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 P R E - C L I N I C A L O P E R A T I V E D E N T I S T R Y

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INTRODUCTION TO OPERATIVE DENTISTRY
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Y A S S E R A L I A L M O RT A D A A L W A S I F I
C O P Y R I G H T © 2 0 2 4 , A L W A S I F I , Y . A . A L L R I G H T S R E S E R V E D
B D S , M S C , D D S , P H D
 - Egyptian dentist
- Researcher, Educator & International Lecturer

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- Founder of LEARN - DENTAL SERIES @ YouTube

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- Presentation skills coach

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- Painter
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- Life long learner -
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 3
DISCLAIMER
STATEMENT

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I don’t receive fees, compensation or royalties from the sales of any of the

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products shown or discussed. Also, I declare that I haven't any conflict of interest

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with any of the discussed products and techniques.

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24 All products, equipment and techniques presented are those most commonly

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used in professional restorative clinical practice. Finally, this presentation has not
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been sponsored by any company, agency or organization and is only prepared for
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educational purposes.
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Yasser Alwasifi
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 4
COPYRIGHT

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Copyright © 2024. All rights reserved. No part of this presentation may be

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reproduced, distributed, or transmitted in any form or by any means, including

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copying, recording, or other electronic or mechanical methods, without the prior

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written permission of the author.

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Yasser Alwasifi
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 5
EXCEPECTED
O U T C O M E S

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By the end of this presentation, you are expected to:

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1. Define operative dentistry

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2. Recognize the objectives and scopes of operative dentistry

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24 3. Differentiate between the different lesions affecting calcified tooth structure

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4. Differentiate between cavity and prepared cavity
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5. Classify cavities and prepared cavities
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6. List the components of prepared cavity
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 6
C O N T E N T S PART I: INTRODUCTION 8

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I.A. DEFINITION 9

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I.B. OBJECTIVES 12

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I.C. SCOPE 18

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I.D. LESIONS AFFECTING CALCIFIED TOOTH STRUCTURE 22

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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 7

C O N T E N T S PART II: CAVITY & PREPARED CAVITY 71

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II.A. CAVITY NOMENCLATURE 72

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II.B. CAVITY CLASSIFICATIONS 77

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II.B.1. SURFACE ANATOMY 79

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II.B.2. NUMBER OF INVOLVED SURFACES 82

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II.B.3. G.V. BLACK’S CLASSIFICATION 85

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II.B.4. SI / STA CLASSIFICATION 99
II.C. COMPONENTS OF PREPARED CAVITY 105
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 8

 .

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PART I: INTRODUCTION
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 9
I. INTRODUCTION I.A. DEFINITION
I.B. OBJECTIVES

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I.C. SCOPE

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I.D. LESIONS AFFECTING CALCIFIED TOOTH STRUCTURES

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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 10
I.A. DEFINITION

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WHAT ? WHEN ? HOW ? WHY ?
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• Calcified tooth structure • Defective or Lost • D i a g n o s i s , Tr e a t m e n t , • Goals, Aims, Objectives
(Enamel, Dentin or Elimination, Restoration &
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Cementum) Prevention
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 11
I.A. DEFINITION

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• OPERATIVE DENTISTRY IS:

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“The art and science concerned with all procedures,

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whereby defects of hard tooth structures are diagnosed,

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eliminated, treated and prevented, and the lost tooth
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structures are restored”
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 12
I. INTRODUCTION I.A. DEFINITION
I.B. OBJECTIVES

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I.C. SCOPE

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I.D. LESIONS AFFECTING CALCIFIED TOOTH STRUCTURES

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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 13
I.B. OBJECTIVES

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• What is the expected drawbacks if the calcified

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tooth structure is defective or lost:

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1. Pain

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2. Improper mastication
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3. Food impaction with subsequent gingival and
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periodontal problems
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4. Teeth migration that affects arch integrity
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5. Speech problems
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6. Esthetic problems
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 14
I.B. OBJECTIVES

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• PATIENT NEEDS

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1. ASYMPTOMATIC

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2. FUNCTIONING
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3. WITHOUT PATHOSIS
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AFFECTED TOOTH
C BIOLOGICALLY ACCEPTABLE TOOTH

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 15

I.B. OBJECTIVES

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1. Restoration of health:

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• Complete elimination of the lesion and defective

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tissues

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• Application of suitable prevention program

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• Protection of remaining tooth structure both
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biologically and mechanically
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 16
I.B. OBJECTIVES

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2. Restoration of efficient and comfortable 3. Restoration of esthetics:

