Pickard's Manual of Operative Dentistry (Oxford Medical Publications) (Paperback) By Edwina A M Kidd (Author), Bernard G N Smith (Author), Timothy F Watson (Author) Paperback: 224 pages Publisher: OUP Oxford; 8 edition (28 Aug 2003) Language English Product Description : Useful for dentistry students, this book describes the indications and methods for several common operative and conservative procedures in dental practice. Procedures and techniques are illustrated in full colour and, where appropriate, step-by-step sequences are given. PART I DISEASES, DISORDERS, DIAGNOSIS, DECISIONS, AND DESIGN 1 Why restore teeth? 5 Dental caries 5 The carious process and the carious lesion 6 Plaque retention and susceptible sites 6 Severity or rapidity of attack 7 The carious process in enamel 7 The carious process in dentine 9 Root caries 11 Secondary or recurrent caries 11 Residual caries 12 Diagnosis of dental caries 12 The diagnostic procedure 12 Assessment of caries risk 16 Symptoms of caries 18 The relevance of the diagnostic information to the management of caries 18 Preventive, non-operative treatment 18 Patient involvement 19 Why is the patient a caries risk? 19 Mechanical plaque control 19 Use of fluoride 20 Dietary advice 20 Salivary flow 20 Operative treatment 20 Caries in pits and fissures 20 Approximal lesions 20 Smooth surfaces and root caries 20 Tooth wear 20 Erosion 22 Attrition 23 Abrasion 24 Summary of the causes of tooth wear 24 Acceptable and pathological levels of tooth wear 24 Consequences of pathological tooth wear 24 Diagnosing and monitoring tooth wear 24 Preventing tooth wear 27 The management of tooth wear 27 Trauma 27 Aetiology of trauma 27 Examination and diagnosis of dental injury 28 Management of trauma to the teeth 28 Developmental defects 28 Acquired developmental conditions 28 Treatment of developmental defects 30 Hereditary conditions 30 Further reading 31 2 Making clinical decisions 35 Who makes the decisions? 35 Professionalism 35 Large and small decisions 36 The four main decisions 36 Diagnosis 36 Prognosis 36 Treatment options 36 Further preventive measures 34 The information needed to make decisions and how it is collected and recorded 36 History 37 Examination 40 Examination of specific areas of the mouth 41 Detailed charts 42 Special tests 43 The history and examination process 45 Planning the treatment 46 Some common decisions which have to be made 47 Diagnosing toothache 47 Whether to restore or attempt to arrest a moderate-size carious lesion and whether to restore or monitor an erosive lesion 50 Whether to extract or root treat a tooth 52 Which restorative material to use 52 Further reading 52 3 Principles of cavity design and preparation 55 G. V. Black 55 Why restore teeth? 55 What determines cavity design? 55 The dental tissues 55 The diseases 56 The properties of restorative materials 56 Resin composites 57 Composition of composites 58 Polymerization of composites 58 Glass ionomer cements 58 Conventional, autocuring, glass ionomer cements 59 Resin-modified glass ionomer cements (RMGIC) 59 Polyacid-modified resin composites (PAMRC) 59 Fluoride-releasing materials 59 Dental amalgam 60 Composition of amalgam alloys and their relevance to clinical practice 60 The safety aspects of amalgam 61 Cast gold and other alloys 61 Principles of cavity design 62 When is a restoration needed? 62 Gaining access to the caries 62 Removing the caries 63 How should soft, infected dentine be removed? 63 Stepwise excavation 64 Put the instruments down: look, think, and design 64 The final choice of restorative material 64 Making the restoration retentive 64 Design features to protect the remaining tooth tissue 65 Design features to optimize the strength of the restoration 65 ‘Resistance form’ 66 The shape and position of the cavity margin 66 Possible future developments in cavity design 66 The control of pain and trauma in operative dentistry 66 Pre-operative precautions 67 Pain and trauma control during tooth preparation 67 Avoiding postoperative pain 68 Cavity lining and chemical preparation 68 Objectives and materials 68 Further reading 69 PART II TREATMENT TECHNIQUES 4 The operator and the environment 75 The dental team 75 The dental school and practice environment 75 The surgery 76 Positioning the patient, the dentist, and the dental nurse 76 Lighting 77 Siting of work-surfaces and instruments 77 Aspirating equipment; cavity washing and drying 78 Hand and instrument cleaning 78 Close-support dentistry 78 Maintaining a clear working field for the dentist 78 Instrument transfer 79 Moisture control 80 Reasons for moisture control 80 Techniques for moisture control 80 Magnification 86 Protection, safety, and management of minor emergencies 88 Eye protection 88 Airway protection 88 Soft tissue protection 89 Avoiding surgical emphysema 89 Dealing with accidents and accident reporting 90 Protection from infection 90 Further reading 90 5 Instruments and handpieces 93 Hand instruments 93 Instruments used for examining the mouth and teeth 93 Instruments used for removing caries and cutting teeth 94 Instruments used for placing and condensing restorative materials 94 Hand instrument design 95 Using hand instruments 96 Maintaining hand instruments 96 Sharpening hand instruments 96 Decontaminating and sterilizing hand instruments 97 Rotary instruments 97 The air turbine 97 Low-speed handpieces 97 Maintaining and sterilizing handpieces 98 Burs and stones 98 Finishing instruments 99 Maintaining and sterilizing burs and stones 101 Tooth preparation with rotary instruments 101 Speed, torque, and ‘feel’ 101 Heat generation and dissipation 101 Effects on the patient 101 Choosing the bur for the job 102 Surface finish 102 Finishing and polishing restorations 102 Air abrasion 103 Auxiliary instruments and equipment 103 6 Bonding to tooth structure 107 Why bond to tooth tissue? 