INTRODUCTION
OPERATIVE
DENTISTRY
TO
By the end of the lectures, the student should:


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

Understand the course description and objectives
Know the course scope and outline
Be familiar with references chosen and resources available
Know the continuous assessment and how you will be evaluated
Know the definition of operative dentistry, its indications and
considerations

Know that caries is a chronic common disease

Know that it can affect developed and developing countries

Understand its distribution and polarization

Be able to define caries and how the process starts

Define dental plaque, and understand the role of bacteria in caries

Know the specific bacteria involved in dental caries

Understand the demineralization – remineralization cycle

Know the meaning of acidogenic, cariogenic, and cariogenic potential

Be able to describe how caries progresses in different locations in the
tooth

Understand different strategies of treating and preventing dental
caries

Know the numbering system used in the school and important
anatomic features of teeth
Titles and subtitles of the subject
DEFINITION.
SCOPE OF OPERATIVE DENTISTRY.
OBJECTIVES OF OPERATIVE
DENTISTRY.
A)
RESTORATION OF HEALTH.
RESTORATION OF EFFICIENT AND
COMFORTABLE MASTICATION.
C) RESTORATION OF ESTHETICS.
D) RESTORATION OF NORMAL OCCLUSION.
B)
LESIONS AFFECTING CALCIFIED
TOOTH STRUCTURE.
A)
a)
DENTAL CARIES:
Factors contributing for dentalcaries.
1)The host including : the tooth
2) saliva.
3)The microbiota in the area.
4)The kind of diet consumed
b)Classification of dental caries.
B)
EROSION.
ABRASION.
D) ATTRITION.
E) FRACTURES.
F) NON-HEREDITARY ENAMEL
G) HYPOPLASIA.
H) AMELOGENESIS IMPERFECTA.
I) DENTINOGENESIS IMPERFECTA.
C)
CAVITY CLASSIFICATION.
A)
SURFACE ANATOMY.
NUMBER OF INVOLVED SURFACES.
C) G.V. BLACK’S CLASSIFICATION.
B)
CAVITY NOMENCLATURE AND
COMPONENTS.
TOOTH HISTOLOGY,
PHYSIOLOGY,
ANATOMY &
NORMAL OCCLUSION
By the end of the lectures the student should understand






Chemical composition of enamel
Chemical composition of dentin
Clinical dentin characterization
Primary dentin
Secondary dentin
TOOTH ANATOMY, PHYSIOLOGY AND
TITELS
AND
SUBJECT
TOOTH HISTOLOGY
A. ENAMEL
Chemical composition of enamel
Structure of enamel
Hardness of enamel
Direction of enamel rods
Dentino-enamel junction (DEJ)
Repair of enamel
Permeability of enamel
Solubility of enamel
B. DENTIN-PULP COMPLEX
1. THE DENTIN
The dentinal tubules
Chemical composition of dentin
Clinical dentin characterization
Dentin sensitivity
Dentin permeability
Smear layer
Primary dentin
Secondary dentin
OCCLUSION
SUB-TITLES
OF
THE
INSTRUMENTS & INSTRUMENTATIONS - 31
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Tertiary dentin
Sclerotic dentin
Intertubular dentin
Intratubular dentin
2. THE PULP
C. CEMENTUM
TOOTH ANATOMY, PHYSIOLOGY AND OCCLUSION
A. FUNCTION
B. ALIGNMENT
C. CONTOUR
D. AXIAL INCLINATION
E. GEOMETRIC CONCEPT OF CROWN OUTLINES
F. PROXIMAL CONTACT AREAS
Contact areas from labial and buccal aspects
Contact areas from incisal and occlusal surfaces
G. EMBRASURES (SPILLWAYS)
H. OCCLUSAL ANATOMY
I. CENTRIC OCCLUSION
INSTRUMENTS & INSTRUMENTATIONS - 32
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INSTRUMENTS &
INSTRUMENTATIONS
By the end of the lectures, the student should:

Know what materials hand instruments are made of

Know different parts of cutting and non cutting hand instruments

Understand the rationale of angulating hand instruments

Be familiar with different nomenclatures and classifications for hand
instruments (descriptive and numeric)

Know the design, function, cutting modes of a hatchet, chisel, spoon, and
gingival marginal trimmers.

