Part 2 book “Textbook of preclinical conservative dentistry” has contents: Principles of tooth preparation, tooth preparation for amalgam and composite restorations, tooth preparation for primary teeth, dental materials, adhesive dentistry,… and other contents.
CHAPTER Principles of Tooth Preparation Nisha Garg CHAPTER OUTLINE Introduction Purpose of Tooth Preparation Classification Definitions Number of Line and Point Angles INTRODUCTION Tooth preparation is the mechanical alteration of a defective, injured or diseased tooth in order to best receive a restorative material which will re-establish the healthy state of the tooth including esthetic correction when indicated along with normal form and function Steps Initial Stage Final Stage Viva Questions CLASSIFICATION Tooth preparation is classified according to location of the tooth defect (Fig 8.1) Class I is the only pit and fissure preparation whereas rest are smooth surface preparations r Class I: Pit and fissure preparations occur on the occlusal surfaces of premolars and molars, the occlusal PURPOSE OF TOOTH PREPARATION two-third of buccal and lingual surface of molars and lingual surface of incisors (Figs 8.2A and B) Earlier when the affected tooth was prepared because of caries, cutting of tooth was referred to as cavity r Class II: Preparations on the proximal surface of premolars and molars are class II (Figs 8.3A and B) preparation But nowadays many indications other than r Class III: Preparations on the proximal surface of anterior caries lead to preparation of the tooth Hence, the term teeth and not involving the incisal angles are class III cavity preparation has been replaced by tooth preparation (Figs 8.4A and B) Tooth preparation is done for: r Class IV: Preparations on the proximal surface of r 5SFBUNFOUPGDBSJPVTUFFUI anterior teeth also involving the incisal angle falls under r 5SFBUNFOU PG NBMGPSNFE GSBDUVSFE PS USBVNBUJ[FE class IV (Figs 8.5A and B) teeth r Class V: Preparations on gingival third of facial and r 3FQMBDFNFOUPGPME EFGFDUJWFSFTUPSBUJPOT lingual or palatal surfaces of all teeth came under Class V r &TUIFUJD JNQSPWFNFOU GPS EJTDPMPSFE BOE VOFTUIFUJD (Figs 8.6A and B) teeth 102 Textbook of Preclinical Conservative Dentistry Figure 8.1: Schematic representation showing GV Black’s classification of dental caries A B Figures 8.2A and B: (A) Clinical picture of class I lesion; (B) Schematic representation of class I lesion showing caries on occlusal surface of molars and premolars, lingual surface of incisors and occlusal third of buccal and lingual surface of molars A B Figures 8.3A and B: (A) Clinical picture of Class II lesion; (B) Schematic representation of Class II lesion Principles of Tooth Preparation A B Figures 8.4A and B: (A) Clinical picture of Class III lesion; (B) Schematic representation of Class III lesion A B Figures 8.5A and B: (A) Clinical picture of Class IV lesion; (B) Schematic representation of Class IV lesion A B Figures 8.6A and B: (A) Clinical picture of Class V lesion; (B) Schematic representation of Class V lesion 103 104 Textbook of Preclinical Conservative Dentistry Modification of Black’s classification was made to QSPWJEFNPSFTQFDJêDMPDBMJ[BUJPOPGQSFQBSBUJPOT r Class II: Preparations on the single or both proximal surface of premolar and molar teeth When there is involvement of both proximal surfaces, it is called mesio-occlusodistal (MOD) preparation (Fig 8.7) r Class VI: Preparations on incisal edges of anterior and cusp tips of posterior teeth without involving any other surface (Figs 8.8A and B) come under Class VI DEFINITIONS Figure 8.7: Schematic representation of MOD preparation Simple Tooth Preparation A tooth preparation involving only one tooth surface is termed simple preparation (Fig 8.9), for example, occlusal preparation Compound Tooth Preparation A tooth preparation involving two surfaces is termed as compound tooth preparation (Fig 8.10), for example, mesio-occlusal or disto-occlusal preparation B A Figures 8.8A and B: (A) Clinical picture of Class VI lesion; (B) Schematic representation of class VI lesion Complex Tooth Preparation A tooth preparation involving more than two surfaces is called as complex tooth preparation (Fig 8.11), for example, MOD preparation For communication and records purpose, surface of tooth preparation is abbreviated by using first letter, capitalized For example r 1SFQBSBUJPOPOPDDMVTBMTVSGBDFBTi0u r 1SFQBSBUJPOPOEJTUBMBOEPDDMVTBMTVSGBDFTBTi%0u r 1SFQBSBUJPO PO NFTJBM PDDMVTBM BOE EJTUBM TVSGBDFT BT i.0%u B A Figures 8.9A and B: Photograph and schematic representation showing simple tooth preparation involving one tooth surface only Walls Internal Wall It is a wall in the preparation, which is not extended to the external tooth surface (Fig 8.12) External Wall An external wall is a wall in the prepared tooth that extends to the external tooth surface (Fig 8.13) External wall takes the name of the tooth surface towards which it is situated A B Figures 8.10A and B: Photograph and schematic representation showing compound tooth preparation involving two surfaces Principles of Tooth Preparation 105 Facts When two or more surfaces are combined, the –al ending of the prefix word is changed to an –o The angle formed by lingual and gingival wall is termed as “linguogingival” line angle An MOD preparation is called mesio-occlusodistal preparation A B Figures 8.11A and B: Photograph and schematic representation showing complex tooth preparation involving more than two surfaces Pulpal Wall A pulpal wall is an internal wall that is towards the pulp and covering the pulp (Fig 8.14) It may be both vertical and perpendicular to the long axis of tooth Axial Wall It is an internal wall which is parallel to the long axis of the tooth (Fig 8.15) Floor Figure 8.12: Schematic representation of internal and external wall of tooth preparation Floor is a prepared wall which is usually flat and perpendicular to the occlusal forces directed occlusogingivally, for example, pulpal and gingival walls (Fig 8.16) Cavosurface Angle Margin Cavosurface angle is formed by the junction of a prepared tooth surface wall and external surface of the tooth (Fig 8.17) The acute junction is referred to as preparation margin or cavosurface margin Line Angle Figure 8.13: Schematic representation of external wall of tooth preparation It is a junction of two surfaces of different orientations along the line Its name is derived from the involved surfaces Point Angle It is a junction of three plane surfaces or three line angles of different orientations Its name is derived from its involved surfaces