Approaches in Conservative Dentistry
presented by:Afnan J. IsmaelOrthodontistDefinition (3 parts)
Art and science of the DIAGNOSIS, TREATMENT, and PROGNOSIS of defects of teeth that do not require full coverage restoration for correction.Conservative Dentistry
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 and soft tissues.Conservative Dentistry
All of which should enhance the general health and welfare of the patient
Conservative Dentistrycoservative Dentistry also known as Restorative Dentistry or oprative Dentistry
Indications for Operative TreatmentCaries,Malformed, discolored, non esthetic, or fractured teeth,Wearing of teeth (attrition, abrasion, etc.)Restoration replacement or repair.
Pit and fissure caries Rampant smooth surface caries
Crevical Abrasion Attrition in Anterior Teeth Attrition in Posterior TeethProcedures
Procedures commonly done areDirect restoration – Amalgam, Composite resin, GIC.Indirect restoration – Inlay, onlay, crowns (base metal, precious metal, porcelain fused to metal, or metal free ceramic)Veneers – Direct or indirectDirect Restoration – After tooth preparation, the restoration is placed in a moldable stage in the prepared tooth to recreate normal contours.Adv. – easy to place, less time consumed, and cost effective.Disadv. – compromised mechanical properties
Indirect Restoration- After tooth preparation, it involves making of impression, pouring of cast, die preparation, wax pattern, investing, casting, finishing, polishing and cementing (or luting) of restoration. (restoration is fabricated outside and cemented to prepared tooth)
Adv.- provide better mechanical properties and stress distributionDisadv.- time consuming, expensive, and more technique sensitive
Cavity Preparation
Is the mechanical alteration of a defective, injured or diseased tooth to receive a restorative material that re-establish a healthy state for the tooth, including esthetic correction where indicated and normal form and function.Purpose of cavity preparationTo remove carious or diseased portion of tooth and to avoid further progression or recurrence of it.Caries might have progressed in an irregular shape, but one must prepare the tooth in an appropriate shape to obtain best mechanical properties of restorative material
How is cavity preparation doneWith diamond burs attached to hand held device called hand piece at high speed (200000 rpm) for gross cutting.With finishing burs attached to slow speed hand piece (30000 – 40000 rpm) or hand cutting instruments for finer adjustments