lenka.roubalikova@tiscali.cz 1 PreclinicalPreclinical DentistryDentistry I.I. DentalDental CariesCaries NonNon cariouscarious lesionslesions: trauma,: trauma, erosionerosion.. abrasionabrasion,, wedgewedge shapedshaped defectsdefects LenkaLenka RoubalíkováRoubalíková lenka.roubalikova@tiscali.cz 2 UnderstandingUnderstanding dentaldental cariescaries lenka.roubalikova@tiscali.cz 3 crown neck root pulp chamber root canal lenka.roubalikova@tiscali.cz 4 Dental Tissues Enamel Dentin Cementum Periodontal ligament Alveolar bone Pulp Gingiva lenka.roubalikova@tiscali.cz 5 tooth microbs sugar time Dental caries caries lenka.roubalikova@tiscali.cz 6 DentalDental CariesCaries InfectiousInfectious microbiologicalmicrobiological diseasedisease ofof thethe teethteeth thatthat resultsresults inin localizedlocalized dissolutiondissolution andand destructiondestruction ofof thethe calcifiedcalcified tissuestissues lenka.roubalikova@tiscali.cz 7 BiofilmBiofilm –– DentalDental PlaquePlaque ComplexComplex communitycommunity SimpleSimple circulationcirculation Better conditions to survive lenka.roubalikova@tiscali.cz 8 DentalDental BiofilmBiofilm –– DentalDental PlaquePlaque AA gelatinousgelatinous massmass ofof bacteriabacteria adheringadhering toto thethe toothtooth surfacesurface.. No shedding lenka.roubalikova@tiscali.cz 9 DentalDental biofilmbiofilm AdhesionAdhesion ColonisationColonisation MaturationMaturation lenka.roubalikova@tiscali.cz 10 SugarSugar FermentableFermentable (mono(mono--,, didi-- tritri-- sacharidessacharides)) Sucrose, glucose, lactose Acids Demineralization lenka.roubalikova@tiscali.cz 11 Dissolution–demineralization Time Cavitated lesion Non – cavitated lesion lenka.roubalikova@tiscali.cz 12 SalivaSaliva PlaquePlaque formationformation MicrobialMicrobial sourcesource MineralMineral sourcesource MicrobialMicrobial clearenceclearence BufferBuffer capacitycapacity lenka.roubalikova@tiscali.cz 13 PredictablePredictable dirtydirty placesplaces PitsPits andand fissuresfissures ProximalProximal surfacessurfaces CervicalCervical areaarea NoNo selfself cleaningcleaning lenka.roubalikova@tiscali.cz 14 PredictablePredictable cleanclean placesplaces CuspsCusps ProximalProximal ridgeridge IncisalIncisal edgeedge BuccalBuccal oror oraloral surfacesurface uponupon thethe maximalmaximal convexityconvexity ProximalProximal surfacesurface uponupon tjetje SelfSelf cleaningcleaning lenka.roubalikova@tiscali.cz 15 CariesCaries -- depthdepth SurfaceSurface cariescaries ((cariescaries superficialissuperficialis)) MiddleMiddle cariescaries ((cariescaries media)media) CariesCaries closeclose to pulp (to pulp (cariescaries pulpaepulpae proximaproxima)) CariesCaries penetratingpenetrating intointo thethe pulp (pulp (cariescaries adad pulpampulpam penetranspenetrans)) lenka.roubalikova@tiscali.cz 16 lenka.roubalikova@tiscali.cz 17 lenka.roubalikova@tiscali.cz 18 CariesCaries -- TopographyTopography CoronalCoronal cariescaries RootRoot surfacesurface cariescaries EnamelEnamel cariescaries DentinDentin cariescaries CementumCementum cariescaries lenka.roubalikova@tiscali.cz 19 CariesCaries AcuteAcute ChronicChronic ArrestedArrested PenetratingPenetrating UnderminingUndermining Acc to its history lenka.roubalikova@tiscali.cz 20 PrimaryPrimary cariescaries SecondarySecondary cariescaries RecurrentRecurrent cariescaries lenka.roubalikova@tiscali.cz 21 PatientPatient assesmentassesment Clinical examinationClinical examination DiagnosisDiagnosis lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 22 DiagnosisDiagnosis ofof dentaldental cariescaries