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Operative Dentistry. Cavity Preparations. Indication of Operative Dentistry. Caries ; Malformed, discolored, or fractured teeth; Restoration replacement. Tooth-colored restoration. For Class Ⅲ , Ⅳ and Ⅴ , Esthetic Dentistry For Class Ⅰand Ⅱ , .

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operative dentistry

Operative Dentistry

Cavity Preparations

indication of operative dentistry
Indication of Operative Dentistry
  • Caries;
  • Malformed, discolored,

or fractured teeth;

  • Restoration replacement.
tooth colored restoration
Tooth-colored restoration

For Class Ⅲ,Ⅳ and Ⅴ,

  • Esthetic Dentistry

For Class Ⅰand Ⅱ,

slide4

What are Tooth-colored materials?

What is their working mechanism?

What are the cavity preparation futures for tooth-colored restoration?

slide5

What are steps for tooth-colored

restoration?

What are the advantage & disadvantage

of tooth-colored restoration?

tooth colored materials
Tooth-Colored Materials
  • Composite resin
  • Glass ionomer cement
  • Compomer
composite resin
Composite Resin

Traditional composites

Hybird composites

Flowable composites

Condensable composites

Packable

Universal composites

glass ionomer
Glass Ionomer
  • Chemical adhesion to dentin
  • Release Fluoride
compomer
Compomer

Compomer =

Composite

+

Ionomer

dental adhesion or dental bonding
Dental Adhesionor Dental Bonding

Adhesion is a process of solid and/or

liquid interaction of one material with

another at a single interface.

slide11

Enamel bonding system

Enamel bongding depends on resin tags

becoming interlocked with the surface

irregularities created by etching.

slide12

Macrotags: form between enamel rod

peripheries.

Microtags: smaller tags form across

the end of each rod.

Macrotags and microtags are the basis

for micro-mechanical bonding.

slide13

Dentin bonding system

The difficulties of dentin bonding:

More water---wet bonding

Lower calcification

Richer organic---collagen network

Smear layer

slide14

The bond strength is primarily related

to micro-mechanical bonding to the

intertubular dentin which occures

between tubules along the cut dentin

surface.

dentin bonding agent dba
Dentin Bonding Agent, DBA

Early DBA were hydrophobic, bonded

directly to the dentin smear layer.

Bond strengths<6MPa.

Later DBA removed the smear layer but

tended to over-etch dentin.

Bond strengths≈10~12MPa.

slide16

DBA were chemically modified to be

more hydrophilic.

Bond Strengths≈18~20MPa.

Careful dentin conditioning,

Coupled with hydrophilic primer,

Bond Strength≈22~35MPa.

the development of dba
The Development of DBA

Enamel etch (1955)

Dentine etch (1960)

Treatment of smear layer (1980)

Wet Bonding technique(1990)

slide18

First generation

Second generation

Third generation

Fourth generation: Total etch technique

Fifth generation: One bottle system

Sixth generation: All in one,2000

Seventh generation

cavity preparation
Cavity Preparation

Three designs of cavity preparation:

1.Conventional

2.Beveled conventional

3.Modified

slide20

Beveled conventional cavity preparations

are similar to conventional preparation,

in that the outline form has external,

“box-like” walls, but with beveled

enamel margin.

slide22

Beveled conventional cavity designs for

Class Ⅲ, Ⅳ and Ⅴ preparations

slide23

The advantages :

The ends of enamel rods are more etched

The increase in etched surface results in

a stronger bond

Increase the retention and reduce marginal

leakage and discoloration.

More esthtically

slide24

Modified cavity preparation

Have neither specified cavity wall structure

nor specified pulpal depth, and have enamel

margins.

Conserve more tooth structure.

initial clinical procedure
Initial Clinical Procedure

Local anesthesia

Preparation of the operating site

Shade selection

Isolation of the operating site

with rubber dam or cotton rolls

clinical procedure
Clinical Procedure

Cavity preparation

Acid etching enamel & conditioning dentin

Matrix application

Application of bonding agent

Insertion of composite

Finishing procedures

conservative operative dentistry
Conservative Operative Dentistry

Minimal intervention dentistry

is regards as a main stream in caries treatment in the 21st century.

slide44

Principles of Minimal Intervention dentistry

  • Remineralization of early lesions
  • Reduction in cariogenic bacteria, to elminate the risk of further demi-neralization and cavitation
  • Minimum surgical intervention of ca-vitated lesions
  • Repair rather than replacement of defective restorations
slide45

“The day is surely coming, and perhaps

within the lifetime of you young men

before me, when we will be engaged in

practicing preventive, rather than reparative, dentistry. ”

  • GV Black in 1896