Biological Principles of Tooth Preparation

Prof. Wedad Etman; MD, PhD Conservative Dentistry; Faculty of Dentistry, Tanta University

PREVENTION OF CARIES RECURRENCE III. I.Biological Principles of Tooth Preparation These principals are primarily concerned with the health and integrity of the remaining tooth tissues. ASEPTIC PROCEDURES . PROTECTION OF THE PULP II.

Thus the following should be considered. Unnecessary pressure is unacceptable. . . PROTECTION OF THE PULP The pulp must be protected against all sorts of irritations during cutting. Cutting must be parallel to the recessional lines of the pulp. .I.

PROTECTION OF THE PULP . . chemicals or sterilizers should be used. Unnecessary heat generation should be avoided during cutting. No cavity caustics. . Limiting the exposed amount of dentin.I. . Large round burs should be used at low speed while removing soft dentin from deep cavity floors. .

. . PREVENTION OF CARIES RECURRENCE . . Removing all carious enamel or dentin. . Extension of the cavity margins to include all areas susceptible to caries as pits and fissures. Correct cavo -surface angle according to the physical characteristics of the restoration type must be performed. Removal of all undermined enamel.II.

Isolation of the operative field. . dry and sterile hands.III. Maintenance of clean. . ASEPTIC PROCEDURES . . Use clean and sterile instruments.

New approach in decision making. cavity design and tooth preparation: Biological forms of cavity preparation .

Biological Forms of Tooth Preparation A. Conservative Factors D. Diagnostic Factors B. Material Factors . Patient Factors C.

Patients concern for esthetics should be considered. There must be a reason to place a restoration in the tooth: caries. . An assessment of both pulpal and periodontal status will influence the potential treatment. . . Diagnostic Factors . Assessment of occlusal relationships.A. . fractured teeth. esthetic needs or for improved form or function.

The relationship of a specific restorative procedure with another treatment planned for the patient must be considered. Diagnostic Factors . . The risk potential of the patient to further dental disease should be assessed. .A. A highrisk patient may require altered treatment planning initially until the risk factors are better controlled.

. active or not. Patient Factors . The patient's economic status.B. is it reversible (incipient) or irreversible (cavitated). . . The patient's age. Caries in this patient. The patient's knowledge and appreciation of good dental health. . Whether or not adequate isolation of the operating site can be obtained. ‘Caries risk assessment’ .

the preservation of the vitality and integrity of the tooth is paramount.C. . Conservative Factors . While one of the primary objectives of operative dentistry is to repair the damage from dental caries. The pulp should not be subjected to unnecessary abuse. The less tooth structure removed the less the potential damage that may occur to the pulp. . .

. Conservative Factors . Examples of conservative tooth preparation features: – Minimal extensions of the tooth preparations. enameloplasty and fissure sealant instead of extension for prevention. – Only uncoalescent fissures are excised.C. . – Supragingival margins and Rounded internal line angles. The smaller the tooth preparation. especially facio-lingually and pulpally. the easier it is to retain the restorative material in the tooth.

An amalgam restoration requires specific mechanical tooth preparation for resistance and retention. .D. Material Factors . An indirect cast metal restoration also requires a specific tooth preparation form that provides: – Draw or draft to provide seating. . – A beveled cavosurface configuration.

. . Bonded amalgam restoration still requires the same tooth preparation as for non-adhesive amalgam restoration. Adhesive composite restorations or GIC do not typically require tooth preparations as precise as those for amalgam and cast metal restorations. Material Factors .D. . Ceramic inlay restorations do require specific preparation depths and wall designs but do not require complex cavosurface marginal configurations.

Sign up to vote on this title
UsefulNot useful