Pickard's Manual of Operative Dentistry

by Kidd, Edwina A. M.; Smith, Bernard G. N.; Watson, Timothy F.

• ISBN13: 9780198509288
• ISBN10: 0198509286
• Edition: 8th
• Format: Paperback
• Copyright: 2003-10-16
• Publisher: Oxford University Press

Summary

The new edition of this best selling dental textbook has been thoroughly updated to keep abreast of current knowledge of the disease processes and the role of operative dentistry in their management. The book describes clearly and concisely the indications and methods for many common operativeand conservative procedures in dental practice. Procedures and techniques are illustrated in full colour and where appropriate, step-by-step sequences are given. Its popularity lies in the fact that it doubles as an atlas and the text is clear and accessible. The new co-author, Tim Watson, is well known as an expert in adhesive dentistry. A new chapter has been added on adhesion and adhesive restorations, since these are now the first choice for primary lesions for all surfaces and all teeth in the mouth. Amalgam is still thoroughly described, butbonding techniques are now included with a shift away from pins where retention is a problem. The diagnosis of failed restorations has been updated in the light of new research and techniques for refurbishment and repair of restorations are advocated where appropriate. As in previous editions, the approach is disease and prevention orientated, is problem based and the changes have a research evidence-base.

Author Biography

Professor Edwina Kidd is Professor of Cariology in the Division of Conservative Dentistry at Guy's, King's and St Thomas' Schools of Medicine, Dentistry & Biomedical Sciences, London Professor Bernard Smith is Professor of Conservative Dentistry in the Department of Restorative Dentistry at Guy's, King's and St Thomas' Schools of Medicine, Dentistry & Biomedical Sciences, London Professor Tim Watson is Professor of Microscopy in relation to Restorative Dentistry at Guy's, King's and St Thomas' Schools of Medicine, Dentistry & Biomedical Sciences, London

