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Fundamentals of Operative Dentistry
Balwant Rai, Jasdeep Kaur
1:
Cement and Tooth Colored Materials
2:
Direct Filling Gold
HISTORICAL BACKGROUND
TYPES
Non-cohesive and Semi-cohesive
Reformed foils
Laminated Gold foil
Platinised gold foil
Electrolytic Precipitate
Alloyed Electrolytic Precipitated
PHYSICAL PROPERTIES OF COMPACTED GOLD
INDICATIONS FOR DIRECT FILLING GOLD (CLASS I, CLASS V, CLASS III, CLASS II AND CLASS VI)
Contraindications
CAVITY PREPARATIONS FOR DIRECT GOLD RESTORATIONS
Class I Cavity Preparation (Fig. 2.1)
Class V Cavity Preparation (Fig. 2.2)
A. The Ferrier Design
Cavity Preparation
B. Class V preparation with a proximal pan handle extension
C. Class V with uni- or bilateral moustache extensions occlusally
D. Partial moon (Crescent) shape cavity preparation
Class III Cavity Preparation for Direct Gold Restorations (Fig. 2.3)
A. Ferrier Design
Internal Anatomy
B. The Loma Linda Design
C. The ingraham design
Internal Anatomy
Instrumentation
Class II Cavity Preparation for Direct Gold Restorations (Fig. 2.4)
A. Conventional design
Instrumentation
B. Conservative Design
Instrumentation
C. The simple design
DESORBING OR DEGASSING AND DECONTAMINATION
OBJECTIVES OF DECONTAMINATION PROCESS
Hazards of overheating of direct gold material
COMPACTION OF DIRECT FILLING GOLD
Modes of Condensation
Gold condensers
Direct Filling Gold
Principles of Condensation (Figs 2.5A to C)
METALLURGICAL CONDENSATION
Metallurgical Consideration of Cohesive Gold Foil
Metallurgical Considerations of Matt Gold Restorations
Metallurgical Considerations of Powdered Gold Restorations
General Steps for Reinsertion of Direct Gold Restoration in a cavity preparation
Three Steps Build Up of the Restoration
Paving of the Restoration
Surface Hardening of the Restoration
Burnishing
Margination
Burnishing
Contouring
Additional Burnishing
Finishing and Polishing
Final Burnishing
Protective Bases Necessary for the Pulp Dentin Organ
STEP F GOLD
CONCLUSION
3:
Pain Control in Operative Procedures
TYPE OF PAIN BY NATURES
Pain Perception
Pain Reaction
Pain Reaction Threshold Factors
Control of Pain
Pulpal Pain
During the Treatment
After Operative Treatment: After 24 hrs
LOCAL OR REGIONAL ANESTHESIA
Definition
Technique
Topical Anesthesia
Local Infiltration (Fig. 3.3)
Field Block (Fig. 3.4)
Nerve Block (Fig. 3.5)
Intraligamentary Technique (Fig. 3.6)
CAT
Electronic Anesthesia
Advantages
Contraindications
Audio Analgesia
Inhalational Anesthesia
HYNOSIS
Definition
Advantages
4:
Biomechanics of Cavity Preparation
INTRODUCTION
What is Mechanics?
What is Biomechanics?
MANDIBLE AS A LEVER
ANALYSIS OF THE FORCES ON THE TOOTH
COMPOSITION AND RESOLUTION OF FORCES
Inclined Plane
Effect of Friction
Wedging
FORCES ACTING ON THE TOOTH
MECHANICAL FUNCTION OF THE MARGINAL RIDGE
RESTORATION BEAMS
Strength of Beam
Deflection of Beam
APPLICATION OF MECHANICAL PRINCIPLE IN CAVITY PREPARATION
Class I Restoration
Class II Restorations
Problems with Class II Restoration
Design Features of Class II Which Aids in Resistance and Retention Form in Amalgam
Axiopulpal Line Angle
Reverse Curve
Proper Carving of Marginal Ridge Anatomy should be done in Case of Cost Metal Restoration as General Feature of Resistance and Retention
Need for Gingival Lock
Reverse Level
Class IV Restoration
Forces Acting on Anterior Teeth
Class V Restoration
Biologic Considerations During Cavity Preparation
Irritating Factors to the Pulp
Speed of Rotation
To Avoid This Injury
Vibrations
BIOLOGICAL CONSIDERATIONS AFFECTING PERIODONTIUMS
CONCLUSION
4A:
Brief Cavity Preparation
5:
Porcelain Cavity Preparation
INTRODUCTION
APPLICATIONS
PORCELAIN JACKET CROWN
Indication for Use
Contraindication
Preparation of Tooth
Incisal Reduction
Axial Reduction
Facial Reduction
Lingual Reduction
Shoulder Formation
PREPARATION FOR A CERESTORE AND DICOR CROWN
For Cerestore Crown
For Dicor Crown
POST PREPARATION PROCEDURES
Die Fabrication
TRY IN OF THE PORCELAIN JACKET CROWN
CEMENTATION PROCEDURE
PORCELAIN FUSED TO METAL (PFM)
Indications
