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Identifying and Charting Restorations. Marcia Espinoza, Reina Ligeralde, Dorinda Thomas DEH 21 5.13.08. Amalgam Composite Porcelain. Sealant Veneer Post. Common Dental Materials. Fixed Partial Denture Inlay Onlay. Amalgam.
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Identifying and Charting Restorations Marcia Espinoza, Reina Ligeralde, Dorinda Thomas DEH 21 5.13.08
Amalgam Composite Porcelain Sealant Veneer Post Common Dental Materials • Fixed Partial Denture • Inlay • Onlay
Amalgam • An alloy that consists chiefly of silver mixed with mercury and variable amounts of other metals • Appears radiopaque radiographically
Amalgam Appearances Clinical Radiographic
Composite • Also called a white filling • Typically consists of a resin-based matrix and an inorganic filler (which gives the composite wear-resistance and translucency) • May appear radiopaque radiographically (older ones may appear radiolucent)
Composite Appearance Clinical Radiographic
Porcelain • Produced by mixing ceramic powder with distilled water • Appears radiopaque radiographically
Porcelain Appearances Clinical Radiographic
Sealant • A tough, plastic material designed to bond to the tooth enamel • Clear or tooth-colored material that seals the pits and grooves • Not seen radiographically
Sealant Appearances Clinical Radiographic • Not seen but possibly a faint radiopacity on occlusal surface
Veneer • A thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface • Two types of materials can be used in a veneer: composite and porcelain • Appears radiopaque radiographically
Veneer Appearances Clinical
Post and Crown • Often, only the root portion is left to retain the crown. • A gold casting called a post and core • Common practice to cement a post about two-thirds of the way into a root canal • Core = the part of the post that protrudes from the root canal
Fixed Partial Denture (FPD) • Designed to replace more than one missing natural tooth • Dentist attaches an FPD to natural teeth (abutments) or roots by cementation • Pontic = artificial tooth suspended from the retainer casting, occupies the space formerly filled by the crown of a natural tooth • Unit castings are joined together by connectors. • The units may be made entirely from metal, combination of metal or resin, or from a combination of metal and porcelain.
Inlay vs. Onlay Clinical Appearances Inlay Onlay
Surface Restorations • Examples: O, B, L, DO, MO, MOD, MOB, OL, OB, MF, ML, DF, or DL • A dental restorative material used to artificially restore the function, integrity, and morphology of missing tooth structure • Appears radiopaque radiographically
Surface Restoration Appearances Clinical Radiographic
How to Identify Dental Materials Clinically • Tactile detection: • Composite restorations have a distinct tactile feel with the explorer that contrasts with a natural tooth or a ceramic or porcelain restoration. • A black line of metal may be apparent when an explorer is used on the material. • Air: • Aesthetic restorations may reveal a dry, chalky appearance when air is applied.
Charting Restorations • Use blue ink and draw symbol for existing restoration. • Place appropriate letter for restoration material (e.g. A, C, P, V) on facial or buccal aspect of chart, above/below root apices. • Place an “S” on the occlusal surface of the tooth that has a sealant.
More on Charting Restorations • For a bridge, mark missing tooth/teeth with straight line, outline the crowns of teeth, and fill in with diagonal lines. Draw 2 sets of parallel lines between crowns of teeth. Place appropriate letter representing type of material on facial or buccal. • Mark a straight line inside root areas(s) of affected tooth for a root canal therapy.
Test YOUR Knowledge! • Identify 3 incorrect charted restorations.
Amalgam or Stain? • Name two ways you can tell if your patient has an amalgam or a stain.
Composite or Sealant? • What is the difference between the two?
Answers • 4 - “P” should be on the buccal, not the lingual, aspect of the chart, above the apices. • 14 – “S” should be on the occlusal surface rather than on the buccal aspect of the chart, above the apices. • 31 – Blue, rather than black, ink should have been used.
More Answers • You can use tactile detection and air. With tactile detection, there will be a distinct difference in sound. There is more of a solid ringing noise when an explorer goes across a restoration and more of a jagged, scratching noise when an explorer runs along a tooth surface that has a stain, especially if the tooth surface has pits. • A composite will cover a surface whereas a sealant will cover a pit or groove.