or line angles NUMBER OF LINE AND POINT ANGLES Figure 8.14: Schematic representation of pulpal floor and axial wall Number of line angles and point angles in different tooth preparations are enumerated in Table 8.1 Line and point angles of class I to class V tooth preparations are enlisted as following 106 Textbook of Preclinical Conservative Dentistry Class I Tooth Preparation For simple class I tooth preparation involving only occlusal surface of molars eight line angles and four point angles are named as follows (Fig 8.18): Line Angles Figure 8.15: Schematic representation showing class III tooth preparation depicting axial wall r r r r r r r r FTJPGBDJBMMJOFBOHMF FTJPMJOHVBMMJOFBOHMF %JTUPGBDJBMMJOFBOHMF %JTUPMJOHVBMMJOFBOHMF 'BDJPQVMQBMMJOFBOHMF -JOHVPQVMQBMMJOFBOHMF FTJPQVMQBMMJOFBOHMF %JTUPQVMQBMMJOFBOHMF Point Angles r r r r FTJPGBDJPQVMQBMQPJOUBOHMF FTJPMJOHVPQVMQBMQPJOUBOHMF %JTUPGBDJPQVMQBMQPJOUBOHMF %JTUPMJOHVPQVMQBMQPJOUBOHMF Class II Tooth Preparation Figure 8.16: Schematic representation showing pulpal and gingival floor of class II preparation For class II preparation (mesio-occlusal or disto-occlusal) 11 line angles and point angles are as follows (Fig 8.19) The following is the nomenclature for mesio-occlusal tooth preparation Line Angles Figure 8.17: Schematic representation showing cavosurface angle is angle formed by junction of prepared tooth surface and external surface of the tooth Table 8.1 ăNumber of line angles and point angles in different tooth preparation designs Type of tooth preparation r r r r r r r r r r r %JTUPGBDJBM 'BDJPQVMQBM "YJPGBDJBM 'BDJPHJOHJWBM "YJPHJOHJWBM -JOHVPHJOHJWBM "YJPMJOHVBM "YJPQVMQBM %JTUPMJOHVBM %JTUPQVMQBM -JOHVPQVMQBM Line angles Point angles Class I Point Angles Class II 11 Class III Class IV 11 Class V r r r r %JTUPGBDJPQVMQBMQPJOUBOHMF "YJPGBDJPQVMQBMQPJOUBOHMF "YJPGBDJPHJOHJWBMQPJOUBOHMF "YJPMJOHVPHJOHJWBMQPJOUBOHMF Principles of Tooth Preparation Figure 8.18: Schematic representation of class I tooth preparation showing line angles and point angles Figure 8.19: Schematic representation of class II tooth preparation showing line and point angles 107 Figure 8.21: Schematic representation of class IV preparation showing line and point angles Figure 8.22: Schematic representation of class V preparation showing line and point angles Line Angles r r r r r r Figure 8.20: Schematic representation of class III preparation showing line and point angles 'BDJPHJOHJWBM -JOHVPHJOHJWBM "YJPHJOHJWBM "YJPMJOHVBM "YJPJODJTBM "YJPGBDJBM Point Angles r "YJPMJOHVPQVMQBMQPJOUBOHMF r %JTUPMJOHVPQVMQBMQPJOUBOHMF r "YJPGBDJPHJOHJWBMQPJOUBOHMF r "YJPMJOHVPHJOHJWBMQPJOUBOHMF r "YJPJODJTBMQPJOUBOHMF Class III Tooth Preparation Class IV Tooth Preparation For class III preparation on anterior teeth, line angles and point angles are as follows (Fig 8.20): For class IV tooth preparation on anterior teeth, 11 line angles and point angles are as follows (Fig 8.21): 108 Textbook of Preclinical Conservative Dentistry Line Angles Steps in Tooth Preparation r r r r r r r r r r r r Stage I: Initial tooth preparation steps – Outline form and initial depth – Primary resistance form – Primary retention form – Convenience form r Stage II: Final tooth preparation steps m 3FNPWBM PG BOZ SFNBJOJOH FOBNFM QJU PS êTTVSF infected dentin and/or old restorative material, if indicated – Pulp protection, if indicated – Secondary resistance and retention form – Procedures for finishing the external walls of the tooth preparation – Final procedures: Cleaning, inspecting and sealing Under special conditions these sequences can be changed 'BDJPHJOHJWBM -JOHVPHJOHJWBM FTJPGBDJBM FTJPMJOHVBM FTJPQVMQBM 'BDJPQVMQBM -JOHVPQVMQBM "YJPHJOHJWBM "YJPMJOHVBM "YJPGBDJBM "YJPQVMQBM Point Angles r r r r r r "YJPGBDJPQVMQBMQPJOUBOHMF "YJPMJOHVPQVMQBMQPJOUBOHMF "YJPGBDJPHJOHJWBMQPJOUBOHMF "YJPMJOHVPHJOHJWBMQPJOUBOHMF %JTUPGBDJPQVMQBMQPJOUBOHMF %JTUPMJOHVPQVMQBMQPJOUBOHMF Class V Tooth Preparation For class V preparation, line angles and point angles are as follows (Fig 8.22): Line Angles r r r r r r r r "YJPHJOHJWBM "YJPJODJTBM "YJPNFTJBM "YJPEJTUBM FTJPJODJTBM FTJPHJOHJWBM %JTUPJODJTBM %JTUPHJOHJWBM Point Angles r r r r "YJPEJTUPHJOHJWBMQPJOUBOHMF "YJPEJTUPJODJTBMQPJOUBOHMF "YJPNFTJPHJOHJWBMQPJOUBOHMF "YJPNFTJPJODJTBMQPJOUBOHMF STEPS For optimal restoration, tooth preparation involves basic mechanical and physical principles which should be followed in an orderly sequence Tooth preparation is EJWJEFEJOUPUXPTUBHFTWJ[ JOJUJBMBOEêOBM INITIAL STAGE Outline Form and Initial Depth Definition Outline form means: r 1MBDJOH UIF QSFQBSBUJPO NBSHJOT JO UIF QPTJUJPO UIFZ will occupy in the final tooth preparation except for finishing enamel walls and margins r BJOUBJOJOHUIFJOJUJBMEFQUIPGmNNJOUPUIFEFOUJO r 0VUMJOF GPSN EFêOFT UIF FYUFSOBM CPVOEBSJFT PG UIF preparations Outline form includes the external outline form and internal outline form External outline form is established first to extend all margins into sound tooth tissue while NBJOUBJOJOHUIFJOJUJBMEFQUIPGmNNJOUPUIFEFOUJO towards the pulp (Fig 8.23) During tooth preparation, the margins of preparation not only extend into sound tooth tissue but also involve adjacent deep pits and fissures in preparation This was referred to as ‘extension for prevention’ by GV Black Factors Affecting the Outline and Initial Depth form of Tooth Preparation r &YUFOTJPOPGDBSJPVTMFTJPO r 1SPYJNJUZPGUIFMFTJPOUPPUIFSEFFQTUSVDUVSBMTVSGBDF defects r /FFEGPSFTUIFUJDT r 3FMBUJPOTIJQXJUIBEKBDFOUBOEPQQPTJOHUFFUI r $BSJFTJOEFYPGUIFQBUJFOU r 3FTUPSBUJWFNBUFSJBMUPCFVTFE Principles of Tooth Preparation 109 Principles r 3FNPWBMPGBMMXFBLFOFEBOEGSJBCMFUPPUITUSVDUVSF r 3FNPWBMPGBMMVOEFSNJOFEFOBNFM(Fig 8.24) r 1MBDFBMMNBSHJOTPGQSFQBSBUJPOJOBQPTJUJPOUPBŀPSE good finishing of the restoration r *ODPSQPSBUFBMMGBVMUTJOQSFQBSBUJPO Features for Establishing A Proper Outline form r r r r 1SFTFSWFDVTQBMTUSFOHUI 1SFTFSWFTUSFOHUIPGNBSHJOBMSJEHF JOJNJ[FUIFCVDDPMJOHVBMFYUFOTJPOT -JNJUJOH UIF EFQUI PG QSFQBSBUJPO m NN JOUP dentin r *G EJTUBODF CFUXFFO UXP GBVMUT JT MFTT UIBO NN connect them r %PFOBNFMPQMBTUZXIFSFWFSJOEJDBUFE B A Figures 8.23A and B: Schematic representation showing initial depth of preparation should be 0.2–0.8 mm into dentin Outline form for Pit and Fissure Lesions r 3FNPWFBMMEFGFDUJWFQPSUJPOBOEFYUFOEUIFQSFQBSBUJPO margins to healthy tooth structure r 3FNPWF BMM VOTVQQPSUFE FOBNFM SPET PS XFBLFOFE enamel margins r *G UIF UIJDLOFTT PG FOBNFM CFUXFFO UXP QSFQBSBUJPO TJUFT JT MFTT UIBO NN DPOOFDU UIFN UP NBLF POF preparation, otherwise prepared as separate tooth preparations r "WPJE FOEJOH UIF QSFQBSBUJPO