Advantages
Disadvantages
Requirements
Tooth Preparation
Incisal Reduction
Facial Reduction
Proximal Reduction
Lingual Reduction
Gingival Margin Preparation
Post Preparation Procedure
Trying and Cementation of PFM Crown
CEMENTATION
Zinc Phosphate
Advantages
Disadvantages
Zinc Silicophosphate
Advantages
Disadvantages
Zinc Oxide Eugenol
Zinc Polycarboxylate Cement
Glass Inomer Cement
Seating of Crown
CERAMIC VENEER
Indications
Contraindications
Advantages
Disadvantages
Advantages of Laminates over Ceramic Metal Crown
Preliminary Tooth Modification
Tooth Preparation
Sequence of Tooth Preparation
Impression
Try in of Porcelain Veneer
Bonding the Porcelain Veneer
CERAMIC INLAYS AND ONLAYS
Advantages
Disadvantages
Indication
Contraindication
Cavity Preparation
Proximal Box Preparation
Final Cavity Preparation
Impression
Temporary
Try in and Cementation
Finishing and Polishing
CONCLUSION
6:
Selection of Restorative Materials
INTRODUCTION
Objectives
Requisites of Ideal Restorative Material
Types of Restorations
Other Classification as Following
FACTORS AFFECTING SELECTION
Relates to the Patient
Age
Physical Status of Patient
Oral Hygiene
Metal Status of Patient
Economics
Relates to the Tooth
Relates to Materials
Primary Factors
Secondary Factors
Restorative Materials
Indications
Contraindications
Direct Filling Gold
Indications
Contraindications
Cast Metal Inlays and Onlays
Indications
Contraindications
Composites
Indications
Contraindications
Ceramics
Indications
Contraindications
GIC
Indications
Contraindications
Resin Reinforced Glass Ionomera
Indications
Compomers
Indications
Contraindications
CONCLUSION
7:
Restoration of Teeth with Silver Amalgam
RESTORATION OF TEETH WITH SILVER AMALGAM
Indications for Silver Amalgam
Contraindications for Silver Amalgam
Advantages of Silver Amalgam
Disadvantages
CAVITY PREPARATION
Class I Cavity
Armamentarium
Conservative Cavity Preparation (Fig. 7.1)
Final Cavity Preparation
Removal of Any Remaining Enamel Pit/Fissure and Infected Dentine
Pulp Protection (Fig. 7.5)
Finishing of External Walls
Cleaning, Inspecting and Varnishing
Cavity Preparation for Extensive Caries
Initial Cavity Preparation
Secondary Resistance and Retention Form
Class II Cavity
Armamentariums
Initial Cavity Preparation
Proximal Box Preparation
Proximal Ditch Cut (Fig. 7.6)
Completion of Proximal Extensions (Fig. 7.7)
Incorporation of Reverse Curve (Fig. 7.8)
Final Cavity Preparation
Secondary Resistance and Retention Forms
Modification in Cavity Design
Slot Preparation for Root Caries (Fig. 7.12)
Rotated Teeth
Tunnel Cavity Preparation
Cavity Preparations Involving both Proximal Surfaces
Class III Cavity Preparation
Armamentarium
Initial Cavity Preparation (Fig. 7.13)
Final Cavity Preparation
Furnishing External Wall
Class V Cavity Preparation (Fig. 7.15)
Initial Cavity Preparation
Final Cavity Preparation
Retention Form
Extended Cervical Restoration that includes Transitional Line Angles
Complex Amalgam Restorations
1. Capping Cusps (Fig. 7.17)
Slot and Lock Retention
Amalgampins (Fig. 7.18)
Disadvantages
Pin-retained Amalgam Restorations
Advantages
Disadvantages
Decreased Strength of Amalgam
Resistance Form
Perforations
Tooth Anatomy
Friction Locked Pins
Pin Retained Class II Amalgam Restorations
Pinhole Preparation
Retrograde Amalgam Restorations
Bonded Amalgam Restorations (Fig. 7.19)
Advantages
Disadvantages
Classification
Improper Case Selection and Diagnosis
Lack of Pulpal Protection
Improper Choice and Use of Amalgam
Lateral Errors in Condensation
Improper Use of Dentine Pins
Improper Contouring, Finishing and Polishing
Defective Material
8A:
Comparison of Composites and Glass Ionomer
8B:
Recent Advances in Gic and Composites
INTRODUCTION
RECENT ADVANCES IN GIC
Metal Modified GIC
Packable GI
Resin Modified GI
Triple Cure
Resin-reinforced Glass Ionomers (RRGI)
Compomers/Polyacid Modified Composite Resin
Flowable Compomers
ADVANCEMENTS IN COMPOSITES
Resin Matrix
Advantages
Filler
Macrofilled Composites
Microfilled Composites
Hybrid Composites
Hybrids (e.g. Charisme F)