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mastication: • Elimination of defective tissues as well as

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• The restoration should be securely retained and reproduction of normal harmonious color, size,

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sufficiently strong to sustain mastication forces form, translucency and surface texture

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• The restoration should be biocompatible, and must
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not inflict any irritational consequences on the teeth, alignment, inter-arch relationship, and ensuring of
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investing tissues, muscles of mastication and TMJ healthy soft tissue form and relation
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 17
I.B. OBJECTIVES

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4. Restoration of normal occlusion:

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• This requires restoration of harmonious biologic • Furthermore, occlusal interference must be

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occlusion including a stable centric occlusion, eliminated, and minor departure from normal tooth

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correct vertical dimension, physiologic axial contour, position, alignment or inter-cuspation should be

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inter-proximal contacts and embrasures, compatible
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ridge height, and proper cusp-fossa development
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 18
I. INTRODUCTION I.A. DEFINITION
I.B. OBJECTIVES

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I.C. SCOPE

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IF

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I.D. LESIONS AFFECTING CALCIFIED TOOTH STRUCTURES

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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 19
I.C. SCOPE

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1. Diagnosis and clinical assessment of patient’s 2. Outlining the treatment plan in a logical

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problem(s): sequential order of procedures:

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• This includes all relevant information on the patient • Based on the collected information, selection of the

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and the insult, such as his age, general health, appropriate restorative material is made and any

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psychological status, main interest, biting and
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dietary habits, caries activity, home-care and determined
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financial status
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 20
I.C. SCOPE

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3. Execution of operative procedure (tooth 5. Regular clinical assessment of restorations

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preparation): and the general health of the dentition:

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• To eliminate the lesion and provide the necessary • During this stage, defective restorations are

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preparation that accommodates the selected necessarily scheduled for maintenance, repair or

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restorative24 total replacement

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4. Construction of restoration
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• To restore tooth functions and occlusion
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 21
TA K E A N OT E

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• Based on our previous discussion, please select the best terminology describing our

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treatments?

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- Operative Dentistry
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- Restorative Dentistry
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- Conservative Dentistry
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 22
I. INTRODUCTION I.A. DEFINITION
I.B. OBJECTIVES

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I.C. SCOPE

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IF

IF
IF
AS

AS
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I.D. LESIONS AFFECTING CALCIFIED TOOTH STRUCTURES

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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 23
 I.D.1. BACTERIAL I.D. LESIONS AFFECTING
I.D.2. MECHANICAL
CALCIFIED TOOTH

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I.D.3. CHEMO-MECHANICAL
STRUCTURES

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I.D.4. PHYSIOLOGICAL

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I.D.5. DEVELOPMENTAL

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I.D.6. ACQUIRED
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 24
 I.D.1. BACTERIAL

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DENTAL CARIES:

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IF

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• WHO Reported:

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- 85% of dental patients seeking for conservative

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treatment24

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- 85% of the 85% needs conservative treatment
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because of DENTAL CARIES
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• The oldest known disease
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 25
 I.D.1. BACTERIAL

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DEFINITION:

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• It is an infectious microbiological disease that

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dissolute and destruct the calcified tooth structure

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• The disease is characterized by periods of high
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production of organic acids formed by microbial
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fermentation of carbohydrates from the diet leading
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to dissolution of hard tooth structure
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 26
 Cariogenic I.D.2. BACTERIAL LESIONS
Microorganisms
D E N T A L C A R I E S

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Deminralize Inorganic
ACID
Tooth Contents

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Deminralize Inorganic
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ACID
Tooth Contents
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Organic Tooth
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Contents
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 27
 I.D.1. BACTERIAL

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Development of caries require interaction between Mutans Streptococci and Lactobacilli are the most

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• •

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plaque microorganism, susceptible tooth, substrate commonly known microorganisms contributing for

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and time dental caries

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• Microorganisms contributing for dental caries are

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not pathogenic microorganisms, they are a
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commensal of normal oral flora
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• They are termed cariogenic microorganisms
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• For microorganism to be cariogenic, it should be
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both acidogenic (acid producing) and aciduric
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(could thrive in acidic pH)
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 28
 SOCIO-ECONOMIC
STATUS

I.D.2. BACTERIAL LESIONS

TOPICAL FLUORIDES D C

N
E N T A L A R I E S

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IO

IN
A

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A
AT
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CO
UC

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E
IF

IF
IF
ED
AS

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AS

IMMUNE SYSTEM
TOOTH DIET

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CONTRIBUTING FACTORS FOR

TIME
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DENTAL CARIES CARIES
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BE
PLAQUE