NBSHJOT JO IJHI TUSFTT areas, such as cusp eminences r &YUFOEUIFQSFQBSBUJPONBSHJOTUPJODMVEFBMMQJUTBOE fissures which cannot be managed by enameloplasty r -JNJU UIF EFQUI PG QSFQBSBUJPO UP NN JOUP UIF dentin, though the actual depth of preparation may WBSZGSPNmNNEFQFOEJOHPOTUFFQOFTTPGDVTQBM slopes and thickness of the enamel A B Figures 8.24A and B: Schematic representation showing removal of all undermined enamel External outline form r Consists of smooth curves, straight lines and rounded line and point angles (Fig 8.25) r Weak unsupported enamel should be removed since it is liable to fracture Internal outline form r *U JODMVEFT UIF SFMBUJPOTIJQ PG PDDMVTBM XBMMT GSPN cavosurface angle to the pulpal floor r 1SFQBSBUJPOEFQUITIPVMECFBUMFBTUmNNWFSUJDBM from the cavosurface margin to the pulpal floor and at MFBTU m NN JO EFOUJO TP BT UP QSPWJEF BEFRVBUF strength to resist fracture due to masticatory forces (Fig 8.26) Figure 8.25: Clinical picture showing that outline form should consist of smooth curves, rounded line and point angles Outline form for Smooth Surface Lesions—Outline form of Proximal Caries (Class II, III and IV lesions) A class II tooth preparation consists of: r 0DDMVTBMTFHNFOU r 1SPYJNBMTFHNFOU 110 Textbook of Preclinical Conservative Dentistry Rules for Making Outline form for Proximal Preparation r &YUFOE UIF QSFQBSBUJPO NBSHJOT VOUJM TPVOE UPPUI structure is reached (Fig 8.27) r 3FTUSJDUUIFEFQUIPGBYJBMXBMMmNNJOUPEFOUJO (Fig 8.28) r "YJBMXBMMTIPVMECFQBSBMMFMUPFYUFSOBMTVSGBDFPGUIF tooth (Fig 8.29) r *ODMBTT**UPPUIQSFQBSBUJPO QMBDFHJOHJWBMTFBUBQJDBM to the contact but occlusal to gingival margin and have UIFDMFBSBODFPGNNGSPNUIFBEKBDFOUUPPUI(Figs Figure 8.26: Schematic representation showing that preparation 8.30 and 8.31) To Recapitulate Axial wall should r #FQMBDFEJOUPEFOUJONNGSPN%&+ r Follow curvature of dentinoenamel buccolingually r Follow curvature of dentinoenamel occlusogingivally depth should be at least 1.5–2 mm from the cavosurface margin and at least 0.2–0.5 mm into dentin junction junction Rules for Class V Cavities r 'PSPVUMJOFGPSN FYUFOTJPOTBSFNBEFNFTJBMMZ EJTUBMMZ occlusally and gingivally till sound tooth structure is reached r "YJBMEFQUIJTMJNJUFEUPmNNQVMQBMMZ Figure 8.27: Schematic representation showing that outline form should include all the carious lesion and undermined enamel Enameloplasty r &OBNFMPQMBTUZ JT SFNPWBM PG TIBSQ BOE JSSFHVMBS enamel margins of the enamel surface by ‘rounding’ or ‘saucering’ it and converting it into a smooth groove making it self-cleansable area Indications r *UJTEPOFXIFODBSJFTJTQSFTFOUJOMFTTUIBOPOFUIJSE thickness of the enamel r 1SFTFODFPGBTIBMMPXêTTVSFDSPTTJOHGBDJBMPSMJOHVBM ridge can be removed by enameloplasty Figure 8.28: Schematic representation showing that depth of axial wall should be restricted 0.2–0.8 mm into dentin Significance r Enameloplasty does not extend the outline form This procedure should not be used unless a fissure can be made into a groove with a saucer base with mild removal of enamel restoration to withstand, without fracture, the stresses of masticatory forces delivered principally along the long axis of the tooth Primary Resistance Form Features of Resistance Form Definition Primary resistance form is that shape and placement of preparation walls to best enable both the tooth and r Box-shaped preparation with flat pulpal and gingival floor: This helps the tooth to resist occlusal loading by virtue of being prepndicular to the masticatory forces directed along the long axis of the tooth (Figs 8.32A and B) 202 Textbook of Preclinical Conservative Dentistry MATERIALS Spotter 18: Amalgam Alloy Powder r "WBJMBCMFJOGPSNPGQPXEFS r $POTJTUTPGTJMWFS UJO DPQQFS [JODBOEQBMMBEJVN r $BO CF DMBTTJêFE BT IJHI BOE MPXDPQQFS BMMPZ BDDPSEJOHUPDPQQFSDPOUFOU r $MBTTJêFEBTMBUIFDVUBOETQIFSJDBMBDDPSEJOHUPTIBQF PGBMMPZ r JYFEXJUINFSDVSZUPGPSNEFOUBMBNBMHBN Spotters: 18 Spotter 19: Mercury r "WBJMBCMFJOMJRVJEGPSN r "DDPSEJOH UP &BNFT UFDIOJRVF JU TIPVME CF NJYFE JO SBUJPXJUITJMWFSBMMPZQPXEFS r PSFNFSDVSZJOBMMPZSFTVMUTJO – PSFDPOUSBDUJPOPGTFUBNBMHBN – PSFDSFFQ – %FDSFBTFJOTUSFOHUI r 4IPVME CF SFNPWFE GSPN NJYFE BNBMHBN CZ NVMMJOH BGUFSUSJUVSBUJPO Spotters: 19 Spotter 20: Amalgam Capsule r *U JT QSPQPSUJPOFE DBQTVMF DPOUBJOJOH BNBMHBN BMMPZ BOENFSDVSZ r 5PQSFWFOUBOZBNBMHBNBUJPOEVSJOHTUPSBHF NFSDVSZ BOEBMMPZBSFQIZTJDBMMZTFQBSBUFEGSPNFBDIPUIFS r *UJTUSJUVSBUFENFDIBOJDBMMZJOBNBMHBNBUPS r 1SFWFOUTTQJMMBHFPGNFSDVSZBOEQSPWJEFTQSPQFSSBUJP PGBNBMHBNBMMPZBOEQPXEFS Spotters: 20 Examination Spotters 203 Spotter 21: Dentin Bonding Agent r r r r "WBJMBCMFJOMJRVJEGPSN BJOMZDPOTJTUTPG)&."BOE#JT(." *UIBTBCJGVODUJPOBMTUSVDUVSF *U IBT CPUI IZESPQIJMJD BOE IZESPQIPCJD FOET )ZESPQIJMJDFOECPOETUIFJOPSHBOJDQBSUPGEFOUJOBOE IZESPQIPCJDFOECPOETUPUIFDPNQPTJUFSFTJO r *U QFOFUSBUFT JO FUDIFE NJDSPQPSFT PG UPPUI TVSGBDF GPSNJOHUIFIZCSJEMBZFS Spotters: 21 Spotter 22: Etchant r "WBJMBCMFBTQIPTQIPSJDBDJEJOGPSNPGMJRVJEPSHFM r "QQMJFEGPSmTFDPOETPOUPPUIBOEUIFOXBTIFEPŀ UPHJWFBGSPTUZXIJUFBQQFBSBODF r JUDMFBOTFTEFCSJTGSPNFOBNFMBOEQSPEVDFTNJDSPQPSFT JOUPXIJDIUIFSFJTNFDIBOJDBMJOUFSMPDLJOHPGUIFSFTJO r *ODSFBTFTUIFFOBNFMTVSGBDFBSFBBWBJMBCMFGPSCPOEJOH r &YQPTFTNPSFSFBDUJWFTVSGBDFMBZFS UIVTJODSFBTJOHJUT XFUUBCJMJUZ Spotters: 22 Spotter 23: Light-cured Composite Resin Spotters: 23 r 3FTUPSBUJWFSFTJOQPMZNFSJ[FECZBMJHIUTPVSDF r $POTJTUTPGPSHBOJDQBSU êMMFST DPVQMJOHBHFOU BDUJWBUPS mJOJUJBUPSTZTUFN JOIJCJUPSTBOEDPMPSJOHBHFOUT r "WBJMBCMFJOEJŀFSFOUTIBEFGPSFTUIFUJDT r "WBJMBCMFBTNJDSPêMMFE IZCSJEBOEOBOPêMMFEUZQF r 6TFEGPSSFTUPSBUJPOPG – JMEUPNPEFSBUFDMBTT*BOEDMBTT**UPPUIQSFQBSBUJPOT – $MBTT*** *7BOE7QSFQBSBUJPOT 204 Textbook of Preclinical Conservative Dentistry Spotter 24: Varnish r *U JT BO PSHBOJD DPQBM PS SFTJO HVN TVTQFOEFE JO TPMVUJPOTPGFUIFSPSDIMPSPGPSN r "QQMJFEPOQSFQBSFEUPPUIXBMMTBOEëPPSTJOmDPBUT VTJOHBTNBMMDPUUPOQMFEHFU r 8IFOBQQMJFEPOUIFUPPUITVSGBDFUIFPSHBOJDTPMWFOU FWBQPSBUFTMFBWJOHCFIJOEBQSPUFDUJWFêMN r 6TFEUPSFEVDFNJDSPMFBLBHF QPTUPQFSBUJWFTFOTJUJWJUZ BOEJNQSPWFTFBMJOHBCJMJUZPGUIFBNBMHBN r 1SFWFOUTEJTDPMPSBUJPOPGUPPUICZDIFDLJOHNJHSBUJPO PGJPOTJOUPUIFEFOUJO r /PU VTFE VOEFS HMBTT JPOPNFST CFDBVTF JU JOUFSGFSFT DIFNJDBMCPOEJOHPGUPPUIBOEDFNFOUT Spotters: 24 Spotter 25: Zinc Oxide Eugenol Cement r 4VQQMJFEBTQPXEFSBOEMJRVJE r 1PXEFSDPOUBJOT[JODPYJEF XIJUFSPTJO [JODTUFBSBUF BOE[JODBDFUBUF-JRVJEDPOUBJOTFVHFOPM r "WBJMBCMF BT 5ZQF * UFNQPSBSZ MVUJOH 5ZQF ** MPOH UFSNMVUJOH 5ZQF*** UFNQPSBSZSFTUPSBUJPO BOE5ZQF *7 JOUFSNFEJBUFSFTUPSBUJPO r 6TFE BT TFEBUJWF DFNFOU GPS UFNQPSBSZ MVUJOH BOE SFTUPSBUJWFQVSQPTF Spotters: 25 Spotter 26: Intermediate Restorative Material (IRM) r r r r 