Disadvantage
Advantages
Optimal Size Particle (e.g. Esthet-X)
Composites Surface Sealants
Flowable Composites
Condensable Composites
Indirect Composites
Advantages
Fiber Reinforced Indirect Composites
Composite Resin Cements
Core Buildup Composites
Whiskers (Under Trial)
Advantages
Calcium Phosphate Composites
Physical Properties of Ormocers
Ormocers:
Advantages
Smart Composites
Ceromers (e.g. Tetric Ceram)
8C:
Biologic Considerations in Restorative Procedures
9:
Nomenclature
10:
Instrument and Laser in Operative Dentistrys
LASERS
Classification of Lasers
Effect of Laser on Dental Hard Tissues and Pulp
Uses of Lasers in Operative Dentistry:
11:
Biocompatibility of Dental Materials
INTRODUCTION
REQUIREMENTS FOR BIOCOMPATIBILITY OF DENTAL MATERIAL
CLASSIFICATION OF MATERIALS
TESTS FOR EVALUATION OF BIOCOMPATIBILITY
Group I: Primary Tests
Types of Cytotoxicity Tests
Group II: Secondary Test
Implantation Test
Group III: Preclinical Usage Tests
Pulp and Dentin Usage Test
Pulp Capping and Pulpotomy Usage Test
Endodontic Usage Test
ALLERGIC RESPONSES TO DENTAL MATERIALS
1. Allergic Contact Dermatitis
Allergy to latex Products
Allergic Contact Stomatitis
Allergy to Nickel
Recommendations by NIOSH for use of nickel
Allergy to Nickel
Toxicity and allergenicity of Beryllium
The mercury controversy
Dental mercury hygiene recommendations according to ADA
HARMFUL INTERACTION OF MATERIALS WITH TISSUES
MINIMIZING DENTAL IATROGENESIS
PARAMETERS OF ASSESSMENT
PULPAL RESPONSE TO VARIOUS TECHNIQUES AND SPECIFIC AGENTS
I. Reaction Of Pulp Dentin Organ To Amalgam
1. Mercury
2. Galvanism
3. Thermal conductivity
4. Energy of Condensation
5. Heat of finishing and polishing
6. Delayed expansion
7. Corrosion Products
8. Induced stress
IX. Plaque adhesion
X. Loose Restoration
II. Biocompatibility Composites
Resin-based composites cements (Dual cure)
Precautions to be taken when using composites:
Pulpal response to acid etching
III. Conditioning agents
IV. Dentin Bonding
Reactions of pulp to microleakage
V. Impression materials
VI. Retraction cords
VII. Biocompatibility of dental cements
1. Silicate cement
2. Zinc Oxide Eugenol
3. Zinc Phosphate Cement
4. Glass ionomer cement
4. Calcium hydroxide cement
5. Polycarboxylate Cements
Bleaching Agents
Pulp capping agents (Biocompatibility)
Root canal filling materials
Endodontic Procedures
Apical filling with dentin chips
Biocompatibility of Dental Ceramics as implant materials
Reactions to metals and alloys
Condensed gold foil
Effect of some other materials used in dentistry
CONCLUSION
12:
Patient Assessment, Examination, Diagnosis and Treatment Planning
PATIENT ASSESSMENT
Vitals
Chief Complaint
Details of the Chief Complaint
History taking
Family History
Medical History
Rheumatic Fever
Artificial Heart Values
Coronary Artery Disease
Hypertension
Diabetes
Syphilis
AIDS
Phychological Problems
Dental History
Past Dental History
CLINICAL EXAMINATION
Extraoral Examination
Intraoral Examination
Visual Examination
Oral Hygiene
Any Prosthetic Appliance
Soft Tissue Lesions
Type and Amount of Saliva
Occlusion
Edentulous Spaces
Periodontium
Dentition
Carious Lesions
Restorations
Palpation
Tactile Examination
Mobility/Depressibility Test
Percussion Test
Transillumination or Fibreoptics
Radiographs
Test Cavity
Selective Anesthesia
Electronic Caries Detector—Cariesmeter
Caries (Detector)—Dyes
Pulp Vitality Tests
Heat Test
Cold Test
Uses
Interpretations
Study Casts
Adjunctive Aids
Xeroradiography
RVG Radiovisuography
OPG Orthopanteomograph
EMG Electromyograph
Laser Doppler Flowmetry
Lasers
Treatment Planning
Treatment Plan Sequencing
CONCLUSION
13:
Pin-retained Restorations
INDICATION FOR PIN-RETAINED AMALGAM AND DIRECT TOOTH COLORED RESTORATION
Advantages of pin-retained amalgam restoration
Disadvantages of pin-retained amalgam restorations
TYPES OF PINS MATERIAL FOR AMALGAM AND DIRECT TOOTH COLORED
Cemented Pins
Friction locked pins
Self-threading pins
DISADVANTAGES
THREAD MATING SYSTEM (TMS — PINS)
FACTORS AFFECTING PIN RETENTION IN DENTIN AND AMALGAM
