SlideShare une entreprise Scribd logo
1  sur  10
CAVO SURFACE MARGIN IN VARIOUS RESTORATIONS
Preparing a tooth to receive a restorative material is a comprehensive endeavor. As
routine or mundane as it may seem, many factors affect the appropriate tooth preparation
design for a given tooth. These factors must be considered for each restorative procedure
contemplated, the end result being that no two preparations are the same.
The cavo surface angle is the angle of tooth structure formed by the junction of a
prepared (cut) wall and the external surface of the tooth. The actual junction is referred to
as cavosurface margin.
This seminar highlights on Cavosurface designs of various restorations like amalgam ,
composite, direct filling gold , glass ionomer restoration, ceramic restoration and cast
restorations.
It also highlights on types and design features of occlusal and gingival bevels, types and
design features of facial and lingual flares, bevels and flares in inlay restoration (primary
flare and secondary flare- Its functions and indications ),bevels and flares in onlay
restoration, tooth preparation for cast restoration with surface extensions and
circumferential tie constituents for extracoronal preparations.
Proper tooth preparation is accomplished through systematic procedures based on
definite physical and mechanical principles. Moreover, the physical properties and
capabilities of the different restorative materials must be appreciated. All of these are
determining factors in understanding proper tooth preparation.
Without this background knowledge, plus additional information concerning the
mechanics of cutting and patient management, the exercise of proper judgment for
efficient and proper tooth preparation cannot be achieved .If the principles of tooth
preparation are followed, the success of any restoration is greatly achieved
CARIOLOGY- ETIOLOGY, CLASSIFICATION,
HISTOPATHOLOGY AND CLINICAL FEATURES
TEETH ARE TOOLS that have evolved to ensure survival of species. Caries is a
biosocial disease rooted in the technology and economy of our society. Dental caries is
unique not only in terms of pathological mechanism; other aspects, social and economic,
are also worthy of note. The uniqueness of dental caries makes it a fascinating study from
a scientific standpoint.
Dental caries is defined as an infectious, microbial disease affecting the hard parts of the
tooth exposed to the oral cavity, resulting in decalcification of inorganic constituents and
dissolution of organic components.
This seminar highlights on classification, etiology-early theories and current concepts,
clinical features, the concept of caries as a specific microbial infection, properties of
cariogenic plaque, concept of critical pH, stephan curve, the role of saliva, nutrition, trace
elements and demographic factors on dental caries.
It also explains morphological and chemical events of dental caries, histopathology of
enamel and dentinal caries, electron microscopic studies of carious enamel and
mechanism of enamel caries and cementum caries at chemical level.
Caries, because of its uniqueness as a disease, its ubiquitous nature, and its stubborn
resistance to resolution remains as one of man’s most common oldest and singly costliest
ailment. The total health handicap due to dental caries is staggering. In western countries
there has been a dramatic decline in caries over the past decade. But in the economically
developing countries caries prevalence is increasing as dietary habits of industrialized
nations are adapted. For this reason, it is important that the subject of dental caries is
given as broad a readership as possible. Recognition of the enormity of the problem
should spur effects to reduce the ravages, the pain and the cost of this disease.
PATHOPHYSIOLOGY OF PAIN
Word pain is derived from a Greek word “Poine” which mean penalty or punishment
Pain is a protective mechanism that occurs when tissues are being damaged. It causes the
individual to remove the painful stimulus. It is probably the most fundamental and
primitive sensation, distributed more or less all over the body.
According to International Association for the Study of Pain (IASP) pain is defined as
“an unpleasant sensory and emotional experience associated with actual or potential
tissue damage, or described in terms of such damage”.
The different components of pain are sensory, emotional, autonomic and motor.
Pain can be felt as superficial or deep pain, referred pain, projected pain, intractable pain
and psychogenic pain. There are two theories of referred pain –convergence projection
theory and convergence facilitation theory. Pain on a broad scale is divided into
Fast pain or acute pain, slow pain or chronic pain and Transient pain.
Pain receptors are free, afferent nerve endings of myelinated A-δ and unmyelinated C-
fibres that encode the occurrence, intensity duration and location of noxious stimuli and
signal pain sensation. Pain receptors are of three types- mechano sensitive, thermo
sensitive, chemo sensitive.
Hyperalgesia is a decrease in pain threshold in an area of inflammation, such that even
trivial stimuli cause pain.
Allodynia – Pain from stimuli that are normally not painful
This seminar highlights on peripheral and central mechanisms contributing to allodynia
& hyperalgesia and various theories explaining mechanism of pain transmission
(Specificity theory, Pattern (Central summation) theory, Sensory interaction theory and
Gate control theory).
Differential Diagnosis of dental pain
PULPAL PAIN
Hyperactive pulpalgia, Dentinal hypersensitivity, Hyperemia, Acute pulpagia-Incipient,
Moderate, Advanced, Chronic pulpalgia and Barodontalgia.
PERIRADICULAR PAIN
Acute apical periodontitis, Acute apical abscess, Periodontal lesion pain, Gingival
abscess, Periodontal abscess and Pericoronitis.
The diagnosis and management of pain are foundation skills in clinical dentistry.
Although the subject of pain is of considerable significance to all health providers, the
simple reality is that many patients consider pain and dentistry to be synonymous. This
association is even stronger between dental pulp and pain – to many patients it comes as
no surprise that the dental pulp is innervated by pain receptors. So the knowledge about
the pain mechanisms of the pulpo – dentin complex helps the clinician to make more
accurate diagnosis and to design more effective pain control plans for their patients.
MANAGEMENT OF PERFORATION
Root canal treatment, like other procedures of dentistry is sometimes associated with
unwanted or unforeseen circumstances; these are collectively termed procedural
accidents. One such procedural accident is perforation.
Perforation is considered as one of the main causes of endodontic failures. Perforation
occurs accidentally during the mechanical aspect of endodontic treatment or during
subsequent preparation for a post or results from mis orientation or searching for a canal.
The main complication that arises from perforation is the potential for secondary
inflammatory periodontal involvement and loss of attachment, eventually causing tooth
loss.
Definition
An endodontic perforation may be defined as “An artificial opening in a tooth or its root,
created by boring, piercing, cutting or pathologic resorption, which results in a
communication between the pulp canal and the periodontal tissues”.
Perforations can be classified into coronal, midroot and apical level and can be identified
