Transcript MODULE 1 - Ivoclar Vivadent

Introduction to Dentistry
and
Dental Terminology
Dentistry
Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment
(nonsurgical, surgical or related procedures) of diseases, disorders and/or
conditions of the oral cavity, maxillofacial area and/or the adjacent and
associated structures and their impact on the human body; provided by a
dentist, within the scope of his/her education, training and experience, in
accordance with the ethics of the profession and applicable law.
Dental Specialties
1.
2.
3.
4.
5.
6.
7.
8.
9.
Dental Public Health
Endodontics
Oral and Maxillofacial Pathology
Oral and Maxillofacial Surgery
Oral and Maxillofacial Radiology
Orthodontics and Dentofacial Orthopedics
Pediatric Dentistry
Periodontics
Prosthodontics
Dental Public Health
Concerned with preventing and controlling dental
diseases and promoting dental health through
organized community efforts.
Endodontics
Concerned with the diagnosis, prevention, and
treatment of diseases and injuries of the pulp and
associated periradicular tissues.
Known most for the performance of:
“Root Canals”
Oral Pathology
Concerned with the nature of disease affecting the oral
structures and adjacent regions
Involved with diagnosis of:
“biopsies”
Oral and Maxillofacial Radiology
Concerned with the production and interpretation of
images and data produced by all modalities of
radiant energy that are used for the diagnosis and
management of diseases, disorders and conditions
of the oral and maxillofacial region.
Oral and Maxillofacial Surgery
Concerned with the diagnosis and surgical treatment of
diseases, injuries, and defects of the oral and
maxillofacial regions
Known for:
“Extraction of Wisdom Teeth”
“Reconstruction of Facial Regions”
Orthodontics and Dentofacial
Orthopedics
Concerned with the supervision, guidance,
and correction of all forms of malocclusion
of the growing or mature dentofacial
structures
Known most for:
“Braces”
Pediatric Dentistry
Concerned with the preventive and therapeutic oral
healthcare of children from birth through
adolescence.
Known as:
“Children’s Dentist”
Periodontics
Concerned with the diagnosis and treatment of disease
of the supporting and surrounding tissues of the
teeth.
Involved mainly with the treatment of:
“Gums”
Prosthodontics
Concerned with the restoration and maintenance of
oral functions by the restoration of natural teeth or
the replacement of missing teeth and contiguous
oral and maxillofacial tissues with artificial
substitutes known as prostheses.
Known for treatment of denture patients or those
patients requiring extensive crown and bridge
work.
Introduction to Dental Terms
Basic Dental Terminology
Teeth
Dentition
Person with teeth
Dentate
Person without teeth
Edentulous
Baby teeth
Deciduous (primary)
Gums
Gingiva
Gums of person
without teeth
ridges
Basic Dental Terminology
Gum disease
Gingivitis / periodontitis
Tartar
Calculus
Roof of mouth
Palate
Upper jaw
Maxilla (maxillary arch)
Lower jaw
Mandible (mandibular arch)
Jaw joint
Temporal mandibular joint (TMJ)
Basic Dental Terminology
Cavity
Caries
Filling
Restoration
Shot
Local Anesthesia
Bite
Occlusion
Teeth cleaning
Oral prophylaxis (prophy)
Tooth Anatomy
root
crown
Tooth Anatomy
Cementum
Cemental
enamel junction
(CEJ)
Enamel
Tooth Anatomy
Enamel
Dentin
Pulp
Cementum
Anatomy of Teeth and
Surrounding Tissues
Enamel
Makes up the anatomic crown of the tooth.
Hardest material of the body.
Is translucent (allows light to pass through it) and
ranges in color from yellow-white to gray-white.
Shade differences are dependent on the color of the
dentin that lies beneath the enamel.
Structure of Enamel
96-99% Inorganic Matter
Hydroxyapatite, which consists primarily
of calcium, is the largest mineral
component.
Enamel is composed of millions of
calcified prisms, known as enamel rods.
These rods extend from the surface of
the tooth into the DEJ.
Dentin
Makes up the main portion of the tooth structure
extending almost the entire length of the tooth.
It is covered by enamel on the crown surface and
cementum on the root surface.
Dentin is light yellow and some what translucent.
The color may darken with age
Structure of Dentin
Dentin is harder than bone and cementum, but not as hard as
enamel.
It is composed of 70% inorganic material and 30% organic
material and water. This decrease in mineralization allows for
the more rapid spread of caries through tooth structure.
Instead of enamel rods, dentin is composed of many, many
microscopic dentin tubules.
Cementum
The primary function of cementum is to anchor the tooth to the bony
socket with attachment.
Cementum is light yellow and is easily distinguished from enamel due to
its lack of luster and darker hue.
Structure of the Pulp
The pulp is made up of nerves
and blood vessels that enter
the pulp chamber via the
apical foramen.
The tissue fluid interchange
between the dentin and the
pulp allow for moisture and
nutrients of the dentin.
