1. 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.

2. CONTENTS Definition Indications for operative treatment
Operative Procedures
Tooth Preparation
G.V.Black’s classification for caries & restorations

3. 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

5. INDICATIONS FOR OPERATIVE TREATMENT

6. 1. DENTAL CARIES Cervical Caries Pit and fissure Caries
Proximal Caries

7. 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

8. 2. MALFORMED, DISCOLORED, OR FRACTURED TEETH
Malformed tooth
Discolored teeth
Fractured tooth

9. 3. WEARING OF TEETH (ATTRITION, ABRASION, EROSION)

10. 4. RESTORATION REPLACEMENT OR REPAIR

11. OPERATIVE PROCEDURES Procedures commonly done are: Direct Restorations
Indirect restoration
Veneers

12. 1. DIRECT RESTORATIONS
Direct Restoration – After tooth preparation, the restoration is placed in a moldable stage in the prepared tooth to recreate normal contours.

13. 1. DIRECT RESTORATIONS Amalgam Composite resin
GIC (Glass ionomer cement).

14. 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

15. 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

16. 2. INDIRECT RESTORATIONS
Inlay
Onlay
Crowns (base metal, precious metal, porcelain fused to metal, or metal free ceramic)

17. 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

18. 3. VENEERS Material: Composite resin (Direct/ Indirect)
Porcelain (Indirect)

19. 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.

20. 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

21. TOOTH PREPARATION How is Tooth preparation done
With diamond or TC burs attached to hand held device called hand piece at high speed ( rpm) for gross cutting.
With finishing burs attached to slow speed hand piece (30000 – rpm) or hand cutting instruments for finer adjustments
Tungsten carbide
Diamond Burs
Hatchet
Spoon excavator

22. 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

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

31. 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

32. THANK YOU!