Factors affecting retention of pins in dentin amalgam
The factor affecting stressing capabilities of pins
Factors aiding in location of position
Guidelines for pin placement (Figs 13.2A and B)
STEPS IN PIN-RETAINED (CLASS II AMALGAM RESTORATION)
Matrices for pin-retained class II amalgam restoration
Compound supported copper band matrix
14:
Extracoronal Cast Metal Restorations
INTRODUCTION
Principles of Tooth Preparation
Mechanical Consideration
Preservation of Tooth Structures
Retention and Resistance
Factors Affecting the Resistance Form
Resistance Form
Structural Durability
Marginal Integrity
BIOLOGICAL CONSIDERATIONS
Pulpal Consideration
Use of Coolants
Periodontal Considerations
Esthetic Principles
Cast Metal Onlay
Indications
Contraindications
Advantages
Disadvantages
Cavity Preparation
Initial Cavity Preparation
Outline, Retention and Resistance Form:
Proximal Boxing
Final Cavity Preparation
Removal of Infected Carious Dentin and Application of Basis:
Preparation of Bevels and Flares
Indicators
Contraindications
Advantages
Disadvantages
Preparation
Finishing of the Preparation
Preparation for Metal Ceramic Crown (Fig. 14.5)
Indications
Contraindications
Advantages
Disadvantages
Preparations
Step 1 — Focial Reduction
Step 2 — Proximal Reduction
Step 3— Lingual Reduction
Angular Wall Reduction
Gingival Margin Preparations
Posterior Metal Ceramic Tooth Preparation (see Fig. 14.5)
Partial Veneer Crown
Indication
Contraindications
Advantages
Disadvantages
Three Quarter Crown Preparation (For anteriors) (Fig. 14.6)
Preparation (Cuspid)
Facial Bevel
Occlusal Reduction
Facial Reduction
Groove Placement, Flaring and Contrabevel
Fabrication of Wax Pattern
Forming the Pattern Base
Forming the Proximal Contour and Contact
Interocclusal Records
Finishing the Wax Pattern
Initially Withdrawing and Residing the Pattern
15:
Isolation of the Operating Field
THE ADVANTAGES OF ISOLATING THE OPERATING FIELD
RUBBER DAM ISOLATION
Uses of Rubber Dam
Definite Advantages of Rubber Dam in Operative Dentistry
Disadvantages of Rubber Dam
Armamentarium for Rubber Dam Isolation
Rubber Dam Material
RUBBER DAM RETAINER (CLAMP) (FIG. 15.1)
RUBBER DAM HOLDER (FIG. 15.2)
Rubber Dam Punch (Fig. 15.3)
Rubber Dam Clamp Forceps (Fig. 15.4)
Rubber Dam Napkin (Fig. 15.5)
Advantages of Using Napkins
Lubricant
GUIDELINES FOR PLACEMENT OF RUBBER DAM
PREPARING THE MOUTH FOR RUBBER DAM APPLICATION
PLACEMENT OF RUBBER DAM
ALTERNATIVE METHODS
REMOVAL OF A RUBBER DAM
SHORT COMING IN APPLICATION AND REMOVAL OF RUBBER DAM
HIGH VOLUME OR SUCKATION APPARATUS
SALIVA EJECTORS (Fig. 15.6)
COTTON ROLL ISOLATION
ABSORBANT PAPER PADS/CELLULOSE WAFERS
TISSUE RETRACTION AND PROTECTION MATERIALS
MOUTH GAGS
THROAT SHIELDS
USE OF MEDICAMENTS TO CONTROL OPERATIVE FIELD
16:
General Principles of Instrumentation
POSITIONING OF THE PATIENT IN DENTAL CHAIR
Position of Operator (Fig. 16.1)
Indication
Rear Position
In Sitting Position
Maximum Visibility
Importance of Visibility
Accessibility
ILLUMINATION
RETRACTION
Retraction is Provided by:
Grasp
Sharp Instruments
Maintain a Clean Field
Be Gentle and Careful
Observe the Patient at all Times
Sterilization and Asepsis
Care and Consumer Protection
17:
Differences between Primary and Permanent Dentition
INTRODUCTION
Chronological Differences
Functional Differences
Clinical Considerations
Regressive Alternations
Clinical Applications in Relation to Conservative Dentistry
Class I Cavity
Class II
Gingival Wall
Matrix Band
Class III
Class IV
Class V
18:
Composites
INTRODUCTION
HISTORICAL DEVELOPMENT
COMPOSITION
Definition
Matrix Phase
Surface Interfacial phase
Dispersed phase
Microceramics
Colloidal and microceramics
Fabricated Macro-reinforcing Phases with Colloidal Microceramic Component Bases
CLASSIFICATION
Polymerization methods
Physical properties of composites
Mechanical properties
Biological consideration
GENERAL CONSIDERATIONS FOR DIRECT COMPOSITE RESTORATIONS
Indications
ACID ETCH TECHNIQUE
POSTERIOR COMPOSITES
Indications
Contraindications
Advantages
Disadvantages
General Considerations
