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Is the art & science of the diagnosis, treatment, & prognosis of defects of teeth which do not require full

coverage restorations for corrections.

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B. C. D.

Dentitions Classes of human teeth Structures of the teeth Physiology of tooth forms

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2.

Deciduous dentition Permanent dentition

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2. 3.

4.

Incisors cutting or shearing instrument Canines seizing, piercing & tearing of food as well as in cutting Premolars dual role * like canines in tearing of food * like molars in the grinding of food Molars crushing, grinding & chewing of food to the smallest dimensions suitable for deglutition

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II. III. IV.

Functions
Contours Proximal contact area Embrasures

Main functions of teeth: 1. Mastication 2. Esthetics 3. Speech 4. Protection of supporting tissues

Facial

and lingual surfaces of the teeth possess convexity for protection and stimulation of the supporting tissues during mastication.

An imaginary curved line encircling a tooth at its greatest bulge Also afford the correct amount of frictional massage to the gingiva Cleansing mechanism

General rule:

Contour will vary from tooth to tooth Height of contour for both anterior and posterior teeth is in the cervical third EXCEPT lingual crest of curvature of posterior teeth which is near the middle third

Anterior tooth showing labial & lingual crest of curvature. Both are in the cervical third.

Maxillary posterior tooth with the buccal crest of curvature in the cervical third and the lingual crest of curvature in the middle third.

A proximal view of a maxillary 1st molar with correct contour. The gingiva is protected, but receives proper stimulation from food flow during mastication.

An over contoured maxillary 1st molar. The gingiva will suffer from lack of stimulation as food is deflected away from the gingival tissues.

A maxillary 1st molar with less than normal contour. This contour gives inadequate protection to the gingiva.

Contacts with the proximal surfaces of the adjacent teeth which prevents food impaction. 2. Adequate embrasure space gingivally for the gingival tissue, supporting bone, blood vessels and nerves that serve the supporting structures.
1.

mesial or distal Where one tooth touches another Prevents food from packing between them Prevents buildup of excessive bacteria, food or debris Affords protection to the gum tissue Offer support and anchorage to one another

The contact area of the remaining teeth going posteriorly is located at the junction of the incisal/occlusal thirds & middle thirds.

Triangular-shaped

spaces between the teeth formed by the bone on one side and the proximal surfaces and their contact area on the other side Normally filled with gingival tissue Papillary gingiva Interdental papilla

are V shaped spaces that originate at the proximal contact areas between adjacent teeth. facial, lingual, incisal or occlusal & gingival interdental papilla fills the gingival embrasure

Open space Spillways Named for their location Facial (buccal and labial Lingual Incisal or occlusal Gingival/cervical (if interproximal space not occupied by tissue or bone

Functions: Allow food to be forced away from contact areas Reduce the forces of occlusal forces Self cleansing Permit a slight amount of stimulation to the gingiva

1. enamel

2. pulp dentin complex


3. cementum

Formed by ameloblasts ( originate from the embryonic germ layer called the ectoderm)
covers the anatomic crown & varies in thickness in different areas of the tooth
enamel rods

color is mostly gray & is semi translucent hardest substance of the human body but is very brittle

chemically - highly mineralized crystalline structure 95% - 98% inorganic matter hydroxyapatite largest mineral constituent 1 - 2 % organic content 4 % water content

Structurally, enamel is composed of millions of enamel rods or prisms (largest structural components), rod sheaths, & a cementing interrod substance Enamel rods may vary in number Enamel rods are densely packed & intertwined in a wavy course & extends from DEJ to the external surface of the tooth.

enamel rods are aligned perpendicularly to both the DEJ & the tooth surface in the deciduous & permanent teeth except in the cervical region of permanent teeth where they are slightly in apical direction

Enamel rod

DEJ

deciduous

permanent

for maximal strength in tooth preparation, all enamel rods should be supported by dentin.
caries

e n a m e l

d e n t i n

Groups of enamel rods that entwine with adjacent group of rods & follow a curving irregular path toward the tooth surface forming GNARLED ENAMEL. Occurs in the cervical regions and incisal & occlusal areas.

Changes in direction of enamel prisms produce an optical appearance called HUNTERSCHREGER bands ( appear as alternate light & dark zones of varying width). Anterior teeth located in the incisal surfaces Molars occurs near the cervical region to the cusp tips.

ENAMEL TUFTS are hypomineralized structures of enamel rods & inter-rod substance that project between adjacent groups of enamel rods from the DEJ ENAMEL LAMELLAE are thin leaflike faults between enamel rod groups that extend from the enamel surface toward the DEJ sometimes extending into the dentin. - contain mostly organic materials which is a weak area & predisposing a tooth to the entry of bacteria & dental caries.

ENAMEL SPINDLES odontoblastic processes that cross the DEJ into the enamel may serve as pain receptors

Enamel rods are formed linearly by successive apposition of enamel in discrete increments resulting in structure & mineralizations called the INCREMENTAL STRIAE OF RETZUIS. - considered as growth rings - in horizontal sections of a tooth it appear as concentric circles; - in vertical sections, symmetric arc pattern descending obliquely to the cervical region & terminating at the DEJ

IMBRICATION LINES PICKERILL incomplete circles of striae of retzuis at the enamel surface formed a series of alternating grooves PERIKYMATA elevations between the grooves; continuous around a tooth & lie parallel to the cementoenamel junction

The interface of the enamel & dentin is called the DENTINOENAMEL JUNCTION.
- scalloped or wavy in outline, with crest of the waves penetrating toward the enamel.

Deep

invaginations occur in pit-and fissure areas of the occlusal surfaces of premolars & molars; decrease the enamel thickness in these areas These fissures & grooves are formed at the junction of the developmental lobes of the enamel Fissures act as food & bacterial trap that may predispose the tooth to dental caries. Occlusal grooves, which are sound, serve as an important function for the movement of food during mastication

Sound coalescence of the lobes results in grooves Faulty coalescence of the lobes results fissure Enamel is incapable of repairing itself once destroyed

Final act of the ameloblast cell is secretion of a membrane covering the end of enamel rod. This layer is referred to as NASMYTH MEMBRANE or PRIMARY ENAMEL CUTICLE.

Enamel is very hard & dense structure, it is permeable to certain ions & molecules. The route of passage is through structural units that are hypomineralized & rich in organic content such as rod sheath, enamel cracks & other defects Water is the transporting medium through small inter crystalline spaces. Enamel permeability decreases with age. This decrease is referred to as ENAMEL MATURATION

Enamel is soluble when exposed to an acid medium. Solubility of enamel increases from the enamel surface to the DEJ.
Fluoride present during enamel formation solubility of enamel is decreased. Trace amounts of fluoride stabilize enamel by: Lowering acid solubility Decrease the rate of demineralization Enhancing the rate of remineraization Topical fluoride increase resistance to dental caries

Acid etching the enamel surface micromechanical bonding of composite restorative materials Etchant is a 35% to 50% solution of phosphoric acid Etching produces an irregular pitted surface with numerous undercuts Composite or pit & fissure sealant is bonded to the enamel surface by RESIN TAGS formed in the acid etched enamel rod structure

Its hardness makes it resistant to the friction of ordinary use The curvatures of enamel rods probably increase the strength of the enamel The presence of pits and fissures influences the occurrence of dental caries The arrangement of enamel rods and the presence of areas of less mineralization influence the pattern and speed of progress of dental caries

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