by direct observation, paper points , radiographs, apex locator. Perforations can be
repaired by three modalities: non-surgical, micro surgical and combined approach.
The four dimensions of perforation are size, level, location and time. The materials used
to repair are grouped into: hemostatics, barrier materials (resorbable and non-resorbable)
and restoratives.
Non-surgical
The internal matrix concept in conjunction with the microscope is an efficient and
effective technique for treating accessible perforation of 1mm or greater in diameter
nonsurgically.This technique involves the placement of biocompatible material into the
perforation site to control hemostasis and prevent overfills acting as an internal matrix
similar for a class II cavity preparation.
Indications for surgery
Large perforations, Nonsurgical inaccessibility, Resorption defects, Failure of healing
after nonsurgical repair, Large overfills of the defect intracoronally.
Intracoronal/surgical approach
A combined approach involves repairing the defect intracoronally, then reflecting a
surgical flap to remove the inevitable over extension of the repair material from the
periodontal space.
In the case of failing furcation repairs; bicuspidisation, hemisection, intentional
replantation, or root amputation may be considered depending on the level of crestal
bone, crown-to-root ratio, and degree of root divergence.
All perforations adversely affect prognosis, some doom the tooth to extraction.
So knowledge of the etiologic factors involved in procedural accidents is essential for
their prevention. In addition, methods of Recognition and treatment as well the effects of
such accidents on prognosis must be learned.
Most problems can be avoided by adhering to the basic principles of diagnosis, treatment
planning, access preparation, cleaning and shaping, obturation and post space
preparation.
CLEANING & SHAPING OF ROOT CANAL SYSTEM WITH
HAND INSTRUMENTS
Cleaning and shaping are the basics of endodontic therapy. Most obturation
problems are really problems of cleaning and shaping. Even simple canals that are poorly
shaped are difficult to obturate properly, whereas extremely complex root canal systems
can be obturated properly if the shaping has been accomplished skillfully. Over the years,
there has been a gradual change in the ideal configuration of a prepared root canal. At
onetime, the suggested shape was round and tapered, almost parallel. After Schilder’s
classic description of “cleaning and shaping,” the more accepted shape for the finished
canal has become a gradually increasing taper, with the smallest diameter at the apical
constricture, terminating larger at the coronal orifice
Cleaning; refers to the removal of all contents of the root canal system before
and during shaping: organic substrates, microflora, bacterial byproducts, food, caries,
denticles, pulp stones, dense collagen, previous root canal filling material, and dentinal
filings resulting from root canal preparation.
Shaping; During this process, instrumentation must give the system a form that
will ensure tissue removal and a shape that will enhance total filling of the root canal
system in three dimensions. Inadequate shaping causes inadequate obturation.
Shaping enlarges the canal’s diameter and smoothes the walls as it removes
crevices, fissures, and irregularities from the system. Cleaning is a combined chemical
and mechanical process, while shaping is purely a mechanical one.
This seminar highlights on pulpectomy, various irrigants used for cleaning and
their importance, precurving, anticurvature filing, different motions (filing, reaming,
watch-winding, turn and pull) and methods of cleaning and shaping with hand
instruments (step-back, modified step-back, step-down, modified crown-down, double-
flared, crown-down pressureless, canal master technique ) with emphasis on balanced
force concept.
NON SURGICAL ENDODONTIC RETREATMENT
Despite new materials, innovative techniques and a plethora of novel devices, the
continuing growth and trend towards more complex forms of endodontics has
been accompanied by an increasing need to manage endodontic failures. Such
failures pose many, varied challenges which, if successfully overcome, can be
both professionally rewarding and a real practice builder.
Rationale for retreatment
• Endodontic failures can be attributable to inadequacies in cleaning, shaping,
and Obturation, iatrogenic events, (or) reinfection of the root canal system
when the coronal seal is lost after completion of root canal treatment.
• The rationale for nonsurgical retreatment is to remove the root canal space
as a source of irritation to the attachment apparatus.
Non-Surgical Versus Surgical Retreatment
"When failure has occurred after root canal treatment, surgical retreatment should
not be chosen as the first treatment option until the possibility of non-surgical
retreatment has been ruled out.
This seminar highlights on different modalities of Coronal disassembly,
identification of missed canals, removal of various obturation materials,
techniques of post removal, broken instrument removal, methods to overcome
blocks, ledges and apical transportations and managing endodontic perforations.
Surgical retreatment encompasses a number of procedures, referred to
synonymously as: · periapical curettage/periradicular curettage · apicectomy/root
end resection/apical resection · root-end filling/retrograde filling · surgical repair
· root resection/root amputation · hemisection/bicuspidization.
With a continuing improvement in oral health and a change in patient
attitude, it is no longer acceptable to extract teeth simply because of periapical
disease and endodontic failure. Advances in scientific knowledge and technical
skills have helped improve the prognosis of treatment, but it may not always lead
to the desired healing response in clinical practice.
If initial treatment is unsuccessful, practitioners are increasingly expected
to possess the necessary knowledge and skills to perform ever more technically
demanding procedures to save teeth. The focus on evidence-based treatment has
resulted in secondary care providers, such as local oral surgery units, no longer
being willing unquestioningly to accept failing endodontic cases for surgery, prior
to an attempt having been made to retreat by non-surgical means
IMPRESSION MATERIALS AND TECHNIQUE
FOR INDIRECT RESTORATION
Dental impression is a negative record of the tissues of mouth. Impression
materials are used to record the surface topography and detail of hard and
soft tissues, and thereby produce a mold for making a replica (cast) of those
structures.
Hydrocolloids and synthetic elastomers are among the materials most
commonly used to make impressions of the various areas of the dental arch.
The accuracy of fit and functional efficiency of the restoration depends on
how well the cast replicates the natural oral tissue, hence it is of great
importance that inaccuracies are minimized at this stage otherwise, they will
be carried through and possibly compounded later on.
The indirect technique for fabricating cast restorations is the most common
technique now in use. This is due to the vast improvement in impression
materials in the past thirty years. So the clinician must be aware of new
materials available in the market and ensure appropriate technique for
obtaining accurate casts.

