Identifying and Charting Restorations Marcia Espinoza, Reina Ligeralde, Dorinda Thomas DEH

Common Dental Materials Amalgam Composite Porcelain Sealant Veneer Post Fixed Partial Denture Inlay Onlay

Amalgam An alloy that consists chiefly of silver mixed with mercury and variable amounts of other metals Appears radiopaque radiographically

Amalgam Appearances ClinicalRadiographic

Composite Also called a white filling Typically consists of a resin-based matrix and an inorganic filler (which gives the composite wear-resistance and translucency) May appear radiopaque radiographically (older ones may appear radiolucent)

Composite Appearance ClinicalRadiographic

Porcelain Produced by mixing ceramic powder with distilled water Appears radiopaque radiographically

Porcelain Appearances ClinicalRadiographic

Sealant A tough, plastic material designed to bond to the tooth enamel Clear or tooth-colored material that seals the pits and grooves Not seen radiographically

Sealant Appearances ClinicalRadiographic Not seen but possibly a faint radiopacity on occlusal surface

Veneer A thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface Two types of materials can be used in a veneer: composite and porcelain Appears radiopaque radiographically

Veneer Appearances Clinical

Post and Crown Often, only the root portion is left to retain the crown. A gold casting called a post and core Common practice to cement a post about two- thirds of the way into a root canal Core = the part of the post that protrudes from the root canal

Post and Crown Radiograph

Fixed Partial Denture (FPD) Designed to replace more than one missing natural tooth Dentist attaches an FPD to natural teeth (abutments) or roots by cementation Pontic = artificial tooth suspended from the retainer casting, occupies the space formerly filled by the crown of a natural tooth Unit castings are joined together by connectors. The units may be made entirely from metal, combination of metal or resin, or from a combination of metal and porcelain.

FPD aka Bridge Appearance

Inlay vs. Onlay

Inlay vs. Onlay Clinical Appearances InlayOnlay

Surface Restorations Examples: O, B, L, DO, MO, MOD, MOB, OL, OB, MF, ML, DF, or DL A dental restorative material used to artificially restore the function, integrity, and morphology of missing tooth structure Appears radiopaque radiographically

Surface Restoration Appearances ClinicalRadiographic

How to Identify Dental Materials Clinically Tactile detection: Composite restorations have a distinct tactile feel with the explorer that contrasts with a natural tooth or a ceramic or porcelain restoration. A black line of metal may be apparent when an explorer is used on the material. Air: Aesthetic restorations may reveal a dry, chalky appearance when air is applied.

Charting Restorations Use blue ink and draw symbol for existing restoration. Place appropriate letter for restoration material (e.g. A, C, P, V) on facial or buccal aspect of chart, above/below root apices. Place an “S” on the occlusal surface of the tooth that has a sealant.

More on Charting Restorations For a bridge, mark missing tooth/teeth with straight line, outline the crowns of teeth, and fill in with diagonal lines. Draw 2 sets of parallel lines between crowns of teeth. Place appropriate letter representing type of material on facial or buccal. Mark a straight line inside root areas(s) of affected tooth for a root canal therapy.

Test YOUR Knowledge! Identify 3 incorrect charted restorations.

Amalgam or Stain? Name two ways you can tell if your patient has an amalgam or a stain.

Composite or Sealant? What is the difference between the two?

Answers 4 - “P” should be on the buccal, not the lingual, aspect of the chart, above the apices. 14 – “S” should be on the occlusal surface rather than on the buccal aspect of the chart, above the apices. 31 – Blue, rather than black, ink should have been used.

More Answers You can use tactile detection and air. With tactile detection, there will be a distinct difference in sound. There is more of a solid ringing noise when an explorer goes across a restoration and more of a jagged, scratching noise when an explorer runs along a tooth surface that has a stain, especially if the tooth surface has pits. A composite will cover a surface whereas a sealant will cover a pit or groove.

Questions?