3FJOGPSDFE[JODPYJEFFVHFOPMDFNFOU 4VQQMJFEBTQPXEFSBOEMJRVJE 1PXEFSSFJOGPSDFECZBEEJOHQPMZNFUIZMNFUIBDSZMBUF 3FTJOIFMQTJO – *NQSPWJOHTUSFOHUIBOETNPPUIOFTTPGUIFNJY – %FDSFBTJOH ëPX TPMVCJMJUZ BOE CSJUUMFOFTT PG UIF DFNFOU r 6TFEBTUFNQPSBSZSFTUPSBUJPO Spotters: 26 Examination Spotters 205 Spotter 27: Zinc Phosphate Cement r 4VQQMJFEBTQPXEFSBOEMJRVJE r 1PXEFS DPOUBJOT [JOD PYJEF NBHOFTJVN PYJEF BOE CJTNVUIPYJEF-JRVJEDPOUBJOTQIPTQIPSJDBDJE XBUFS BOEBMVNJOB r "WBJMBCMFBTUXPUZQFT – 5ZQF* VTFEGPSMVUJOHQVSQPTF – 5ZQF** VTFEBTCBTF r )BTIJHIDPNQSFTTJWFTUSFOHUIBOEUIJOêMNUIJDLOFTT r 6TFEGPSMVUJOHDSPXOT JOMBZTBOEPSUIPEPOUJDTCBOET r 6TFE BT JOUFSNFEJBUF CBTF BOE UFNQPSBSZ SFTUPSBUJPO NBUFSJBM Spotters: 27 Spotter 28: Zinc Polycarboxylate Cement r r r r 4VQQMJFEBTQPXEFSBOEMJRVJE 1PXEFSDPOUBJOT[JODPYJEFBOENBHOFTJVNPYJEF -JRVJEDPOUBJOTQPMZBDSZMJDBDJE #POET DIFNJDBMMZ UP UIF UPPUI TUSVDUVSF 1PMZBDSZMJD BDJESFBDUTXJUIDBMDJVNJPOPGUFFUIWJBDBSCPYZMHSPVQ BOEGPSNDIFNJDBMCPOE r #JPDPNQBUJCJMJUZ CFDBVTF PG CJHHFS TJ[F PG QPMZBDSZMJD BDJE NPMFDVMF VOBCMF UP QFOFUSBUF JOUP EFOUJOBM UVCVMFT BOESJTFPGQ)PGUIFDFNFOUPONJYJOH r 6TFEUPDFNFOUJOMBZTPSDSPXOT r 6TFEBTCBTFBOEUFNQPSBSZSFTUPSBUJPO Spotters: 28 Spotter 29: Calcium Hydroxide Spotters: 29 r 4VQQMJFEBTCBTFBOEDBUBMZTU r *UT IJHI BMLBMJOF Q) IFMQT JO OFVUSBMJ[BUJPO PG BDJETQSPEVDFECZUIFNJDSPPSHBOJTNT r 1SPWJEFTBOUJCBDUFSJBMQSPQFSUJFT r 1SPNPUFTSFQBSBUJWFEFOUJOGPSNBUJPO r 6TFEBTTVCCBTFBOEMJOFS r 6TFEJOQVMQPUPNZBOEQVMQDBQQJOHQSPDFEVSFT 206 Textbook of Preclinical Conservative Dentistry Spotter 30: Type Glass Ionomer Cement r 6TFEGPSMVUJOHQVSQPTF r 4VQQMJFEBTQPXEFSBOEMJRVJE r 1PXEFS DPOUBJOT DBMDJVN ëVPSPBMVNJOPTJMJDBUF HMBTT BOE MJRVJE DPOUBJOT QPMZBDSZMJD BDJE JUBDPOJD BOE UBSUBSJDBDJE r #POETDIFNJDBMMZUPUPPUITUSVDUVSF r #JPDPNQBUJCMF r -PXTPMVCJMJUZ Spotters: 30 Spotter 31: Type Glass Ionomer Cement r 6TFEBTSFTUPSBUJWFDFNFOU r 4VQQMJFEBTQPXEFSBOEMJRVJE r 1PXEFS DPOUBJOT DBMDJVN ëVPSPBMVNJOPTJMJDBUF HMBTT BOE MJRVJE DPOUBJOT QPMZBDSZMJD BDJE JUBDPOJD BOE UBSUBSJDBDJE r #POETDIFNJDBMMZUPUPPUITUSVDUVSF r "OUJDBSJPHFOJDDFNFOUEVFUPSFMFBTFPGëVPSJEFT r #JPDPNQBUJCMF FTUIFUJDJOOBUVSFBOEIBTMPXTPMVCJMJUZ r 4FOTJUJWF UP CPUI NPJTUVSF DPOUBNJOBUJPO BOE EFTJDDBUJPOEVSJOHTFUUJOHQIBTF r *OEJDBUFE GPS DMBTT 7 *** BOE TNBMM DMBTT * UPPUI QSFQBSBUJPOT Spotters: 31 Spotter 32: MTA Spotters: 32 r #JPNBUFSJBM VTFE JO QVMQ DBQQJOH QVMQPUPNZ BOE BQFYJêDBUJPO r BJOMZDPOTJTUTPGUSJDBMDJVNTJMJDBUF EJDBMDJVNTJMJDBUF USJDBMDJVN BMVNJOBUF CJTNVUI PYJEF UFUSBDBMDJVN BMVNJOPGFSSJUF r 4FUT JO QSFTFODF PG NPJTUVSF JYFE XJUI TBMJOF BOE DBSSJFEXJUIBNBMHBNDBSSJFS Examination Spotters 207 Spotter 33: Base-metal Alloy pellets r BJOMZDPOTJTUTPGOJDLFM DISPNJVNBOEDPCBMU r $MBTTJêFE BT 5ZQF * TPGU 5ZQF ** NFEJVN 5ZQF *** IBSE BOE5ZQF*7 FYUSBIBSE BDDPSEJOHUPUIFJSVTF r 6TFE GPS GBCSJDBUJPO PG JOMBZT POMBZT DSPXOT CSJEHFT BOEQBSUJBMEFOUVSFT Spotters: 33 Spotter 34: Inlay wax r 6TFEGPSNBLJOHQBUUFSOTGPSJOMBZT POMBZTBOEDSPXOT r $POUBJOTQBSBŁOXBY DBSBOVCBXBY DFSFTJOBOEHVN EBNNFS r "WBJMBCMFBT – 5ZQF*.FEJVNXBYGPSEJSFDUUFDIOJRVF – 5ZQF**4PGUXBYGPSJOEJSFDUUFDIOJRVF r "WBJMBCMF JO EJŀFSFOU DPMPST UP DPOUSBTU XJUI EJF GPS CFUUFSEFNBSDBUJPOBOEêOJTIJOHPGNBSHJOT Spotters: 34 Glossary Anamika Thakur, Simran Pal Singh Bindra Abfraction: Recently, it has been proposed that the predominant causative factor of some of the cervical, wedge-shaped defects is a strong (heavy) eccentric occlusal force (shown as an associated wear facet) resulting in microfractures or abfractures Abrasion: Abrasion is abnormal tooth surface loss resulting from direct friction forces between the teeth and external objects or from frictional forces between contacting teeth components in the presence of an abrasive medium ACCESS CAVITY: It is defined as endodontic coronal preparation which enables unobstructed access to the canal orifices, a straight line access to apical foramen, complete control over instrumentation and to accommodate obturation technique Acid-Etching: Process of roughening a solid surface by exposing it to an acid and thoroughly rinsing the residue to promote micromechanical bonding of an adhesive to the surface Acute (Rampant) Caries: Acute caries, often termed rampant caries, is when the disease is rapid in damaging the tooth Adherend: A material substrate that is bonded to another material by means of an adhesive Adhesion: A molecular or atomic attraction between two contacting surfaces promoted by the interfacial force of attraction between the molecules or atoms of two different species; adhesion may occur as physical adhesion, chemical adhesion, mechanical adhesion (structural interlocking) or a combination of all types Adhesive Bonding: Process of joining two materials by means of an adhesive agent that solidifies during the bonding process Adhesive: Substance that promotes adhesion of one substance or material to another Affected dentin: Softened dimeralized dentin not yet invaded by bacteria Amalgam: Technically means an alloy of mercury (Hg) with any other metal Amelogenesis Imperfecta: In amelogenesis imperfecta, the enamel is defective either in form or calcification as a result of heredity and has an appearance ranging from essentially normal to extremely unsightly ANATOMIC TOOTH CROWN: It is the portion of the tooth covered with enamel APEX: Refers to tip or most superior point of the structure Tip of root of the tooth is also known as apex APICAL DENTAL FORAMEN: It is the main apical opening on the surface of root canal through which blood vessels enter the canal Attrition: Attrition is mechanical wear of the incisal or occlusal surface as a result of functional or parafunctional movements of the mandible (tooth-to-tooth contacts) Axial wall: An axial wall is an internal wall parallel with the long axis of the tooth Backward Caries: When spread of caries along DEJ exceeds the caries in surface enamel, it is termed as backward caries BALANCE: It is achieved by designing the angles of the shank so that the cutting edge of the blade lies within the projected diameter of the handle and nearly coincides with the projected axis of the handle BAND: It is a piece of metal or polymeric material, intended to give support and form to the restoration during its insertion and setting Bases: Bases (cement bases, typically 1–2 mm) are used to provide thermal protection for the pulp and to supplement mechanical support for the restoration by distributing local stresses from the restoration across the underlying dentinal surface BEVELS: Bevel are “flexible extensions” of a cavity preparation, allowing the inclusion of surface defects, supplementary