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HA

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OR

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SALIVA
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 29
 I.D.2. BACTERIAL LESIONS
D E N T A L C A R I E S

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IF

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IF
AS

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AS
LW

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©
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 30
 I.D.1. BACTERIAL

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SUSCEPTIBILITY OF TOOTH SURFACES TO CARIES:

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IF

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• Not all tooth surfaces are equally susceptible to • These areas include:

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caries: 1. Pits, fissures and grooves

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24 2. Contact areas

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a) Stagnation Areas: 3. Cervical areas of buccal and lingual surfaces
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• That could not be naturally cleaned, are highly beyond the height of contours
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©
susceptible to caries attack
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• These areas should be cleaned mechanically by
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R
R
tooth brushes or dental floss to reduce the risk of
PY

PY
PY
caries attack
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 31
 I.D.2. BACTERIAL LESIONS
D E N T A L C A R I E S

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
STAGNATION HIGH CARIES RISK AREA
R

R
R
1. Pits, fissures and grooves
PY

PY
PY
2. Contact areas
O

O
O
C

C
C
3. Cervical areas of buccal and lingual surfaces beyond the height of contours

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 32

 I.D.1. BACTERIAL

.
.
A

A
A
SUSCEPTIBILITY OF TOOTH SURFACES TO CARIES:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
b) Self - Cleansable Areas:

LW

LW
LW
• That could be naturally cleaned by the action of • These areas include:

,A

,A
,A
tongue or check muscles or by the action of
24 1. Cusp tip and cusp inclined planes

24
24
mastication 2. Incisal edge
20

20
20
• These areas are less susceptible to caries 3. Embrasures
©

©
©
• It could be attacked by caries if the patient has a 4. Buccal and lingual surfaces above the height of
T

T
T
IG

IG
IG
bad oral hygiene contours
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 33
 I.D.2. BACTERIAL LESIONS
D E N T A L C A R I E S

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
SELF - CLEANSABLE LOW CARIES RISK AREA
R

R
R
1. Cusp tip and cusp inclined planes
PY

PY
PY
2. Incisal edge
O

O
O
C

C
C
3. Embrasures
4. Buccal and lingual surfaces above the height of contours

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 34

TA K E A N OT E

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Microorganisms contributing to dental caries are cariogenic not pathogenic

LW

LW
LW
microorganisms
,A

,A
,A
24

24
24
20

20
20
• Cariogenic microorganisms should be both acidogenic and aciduric
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 35
TAKE HOME
M E S S A G E Dental caries is a major public health problem globally and is the most widespread

.
.
•

A
A
Y.

Y.
Y.
noncommunicable disease (NCD)

I,

I,
I,
IF

IF
IF
• Everyone is at risk of dental caries, but children and adolescents are most at risk

AS

AS
AS
• The majority of dental caries occurs in adults because the disease is cumulative

LW

LW
LW
There is a clear dose–response relationship between sugars consumption and dental
,A

,A
,A
24 •

24
24
caries
20

20
20
• Importantly, chewing whole fresh fruit stimulates salivary flow that protects against
©

©
©
demineralization of tooth substance.
T

T
T
IG

IG
IG
• The disease is also associated with socioeconomic status, with high prevalence rates
R

R
R
PY

PY
PY
among the poor and disadvantaged population groups
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 36
 I.D.1. BACTERIAL I.D. LESIONS AFFECTING
I.D.2. MECHANICAL
CALCIFIED TOOTH

.
.
A

A
A
Y.

Y.
Y.
I.D.3. CHEMO-MECHANICAL
STRUCTURES

I,

I,
I,
IF

IF
IF
I.D.4. PHYSIOLOGICAL

AS

AS
AS
I.D.5. DEVELOPMENTAL

LW

LW
LW
I.D.6. ACQUIRED
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 37
 I.D.2. MECHANICAL

.
.
A

A
A
1. ABFRACTION:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Abfraction means to break away and the term is

LW

LW
LW
used to define the tooth structure loss under the

,A

,A
,A
CEJ that is caused by abnormal tooth flexion
24

24
24
• It was suggested to arise from eccentric and cyclic
20

20
20
occlusal loading which creates flexure and shearing
©

©
©
stresses, and disruption of the bond between
T

T
T
IG

IG
IG
enamel and dentin
R

R
R
The defect is sharp- wedge-shaped loss of enamel
PY

PY
PY
•

along the cervical area of the labial and buccal

O

O
O
C

C
C
surfaces mostly at the mandibular premolar teeth

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 38

 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
Abfraction: (A) Abfraction or idiopathic erosion lesion at CEJ is hypothesized to be associated with abnormal occlusal force (B) A clinical anterior view of
C