Contenu connexe

Tendances

Post endodontic restoration/ orthodontic continuing education
Post  endodontic restoration/ orthodontic continuing educationPost  endodontic restoration/ orthodontic continuing education
Post endodontic restoration/ orthodontic continuing educationIndian dental academy
 
Bevels in Dental Restorations
Bevels in Dental RestorationsBevels in Dental Restorations
Bevels in Dental RestorationsHaritha RK
 
Provisional restoration
Provisional restorationProvisional restoration
Provisional restorationSk Aziz Ikbal
 
Shade selection for FPD
Shade selection for FPDShade selection for FPD
Shade selection for FPDSk Aziz Ikbal
 
Techniques of direct composite restoration
Techniques of direct composite restorationTechniques of direct composite restoration
Techniques of direct composite restorationMrinaliniDr
 
Restoration of endodontically treated teeth
Restoration of endodontically treated teethRestoration of endodontically treated teeth
Restoration of endodontically treated teethLama K Banna
 
Dentin hypersensitivity
Dentin hypersensitivityDentin hypersensitivity
Dentin hypersensitivityKirthana MS
 
Access cavity preparation
Access cavity preparationAccess cavity preparation
Access cavity preparationSana Khan
 
Laminates & Veneers
Laminates & Veneers Laminates & Veneers
Laminates & Veneers Self employed
 
