Restorative Final (A1-A4) 3 PDF

Ghazal Mani @h both the permanent Nomination > morphology oietofteeth > systems NOT...

Ghazal Mani @h both the permanent Nomination > morphology oietofteeth > systems NOTES Tooth Anatomy Morphology CROWN thepartoftheloothvisible.in/-heoralcavity( tooth > CROWN, NECK ROOT , covered by enamel) NECK - the cross section oftheneckofatoothis important as during a tooth extraction the forceps grasp the neck cross - ROOT intheavedarboneand - section. is covered by cementum deciduous/milk teeth 20in total : → 51eethineachquadrant-i.NO premolars → No3rdmdar(wisdom tooth) Remaining /permanent teeth 32leethinlotal-8teethpe.ir : quadrant → central incisor a. > 1126rad 1 canine incisor lgzfrontleeth s2 premolars > 3. molars > the 3rd molar __ wisdom tooth maxillary teeth COPPER) srleethperquadrant 1) maxillary central incisor crown - bigrshovel shaped cross-section of neck → almost circle shaped Root - not curved > Iroot - Lrootcanal > cirdecrossseclianoftheneckisheldunlilthe apex  2) maxillary lateral incisor - - crown ssimilarshovelshape > Smaller - - snore gracile cross-section of neck > Oval ( flattened inmesiodistal direction) Root -1 root - Iovalcanal foramen coecum v1 → atthelastthirdoftheapexthe cross-section palatal surface oftheroot becomes circular → oflenbentinapi.cat/-hirdCpalatnally&distally) 3) maxillary canine > BIGGEST INTHEORALCAVITY crown → bigrxmassive → wedge shaped cross-section of neck - rounded equilateral triangle Coneedgelooksin vestibular direction) Root → Lroot - Lrootcanal > Stronger straight biggestintheoralcavilyQ-lapex ongestroottscanalci↳rcularh.tl → 20 -22mm 4) maxillary first premolar ( bicuspid) crown → flat , looks rounded rectangular.no/-big,gracile-s2cuspsC1buccal,LpalataD BICUSPID - cross-section of neck sfingerbisquitshaped root -113 of 2rootscbuc.cat/-palatal)s2rootcanails 213 of population Iroot population , → bifurcation canbeanywherebetweentheneckandapex → after bifurcation the roots are thin and fragile > after bifurcation thecrosssedicnoftherootis rounded Cintheneckitwasfingerbisquitshaped D M  5) maxillary second pre - mdarcbicuspid) crown similar 101st premolar s2CUSps ( BICUSPID) cross section of neck → not so significantly fingerbisquit shaped Cdepressionatmesialside) root :L root - Lorrdcanals ( cross section is irregularly flattened across the whole radix 6. 7. 8) Maxillary molars sm BIGGEST CROWN / NTHEORALCAVITY grounded rhomb cross section ofneck-slikeaheartonthecardscdepressionis.in the vestibular side) root gmesiobuc.cat 3 roots -2 buccal sdiskbuccal 30hr4 root canals ! → Ipalahnal Palatina Mesiobuccal Distbuccal Biggest/ most massive also strong weakest root root Lcanal most cases 2 canals 1 canal circular cross-section fingerbisquitcross section - circular cross section 1st molar : mesiobuccal ( BIGGEST ) > ↳ hasa special ↳ cusps -2 buccal sdistbuccal cuspofcarabelli ↳ palatal smesiopalatal sdislopalatal ( SMALLEST ) foramen coecum may have canals tr palatal surface 3. roots -30124 canals )^ 2buccal-smesiobuccals1palatinadQ-distbuc.cat >  2nd molar - smaller than 1st molar 32001-5-3 root canals ↳ mesiobuccal 3rd molar → distbuccal VERY VARIABLE ↳ palatina mandibular teeth CLOWER) 1) mandibular central incisor - SMALLEST TOOTH / NTHEORALCAVITY crown → chisel shaped crosssedionoftheneck → thin → elliptic root → Iroot - Irootcanal 2) mandibular lateral incisor crown → still chisel shaped sabitbiggerklessgra.ci/ethancentral cross section > rounded rectangular shape root stroot Lrootcanalcflatened) - → flattened