grooves, or other areas on the tooth surface Bevels require minimum tooth involvement, and not 210 Textbook of Preclinical Conservative Dentistry sacrifice the resistance and retention for the restoration BLADE ANGLE: It is the angle between the rake face and the clearance face BLADE: It is the working end of the instrument BUR BLADE: Blade is a projection on the bur head which forms a cutting edge Blade has two surfaces: Blade face/Rake Face: It is the surface of bur blade on the leading edge Clearance face: It is the surface of bur Blade on the trailing edge Butt joint: When cavosurface margin is 90 degree, it is a butt joint It is generally given for amalgam restorations Cavitated Caries (Nonreversible): In cavitated caries, the enamel surface is broken (not intact), and usually the lesion has advanced into dentin Cavosurface Angle and Cavosurface Margin: Cavosurface angle is angle formed by junction of a prepared wall and the external surface of the tooth Actual junction is referred to as the cavosurface margin Cement liners: Thicker liners that are selected primarily for pulpal medication and thermal protection CEMENTOENAMEL JUNCTION: It is the junction of enamel of crown and cementum of the root Chronic (Slow or Arrested) Caries: Chronic caries is slow, or it may be arrested following several active phases CINGULUM: It is the lingual lobe of an anterior tooth making bulk of the cervical third of palatal surface CLASS I RESTORATION: All pit and fissure restorations are Class I Assigned to three groups • Restorations on lingual surface of maxillary incisors • Restorations on occlusal surface of premolars and molars • Restorations on occlusal two thirds of the facial and lingual surfaces of molars CLASS II INLAY: Is an intracoronal cast metal restoration that involves the occlusal and proximal surface of a posterior tooth CLASS III RESOTRATIONS: Restorations on the proximal surfaces of anterior teeth that not involve the incisal angle are Class III CLASS IV RESTORATIONS: Restorations on the proximal surfaces of anterior teeth that involve the incisal edge are Class IV CLASS V RESTORATIONS: Restorations on the gingival third of the facial or lingual surfaces of all teeth (except pit and fissure lesions) are Class V CLEANING AND SHAPING: Use of rotary and /or hand instruments to expose ,clean, enlarge and shape the pulp canal space, usually in conjunction with irrigant CLINICAL TOOTH CROWN: It is the visible part of a tooth above the gum line COLLAR PREPARATION: To increase the retention and resistance forms when preparaing a weakened tooth for a mesioocclusodistal onlay to cap all cusps, a facial or lingual “collar” or both may be provided CONCENTRICITY: Direct measurement of the symmetry of the bur head itself Condensation: Process of packing the triturated mass into the cavity CONTACT AREA: Area of mesial or distal surface of a tooth that touches to its adjacent tooth in the arch is called contact area CONVENIENCE FORM Convenience form is that shape or form of the preparation that provides for adequate observation, accessibility, and ease of operation in preparing and restoring the tooth Creep: Amalgam creep is defined as the time dependent plastic deformation of Zinc containing amalgam alloys principally resulting from slow metallurgic phase transformation that involve diffusion controlled reactions and produces volume increase CUSP: A cusp is an elevation on the crown of a tooth making up a divisional part on the occlusal surface Class Ii Onlay: It is a cast metal restoration that involves the occlusal and proximal surface of a posterior tooth and caps all of the cusps Delayed expansion: Zinc containing low copper or high copper amalgam alloys which get contaminated by moisture during manipulation results in delayed expansion or secondary expansion This occur 3–5 days after insertion and continues for months This type of expansion can reach values greater than 400 mm (4%) CLASS II RESTORATIONS: Restorations on the proximal surfaces of posterior teeth DENTAL AMALGAM: Is a metallic restorative material composed of a mixture of silver-tin-copper alloy and mercury Glossary 211 DENTAL BUR: Bur is a rotary cutting instrument which has bladed cutting head a wall takes the name of the tooth surface (or aspect) that the wall is toward Dentin Bonding Agent: A thin layer of resin between conditioned dentin and the resin matrix of a composite FACE: The end of the nib or working surface is known as face Dentin Bonding: The process of bonding a resin to conditioned dentin Floor (or Seat): A floor (or seat) is a prepared (cut) wall that is reasonably flat and perpendicular to those occlusal forces that are directed occlusogingivally (generally parallel to the long axis of the tooth) Dentin Conditioner: An acidic agent that dissolves the inorganic structure in dentin, resulting in a collagen mesh that allows infiltration of an adhesive resin Dentinal Wall: The dentinal wall is that portion of a prepared external wall consisting of dentin, in which mechanical retention features may be located DENTINOENAMEL JUNCTION: It is the interface of enamel and dentin of a tooth crown Dentinogenesis Imperfecta: Dentinogenesis imperfecta is a hereditary condition in which only the dentin is defective Normal enamel is weakly attached and lost early Forward Caries: Forward caries is wherever the caries cone in enamel is larger or at least the same size as that in dentin FOSSA: It denotes an irregular depression or concavity on the tooth Hybrid Layer: An intermediate layer of resin, collagen, and dentin produced by acid, etching of dentin and resin infiltration into the conditioned dentin Incipient Caries (Reversible): Incipient caries is the first evidence of caries activity in the enamel DEVELOPMENTAL GROOVE: It is a shallow groove between primary parts of crown or the root Infected dentin: It is softened demineralized dentin containing bacteria DOUBLE WEDGING: Here two wedges are used—one is inserted from buccal embrasure and another is inserted from lingual embrasure INITIAL TOOTH PREPARATION: Initial tooth preparation is the extension and initial design of the external walls of the preparation at a specified, limited depth so as to provide access to the caries or defect, reach sound tooth structure (except for later removal of infected dentin on the pulpal or axial walls), resist fracture of the tooth or restorative material from masticatory forces, principally directed with the long axis of the tooth, and retain the restorative material in the tooth (except for the Class V preparation) Dovetail: Auxiliary retention feature given