Unit 1 Restorative Dentistry - Dentistry Theory Guide PDF

WELCOME BACK! CLINIC THEORY II CLIN 2502 UNIT 1 Restorative Dentistry Matrix Systems Restorative dentistry is also known as operative dentistry Restorative dentistry is focused on the general dental needs of the client Indicated when teeth are to be restored to their original form and shape throug...

WELCOME BACK! CLINIC THEORY II CLIN 2502 UNIT 1 Restorative Dentistry Matrix Systems Restorative dentistry is also known as operative dentistry Restorative dentistry is focused on the general dental needs of the client Indicated when teeth are to be restored to their original form and shape through the use of direct and indirect restorative materials  Specific Conditions That Indicate The Need For Restorative Dentistry Include: 1. Initial or recurrent decay 2. Replacement of broken or fractured restorations 3. Abrasion or wearing a way of tooth structure 4. Erosion of tooth structure Discuss Black’s Cavity Classification Teeth are restored according to a method developed by G.V. Black in the early 1900’s Based on where the decay is present Universal system  Class I Class I lesions, affecting the pits and fissures of the teeth The following surfaces are involved: Occlusal pits and fissures of premolars and molars Buccal/lingual pits and fissures of molars Lingual pits of maxillary incisors, most frequently in the pit near the cingulum  Typical class I tooth preparation Class I for amalgam on maxillary premolar  Class II Class II lesion is the extension of a Class I lesion into the proximal surfaces of premolars and molars The following surfaces are involved: Two-surface restoration of posterior teeth Three-surface restoration of posterior teeth Multi-surface, four-surface (or more) restoration of posterior teeth Which type of radiographs would be utilized for diagnosing class II decay? Which oral hygiene regime would assist with prevention? Class II A. 2 surface restoration B. 3 surface restoration C. Multi-surface restoration  Typical class II MO conventional tooth preparation for amalgam on Class II maxillary molar  Affects the interproximal Class III surface of incisors and canines  Class IV Involves a larger surface area, including the incisal edges and interproximal surface of incisors and canines  Class V Class V restoration Classified as a smooth surface restoration Decayed lesions occur at: Gingival 1/3 of the facial or lingual surfaces of any tooth Root of a tooth, near the CEJ  Tend to occur in older clients (but not always) Composite resin is generally utilized for this type of Class V restoration unless isolation is unable to be achieved Class VI Incisal edge of anterior dentition (does not include proximal surfaces) The cusp tips of posterior dentition Describe The Process and Principles of a Cavity Preparation When preparing a tooth for a permanent restoration, the dentist has the acquired knowledge about tooth anatomy: 1. The direction of the enamel rods 2. The thickness of the enamel 3. The body of the dentin 4. The size and position of the pulp 5. The crown of the tooth as it relates to the gingival tissues  Describe The Process and Principles of a Cavity Preparation Cavity Preparation: the process of removing diseased tooth structure while leaving a limited amount of healthy tooth structure for the tooth to maintain the restoration Conservation of Tooth Structure Extensive vs. Minimal  Cavity Preparation The dentist uses the following steps in order to achieve an ideal cavity preparation Initial Preparation: involves the initial design and extension of the prep’s external walls to a limited depth The initial prep intends to help the dentist gain access to the decay or defect and reach sound tooth structure  Client Preparation For Restorative Procedures Inform the client what to expect throughout the procedure Position the client correctly for the dentist and the type of procedure Explain each step to the client as the procedure progresses  Responsibilities of The DA Prepare the setup for the procedures Know and anticipate the dentist's needs Provide moisture control Transfer dental instruments and accessories Mix and transfer dental materials Maintain client comfort Steps In Initial Preparation Page 807 MDA Outline Form Design and initial depth of sound tooth structure Resistance Form Shape and placement of cavity walls Retention Form Help in securing the restoration in place Convenience Form Accessibility in preparing and restoring tooth  Outline Form 1. Dentist decides the design and initial depth of sound tooth structure  Resistance Form 2. Dentist determines shape and placement of cavity walls  Retention Form 3. Retains the restoration, helps resist displacement of the restoration  Convenience Form 4. Provides