shape nasabitlongerrootthancentralincisor 3) mandibular canine crown - Similar to maxillary canine > BIT ! smaller & rounded shaped cross-section of neck ellipsoid shaped - > root→ Lroot - Lrootcanal SECOND LONGEST ROOT inI.5.tofall cases the > Huge &Stong apexofthe rootbifurcates > elliptic shape along the whole radix 4) mandibular first premolar ( bicuspid) 205ps ( BICUSPID) > 1 buccal ( BIGGER) stlingual cross-section of neck - irregularly flattened inmesiodistal direction root - Iroot Irootcanal - Buccalcusp bigger than palatal 5) mandibular second premolar ( BICUSPID) Cusp may have 20R3_cusps buccatxiñgual s1buccal£2 lingual Iroot - Lrootcanal 6,7 8) mandibular molars , crown → smaller than upper > Square rectangular ( rounded corners) 2 roots Imesialccanhaverdcanals) 20133 canals } - stdistal Mesial Distal mandibular 1St molar fingerbisquitcross section stronger/more massive - can have 2 canals less flattened /rounded distally bent foramencoecum flatened t buccal surface mandibular 2nd molar ↳ cusps 2roots -20123 + canals mesio& smesialroot distr distal root buccalt mesiooxdish > scoops 2 roots -3 root canals smesiobuccalcbiggest) smesialrootc2canalsldistbuccalcsmaues.tl/sdistalroot lingual foramencoecum mesiolingual t buccal surface distlingual distal  mandibular 3rd molar where aretheforamencoecum ? VARIABLE lateral incisor 1) maxillary 4or5or6 cusps → Palatal surface Usually 2roots( mesial 2) maxillary molars → Palatal surface & distal )BUTit may 3) mandibular molars - buccal surface have 1-4 roots ! https://youtu.be/suhwJXA0m6A?si=1nDZp-rho2vW0t5v Nomination systems > Marking of teeth Reminder permanent teeth → 8 per quadrant Deciduous teeth → sperquadrant *^"""°* 1. central incisor Deciduous teeth to 2. lateral incisor 1. central incisor 3 canine : 2. lateral incisor 42-5 :first&second premolars In deciduous teeth 3. canine 62.72×8 1st 2nd 3rd molars : , , nothirdmolarcwisdom42-5.IS/-&2ndmo1ars premolars no - tooth ) 1) Zsigmondy / palmer Cross } records quadrants dentition is divided into 4 quadrants by across * t 8- 1g 1-8 AR } upper arch for deciduous teeth 1-8 8- I [ } lower arch itisdenoledwithroman g tooth nearest each quadrant is assigned a symbol numerals to midline is Lalways ( corner) that represents that quadrant ( I.It, II.V ) 2) FDI → Federation Dentaire Internationale 2 digit tooth numbering system slstnumberindicatesthenumberofthe quadrant > 2nd number indicates tooth number within quadrant AB for permanent teeth for deciduous teeth R R L 1 2 ↳ upper and then (1-8) 5 6 4 3 } lower depending on the number of the 8 7 Soe g.quadrants is - tooth AE and then ( 1- 5) depending maxillary /upper right onthenumberofthetothsgq  Permanent teeth 3) Universal System > maxillary teeth are numbered from 1-16 ( starting from maxillary rightthirdmdarandendingwith maxillary /eftthirdmdar UPPER ARCH """""" " """ """ " cfromleftmandibularthirdmdarzends.at right mandibular third molar) LOWER ARCH start point sright maxillary 3rd molar Endpoint - right mandibular 3rd molar Deciduous teeth } instead of numbers we use alphabets maxillary A 5J UPPER ARCH mandibular _K→T LOWER ARCH Wearemovinginaclockwise position ! 