C
C
a patient with labial–cervical abfraction. Note the reflective, smooth, featureless labial enamel surfaces of UR2 and UL2. There are early signs of incisal
attrition and the resulting blue-grey translucency.
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 39
 I.D.2. MECHANICAL

.
.
A

A
A
2. ABRASION:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• It is a progressive abnormal loss of hard tooth • It may be due to:

LW

LW
LW
substances caused by mechanical actions other - Improper brushing techniques

,A

,A
,A
than mastication or tooth-to tooth contacts
24 - Habits such as holding a pipe stem by the teeth

24
24
• This mechanical action may be between teeth and or any other hard object
20

20
20
external object or frictional forces between - Tobacco chewing
©

©
©
contacting teeth components in the presence of an - Vigorous use of toothpicks between adjacent
T

T
T
IG

IG
IG
abrasive medium teeth
R

R
R
It is localized to the area of friction and takes the
PY

PY
PY
•

shape of the external object

O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 40
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
Abrasion: (A) Wedge-shaped abrasive lesion from toothbrushing. (B) Extensive wedge-shaped abrasive lesion due to wrong toothbrushing technique

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 41

 A C

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
B
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
Abrasion: Incisal undulating abrasion lesions (A) Friction with seeds. (B) Friction with metallic pins . (C) Friction with pipe stem

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 42

 I.D.2. MECHANICAL

.
.
A

A
A
3. FRACTURE:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Traumatic injuries mainly affect the anterior teeth

LW

LW
LW
of adolescents

,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 43
 I.D.1. BACTERIAL I.D. LESIONS AFFECTING
I.D.2. MECHANICAL
CALCIFIED TOOTH

.
.
A

A
A
Y.

Y.
Y.
I.D.3. CHEMO-MECHANICAL
STRUCTURES

I,

I,
I,
IF

IF
IF
I.D.4. PHYSIOLOGICAL

AS

AS
AS
I.D.5. DEVELOPMENTAL

LW

LW
LW
I.D.6. ACQUIRED
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 44
 I.D.3. CHEMO-MECHANICAL

.
.
A

A
A
EROSION:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Chemo-mechanical loss of calcified tooth • It may be due to:

LW

LW
LW
structure due to weak chemical agent motivated - Habitual sucking of lemon

,A

,A
,A
by weak mechanical agent
24 - Regurgitation of stomach up take (Pregnancy) –

24
24
• Most commonly affecting the cervical 1/3 of labial affecting the palatal surfaces
20

20
20
surfaces of canine and premolar teeth - Eccentric occlusal forces that leads to tooth
©

©
©
flexion
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 45
A B

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
Erosion: (A) Chronic lemon sucker. (B) Chronic regurgitation of gastric uptake

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 46

 I.D.1. BACTERIAL I.D. LESIONS AFFECTING
I.D.2. MECHANICAL
CALCIFIED TOOTH

.
.
A

A
A
Y.

Y.
Y.
I.D.3. CHEMO-MECHANICAL
STRUCTURES

I,

I,
I,
IF

IF
IF
I.D.4. PHYSIOLOGICAL

AS

AS
AS
I.D.5. DEVELOPMENTAL

LW

LW
LW
I.D.6. ACQUIRED
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 47
 I.D.4. PHYSIOLOGICAL

.
.
A

A
A
ATTRITION:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Attrition is a type of tooth wear caused by tooth-

LW

LW
LW
to-tooth contact, resulting in loss of tooth tissue,

,A

,A
,A
usually starting at the incisal or occlusal surfaces
24

24
24
• Tooth wear is a physiological process and is
20

20
20
commonly seen as a normal part of aging
©

©
©
• Mainly affecting incisal, occlusal and proximal
T

T
T
IG

IG
IG
surfaces of all teeth
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 48
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
Attrition: (A) Generalized attrition caused by excessive functional or parafunctional mandibular movements, (B) A clinical image of the maxillary right
quadrant of a patient, showing the cupping lesions associated with attrition
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 49
 A clinical case of tooth wear showing the
multifactorial etiology, including incisal attrition, labial

.
.
erosion, and buccal cervical abrasion in a middle-

A
A
Y.

Y.
Y.
aged patient

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 50
TA K E A N OT E
• Attrition is a normal physiologic aging loss of hard tooth structure that affects the incisal,

.
.
A

A
A
Y.

