dentist

1. I N T R O D U C T I O N T O O P E R A T I V E
D E N T I S T R Y
B Y
DR. NUHA ELKADIKI
(MDS)

3. CONTENT OF LECTURE:
1. Definition of operative dentistry.
2. History and Epidemiology.
3. Indication of operative dentistry.
4. Objective of operative dentistry.
5. Tooth numbering system(tooth notation) :
A. Universal numbering system.
B. Palmer national numbering system.
C. Federation Dentaire Internationale Numbering System (FDI).

4. 1. DEFINITION OF OPERATIVE
DENTISTRY:
Operative Dentistry is the art and science of the prevention,
diagnosis, treatment and prognosis of defects in the enamel and
dentin of individual teeth.
Also known as Restorative Dentistry or Conservative Dentistry.
According to Mosby's dental dictionary's, operative dentistry
deal with the function and esthetic restoration of hard tissue of
individual teeth.

5. 1. DEFINITION OF OPERATIVE
DENTISTRY:
• 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.

8. 2. HISTORY AND EPIDEMIOLOGY
 Operative Dentistry was considered to be the entirety of
the clinical practice of dentistry.
Has been recognized as the foundation of dentistry and the
base from which most other aspects of dentistry evolved.

9. 2. HISTORY AND EPIDEMIOLOGY
The profession of dentistry was born during the early
middle ages.
Barbers was doing well for dentistry ,by removing teeth
with complications .

10. 2. HISTORY AND EPIDEMIOLOGY
The practice of these early dentists consisted mainly of tooth
extraction and practice of dentistry during the founding year was not
based on scientific knowledge.
Baltimore College of Dental Surgery in 1840 ⇒ dental education.
 Harvard University in 1867 ⇒ dental program.
In France, Louis Pasteur discovered the role of microorganisms in
disease ⇒ have a significant impact on the developing dental +
medical profession.

11. 2. HISTORY AND EPIDEMIOLOGY
In 1898, Dr. G.V. Black is known as father of operative
dentistry.
In United States, G.V. Black became the foundation of the
dental professions ⇒related the clinical practice of dentistry
to a scientific basis.

12. 2. HISTORY AND EPIDEMIOLOGY
The scientific foundation for operative dentistry was
further expanded by Blacks son , Arthur Black.
Others made significant contributions in the early
development of Operative Dentistry:
– Charles E. Woodbury
– E.K. Wedelstaedt
– Waldon I. Ferrier
– George Hollenback

13. 2. HISTORY AND EPIDEMIOLOGY
• In early part of 1900s ,progress in dental sciences and
technologies was slow .many advance were made during
the 1970s in materials and equipiements.by this time ,it was
also proved that dental plaque was the causative agent for
caries.

14. 2. HISTORY AND EPIDEMIOLOGY
In the 1990s, oral health science ,started moving toward an
evidence-based approach for treatment of decayed teeth.
The recent concept of treatment of dental caries comes
under minimally invasive dentistry.
In December 1999 ,the world congress of minimally
invasive dentistry (MID)was formed.

15. 2. HISTORY AND EPIDEMIOLOGY
Current minimally intervention philosophy ,Follow three
concepts of disease treatment:
1. Identify : identify and assess risk factors early.
2. Prevent :prevent disease by eliminating risk factors.
3. Restore: restore the health of the oral environment.

16. 3. INDICATION OF OPERATIVE
DENTISTRY.
Is indicated in following conditions :
1. Caries.

17. 3. INDICATION OF OPERATIVE
DENTISTRY.
Is indicated in following conditions :
2. Developmental structural defects.
Infectious disease in childhood
a. Trauma.
b. Fever.
c. Abscess in developing teeth .

18. 3. INDICATION OF OPERATIVE
DENTISTRY.
Is indicated in following conditions :
3. Hereditary conditions
Amelogenesis imperfectionDentinogenisis imperfecta

19. 3. INDICATION OF OPERATIVE
DENTISTRY.

20. 3. INDICATION OF OPERATIVE
DENTISTRY.
4. Nutritional defect:
Enamel hypo-calcification

21. 3. INDICATION OF OPERATIVE
DENTISTRY.
5. Formative destruction: (tooth with in tooth)

22. 3. INDICATION OF OPERATIVE
DENTISTRY.
5. Acquired tooth defect

23. 3. INDICATION OF OPERATIVE
DENTISTRY.
6. discoloration:

24. 3. INDICATION OF OPERATIVE
DENTISTRY.
7. Accidental trauma:

25. 3. INDICATION OF OPERATIVE
DENTISTRY.
8. Malformed tooth:

26. 3. INDICATION OF OPERATIVE
DENTISTRY.
9. Esthetic improvement:

27. INDICATION OF OPERATIVE
DENTISTRY.
10. Restoration replacement and repair

28. 4.OBJECTIVE OF OPERATIVE
Operative dentistry have a five fundamental aims:
A. Diagnosis .
B. Prevention.
C. Interception.
D. Preservation.
E. Restoration.
F. Maintenance

29. 4. OBJECTIVE OF OPERATIVE
A. Diagnosis:
It’s the determination of the nature of the disease ,injury
and congenital defects by examinations ,tests and
investigations .
Proper diagnosis is vital for treatment planning.

