Treatment planning in operative dentistry-1-1.pptx

Treatment planning in operative

1. Dr. Abdalmagid Alhammaly Conservative Thr³ year

2. Head lines

3. Patient Assessment : 1- medical history 2- dental History 3- Chief Concern Examination: 1- Extra oral Examination 2- Intraoral Examination Patient Assessment, Examination and Diagnosis

4. Definition Its carefully sequenced series of services designed to a- Eliminate and control etiological factors B- Repair the existing damage C- Create functional and maintable environment

5. Order of Treatment Operative treatment generally proceeds from: The most to least involved teeth. • 1 st → Treatment of the chief complaint of dental pain . • Early in ttt plan also. → Certain functional and esthetic considerations as: Broken teeth, even though not painful relieve discomfort of sharp margins. - Sensitive teeth Areas of food impaction . .

6. Treatment plane depend on

7. Treatment Plan Sequencing :

8. A- Urgent Phase A patient presenting with swelling, pain, bleeding , broken teeth or infection should have these problems managed as soon as possible

9. B- control phase (1) eliminating active disease such as caries and inflammation (2) removing conditions preventing maintenance (3) eliminating potential causes of disease (4) beginning preventive activities

10. Improve oral hygiene

11. C- re-evaluation phase This phase allows time between the control and definitive phases for resolution of inflammation and healing. NB : CONTROL PHASE + RE-EVALUATION PHASE = HOLDING PHASE

12. D- defenitive phase - Reasses initial treatment -Patient receive his actual treatment -This phase may include endodontic, periodontal, orthodontic, and surgical procedures before fixed or removable prosthodontic treatment

13. E- maintenance phase includes regular re-evaluation or re- examination s that (1) may reveal the need for adjustments to prevent future breakdown and (2) provide an opportunity to reinforce home care.

14. Interdisciplinary Considerations in Operative Treatment Planning

15. A- Endodontic All teeth to be restored with large restorations should have a pulpal or periapical evaluation 1- If indicated, teeth should have endodontic treatment before restoration is completed. 2- a tooth previously endodontically treated that shows no evidence of healing or has an inadequate filling or a filling exposed to oral fluids should be evaluated for re- treatment before restorative therapy is initiated

16. B- periodontal 1-periodontal treatment should precede operative care, especially when improved oral hygiene, initial scaling, and root planning procedure 2- Tooth with a questionable periodontal prognosis should not receive an extensive restoration 3- The correction of gross restorative defects in restoration contours (e.g., open contacts, gingival overhangs, and poor embrasure form) is considered a part of initial periodontal therapy

17. C- orthodontic 1-Orthodontic therapy may include extrusion or realignment of teeth to provide favorable interdental spacing, stress distribution, function, and esthetics 2-All teeth should be caries-free before orthodontic banding..

18. D- surgical 1- impacted , unerupted , and hopelessly involved teeth should be removed before operative treatment when second molars that are to be restored might be damaged or dislodged during the removal of third molar 2-soft-tissue lesions, complicating , and improperly contoured ridge areas should be eliminated or corrected before final restorative care.

19. E- prosthodontic 1-restorations should be completed before placing indirect restorations 2- retention features must be placed well inside the restoration so that the material remains after tooth preparation for a crown 3-tooth preparations and restorations should allow for the design of the removable partial denture. This includes allowance for rests, guide planes , and clasps.

20. F- OCCLUSION 1-The occlusion should be evaluated ,adjusted to establish static anatomic occlusion 2-eliminate non functional interference before any extensive restoration therapy

21. G- IMPLANT . 1-operative dentistry restorations should be planned and executed to allow for all the necessary parameters for successful implant restorations, including adequate space mesiodistally and vertically . 2- Also, implant restorations may sometimes have unusual proximal contours , and adjacent amalgam or composite restorations should be designed to create the best proximal contact relationships possible.

22. Indication for operative dentistry A. Preventive measures (medical model of treatment) B. Incipient caries C. Esthetic Treatment D. Non carious lesions (abrasion, erosion, and attrition). E. Root surface caries F. Root surface sensitivity G. Repair of an exciting restoration H. Replacement of an exciting restoration

23. Thank you