4) European Haderup Scandinavian :ma/ illary ( Upper) : mandibular ( Lower) thepositonoftl - indicates whether its left or right for permanent : andthenthenumberoftothct → 8) * for deciduous : e. g. Iz - same signs + for upper & forlower - Ttfomci → means - 8) numbers - weaddaobeforethenumberofthetoth upper is 'd "nine* ( t) there is no ( number of tooth 01-05 > to zero before the } soit 's a thectisatthe 01,02 03,0405 , permanent leftsideofthe tooth number so it's left Answer Upper left permanent canine : Identification of teeth EM OHLREITERMARKS - the Mohlreiler ✗ Right signs aroused OR this is Left ? to distinguish all based between left on the anatomy teeth of the Enright teeth both 1) lnoisaledgesigncatincisors) from vestibular view mesial → sharp mesialinasalangle → sharp distal → Rounded distatincisalangle → Rounded 2) Vestibular cunahresigncatthefrontlxpremolarleeth) = fromtheincisdlocclusalviewthe roundness roundness ofuesybutdroftheveslibularsurface.is/3lGGER0NTHE- is MESIALSIDE surfaceon bigger side mesial 3) Root sign - Jano - longaxisoftherootistilted distally & orally long axis , compared ttheaxisofthecrown tilted distally &oraHy axisof 4) Rootcurvesign thecrown - apical 113 of the root CURVE to the DISTAL = - 5) cusp inclination sign ( Inlowermdarteeth) buccal cusps LEAN ORALLY 6) Abrasion sign > ORALSIDEOF the OCCLUSAL SURFACE at the MAXILLARY > BUCCAL SIDE of the OCCLUSAL SURFACE at the MANDIBULAR TEETH  - 7) Rootgroovesign surface oftheroot - mesial > CONVEX distal surface of thereof > FLAT HAVE A CONVEX Tfatorhavea groove GROOVE 8) Cervical concavity sign from @ cervical cross-section mesial side > CONCAVE OR FLAT concave distal side CONVEX convex opfiat → Justasa reminder : concave → curving inward convex > Curving outward  they are Dentalcaries } interconnecting topics CARIES an infectious microbiological disease 1 a oftheteeth a - results in localized dissolution - results in destruction of the calcified tissues ( MOST COMMON CHRONIC DISEASE) There are simultaneously temineralizah'on& demineralization processes → CARIES FOMATIONOCCURSWHENTHE DEMINERALIZATION PREVAILS THE CARIES BALANCE { (disequilibrium between demineralization & soccursataptlunder-5.rs ! ! ! remineralizalian) ( critical pH) 1. normal Demineralization ( CARIES) Remineralizalian CNOCARIES) oralptltefers.to/-he1ossofessen1iatmineralsprocessof- restoring lost minerals back 6.2 primarily calcium phosphate from the tooth into the tooth enamel - a. , 6. -7 enamel ssalivaplaysacrucialrole supplying tr This process occurs when acids minerdlssuchascakiumQ-phosphateloofdea.ie equilibration > produced by - repair damaged bacteria inthemouthoflen the enamel mineralization duetthebreakdownofsugarrx fluoride also enhances remineralizatior > carbohydrates from food attacks the , ↳ from fluoridated water tooth , toothenamelctheyenlerthroughtheinlerpn-sma.to pastor professional treatments substance - mineral content dissolves & diffuses) 1- also fluoridated mouthwash results in : > enamel crystalsthin > interprismalic substance increases > regular arrangement ofthecrystalslwctre ofthee.name/isdamagedDentalcan-esisa multifactorial disease : mainly factors influencing caries > 1) Substrate 2) time But also genetics fluoride , 3) microorganism - diet → composition , sugar , frequency 4) host - Saliva → Composition flow rate buffer , , capacity  - canstrecarbohydrates as dextrin cariogenic bacteria > Streptococcus mutans > Lactobacillus caries Predilection area's ( not self-cleaning) develop in - pitsxfissures smooth surfaces - Cundercontactpoints) - on the root surface → approximal QNestibular.ORG - Gingival third on vestibular/ lingual * Surface stoothadherentcariogenic bacteria metabolize sugars tproduceaa-dwhichoverhmedemineraliz.es/ooth structure by attacking the enamel U-typefv-typefissuresI-typeQ.TK - type fissures > easytdean → difficult tdean ↳ risk factors & Protective components