1. GOOD MORNING

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

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

4. 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.

5. 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

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

7. Teeth are divided in to four quadrant

8. 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

9. 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

10. 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

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

12. 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 – years
Second premolars – years
First molars – 6-7 years
Second molars – years
Third molars – years

13. Permanent dentition

14. Primary & Permanent dentition

15. 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

16. Structure of tooth
Enamel
Dentin
Cementum
Pulp

17. 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.

18. Dentino-enamel junction - DEJ
Cemento-enamel junction - CEJ

19. Central Incisor

20. Lateral Incisor

21. Canine

22. First Premolar

23. Second Premolar

24. First Molar

25. Second Molar

26. Third Molar

27. 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.

28. 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

29. 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

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

31. Tooth Notation

32. 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.
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

33. 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

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

35. Having a different notation for the teeth in each segment -- UNIVERSAL SYSTEM
Universal system was given by American dental association in 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

36. UNIVERSAL SYSTEM -Having a different notation for the teeth in each segment
PERMANENT TEETH
PRIMERY TEETH
A B C D E F G H I J
T S R Q P O N M L K

37. 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

38. ARMY SYSTEM -Having a different notation for the teeth in each segment
PERMANENT TEETH PRIMARY TEETH E D C B A A B C D E J I H G F F G H I J

39. 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.

40. 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

41. 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

42. FDI SYSTEM (FERATION DENTAIRE INTERNATIONALE(FDI) IN THIS SYSTEN TWO DIGIT ARE ACCEPTED
PRIMARY TEETH

43. 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

44. 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

45. 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

46. 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

47. Caries of Tooth

48. 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.

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

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

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

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

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

54. 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.

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

56. Abnormal form of tooth–peg shape lateral, taurodontism

57. 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.

58. 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.

59. 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

60. TERMINOLOGY RELATED TO TOOTH
Anatomical crown clinical crown

61. 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

62. 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.

63. 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

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

65. 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

66. 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 .

67. 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.

68. 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.

69. 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

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

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

72. 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.

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

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

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

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

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

78. 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

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

80. 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

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

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

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

84. 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

85. 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

86. 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

87. THANK YOU