Operative Dent Session 3 Flashcards
what is operative dentistry
the art and science of the prevention, diagnosis, and treatment of defects in the enamel, dentin, and cementum of teeth
- foundation of dentistry and base from which other aspects evolved
what are the 5 purposes of operative dentistry
diagnosis, prevention, interception, preservation (minimally invasive), and resoration
what are the 4 types of tooth destruction
caries, tooth wear, trauma, developmental defects
what services do we provide
diet and caries counseling, cleanings, fluoride & preventative treatments, composite build ups, tooth whitening, porcelain veneers
what are the first 7 rules of sim clinic
1) keep your unit clean
2) keep your instruments organized
3) correct patient position and posture
4) Listen to instructions
5) always use rubber dam, if torn reapply
6) do not leave before you are done w/ the exercise of the day (good quality)
7) if you need to redo, get approval
what are the types of materials we have for fillings/ crowns
sealants, amalgam, composite resin, gold, cuspal coverage, porcelain onlays
what are general tasks we will do in sim clinic
practice psychomotor skills, perform procedures, use a clinically relevant approach
what are the second 7 rules of sim clinic
8) before getting a new tooth, let instructor know what went wrong and how to fix
9) if you injure adjacent tooth, have to redo entire procedure
10) no material waste!!
11) minimally acceptable is NOT acceptable
12) will have to redo some procedures, don’t take it personal
13) many different ways to do things, respect suggestions and try them
14) questions are welcome always
define carie
commonly used for tooth decay
define carious lesion
cavity caused by caries
define cavity
missing tooth structure, may be due to decay, erosion, or abrasion
what is decay
lay term for caries
what is a filling
lay term for restoring of lost tooth structure by using materials such as metal, alloy, plastic or porcelain
what is a preparation
mechanical alteration of a defective, injured, or diseased tooth to receive restorative treatment
what is the anatomical crown
part of the tooth that is covered by enamel. it is up to the cementoenamel junction
what is the clinical crown
part that is visible in the oral cavity
which organic items make up the hard tissue composition
lipids, proteins, collagen
which inorganic items make up the hard tissue composition
carbonated apatite, hydroxy apatite, fluro- apatite
what is the basic unit of tooth enamel
enamel rod
what is an enamel rod
tightly packed, highly organized mass of hydroxyapatite crystals, hexagonal in shape and provide rigidity and strengthen the enamel
what is perikymata
incremental growth line that appear on the surface of tooth enamel as a series of linear grooves aka stria of retzius
what are diffusion channels
enamel has these that allow for acid/ ionic exchange
what are the components of enamel? describe each
- enamel rods
- interrod enamel: located around the rod enamel, same composition as enamel rod, just different direction
- rod sheath contains proteins, water, and lipids. perpendicular to tooth surface
what is dentin composed of
microscopic channels called dentinal tubules, which radiate outward through the dentin from the pulp to the exterior cementum or enamel border
compare the composition of dentin vs. enamel
- hydroxyapatite crystals are 30 times smaller making dentin somewhat softer than enamel
- dentin is duller and darker in appearance
what is peritubular dentin
relatively dense mineralized tissue that surrounds the dentinal tubules, composed of crystals of carbonated/ hydroxy apatite together w/ a small amount of collagen
what is intertubular dentin
lies between tubules, less-calcified matrix that consists of some apatite crystals embedded w/in a collagen matrix
what are the 4 types of dentin, describe each
primary: first dentin deposited during development
secondary: dentin deposited as a process of normal aging
tertiary: dentin deposited in response to trauma
sclerotic: hyper mineralized dentin, darker, non-carious, not necessary to remove (happens over a very long time)
define pulp
connective tissue that contains blood vessels and nerve tissue which occupies the pulp cavity of a tooth
what are the functions of pulp
1) formative: generate primary, secondary, and tertiary dentin
2) nutritive: provides vascular supply and transfer medium for metabolic fxns and maintenance of cells and organic matrix