Y.
Y.
occlusal and proximal surfaces

I,

I,
I,
IF

IF
IF
• The major contributing factor is the normal functional friction between teeth and each other

AS

AS
AS
LW

LW
LW
• Abrasion is a mechanical loss of hard tooth structure due to frictional abrasive force between
,A

,A
,A
teeth and external object or between teeth and each others in presence of abrasive material
24

24
24
Abrasion is limited only to the area of mechanical friction and abrasive loss took the shape of the
20

20
20
•
abrasive object
©

©
©
T

T
T
IG

IG
IG
Erosion is a chemo-mechanical loss of hard tooth structure due to synergistic effect of weak
R

R
R
•
PY

PY
PY
chemical agent motivated by weak mechanical action
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 51
 I.D. LESIONS OF
CALCIFIED TOOTH

.
.
A

A
A
Y.

Y.
Y.
S T R U C T U R E

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 52
 I.D.1. BACTERIAL I.D. LESIONS AFFECTING
I.D.2. MECHANICAL
CALCIFIED TOOTH

.
.
A

A
A
Y.

Y.
Y.
I.D.3. CHEMO-MECHANICAL
STRUCTURES

I,

I,
I,
IF

IF
IF
I.D.4. PHYSIOLOGICAL

AS

AS
AS
I.D.5. DEVELOPMENTAL

LW

LW
LW
I.D.6. ACQUIRED
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 53
 I.D.5. DEVELOPMENTAL

.
.
A

A
A
As teeth develop and form, they are at risk of These defects must be detected and diagnosed from

Y.

Y.
Y.
• •

I,

I,
I,
developing defects that manifest clinically after tooth the intra-oral dental examination and careful history

IF

IF
IF
AS

AS
AS
eruption, often affecting tooth size/ shape/number or taking, especially of childhood or maternal illnesses

LW

LW
LW
the quality/quantity of the mineralized tissues or trauma to the deciduous dentition

,A

,A
,A
themselves 24

24
24
20

20
20
• These affected teeth can pose an aesthetic problem
©

©
©
and may also be more prone to the ravages of tooth
T

T
T
IG

IG
IG
wear and/or carious attack
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 54
 I.D.5. DEVELOPMENTAL

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 55
 I.D.5. DEVELOPMENTAL

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 56
 Different grades
and shapes of

.
.
E n a m e l

A
A
Y.

Y.
Y.
Hypoplasia

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 57
 I.D.5. DEVELOPMENTAL

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 58
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
Enamel Hypomineralization: (A) Molar hypomineralization, (B) Incisor hypomineralization and (C) Hypomineralization following orthodontic treatment

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 59

 I.D.5. DEVELOPMENTAL

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 60
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
Dental Fluorosis: Dean’s Fluorosis Index
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 61
 Dental Fluorosis. (A) Very mild, (B)
Mild, (C) Moderate, (D & E) Severe.

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
A B C

IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
D E

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 62

 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
Tetracycline Staining
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 63
 I.D.5. DEVELOPMENTAL

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 64
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
Peg-shaped lateral incisors (Microdontia)
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 65
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
Amelogenesis Imperfecta: (A) Mild, (B) Severe hypoplastic amelogenesis imperfecta with hard, thin, and pitted enamel remaining on the teeth. The
patient presented with two poor-quality acrylic crowns on the upper central incisors, and buccal cervical caries on the lower incisors
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 66
 I.D.5. DEVELOPMENTAL

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 67
 Dentinogenesis Imperfecta

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 68
 I.D.1. BACTERIAL I.D. LESIONS AFFECTING
I.D.2. MECHANICAL
CALCIFIED TOOTH

.
.
A

A
A
Y.

Y.
Y.
I.D.3. CHEMO-MECHANICAL
STRUCTURES

I,

I,
I,
IF

IF
IF
I.D.4. PHYSIOLOGICAL

AS

AS
AS
I.D.5. DEVELOPMENTAL

LW

LW
LW
I.D.6. ACQUIRED
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 69
 I.D.6. ACQUIRED

.
.
A

A
A
DISCOLORATION:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
Acquired causes of intrinsic staining include

AS

AS
AS
• Discoloration of hard tooth structure may be either •

restorations, trauma, and infections that cause loss of

LW

LW
LW
intrinsic or extrinsic which may be attributed to either
congenital or acquired factors tooth vitality, intake of specific drugs (such as
,A

,A
,A
Genetic processes that alter tooth structure and color tetracycline and ciprofloxacin) and chemicals (such as
24