Resin Bonded Bridges
Resin Bonded BridgesResin Bonded Bridges
Resin Bonded BridgesDr. Almas A
 
Rationals of endodontics best ppt
Rationals of endodontics best pptRationals of endodontics best ppt
Rationals of endodontics best pptEphrem Tamiru
 
BIOMECHANICAL PRINCIPLES OF TOOTH PREPARATION
BIOMECHANICAL PRINCIPLES OF TOOTH PREPARATIONBIOMECHANICAL PRINCIPLES OF TOOTH PREPARATION
BIOMECHANICAL PRINCIPLES OF TOOTH PREPARATIONAamir Godil
 
Full Mouth Rehabilitation
Full Mouth RehabilitationFull Mouth Rehabilitation
Full Mouth RehabilitationSelf employed
 
Residual Ridge Resorption
Residual Ridge ResorptionResidual Ridge Resorption
Residual Ridge ResorptionSk Aziz Ikbal
 
Gingival finish lines in fixed prosthodontics
Gingival finish lines in fixed prosthodonticsGingival finish lines in fixed prosthodontics
Gingival finish lines in fixed prosthodonticsNAMITHA ANAND
 

Tendances (20)

Post endodontic restoration/ orthodontic continuing education
Post  endodontic restoration/ orthodontic continuing educationPost  endodontic restoration/ orthodontic continuing education
Post endodontic restoration/ orthodontic continuing education
 
Class II Inlay
Class II InlayClass II Inlay
Class II Inlay
 
Post and core
Post and corePost and core
Post and core
 
Bevels in Dental Restorations
Bevels in Dental RestorationsBevels in Dental Restorations
Bevels in Dental Restorations
 
indirect restorations
indirect restorationsindirect restorations
indirect restorations
 
Provisional restoration
Provisional restorationProvisional restoration
Provisional restoration
 
Shade selection for FPD
Shade selection for FPDShade selection for FPD
Shade selection for FPD
 
Resin bonded fixed partial denture
Resin bonded fixed partial dentureResin bonded fixed partial denture
Resin bonded fixed partial denture
 
Techniques of direct composite restoration
Techniques of direct composite restorationTechniques of direct composite restoration
Techniques of direct composite restoration
 
Restoration of endodontically treated teeth
Restoration of endodontically treated teethRestoration of endodontically treated teeth
Restoration of endodontically treated teeth
 
Resin Luting cements (2nd edition)
Resin Luting cements (2nd edition) Resin Luting cements (2nd edition)
Resin Luting cements (2nd edition)
 
Dentin hypersensitivity
Dentin hypersensitivityDentin hypersensitivity
Dentin hypersensitivity
 
Access cavity preparation
Access cavity preparationAccess cavity preparation
Access cavity preparation
 
Laminates & Veneers
Laminates & Veneers Laminates & Veneers
Laminates & Veneers
 
Resin Bonded Bridges
Resin Bonded BridgesResin Bonded Bridges
Resin Bonded Bridges
 
Rationals of endodontics best ppt
Rationals of endodontics best pptRationals of endodontics best ppt
Rationals of endodontics best ppt
 
BIOMECHANICAL PRINCIPLES OF TOOTH PREPARATION
BIOMECHANICAL PRINCIPLES OF TOOTH PREPARATIONBIOMECHANICAL PRINCIPLES OF TOOTH PREPARATION
BIOMECHANICAL PRINCIPLES OF TOOTH PREPARATION
 
Full Mouth Rehabilitation
Full Mouth RehabilitationFull Mouth Rehabilitation
Full Mouth Rehabilitation
 
Residual Ridge Resorption
Residual Ridge ResorptionResidual Ridge Resorption
Residual Ridge Resorption
 
Gingival finish lines in fixed prosthodontics
Gingival finish lines in fixed prosthodonticsGingival finish lines in fixed prosthodontics
Gingival finish lines in fixed prosthodontics
 

Similaire à Factors to Consider for Cavosurface Margin Design in Dental Restorations

1. Introduction To Endodonticsss (1).pdf
1. Introduction To Endodonticsss (1).pdf1. Introduction To Endodonticsss (1).pdf
1. Introduction To Endodonticsss (1).pdfssusere7b3c41
 
Minimally invasive endodontics
Minimally invasive endodonticsMinimally invasive endodontics
Minimally invasive endodonticsNivedha Tina
 
Bio minimalism
Bio minimalismBio minimalism
Bio minimalismPing Lin
 
Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...
Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...
Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...Abu-Hussein Muhamad
 
Periodontal changes in ortho treatment/certified fixed orthodontic courses by...
Periodontal changes in ortho treatment/certified fixed orthodontic courses by...Periodontal changes in ortho treatment/certified fixed orthodontic courses by...
Periodontal changes in ortho treatment/certified fixed orthodontic courses by...Indian dental academy
 