accessibility in preparing and restoring the tooth  Terminology in Cavity Axial Wall Preparation Internal wall/surface of the prepared tooth that runs parallel to the long axis of the tooth Pulpal Wall AKA pulpal floor, internal wall/surface of the prepared tooth that is perpendicular to the long axis of the tooth Line Angle Angle formed by the junction of 2 walls/surfaces in a cavity preparation Example: Mesiolingual line angle Point Angle Junction of 3 walls/surfaces  Describe The Procedure For Retentive Pins In An Extensive Restoration If decay has extended beyond a normal size or shape, it may be necessary for the dentist to utilize a stronger system to support the restoration other than retentive grooves or bonding material Retentive pins are used to aid in retention of restorations when extensive tooth structure is missing  Describe The Procedure For Retentive Pins In An Extensive Restoration Aid in retaining and supporting restoration One pin is usually placed for each missing cusp Retention pins have deep threads that grip the dentin when screwed into the tooth structure Other end of pin grips restorative material Must use dental dam as pins can be dropped and cause a choking hazard Retention Pins Retention Pins  Matrix System When a tooth has been prepared for a class II, III or IV restoration, at least one interproximal wall of the tooth has been removed. A Matrix system provides a temporary wall for the restoration process of class II, III and IV preparations Explain why a class I or V restoration would not require a matrix band?  Posterior Matrix Systems for Amalgam Restorations Universal Retainer Also referred to as Tofflemire retainer Holds matrix band in position Positioned most commonly from buccal surface of tooth being restored Common Designs of Matrix Bands 1. Universal band is used for a class II where the proximal box is prepared to a minimal depth 2. Extension band is used for a class II preparation with gingival extensions and where the height of contour of the band cannot exceed the height of the tooth Matrix Bands for Tofflemire Retainer Components of a Tofflemire Retainer  Assembly Of The Matrix Band and Tofflemire Retainer Page 835 MDA 1. Hold the retainer with the diagonal slot facing the operator  Assembly Of The Matrix Band and Tofflemire Retainer 2. Hold the frame Turn inner knob until the vise moves next to the guide channels  Assembly Of The Matrix Band and Tofflemire Retainer 3. Loop ends together Gingival edge will be on the top (smaller) Occlusal edge is on the bottom (larger)  Assembly Of The Matrix Band and Tofflemire Retainer 4. Place band in the guide channel  Assembly Of The Matrix Band and Tofflemire Retainer 5. Depends on which tooth is being restored  Assembly Of The Matrix Band and Tofflemire Retainer 6. Turn the outer knob until the tip of the spindle is tight against the band in the vise slot  Assembly Of The Matrix Band and Tofflemire Retainer 7. If the band becomes bent it can be smoothed out Insert a mirror handle into the loop Run it around the inside of the band Placement of Tofflemire Matrix Page 836 MDA Position and seat loop of the band over the occlusal surface Retainer parallel to the buccal surface Slot towards gingiva Placement of Tofflemire Matrix Page 836 MDA Ensure band remains 1-1 ½ mm beyond occlusal edge Hold the band securely in place by applying pressure Slowly turn inner knob to tighten the band around the tooth May need to contour with a ball burnisher Place a wedge  Wedges Holds band tight against the tooth Allows for good contour Eliminates overhangs Variety of sizes and colours Usually wooden but some are plastic Triangular, pointed, tapered Against side where wall is missing Base of triangle toward gingiva Place with cotton pliers  Wedge Page 830 MDA Position the wedge into the lingual embrasure of Class II preparation after band placement The wedge helps position the matrix band firmly against the gingival margin of the preparation Armamentarium Automatrix System No retainer necessary to hold band in place Available in metal and plastic Band already formed in circle and have a coil like locking loop Tightening wrench is inserted into the coil and turned clockwise  T Bands Copper band in T shape No retainer needed to hold the band in place Used for primary molars Bend T up and form band Sectional Matrices (Palodent)  Sectional Matrices Small, oval, polished stainless steel matrix Used with a tension ring for tight contact Used for posterior composite resin Matrix, wedge, tension ring  Review Amalgam Post-Op Instruction How long will the anesthetic remain How long until client can eat, drink hot beverages Do not bite anything hard on the restored dentition for 24 hours Instruct client to call if any problems