Академический Документы
Профессиональный Документы
Культура Документы
Dental Caries
Dental Caries
Subsurface
demineralization of
enamel
Dental Caries
No sugar before
sleeping
Dental Caries
Resistance
Plaque removal
Sugar reduction
Fluoride
Sealants
Chlorhexidine
Dental Caries
Living tissue
Peritubular dentine
Intertubular dentine
Apatite crystals
Intermolecular cross-linking
Dental Caries
Dental Caries
Bacterial Invasion
1
8
Dental Caries
Bacterial Invasion
1
2
Bacteria need to have a source of nutrients,
3
4
i.e. from the oral environment.
5
6
Bacteria are found mostly in the
7
8
biomass with few being found in the
dentine tubules.
Dental Caries
8
Dental Caries
5
This softens the dentine matrix.
6 The collagen fibres are reversibly damaged
7
in the dissolution process.
8
cont’d
Dental Caries
5
Further continuation of acid production
6 breaks the intermolecular crosslinks of
7 collagen fibres irreversibly.
8
Dental Caries
8
Dental Caries
cont’d
Dental Caries
5
SCLEROSIS.
6 It is seen clinically as yellow-brownish
7
discoloration of the dentine.
8
Dental Caries
4
Dental Caries
4
Dental Caries
Fissure cavity
1
3.6 mm
Dental Caries
Lateral spread of
1 fissure cavity
2
3.6 mm
Dental Caries
4
Dental Caries
4
Dental Caries
4
Dental Caries
4
Dental Caries
1
GV Black’s cavity preparations followed
2
3
designs that were largely dictated by the
4 physical properties of the filling materials (e.g.,
amalgam and silicate cement).
These materials needed mechanical retention
Dental Caries
1
Mechanical retention
2
3
Flat floors
4 Vertical walls
Triangular retention
niches
Undercut areas
Dental Caries
4
The preparation did not follow the way a dentine
lesion progresses.
2
biological process'
3
4
Dental Caries
Research findings
survival time single surface: 10 – 8 years
survival time multiple surface: 8 - 6 years
2
Repeat restoration cycle
3 Occlusal lesion and occlusal restoration
2-Surface restoration
Extended restoration
Crown or Extraction
Dental Caries
2
Perceived (but erroneous) requirement to
3
‘freshen up’ the cavity walls and margins.
The teeth inevitably become weaker, thereby
reducing their prognosis.
The complexity of the restorations increases or
Tooth needs to be extracted.
Dental Caries
2
Much sound tooth tissue needs to be
removed.
Traditionally placed restorations, on
average, do not last long.
The replacement restorations, in many
cases, last for less time.
Dental Caries
1
Cavity cleaning
2 Obtaining access
Removal of dead dentine and enamel
Anatomy determines the shape
No preconceived cavity design
Black's principles are redundant
Dental Caries
2
Dental Caries
8
Dental Caries
Question:
1
8
Dental Caries
3
removing only soft, completely demineralized tooth
4
tissue and
5
6
preserving as much as possible remineralizable
7
enamel and dentine.
8
Dental Caries
Hand instrument:
1
Dental hatchet
2
(e.g., 10 – 6 - 12)
Dental Caries
Hand instrument:
1
Excavator
2
8
Dental Caries
3
High speed drill
4
onlyfor opening cavities that are inaccessible
5
6
removal of failed restorations.
8
Dental Caries
3
shape
4 gives the operator improved tactile sense
5 does not damage surfaces adjacent to the
6
7
lesion, in the case of approximal lesions and
8
therefore, does not promote caries
development.
Dental Caries
4 Preservation =
restoration + prevention
Dental Caries
Sealant
restorations
Dental Caries
3
dentine lesion is to only remove soft, completely
4
demineralized tooth tissue. This is best achieved
through using hand instruments and/or a slowly
rotating drill rather than a high-speed drill. In doing
so, less sound tooth tissues are removed and
damage to surfaces of other teeth is minimized.
Dental Caries
2
tissue is removed, there can be no
3 preconceived cavity design; the anatomy of
4
the carious lesion dictates the size and
shape of the cavity preparation.
Dental Caries
2
adhesive filling material into the cleaned cavity
3
preparation, over its margin, and over the
4 adjacent pits and fissures. This sealant
restoration will arrest caries activity that is
present in dentine and enamel, provided that
the bonding of the material to these tooth
tissues is adequately established.
Dental Caries
2
control dentine caries
3 increase survival of the restoration
4
save tooth tissues and thus
increase tooth life expectancy.
Dental Caries
Remember:
TO APPLY PREVENTIVE MEASURES