Prerequisite Procedure before Cavity Preparation for Composite
Cavity preparation design
Class I Cavity Preparation for Composite Technique
Class II Cavity Preparation Technique (Fig. 18.3)
Extensive Class Ii Cavity Preparation
Difference between cavity preparation for Composite in class I and class II situation from amalgam
Class I and Class Ii Restoration for Composite
Developed by Buonocore (1955)
Procedure for acid etching (Fig. 18.4)
Liquid Etchents
Gel Etchants
Dentin bonding system
Procedure
Insertion of composite
CLass III Cavity Preparation for Composite Restorations (Fig. 18.6)
Convention class III cavity preparation
Bevelled Conventional Class Iii Cavity Preparation (Figs 18.5 and 18.6)
Modified class III cavity preparation (Fig. 18.7)
Gingival Tissue Management
Advantages
Disadvantages
Chemico-mechanical Methods
Problems Encounted with this Method
Radical method
Surgical method can be either
Chemical Cauterization
Class IV Cavity Preparation for Composites
Conventional Class Iv Cavity Preparation (Fig. 18.8)
Beveled Conventional Class IV Cavity Preparation
Modified Class IV Cavity Preparation
Class V Cavity Preparation for Composites
Conventional Class V Cavity Preparation
Features
Beveled Conventional Class V Cavity Preparation
Features
Modified Class V Cavity Preparation
Features
CONTROVERSIES IN POSTERIOR COMPOSITE RESIN RESTORATION
ADDITIONAL USES OF COMPOSITE
RECENT ADVANCES
Composite Inlays
Direct Technique
Indirect Technique
Advantages
CONCLUSION
19:
Infection Control
INTRODUCTION
VIRAL HEPATITIS
Hepatitis B
Hepatitis B
MODES OF TRANSMISSION IN DENTISTRY
FREQUENCY OF INFECTION
Prevention of Transmission through Immunoprophylaxis
Active and Passive Immunity
Hepatitis B vaccine
AIDS/HIV INFECTION
HIV Epidemiology and Transmission
Progression of HIV Infection into AIDS
Symptoms and Oral Manifestations
Serology of Hiv Infection
Hiv Data Related to Infection Control
PERSONAL BARRIER PROTECTION
Protection of the Dental Team
Protection of Patients
USES AND TYPES OF GLOVES
Types
Patient care gloves
Utility Gloves
Other Gloves
Uses
Limitations of Gloves
Handwashing
Instructions for Handwashing
Masks
Limitations of Face Masks
Protective Eyewear
Hepatitis B
Protective Clothing
HAZARDOUS WASTE MANAGEMENT
Biohazardous Waste Means any of the Following
ASEPTIC TECHNIQUES
Operatory Asepsis
Preparation of Semicritical (Attached to Unit for re-use) and Non-critical Items (Supporting or Environmental)
Critical Items
Semicritical Items
Noncritical Items
Disinfectants Preferred
Step by Step Preparation of Dental Chair, Dental Unit and Instruments
Principle and Procedures for Handling and Cleaning Instruments after Treatment
Ultrasonic Cleansers
Operating Precautions
Foil Test
STERILIZATION
Accepted Methods of Sterilization
Selection of Sterilization Methods and Equipment
Disadvantages
Sterilization of Burs in Autoclaves
CHEMICAL VAPOR STERILIZATION (CHEMICLAVING)
Advantages
Disadvantages
DRY HEAT STERILIZATION
Prolonged Dry heat
Advantages
Disadvantages
Rapid Dry Heat Sterilization
Advantages of Dry Heat
Disadvantages
Intense Dry Heat Sterilization
Advantages
Disadvantages
ETHYLENE OXIDE GAS STERILIZATION (ETO)
Advantages
Disadvantages
BOILING WATER
Handpiece Sterilization
GLUTARALDEHYDE SOLUTIONS
Advantages
Disadvantages
Monitoring Sterilization
Process Indicator
Biologic Indicators
Gutta Percha Sterilization
New Methods of Sterilization
Infection Control Procedures for Handling and Transporting to a Remote Laboratory Items for a Non-Aqueous Polymer Based Rubber Impression Technique and Any Associated Registration
Infection Control, Procedure for Handling and Transporting to a Remote Lab Items From an Aqueous Impression Material Technique [Using Alginate (Irreversible Hydrocolloid) Or Reversible Hydrocolloid] and any Associated Registration
Infection Control for Handling Impressions and associated in the On-site Lab
SUMMARY
20:
Recent Concepts in Cavity Preparation
MINIMAL INTERVENTION DENTISTRY (MID)
INTRODUCTION
Advantages of Fluoride
Adhesion in Restorative Dentistry
Chemomechanical Caries Removal
Principle