30. 4.OBJECTIVE OF OPERATIVE
B. Prevention:
Ultimate goal regarding dental caries is its prevention.
(sealing enamel fault pit and fissures).
To prevent any recurrence of the causative disease and
their defect.

31. 4. OBJECTIVE OF OPERATIVE
C. Interception:
This procedure in operative dentistry refers to preventing
further loss of tooth structure by stabilizing an active disease
process.

32. 4. OBJECTIVE OF OPERATIVE
D. Preservation:
Preservation of vitality of tooth and periodontal support of
remaining tooth structure.

33. 4. OBJECTIVE OF OPERATIVE
E. Restoration:
Restoring form ,function ,phonetic and esthetic.

36. •To achieve the ultimate goals of operative
dentistry, any restorative performance,
requires:
1. Full knowledge about human anatomy and
microbiology.
2. Posses a high developed technical skills.
3. Demonstrated artistic abelites.

38. 3. TOOTH NOTATION

39. 3. TOOTH NOTATION
Several different systems are available for tooth reference;
there are however three systems that most practitioners
should be aware of in order to be familiar with the increasing
internationalization of dental journals, conferences and other
forms of communication. Most systems divide the mouth into
four quadrants, which are indicated as if one is viewing the
patient from the front:

41. THE DENTAL ARCH
The human dentition: 20 primary & 32 permanent teeth

42. SURFACES
When describing a cavity or restoration, the location can be
described by the surfaces of the tooth that are involved. These areas
follows:
• Mesial: nearest to the midline of dental arch
• Distal: further from the midline of dental arch
• Labial: next to lips (anterior teeth)
• Buccal: next to cheeks (posterior teeth)
• Lingual: next to tongue (lower teeth)
• Palatal: next to palate (upper teeth)
• Incisal: cutting edge of anterior teeth
• Occlusal: chewing surface of posterior teeth

43. SURFACES
• These surfaces can be represented diagrammatically as a box with
five areas, each of which represents a surface .A series of such
boxes is used to represent all of the teeth.

44. SURFACES

45. QUADRANTS

46. 3.TOOTH NOTATION:
A. Palmer system :
 In 1861 Adolph Zsigmondy of Vienna introduced the
symbolic system for permanent dentition. He then modified
it for the primary dentition in 1874. The symbolic system is
now commonly referred to as the Palmer notation system or
Zsigmondy system. Also called Angular or Grid system.
Oldest numbering system.

47. TOOTH NOTATION:
A. Palmer system :
The permanent teeth are numbered from 1 to 8, from central incisor to third
molar. Each tooth also has be identified by the quadrant, thus the upper right first
permanent molar is designated 6|, while the upper left first permanent molar is
designated 6 :

48. TOOTH NOTATION;
A. Palmer system :
The primary (deciduous) teeth are represented by the letters A to E, from central
incisor to second deciduous molar and also have to have a quadrant designation
e.g. the upper right deciduous central incisor is A|.

50. 3. TOOTH NOTATION;
Advantages of Palmer:
1. Simple to use.
2. No confusion between primary & permanent dentition.
Disadvantage of palmer system:
1. Oral communication is difficult.
2. Opposing or contralateral teeth are indicated by same number
or alphabet which is confusing.

51. 3. TOOTH NOTATION;
B. UNIVERSAL SYSTEM
This system is commonly used in America. The teeth
are given individual numbers from 1 to 32, starting with the
upper right third molar and moving clockwise round the arch
to the lower right third molar.

52. 3. TOOTH NOTATION;
B. UNIVERSAL SYSTEM
ADA officially recommended the Universal system in 1968.
 In this system for the permanent dentition the maxillary teeth
are numbered through 1 to 16 beginning with upper right third
molar.
• The mandibular teeth are numbered through 17 to 32
beginning with lower left third molar. The universal system
notation for primary dentition utilises upper case alphabets.

55. 3. TOOTH NOTATION;
B. UNIVERSAL SYSTEM
In this system, the teeth that should be there are numbered. If you are
missing your third molars, your first number will be 2 instead of 1,
acknowledging the missing tooth. If you’ve had teeth removed or teeth
missing, the missing teeth will be numbered as well.

56. 3. TOOTH NOTATION;
Advantages ADA
1. Each tooth has a separate unique letter or number to denote it.
Disadvantage of ADA
1. Difficult to remember letters or numbers of individual teeth.

57. 3. TOOTH NOTATION;
C. FDI system (Federation Dentaire Internationale)(Two
Digit Notation):
• The FDI system is a two digit system that has been adopted by WHO .
• In this system the first digit indicates the quadrant and the second digit
indicates the tooth within the quadrant. 1 to 4 and 5 to 8 as the first digit
indicates permanent and primary dentition respectively.
• 1 to 8 and 1 to 5 as the second digit indicates permanent and primary
teeth respectively.

59. 3. TOOTH NOTATION;
Advantages:
1. Each tooth has a separate number.
2. Simple to understand and teach.
3. Easy to pronounce in conversation.
4. Easy to transmit over computer & easy for charting.
Disadvantage:
May be confused with ADA numbers.