3) sensory: transmits afferent pain sensation
4) protective: coordinates inflammatory responses to injury
what is the hydrodynamic theory of pulpal pain
inflammation -> swelling of odontoblasts -> occlude dentinal tubules -> increased pressure and sensitivity to fluid movements in the tubules
what are the 4 causes of pulpal inflammation
1) bacterial influences
2) desiccation (overdrying dentin after etching)
3) heat damage (bur friction, polymerization of temp. & composite materials)
4) osmotic changes (sweets)
what are the 4 biomechanical factors affecting pulpal health
1) depth and extent of prep
2) bur used (dull)
3) bur rotation (static, too much pressure)
4) use of coolants (H2O)
what are the 3 numbering systems
1) Palmar notation
2) FDI international
3) universal numbering system
describe the palmer notation system
- 4 quadrants, maxillary right and left, mandibular right and left
- numbering is 1-8 and begins at the midline
which numbers belong to the mandibular right area for international numbering
25-32
describe the FDI international numbering system
- quadrants are numbered 1-4, top right, top left, bottom left, bottom right
- numbering is 1-8 and begins at the midline
which numbers belong to the maxillary left area
9-16
which numbers belong to mandibular left area
17-24
which numbers belong to the maxillary right area
1-8
what are the 7 tooth surfaces
1) buccal
2) occlusal
3) mesial
4) facial
5) distal
6) incisal edge
7) lingual
which are the two biting surfaces?
occlusal and incisal
which are the four surfaces of the anterior teeth
mesial, distal, facial, palatal
what are the tooth surfaces of the posterior teeth
mesial, distal, facial, lingual
what was the first caries classification and when was it created
GV black classes of cavity preparations, 1908
describe GV Black class I
- pits and fissures of occlusal surfaces of posterior teeth
- pits in the occlusal 2/3 of facial and lingual surfaces of molars
describe GV Black class II
smooth proximal surfaces of posterior teeth
describe GV Black class III
smooth proximal surfaces of anterior teeth
describe GV Black class IV
smooth proximal surfaces of anterior teeth, involve the incisal edge as well
which are the anterior teeth
incisors and canines
which are the posterior teeth
premolars and molars
describe GV Black class V
smooth surfaces of all teeth in gingival 1/3 of facial and lingual surfaces
describe GV Black class VI
incisal edges of anterior teeth and occlusal cusp tips of posterior teeth
what is ICDAS? what did it do?
- international caries detection and assessment system
- in 2004 updated caries classification to 0-6 scores
what is ICDAS score 0
no or slight change in enamel translucency after 5 s air drying
what is ICDAS score 1
first visual change in enamel (only seen after prolonged air drying, and w/in pit or fissure)
what is ICDAS score 2
distinct visual changes in enamel
what is ICDAS score 3
localized enamel breakdown in opaque or discolored enamel (no visual signs of dentinal involvement)
what is ICDAS score 4
underlying dark shadow from dentine
what is ICDAS score 5
distinct cavity w visible dentin
what is ICDAS score 6
extensive distinct cavity w visible dentin (more than half of the surface)
what is ICDAS radiographic score 0
no radiolucency
what is ICDAS radiographic score RA1
initial stage: radiolucency in the outer 1/2 of the enamel
what is ICDAS radiographic score RA2
initial stage: radiolucency in the inner 1/2 of the enamel +/- enamel-dentin junction
what is ICDAS radiographic score RA3
initial stage: radiolucency limited to the outer 1/3 of dentin
what is ICDAS radiographic score RB4
moderate: radiolucency reaching the middle 1/3 of dentine
what is ICDAS radiographic score RC5
extensive: radiolucency reaching the inner 1/3 of dentin, clinically cavitated
what is ICDAS radiographic score RC6
extensive: radiolucency into the pulp, clinically cavitated
what is the ICCMS
international caries classification and management system
what are the 5 components of the ICCMS
history, classification, decision making, management, and risk- based
what diagnostic data is needed
caries risk assessment
medical and dental history
occlusion
diet
patient exam and charting
intra and extra oral exam
what are the methods of pulp vitality testing
- electric (EPT)
- temperature (cold test)
what are the 3 phases after identifying caries risk
phase I: emergencies, infections, prevention, gingival health, sealants
phase II: simple restorations
phase III: complex restorations