Material
Use
Indications
Advantages
Disadvantages
Advantages Over Caridex
Indications
Clinical Procedure
Instrumentations
Cavity Preparation
Cavity Assessment
Air Abrasion Technology
Principle
Tooth Preparation
Distance of Nozzle from Tooth Surface
SEM Observation of Surface Shows
Uses
Advantages
Limitations
21A:
Inlays and Onlays
MATERIALS USED FOR INLAYS
Indications for Inlays
Contraindications of Inlay
Preoperative Evaluation of Occlusion
Basic Concepts of Cavity Design for Cast Restoration
Variation in Proximal Marginal Design
Box Preparation (Fig. 21A.3)
Slice Preparation (Fig. 21A.4)
Auxiliary Slice
Modified Flare Preparation
Advantages of Cast Restoration Over Other Restorations (Amalgam)
Disadvantages of Cast Restoration Over Amalgam Restorations
Types of Bevels
Factors that Affect Cavity Design for Cast Restorations
Principles of Cavity Reparation for Cast Gold Restorations
Outline Form (Fig. 21A.6)
Internal Outline Form
Resistance and Retention Form (Fig. 21A.7)
Removal of Any Remaining Infected Dentin
Convenience Form
Finishing Enamel Walls and Margins
Final Procedure of Cleansing and Inspecting the Cavity
DIFFERENCE BETWEEN CAVITY PREPARATION FOR AMALGAM AND CAST INLAYS
21B:
Contours and Contact
CONTOUR
CONTACT
Location of Contact
Importance of Contours and Contacts
Material Used to Build up Contact
Causes of Disturbances in Contact
22:
Silver Amalgam
INTRODUCTION
HISTORICAL ASPECT
Definition
Advantages
Disadvantages
Generations
Classification
COMPOSITION
Role of Individual Constituents
Silver
Tin
Copper
Zinc
Mercury
Platinum
Palladium
MANUFACTURE OF ALLOY POWDER
Lathe Cut Alloy Powder
Spherical Particles
Prepared by Atomization
Amalgamation
Admixed Alloys
Single Composition Alloys
Strength of Various Phases
Corrosion of Various Phases
PROPERTIES OF AMALGAM
Microleakage
Dimensional Change
Effect of Manipulation
Effect of Moisture Contamination
Effects of Delayed Expansion
Strength
Effect of Trituration
Effect of Mercury
Effect of Condensation
Effect of Porosity
Effect of Rate of Hardening
Creep
Mercury Alloy Ratio
Trituration
Hand Trituration
Mechanical Trituration
Work of Trituration
Mulling
Condensation
CARVING AND FINISHING
Precarve Burnishing Procedure
Carving
Post Carve Burnishing
Polishing
Mercury Toxicity
Pronounced Symptoms
Mild to Moderate Symptoms
Subtle Changes on Some Tests but No Overt Symptoms
DENTAL MERCURY HYGIENE RECOMMENDATIONS
Effect of Excess Mercury on Restorations
Effect of Less Mercury on Restorations
Dental Mercury Hygiene Recommendations
SYMPTOMS OF MERCURY TOXICITY
Systemic
Oral
Clinical Considerations
23:
Tooth Separation
REASONS FOR TOOTH SEPARATION
Methods of Tooth Movement
RAPID/IMMEDIATE TOOTH MOVEMENT
Wedge Method
Traction Method
Slow or Delayed Tooth Movement
24A:
Dental Casting Alloys
INTRODUCTION
EFFECTS OBSERVED ON MELTING COMPONENTS TOGETHER
Alloys No Mixing in the Liquid
SOLID SOLUTION
Formation of a Two-Phase Solid
EUTECTIC SYSTEMS
General
Peritectics
Desirable Properties of Dental Casting Alloys
Historical Perspective
Classification of Dental Casting Alloys (Tables 24A.1 to 24A.3)
Gold Casting Alloys
High-Content Gold Alloys (Table 24A.3)
Softening
Porcelain Fused to Metal (PFM)
Gold Alloys
MEDIUM-CONTENT GOLD CASTING ALLOYS
SILVER-PALLADIUM CASTING ALLOYS (WHITE GOLD)
HIGH-CONTENT PALLADIUM CASTING ALLOYS
BASE METAL CASTING ALLOYS
COBALT-CHROMIUM CASTING ALLOYS
NICKEL-CHROMIUM CASTING ALLOYS
HEAT TREATMENT OF BASE METAL ALLOYS
BONDING ALLOYS TO TOOTH MATERIAL
SILICOATING TIN
BIOCOMPATIBILITY OF DENTAL CASTING ALLOYS
DIFFERENCE BETWEEN ALLERGY AND TOXIC REACTIONS
Conclusion
24B:
Dental Casting Procedures
INTRODUCTION
Formation of Wax Pattern (Figs 24B.1A and B)
Direct Wax Patterns
Indirect Wax Patterns
Spruing the Pattern (Fig. 24B.2)
Investing the Pattern
Advantages of Vacuum Investing
Casting Ring Liners
Types
Hygroscopic Low Heat (Water Immersion Technique Figs 24B.3A to E)
High Heat Technique
Controlled Water Added Technique (Low Heat Hygroscopic)
Phosphate Bonded Investment
Casting Procedure
Casting Machines
Methods of Alloy Melting
