Patient assesment Clinical examination Diagnosis lenka.roubalikova@tiscali.cz Clinical examination Hands on process of observing both normal and abnormal conditions. lenka.roubalikova@tiscali.cz Diagnosis Determination and judgement of variations from normal. lenka.roubalikova@tiscali.cz Precautions Standard precautions to avoid the transmission of disease. lenka.roubalikova@tiscali.cz Standard precautions to avoid the transmission of disease. Sterilization of all instruments, supplies, desinfection of operátory surfaces, barrier techniques / gloves, masks, protective eyewear, gowns, lenka.roubalikova@tiscali.cz Cursory examination Tooth alignment, occlusal relationship. lenka.roubalikova@tiscali.cz Charting and records Identification data Medical history Dental history Clinical examination Diagnosis Treatment planning Documentation of informed consent Completion notes lenka.roubalikova@tiscali.cz Charting and records Teeth denotation Periodontal status Oral mucosa status Systemic diseases Medication Other notes lenka.roubalikova@tiscali.cz Charting and records the most important notation Caries / Filling P Tooth for extraction X Extracted tooth + Crown Pontic n n Tooth in removable denture 0 lenka.roubalikova@tiscali.cz Instruments for investigation -investigative instruments Explorer (probe): Sharp, straight or bow shaped: Caries detection - Ight motion without any pressure: dental surfaces, fillings. Periodontal explorer (probe): not sharp, calibrated, investigation of periodontal pockets lenka.roubalikova@tiscali.cz Instruments for investigation -investigative instruments irror - flat or concave To see less available regions To illuminate To move off soft tissues (cheeks, tongue etc.) lenka.roubalikova@tiscali.cz 7 Instruments for investigation -investigative instruments Tweezer To grip various instruments and supplies. lenka.roubalikova@tiscali.cz Examination Clinical Radiografic examination Adjunctive examination illumination, percusion test, palpation, thermal test, electric pulp test, test preparation. Instruments for cavity preparation Hand instruments for cutting Two main materuials: Stainless steel (loses keen edge) Carbon steel (corrode) Excavator Chisel lenka.roubalikova@tiscali.cz Instruments for cavity preparation Power driven instruments for cutting - Rotary instruments Comon design characteristics shank neck lenka.roubalikova@tiscali.cz Shank The part that fits into the handpiece Accepts the rotary motion from the handpiece Provides a bearing surface to control the alignment and concentricity of the instrument lenka.roubalikova@tiscali.cz Straight handpiece shank - Simple cylinder held in the handpiece in a metal chuck Latch angle handpiece shank Shorter length - access to posterior regions Handpiece - contra angle, metal bur tube. The end of the instrument fits into D-shaped socket at the bottom of the bur tube. The instrument retained by a retaining latch that slides into the groove found at the shank end of the instruments. Low and medium speed 18 Friction grip handpiece shank Smaller design, simple cylinder. Held in the handpiece by friction in plastic or metal chuck. lenka.roubalikova@tiscali.cz Neck design Intermediate portion opf an instrument that connects the head to the shak Tapered, shorter or longer. lenka.roubalikova@tiscali.cz Head design Burs - cut of steel or tungsten carbid Diamond (diamond burs)- covered with the diamond bort lenka.roubalikova@tiscali.cz Head design Burs classification systém Round Inverted cone Pear shaped Straight fisure Tapered fissure HE 7-34 Basic bur head sha lenka.roubalikova@tiscali.cz Bur blade design Rake face (towards the direction of cutting) Clearence face ,TO AXIS OF BUB Rake angle - slightly negative Edge angle - appr 90° Clearence angle Clearence face rounded or two surfaces '/ A ^'CLEARANCE ANGLE RAKE FACE CLEARANCE FACE DIRECTION OF ROTATION Head design Diamond classification systém Round Inverted cone Pear shaped Cylinder Taper Lens Needle etc. lenka.roubalikova@tiscali.cz Diamond abrasive instruments Diamond bort - small aharp particles in softer matrix. Cutting occurs at a large number of points. Metal blank Diamond powder Metallic bonding material 26 Preparation speed Low (slow) speeds - below 12.000rpm Medium or intermediate speeds 12.000 -200.000 rpm High or ultrahigh speeds above 200.000 rpm \ 1:1 Gear assembly SSs Speed increasing gear MG jjpj ■ %^ /'' ^ ■:^1 ŕjj^, ' ■: ■ Ifr/f^ PH fiás í ^'Sp^f^!pT7^^,fe*řu*™^^ KSH§ ^ 1 Green ring: 2,7:1 2 Green rings: 7,4:1 Speed decreasing gear 30 Jf% Spitting box with amalgam separator Light )riving system Tray 31 ,E » ill III IIA« Hfl ■ ■HflJ 4ÍS '*. >J Hoses lower leading 32 Hoses - uper leading