Operative Dentistry Flashcards
What determines cavity design?
- Structure and properties of dental tissues
- The disease - caries, periodontal disease, tooth surface loss
- Properties of restorative materials
Mention things you need to consider during cavity preparation and restoration
- Position of caries
- Extent of caries
- Shape of prepared cavity
- Restorative material
Position of Caries
- Pit & fissure (Susceptible areas)
- Approximal areas (Posterior & Anterior)
- Smooth surfaces (Gingival margins, erosion etc.)
- Roots (Those with periodontal disease)
When we may consider a restoration?
- Lesion has spread to dentine radiographically
- Lesion has caused pulpitis
- Lesion is unaesthetic
No attempt to remove healthy tissue should be made, unless…
- Material for restoration requires it
- Margins of cavity are in contact with another tooth surface
- Margins of cavity cross occlusal contact
Mention principles of cavity preparation
- Identify & remove carious enamel
- Remove enamel to identify extent of lesion at ADJ & smooth enamel margin
- Remove peripheral caries in dentine (From ADJ → Deeper regions)
- Remove deep caries over pulp (if applicable)
- Outline form modification (Shape)
- Internal design modification (internal line & point angles)
Mention ore detail on outline and internal design modifications of cavity prep (5,6)
- Remove unsupported enamel for proper etch adhesion.
- Smooth cavosurface margins and line angles.
- Avoid excessively acute line angles; ensure a smooth, rounded outline.
- Ensure no traces of previous restorative material remain unless doing a repair.
- Check for stress concentrators.
What CSMA Stands for?
Cavosurface Margin Angle
Things to consider when establishing final seal of cavity:
-Smooth margins present
-Appropriate CSMA
-No unsupported tooth tissue
-No stress concentrators
-Internal anatomy that allows adaptation of material
Explain 1st Principle – Access Caries
- Apply Dental dam
- Remove overlying enamel w/ high-speed bur
- Follow caries at ADJ
- Do NOT extend into non-carious areas
Explain 2nd Principle – Extent
- Caries spread at ADJ identifies cavity outline form
- Clear all caries at ADJ
- Check staining at ADJ
- Smooth Cavo-surface margins
- Examine adjacent contact for caries
- Avoid trauma to adjacent tooth
Why you should NEVER remove a restoration by
cutting around the edges?
Because you will increase the size of the cavity unnecessarily
Explain Principle 3 - Remove Dentinal Caries
- Softened ‘brown-stained’ tissue can stick to sharp probe
- Should all be removed using slow speed steel cutting bur
- Work from ADJ to Pulpal floor
- Do not probe uncavitated carious enamel
- Caution: pulpal exposure
How pulpal floor caries should be removed?
Large instrumentation to be used:
- Large round bur
- Large excavator ⛏️
- Chemo-Mechanical caries removal
Why you should use large instrument in removing pulpal floor caries?
Small burs and excavators will cut deeply more quickly – risk of pulp exposure