Centrifugal Casting Machine (Figs 24B.4A and B)
Electrical Resistance Heated Casting Machine
Advantages
Induction Melting Machine
Casting Crucibles
Clearing the Casting
Advantages of Quenching
Compensation for Casting Shrinkage
25:
Porcelain Material
INTRODUCTION
Feldspar
Kaolin
Silica
Aluminium Oxide
Fluxes and Glass Modifiers
Coloring Frits
PROPERTIES OF FUSED PORCELAIN
Strength
Modulus of Elasticity
Surface Hardness
Wear Resistance
Thermal Properties
Specific Gravity
Dimensional Stability
Chemical Stability
Esthetic Properties
Biocompatibility
CLASSIFICATION
METHODS OF CONDENSATION
Firing
Stages of Firing
Note:
Glazing
Purpose
Types
Cooling
Firing Shrinkage
Linear Shrinkage
Volumetric Shrinkage
Compensation of Firing Shrinkage
Layer Method
POROSITY
Vacuum Offset Firing
A. Strengthening Brittle Material
Introduction of Residual Compressive Stresses
1. Ion Exchange
2. Thermal Tempering
3. Thermal Expansion Coefficient Mismatch
Interruption of Crack Propagation
1. Dispersion of a Crystalline Phase
Transformation Toughening
B. Design of Dental Restoration Involving Ceramics
1. Minimizing Tensile Stresses
2. Avoiding Stress Concentration
Factors Affecting Stress
ALL CERAMIC RESTORATIONS
Ceramic Jacket Crown
Composition of Aluminous Porcelain
Properties
Advantages
Denture Teeth
Advantages
Disadvantages
Porcelain Fused to Metal (PFM)
Composition of Ceramics
Composition of Alloy
Enamel Metal Bonds
Mechanical Retention
Compressive Stresses
Chemical Bonding
Bonding Using Electrodeposition
Advantages
Proprietary Agents
Function
Types of Metal Ceramic System
Classification of Bond Failure in Metal Ceramics
TECHNICAL CONSIDERATION FOR METAL CERAMIC RESTORATION
Metal Preparation
Degassing
Opaquer
Cooling
Recent Advances in Porcelain
Advantages
Disadvantage
Advantages
Disadvantages
Chemical Transformation
Crystalline Transformation
Advantages
Disadvantages
Advantages
Disadvantages
Advantage
Disadvantages
Advantages
Disadvantages
CONCLUSION
26:
Dentine Hypersensitivity
DEFINITION
PREVALENCE
ETIOLOGY
Measures of Sensitivity
Causes
Theories of hypersensitivity
Direct nerve stimulation theory or neural theory (Fig. 26.1)
Odontoblast transudation theory (Fig. 26.2)
Hydrodynamic theory (Fig. 26.3)
Treatment of hypersensitivity
Grossman's criteria for desensitizing material
Treatment Modalities
Clean the tooth
Chomical Agents
Mechanism of action
Physical Agents
27:
Non-carious Hard Tissue Lesions
INTRODUCTION
WASTING DISORDERS OF TEETH
Attrition (Fig. 27.1)
Etiology
Clinical features
Proximal surface Attrition
Occlusal Surface Attrition
Treatment
Abrasion (Fig. 27.2)
Etiology
Tooth Brush Abrasion
Clinical signs and symptoms
Treatment
Erosion
Etiology
Clinical features
Treatment
NON-CARIOUS LESIONS IN ENAMEL
Localized Non-hereditary Enamel Hypoplasia (Fig. 27.3)
Clinical features
Etiology
Treatment
Localized Non-hereditary Enamel Hypocalcification
Clinical features
Treatment
Amelogenesis Imperfecta
Clinical features
Radiographic features
Treatment
NON-CARIOUS LESIONS OF DENTIN
Localized Non-hereditary Dentin Hypoplasia
Localized Non-hereditary Dentin Hypocalcification
Dentinogenesis Imperfecta (Fig. 27.4)
Clinical features
Radiographic features
Treatment
Dentinal Sclerosis (Fig. 27.5)
Irritation Dentin
Clinical features
Dead Tracts
NON-CARIOUS LESIONS OF CEMENTUM
Hypercementosis (Fig. 27.7) Syn: Cementum Hyperplasia
Etiology
Radiograph features
Cementicles (Fig. 27.8)
PULP CALCIFICATION
Pulp Stones
Diffuse Calcification
Dystrophic Calcification
TRAUMA
Classification
WHO Classification
Treatment
Root Fracture
Vertical root fractures
Crown Root Fracture
Avulsion
Enamel cracking
Diagnosis
Treatment
Teeth Fracture due to Cyclic Loading
RESORPTION (FIG. 27.9)
Internal Resorption (Fig. 27.9)
Etiology
Clinical features
Treatment
Surgical
External resorption
Etiology
Cervical resorption
Lateral resorption
Non-perforating lateral resorption
Perforating lateral resorption
Resorption following replantation of teeth
CONCLUSION
28A:
Wedge and Instrument Grasp
DEFINITION
Objectives of using a Wedge
