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Prof. Wedad Etman; MD, PhD Conservative Dentistry; Faculty of Dentistry, Tanta University
A. Diagnostic Factors
. There must be a reason to place a restoration in the tooth: caries, fractured teeth, esthetic needs or for improved form or function. . An assessment of both pulpal and periodontal status will influence the potential treatment. . Assessment of occlusal relationships. . Patients concern for esthetics should be considered.
A. Diagnostic Factors
. The relationship of a specific restorative procedure with another treatment planned for the patient must be considered. . The risk potential of the patient to further dental disease should be assessed. A highrisk patient may require altered treatment planning initially until the risk factors are better controlled.
B. Patient Factors
. The patient's knowledge and appreciation of good dental health. . The patient's economic status. . The patient's age. . Whether or not adequate isolation of the operating site can be obtained. . Caries in this patient, is it reversible (incipient) or irreversible (cavitated); active or not. Caries risk assessment
C. Conservative Factors
. While one of the primary objectives of operative dentistry is to repair the damage from dental caries, the preservation of the vitality and integrity of the tooth is paramount. . 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.
C. Conservative Factors
. The smaller the tooth preparation, the easier it is to retain the restorative material in the tooth. . Examples of conservative tooth preparation features:
Minimal extensions of the tooth preparations, especially facio-lingually and pulpally. Supragingival margins and Rounded internal line angles. Only uncoalescent fissures are excised, enameloplasty and fissure sealant instead of extension for prevention.
D. Material Factors
. An amalgam restoration requires specific mechanical tooth preparation for resistance and retention. . An indirect cast metal restoration also requires a specific tooth preparation form that provides:
Draw or draft to provide seating, A beveled cavosurface configuration.
D. Material Factors
. Adhesive composite restorations or GIC do not typically require tooth preparations as precise as those for amalgam and cast metal restorations. . Ceramic inlay restorations do require specific preparation depths and wall designs but do not require complex cavosurface marginal configurations. . Bonded amalgam restoration still requires the same tooth preparation as for non-adhesive amalgam restoration.