conservative dentistry lab manual

8/4/2019 Conservative Dentistry Lab Manual

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Conservative Dentistry 1- Dent 335

(Operative Dentistry) Manual

First Semester 2011-2012

Dr.Ghada Maghaireh, Course Coordinator

Jordan University of Science and Technology

Faculty of Dentistry

Department of Conservative Dentistry


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Assessment Type N-A

Midterm Theoretical

Exam15%

Midterm Practical Exam 15%

Final Exam 60%

Assignments 10%Attendance N-A

Participation N-A

Course Objectives Weights

To understand the principals,terminology, instruments,materials and techniques used

in the practice of Operative

Dentistry

To understand the use ofamalgam, resin composite and

glass inomer materials in thescope of operative Dentistry.

To understand the basicprinciples of cavity design for

amalgam and resin composite

restorations.

To practice caries removal andpulp protection prior to

restorative procedures on

extracted natural teeth.

To understand and practice

perator positions for operativeprocedures.

30%

20%

30%

10%

10%

Teaching & Learning Methods

Classroom lectures

Tests and exams

Review of exams

Textbook reading assignments

Lab demonstrations and videos

The Operative Dentistry manual

Learning Outcomes: Upon successful completion of this course, students will be able toRelatedObjective(

s)

Refrance

1

List anddifferentiatebetween differentmethods of cavities

Chapter # 6 Fundamentals


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classifications.

2Identify thecomponent parts ofa prepared cavity.


3

List and describe

the basic steps incavity preparation,in order orsequence.

chapter 6 art & science

4Identify instrumentsby name and use.


5

Describe and givereasons for thedifferencesbetween the cavitypreparation for

amalgam and resincomposite.

Chapter 6 art & science

6

List the basicphysical propertiesof and describedifferencesbetween amalgamand resincomposite

Chapter 6 art & science

7

List the steps inplacement and

describe thedifferences intheses steps foramalgam and resincomposite.

Chapter 11 Fundamentals, Chapter 11 Art &

Science

8

List and describedifferencesbetween finishingand polishingtechniques foramalgam and resin

composite.

Chapter 11 Fundamentals, Chapter 11 Art &

Science

10

List the basicphysical propertiesof glass inomer,differentiatebetween differenttypes of glassinomer materials

Chapter 13 Fundamentals


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and their uses.

11

Describe thematerials and

techniques used incaries removal andpulp protection,including burs,spoon excavators,cavity liners, andtemporaryrestorativematerials.

Handout

12

Identify the basicpositions for the

operator whileperformingoperative dentistryprocedures.

Handout

Useful Resources

The Art & Science of Operative Dentistry, Theodore M.Roberson, Harald O.Heymann,

Edward J.Swift JR., Fourth Edition.

* Other assigned reading materials

Course Content

Week Topics Chapter in text

1 ( Sep.22) Introduction

2 ( Sep. 29)Caries classification + cavity

classification


3 ( Oct. 6) Instrumentation Chapter # 6 Fundamentals

4 ( Oct.13) Principles of Cavity Preparation I Chapter# 6 Art & Science

5 ( Oct.20) Principles of Cavity Preparation II Chapter# 6 Art & Science

6 ( Oct.27) Amalgam Restorations I Chapter # 6 Fundamentals

7 (Nov.3) Amalgam Restorations II Chapter # 11 Fundamentals

8 (Nov.10) Happy Eid

9 (Nov.17) Midterm Exam

10 (Nov.24) Glass Inomer Restorations Handout + Chapter # 13Fundamentals

11 (Dec.1)Liners and bases Handout + Chapter # 5

Fundamentals

13 (Dec.8)Principles of Adhesion I Chapter # 8 Fundamentals

14 (Dec.15) Principles of Adhesion II Chapter # 8 Fundamentals


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15(Dec.22) Resin Composite Restorations I Chapter # 9 & #10 Fundamentals

16(Dec.29) Resin Composite Restorations II Chapter # 9 & #10 Fundamentals

Additional Notes

Attendance:

Students must attend 100% of all scheduled classes and labs. Class participation isrequired. Should an absence be necessary, student should contact the course instructor

immediately. Work missed can ONLY make up with an excused absence.

No make-up exams or quizzes will be given for unexcused absences.

Late arrivals to class are unexcused absences.

All course make-ups, test, and so forth, must be completed within 14 days fromthe date of the excused absence.