Wedging System
Instrument Grasp
28B:
Matrices
29A:
Management of Carious Lesion
INTRODUCTION
CLASSIFICATION OF CARIOUS LESIONS
Location of Caries
Primary Caries
Enamel Pit and Fissure Caries
Enamel Smooth Surface Caries (Fig. 29A.1)
Backward Caries (Fig. 29A.2)
Forward Caries (Fig. 29A.3)
Residual Caries (Figs 29A.4A and B)
Root Surface Caries (Fig. 29A.5)
Secondary Caries (Fig. 29A.6)
Blacks classification of carious lesions(Figs 29A.7A to F)
Class I
Class II
Class III
Class IV
Class V
Class VI
II. Extent of Caries
Incipient Caries (Reversible)
Cavitated Caries (Non-reversible)
III. Rate (speed) of Caries
Acute Dental Caries (Rampant Caries) (Fig. 29A.8)
Arrested Caries (Fig. 29A.9)
Caries Classification Based on Dynamics
Diagnosis of a Carious Lesion
Visual Examination
Tactile Examination
Radiographs (Posterior Bitwing Radiographs) (Fig. 29A.10)
Clinical Features of Caries for Diagnosis
Advances in Caries Diagnosis
Electronic Caries Diagnosis (Caries meter)
Transillumination (Proximal Lesion)
Caries Detector Dyes
Dental floss
Lasers
Treatment of the Different Types of the Carious Lesions
Enamel Caries or Incipient Carious lesion
Pit and Fissure Caries
Prophylactic Odontotomy
Pit and Fissure Sealants
Recent Advances
Indirect Pulp Capping (Figs 29A.11A to C)
Materials Used for Indirect Pulp Capping
Procedure for Indirect Pulp Capping
Direct Pulp Capping (Fig. 29A.12A)
Pulp Capping Materials are:
Procedure
29B:
Management of Deep Carious Lesion
DIAGNOSIS OF DEEP CARIOUS LESION
Pains
Pulp Testing
Thermal Pulp Testing
Electric Pulp Testing
Direct Pulp Exposure
Percussion Sensitivity
Visual Examination and Tactile Evaluation
Removal of Tooth Structure without Anesthesia
Selective Infiltration or Ligamental Anesthesia
Use of Certain Dyes to Differentiate Reparable Dentin from Irreparable Dentin
Radiographic Diagnosis of Deep Caries Lesion
Treatment of Deep Caries
For Acute Decay
For Chronic Decay
Indirect Pulp Capping (Figs 29B.1A to C)
Technique
Direct Pulp Capping (Figs 29B.2A to D)
Rationale
Procedure
30:
Speed in Dentistry
INTRODUCTION
DEFINITION
Speed
Handpiece
HISTORICAL BACKGROUND
Development of rotary cutting Equipment
CLASSIFICATION
Coast Speed
Low speed
Disadvantages of Low Speed
History of high speed
High Speeds
Advantages of High Speed
Disadvantages of High Speed
Ultraspeed
Rotary Cutting Equipment Development
DEVELOPMENT OF DENTAL HANDPIECES
Hand Drills
Straight hand drills
CLASSIFICATION OF HANDPIECES
Belt Driven Handpieces
Gear Driven Handpieces
Water Driven Handpiece
Air Driven Handpieces
Reciprocating handpiece
Miniature handpieces
DENTAL BURS (FIG. 30.1)
Historical Development of Dental Burs
Classification of Dental Burs
Round Bur
Inverted Cone Bur
Pear-shaped Bur
Straight Fissure Burs
Used for
Tapered Fissure Burs
Size of the Burs
Common Designs of Shank of Burs
Rotary Diamond Instruments
Availability
Considerations for use of Rotary Diamond Instruments
Coarse Grit Diamond Instruments
Regular or Medium Grit Instruments
First Grit Instruments
Extra Fine, Very Fine or Superfine Grit
For Optimum Efficiency
Criteria for Consideration
For Accuracy or Efficiency
Factors Influencing the Cutting Efficiency of Burs
Bur Tooth
Rake Angle (Fig. 30.2)
Land (Figs 30.3 and 30.4)
Clearance Angle (Fig. 30.5)
Tooth Angle
Flute or Chip Space
CUTTING EFFICIENCY IN RELATION WITH RAKE ANGLE
Instrument Design
Friction
Torque
Vibration
Cross Cuts
Concentricity
Run Out
Dental Abrasive Stones
LASER EQUIPMENT
Ultrasound in Dentistry
Air Abrasives
BIOLOGICAL CONSIDERATIONS
Periodontium
Prevention
Enamel
Dentin
During Cavity Preparations
Operative Precautions
Pulp
VIBRATIONS
PROTECTION
PROTECTION FROM NOISE
NOISE
Noisy Environment also
Methods to Avoid Noise Levels
MAINTENANCE
STERILIZATION AND DISINFECTION OF THE ROTARY EQUIpMENT
Definition
Sterilization
Disinfection
Handpiece Surface Contamination Control
OTHER METHODS OF HANDPIECE STERILIZATION
Chemical vapor pressure sterilization
Sterilization of Burs in Autoclaves
CONCLUSION
INDEX
TOC
Index
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