Indications for Operative Treatment Considerations Prior to Treatment

1. Caries 1. Health of the patient

1909
2. Pain 2. Filling or extraction
3. Payment for services

1. Caries (tooth decay) 1. An understanding and appreciation for infection control to safeguard
2009 both health service personnel and patients
2. Malformed, discolored, nonesthetic, or
fractured teeth 2. A thorough examination of the affected tooth as well as the oral and
3. Restoration replacement or repair systemic health of the patient
4. Pain 3. A diagnosis of the dental problem that recognizes the interaction of
the affected area with other body tissues
4. A treatment plan that has the potential to return the affected area
to a state of health and function
5. An understanding of the material to be used to restore the affected
area to a state of health and function, including a realization of both
the material's limitations and techniques involved in using it
6. An understanding of the oral environment into which the restoration
will be placed
7. The biologic knowledge necessary to make the previously
mentioned determinations
8. An understanding of the biologic basis and function of the various
tooth components and supporting tissues
9. An appreciation for and knowledge of correct dental anatomy
10. The effect of the operative procedure on other dental treatments
11. Payment for services

Amalgam Composite

Outline form Include fault, break proximal & gingival Include fault, break gingival contact, seal
contacts, include all suspicious areas suspicious areas

Pulpal depth Uniform 1.5 – 2.0 mm Remove fault, not always uniform

Axial depth Uniform 0.2 – 0.5 mm into DEJ Remove fault – not always uniform

Cavosurface angle 90 degrees buccal and lingual >90 degrees buccal and lingual

Bevels None Only for esthetics and retention

Texture of prep walls Smooth Rough

Primary retention Convergence occlusally Enamal/dentin Bond

Secondary retention Grooves, slots, pins Grooves, convergence

Resistance form Flat floors perpendicular to occlusal forces Flat floors perpendicular to occlusal forces for
large preparations

Base indications 2mm distance between amalgam and pulp none

Liner indications Ca(OH) over direct pulp cap Ca(OH), GI, Flowable composite

Sealer GLUMA or bonding agent Bonding agent