24
24
•

excess fluoride), and certain disease states (hepatitis,

20

20
20
include amelogenesis and dentinogenesis imperfecta
and dentin dysplasia biliary disease, erythroblastosis fetalis, and porphyria)
©

©
©
T

T
T
that occur during periods of tooth development
IG

IG
IG
• Extrinsic staining, in contrast to intrinsic staining,
R

R
R
PY

PY
PY
results from dark substances adhering to the external
O

O
O
tooth surface
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 70
A C
Discoloration: (A) Non-vital
tooth, (B) Chlorhexidine stains, (C)
& (D) Tobacco stains

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
B
24

24
24
D
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 71
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
PART II: CAVITY & PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 72
[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 73
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
A B
R

R
R
PY

PY
PY
O

O
O
C

C
C
What Is the Difference Between A & B

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 74

II.A. CAVITY NOMENCLATURE

.
.
A

A
A
CAVITY:

Y.

Y.
Y.
I,

I,
I,
• Defect of the calcified tooth structure (Enamel or

IF

IF
IF
AS

AS
AS
Enamel & Dentin) due to pathological lesion without

LW

LW
LW
definite shape or extension

,A

,A
,A
24

24
24
PREPARED CAVITY:
20

20
20
• Design or form created into a defective tooth
©

©
©
according to bio-mechanical basics to receive and
T

T
T
IG

IG
IG
retain restorative material
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 75
 .

.
.
A

A
A
The journey of treating defective tooth

Y.

Y.
Y.
structure:

I,

I,
I,
IF

IF
IF
AS

AS
AS
A: Carious Cavity

LW

LW
LW
A B
B: Designing prepared cavity
,A

,A
,A
C: Prepared cavity
24

24
24
20

20
20
D: Final restoration
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C D C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 76
II.A. CAVITY NOMENCLATURE

.
.
A

A
A
Y.

Y.
Y.
AMALGAM

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
INSTRUMENTS COMPOSITE RESIN

,A

,A
,A
24

24
24
20

20
20
GOLD
©

©
©
T

T
T
IG

IG
IG
BIO-MECHANICAL
GLASS IONOMER
R

R
R
BASICS
PY

PY
PY
CAVITY PREPARED CAVITY
O

O
O
C

C
C
LINER & BASE

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 77

[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 78
II.A. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24 1. SURFACE ANATOMY

24
24
2. NUMBER OF INVOLVED SURFACES
20

20
20
• Cavities are classified according to:
3. G.V. BLACK’S CLASSIFICATION
©

©
©
T

T
T
IG

IG
IG
4. SITE & STAGE OF THE LESION (SI / STA)
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 79
[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 80
 II.B.1. SURFACE ANATOMY

.
.
A

A
A
A) PITS & FISSURES CAVITIES: B) SMOOTH SURFACE CAVITIES

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• On the occlusal surfaces and occlusal 1/3 of buccal • On the approximal surfaces, gingival 2/3 of buccal

LW

LW
LW
and lingual surfaces of posterior teeth and palatal and lingual surfaces of posterior teeth

,A

,A
,A
pit of upper anterior teeth
24 • Also, on the approximal, labial and palatal or lingual

24
24
surfaces of anterior teeth
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 81
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
a) Pits & Fissures Cavities
C b) Smooth Surface Cavities
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 82
[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 83
 II.B.2. NUMBER OF INVOLVED SURFACES

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
A) SIMPLE B) COMPOUND C) COMPLEX

IF

IF
IF
AS

AS
AS
• The lesion involves only one • The lesion involves two • The lesion involves more than

LW

LW
LW
surface of the affected tooth surfaces of the affected tooth two surfaces of the affected
,A

,A
,A
tooth
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 84
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
2 . N U M B E R O F S U R FAC E S

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
a) Simple b) Compound c) Complex
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 85
[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 86
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
• This classification is based on the site of the onset of

Y.