Laboratory:Required Teeth: Lower 6 (10 teeth), Upper 6 (4 teeth), Upper 4(4 teeth), Lower 4or 5 (4 teeth), Upper central incisor (4 teeth), Upper canine (4 teeth).Naturalmolar tooth (2 teeth)High speed burs: Straight fissure bur (medium, # 56) 4 burs, round bur (small,#1/2) 2 burs, diamond finishing burs.Low speed burs: Straight fissure bur (medium, # 56) 2 burs, round bur (small, # 2and large size # 6) 2 burs.

Lab ScheduleWeek

Lab ProcedureTooth

number

1 (18-22/9) 1 +2 Introduction to ODS Lab -

2(25-29/9)1 Exercise for operator positions+

Instruments-

2(25-29/9) 2 Class I amalgam preparation (DEMO) Lower 63(2-6/10) 1 Class I amalgam preparation + buccal pit Lower 6

3(2-6/10)2 Class I amalgam preparation with buccal

extension (DEMO)Lower 6

4(9-13/10) 1 Amalgam restoration of the teeth (DEMO) Lower 64(9-13/10) 2 Amalgam restoration of the teeth 3 TEETH

5(16-20/10)1 Class I amalgam preparation with lingual

extension + amalgam restoration (DEMO)Upper 6

5(16-20/10)2 Class I amalgam preparation with lingual

extension + amalgam restoration

Upper 6

6(23-27/10)1 Midterm Practical Exam (Class I cavity

preparation + restoration) (1 hour)Lower 6

6(23-27/10)2 Class II amalgam preparation MO

(DEMO)Lower 6

7(30/10-3/11) 1 Class II amalgam preparation DO Upper 6

7(30/10-3/11)2 Amalgam restoration for Class II teeth

(DEMO)Lower 6


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8(6-10/11) 1 Happy Eid8(6-10/11) 2 Happy Eid9(13-17/11) 1 Amalgam restoration for Class II t 2 TEETH

9(13-17/11)2 Class II MOD amalgam preparation +

amalgam restorationLower 4

10(20-24/11)1 Class III cavity preparation + composite

restoration (DEMO)Upper 1

10(20-24/11)2 Class III cavity preparation + composite

restorationUpper 1

11(27/11-1/12)1 Class IV cavity preparation + composite

restoration (DEMO)Upper 1

11(27/11-1/12)2 Class IV cavity preparation + composite

restorationUpper 1

12(4-8/12)1 Class V cavity preparation + composite

restorationUpper 3

12(4-8/12) 2 Class II cavity preparation MO forcomposite restoration

Upper 4

13(11-15/11) 1 Class II composite restoration Upper 4

13(11-15/11)2 Class V cavity preparation+ Glass inomer

restorationUpper 3

14(18-22/11)1 Caries detection and excavation on

natural tooth exercise+Molar withocclusalcaries

14(18-22/11)

2 Cavity liner placement + Placement ofIRM temporary restorationHandout of all teeth & Assessment

sheet

Molar withocclusalcaries

15(25-29/12)

1 Final practical Exam (Class II amalgampreparation + restoration)Handout of all teeth & Assessmentsheet

Lower 6

15(25-29/12)2 Final practical Exam (Class II amalgam

preparation + restoration)Lower 6


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Conservative Dentistry 1- Dent 335 (Operative Dentistry)

Evaluation Sheet

STUDENT NAME: STUDENT NUMBER:

Procedure Tooth

number

Mark Signature

Class I amalgam preparation Lower 6

Class I amalgam preparation + buccal pit Lower 6

Class I amalgam preparation with buccal

extension

Lower 6

Amalgam restoration of Class I Lower 6

Amalgam restoration of Class I + Buccal pit Lower 6

Amalgam for Class I preparation with buccal

extension

Lower 6

Class I amalgam preparation with lingual

extension

Upper 6

Amalgam restoration for Class I with lingualextension

Upper 6

Class II MO amalgam preparation Lower 6

Class II DO amalgam preparation Upper 6

Amalgam restoration for Class II MO Lower 6

Amalgam restoration for Class II DO Upper 6

Class II MOD amalgam preparation Lower 4

Class II MOD amalgam restoration Lower 4

Class III cavity preparation Upper 1

Class III composite restoration Upper 1

Class IV cavity preparation Upper 1

Class IV composite restoration Upper 1

Class V cavity preparation Upper 3

Class V composite restoration Upper 3

Class II MO cavity preparation Upper 4

Class II MO composite restoration Upper 4

Class V cavity preparation Upper 3

Class V Glass inomer restoration Upper 3

Caries detection and excavation on natural toothexercise

Natural tooth

Cavity liner placement Natural tooth

Placement of IRM temporary restoration Natural toothEvaluation Criteria

9: Excellent

8: Good

6-7: Satisfactory

5 and under: failure

Grade 5 and under is unacceptable and will not be considered in the continuous assessment, the student

should repeat the work until he/she get a satisfactory mark. All work should be finished and marked in the

assigned date, any work that is completed after the assigned date will be graded as pass only (6).


