AMALGAM OBTURATION
The differences between class I & II are place, remove matrix and verify interproximal
***Dental materials: first - dycal or vitrebond then - copalite (not obligate)
Class I
1. Anesthetic
○ Basic kit, 2x2 gauge, Q-tip, topical,
carpule, syringe, needle
○ Garbage cup, patient file + radiograph,
bib + chain, protective glasses, gloves,
masks
2. Isolation
○ Rubber dam, clamp, frame, punch-holes
+ clamp forceps, dry angle, cotton rolls
3. Prepare the cavity (open, remove, finish
cavity wall, rinse and dry)
○ High speed, low speed, 557 FG bur, RA
remove decay bur, inverted cone bur,
○ Spoon excavator, enamel hatchet (finish
cavity wall)
4. Place dental materials (liner, base, varnish)
○ Pad, spatula, applicator, 2x2 alcohol
5. Triturate + place amalgam into cavity
○ Capsule, amalgamator, well, amalgam
carrier, woodson, interproximal carver
(double-spatula)
6. Condense amalgam
○ Plugger/ Condenser
7. Burnish amalgam (quickly)
○ Burnisher
8. Sculpt amalgam
○ Discoid cleoid carver
9. Verify occlusion
○ Occlusal paper, occlusal paper forceps
10. Final burnish
Class II
1. Anesthetic
○ Basic kit, 2x2 gauge, Q-tip, topical,
carpule, syringe, needle
○ Garbage cup, patient file + radiograph,
bib + chain, protective glasses, gloves,
masks
2. Isolation
○ Rubber dam, clamp, frame, punch-holes
+ clamp forceps, dry angle, cotton rolls
3. Prepare the cavity (open, remove, finish
cavity wall, rinse and dry)
○ High speed, low speed, 557 FG bur, RA
remove decay bur, inverted cone bur,
○ Spoon excavator, enamel hatchet (finish
cavity wall)
4. Place matrix + wedge
○ Matrix holder, matrix band, wedge,
scissors
5. Place dental materials (liner, base, varnish)
○ Pad, spatula, applicator, 2x2 alcohol
6. Triturate + place amalgam into cavity
○ Capsule, amalgamator, well, amalgam
carrier, woodson, interproximal carver
(double-spatula)
7. Condense amalgam
○ Plugger/ Condenser
8. Burnish amalgam (quickly)
○ Burnisher
9. Remove wedge and matrix
10. Verify interproximal
○ Floss, abrasive strip (metallic)
11. Sculpt amalgam
○ Discoid cleoid carver
12. Verify occlusion
○ Occlusal paper, occlusal paper forceps
13. Final burnish
 COMPOSITE OBTURATION
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GINGIVECTOMY
Removal of the apical portion of the root, accessory canals or fractures of the root

1. Set out the patient for health history, radiograph and periodontal chart
○ Mouth mirror, explorer, cotton forceps, sterile blue field
○ Patient file + radiograph, bib + chain, protective glasses, gloves, masks
○ Rinse the site with antiseptic solution, cup, 2x2 gauge
○ Plastic cup for garbage
2. Local anesthesia
○ 2x2 gauge, Q-tip, topical, carpule, syringe, needle
3. Be prepared to transfer & retrieve surgical instruments
○ High speed handpiece, diamond ovoid bur, bur block, peridex, cup
○ Syringe with saline, dry 2x2, 2x2 with alcohol
4. Marks the pockets on Buccal + Lingual
○
5. Incision of the gingiva at 45° angle
6. Provide oral evacuation and retraction
7. Remove gingival tissue
8. Remove tissue from the instruments if necessary
9. Tapers the gingival margins
10. Shapes the interdental papillae
11. Scaling & Root planning
12. Place sutures
13. Irrigate & Periodontal dressing
14. Post-op instructions

APICOECTOMY
Removal of the apical portion of the root, accessory canals or fractures of the root

1. Clinical & radiograph exam

○ Mouth mirror, explorer, cotton forceps, sterile blue field
○ Patient file + radiograph, bib + chain, protective glasses, gloves, masks
○ Rinse the site with antiseptic solution, cup, 2x2 gauge
○ Plastic cup for garbage
2. Small incision + Retract gingival
○ #15 blade, blade remover, surgical suction, scalpel
○ Periosteal elevator, minnesota, hemostat
Drill to access root
○ Highspeed, surgical 557 long bur, bur block, 2x2 alcohol, sterile 2x2
3. Remove infected tissue
○ Surgical curette
4. May use a dye to highlight cracks + breaks
**** This will determine whether the tooth is needed to be extracted
5. Clean & irrigate
○ Surgical curette, syringe with saline
6. Seal the root
○ Amalgam kit, bone graft
7. Take radiograph → OK → Stitching
○ Silk sutures, needle holder, suture scissors
8. Post-op instructions

GRAFT TREATMENT
A free gingival graft is when gingiva removed from the palate to a recipient site
***To prevent gum recession

1. Clinical & radiograph exam

○ Mouth mirror, explorer, cotton forceps, sterile blue field
○ Patient file + radiograph, bib + chain, protective glasses, gloves, masks
○ Plastic cup for garbage
○ Saliva ejector, air/water syringe
○ Service forceps
2. Preoperative disinfection
○ Rinse the site with antiseptic solution, cup, sterile 2x2 gauge
3. Anesthetic
○ 2x2 gauge, Q-tip, topical, carpule, syringe, needle
4. Quick exam of donor site and recipient site
5. Measure gum tissue that needs to be cut from the palate
○ Periodontal probe
6. Incision at the recipient
○ Minnesota, blade remover, scalpel holder, #15 blade, surgical suction, hemostat
○ Periosteal elevator, Universal or Gracey curette, dry 2x2, syringe with saline
7. Cut a piece of palate to place at the recipient site
○ Tissue forceps
○ Two ways of putting the palate tissue together
■ Scissors, sponge, periodontal tissue adhesive (GluStitch)
■ Palatal protective stent
8. Stitch it up at recipient site
○ Silk suture, suture scissors, needle holder
9. Place a periodontal dressing on the graft
○ COE-Pak dressing, pad, spatula, 2x2 alcohol
10. Post-op instructions