The nerve supply of the pulp
receives and transmits pain
stimuli.
How does the tooth “attach” to the bone?
The tooth is not in contact with the
bone but is suspended in place by
the periodontal ligament which is
sandwiched between the cementum
and the alveolar bone
Oral Cavity Terminology
and
Anatomy
Oral Cavity
Many areas in the oral cavity are identified according to their relationship
with the tongue, palate, cheek, facial surface or lips.
Lingual- closest to the tongue.
Palatal-closest to the palate.
Buccal-closest to the cheek (also Facial)
Labial-closest to the lips (also Facial)
Vestibules
The spaces between the lips,
cheeks, and gingiva are called
the maxillary and the
mandibular vestibules.
A frenum is a band of tissue
that connects two structures.
Labial Frenum
Buccal Frenum
Gingiva
Most commonly referred to
as the gums. The gingiva
is the masticatory mucosa
previously discussed.
Palate
The roof of the mouth
has two parts:
Anterior
Posterior
The anterior firm portion
is called the hard palate.
The posterior loose
portion is called the soft
palate.
The uvula hangs down in
this region.
Tongue
Dorsal surface
Lateral surface
The dorsal (top) surface is
covered by thick and highly
specialized epithelium,
The ventral (underside)
surface is highly vascular
and covered with a very
delicate lining mucosa.
The tip of the tongue is
termed the apex of the
tongue.
Apex
Ventral surface
Lips
Philtrum
Also known as Labia.
Formed externally by the skin and
internally by mucous membranes.
Commisure: the angle at the corner
of the mouth where the upper and
lower lips meet.
Vermillion Border-the red free
margins, representing a transition
from skin to the red mucous
membrane portion.
Vermilion Zone
Tooth Numbering
32 adult teeth total
Each arch (maxilla & mandible) has 16 teeth
Each arch has two quadrants of 8 teeth
32 adult teeth
Each arch has 16 teeth
Each arch has two quadrants
of 8 teeth
Universal Numbering System (ADA)
The permanent teeth are
numbered 1-32.
Numbering begins with the
upper right third molar
continues around to the
upper left third molar.
The mandibular numbering
starts at 17, with the
mandibular left third molar
continuing to the mandibular
right third molar.
Primary Dentition
There are 20 teeth in the primary dentition, all teeth are eventually
exfoliated during the eruption of the permanent dentition.
There are no premolars in the primary dentition. However when
erupted the premolars replace the existence of the primary first
and second molars.
Each quadrant contains five teeth
Two incisors (central & lateral)
One cuspid
Two molars (1st & 2nd)
Types of Teeth
Types of Teeth
Anterior teeth
Central incisor
Lateral incisor
Posterior teeth
1st premolar
2nd premolar
1st molar
2nd molar
3rd molar
Canine (cuspid)
Incisors
Incisors are single rooted
with a sharp thin edge.
They are located at the
front of the mouth.
They are designed to cut
food without the
application of heavy
forces.
8 in total dentition (4 in
maxillary arch, 4 in
mandibular arch.
Canines
Designed for the cutting and tearing of foods
that require the application of force.
The single canine root is the longest in the
dentition. The bony ridge over the facial part of
the root is called the “bony eminence.”
The canine crown is thick with one well
developed pointed cusp.
4 in total, 2 maxillary, 2 mandibular arch.
Referred to as the cornerstone of the dental
arch due to location. Usually one of the last
teeth in the mouth to be lost.
Premolars
Similar to canines in that they have
points and cusps for grasping and
tearing.
They have a somewhat broader working
surface for chewing.
8 in total, 4 in maxillary arch, 4 in
mandibular arch.
The premolar is the only type of tooth
that is not found in the primary dentition.
Molars
Molars have the most cusps of all the
teeth in the dentition.
The shorter, blunter design of these
cusps produces a broad working
surface that is used for chewing and
grinding solid masses of food that
require the application of heavy forces.
An adult dentition has up to 12 molars
present. The number depends on
development, eruption, and prior needs
for extraction.
Tooth Surfaces
Tooth Surfaces
Five surfaces:
1. Facial (labial / buccal)
Facing out
2. Lingual (palatal)
Facing in
3. Masticatory (incisal/occlusal)
Chewing surface
4. Mesial
Towards the midline
5. Distal
Away from the midline
Tooth Surfaces
4. Mesial
5. Distal
2. Palatal
3. Incisal
1. Facial (labial)
Tooth Surfaces
Distal
Mesial
Both Mesial and Distal Surfaces are also referred to as PROXIMAL
Anatomic Features of the Teeth
Cusp:
A pronounced elevation on the
occlusal surface terminating in a
conical or rounded surface.
Anatomic Features of the Teeth
Mamelon:
A rounded or conical
prominence on the incisal ridge
of a newly erupted incisor.
They are usually three in
number, and soon disappear as
a result of wear.
