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[KUILLIYYAH OF DENTISTRY INTERNATIONAL ISLAMIC

UNIVERSTY MALAYSIA]

[PRATICAL HANDOUT]
[OPERATIVE
DENTISTRY]
DR.SHAWFEKAR

[2009]

[ INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA]


OPERATIVE DENTISTRY

LOCATION OF CARIES: Primary Caries. Primary caries is the original


carious lesion of the tooth. The etiology, morphology, control, and prevention of
caries are presented in Chapter 3. Associated with certain areas of the teeth, variations
of this pathologic condition fundamentally influence tooth preparation and should be
emphasized. Three morphologic types of primary caries are evident in clinical
observation: (1) carious lesions originating in enamel pits and fissures, (2) carious
lesions originating on enamel smooth surfaces, or (3) carious lesions originating on
root surfaces. Also described in the following sections are backward caries, forward
caries, and residual caries. Of these, the terms backward caries and forward caries are
used.

Caries of Pit-and-Fissure Origin. Pit-and-fissure caries can form in the regions of


pits and fissures usually resulting from the imperfect coalescence of the
developmental enamel lobes.

Pit and fissure of tooth caries (decay)

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Caries of Enamel Smooth-Surface Origin. Smooth-surface caries does not begin in
an enamel defect, but rather in a smooth area of the enamel surface that is habitually
unclean and is continually, or usually, covered by plaque.

Facial caries (decay) of the tooth

Caries on proximal surface of the tooth

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Cavity prepation for occlusal pit and facial caries.

Forward Caries. Forward caries is wherever the caries cone in enamel is larger or at
least the same size as that in dentin.

Backward Caries extends from DEJ into enamel

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Residual Caries. Residual caries is caries that remains in a completed tooth
preparation, whether by operator intention or by accident. Such caries is not
acceptable if at the DEJ or on the prepared enamel tooth wall.

Root-Surface Caries. Root-surface caries may occur on the tooth root that been
exposed to the oral environment and habitually covered with plaque

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Root surface caries

Secondary (Recurrent) Caries. Secondary caries occurs at the junction of a


restoration and the tooth and may progress under the restoration. It is often termed
recurrent caries. This condition usually indicates that microleakage is present, along
with other conditions conducive to caries

Secondary (recurrrend caries)

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Illustration indicating external and internal walls for an amalgam

Tooth preparation.

Visualization of cavosurface angle and associated

minimal restorative material angle for a typical amalgam tooth preparation

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Classification of tooth preparations

Typical Class I tooth preparation for amalgam on maxillary premolar

Illustrating tooth preparation walls: facial (f), distal(d), lingual (l), mesial(m),
and pupal (p)

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Illustrating tooth preparation line angles and point angles, line angles are
faciopulpal (fp), distofacial (df), distopulpal (dp), distolingual (dl), lingualpulpal
(lp), mesiolingual (ml), mesiopulpal (mp), and mesiofacial (mf), point angles
are distofaciopulpal (dfp), distolingualpulpal (dlp), mesiolingupulpal (mip), and
mesiofaciopulpal (mfp).

Sample of Class I Caries And Preparation

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Conservative Composite Restoration. Dotted line indicates the area to be sealed
around central pit tooth preparation.

Inverted Cone Composite Preparation Instrument

Class I Cavity Preparation

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Instrument is move mesially to all faults

Preserve Dentin support of marginal ridge enamel (A)


maolar, (B) premolar

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Bevelling Facial groove extension (A) facial view, (B) occlusal view

Modified Class I tooth preparation using round diamond bur.

Class I pit preparation for composite restoration

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Sample of Class I Composite Restoration

Contouring and polishing Class I Composite Restoration

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Caries can be diagnosed by radio graphically by translucencies in enamel or
dentin. (A) and (B) Proximal caries, (C) Occlusal caries , and (D) Recurrent
caries.

Proximal overhang (a) can be diagnosed radiographically.

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Retract the lip using mouth mirror

Examining the tooth

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Recommended seating position for operator and chair side assistant

CLASS II CAVITY PREPARATION

A B

(A)Typical class II Mesio-occlusal on maxillary premolar, (B) Illustration


tooth preparation wall (f) facial of proximal and occulsal portion, (g)
gingival, (l) lingual of proximal and occlusal portion, (d) distal, (p)
pulpal, and (a) axial.

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fg ag lg
fg

Illustration tooth preparation line angle and point angle. Line angle are
distofacial (df), Facialpulpal(fp), axiofaxial (af), fasiogingival (fg), axiogingival
(ag), linguogingival (lg), axiolingual (al), axiopulpal(ap), linguopupal (lp),
distilingual (dl) and distopupal. Point angle are distofasiopulpal (dfp),
axiofaciopulpal (afp), axiofaciogingival (afg), axiolinguogingival (alg),
axiolinguopulpal (alp), and distolinguopulpal (dlp).

A sample of Amalgam Class II restoration.

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Class II Composite Conventional Tooth Preparation

(A)Occlusal View, (B) Proximal View

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Class III, Class IV and Class V preparation

Modified preparation design for Class III, Class IV, and Class V

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Class III tooth preparation for maxillary central incisor

Illustrating tooth preparation wall, facial (f), axial (a), lingual (l),

and gingival (g)

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Illustrating tooth preparation for class III line angles and point angles. Line
angles are incisal (i), axiolingual (al) linguogingival (lg), axiogingival (ag),
faciogingival (fg) and axiofacial (af). Point angles are axiolinguogingival (alg),
axiofaciogingival (afg) and axioincisal (ai).

Sample of Class III Cavity

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Class IV conventional tooth preparation for inlay on maxillary canine.

Illustrating tooth preparation wall: facial (f) of proximal and incisal portions,
gingival (g), lingual (l) of proximal and incisal portions, axial (a), pulpal (p),
and mesial (m)

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Illustrating tooth preparation line angles and point angles. Line angles are
(mp),(mf), (fp), (af), (fg),(ag), (lg), (al), (ap), (lp), and (ml). Point angles are
(mfp), (afp), (afg), (alg), (alp), and (mlp).

Sample of Class IV cavity

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Clinical Procedure of Class IV Composite
Restoration

A B

C D

E F

G H

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I

Class V Cavity Preparation

Class V conventional tooth preparation

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Illustrating tooth preparation walls: mesial (m), axial (a), gingival (g), distal (d),
and incisal (i) or occlusal (o) if preparation on posterior.

di
ad

dg

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Sample of Class V Caries

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Class V
AR

Class V Glassionomer Restoration as shown in below

A B

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Caries Outline
form

Class V caries and outline form

Conventional Class V tooth preparation (A) leasoin entirely on the root surface,
(B) Intial tooth preparation with 90% carvosurface margin and axial wall depth
0.2mm, (C) remaining infected dentine exavated and incisal and gingival
retention form.

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Illustrating tooth preparation line angles and point angles. Line angles are
(ai),(mi), (am), (mg), (ag),(dg), (ad),and (di). Point angles are (adi),(ami),(amg),
and (adg)

A. view of stress transfer into an unrestored tooth, B. view of stress


transfer into restored with amalgam

Occlusal view of amalgam restoration

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A

B
Example of function of sealant on first molar after 5 years(A), and
after 15 years (B) of clinical service.

Locations of different types of wear on posterior composite restorations

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Composite restoration Class II and Class IV

Porcelain Pontics

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