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Class I Amalgam Preparation

P P F

External Outline Form Correct Slight Error Unacceptable

Convergence of B & L Walls Convergent Slight divergent Gross

Divergance

Pulpal Depth 1.5-2 mm Slightly shallow/ > 3 mm deep

Slightly deep

Pulpal Floor (Horizontal) Correct Slight error Unacceptable

Margins Smooth Rough Grossly Rough

Line Angles Defined Lack Definition Poorly Defined

Class I Amalgam Restoration

P P F

Margins Smooth Excess or Gross Excess& Regular Deficiency

Tooth Structure No Damage Damage Gross Damage

Condensation No pits or voids Pits or voids Gross Voids

Surface Finish Smooth Rough Grossly Rough

Anatomy Correct Slight Error Unacceptable


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Class II Amalgam Preparation

P P F

External Outline Form (O) Correct Slight Error UnacceptableExternal Outline Form(P) Correct Slight Error Unacceptable

Convergence of B & L Walls (O) Convergent Slight divergent Gross

Convergence of B & L Walls (O) Convergent Slight divergent Gross

Pulpal Depth 1.5-2 mm Slightly shallow/ > 3 mm deepSlightly deep


Gingival Floor Horizontal Angled Unacceptable


Retention Grooves Correct Slight Error Unacceptable

Class II Amalgam Restoration

P P F

Margins Smooth Excess or Gross Excess

& Regular Deficiency


Condensation No pits or voids Pits or voids Gross Voids


Anatomy (O & B) Correct Slight Error Unacceptable

Marginal Ridge Proper Height, High, Low GrossWidth & Contour Wide or Narrow


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Class V Amalgam Preparation

P P F


Convergence of O & G Walls Convergent Slight divergent Gross

Divergance

Pulpal Depth 1.25-1.5 mm Slightly shallow/ > 3 mm deep

Slightly deep

Axial Wall Convex Slight error Unacceptable




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Class V Preparation for Glass Inomer

P P F


Convergence of O & G Walls Convergent Slight divergent Gross

Divergance

Pulpal Depth 1.25-1.5 mm Slightly shallow/ > 3 mm deep

Slightly deep

Axial Wall Convex Slight error Unacceptable



Class V Glass Inomer Restoration

P P F




Placment No pits or voids Pits or voids Gross Voids


Anatomy Correct Slight Error Unacceptable


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Class III Composite Preparation

P P F


Axial Extension 1.0-1.25 mm Slightly shallow/ > 2.5 mm deep

Slightly deep



Internal Walls Smooth Rough Grossly Rough

Class III Composite Restoration

P P F

Margins No Excess Excess or Gross Excess

or Deficiency Deficiency

Surface Finish Smooth Polished Rough, Dull Gross Rough


Facial & Proximal Correct Not Correct Unacceptable

Contour

Lingual Contour Correct Not Correct Unacceptable


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Class IV Composite Preparation

P P F


Axial Extension 1.0-1.25 mm Slightly shallow/ > 2.5 mm deep

Slightly deep



Internal Walls Smooth Rough Grossly Rough

Class IV Composite Restoration

P P F

Margins No Excess Excess or Gross Excessor Deficiency Deficiency

Surface Finish Smooth Polished Rough, Dull Gross Rough


Facial & Proximal Correct Not Correct Unacceptable

Contour

Lingual Contour Correct Not Correct Unacceptable


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Class II Composite Preparation

P P F

External Outline Form (O) Correct Slight Error Unacceptable

External Outline Form(P) Correct Slight Error Unacceptable

B & L Walls (O) Parallel Slight divergent Gross

B & L Walls (O) Parallel Slight divergent Gross

Pulpal Depth 1.5-2 mm Slightly deep > 3 mm deep


Gingival Floor Horizontal Angled Unacceptable


Class II Composite Restoration

P P F





Polish

Anatomy (O & P) Correct Slight Error Unacceptable

Marginal Ridge Smooth, Regular Rough, Excess Unacceptable

No Excess or open Open Margin

Margin


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NATURAL TOOTH EXCERSISE

Caries Removal/Liner

1. Select an extracted molar with caries

An extracted molar with occlusal caries will be used for this exercise. Check the pits

and grooves with an explorer. Choose a molar with a definite explorer catch in a pitor a fissure that indicates caries. Do not use a molar with gross caries that extends to

the pulp. Discuss caries location and the proposed outline of the preparation with the

instructor before proceeding.