in the occlusal part of a class II cavity EMBRASURES (SPILLWAYS): When two teeth of same arch contact, their curvatures adjacent to the contact areas are called embrasures Spaces which widen out buccally, lingually, occlusally or gingivally are called buccal, lingual, occlusal or gingival embrasures respectively Enamel Wall: The enamel wall is that portion of a prepared external wall consisting of enamel Enameloplasty: Enameloplasty is removal of a shallow enamel developmental pit or fissure to create a smooth, saucer-shaped self- cleansing area ENDODONTICS: Branch of clinical dentistry associated with the prevention, diagnosis and treatment of the pathosis of the dental pulp and their sequelae Erosion: Erosion is the wear or loss of tooth surface by chemicomechanical action External line angle: It is a line angle whose apex points away from the tooth External Wall: An external wall is a prepared (cut) surface that extends to the external tooth surface, and such Internal line angle: It is a line angle whose apex points into the tooth Internal Wall: An internal wall is a prepared (cut) surface that does not extend to the external tooth surface IRREVERSIBLE PULPITIS: It is the persistent inflammatory condition of the pulp, symptomatic or asymptomatic, caused by a noxious stimulus Isthmus: The part of class II cavity preparation that connects the occlusal preparation to the proximal box Line Angle: A line angle is the junction of two planal surfaces of different orientation along a line LINERS: Are relatively thin layers of material used primarily to provide a barrier to protect dentin from residual reactants diffusing out of a restoration or from oral 212 Textbook of Preclinical Conservative Dentistry fluids (or both) that may penetrate leaky tooth restoration interfaces and soft tissues, all of which should enhance the general health and welfare of the patient MAJOR APICAL DIAMETER: It is the apical part of root canal having the narrowest diameter short of the apical foramen or radiographic apex It may or may not coincide with (CDJ) OUTLINE FORM: Establishing the outline form means: • Placing the preparation margins in the positions they will occupy in the final preparation, except for finishing enamel walls and margins, and • Preparing an initial depth of 0.2–0.8 mm pulpally of the DEJ position or normal root-surface position (no deeper initially whether in tooth structure, air, old restorative material, or caries unless the occlusal enamel thickness is minimal and greater dimension is necessary for strength of the restorative material) MARGINAL RIDGES: These are the rounded borders of enamel that form mesial and distal margins of posterior teeth and mesial and distal margins of lingual surfaces of anterior teeth MATRICING: It is the procedure by which a temporary wall is built opposite to the axial wall, surrounding the tooth structure which has been lost during the tooth preparation MATRIX: It is an instrument which is used to hold the restoration within the tooth while it is setting Mercuroscopic expansion: Mercury from Sn-Hg of set amalgam re-reacts with Ag-Sn particles and produce further expansion during new reaction This mechanism is called as mercuroscopic expansion Microleakage: Flow of oral fluid and bacteria into the microscopic gap between a prepared tooth surface and a restorative material Mulling: It is a continuation of trituration, to increase the homogeneity of the amalgam mass NIB: For noncutting instruments, part corresponding to the blade is termed as nib Nonhereditary Enamel Hypoplasia: Nonhereditary enamel hypoplasia occurs when the ameloblasts are injured during enamel formation, resulting in defective enamel (diminished form and/or calcification) OBLIQUE RIDGE: It is a ridge obliquely crossing the occlusal surface of maxillary first molar and is formed by union of triangular ridges of distobucal cusp and distal cusp ridge of mesiopalatal cusp OBTURATION: To fill the shaped and debrided root canal space with a temporary or permanent filling material OPERATIVE DENTISTRY: Operative dentistry is the art and science of the diagnosis, treatment, and prognosis of defects of teeth that not require full coverage restorations for correction Such treatment should result in the restoration of proper tooth form, function, and esthetics while maintaining the physiologic integrity of the teeth in harmonious relationship with the adjacent hard PARTIAL ONLAY: Is cast metal restoration that involves the occlusal and proximal surface of a posterior and covers and restores at least one but not all of the cusp tips of posterior tooth PERIAPICAL ABSCESS(PERIRADICULAR ABSCESS): A localized collection of pus within the periradicular tissues PERIODONTITIS (PERICEMENTITIS): Inflammation of periodontium PIGGYBACK WEDGING: In this technique, one (larger) wedge is inserted as used normally, while the other smaller wedge (piggyback) is inserted above the larger one PITS: These are small pinpoint depressions located at the junction of developmental grooves Point Angle: A point angle is the junction of three planal surfaces of different orientation Primary Caries: Primary caries is the original carious lesion of the tooth PRIMARY FLARE: First Flare that brings proximal preparation out of contact area PRIMARY RESISTANCE FORM: Primary resistance form may be defined as that shape and placement of the preparation walls that best enable both the restoration and the tooth to withstand, without fracture, masticatory forces delivered principally in the long axis of the tooth PRIMARY RETENTION FORM: Primary retention form is that shape or form of the conventional preparation that resists displacement or removal of the restoration from tipping or lifting forces Primer: A hydrophilic, low viscosity resin that promotes bonding to a substrate, such as dentin Resin tag-extension of resin that has penetrated into etched enamel or dentin Glossary Prophylactic Odontotomy: Prophylactic odontotomy is presented only as a historical concept characterized by minimally preparing and filling with amalgam, developmental, structural imperfections of the enamel, such as pits and fissures, to prevent caries originating in these sites PULP CAVITY: The pulp cavity lies within the tooth and is enclosed by dentin all around, except at the apical foramen, Pulpal wall: A pulpal wall is an internal wall that is both perpendicular to the long axis of the tooth and occlusal of the pulp Residual Caries: Residual caries is caries that remains in a completed tooth preparation, whether by operator intention or by accident RETAINER: It holds a band