Introduction to Operative Dentistry

Dr. Wael Al-Omari BDS, MDentSci, PhD

Definition

Operative Dentistry is the art and science of the diagnosis, prevention,, treatment and prognosis of defects in the enamel and dentin of teeth that do not require full coverage restorations for correction.

Aim of treatment

Restore proper tooth form, function, phonetics and esthetics. Maintain physiological integrity of the teeth in harmonious relationship with adjacent tissues. Enhance the general health ad welfare of the patient.

History

The foundation of dental practice from which most other aspects of dentistry evolved Barber-dentist: practice mainly extraction of teeth. First dental school: Baltimore College of Dental Surgery 1840 Harvard University dental school in 1867

History

Louis Pasteur discovered the role of microorganisms in disease G. V. Black: related the clinical practice of dentistry to a scientific basis The scientific foundation expanded by Blacks son, Arthur Black.

Indication for Operative Treatment

1. 2.

3. 4.

Indications Caries Malformed, discolored, non-esthetic or fractured tooth Tooth wear Restoration replacement or repair

Caries

Fractured, malformed and discolored teeth

Tooth wear

Fractured restorations

Considerations

Infection control. Examine tooth and oral and systemic health Diagnose the interaction with general health. Proper treatment planning. Understanding of materials to be used. Understand oral environment. Understand biological basis of function of various tooth components. Thorough knowledge of anatomy

Requirement

Knowledge of human biology and microbiology Knowledge of material science Good technical and clinical skills. Artistic abilities

Procedures

Direct restorations: amalgam, composite resin, glass ionomer Indirect restorations: inlays, onlays, crowns Veneers: direct and indirect

Direct restorations

A restorative material is directly placed in the prepared tooth to restore anatomy and contour and replace the removed diseased tooth structure

Direct restorations

Advantages: Easy to place, less time consuming, cost effective

Conservative approach

Extension for prevention concept is outdated and not acceptable Increased knowledge of preventive methods, advanced clinical techniques and improved materials allowed fro more conservative approach in tooth preparation

Cavity preparation

The mechanical alteration of a defective, injured or diseased tooth in order t best receive a restorative material which will re-establish a healthy state for tooth including esthetic corrections where indicated, along wit normal form and function

Objectives of cavity preparation

To remove carious or defective tooth structure and prevent progression of the disease Allow for the esthetic and functional placement of a restorative material

Method of cavity preparation

Gross cutting: diamond or tungsten carbide burs attached to hand-held device called hand piece at high speed of 200000 rpm Finishing and fine adjustment: finishing burs attached to slow speed hand piece (30000-40000 pm).

Factors influencing the practice of operative dentistry

Demographic Advances in technology Economic factors General and dental health Dental manpower

Future of operative dentistry

knowledge on biologic basis should be encouraged. Practitioners must be educated and trained on the new advances in technology and materials. Increased research activity and continued practitioner adaptability will result in improved oral health of population throughout the world.