Patient assesment Clinical examination Diagnosis Clinical examination Hands on process of observing both normal and abnormal conditions. Diagnosis Determination and judgement of variations from normal. Precautions Standard precautions to avoid the transmission of disease. Standard precautions to avoid the transmission of disease. Sterilization of all instruments, supplies, desinfection of operatory surfaces, barrier techniques / gloves, masks, protective eyewear, gowns, Cursory examination Tooth alignment, occlusal relationship. Charting and records • Identification data • Medical history • Dental history • Clinical examination • Diagnosis • Treatment planning • Documentation of informed consent • Completion notes Charting and records • Teeth denotation • Periodontal status • Oral mucosa status • Systemic diseases • Medication • Other notes Charting and records the most important notation • Caries / • Filling P • Tooth for extraction X • Extracted tooth + • Crown • Pontic • Tooth in removable denture 0 Instruments for investigation – investigative instruments Explorer (probe): Sharp, straight or bow shaped: Caries detection – lght motion without any pressure: dental surfaces, fillings. Periodontal explorer (probe): not sharp, calibrated, investigation of periodontal pockets Instruments for investigation – investigative instruments Mirror – flat or concave • To see less available regions • To illuminate • To move off soft tissues (cheeks, tongue etc.) Instruments for investigation – investigative instruments Tweezer To grip various instruments and supplies. 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 Instruments for cavity preparation Power driven instruments for cutting - Rotary instruments Comon design characteristics 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 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. Friction grip handpiece shank Smaller design, simple cylinder. Held in the handpiece by friction in plastic or metal chuck. Neck design Intermediate portion opf an instrument that connects the head to the shak Tapered, shorter or longer. Head design Burs – cut of steel or tungsten carbid Diamond (diamond burs)– covered with the diamond bort Head design Burs classification systém Round Inverted cone Pear shaped Straight fisure Tapered fissure Bur blade design • Rake face (towards the direction of cutting) • Clearence face Rake angle – slightly negative Edge angle – appr 90° Clearence angle Clearence face rounded or two surfaces. Head design Diamond classification systém Round Inverted cone Pear shaped Cylinder Taper Lens Needle etc. 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 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