107 The substrate; enamel and dentine 107 Enamel 107 Dentine 108 Enamel–dentine junction 108 Cutting 109 Choice of materials for bonding techniques 109 Spectrum of bonding materials 109 Overall requirements for adhesion 109 Composites 110 Bonding to enamel 110 Bonding to dentine 110 Bonding to wet dentine (and enamel) 112 Important considerations on the use of bonding agents 113 Number of stages and film thickness 113 Speed of application 113 Good clear instructions 114 Ease of dispensing and handling 114 Sensitization 114 Shelf-life 114 Glass ionomer cements 114 Adhesion mechanisms: conventional glass ionomer cements 114 Conditioning the dentine 115 Bonding glass ionomer cements to enamel 115 Bonding glass ionomer cements to dentine 116 The resin-modified glass ionomer cements 116 The polyacid-modified resin composites 117 Bonded amalgam restorations 117 Further reading 118 7 Treatment of pit and fissure caries 121 Introduction 121 Fissure sealing 121 Indications 121 Clinical technique for resin sealers 122 Clinical technique for glass ionomer cement sealers 123 The sealant restoration (or preventive resin restoration) 124 Indications 124 Clinical technique 124 Larger posterior composites 127 Amalgam restorations for pit and fissure caries 127 Further reading 128 8 Treatment of approximal caries in posterior teeth 131 Introduction 131 Approximal amalgam restorations: access through the marginal ridge 131 Pre-operative procedures 131 Access to caries and clearing the enamel–dentine junction 133 Finishing the enamel margins 133 Removing caries over the pulp 133 Retention 134 Lower premolars 135 Lining the cavity 135 Applying the matrix band 135 Choice of amalgam 137 Inserting the amalgam 137 Carving and finishing the amalgam 137 Polishing 138 Approximal composite restorations: access through the marginal ridge 138 Indications 138 Aspect of cavity preparation 139 Lining and etching the cavity 139 Placing the matrix and restoration 139 Finishing the restoration 143 Approximal ‘adhesive’ restorations: marginal ridge preserved 143 Occlusal approach 143 Buccal approach 144 Approximal root caries 145 The mesial–occlusal–distal (MOD) cavity 145 Problems of the larger cavity 145 Pre-operative assessment 146 Caries removal 146 Desining the restoration 146 Choice of restorative material 147 Bonded amalgam restorations 148 Pin retention for large restorations and cores 148 Placing the matrix, packing, carving, and finishing 150 Further reading 151 9 Treatment of smooth surface caries, erosion–abrasion lesions, and enamel hypoplasia 155 Smooth surface enamel caries 155 Root caries 155 Restoration of free smooth surface carious lesions (both enamel and root caries) 156 Access to caries 156 Removal of caries 157 Choice of restorative material 157 Lining 158 Applying the matrix and placing the restoration 158 Finishing 159 Erosion–abrasion lesions 159 Choice of restorative material for erosion–abrasion lesions 161 Cavity preparation, lining, and filling 161 Enamel hypoplasia 161 Summary of the choice of restorative materials for smooth surface lesions 161 10 Treatment of approximal caries, trauma, developmental disorders, and discoloration in anterior teeth 165 Conditions affecting anterior teeth which may need restorations 165 Approximal caries 165 Approximal caries which also involves the incisal edge 165 Trauma 165 Developmental disorders 166 Discoloured teeth 166 Tooth wear 166 Treatment options 166 Uses and limitations of anterior composite materials 166 Retention of composite to dentine 166 Porcelain veneers 166 Examples of anterior restorations 167 Restoration of approximal caries in an anterior tooth 167 Composite restorations involving the incisal edge 169 Veneering techniques for hypoplastic and discoloured teeth 171 Bleaching discoloured anterior teeth 172 Further reading 173 11 Indirect cast metal, porcelain, and composite intracoronal restorations 177 Plastic compared with rigid restorations 177 The lost wax process 177 Intracoronal and extracoronal restorations 177 Materials 177 Cast metal 177 Porcelain 178 Advantages and disadvantages of cast metal and porcelain restorations 179 Strength 179 Abrasion resistance 179 Appearance 179 Versatility 179 Cost 179 The cement lute 180 Indications 180 Preparations and clinical techniques 181 Indirect cast metal inlay 181 Porcelain inlay 184 Porcelain veneer 186 Further reading 187 PART III MONITORING AND MAINTENANCE 12 The long-term management of patients with restored dentitions 193 Introduction 193 How long do restorations last? 193 The ways in which restorations fail 194 New disease 194 Technical failure 198 Acceptable and unacceptable deterioration or failure 200 The patient’s perception of the problem 200 The dentist’s assessment of the effect of technical failure 200 Monitoring techniques: recall and reassessment 201 Frequency of recall 201 The recall assessment 202 Techniques for removal, adjustment, and repair 202 Amalgam 202 Composite and glass ionomer cement 203 Cast metal and ceramic restorations 204 Removal of ledges 204 Further reading 204 Index 205