Orthodontic therapy to correct Malocclusion and dentofacial anomalies. Discuss
Orthodontic therapy to correct Malocclusion and dentofacial anomalies. DiscussOrthodontic therapy to correct Malocclusion and dentofacial anomalies. Discuss
Orthodontic therapy to correct Malocclusion and dentofacial anomalies. DiscussOdeyemiKolade
 
Multidisciplinary approach in the rehabilitation of congenitally missing late...
Multidisciplinary approach in the rehabilitation of congenitally missing late...Multidisciplinary approach in the rehabilitation of congenitally missing late...
Multidisciplinary approach in the rehabilitation of congenitally missing late...Abu-Hussein Muhamad
 
PERIODONTAL DXS PPT final
PERIODONTAL DXS PPT finalPERIODONTAL DXS PPT final
PERIODONTAL DXS PPT finalOkoluko Victor
 
Endo ortho interface by DR. JAGADEESH KODITYALA
Endo ortho interface by DR. JAGADEESH KODITYALAEndo ortho interface by DR. JAGADEESH KODITYALA
Endo ortho interface by DR. JAGADEESH KODITYALAJagadeesh Kodityala
 
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTIONMANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTIONAbu-Hussein Muhamad
 
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION Abu-Hussein Muhamad
 
Aggressive periodontitis
Aggressive periodontitisAggressive periodontitis
Aggressive periodontitisLal Babu Kamait
 
Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
 
Dentinalhypersensitivity
DentinalhypersensitivityDentinalhypersensitivity
Dentinalhypersensitivityaasthaminocha
 
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Abu-Hussein Muhamad
 

Similaire à Factors to Consider for Cavosurface Margin Design in Dental Restorations (20)

Non surgical periodontal therapy
Non surgical periodontal therapyNon surgical periodontal therapy
Non surgical periodontal therapy
 
1. Introduction To Endodonticsss (1).pdf
1. Introduction To Endodonticsss (1).pdf1. Introduction To Endodonticsss (1).pdf
1. Introduction To Endodonticsss (1).pdf
 
Minimally invasive endodontics
Minimally invasive endodonticsMinimally invasive endodontics
Minimally invasive endodontics
 
PERIODONTICS 4th stage
PERIODONTICS 4th stagePERIODONTICS 4th stage
PERIODONTICS 4th stage
 
endo-perio.ppt
endo-perio.pptendo-perio.ppt
endo-perio.ppt
 
Bio minimalism
Bio minimalismBio minimalism
Bio minimalism
 
Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...
Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...
Congenitally Missing Upper Laterals. Clinical Considerations: Orthodontic Spa...
 
Periodontal changes in ortho treatment/certified fixed orthodontic courses by...
Periodontal changes in ortho treatment/certified fixed orthodontic courses by...Periodontal changes in ortho treatment/certified fixed orthodontic courses by...
Periodontal changes in ortho treatment/certified fixed orthodontic courses by...
 
Orthodontic therapy to correct Malocclusion and dentofacial anomalies. Discuss
Orthodontic therapy to correct Malocclusion and dentofacial anomalies. DiscussOrthodontic therapy to correct Malocclusion and dentofacial anomalies. Discuss
Orthodontic therapy to correct Malocclusion and dentofacial anomalies. Discuss
 
Multidisciplinary approach in the rehabilitation of congenitally missing late...
Multidisciplinary approach in the rehabilitation of congenitally missing late...Multidisciplinary approach in the rehabilitation of congenitally missing late...
Multidisciplinary approach in the rehabilitation of congenitally missing late...
 
PERIODONTAL DXS PPT final
PERIODONTAL DXS PPT finalPERIODONTAL DXS PPT final
PERIODONTAL DXS PPT final
 
Endo ortho interface by DR. JAGADEESH KODITYALA
Endo ortho interface by DR. JAGADEESH KODITYALAEndo ortho interface by DR. JAGADEESH KODITYALA
Endo ortho interface by DR. JAGADEESH KODITYALA
 
Clinical diagnosis
Clinical diagnosisClinical diagnosis
Clinical diagnosis
 
Endo diagnosis oct2002
Endo diagnosis oct2002Endo diagnosis oct2002
Endo diagnosis oct2002
 
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTIONMANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
 
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
MANAGEMENT OF LOWER SECOND PREMOLAR IMPACTION
 
Aggressive periodontitis
Aggressive periodontitisAggressive periodontitis
Aggressive periodontitis
 
Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Pre prosthetic orthodontic implant for management of congenitally unerupted l...
Pre prosthetic orthodontic implant for management of congenitally unerupted l...
 