lenka.roubalikova@tiscali.cz 23 lenka.roubalikova@tiscali.cz 24 InvestigationInvestigation MirrorMirror SharpSharp ProbeProbe IllimunationIllimunation MagnificationMagnification XX-- rayray,, otherother methodsmethods i.e.i.e. transilluminationtransillumination,, infraredinfrared laserlaser fluorescencyfluorescency Dark spot, hole, defect lenka.roubalikova@tiscali.cz 25 DentalDental CariesCaries -- TreatmentTreatment NonNon cavitatedcavitated lesionlesion:: OnOn molecularmolecular basisbasis -- DentalDental hygienehygiene -- FluoridesFluorides,, CalciumCalcium,, PhosphatesPhosphates -- DietDiet -- AntimicrobialAntimicrobial agentsagents lenka.roubalikova@tiscali.cz 26 DentalDental CariesCaries -- TreatmentTreatment CavitatedCavitated lesionlesion:: PreparationPreparation FillingFilling Drill anf fill lenka.roubalikova@tiscali.cz 27 PreparationPreparation InstrumentalInstrumental treatmenttreatment RemoveRemove cariescaries LeaveLeave thethe restrest ofof thethe dentaldental tissuestissues -- toto bebe restoredrestored -- toto bebe resistentresistent againstagainst thethe bitebite forcesforces -- toto bebe preventedprevented againstagainst thethe recurrentrecurrent cariescaries ((BlackBlack 1914)1914) lenka.roubalikova@tiscali.cz 28 ClassificationClassification ofof cavitiescavities accordingaccording toto BlackBlack lenka.roubalikova@tiscali.cz 29 ClassClass I.I. CariesCaries inin fissuresfissures andand pitspits –– occlusalocclusal surfacessurfaces ofof premolarspremolars andand molarsmolars lenka.roubalikova@tiscali.cz 30 ClassClass II.II. ProximalProximal surfacessurfaces ofof molarsmolars andand premolarspremolars lenka.roubalikova@tiscali.cz 31 ClassClass III.III. ProximalProximal surfacessurfaces ofof incisorsincisors andand caninescanines withoutwithout lossloss ofof thethe incisalincisal edgeedge lenka.roubalikova@tiscali.cz 32 ClassClass IVIV ProximalProximal surfacessurfaces ofof incisorsincisors andand caninescanines withwith thethe lossloss ofof incisalincisal edgeedge lenka.roubalikova@tiscali.cz 33 ClassClass V.V. CervicalCervical areaarea lenka.roubalikova@tiscali.cz 34 Charting and recordsCharting and records thethe mostmost importantimportant notationnotation CariesCaries // FillingFilling PP ToothTooth forfor extractionextraction XX ExtractedExtracted toothtooth ++ CrownCrown PonticPontic ToothTooth inin removableremovable denturedenture 00 lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 35 InstrumentsInstruments forfor investigationinvestigation –– investigativeinvestigative instrumentsinstruments Explorer (Explorer (probeprobe):): Sharp,Sharp, straightstraight oror bowbow shapedshaped:: CariesCaries detectiondetection –– lghtlght motionmotion withoutwithout anyany pressurepressure: dental: dental surfacessurfaces,, fillingsfillings.. PeriodontalPeriodontal explorerexplorer ((probeprobe): not): not sharpsharp,, calibratedcalibrated,, investigationinvestigation ofof periodontalperiodontal pocketspockets lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 36 InstrumentsInstruments forfor investigationinvestigation –– investigativeinvestigative instrumentsinstruments MirrorMirror –– flatflat oror concaveconcave ToTo seesee lessless availableavailable regionsregions ToTo illuminateilluminate ToTo movemove offoff softsoft tissuestissues ((cheekscheeks,, tonguetongue etcetc.).) lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 37 InstrumentsInstruments forfor investigationinvestigation –– investigativeinvestigative instrumentsinstruments TweezerTweezer ToTo gripgrip variousvarious instrumentsinstruments