Chapter 1: Introduction to Operative Dentistry.
Operative Dentistry: Deals with the functional and esthetic restoration of hard tissues of the individual
teeth. It is the science and art of dentistry that deals with diagnosis, treatment, prognosis of defects of
the teeth which do not require full coverage restorations for correction. Should result in restoration of
form, function and esthetics of the teeth whilst maintaining physiological integrity of the teeth in
harmonious relationship with adjacent hard and soft tissues, all of which should enhance the general
health and welfare of the patient.
The recent concept of dentistry. Comes under minimally invasive dentistry, of which the World Congress
of Minimally Invasive Dentistry was formed in 1999. Minimally invasive dentistry initially focused on
minimal removal of disease structure but later evolved into preventative measures to control disease.
Current minimally invasive philosophy follows 3 concepts of disease treatment: identify (identify and
assess risk factors early), prevent (prevent disease by eliminating risk factors), restore (restore the
health of the oral environment).
Indications of Operative Dentistry.
Caries. The most common disease affecting the teeth. This is a microbiological disease of the teeth that
results in localised dissolution and destruction of calcified tissue, caused by the action of microbes and
fermentable carbohydrates. Dental caries can be of pit and fissure, smooth surface or root carious lesion
type.
Non carious loss of the tooth structure. This could occur by attrition (mechanical wear of opposing teeth
commonly seen on contacting occlusal, interproximal and incisal surfaces. This could occur by abrasion,
loss of tooth material by mechanical wear other than contacting surfaces, commonly due to improper
brushing and use of abrasive tooth powder. This could be due to erosion, losing hard tissue as a
chemical process involving bacteria.
Malformed, fractured, traumatized teeth. Injuries may involve dental pulp or hard tissue, requiring
restoration.
Esthetic improvement. Discolored teeth because of staining or other reasons look unaesthetic, require
restoration.
Replacement or repair of restoration. Repair or replacement of existing restoration is indicated for
operative treatment.
Developmental defects. Such as enamel and dentin hypoplasia, hypomineralisation, amelogenesis and
dentinogenesis imperfecta.
Objectives of Operative Dentistry
Diagnosis, Prevention, Interception, Preservation, Restoration, Maintenance.
Recent Advancements
Development of diagnostic aids such as ultrasonic illumination, fibre optic transillumination, digital
imaging, diagnodent.
Recent advancements in treatment planning such as minimal intervention dentistry, ozone therapy.