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OPERATIVE

DENTISTRY It is the art and science that relates to the diagnosis, treatment and prognosis of those defects of teeth which do not requires full coverage for correction; to the restoration of proper tooth form, functions, and aesthetics and maintenance of physiological integrity of the teeth in harmonious relationship with the adjacent hard and soft tissues; all to enhance the general health and welfare of the patient. INDICATIONS FOR OPERATIVE PROCEDURES CARIES MALFORMED, DISCOLORED, FRACTURED TEETH REPLACEMENT NEEDS CONSIDERATIONS THAT MUST BE UNDERTAKEN BEFORE ANY OPERATIVE TREATMENT Thorough examination of the affected tooth and the oral and systemic health of the patient. Diagnosis of the problem that recognizes the interaction of the affected area with other bodily tissues. Treatment plan that has the potential to return the affected area to a state of health and function Understanding of the material to be used Understanding of the oral environment into which the restoration will be placed Biological knowledge necessary to make the previously mentioned determination Understanding of the biological basis and function of various tooth components and supporting tissues. Appreciation for a knowledge of correct dental anatomy Effect of the operative procedure on the treatment of other disciplines STRUCTURES OF THE TEETH Enamel - outer covering of the tooth 1. Enamel Tufts are hypo-mineralized structures that project between adjacent groups of enamel rods from DEJ. May play a role in the spread of caries. 2. Enamel Spindles are the thickened ends of odontoblastic processes which sometimes cross the DEJ into the enamel. It serve as pain receptors. 3. Enamel Lamellae are thin, leaf like faults between enamel rod groups that extend from the enamel surface toward the DEJ, sometimes extending into the dentin. Mostly contains organic materials.

4. DEJ is scalloped or wavy in outline with the crest of the waves penetrating toward the enamel 5. Nasmyths Membrane covers the newly erupted tooth and in sworn away by mastication and cleaning. The membrane is replaced by an organic deposit called PELLICLE which is a precipitate of salivary proteins. Dentin serve as shock absorber of the tooth 1. Primary Dentin is that dentin formed before and shortly after eruption. 2. Secondary dentin is a continuation of primary dentin that forms at a lower rate as the tooth ages physiologically. 3. Reparative or Tertiary Dentin is formed by replacement or secondary odontoblasts in response to Irritation caused by attrition, abrasion, erosion, trauma, some operative procedures and other irritants. It is a defense reaction to an area of injury 4. Sclerotic or transparent or peritubullar dentin result from aging or mild irritation and can cause change in the composition of primary dentin. Commonly seen under old restoration and maybe discolored Cementum is a light yellow and slightly lighter than dentin. It has the highest content of fluoride of all mineralized tissues Pulp is is a specialized connective tissue that occupies the pulp cavity in the tooth FUNCTIONS Formative / developmental Nutritive Sensory Denfensive PHYSIOLOGY OF TOOTH FORM Four Main Functions of the Teeth Mastication Aesthetics Speech Protection of the Supporting Tissue

Embrasures of the Tooth Facial Lingual Incisal and Occlusal Gingival Periodontium Gingival Unit Free Gingiva Attached Gingiva Alveolar Mucosa

Attachment Apparatus Cementum Periodontal Ligaments alveolar process