Definition:

 Operative dentistry is the art and science

of the diagnosis, treatment, and prognosis
of defects of teeth that do not require
full coverage restorations for correction.

Restoration of proper tooth form, function, and esthetics.

Maintaining the physiologic integrity of

the teeth in harmonious relationship
with the adjacent hard and soft tissues.
Types of lesions involved in
tooth destruction

Dental Caries

Non-carious lesions
A. Dental caries
Is an infectious microbiologic
disease that results in localized
dissolution and destruction of the
calcified tissues of the teeth.

 Areas susceptible to caries:

1. Pits and fissures:

A fissure is resulted from incomplete

union of two enamel lobes during
the formative period of enamel.

A pit is resulted from incomplete

union of three enamel lobes during
the formation period.

pits and fissures represent areas of

food stagnation with subsequent
fermentation and caries production.
2. Areas in the proximal surfaces of teeth gingival to
the contact points where food debris can stagnate,
ferment, acid produced which decalcify enamel
resulting in interproximal cavities.
3. Areas blew the greatest diameter of the tooth on
buccal and lingual surfaces which provide a shelter
for food debris.
B. Non-Carious Tooth Defects
Abrasion: Is abnormal tooth surface loss resulting from direct friction
forces between the teeth and external objects.
 Improper brushing techniques,
 Vigorous use of toothpicks between adjacent teeth.
Toothbrush abrasion is the most common example and is usually seen
as a sharp, V-shaped notch in the gingival portion of the facial aspect
of a tooth.
Erosion: Is the wear or loss of tooth surface by chemico-
mechanical action.

Regurgitation of stomach acid can cause this condition on the lingual surfaces
of maxillary teeth (particularly anterior teeth).
Other examples are the dissolution of the facial aspects of anterior teeth
because of habitual sucking of lemons or the loss of tooth surface from ingestion
of acidic medicines.
Attrition: Is mechanical wear of the incisal or
occlusal surface as a result of functional or parafunctional
movements of the mandible (tooth-to-tooth contacts).
Attritionalso includes proximal surface wear at the
contact area because of physiologic tooth movement.
Fractures: An external blow is frequently the
cause of anterior teeth fracture; however, a molar
or bicuspid may split from only masticatory forces
when the individual inadvertently closes down on a
hard bony object.
 Maintaining the physiologic integrity of the teeth
in harmonious relationship with the adjacent
hard and soft tissues.

 Hypomineralised
 enamel

 Enamel Fluorosis
Discoloration: Is the deviation from
the normal color. It can affect one
tooth or it can be generalized. Caused
by either external surface staining
from chromogenic food.
 OR
 Internal staining
A discoloured upper right central Severe tetracycline stain
incisor resulting from a necrotic
untreated pulp.
Indications of restorative intervention

1. To repair a tooth after destruction from a carious lesion.

2. Replacement or repair of restoration with serious defects, such as
improper proximal contact, gingival excess, caries risk margin
and poor aesthetics.
3. To restore fractured tooth to proper form and function.
4. To restore a congenitally malformed tooth to proper form and function.
5. To enhance aesthetics.
6. As a part of the treatment plan for other restorative procedures, for example
a tooth adjacent to a missing tooth may require some treatment before placing
a bridge, in which it acts as an abutment.
To restore teeth with
caries.
To replace or repair existing,
faulty restorations.
To restore fractured tooth to
proper form and function.
To enhance the
esthetic appearance
of patients due to
malformed,
discolored,
non-esthetic,
or fractured teeth.
DentalOperator and
Chair Position