Dentinalhypersensitivity
DentinalhypersensitivityDentinalhypersensitivity
Dentinalhypersensitivity
 
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...
 

Plus de Indian dental academy

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian dental academy
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Indian dental academy
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeIndian dental academy
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesIndian dental academy
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Indian dental academy
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  Indian dental academy
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Indian dental academy
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesIndian dental academy
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Indian dental academy
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesIndian dental academy
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Indian dental academy
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesIndian dental academy
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Indian dental academy
 

Plus de Indian dental academy (20)

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdom
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics pratice
 
online fixed orthodontics course
online fixed orthodontics courseonline fixed orthodontics course
online fixed orthodontics course
 
online orthodontics course
online orthodontics courseonline orthodontics course
online orthodontics course
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant courses
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental courses
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic courses
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic courses
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic courses
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry courses
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  
 

Dernier

Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowRiya Pathan
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024Gabriel Guevara MD
 
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...narwatsonia7
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girlsnehamumbai
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...narwatsonia7
 
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknownarwatsonia7
 
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbaisonalikaur4
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingNehru place Escorts
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptxDr.Nusrat Tariq
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.MiadAlsulami
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformKweku Zurek
 
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...narwatsonia7
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Miss joya
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliRewAs ALI
 

Dernier (20)

Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
 
Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024
 
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
Call Girls Frazer Town Just Call 7001305949 Top Class Call Girl Service Avail...
 
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy GirlsCall Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
 
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
 
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
 
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jayanagar Just Call 7001305949 Top Class Call Girl Service Available
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptx
 
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCREscort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
 
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy PlatformSee the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
 
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
Russian Call Girl Brookfield - 7001305949 Escorts Service 50% Off with Cash O...
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas Ali
 