Be able to differentiate between different gingival marginal trimmers (eg.
Mesial from distal) and different angle formers

Be able to differentiate hatchets from chisels

Understand and use the Black’s numeric classifications (three and four
numbered formulas), and when both are used

Be familiar with the function and design of non cutting instruments such as
(amalgam carriers, condensers, carvers, burnishers, plastic instruments,
spatulas, mirrors, explorers, periodontal probes, and forceps)

Know the common instruments grasps, and be able to describe them

Know the types of handpieces (hp) used in dentistry
INSTRUMENTS & INSTRUMENTATIONS - 33
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
Know the types of contra-angle available (high and low speed)

Be familiar with speed ranges for both high and low speed and their
indication of use

Know different types of heads used with the contra-angle hp

Be familiar with the components of dental burs their function, and types
o
Shank (differentiate between types)
o
Neck
o
Head [two major types: bladed and abrasive, different shapes(eg.
Round, fissure…)]

Know the basic shapes of burs and how they are numbered

Know the different materials burs are made of

Be familiar with the indication of use of common dental burs (eg. Round,
inverted cone…)

Know the different modifications of the bur head

Be familiar with finishing burs (12 or more flutes),and their uses

Know hazards of cutting instruments, and how to prevent or avoid them

Be familiar with common and avoidable patient positions

Know the different operator positions (7, 9, 11, 12, 5, 3, and 1 o’clock )

Know the best operator position for working on different quadrants

Be familiar with the angle of maxillary and mandibular arches in relation to
the floor
INSTRUMENTS & INSTRUMENTATIONS - 34
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
Know what the exchange zone is