andand suppliessupplies.. lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 38 InstrumentsInstruments forfor cavitycavity preparationpreparation HandHand instrumentsinstruments forfor cuttingcutting TwoTwo mainmain materialsmaterials:: StainlessStainless steelsteel ((losesloses keenkeen edgeedge)) CarbonCarbon steelsteel ((corrodecorrode)) ExcavatorExcavator ChiselChisel-- cleavercleaver lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 39 InstrumentsInstruments forfor cavitycavity preparationpreparation PowerPower drivendriven instrumentsinstruments forfor cuttingcutting -- RotaryRotary instrumentsinstruments ComonComon designdesign characteristicscharacteristics lenka.roubalikova@tiscali.cz shank neck head lenka.roubalikova@tiscali.cz 40 ShankShank TheThe partpart thatthat fitsfits intointo thethe handpiecehandpiece AcceptsAccepts thethe rotaryrotary motionmotion fromfrom thethe handpiecehandpiece ProvidesProvides aa bearingbearing surfacesurface toto controlcontrol thethe alignmentalignment andand concentricityconcentricity ofof thethe instrumentinstrument lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 41 StraightStraight handpiecehandpiece shankshank SimpleSimple cylindercylinder heldheld inin thethe handpiecehandpiece in a metalin a metal chuckchuck lenka.roubalikova@tiscali.cz 42 LatchLatch angleangle handpiecehandpiece shankshank ShorterShorter lengthlength –– accessaccess toto posteriorposterior regionsregions HandpieceHandpiece –– contracontra angleangle, metal, metal burbur tube.tube. TheThe endend ofof thethe instrumentinstrument fitsfits intointo DD--shapedshaped socketsocket atat thethe bottombottom ofof thethe burbur tube.tube. TheThe instrumentinstrument retainedretained by aby a retainingretaining latchlatch thatthat slidesslides intointo thethe groovegroove foundfound atat thethe shankshank endend ofof thethe instrumentsinstruments.. Low and medium speed lenka.roubalikova@tiscali.cz 43 FrictionFriction gripgrip handpiecehandpiece shankshank SmallerSmaller design,design, simplesimple cylindercylinder.. HeldHeld inin thethe handpiecehandpiece byby frictionfriction inin plasticplastic oror metalmetal chuckchuck.. lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 44 NeckNeck designdesign IntermediateIntermediate portionportion ofof anan instrumentinstrument thatthat connectsconnects thethe headhead toto thethe shakshak TaperedTapered,, shortershorter oror longerlonger.. lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 45 HeadHead designdesign BursBurs –– cutcut ofof steelsteel oror tungstentungsten carbidcarbid DiamondDiamond ((diamonddiamond burs)burs)–– coveredcovered withwith thethe diamonddiamond bortbort lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 46 HeadHead designdesign BursBurs classificationclassification systémsystém RoundRound InvertedInverted conecone PearPear shapedshaped StraightStraight fisurefisure TaperedTapered fissurefissure lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 47 BurBur bladeblade designdesign RakeRake face (face (towardstowards thethe directiondirection ofof cuttingcutting)) ClearenceClearence faceface RakeRake angleangle –– slightlyslightly negativenegative EdgeEdge angleangle –– apprappr 90°90° ClearenceClearence angleangle ClearenceClearence faceface roundedrounded oror twotwo surfacessurfaces.. lenka.roubalikova@tiscali.cz 48 HeadHead designdesign DiamondDiamond classificationclassification systémsystém RoundRound InvertedInverted conecone PearPear shapedshaped CylinderCylinder TaperTaper LensLens NeedleNeedle