under pH 5.5 Influencing factors : - acid from bacteria - - saliva > behaviour - oral hygiene - Sub normal saliva flow - - fluoride snacking / diet / sugars frequent eating sugaracarbs-goodoralhygienesbacteriainbioh.IM - - ' diet> hygiene healthy - poor oral - microbiome scariogenic bacteria - changingto ssalivacflowrate composition buffer capacity) , , improved eating scakiumrxphosphateinenamel habits > fluoride > Income education knowledge attitude > , ,  duet diffusion of diffusion of calcium & acids ( produced by phosphate ions into the bacteria in the mouth demineralizedenamekyour duet breakdown of body takes minerals from sugarszcarbohydraleslintena.net your saliva sits mineral content calcium G- phosphate> is dissolved fluoroapalitecanalsobe formed in the presence of Bacteria inthemouth fluoride } which is more resistant hoacids ✓ theintakedsugar (acid attacks) e. fermenting producing harmful acids serosionoftoothena.me/- demineralization STRUCTURE OF ENAMEL composition : 97-1 Inorganic - 3-1. organic & water (1-120) lnterprismalic substance enamelprismcrods) } Basic structural ✗ material between enamel unitofenamel ( with prisms hydroxyapatite crystals) made of hydroxyapatite crystals > calcium ions phosphate ions hydroxyl , , butdif era.in/-heorientat-onofthecrystalsions5tiaof- retzius } incremental growthlinesseeninenamelcrepresent periodic deposition of e.name/dun-ngtoothdevel } they opment7Pen-kymata are the external manifestations ofthestiaeofretziusonthe enamel surface  > is formed throughout life ! STRUCTURE OF DENTINE first forming dentin layer a. Mantle dentine -1500m wide IRREGULAR GLOBULAR STRUCTURE a- Primary dentine REGULAR TUBULES a- Secondary dentine → Slow dentin formation → lastsalifeh-mecresponsible.fr the narrowing of the pulp chamber> REGULAR TUBULES a- Tertiary dentine → Reparative Regenerative dentine 0 mantle protective dentine layer dentin > forms quickly inalocalizedarea circumpulpdl 0 enamel LESS REGULAR STRUCTURE dentin - dentin tubules referstothelayerofdenlinethat directly - fluiditnside surrounds thepulpchamberofthetoth + nerve + endings - bulkofdenlinenearthepulp Odontoblast - lies beneath the mantle dentine CIRCUMPULPAL Process DENTINE : (sensitivity) primarily composed of hydroxyapatite crystals.co/lagenf-bres&watery,y,ckLAy.gpofaadiameterof - produced byodontblastsduringtooth development - DENTINE THAT dentinal tubules ! part of the dentine initially formed and continues and : primary SURROUNDS THE PULP - 1- Imax microns continues as secondary dentine after root formation is complete OFTHETOOTH types of CIRCUMPULPALDENTINE 1) inlertubulardentine > found between dentinal tubules (contains a dense network of collagen fibers ) 2) intratubulardenline - lines the inside walls of dentinal tubules ( highly mineralized ) 3) lnterglobulardentine found in regions > where mineralization is incomplete  Q what determines spreadoncariesin : : enamel → enamel prism localization dentin → the tubules CARIES CLASSIFICATION TYPES 2) Based on localization & specifically enamel prism localization 1) primary secondary coronal caries Root caries according to } morphology pitsrxfissures - - Smooth surfaces → approximal > Vestibular oral this is coronal caries 3) Based on the spatial spread / spatial progression ofthecan-escaccording.to/-hedepthofthelesion7 Incipient & superficial they : spread ofpits smooth surface itisan are enamel caries & fissures a enamel caries caries Incipient ↳ very early stages media / ptofundtdlpenetrans : of dental caries ctnickdeniiniayer