Factors to Consider for Cavosurface Margin Design in Dental Restorations

  • 1. CAVO SURFACE MARGIN IN VARIOUS RESTORATIONS Preparing a tooth to receive a restorative material is a comprehensive endeavor. As routine or mundane as it may seem, many factors affect the appropriate tooth preparation design for a given tooth. These factors must be considered for each restorative procedure contemplated, the end result being that no two preparations are the same. The cavo surface angle is the angle of tooth structure formed by the junction of a prepared (cut) wall and the external surface of the tooth. The actual junction is referred to as cavosurface margin. This seminar highlights on Cavosurface designs of various restorations like amalgam , composite, direct filling gold , glass ionomer restoration, ceramic restoration and cast restorations. It also highlights on types and design features of occlusal and gingival bevels, types and design features of facial and lingual flares, bevels and flares in inlay restoration (primary flare and secondary flare- Its functions and indications ),bevels and flares in onlay restoration, tooth preparation for cast restoration with surface extensions and circumferential tie constituents for extracoronal preparations. Proper tooth preparation is accomplished through systematic procedures based on definite physical and mechanical principles. Moreover, the physical properties and capabilities of the different restorative materials must be appreciated. All of these are determining factors in understanding proper tooth preparation. Without this background knowledge, plus additional information concerning the mechanics of cutting and patient management, the exercise of proper judgment for efficient and proper tooth preparation cannot be achieved .If the principles of tooth preparation are followed, the success of any restoration is greatly achieved
  • 2. CARIOLOGY- ETIOLOGY, CLASSIFICATION, HISTOPATHOLOGY AND CLINICAL FEATURES TEETH ARE TOOLS that have evolved to ensure survival of species. Caries is a biosocial disease rooted in the technology and economy of our society. Dental caries is unique not only in terms of pathological mechanism; other aspects, social and economic, are also worthy of note. The uniqueness of dental caries makes it a fascinating study from a scientific standpoint. Dental caries is defined as an infectious, microbial disease affecting the hard parts of the tooth exposed to the oral cavity, resulting in decalcification of inorganic constituents and dissolution of organic components. This seminar highlights on classification, etiology-early theories and current concepts, clinical features, the concept of caries as a specific microbial infection, properties of cariogenic plaque, concept of critical pH, stephan curve, the role of saliva, nutrition, trace elements and demographic factors on dental caries. It also explains morphological and chemical events of dental caries, histopathology of enamel and dentinal caries, electron microscopic studies of carious enamel and mechanism of enamel caries and cementum caries at chemical level. Caries, because of its uniqueness as a disease, its ubiquitous nature, and its stubborn resistance to resolution remains as one of man’s most common oldest and singly costliest ailment. The total health handicap due to dental caries is staggering. In western countries there has been a dramatic decline in caries over the past decade. But in the economically developing countries caries prevalence is increasing as dietary habits of industrialized nations are adapted. For this reason, it is important that the subject of dental caries is given as broad a readership as possible. Recognition of the enormity of the problem should spur effects to reduce the ravages, the pain and the cost of this disease.
  • 3. PATHOPHYSIOLOGY OF PAIN Word pain is derived from a Greek word “Poine” which mean penalty or punishment Pain is a protective mechanism that occurs when tissues are being damaged. It causes the individual to remove the painful stimulus. It is probably the most fundamental and primitive sensation, distributed more or less all over the body. According to International Association for the Study of Pain (IASP) pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. The different components of pain are sensory, emotional, autonomic and motor. Pain can be felt as superficial or deep pain, referred pain, projected pain, intractable pain and psychogenic pain. There are two theories of referred pain –convergence projection theory and convergence facilitation theory. Pain on a broad scale is divided into Fast pain or acute pain, slow pain or chronic pain and Transient pain. Pain receptors are free, afferent nerve endings of myelinated A-δ and unmyelinated C- fibres that encode the occurrence, intensity duration and location of noxious stimuli and signal pain sensation. Pain receptors are of three types- mechano sensitive, thermo sensitive, chemo sensitive. Hyperalgesia is a decrease in pain threshold in an area of inflammation, such that even trivial stimuli cause pain. Allodynia – Pain from stimuli that are normally not painful This seminar highlights on peripheral and central mechanisms contributing to allodynia & hyperalgesia and various theories explaining mechanism of pain transmission (Specificity theory, Pattern (Central summation) theory, Sensory interaction theory and Gate control theory).
  • 4. Differential Diagnosis of dental pain PULPAL PAIN Hyperactive pulpalgia, Dentinal hypersensitivity, Hyperemia, Acute pulpagia-Incipient, Moderate, Advanced, Chronic pulpalgia and Barodontalgia. PERIRADICULAR PAIN Acute apical periodontitis, Acute apical abscess, Periodontal lesion pain, Gingival abscess, Periodontal abscess and Pericoronitis. The diagnosis and management of pain are foundation skills in clinical dentistry. Although the subject of pain is of considerable significance to all health providers, the simple reality is that many patients consider pain and dentistry to be synonymous. This association is even stronger between dental pulp and pain – to many patients it comes as no surprise that the dental pulp is innervated by pain receptors. So the knowledge about the pain mechanisms of the pulpo – dentin complex helps the clinician to make more accurate diagnosis and to design more effective pain control plans for their patients.
  • 5. MANAGEMENT OF PERFORATION Root canal treatment, like other procedures of dentistry is sometimes associated with unwanted or unforeseen circumstances; these are collectively termed procedural accidents. One such procedural accident is perforation. Perforation is considered as one of the main causes of endodontic failures. Perforation occurs accidentally during the mechanical aspect of endodontic treatment or during subsequent preparation for a post or results from mis orientation or searching for a canal. The main complication that arises from perforation is the potential for secondary inflammatory periodontal involvement and loss of attachment, eventually causing tooth loss. Definition An endodontic perforation may be defined as “An artificial opening in a tooth or its root, created by boring, piercing, cutting or pathologic resorption, which results in a communication between the pulp canal and the periodontal tissues”. Perforations can be classified into coronal, midroot and apical level and can be identified by direct observation, paper points , radiographs, apex locator. Perforations can be repaired by three modalities: non-surgical, micro surgical and combined approach. The four dimensions of perforation are size, level, location and time. The materials used to repair are grouped into: hemostatics, barrier materials (resorbable and non-resorbable) and restoratives. Non-surgical The internal matrix concept in conjunction with the microscope is an efficient and effective technique for treating accessible perforation of 1mm or greater in diameter nonsurgically.This technique involves the placement of biocompatible material into the