Table of Contents

PART I DISEASES, DISORDERS, DIAGNOSIS, DECISIONS, AND DESIGN
1 Why restore teeth?	5	(30)
Dental caries	5	(7)
The carious process and the carious lesion	6	(1)
Plaque retention and susceptible sites	6	(1)
Severity or rapidity of attack	7	(1)
The carious process in enamel	7	(2)
The carious process in dentine	9	(2)
Root caries	11	(1)
Secondary or recurrent caries	11	(1)
Residual caries	12	(1)
Diagnosis of dental caries	12	(6)
The diagnostic procedure	12	(4)
Assessment of caries risk	16	(2)
Symptoms of caries	18	(1)
The relevance of the diagnostic information to the management of caries	18	(1)
Preventive, non-operative treatment	18	(2)
Patient involvement	19	(1)
Why is the patient a caries risk?	19	(1)
Mechanical plaque control	19	(1)
Use of fluoride	20	(1)
Dietary advice	20	(1)
Salivary flow	20	(1)
Operative treatment	20	(1)
Caries in pits and fissures	20	(1)
Approximal lesions	20	(1)
Smooth surfaces and root caries	20	(1)
Tooth wear	20	(7)
Erosion	22	(1)
Attrition	23	(1)
Abrasion	24	(1)
Summary of the causes of tooth wear	24	(1)
Acceptable and pathological levels of tooth wear	24	(1)
Consequences of pathological tooth wear	24	(1)
Diagnosing and monitoring tooth wear	24	(3)
Preventing tooth wear	27	(1)
The management of tooth wear	27	(1)
Trauma	27	(1)
Aetiology of trauma	27	(1)
Examination and diagnosis of dental injury	28	(1)
Management of trauma to the teeth	28	(1)
Developmental defects	28	(3)
Acquired developmental conditions	28	(2)
Treatment of developmental defects	30	(1)
Hereditary conditions	30	(1)
Further reading	31	(4)
2 Making clinical decisions	35	(20)
Who makes the decisions?	35	(1)
Professionalism	35	(1)
Large and small decisions	36	(1)
The four main decisions	36	(1)
Diagnosis	36	(1)
Prognosis	36	(1)
Treatment options	36
Further preventive measures	34	(2)
The information needed to make decisions and how it is collected and recorded	36	(9)
History	37	(3)
Examination	40	(1)
Examination of specific areas of the mouth	41	(1)
Detailed charts	42	(1)
Special tests	43	(2)
The history and examination process	45	(1)
Planning the treatment	46	(1)
Some common decisions which have to be made	47	(5)
Diagnosing toothache	47	(3)
Whether to restore or attempt to arrest a moderate-size carious lesion and whether to restore or monitor an erosive lesion	50	(2)
Whether to extract or root treat a tooth	52	(1)
Which restorative material to use	52	(1)
Further reading	52	(3)
3 Principles of cavity design and preparation	55	(20)
G.V Black	55	(1)
Why restore teeth?	55	(1)
What determines cavity design?	55	(2)
The dental tissues	55	(1)
The diseases	56	(1)
The properties of restorative materials	56	(1)
Resin composites	57	(1)
Composition of composites	58	(1)
Polymerization of composites	58	(1)
Glass ionomer cements	58	(2)
Conventional, autocuring, glass ionomer cements	59	(1)
Resin-modified glass ionomer cements (RMGIC)	59	(1)
Polyacid-modified resin composites (PAMRC)	59	(1)
Fluoride-releasing materials	59	(1)
Dental amalgam	60	(1)
Composition of amalgam alloys and their relevance to clinical practice	60	(2)
The safety aspects of amalgam	61	(1)
Cast gold and other alloys	61	(1)
Principles of cavity design	62	(4)
When is a restoration needed?	62	(1)
Gaining access to the caries	62	(1)
Removing the caries	63	(1)
How should soft, infected dentine be removed?	63	(1)
Stepwise excavation	64	(1)
Put the instruments down: look, think, and design	64	(1)
The final choice of restorative material	64	(1)
Making the restoration retentive	64	(1)
Design features to protect the remaining tooth tissue	65	(1)
Design features to optimize the strength of the restoration 'Resistance form'	66	(1)
The shape and position of the cavity margin	66	(1)
Possible future developments in cavity design	66	(1)
The control of pain and trauma in operative dentistry	66	(2)
Pre-operative precautions	67	(1)
Pain and trauma control during tooth preparation	67	(1)
Avoiding postoperative pain	68	(1)
Cavity lining and chemical preparation	68	(1)
Objectives and materials	68	(1)
Further reading	69	(6)
PART II TREATMENT TECHNOQUES
4 The operator and the environment	75	(18)
The dental team	75	(1)
The dental school and practice environment	75	(1)
The surgery	76	(2)
Positioning the patient, the dentist, and the dental nurse	76	(1)
Lighting	77	(1)
Siting of work-surfaces and instruments	77	(1)
Aspirating equipment; cavity washing and drying	78	(1)
Hand and instrument cleaning	78	(1)
Close-support dentistry	78	(2)
Maintaining a clear working field for the dentist	78	(1)
Instrument transfer	79	(1)
Moisture control	80	(6)
Reasons for moisture control	80	(1)
Techniques for moisture control	80	(6)
Magnification	86	(2)
Protection, safety, and management of minor emergencies	88	(2)
Eye protection	88	(1)
Airway protection	88	(1)
Soft tissue protection	89	(1)
Avoiding surgical emphysema	89	(1)
Dealing with accidents and accident reporting	90	(1)
Protection from infection	90	(1)
Further reading	90	(3)
5 Instruments and handpieces	93	(14)
Hand instruments	93	(2)
Instruments used for examining the mouth and teeth	93	(1)
Instruments used for removing caries and cutting teeth	94	(1)
Instruments used for placing and condensing restorative materials	94	(1)
Hand instrument design	95	(1)
Using hand instruments	96	(1)
Maintaining hand instruments	96	(1)
Sharpening hand instruments	96	(1)
Decontaminating and sterilizing hand instruments	97	(1)
Rotary instruments	97	(4)
The air turbine	97	(1)
Low-speed handpieces	97	(1)
Maintaining and sterilizing handpieces	98	(1)
Burs and stones	98	(1)
Finishing instruments	99	(2)
Maintaining and sterilizing burs and stones	101	(1)
Tooth preparation with rotary instruments	101	(2)
Speed, torque, and 'feel'	101	(1)
Heat generation and dissipation	101	(1)
Effects on the patient	101	(1)
Choosing the bur for the job	102	(1)
Surface finish	102	(1)
Finishing and polishing restorations	102	(1)
