries due to accident, excessive occlusal load, carious process and improper cavity preparation.

DISCOLORATION OF TEETH – occurs due to various reasons like trauma,drugs,fluroisis,hypoplasia ………………….ect.

HYPOPLASIA OF TOOTH - It refers to the localized defects in the crown portion of tooth caused due to injury to ameloblast during the enamel matrix formative stage.

HYPO CALCIFICATION OF TOOTH –. It refers to the localized defects in crown portion of tooth due to injury caused to ameloblast during mineralization stage

Abnormal form of tooth–peg shape lateral, taurodontism

Nomenclature For understanding the concept s of conservative dentistry it is essential for clinician be thoroughly familiar with the technical terms used during treatment, these terms helps in recording the patient’s sign and symptoms which can be useful during subsequent visits of the patient.

Tooth Crown Are of two types Anatomical tooth crown- means portion of tooth that is covered with enamel. Clinical tooth crown- is portion of tooth that is exposed in the oral cavity.

Tooth Root Anatomical tooth root – is portion of the tooth that is covered with cementum Clinical tooth root - is portion of the tooth that is not visible in the oral cavity is referred to as clinical root

TERMINOLOGY RELATED TO TOOTH Anatomical crown clinical crown

Terminology Related To Tooth Different surface of the tooth are named according to their adjoining anatomic structures e.g. facial surface- facing toward lips-labial surface-F / La Facing towards cheek –buccal surface - B Lingual surface –facing toward tongue - L / Li Palatal surface – facing toward palate -P

Terminology Related To Tooth Mesial surface-facing toward mid line - M Distal surface –facing away from midline – D Incisal surface-functioning edge of the incisor and canine – I Occlusal surface-functioning surface of molar and premolar -O Cervical portion –portion of tooth related to the cervical line or neck of teeth Gingival portion –portion of the tooth close to the gingiva.

Division Of Tooth Crown Crown of tooth Horizontally- occlusal third, Middle third Cervical third Vertically- Mesial third Distal third occlusal middle cervical middle mesial distal

Division of tooth crown occlusal surface Horizontally- Buccal third Middle third Lingual third Vertically – Mesial third Distal third buccal middle lingual Mesial middle distal

Division Of Tooth Root Root of tooth Horizontally Cervical third Middle third Apical third Vertically- Mesial third Distal third Cervical line Cervical Middle apical middle distal mesial

Cavity & Cavity Preparation Cavity – a cavity refers to as a defect in enamel or both enamel and dentin subsequent to the destruction caused by disease.(Breach in the surface integrity of the tooth) Cavity Preparation – as removal of disease structure and the cutting or preparation of remaining tooth structure to best receive a restorative material .

Tooth Preparation Now many indication for teeth are not due to caries and there for it refers to as tooth preparation. Tooth Preparation – is the mechanical alteration of defective ,diseased or injured tooth structure to best receive a restorative material that will reestablish a healthy state for the tooth including esthetic corrections where indicated along with normal form and function.

Restoration- After cavity preparation we replaced the tooth structure with artificial material is known as restoration Restoration- is artificial replacement of lost tooth structure in proper form and function with various restorative material.

Functions Of Restoration Repair of loss tooth structure Establish function of teeth Establish loss contact between teeth Removal of all defects and provide necessary protection to pulp Conservation of tooth Improving appearance of individual

Different types of restorative materials Silver Amalgam Cast Gold Direct Filling Gold (Gold Foil) Glass-ionomer Composite Resin Ceramic

Classification Of Restoration/cavity According to its presence Intra coronal Restoration Extra coronal Restoration According to surface involve Simple Restoration Compound Restoration Complex Restoration

Classification Of Restoration Temporary restoration – is used for short period of time like for 2- 3 days or one week or 15 days or one month Permanent restoration – is used for long period of time like 5 to 6 years or 10 to 15 years.

TYPE OF RESTORATION /CAVITY Intra coronal - means cavity or restoration done interior of the tooth

TYPE OF RESTORATION /CAVITY Extra coronal means cavity or restoration done involving external surface of the tooth

TYPE OF RESTORATION /CAVITY Simple – involving only one surface of the tooth

TYPE OF RESTORATION /CAVITY Compound – involving two adjoining surface of the tooth

TYPE OF RESTORATION /CAVITY Complex - involving more than two adjoining surface s of the tooth

Tooth Preparation Preparation involving occlusal surface is -O Preparation involving the mesial and occlusal surface is – MO Preparation involving the distal and occlusal surface is - DO Preparation involving the mesial occlusal and distal surfaces is - MOD

TOOTH PREPARATION TERMINOLOGY Occlusal -O Mesio-occlusal- MO Disto-occlusal -DO Mesio-occlusal-distal -MOD

Objective Of Tooth Preparation Removal of all defects and provide necessary protection of the pulp Extend the as minimum as possible and conserve remaining tooth structure Form the preparation is such way that under force of mastication tooth or restoration will not fracture or displaced Allow for esthetic and functional placement of restorative material

Terminology for tooth preparation ANGLE –junction of two surfaces is referred to as an angle.

Tooth Preparation Angle - LINE ANGLE – is junction of two planal surface s of different orientation along a line. Line angle M B

Tooth preparation angle POINT ANGLE is junction of three planal surfaces of different orientation Point angle m B P

Terminology for tooth preparation For describing line angle and point angle –surface which form the angle ,they are named accordingly e.g. line angle formed by Lingual and incisal surfaces is termed as linguoincisal line angle, Mesial and buccal surface –mesiobuccal line angle

Terminology for tooth preparation Internal Line Angle is angle whose apex is points in to the tooth External Line Angle whose apex points away from the tooth

Terminology for tooth preparation Cavo-surface Angle –is angle of tooth structure formed by the junction of a prepared tooth surface and the external surface of the tooth. Cavo-srface Margin is actual junction of prepared tooth surface and external surface of tooth

THANK YOU