2. Mount the tooth

3. Cut an initial Class I prep

Cut an initial (ideal) Class I cavity preparation and then get instructors approval.

4. Excavate Caries

Caries remaining in the pulpal floor after the initial prep is cut should be removedwith a round bur and the slow speed handpiece. Choose the size of the round bur that

is about the size of the area of the carious dentin. Check remaining dentin with

explorer. If sticky or leathery dentin remains, remove it with the low speed handpiece.

Do not be too aggressive when probing pulpally or when using the handpiece in thearea over the pulp to avoid pulp exposure. If soft, carious dentin extends all the way

to the pulp, then a pulp exposure cannot be avoided since all of the caries must be

removed.

5. Check for undermined enamel

If caries has extended laterally under cusps, then switch to the high speed handpiece

and widen the enamel portion of the prep to remove the undermined (no dentin

support) enamel. Next, check the lateral walls for carious dentin that may have been

exposed by widening the cavity. Switch back to the slow speed handpiece to removeany remaining caries.

6. When caries removal is complete, get the preparation checked by the instructor.

7. Place a liner.

The next step is to apply the liner to the area of dentin that is deeper than the ideal

because of caries removal.

8. Place IRM temporary filling.


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Cavity Preparations and Restorations

Class I amalgam preparation:

Outline: Include mesial & distal pit. Central, buccal & lingual grooves.

Isthmus width: 1-1.25 mm. Pulpal depth: 1.5-2.0 mm.

B, L walls: Parallel or slightly convergent occlusally.

M, D walls: Diverge occlusally.

Retention: no grooves or points.

Margins: No bevel.

Class I amalgam Restoration:

Grooves: Central & triangular grooves.

Fossae: Mesial & distal pits.

Cusp planes: B & L slopes reproduce triangular ridges.

Margins: smooth and regular. No excess amalgam over margins (flash). Nodeficiencies or open margins.

Condensation: No pits or voids.

Surface finish: uniformly smooth and free of scratches and irregularities. Burnished.


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Buccal pit preparation:

Outline: Located at gingival end of buccal groove.

Diameter: 1mm.

Axial depth: Axial wall is 1.5 mm deep.

Wall angulation: Walls are 90 to cavosurface and parallel.

Retention: no grooves or points are necessary. In larger preps, retention may beplaced in mesial, distal and gingival walls.

Margins: No bevels.


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Class I with buccal extension amalgam preparation:

Outline: Include M, C, D pits. L groove. Extend B groove to include B pit onbuccal surface.

Isthmus width: 1-1.25 mm. Pulpal depth: 1.5-2.0 mm.

B, L walls: Parallel or slightly convergent occlusally.

M, D walls: Those on occlusal diverge occlusally. Those on facial extension areparallel.

Axial wall: Parallel B surface. 1.25 mm deep.

Retention: Groovesin M, D walls of buccal extension to pulpal floor.

Margins: No bevel.

Class I with buccal extension amalgam restoration:

Grooves: Central, buccal and lingual grooves. None on facial surface. Central grooveis not straight.

Fossae: Mesial & distal pits. 2 central pits.

Cusp planes: B & L slopes reproduce triangular ridges. Inclines are not concave.

Margins: smooth and regular. No excess amalgam over margins (flash).Nodeficiencies or open margins.


Surface finish: uniformly smooth and free of scratches and irregularities. Burnished.


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Class I with lingual extension amalgam preparation:

Outline: Central pit, mesial pit, of buccal groove. L shaped preparation. Includedistal pit and lingual groove.

Isthmus width: 1-1.25 mm.

Pulpal depth: 1.5-2.0 mm. Pulpal floor slopes occlusally toward lingual to maintainconstant depth.

B, L walls: Parallel or slightly convergent.

M, D walls: Mesial diverges. Distal wall is vertical.

M, D walls of the extension: Parallel.

Axial wall: Parallel to lingual surface. Depth 1.25 mm.

Retention: Groovesin the lingual box. In M, D walls, from gingival to pulpoaxiallline angle.

Margins: No bevels.

Class I with lingual extension amalgam restoration:

Grooves: O: Central and buccal grooves. Extension: Groove on occlusal but notlingual.

Fossae: Central, mesial & distal pits.