Air abrasion	103	(1)
Auxiliary instruments and equipment	103	(4)
6 Bonding to tooth structure	107	(14)
Why bond to tooth tissue?	107	(1)
The substrate; enamel and dentine	107	(2)
Enamel	107	(1)
Dentine	108	(1)
Enamel-dentine junction	108	(1)
Cutting	109	(1)
Choice of materials for bonding techniques	109	(1)
Spectrum of bonding materials	109	(1)
Overall requirements for adhesion	109	(1)
Composites	110	(3)
Bonding to enamel	110	(1)
Bonding to dentine	110	(2)
Bonding to wet dentine (and enamel)	112	(1)
Important considerations on the use of bonding agents	113	(1)
Number of stages and film thickness	113	(1)
Speed of application	113	(1)
Good clear instructions	114	(1)
Ease of dispensing and handling	114	(1)
Sensitization	114	(1)
Shelf life	114	(1)
Glass ionomer cements	114	(2)
Adhesion mechanisms: conventional glass ionomer cements	114	(1)
Conditioning the dentine	115	(1)
Bonding glass ionomer cements to enamel	115	(1)
Bonding glass ionomer cements to dentine	116	(1)
The resin-modified glass ionomer centents	116	(1)
The polyacid-modified resin composites	117	(1)
Bonded amalgam resioraliut1s	117	(1)
Further reading	118	(3)
7 Treatment of pit and fissure caries	121	(10)
Introduction	121	(1)
Fissure sealing	121	(3)
Indications	121	(1)
Clinical technique for resin sealers	122	(1)
Clinical technique for glass ionomer cement sealers	123	(1)
The sealant restoration (or preventive resin restoration)	124	(3)
Indications	124	(1)
Clinical technique	124	(3)
Larger posterior composites	127	(1)
Amalgam restorations for pit and fissure caries	127	(1)
Further reading	128	(3)
8 Treatment of approximal caries in posterior teeth	131	(24)
Introduction	131	(1)
Approximal amalgam restorations: access through the marginal ridge	131	(7)
Pre-operative procedures	131	(2)
Access to caries and clearing the enamel-dentine junction	133	(1)
Finishing the enamel margins	133	(1)
Removing caries over the pulp	133	(1)
Retention	134	(1)
Lower premolars	135	(1)
Lining the cavity	135	(1)
Applying the matrix band	135	(2)
Choice of amalgam	137	(1)
Inserting the amalgam	137	(1)
Carving and finishing the amalgam	137	(1)
Polishing	138	(1)
Approximal composite restorations: access through the marginal ridge	138	(5)
Indications	138	(1)
Aspect of cavity preparation	139	(1)
Lining and etching the cavity	139	(1)
Placing the matrix and restoration	139	(4)
Finishing the restoration	143	(1)
Approximal 'adhesive' restorations: marginal ridge preserved	143	(2)
Occlusal approach	143	(1)
Buccal approach	144	(1)
Approximal root caries	145	(1)
The mesial-occlusal-distal (MOD) cavity	145	(6)
Problems of the larger cavity	145	(1)
Pre-operative assessment	146	(1)
Caries removal	146	(1)
Desining the restoration	146	(1)
Choice of restorative material	147	(1)
Bonded amalgam restorations	148	(1)
Pin retention for large restorations and cores	148	(2)
Placing the matrix, packing, carving, and finishing	150	(1)
Further reading	151	(4)
9 Treatment of smooth surface caries, erosion-abrasion lesions, and enamel hypoplasia	155	(10)
Smooth surface enamel caries	155	(1)
Root caries	155	(1)
Restoration of free smooth surface carious lesions (both enamel and root caries)	156	(3)
Access to caries	156	(1)
Removal of caries	157	(1)
Choice of restorative material	157	(1)
Lining	158	(1)
Applying the matrix and placing the restoration	158	(1)
Finishing	159	(1)
Erosion-abrasion lesions	159	(2)
Choice of restorative material for erosion-abrasion lesions	161	(1)
Cavity preparation, lining, and filling	161	(1)
Enamel hypoplasia	161	(1)
Summary of the choice of restorative materials for smooth surface lesions	161	(4)
10 Treatment of approximal caries, trauma, developmental disorders, and discoloration in anterior teeth	165	(12)
Conditions affecting anterior teeth which may need restorations	165	(1)
Approximal caries	165	(1)
Approximal caries which also involves the incisal edge	165	(1)
Trauma	165	(1)
Developmental disorders	166	(1)
Discoloured teeth	166	(1)
Tooth wear	166	(1)
Treatment options	166	(1)
Uses and limitations of anterior composite materials	166	(1)
Retention of composite to dentine	166	(1)
Porcelain veneers	166	(1)
Examples of anterior restorations	167	(5)
Restoration of Approximal caries in an anterior tooth	167	(2)
Composite restorations involving the incisal edge	169	(2)
Veneering techniques for hypoplastic and discoloured teeth	171	(1)
Bleaching discoloured anterior teeth	172	(1)
Further reading	173	(4)
11 Indirect cast metal, porcelain, and composite intracoronal restorations	177	(16)
Plastic compared with rigid restorations	177	(1)
The lost wax process	177	(1)
Intracoronal and extracoronal restorations	177	(1)
Materials	177	(2)
Cast metal	177	(1)
Porcelain	178	(1)
Advantages and disadvantages of cast metal and porcelain reslorations	179	(2)
Strength	179	(1)
Abrasion resistance	179	(1)
Appearance	179	(1)
Versatility	179	(1)
Cost	179	(1)
The cement lute	180	(1)
Indications	180	(1)
Preparations and clinical techniques	181	(6)
Indirect cast metal inlay	181	(3)
Porcelain inlay	184	(2)
Porcelain veneer	186	(1)
Further reading	187	(6)
PART III MONITORING AND MAINTENANCE
12 The long-term management of patients with restored dentitions	193	(12)
Introduction	193	(1)
How long do restorations last?	193	(1)
The ways in which restorations fail	194	(6)
New disease	194	(4)
Technical failure	198	(2)
Acceptable and unacceptable deterioration or failure	200	(1)
The patient's perception of the problem	200	(1)
The dentist's assessment of the effect of technical failure	200	(1)
Monitoring techniques: recall and reassessment	201	(1)
Frequency of recall	201	(1)
The recall assessment	202	(1)
Techniques for removal, adjustment, and repair	202	(2)
Amalgam	202	(1)
Composite and glass ionomer cement	203	(1)
Cast metal and ceramic restorations	204	(1)
Removal of ledges	204	(1)
Further reading	204	(1)
Index	205