Know that you need to always rest your fingers when working
Titles and sub- titles of the subject:
GENERAL CLASSIFICATION:
1.
2.
3.
Diagnostic instruments.
Instruments for preparing tooth structures.
Restoring instruments.
1. Diagnostic Instruments.
A)
B)
C)
MIRRORS.
EXPLORERS.
PROBES.
2. INSTRUMENTS FOR PREPARING TOOTH STRUCTURES
I. Hand Cutting Instruments:
a)
b)
c)
d)
e)
f)
g)
INSTRUMENTS PARTS.
INSTRUMENTS NOMENCLATURE.
INSTRUMENTS FORMULA.
INSTRUMENTS DESIGN.
1. Direct and lateral cutting.
2. Contra angling.
3. Single beveled instrument.
4. Bibeveled instruments.
5. Triple-beveled instrument.
6. Circumferential beveled. Instrument.
7. Right and left instruments.
8. Single ended and double ended instruments.
TYPES OF HAND CUTTING INSTRUMENTS.
INSTRUMENTS GRASPS, RESTS AND GUARDS.
SHARPENING AND CARE.
II. ROTARY CUTTING AND ABRASIVE INSTRUMENTS:
a)
b)
c)
OPERATING SPEED RANGES.
COMMON DESIGN CHARACTERISTICS.
ROTARY TOOLS:
1. DENTAL CUTTING BURS:
Types and classifications.
60 - CHAPTER IV
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Head design.
Cutting efficiency.
2. DENTAL ABRADING TOOLS:
Types and classifications.
Head design.
Cutting efficiency.
d)
e)
f)
ADVANTAGES AND LIMITATIONS OF ROTARY INSTRUMENTS.
ECCENTRICITY.
HEAT GENERATION.
III. ULTRASONIC INSTRUMENTS.
IV. LASER EQUIPMENT.
3. Restoring Instruments
a)
b)
c)
d)
e)
f)
g)
MIXING INSTRUMENTS.
PLASTIC INSTRUMENTS.
CONDENSING INSTRUMENTS.
BURNISHING INSTRUMENTS.
CARVERS.
FINISHING AND POLISHING INSTRUMENTS.
MATRICES:
Definition.
Importance.
Requirements.
Types.
Instructions for using matrix band.
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61
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FUNDAMENTAL
PRINCIPLES OF
TOOT H
PREPARATION
DEFINITION
Need and objectives of restorations
PRINCIPLES OF TOOTH
PREPARATION:
A.
B.
Biological form.
Mechanical form.
A. BIOLOGICAL FORM OF TOOTH
PREPARATION:
1) PROTECTION OF THE PULP.
2) PREVENTION OF CARIES RECURRENCE.
B. MECHANICAL FORM OF TOOTH
PREPARATION:
I. Outline form and initial depth.
II. Performing
resistance
and
retention forms.
III. Convenience form.
IV. Removal of any remaining
infected dentin.
V. Finishing
of
enamel
and
external cavity walls.
VI. Cleaning and toileting.
I. OUTLINE FORM AND INITIAL DEPTH:
Definition.
Principles.
Factors.
Features:
a) Outline form of pit-and-fissure
lesions.
b) Outline form of smooth surface
lesions.
II. PERFORMING RESISTANCE AND
RETENTION FORMS:
A) PRIMARY RESISTANCE FORM:
Definition.
Principles.
Factors.
Features.
B) PRIMARY RETENTION FORM:
Definition.
Principles.
Factors.
Features.
C) SECONDARY RESISTANCE AND RETENTION
FORMS:
Mechanical features.
Cavity
wall
conditioning
features.
D) RELATION BETWEEN RESISTANCE AND
RETENTION FORMS.
III. CONVENIENCE FORM:
Definition.
Features.
IV. REMOVAL OF ANY REMAINING INFECTED
DENTIN:
Conditions at routine cavity
depth.
Technique.
V. FINISHING OF ENAMEL AND EXTERNAL
CAVITY WALLS:
Definition.
Objectives.
Factors.
Features.
Technique.
VI. CLEANING AND TOILETING.
THE AMALGAM RESTORATIONS –
60
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THE AMALGAM
RESTORATIONS
ADVANTAGES
B)
C)
DISADVANTAGES
INDICATIONS
D)
E)
DEFINITION AND COMPOSITION
CLASSIFICATION
burnishing.
COMPOSITION AND STRUCTURE:
A) CONVENTIONAL DENTAL AMALGAM.
B)
HIGH-COPPER DENTAL AMALGAM.
PROPORTIONING.
TRITURATION:
Methods.
Mulling.
CONDENSATION.
CARVING:
Timing of carving.
Direction of carving.
Carvers.
Precarve and postcarve
F)
FINISHING AND POLISHING:
Objectives.
Principles and procedures.
CAVITY PREPARATIONS:
A) GENERAL FEATURES.
B)
DESIGNS OF CLASS I CAVITY
PREPARATION.
C) DESIGNS OF CLASS II CAVITY