Y.
Y.
I,

I,
I,
the carious lesion and describes cavities in five

IF

IF
IF
AS

AS
AS
classes with the sixth one added to them later

LW

LW
LW
,A

,A
,A
• G.V. Black proposed that the occlusal forces
24

24
24
magnitude differs from site to another of the same
20

20
20
tooth
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 87
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
CLASS I:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Pits and fissures cavities in the occlusal 1/3 of molars

LW

LW
LW
and premolars, and palatal pit of upper incisors

,A

,A
,A
• It may be simple, compound or complex
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 88
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
3. B L A C K ’ S C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C CLASS I
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 89
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
CLASS II:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Smooth surface cavity, in proximal surface of

LW

LW
LW
posterior teeth

,A

,A
,A
• It is mainly compound or complex and rarely simple
24

24
24
20

20
20
• It could be simple according to the available
©

©
©
accessibility as in case of missing neighboring tooth
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 90
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
3. B L A C K ’ S C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C CLASS II
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 91
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
CLASS III:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Smooth surface cavity, in proximal surface of

LW

LW
LW
anterior teeth without involving the incisal angle

,A

,A
,A
• It is mainly compound or complex and rarely simple
24

24
24
20

20
20
• It could be simple according to the available
©

©
©
accessibility as in case of missing neighboring tooth
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 92
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
3. B L A C K ’ S C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
CLASS III C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 93
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
CLASS IV:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Smooth surface cavity, in proximal surface of

LW

LW
LW
anterior teeth involving the incisal angle

,A

,A
,A
• It is mainly compound or complex but never to be
24

24
24
simple
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 94
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
3. B L A C K ’ S C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
CLASS IV C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 95
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
CLASS V:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Smooth surface cavity in the gingival 1/3 both

LW

LW
LW
buccally and lingually of all teeth

,A

,A
,A
• It is mainly simple
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 96
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
3. B L A C K ’ S C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
CLASS V C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 97
 II.B.3. G.V. BLACK’S CLASSIFICATION

.
.
A

A
A
CLASS VI:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• Cavities not involved by Black’s classification

LW

LW
LW
• e.g. cusp tip and incisal edge

,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 98
 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
3. B L A C K ’ S C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C CLASS VI
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 99
[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 100
 II.B.4. SI / STA CLASSIFICATION

.
.
A

A
A
• All the previously discussed classifications have • They proposed that all clinically revealed carious

Y.

Y.
Y.
I,

I,
I,
limited or no explanation of the carious lesion lesion may be at one of (3) sites and (5) stages

IF

IF
IF
AS

AS
AS
condition or extension

LW

LW
LW
,A

,A
,A
• A new classification based on the site (Si) and
24

24
24
stage (Sta) of the carious lesion was described by
20

20
20
Mount & Hume, in 1997
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 101
 II.B.4. SI / STA CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
STAGE 0: 0/5, only demineralization activity

I,

I,
I,
IF

IF
IF
AS

AS
AS
3 5
SITE 1: OCCLUSAL

LW

LW
LW
STAGE 1: 1/5, caries in enamel

,A

,A
,A
24

24
24
Site 2: Proximal STAGE 2: 2/5, carious dentin with no
20

20
20
SITES STAGES
lateral spread
(Anterior & Posterior)
©

©
©
T

T
T
IG

IG
IG
STAGE 3: 3/5, carious dentin that spreads
Site 3: Cervical
R

R
R
laterally and in depth
PY

PY
PY
(Buccal & Lingual)
O

O
O
C

C
C
STAGE 4: 4/5, extensive carious lesion in
width and depth

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 102

 SITE 1
I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
4. S I / S TA C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
SITE 2
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C SITE 3
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 103
 Progression of the restoration / tooth ration in connection with the stage I I . B . C A V I T Y
of carious lesion
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
STAGE 0 STAGE 1 STAGE 2 STAGE 3 STAGE 4 STAGE 5 4. S I / S TA C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
0/5 ratio 1/5 ratio 2/5 ratio C
3/5 ratio 4/5 ratio 5/5 ratio

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 104

 I I . B . C A V I T Y
CLASSI F I CAT I O N

.
.
A

A
A
Y.

Y.
Y.
4. S I / S TA C L A S S I F I C AT I O N

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 105
[Link] CAVITIES II.A. CAVITY NOMENCLATURE
II.B. CAVITY CLASSIFICATION

.
.
A

A
A
Y.

Y.
Y.
II.B.1. SURFACE ANATOMY

I,

I,
I,
IF

IF
IF
II.B.2. NUMBER OF INVOLVED SURFACES

AS

AS
AS
II.B.3. [Link]’S CLASSIFICATION

LW

LW
LW
II.B.4. SI / STA CLASSIFICATION
,A

,A
,A
II.C. COMPONENTS OF PREPARED CAVITY
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 106
II.C. COMPONENTS OF PREPARED CAVITY

.
.
A

A
A
• Prepared cavity is a design or form composed of:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
1. Walls

LW

LW
LW
2. Floor(s) or Seat(s)

,A

,A
,A
3. Line Angles
24

24
24
4. Point Angles
20

20
20
5. Cavo Surface Angle (CSA)
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 107
II.C. COMPONENTS OF PREPARED CAVITY