Contours
When tooth is restored, it is important to return it to normal contour
With inadequate contour, the gingiva may be damaged (B)
With overcontouring the gingiva will lack adequate stimulation (C)
Contacts
The contact area is the region of the
mesial and distal surfaces (proximal
surface) of a tooth that touch the
adjacent tooth.
Contacts
The proper contact relationship between adjacent teeth
accomplished 3 things
It serves to keep food from being trapped between teeth
It helps to stabilize the dental arches by combined
anchorage of all teeth in either arch in positive
contact with each other.
It protects the interproximal gingival tissue from trauma
during mastication.
Occlusion
Occlusion is the contact between the maxillary and mandibular teeth in
all mandibular positions and movements.
Occlusion
Centric Occlusion
Occurs when the jaws are closed in a position that produces
maximal stable contact between the occluding surfaces of the
maxillary and mandibular teeth.
Malocclusion
Refers to abnormal or malpositioned relationships of the maxillary
teeth to mandibular teeth
Dental Restorations
Dental Decay
Periodontal Disease
Genetic Disorder
Missing Teeth
Missing Tooth Structure
(Esthetic Imperfections)
Restoring Form & Function
(Esthetic Improvements)
Restoration of Tooth Structure
Direct Restorations
Composite Fillings
Amalgam Fillings
Gold Foil Fillings
Indirect Restorations
Crowns
Inlays/Onlays
Veneers
Replacing Missing Teeth
Fixed Restorations
Bridges (w/Pontic)
Implants
Removable Rest.
Partial Denture
Complete Denture
Restoration of Tooth Structure
Direct Restorations
(Fillings placed directly in the mouth)
Gold Foil
“Gold fillings”
Declining
Amalgam
“Silver fillings”
Economic
Composite (Resin)
“White fillings”
Most popular
Bonded Restorations
 Adhesives
 Composites
 Polishers
Fixed vs Removable Restorations
Some restorations are meant to be fixed to the patient’s tooth /
teeth
– Veneers
– Inlay
– Onlay
– Crown
– Bridge
Some restorations are meant to be removable by the patient
– Partial denture
– Complete denture
Restorations
Direct restoration (Clinical)
Indirect restoration (Technical)
Clinical restorations
A typical clinical restoration can be a silver filling (amalgam) or a tooth colored
filling (direct resin).
Indirect Restorations
The decision to do an indirect (technical restoration) is
usually determined by the amount of tooth structure that
needs restoration. The following is a list of technical
restorations from the least amount of tooth structure /
teeth that needs to be replaced to the most.
–
–
–
–
–
–
–
Veneer
Inlay
Onlay
Crown
Bridge
Partial denture
Complete denture
Veneers
A veneer is a conservative restoration that is selected when
the facial surface of a tooth requires replacement primarily
due to esthetic considerations.
Minimal tooth structure is removed (0.3-0.8mm)
Inlay
An inlay is a conservative
restoration that is designed to
fit into a preparation that is
within the tooth.
It does not involve
replacement of the cusps.
Like a Class II restoration,
covers a portion of the
occlusal and proximal surface
areas.
The materials of choice are;
•Indirect resin
•Cast metal
•Porcelain
Onlay
An inlay is a conservative
restoration that is designed to fit
into a preparation that is within
the tooth.
It does involve replacement of
one or more cusps.
The material options are;
Indirect resin
Cast metal
porcelain
Crown
When more than 50% of the crown of a
tooth must be replaced it is necessary to
prepare the tooth for a full crown in order
to restore the tooth back to its original
contour and function.
Material options:
•All metal
•All ceramic
•Porcelain fused to metal (PFM)
Bridge (Fixed Partial Dental Prosthesis/ FPDP)
If a tooth is missing it can be
replaced by preparing a tooth on
either side of the missing tooth
and fabricate a “bridge”
Material options;
Material options:
•All metal
•All ceramic
•Porcelain fused to metal (PFM)
Bridge (Fixed Partial Dental Prosthesis/ FPDP)
A pontic is an artificial tooth, or part of
the dental appliance that replaces a
missing natural tooth.
An abutment, also known as a retainer,
is a natural tooth that serves as the
support for the replacement tooth or
teeth in a fixed bridge. The abutment
tooth is usually prepared with an onlay
or a cast crown.
Bridge (Fixed Dental Prosthesis/ FDP)
Framework Material Options:
Metal (PFM)
Ceramic (All ceramic)
•
Pressed
•
CAD/CAM
Partial Denture
Removable Prosthodontics is the area
of dentistry dealing with replacement
of missing teeth with a prosthesis that
the patient is able to remove and
replace.
Removable Partial Denturescommonly referred to as a partial,
replaces one or more teeth in one arch
Partial Denture
Base metal
framework
Denture
teeth
Denture
Base Resin
Complete Denture
Removable Complete Denture,
(Denture):
A removable dental prosthesis
that replaces all the teeth and
associated structures of one
arch.
Complete removable dental
prosthesis.