I NTRODUCTION AND SCOPE OF

OPERATIVE DENTISTRY

DEFINITION

Operative dentistry is the art and science of the diagnosis, treatment and prognosis of defects of teeth that do not require full coverage restoration for correction. Such treatment should result in the restoration of proper tooth form, function, and esthetics while maintaining the physiologic integrity of the teeth in harmonious relationship with the adjacent hard and soft tissues , all of which should enhance the general health and welfare of the patient.

C AVITY

PREPARATION

Cavity preparation defined as mechanical alteration of a defective, injured or diseased tooth in order to best receive a restorative material which will enhance or reestablish a healthy state of the tooth including esthetic corrections where indicated alongwith normal form and function.

I NDICATIONS OF RESTORATIVE TREATMENT

To restore proper form and function in a tooth. Congenitally malformed teeth Restoration or repair after destruction from carious lesion. Esthetic demands of a patient like tetracycline staining, discolored teeth. Restore the tooth in the preventive sense, that is, A) rampant caries B) pit and fissure sealants

Modern conservative dentistry may be divided, according to the stage of disease development, into three, strictly associated fields: Prevention - prophylaxis of the development of dental caries and periodontosis Cariology - treatment of simple caries (not complicated by reaction of the pulp) Endodontics - treatment of dental caries complicated by inflammation, death or gangrene of the pulp.

PREVENTION

The prevention of caries allows the most excellent results to be obtained, i.e. healthy strong dentition. The main goal of the prevention is to combat dental plaque, the main cause of dental caries development.
Dental prevention includes:

Instruction in oral hygiene Nutritional guidelines Professional tooth cleaning - removal of plaque, deposit and tartar Individual dental fluoridation.

TREATMENT FOR SIMPLE CARIES

Remineralisation - in the case of initial caries, manifesting itself as a carious spot, fluoride formulas are rubbed on the affected surface; this procedure to prevent further caries development should be repeated several times every few days.

Preparation and filling the carious cavity - the procedure consists of the removal of cariesaffected tooth tissues and filling of the cavity with special material.

ENDODONTIC TREATMENT

Endodontic treatment, applied in cases of caries complicated by inflammation, necrosis or gangrene (disintegration) of the dental pulp.

The treatment consists of the removal of infected or dead pulp from the pulp chamber and root canals, mechanical dilatation and disinfection of canals and tight filling of these spaces with root canal filling material.

C ONSERVATIVE

APPROACH -

The primary results of conservative treatment are retention of more intact tooth structure and less trauma to the pulp tissue and contiguous soft tissue.

O BJECTIVES OF CAVITY PREPARATION

1- removal of all defects and to give necessary protection to the pulp. 2- locate the margins as conservatively as possible.

3- to form the cavity so that under forces of mastication, the tooth or the restoration or both will not fracture.
4- allow for the esthetic and functional placement of a restorative material

R ECENT

ADVANCEMENTS -

Use of lasers for welding dental alloys or alteration in tooth structure preparation Lasers used for Etching enamel and making them more resistant to demineralization.

Extended use of bonding techniques- led to developments in composite and adhesive restorative materials.
Beneficial use of composites in posterior teeth.

Castable or pressed ceramic materials.

Computer generated restorations