in desired position and shape REVERSE BEVEL OR COUNTER BEVEL: It is a bevel of which is prepared on the facial (lingual) margin of a reduced cusp with a flame-shaped, fine-grit diamond instrument REVERSIBLE PULPITIS: Is the general category which histologically may represent a range of responses varying from dentin hypersensitivity without concomitant inflammatory response to anearly phase of inflammation RIDGE: It is any linear elevation on the surface of a tooth and is named according to its location For example buccal or marginal ridge ROOT CANAL SYSTEM: The entire space in the dentin where the pulp is housed is Called the root canal system Root Surface Caries: Root surface caries may occur on the tooth root that has been both exposed to the oral environment and habitually covered with plaque RUNOUT: Dynamic test measuring the accuracy with which all blade tips pass a single point when the instrumented is rotated Sclerotic/eburnated dentin: An arrested, dentinal lesion typically is “open” (allowing debridement from tooth brushing), dark and hard, and this dentin is termed sclerotic or eburnated dentin Secondary (Recurrent) Caries: Secondary caries occurs at the junction of a restoration and the tooth and may progress under the restoration It is often termed recurrent caries 213 SECONDARY FLARE: Is given to provide marginal metal angle of 40 degree SHANK: Shank connects handle to working end of the instrument SKIRT PREPARATION: Skirts are thin extension of facial or lingual proximal margins of the cast metal onlay that extend from primary flare to a termination just past the transition line angle of the tooth Smear Layer: Poorly adherent layer of ground dentin produced by cutting a dentin surface Solution liners: Any liner based on nonaqueous solvents that rely on evaporation for hardening is designated as a solution liner (or varnish) Strongest enamel margin: The strongest enamel margin is one that is composed of full-length enamel rods supported on the preparation side by shorter enamel rods, all of which extend to sound dentin Suspension liner: Liners based on water have many of the constituents suspended instead of dissolved and are called suspension liners TOOTH PREPARATION is defined as the mechanical alteration of a defective, injured, or diseased tooth to best receive a restorative material that will re-establish a healthy state for the tooth, including esthetic corrections where indicated, along with normal form and function TRIANGULAR RIDGE: It descends from tip of cusp of molar and premolar towards central part of occlusal surface Trituration: Process to bring the particles of the alloy in contact with mercury Unsupported enamel margin: An enamel margin composed of rods which not run uninterrupted from the surface to the sound dentin is termed as unsupported enamel margin WEDGE WEDGING: In this technique, two wedges are used, one wedge is inserted from lingual embrasure area while another is inserted between the wedge and matrix band at right angle to first wedge WORKING LENGTH: Defined as distance from a coronal reference point to a point at which canal preparation and obturation should terminate Index Page numbers followed by f refer to figure and t refer to table A Acids, role of 57 Alloy 161 admixed 161 high-copper 162 binary 161 metals 161 pellets, base-metal 207 quaternary 161 tertiary 161 Aluminophosphate gel 149f Amalgam capsule 202 carrier 80, 80f, 165f changes of 165 file 79f insertion of 164 mechanical trituration of 163f over-triturated 164f polishing kit 201 silver 162t structure of set 162 Amalgam alloy 162 powder 202 copper in 161f silver in 161f tin in 161f zinc in 161f Amalgam restoration carved 166f for primary teeth 143 fractured 3f preparation for 122 Amalgapins 114 American Dental Association, classification of dental casting alloys 167t Anatomic crown 46 Armamentarium 3, 70 B Bacteria 60 Ball burnishers Binangle chisel 76, 77 Black’s classification 137 of dental caries 102f Buccal aspect 9, 11, 12, 14, 18-21, 31, 35, 37 Buccal embrasure 48f Buccal pit 125f Buccal surface 46 Bur 84 blade 88 classifications of 85 design 87, 88, 88t gingivally 127f head design of 86f, 87 sizes 87t types of 86f materials for 84 parts of 85 size 87 stainless steel 84 Burnishing postcarve 164, 166f precarve 164 Butt joint 115t C Calcium hydroxide 152, 152f, 160f, 205 cement 152 Canal instrumentation 193 Canine 8, 17, 29, 34, 41 Carbohydrate intake, frequency of 59 role of 57 Caries 61 backward 61 balance concept 57 cavitated 65 chronic 61 complex 65 compound 65 extent of 61 fissure 60, 65 in maxillary first molar 62f premolar 62f in premolar, primary 62f incipient 61 pit 60, 65 primary 61 progression 61 rampant 61 residual 61 smooth surface 61, 65 spread, pathway of 61 Carious buccal pit 125f Carious lesion 61 active 61 size of 64t Carious palatal pit 125f Cavity 189 designs 135 Cement 194 adhesive luting 115 cermet 155 spatulas 79 Cementodentinal junction 191 Cementoenamel junction Cheek, retraction of 75f Chisel 77, 198 straight 76, 77 triple angle 77 Cingulum 6 Collagen fibrils 172f Composite resins, light-activated 181 Condensers, types of 80f Conservative dentistry, preclinical 1, Coronal restoration 195 Crown down technique 192f, 194, 194f Cuspids 41 D Deciduous teeth 45, 46 palmer system for 42 system for 44 Dental amalgam 160 arches 41 casting alloys 166, 167 operatory 51 plaque, role of 57 216 Textbook of Preclinical Conservative Dentistry procedures 51 pulp 40 Dental bur 84 parts of 85f slow-speed 200 Dental caries 56, 56f, 63f, 64f classification of 137 pathogenesis of 57 Dental cements 145, 146 classification of 146 uses of 146 Dental composites 177 Dental materials 145 classification of 145 properties of 145 Dentin 40 affected 67t, 113f causes of 172f dehydrated 172f dry 172 hard shell of 185f infected 67t, 112, 113t moist 172 Dentin bonding agent 173, 174, 177t, 203 fourth generation 174 requirements of 173 seventh generation 176 sixth generation 174 Dentin conditioning 115 etching 115 priming 115 Dentinal caries 66, 67f zones of 67 Dentinal changes advanced 67 early 66 Dentinal tubules 173f Dentistry adhesive 171 conservative 1 operative 3, ranges in operative 85t uses of alloys in 167f metals in 167f Dentition primary 27, 44 types of 42 Direct cutting instruments 74 Double-wedging technique 95f E EBA on eugenol cement, effect of 148 Enamel 39 bonding 172 steps for 172 caries 65 zones in 65, 66f margins, beveled 114 rods, direction of 136 thin 136 wall etching 114 Enameloplasty 110 Endodontic 185 instrument 186, 186f, 186t, 187t treatment 195 Etching, effects of 172 Ethoxybenzoic