Clinical Experience I- Ch 48- Complete

Restorative Dentistry

What types of materials are used for esthetic dentistry?

Direct and indirect restoration materials, along with whitening materials

restorative dentistry

Cavity Preparation

When preparing a tooth for a permanent restoration, the dentist has the acquired knowledge about the:

• Direction of the enamel rods

• Thickness of the enamel

• Body of the dentin

• Size and position of the pulp

• Crown of the tooth as it relates to the gingival tissues

standardized plan of a restoration

Initial Cavity Preparation

1. Outline form

• Design and initial depth of sound tooth structure

2. Resistance form

• Primary shape and placement of cavity walls

3. Retention form

• To resist displacement or removal

4.Convenience form

• Accessibility in preparing and restoring the tooth

Final Cavity Preparation

Includes:

Removing enamel, diseased dentin, or old restorative material (or a combination)

Inserting additional resistance and retention notches, grooves, and coves

Placing protective dental materials (lining agents, bases, desensitizing, or bonding agents)

Standardized Plan of a Restorative Procedure

Communicate with the patient about the procedure and what to expect

Position the patient correctly for the dentist and have ready the type of procedure

Dentist will evaluate the tooth

Dentist administers local anesthesia

Assistant readies the means of moisture control

Dentist prepares the tooth

Dentist determines the type of dental materials to be used

Dentist burnishes, carves, or finishes the dental material

Dentist checks the occlusion of the restoration

Dentist finishes and polishes the restoration

Dental Assistant’s Role in a Restorative Procedure

Permanent Restorations

Class I Restorations

Class II Restorations

Class III and IV Restorations

Anterior Teeth: Class III lesion

• Affects the interproximal surface of incisors and canines

(M or D)

Anterior Teeth: Class I lesion

• Involves a larger surface area, including the incisal edges and interproximal surface of incisors and canines

(MI/DI)

Class V Restorations

Class V restoration

• Classified as a smooth surface restoration, occurs more in older patients

Decayed lesions occur at:

• Gingival third of the facial or lingual surfaces of any tooth

• Root of a tooth, near the cementoenamel junction

• (F)

Complex Restorations

In certain situations, during tooth preparation, the loss of tooth structure will become greater than what is remaining of the natural tooth structure

The dentist must decide whether to:

• Restore the tooth with a direct restoration

• Change the treatment plan and advise the patient that an indirect restoration would be more suitable

Retention Pins

It may be necessary for the dentist to use a stronger system for retaining and supporting the restoration other than retentive grooves or bonding materials

In general, when using retention pins, one pin is placed for each missing cusp

Pins are available in several diameters (widths) and styles

The retention pin has deep threads that grip the dentin when screwed into tooth structure

Intermediate Restorations

Veneers

Tooth Whitening

Treatment Options

 In-office treatment

 At-home treatment

 Over-the-counter options

In-Office Treatment

At-Home Treatment

Over-the-Counter Options

Dental Assistant’s Role in Tooth Whitening

Patient Instructions in Tooth Whitening

Abuse of Whitening Products

With at-home and over-the-counter whitening products, the patient may have greater potential for abuse

A patient will abuse a whitening product by

1.) not following directions

2.) by overusing it to achieve whiter teeth

Adverse Effects of Tooth Whitening

Veneer

a thin layer of composite resin or porcelain that is bonded or cemented to a prepared facial surface for an aesthetic appearance

diastema

a gap or space between two adjacent teeth, often seen in maxillary central incisors

Which classification involves the incisal and interproximal surface of an anterior tooth?

Class IV (4)

Direct veneers are made of what material?

composite resin

What is the active ingredient in tooth whitening products?

Hydrogen peroxide

What does the inital cavity preparation include?

convenience form

outline and resistance form

retention form

In which teeth are Class II restorations found?

premolars/molars

What is the final step in a cavity preparation?

placing a desensitizing or lining agent

During a Class III or IV restoration, the dentist may use a ___ to help reproduce the correct contact between the teeth.

mylar matrix system

A point angle is the junction of ___walls or surfaces that come from different orientation.

three

Which describes why a composite restoration stays in a tooth?

bonding

class I

Cavities in the pits and fissure surfaces of the molars, premolars, and lingual surfaces of anterior teeth

Class II

Cavities in the proximal surfaces of premolars and molars.

Class III

Cavities in the proximal surfaces of anterior teeth (canines and incisors), excluding the incisal edge.

Class IV (4)

cavities on the proximal surfaces of anterior teeth that involve the incisal edge.

Class V

Cavities located on the cervical third of the facial or lingual surfaces of any tooth.

Class VI (6)

Cavities located on the incisal edges of anterior teeth or the cusps of posterior teeth. (later added to the G.V Black Classification of Cavities as a new category in 1956 but W.J Simon.)