Cusp planes: B & L slopes reproduce triangular ridges. Inclines are not concave.



Surface finish: uniformly smooth and free of scratches and irregularities. Burnished


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Class II amalgam preparation:

Outline: Include mesial or distal pit.


Pulpal depth: 1.5-2.0 mm.

Proximal clearance: Visually free of contact, 0.25-0.5 mm. B, L walls: Parallel or slightly convergent occlusally. B & L walls of box form 90

angle with proximal surface.

Axial wall: Convex, vertical, 1-1.25 mm deep measured mesiodistally at the gingivalfloor.

Retention: Groovesin B- & L- axial line angles from gingival to pulpal. Depth head of bur (0.25 mm).

Pulpoaxial line angle: Rounded or beveled.

Margins: No bevels.

Class II amalgam restoration:


Fossae: mesial & distal pits.

Cusp planes: B & L slopes match those of tooth. Inclines are not concave.

Contacts: Visual contact with adjacent tooth. Definite but not excessive resistance tofloss.

Embrasures: Occlusal, gingival, facial and lingual embrasures are reproduced.

Marginal ridge: Same height as that on adjacent tooth.



Surface finish: uniformly smooth and free of scratches and irregularities. Burnished


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Class III cavity preparation:

Outline: Lingual approach, just gingival to contact area.Incisal margin is in middle of contact area and dosesnot break contact. Rectangular with no sharp angles.

Incisogingival width: 1.75-2 mm without bevel. Mesiodistal width (axial depth): 1.25 mm without bevel.

Facial wall: Parallel to lingual surface. 90 to proximal.1.5 mm deep measured at axial wall.

I, G walls: Parallel or slightly divergent. 90 to surface.No undercuts.

Axial wall: Parallel to proximal surface. 90 to lingual.

Margins: Place round bur, 45 bevels on accessible margins.Use flame finishing bur on low speed handpiece.

Class III composite restoration:

Contour: Contours follow that of tooth. Proximal is convex, lingual is concaveocclusogingivally.

Contact: Incisal potion contacts adjacent tooth.

Embrasure: 4 embrasures are present. Note that occlusal embrasure is tooth.

Margins: smooth and regular. No excess or deficiencies detectable visually or withexplorer. Composite does not extend beyond cavosurface margin.

Surface finish: uniformly smooth and free of pits. Polished to shine. No dirt ordiscoloration.


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Class IV cavity preparation (Simulated fracture):

Outline: Remove both facial and lingual walls to simulate fracture.

Incisogingival width: 5 mm or sufficient to break contact6 mm with gingival bevelincluded. Keep margin above the gingiva when beveling.

Mesiodistal width: 2 mm at contact, 1.5 mm at gingival floor before beveling. Facial wall: Parallel to lingual surface. 90 to proximal. 1.5 mm deep measured at

axial wall.

Preparation bevels: 1.5-2 mm width bevel on facial. 1 mm width on gingival &lingual.

Class IV composite restoration:

Contour: Facial, lingual & proximal contours and line angles reproduce tooth andmatch the adjacent tooth.

Incisal edge/point angle: Incisal edge is horizontal and matches the adjacent. Pointangle is same shape as the adjacent.

Contact: Incisally located at height of contour of adjacent tooth. Visually presentcontact. Contact area is convex.

Embrasure: Incisal and gingival embrasures are symmetrical with the adjacent.

Margins: smooth and regular. No excess or deficiencies detectable visually or withexplorer. Composite does not extend beyond cavosurface margin.

Surface finish: uniformly smooth and free of pits. Polished to shine. No dirt ordiscoloration.


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Class II composite preparation:

Outline: Include mesial or distal pits.


Pulpal depth: 1.5-2.0 mm. Proximal clearance: Visually free of contact, 0.25-0.5 mm.

B, L walls: Parallel or slightly convergent occlusally. B & L walls of box form 90 angle with proximal Surface.

Axial wall: Convex, vertical, 1-1.25 mm deep measured mesiodistally at the gingivalfloor.

Pulpoaxial line angle: Rounded or beveled.

Margins: No bevels.

Class II composite restoration:


Fossae: mesial or distal pit.

Cusp planes: B & L slopes match those of tooth. Inclines are not concave.

Contacts: Visual contact with adjacent tooth. Definite but not excessive resistance tofloss.

Embrasures: Occlusal, gingival, facial and lingual embrasures are reproduced.

Marginal ridge: Same height as that on adjacent tooth.


Surface finish: uniformly smooth and free of scratches and irregularities. Polished.

conservative dentistry lab manual

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