.
.
A

A
A
1. WALLS:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• The walls of the prepared cavity are running parallel • Such a wall takes the name of the tooth surface (or

LW

LW
LW
to the long axis of the tooth and named according aspect) that the wall is toward

,A

,A
,A
to the adjoining or corresponding tooth surface
24

24
24
• An axial wall is an internal wall parallel with the
20

20
20
• The cavity wall may be internal or external long axis of the tooth
©

©
©
• The internal wall does not extend to the external
T

T
T
IG

IG
IG
tooth surface and composed of dentin only
R

R
R
The external wall extends to the external tooth
PY

PY
PY
•

surface and composed of enamel and dentin

O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 108
 II.C. C OMPONENTS OF
PREPARED CAVITY

.
.
A

A
A
Y.

Y.
Y.
1. W A L L S

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 109
TA K E A N OT E

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
Any cavity wall composed of enamel wall and dentin wall except axial wall composed of
,A

,A
,A
24 •

24
24
dentin only
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 110
II.C. COMPONENTS OF PREPARED CAVITY

.
.
A

A
A
2. FLOOR(S) OR SEAT(S)

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• A floor (or seat) is a prepared cavity wall, which is

LW

LW
LW
reasonably flat, and perpendicular to those

,A

,A
,A
occlusion forces that are directed occluso-gingivally
24

24
24
20

20
20
• Examples are the pulpal and gingival walls
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 111
II.C. COMPONENTS OF PREPARED CAVITY

.
.
A

A
A
3. LINE ANGLES:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• A line angle is the junction of two plane surfaces of

LW

LW
LW
different orientation along a line

,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 112
II.C. COMPONENTS OF PREPARED CAVITY

.
.
A

A
A
4. POINT ANGLES:

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• A point angle is the junction of three plane surfaces

LW

LW
LW
of different orientation

,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 113
II.C. COMPONENTS OF PREPARED CAVITY

.
.
A

A
A
5. CAVO SURFACE ANGLE (CSA)

Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
• The angle of tooth structure formed by the junction

LW

LW
LW
of a prepared cavity wall and the external surface of

,A

,A
,A
the tooth 24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 114
 II.C. C OMPONENTS OF
PREPARED CAVITY

.
.
A

A
A
Y.

Y.
Y.
5. C AV O S U R FA C E A N G L E

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 115
 II.C. C OMPONENTS OF
PREPARED CAVITY

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
SIMPLE OCCLUSAL CLASS I C
COMPOUND CLASS II
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 116
 II.C. C OMPONENTS OF
PREPARED CAVITY

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
SIMPLE CLASS III C
SIMPLE CLASS V
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 117
 Customer Book Title Stage Supplier Date
OUP Pickard’s Guide to Minimally Invasive Operative Dentistry Revise 2 Thomson Digital 28 April 2015

SUGGESTED
R E A D I N G S

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
C
INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 118
 @YWasifi

.
.
[Link]

A
A
Y.

Y.
Y.
yasseralwasifi

I,

I,
I,
IF

IF
IF
AS

AS
AS
[Link]

LW

LW
LW
yasseramw

,A

,A
,A
24

24
24
LEARN - Dental Series
20

20
20
"Yasser Al Wasifi"
©

©
©
T

T
T
[Link]
IG

IG
IG
Learn_Dental_Series Yasser Alwasifi
R

R
R
PY

PY
PY
O

O
O
yasseramw@[Link]
C

C
C
yasseramw67@[Link]
[Link]@[Link]

INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 119

 .

.
.
A

A
A
Y.

Y.
Y.
DESIGN & EDITING: YASSER ALWASIFI

I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
PATTERNS & BACKGROUNDS:
,A

,A
,A
24

24
24
20

20
20
VECTOR GRAPHICS & ICONS:
©

©
©
T

T
T
IG

IG
IG
PHOTOS & SOUND EFFECTS: ONLINE FREE SOURCES
R

R
R
PY

PY
PY
O

O
O
C

C
C
 .

.
.
A

A
A
Y.

Y.
Y.
I,

I,
I,
IF

IF
IF
AS

AS
AS
LW

LW
LW
,A Your questions are welcomed

,A
,A
24

24
24
20

20
20
©

©
©
T

T
T
IG

IG
IG
R

R
R
PY

PY
PY
O

O
O
C

C
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INTRODUCTION TO OPERATIVE DENTISTRY - Copyright © 2024, AlWASIFI, Y.A. 121
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