A Practical Approach to Operative Dentistry

Preface ix

About the Companion Website xi

Section I Restorative Dentistry 1

1 Instruments 3

Diagnosis 3

Operative Management 3

Instrument Tray 4

Handpieces and Burs 9

Air Turbine 9

Contra-Angled Handpiece 9

Burs 10

Matrix Systems 12

Further Reading 16

2 Isolation 17

Methods of Isolation 17

Further Reading 21

3 Dental Charting 23

Charting Notations 23

Zsigmondy-Palmer Notation 23

FDI Two-Digit Charting Notation (Fédération Dentaire Internationale) 24

Forensic Dental Notation (Box Charting) 24

Tooth Surfaces 24

Abbreviations for Dental Charting 25

US Tooth Numbering Notation 27

Further Reading 28

4 Minimally Invasive Dentistry 29

Protocol for Using Minimally Invasive Dentistry 29

Diagnosis 29

Alternative Cavity Classification System 30

Assessment of Caries Risk 30

Reduction in Cariogenic Bacteria 31

Arresting Active Lesions 31

Remineralisation of Carious Lesions and Monitoring 31

Restoration of Cavities Using Minimal Cavity Designs 31

Repairing Defective Restorations 32

Monitoring 32

Cavity Preparation 33

MID for Pits and Fissures 33

MID for Interproximal Lesions 34

Tunnel Restorations 34

Box Preparation 35

Icon 35

Other Examples of a More Minimal Approach to Treatment 35

Micro-Abrasion 35

Veneers 37

Adhesive Bridges 37

Adhesive Onlays 38

Further Reading 40

Section II Intra-Coronal Restorations 41

5 Pit and Fissure Caries 43

Dental Probe 44

Visual Method 45

Visual Method with Magnification 46

Transillumination 46

Bitewing Radiograph 47

Electronic Methods of Fissure Caries Diagnosis 48

Enamel Biopsy 49

Caries Risk Assessment 50

Categorising Fissure Lesions and Selecting a Management Option 51

Sealant Restorations 51

Evidence Based Dentistry 52

International Caries Classification and Management System 53

Clinical Guide to Restoring a Tooth Using a Sealant Restoration Technique 55

Clinical Guide to Restoring a Posterior Tooth with a Composite Resin 66

A Clinical Case 77

Further Reading 79

6 Posterior Approximal Restorations 81

Tunnel Restorations 83

Removal of the Marginal Ridge 83

Lining 84

Matrix Bands 84

Finishing the Restoration 84

The Extensive Restoration 85

Clinical Guide to Restoring an Interproximal Lesion with a Self-Retentive Box 87

Clinical Guide to Restoring a Class II Lesion with Composite Resin 98

A Clinical Case 110

Clinical Guide to Restoring a Class II Lesion with Amalgam 111

Clinical Guide to Restoring an Extensive Class II Lesion 122

Further Reading 134

7 Restorations in Anterior Teeth 135

Cavity Design 136

Isolation 136

Accessing the Carious Lesion 137

Caries Removal 137

Enamel Margins 137

Use of a Lining Material 137

Restoration of Anterior Interproximal Caries 139

Restoration of a Fractured Incisor 152

A Clinical Case 160

Further Reading 161

8 Restoration of Lesions in Cervical Third 163

Aetiology 163

Appearance 164

Factors Increasing Incidence of Lesions 164

Direct Replacement Restorations 164

Cervical Glass Ionomer Cement (GIC) and Compomer Restorations 166

Compomer Restorations 174

Further Reading 180

Section III Indirect Restorations 181

9 Indirect Restorations 183

Principles of Crown Preparation 184

Assessment of a Patient for an Onlay or Crown 189

MOD Gold Onlay 190

Full Gold Crown 199

A Clinical Case of Porcelain Onlay 210

Further Reading 211

10 Porcelain Fused to Metal and All-Ceramic Crowns 213

PFM Crown 216

All- Ceramic Crown 229

Clinical Sequence for All-Ceramic Crown 239

Further Reading 240

Index 241