etcetc.. lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz 49 DiamondDiamond abrasiveabrasive instrumentsinstruments DiamondDiamond bortbort –– smallsmall aharpaharp particlesparticles inin softersofter matrix.matrix. CuttingCutting occursoccurs atat aa largelarge numbernumber ofof pointspoints.. MetalMetal blankblank DiamondDiamond powderpowder MetallicMetallic bondingbonding materialmaterial lenka.roubalikova@tiscali.cz 50 PreparationPreparation speedspeed LowLow ((slowslow)) speedsspeeds –– belowbelow 12.00012.000 rpmrpm MediumMedium oror intermediateintermediate speedsspeeds 12.00012.000 –– 200.000200.000 rpmrpm HighHigh oror ultrahighultrahigh speedsspeeds aboveabove 200.000200.000 rpmrpm lenka.roubalikova@tiscali.cz 51 1 : 1 Gear assembly lenka.roubalikova@tiscali.cz 52 1:4 až 1:5 Speed increasing gear lenka.roubalikova@tiscali.cz 53 1 Green ring: 2,7:1 2 Green rings: 7,4:1 Speed decreasing gear lenka.roubalikova@tiscali.cz 54 Spitting box with amalgam separator Light Driving system Tray lenka.roubalikova@tiscali.cz 55 Hoses lower leading lenka.roubalikova@tiscali.cz 56 Hoses – uper leading lenka.roubalikova@tiscali.cz 57 lenka.roubalikova@tiscali.cz 58 CavityCavity preparationpreparation PowerPower drivendriven HandHand lenka.roubalikova@tiscali.cz 59 400.000400.000 rpmrpm lenka.roubalikova@tiscali.cz 60 Electromotors – maximum 40.000/min Airmotors – maximum 20.000/min Gearing to fast speed Gearing to slow speed Oscillation lenka.roubalikova@tiscali.cz 61 1 : 1 as far as 40.000 rpm lenka.roubalikova@tiscali.cz 62 RedRed codedcoded handpiecehandpiece 1:4 až 1:5 as far as 160.000 – 200.000 rpm lenka.roubalikova@tiscali.cz 63 Preparace strojováPreparace strojová -- pohonypohony 2,7:1 7,4:1 lenka.roubalikova@tiscali.cz 64 BlueBlue andand greengreen codedcoded handpiecehandpiece lenka.roubalikova@tiscali.cz 65 HanpiecesHanpieces combinedcombined 1:1 2:1 nerotuje lenka.roubalikova@tiscali.cz 66 ISO 6360 lenka.roubalikova@tiscali.cz 67 lenka.roubalikova@tiscali.cz 68 FillingFilling materialsmaterials TemporaryTemporary ZinkoxidsulphateZinkoxidsulphate cementcement OneOne componentcomponent cementscements basedbased onon gypsumgypsum andand organicorganic lutelute ZinoxidphosphateZinoxidphosphate cementcement DefinitiveDefinitive AmalgamAmalgam CompositesComposites lenka.roubalikova@tiscali.cz 69 FillingFilling materialsmaterials Amalgam:Amalgam: MercuryMercury PowderPowder –– metalmetal alloyalloy:: SilverSilver TinTin CopperCopper ZincZinc lenka.roubalikova@tiscali.cz 70 ChiselChisel –– forfor enamelenamel CleaverCleaver lenka.roubalikova@tiscali.cz 71 ChiselChisel forfor enamelenamel lenka.roubalikova@tiscali.cz 72 ExcavatorExcavator lenka.roubalikova@tiscali.cz 73 FillingFilling instrumentsinstruments lenka.roubalikova@tiscali.cz 74 BurnisherBurnisher --planeplane AngularAngular-- troughtrough edgeedge troughtrough faceface lenka.roubalikova@tiscali.cz 75 BurnisherBurnisher –– angularangular threethree faceface lenka.roubalikova@tiscali.cz 76 CondensorCondensor andand burnisherburnisher combinedcombined lenka.roubalikova@tiscali.cz 77 AmalgamAmalgam carriercarrier lenka.roubalikova@tiscali.cz 78 CondensorCondensor forfor amalgamamalgam lenka.roubalikova@tiscali.cz 79 CondensorCondensor forfor guttaprechaguttaprecha -- hoofhoof lenka.roubalikova@tiscali.cz 80 BallBall condensorcondensor lenka.roubalikova@tiscali.cz 81 CondensorCondensor ––stamenstamen lenka.roubalikova@tiscali.cz 82 FosterflaggFosterflagg lenka.roubalikova@tiscali.cz 83 FrahmFrahm lenka.roubalikova@tiscali.cz 84 CarverCarver:: DiscoidDiscoid -- CleoidCleoid