PREPARATION.
MATRICES FOR COMPOUND
CAVITY PREPARATION:
A)
B)
C)
UNIVERSAL MATRIX.
COMPOUND-SUPPORTED MATRIX.
AUTOMATRIX.
MERCURY MANAGEMENT AND
MERCURY HYGIENE
MANIPULATION OF AMALGAM:
A)
SELECTION OF ALLOY AND MERCURY.
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THE CAST GOLD
RESTORATIONS
Definition
MATERIAL:
A)
B)
COMPOSITION AND EFFECTS
COMPONENT.
CLASSIFICATION AND TYPES
ALLOYS.
OF EACH
OF GOLD
ADVANTAGES
DISADVANTAGES.
INDICATIONS.
CONTRAINDICATIONS.
STEPS OF CONSTRUCTION OF GOLD
INLAY RESTORATION:
I. CAVITY PREPARATION:
a) General features.
b) Cavity preparation for occlusoproximal inlay.
c) Cavity preparation for MOD onlay.
d) Checking the prepared cavity.
II. CONSTRUCTION OF WAX PATTERN:
a) Requirements of ideal wax pattern.
b) Technique, indications, advantages
and disadvantages of direct wax
pattern.
c) Indications,
advantages
and
disadvantages of indirect wax
pattern.
III. SPRUING THE PATTERN, INVESTING, WAX
ELIMINATION AND MOLD EXPANSION:
a) Types of the sprue formers.
b) Requirements of sprue former and
attachment.
c) Mounting ring, investing the pattern,
wax
elimination
and
mold
expansion.
IV. HEATING ALLOY, MELTING AND CASTING.
V. INSPECTION OF CASTING,
POLISHING:
a) Finishing procedures.
b) Casting errors.
VI. CEMENTATION.
FINISHING AND
THE COMPOSITE RESIN RESTORATIONS – 117
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THE COMPOSITE
RESIN
RESTORATIONS
COMPONENTS OF DENTAL
COMPOSITE
TYPES AND PROPERTIES OF
DENTAL COMPOSITES
A)
MACROFILLED COMPOSITES.
MICROFILLED COMPOSITES.
C) SMALL PARTICLE COMPOSITES.
D) HYBRID COMPOSITES.
E) FLOWABLE COMPOSITES.
F) CONDENSABLE (COMPACTABLE)
COMPOSITES.
B)
Fundamentals and Direct Technique
of Composite Resin Restorations for
Class III, IV and V
A)
CLASS III RESTORATIONS.
CLASS IV RESTORATIONS.
C) SHADE OR COLOR SELECTION.
D) MATRICES.
E) METHOD OF CURING OF RESIN COMPOSITE
RESTORATION AND INSERTION.
F) FINISHING AND POLISHING.
G) CLASS V RESTORATIONS.
B)
Longevity of Composite Restorations
The Glass Ionomer
Restorations
ADVANTAGES
MANIPULATION:
A)
DISADVANTAGES
COMPOSITION AND STRUCTURE:
A)
THE GLASS POWDER.
THE POLYACID LIQUID.
C) COMPOSITIONAL FORMS:
1. Polyacid-mixable cements.
2. Water-mixable cements.
3. Mixed cements.
B)
TYPES OF GLASS IONOMER
CEMENTS:
A)
CONVENTIONAL GLASS IONOMER
CEMENTS:
Setting reaction.
Types.
B)
RESIN-MODIFIED GLASS IONOMER
CEMENTS:
Setting reaction.
Types.
C)
POLYACID-MODIFIED RESIN COMPOSITE:
Setting reaction.
Clinical applications.
PROPERTIES OF GLASS IONOMER
CEMENTS:
A)
HYDRATION AND DEHYDRATION.
BIOCOMPATIBILITY.
C) SETTING SHRINKAGE.
D) BONDING TO TOOTH STRUCTURE.
E) WEAR PROPERTIES .
F) STRENGTH PROPERTIES .
G) FLUORIDE RELEASE/UPTAKE.
B)
CLINICAL INDICATIONS.
CONTRA-INDICATIONS.
CAVITY DESIGN.
B)
DISPENSING AND MIXING.
PLACEMENT TECHNIQUE.
CAVITY LINING AND
PROTECTION OF
THE DENTIN-PULP
SYSTEM
THE PROTECTIVE FUNCTIONS OF
ENAMEL AND DENTIN.
PROBLEMS ASSOCIATED WITH
LOSS OF HARD TOOTH
STRUCTURE.
INDICATIONS FOR CAVITY LINING.
DETERMINING THE AMOUNT OF
REQUIRED DENTIN-PULP
PROTECTION.
REQUIRED MATERIAL
PROPERTIES.
CAVITY LINERS:
A)
THIN LINERS:
1. Solution liners (Cavity varnish).
2. Suspension liners.
3. Bonding agent.
B) THICK
1.
2.
3.
4.
LINERS (CEMENT LINERS):
The hard setting calcium
hydroxide cement.
The light-cured calcium
hydroxide.
The low viscosity (Type IV) zinc
oxide eugenol cement.
The resin-modified glass ionomer
cement.
CEMENT BASES:
A)
ZINC PHOSPHATE CEMENT.
THE RESIN REINFORCED (TYPE III) ZINC
OXIDE EUGENOL CEMENT.
C) THE ZINC POLYCARBOXYLATE CEMENT.
B)
D)
THE RESIN-MODIFIED GLASS IONOMER
CEMENT.
13
- CHAPTER 2
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