Protocol
Restorative VI. 5th year
Simulated part
Name and surname:
Identity number:
Date:
1. Cavity class II. OD for amalgam on the tooth 26
2. Cavity class II. for composite, tooth 35 MOD make a filling
3. Cavity class III.. tooth 21 mesially and distally, make a filling
4. Cavity class V. for composite tooth 21, make a filling.
5. Cavity class V. for GIC, tooth 26, make a filling
6.
Cavity class II. for Ag
Cavity class II. for
composite
Cavity class III.. tooth
21 mesilly – prep.filling
Cavity class III.. tooth
21 distally –
prep.filling,
Class V.preparation,
filling
Protokol praktické výuky
Restorative VI. 5th year
Clinical part + enclose socumentation of the patient (signed by the teacher)
Name and surname:
Identity number:
Date Pacient Diagnosis Treatment Code
Stamp and
signature