  • 6. perforation site to control hemostasis and prevent overfills acting as an internal matrix similar for a class II cavity preparation. Indications for surgery Large perforations, Nonsurgical inaccessibility, Resorption defects, Failure of healing after nonsurgical repair, Large overfills of the defect intracoronally. Intracoronal/surgical approach A combined approach involves repairing the defect intracoronally, then reflecting a surgical flap to remove the inevitable over extension of the repair material from the periodontal space. In the case of failing furcation repairs; bicuspidisation, hemisection, intentional replantation, or root amputation may be considered depending on the level of crestal bone, crown-to-root ratio, and degree of root divergence. All perforations adversely affect prognosis, some doom the tooth to extraction. So knowledge of the etiologic factors involved in procedural accidents is essential for their prevention. In addition, methods of Recognition and treatment as well the effects of such accidents on prognosis must be learned. Most problems can be avoided by adhering to the basic principles of diagnosis, treatment planning, access preparation, cleaning and shaping, obturation and post space preparation.
  • 7. CLEANING & SHAPING OF ROOT CANAL SYSTEM WITH HAND INSTRUMENTS Cleaning and shaping are the basics of endodontic therapy. Most obturation problems are really problems of cleaning and shaping. Even simple canals that are poorly shaped are difficult to obturate properly, whereas extremely complex root canal systems can be obturated properly if the shaping has been accomplished skillfully. Over the years, there has been a gradual change in the ideal configuration of a prepared root canal. At onetime, the suggested shape was round and tapered, almost parallel. After Schilder’s classic description of “cleaning and shaping,” the more accepted shape for the finished canal has become a gradually increasing taper, with the smallest diameter at the apical constricture, terminating larger at the coronal orifice Cleaning; refers to the removal of all contents of the root canal system before and during shaping: organic substrates, microflora, bacterial byproducts, food, caries, denticles, pulp stones, dense collagen, previous root canal filling material, and dentinal filings resulting from root canal preparation. Shaping; During this process, instrumentation must give the system a form that will ensure tissue removal and a shape that will enhance total filling of the root canal system in three dimensions. Inadequate shaping causes inadequate obturation. Shaping enlarges the canal’s diameter and smoothes the walls as it removes crevices, fissures, and irregularities from the system. Cleaning is a combined chemical and mechanical process, while shaping is purely a mechanical one. This seminar highlights on pulpectomy, various irrigants used for cleaning and their importance, precurving, anticurvature filing, different motions (filing, reaming, watch-winding, turn and pull) and methods of cleaning and shaping with hand instruments (step-back, modified step-back, step-down, modified crown-down, double- flared, crown-down pressureless, canal master technique ) with emphasis on balanced force concept.
  • 8. NON SURGICAL ENDODONTIC RETREATMENT Despite new materials, innovative techniques and a plethora of novel devices, the continuing growth and trend towards more complex forms of endodontics has been accompanied by an increasing need to manage endodontic failures. Such failures pose many, varied challenges which, if successfully overcome, can be both professionally rewarding and a real practice builder. Rationale for retreatment • Endodontic failures can be attributable to inadequacies in cleaning, shaping, and Obturation, iatrogenic events, (or) reinfection of the root canal system when the coronal seal is lost after completion of root canal treatment. • The rationale for nonsurgical retreatment is to remove the root canal space as a source of irritation to the attachment apparatus. Non-Surgical Versus Surgical Retreatment "When failure has occurred after root canal treatment, surgical retreatment should not be chosen as the first treatment option until the possibility of non-surgical retreatment has been ruled out. This seminar highlights on different modalities of Coronal disassembly, identification of missed canals, removal of various obturation materials, techniques of post removal, broken instrument removal, methods to overcome blocks, ledges and apical transportations and managing endodontic perforations.
  • 9. Surgical retreatment encompasses a number of procedures, referred to synonymously as: · periapical curettage/periradicular curettage · apicectomy/root end resection/apical resection · root-end filling/retrograde filling · surgical repair · root resection/root amputation · hemisection/bicuspidization. With a continuing improvement in oral health and a change in patient attitude, it is no longer acceptable to extract teeth simply because of periapical disease and endodontic failure. Advances in scientific knowledge and technical skills have helped improve the prognosis of treatment, but it may not always lead to the desired healing response in clinical practice. If initial treatment is unsuccessful, practitioners are increasingly expected to possess the necessary knowledge and skills to perform ever more technically demanding procedures to save teeth. The focus on evidence-based treatment has resulted in secondary care providers, such as local oral surgery units, no longer being willing unquestioningly to accept failing endodontic cases for surgery, prior to an attempt having been made to retreat by non-surgical means
  • 10. IMPRESSION MATERIALS AND TECHNIQUE FOR INDIRECT RESTORATION Dental impression is a negative record of the tissues of mouth. Impression materials are used to record the surface topography and detail of hard and soft tissues, and thereby produce a mold for making a replica (cast) of those structures. Hydrocolloids and synthetic elastomers are among the materials most commonly used to make impressions of the various areas of the dental arch. The accuracy of fit and functional efficiency of the restoration depends on how well the cast replicates the natural oral tissue, hence it is of great importance that inaccuracies are minimized at this stage otherwise, they will be carried through and possibly compounded later on. The indirect technique for fabricating cast restorations is the most common technique now in use. This is due to the vast improvement in impression materials in the past thirty years. So the clinician must be aware of new materials available in the market and ensure appropriate technique for obtaining accurate casts.