acid reinforced cement 147 Extraoral finger rest 83 Eye wear 53f protective 54 F Face clearance 88 mask 53f, 54 shield 53f Facial surface 46 Filling instrument Finn’s modification 137 Fluoride release 158 Foramen 193 Hand hygiene 54 Hand instrument 181 parts of 71f Head cap 53f Hedstroem file 188 Hoe excavator 77, 78f Hybrid composite resins 178 I Incisal aspect 7-9, 16-18, 29, 34 Incisal edge 28 of anterior teeth 192f Incisal embrasure 47 Incisal surface 46 Inlay wax 207 Instrument designs 73 handles, types of 71f left bevel 73 right bevel 73 Intraoral finger rests 82 Ivory matrix band retainer 91 holder 89 J Joint, lap 115t G Gingiva 48 Gingival embrasure 47, 48f Gingival floor of class II preparation 106f Gingival margin 111f distal 78f trimmer 77, 199 Gingival recession 47f Gingival surface 46 Gingival tissue 48f Glass ionomer cement 154, 155, 157f autocure 156 type 1 206 type 2 206 Graham Mount’s classification of carious lesion 65 Grossman’s classification of endodontic instruments 186t Gutta percha 195f, 196f cone 195f GV Black’s classification of instruments 71 H Hand cutting instruments 76 K Keyes’ triad 58 K-flex file 188 L Lathe-cut low-copper alloys 162 Lingual aspect 7, 15-21, 33-35, 37 Lingual embrasure 47, 48f M Macrofilled composite resin 178 Mandibular anterior teeth 2f canine 17f, 34f central incisor 15, 33f incisor 129f lateral incisors 16f, 33f Mandibular first molar 21f, 35f, 126f premolar 18f Mandibular molar 125f, 126f buccal pit for 124 cavity preparation for 190 preparation of 191f Index Mandibular premolar, class I preparation in 125f Mandibular second molar 22f, 36f premolar 19f Mandibular teeth 15, 32 Matrices, classification of 89t Maxillary anterior teeth, erosion of 2f Maxillary canine 10f, 29f Maxillary central incisor 8f, 28f, 182f Maxillary first molar 12, 13f, 30f, 126f, 190f premolar 11f Maxillary incisor 63f cavity of 189f lateral 7, 125f Maxillary molars cavity 190f preparation for 190 fissure caries in 62f Maxillary second molar 14f, 31f premolar 12f Maxillary teeth 7, 28 Mercury 202 alloy ratio 162 Mesial bevel instruments 73 Mesial gingival marginal trimmer 78f Metabolites from plaque 60 Metal cores 194 Metal reinforced glass ionomer cement 155 Microhybrid composites 179 Microorganisms, role of 57 Modern adhesives, classification of 173 Molar 42, 63f first 12, 20, 30, 35 fissures of 56f lingual surface of 102f occlusal surface of 102f proximal surface of 63f second 14, 21, 31, 36 Monoangle chisel 77 Mount’s caries classification 64t Mouth mirror 74, 75f N Nanofill composite 179, 179f Nanohybrid composite 179 Neck design of burs 86 Noble metal content 167t O Obturation techniques 194 Occlusal aspect 12, 14, 15, 19-21, 30, 32, 33f, 34f, 37 Occlusal embrasure 47, 48f Occlusal preparation 124, 139 Oral cavity 46f P Palatal fissure 126f Palatal pit 125f Periodontal ligament 40 Periradicular tissue 40 Permanent dentition 27, 135 Permanent mandibular teeth 42f Permanent maxillary teeth 42f Permanent teeth 27f, 36f, 42, 43f, 44f, 45, 45f, 46, 136f, 137f morphology of Palmer system for 42 system for 44 Piggyback wedging 96 Pigtail explorer 75 Pioneer bacteria 66 Plastic deformation 165 Plastic filling instrument 79 types of 80f Plastic wedges 95 Premolar 41, 63f cavity 189f preparation for 190 first 9, 18 fissure 56f caries in 2f occlusal surface of 102f proximal surface of 63f Proteolysis-chelation theory 57 Pulp 27 cavity 28, 30-33, 35, 36, 37 protection 113, 159f materials 159 Pulpal diseases 186 Pulpal floor of class II preparation 106f Pulpal pathologies, progression of 186 Pulpal wall 105 R Resin bonding agents 159 Resin-modified glass ionomer 157 cement 155 Root 27-29, 31, 34, 35 canal 192f, 196f orifices 190f preparation 193 system 192, 194 techniques of 193 caries 61, 62f perforation, apical 196f Rotary cutting instruments 84 types of 84 S Saliva 59 bicarbonates in 60 Shepherd’s hook 75 Silver alloy 162 Single wedging technique 95 Step back technique 192f T Teflon-coated hand instruments 82f instruments 81 Temporary restoration 151f Thermal expansion 166, 179 Thumb grasp 82 Toffelmire retainer 143, 200 and band procedure for 92 removal of 92 Tongue, retraction of 75f Tooth 59 abrasion of 2f anatomy 41 anterior 47f, 189 class I cavity of primary 138f classes of 41, 41f combination of 45f crown of 47f cusp tip of posterior 192f external surface of 111f form, physiology of 46 morphology of primary 26 nomenclature 41 notation systems 42 physiology 39 posterior 47f preparation 101, 104, 108, 115, 124, 126f, 131f, 132, 135, 137, 180, 181 axial wall, class III 106f beveled 131 class 5f, 106, 107, 107f, 108, 122, 128-133, 137, 140f complex 104 compound 104 conservative 181 conventional 131, 132 designs 106t external wall of 105f final 124, 126, 129, 138, 139 for amalgam 122 217 218 Textbook of Preclinical Conservative Dentistry for composite restoration 129 internal wall of 105f kidney-shaped class V 129f on extracted teeth on plaster models on typhodonts preclinical proximal 111f purpose of 101 retention grooves for 114t steps in 108, 132 type of 89t preparation for composite class 131f, 133f restoration 133f preparation in mandibular molar 129f premolar 125f preparation in primary teeth 135 preparation in typhodont 5f preparation of buccal pit 126f preparation of maxillary first molar, class II 129f premolar, class II 128f primary 27f, 136f, 137f proximal surface of anterior 63f substance causes of loss of surface 46, 46f, 64f, 106f, 125f number of 65 Triple-beveled instrument 74 Tungsten carbide burs 85 U Urethane dimethacrylate 172 V Varnish 159 W Water absorption 179 hardening glass ionomer cements 155 sensitivity 158 Wedelstaedt chisel 76, 77 Wedge-wedging technique 95f Wedging techniques 95 Wooden wedges 94 Z Zinc containing alloys 161 content 161 free alloys 161 oxide eugenol cement 146, 146f, 147, 148f, 204 phosphate cement 149, 149f, 205 powder 151f polyacrylate cement 152 polycarboxylate cement 152, 152f, 205 silicophosphate cements 151 ZOE cement, manipulation of 148 ... Outline form of conservative tooth preparation of mandibular premolar (B) Outline form of conventional tooth preparation of mandibular premolar 126 A Textbook of Preclinical Conservative Dentistry. .. removal of remaining caries Remove only deep carious lesion with the help of spoon excavator or round bur instead of deepening of whole floor A B 124 Textbook of Preclinical Conservative Dentistry. ..1 02 Textbook of Preclinical Conservative Dentistry Figure 8.1: Schematic representation showing GV Black’s classification of dental caries A B Figures 8.2A and B: (A) Clinical picture of class