Operative Dentistry

Cavity Preparations
Indication of Operative Dentistry
Caries;
Malformed, discolored,
or fractured teeth;
Restoration replacement.
 Tooth-colored restoration
For Class and
Esthetic Dentistry

For Class and

What are Tooth-colored materials?

What is their working mechanism?

What are the cavity preparation

futures for tooth-colored
restoration?
What are steps for tooth-colored
restoration?

What are the advantage & disadvantage

of tooth-colored restoration?
 Tooth-Colored Materials

Composite resin

Glass ionomer cement

Compomer
 Composite Resin

Traditional composites

Hybird composites

Flowable composites
Condensable composites Packable
Universal composites
 Glass Ionomer

Chemical adhesion to dentin

Release Fluoride
 Compomer

Compomer =

Composite + Ionomer
 Dental Adhesion
or
Dental Bonding

Adhesion is a process of solid and/or

liquid interaction of one material with
another at a single interface.
 Enamel bonding system

Enamel bongding depends on resin tags

becoming interlocked with the surface
irregularities created by etching.
Macrotags: form between enamel rod
peripheries.

Microtags: smaller tags form across

the end of each rod.

Macrotags and microtags are the basis

for micro-mechanical bonding.
 Dentin bonding system

The difficulties of dentin bonding:

More water---wet bonding

Lower calcification
Richer organic---collagen network
Smear layer
The bond strength is primarily related
to micro-mechanical bonding to the
intertubular dentin which occures
between tubules along the cut dentin
surface.
 Dentin Bonding Agent, DBA

Early DBA were hydrophobic, bonded

directly to the dentin smear layer.
Bond strengths 6MPa.

Later DBA removed the smear layer but

tended to over-etch dentin.
Bond strengths10~12MPa.
DBA were chemically modified to be
more hydrophilic.
Bond Strengths18~20MPa.

Careful dentin conditioning,

Coupled with hydrophilic primer,
Bond Strength22~35MPa.
The Development of DBA
Enamel etch (1955)

Dentine etch (1960)

Treatment of smear layer (1980)

Wet Bonding technique(1990)

First generation
Second generation

Third generation
Fourth generation: Total etch technique
Fifth generation: One bottle system

Sixth generation: All in one,2000

Seventh generation
 Cavity Preparation
Three designs of cavity preparation:

1.Conventional

2.Beveled conventional
3.Modified
Beveled conventional cavity preparations
are similar to conventional preparation,
in that the outline form has external,
box-like walls, but with beveled
enamel margin.
Beveled enamel margin
Beveled conventional cavity designs for
Class , and preparations
The advantages :

The ends of enamel rods are more etched

The increase in etched surface results in
a stronger bond
Increase the retention and reduce marginal
leakage and discoloration.
More esthtically
Modified cavity preparation

Have neither specified cavity wall structure

nor specified pulpal depth, and have enamel
margins.

Conserve more tooth structure.

Modified cavity preparation
 Initial Clinical Procedure

Local anesthesia
Preparation of the operating site
Shade selection
Isolation of the operating site
with rubber dam or cotton rolls
Rubber dam
 Clinical Procedure

Cavity preparation
Acid etching enamel & conditioning dentin
Matrix application
Application of bonding agent
Insertion of composite
Finishing procedures
Matrix application
Final procedures
Cases
Conservative Operative Dentistry
Minimal intervention dentistry

is regards as a main stream

in caries treatment in the 21 st
century.
Principles of Minimal Intervention
dentistry
Remineralization of early lesions
Reduction in cariogenic bacteria, to
elminate the risk of further demi-
neralization and cavitation
Minimum surgical intervention of ca-
vitated lesions
Repair rather than replacement of
defective restorations
The day is surely coming, and perhaps
within the lifetime of you young men
before me, when we will be engaged in
practicing preventive, rather than
reparative, dentistry.

GV Black in 1896