separating lesicnfompuip , ↳ no macroscopic they ate dentin ties material loss cthindenlinlayerseparaiingiesionfompop , ↳ reversible / temineralizable cementum caries - can mostly be ↳ nocavitl formation ↳ white spot lesion seeninthecemento-enameljunch.cn → areasofdecaythathavebeen stopped progressing fare inactive VERYFAST SLOW g. → 4) Basedonthecourseoftme - RAMPANT & TARDA - Childhood / < g. - old patients baby bottle canes - slow progression - Very fast - Dark brown / black Ccariesnigra) - whitecoiorccan.es - drieroaharderccariessicca) & alba) softpulpymassccan.es humid'd)  ZONES Zones of incipient lesion (enamel caries ) layers of the demineralized area in the enamel of caries inapiens : ÷÷f÷÷÷÷ it. enamel surface Surface zone 2 body of lesion the body of lesion is T porosity 3 - Dark zone - less minerals 4 Translucent zone zones of dentinal caries 15 zones ) 1) Infected dentin } OUTER carious dentine 2) Turbid dentin } tubules invaded by bacteria , acid decalcifies dentin Ct mineral content) & bacteria dissolves E the proteins ( destroys collagen) 3)Transparent dentin } loss of minerals from intertubular dentine , no bacteria in this region & collagen is intact According to GDP course : of destruction 4) Subtransparent dentin } re mineralization 1) zone 5) Normal dentin /Reparative dentin 2) Zone of bacterial invasion 3) Zoneof demineralization 4) Sclerotic / translucent zone 5) Tertiary / reactive dentine  INDICES D: decayed M : missing F. filling T tooth: & s:Sdce ↳ more accurate ! df &def → for deciduous teeth Cprimary dentition) e : extraction def 1- ( teeth) def - - S Ctooth surfaces) Root caries Index ( RCI) Pre & probiotics } maintain a healthy oral microflora t sugar consumption (change eating habits) Use of fluorides daily tooth brushing / improving oral hygiene saliva stimulation ( composition of saliva!) calcium containing remineralizat.cn processes fluoride alters crystal structure by developing fluoroapatite ( has less acid solubility) which means strengthening of crystal structure PROMOTES REMINERALIZATION ! ! !  ↳ different shapes of fissures ! U type &V type fissures - - - easytdeancwidenottoodeepfissureblown-skofcan.es > formation I-typeEIK-ty.pe fissures → difficult tdeancverythinox deep }p1aque& bacteria in the bottom of fissure andacariouslesian - is very easily developed - discoloration devices are also darkshadowmeansunderthe - alteration of enamel used for detection fissurecariesspreadinhthedenh-r.ie (caries diagnostics) andifweopenthiscariouslesicnwewil f-ndatelalivbig e.ly transparency → hole under the occlusal surface classification systems nowadays ofcan-es-aclivityofcan.es - localization + provides treatment FDIcan.es L matrix : ifitrachesdenlineesyouneedtuse combines restorative therapies cifitomyinvowesenamel many caries itisgenerallyenoughtousefissuresealing) classification systems inane checks radiological appearance aswell differential diagnosis ofcariesincipienswith erosion , mild fluorosis Genome/ hypoplasia  }e%9¥mme¥ note recognition Manual → Hand instruments - nowdayshandinstnmentsarenotusedforprimer preparation Instruments forenamed preparation : Instruments fordenlin preparation : Ba. chisel ( Black) BB. Excavators i. types are > Spoon excavators Hatchets s f r ↳Hatchet B# Gingivalmargintnmmer > bevellingthegingival margins of cavity preparations BMScalers3removingcakulusordebn-sdun-ng.FM Files cavity preparation or restoration trimming and shaping restorations especially for finishing amalgams ther cutting manual instruments in general : rfusedforcutlingwax } Used for cutting gypsum / dental cast CANNOT BEHOLD INTO FLAMES ! sharp end spoon form can behold into flames  Used for cutting metal wires & cutting retraction cords activating metal or trimming clasps immediate crowns Rotatory powered cutting instruments Hand pieces g. electric driven ( MICRO MOTOR) g. air driven (TURBINE ) connected to the clutch TURBINE - Air driven - friction grip G-G) connection → is referringto the end of the burdowards the Shank) 450000-500000 rpm1min (this is the speed of rotation called as revolutions per minute) (Rotation direction cannot be changed] The turbine has a high operating speed Used with , WATER COOLING - - prevent overheating of the pulp often haslight → has become popular over - abraded material is removed the last 20 years g. illuminating the treatment site ( LED or halogen lamps) - Used with diamond &carbide burs - direction of rotation can't change  air driven micromolar exist MICROMOTOR - Electric driven -40000 rpmlminmax ( Nora) - constant power - direction of rotation can bechanged micromolar's speed can be changed by Accelerators ( Red Ring) Redactors ( Green Rings → the normal micromohrhasa (Buening) Normal ( BLUE > 1.1-4000-40000 rpm Accelerator CRED) I :3 → 12000-120000 rpm normal reduction accelerator I :S 20000 200000 (BLUE ) rpm ( GREEN, CRED) - → Reductr Green) 10 :L , 5. 1,2 :L } ratio reduction BANO rmat-Redudorhandpieces-slatchty.pe Accelerator handpiece Gn-pcfdconnect-on-US.es/ongshankburs-forlabwork Btk _ Friction , adjusting or polishing prosthetics in the dental lab Friction Grip Latch type CFG) Normal } turbine - hand - - accelerator Pieces - - Redactor hand piece BURS composed of : - ahead - neck / connector - Shank → itfitsintthehand piece sshankcanbe.fn-ctongn-pc-oo.la/-chtype a. long straight  for removing enamel > they have @ friction grip Shank (coated with diamond particles) they are color coded / categorized accordingto the diamond particle size 1µm) 8 extra coarse ( BLACK) coarse ( GREEN) While also exists which is Ullrafine medium ( BLUE) ✓ and is also for finishing = } for preparation extra fine fine ( RED) } for preparation Zxfinishing - contouring (YELLOW) } for finishing fissure flat!end chamfer long round large flame long needle diamond bur diamond end bur tapered bur tapered or rugby ball diamond bur diamond diamond bur bur they have alatchtype connection morecuttngedgesofthebur -_ smoother prepared to surfaces 4.E.8-cutting edges (for preparation) edgescforfinishing-temovingcan-ousdenh.no 16-1-8,3-0 Cutting carbide burisfrthe removing amalgam filling & cutting metal crown - friction grip accelerator with water - cooling ( high speed ! ) duelospeedofbur diamond burst generation# heat t causes damageto the pulp white yellow } finishing of composite restorations red } finishing of ceramics ( contouring)  360 Reshaping the old amalgam with steel finishing burs ! amalgam restorations mayalso be polished using abrasive coated rubber cups Steel finishing burs aluminium oxide abrasive * refine the surface discsrxstipscalsofor Polishing) of the amalgam existsinbothfn-diongrip-GIandlatchtypeconnech.cn → forcontounng fillings - → for contouring Quinoline finishing , refining & polishing 0 0 latch friction type grip → we use them after scaling - low speed - without water cooling used in interproximal area's& contact points , ssofextiscs they : come indifferent colors which represent thecoarsnessof material embedded onthemcthecoatingonthemcanbe diamond aswell) for finishingthesmoothsurfaces (buccal palatal) ,