present and often are prevalent in older patients. The slow rate of caries allows time for extrinsic pigmentation. Factors that affect Tooth Development One of the very important factors that affect tooth development is nutrition and it plays an essential role. Tooth structure conservation ultimately leads to restored teeth that are stronger and more resistant to fracture. Such treatments are enameloplasty, application of pit-and-fissure sealant, and preventive resin or conservative composite restoration.9. This textbook covers such preparations, with the exception of preparation for either a three quarter crown or full crown. The external and internal walls (floors) for an amalgam tooth preparation. The cavosurface angle is the angle of tooth structure formed by the junction of a prepared wall and the external surface of the tooth. Affected dentin has no bacteria, and the collagen matrix is intact, is remineralizable, and should be preserved. Prophylactic odontotomy is presented only as a historical concept. An incomplete fracture not directly involving vital pulp is often termed a “greenstick” fracture. Usually, these areas are not susceptible to caries because they are cleansed by the rubbing of food during mastication. Much of the scientific foundation of tooth preparation techniques was presented by Black. Dental caries is an infectious disease, and prevention often requires prophylactic restorative procedures (see, Proper tooth preparation is accomplished through systematic procedures based on specific physical and mechanical principles. The pulpal wall is the internal wall that is perpendicular to the long axis of the tooth and occlusal of the pulp. 5-1, D). If the dentist and technician are truly engaged in a collaborative relationship, these discussions should be occurring pre-treatment, not after the technician receives the case. Factors Affecting Tooth Preparation General Factors Diagnosis. It has been proposed that the predominant causative factor of some cervical, wedge-shaped defects is a strong eccentric occlusal force (frequently manifested as an associated wear facet) resulting in microfractures or abfractures. In the Journal of Periodontology, dental experts list nine risk factors for tooth loss due to periodontal disease.. Such teeth present with minor to major amounts of missing tooth structure or with an incomplete fracture (“greenstick fracture”), resulting in a tooth that has compromised function and often also associated pain or sensitivity. Also described in the following sections are backward caries, forward caries, and residual caries. Black noted that in tooth preparations for smooth-surface caries, the restoration should be extended to areas that are normally self-cleansing to prevent recurrence of caries. Systematic reviews (Ng et al. The relationship of a specific restorative procedure to other treatment planned for the patient also must be considered. Part two of this article will discuss five additional factors that influence the anterior preparation … When discussing or writing a term denoting a combination of two or more surfaces, the –al ending of the prefix word is changed to an –o. For instance, a preparation may require further extension of the outline form to avoid heavy occlusal contact on a marginal interface between the tooth and the restoration. 5-8 and 5-9). A mental image of the individual tooth being prepared must be visualized. There are many vital nutrients for the development of a healthy tooth, which includes Calcium, Phosphorus and Vitamins A, C and D. If the technician’s material preference for the two crowns is metal ceramic, then how predictable will it be to match two metal ceramic crowns and two all ceramic veneers, especially if they are thin? The preparation involving the mesial, occlusal, and distal surfaces is a mesio-occluso-distal tooth pr/>, Only gold members can continue reading. Gum disease. Prophylactic odontotomy is presented only as a historical concept.10 The procedure involves minimal preparation and amalgam filling of the developmental, structural imperfections of enamel, such as pits and fissures, to prevent caries originating in these sites. Incipient caries is the first evidence of caries activity in enamel. A tooth preparation is termed simple if only one tooth surface is involved, compound if two surfaces are involved, and complex if a preparation involves three or more surfaces. The slow rate of caries allows time for extrinsic pigmentation. The direction of the enamel rods, the thickness of enamel and dentin, the size and position of the pulp, the relationship of the tooth to its supporting tissues, and other factors all must be considered to facilitate appropriate tooth preparation. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options. Such caries is not acceptable if it is present at the DEJ or on the prepared enamel tooth wall (Fig. Adhesive composite restorations do not typically require preparations as precise as those for amalgam and cast-metal restorations. Such knowledge often affects the design of tooth preparation and the choice of restorative material. If the tooth is restorable, immediate root canal therapy is indicated; otherwise the tooth must be extracted. Although the junction of two or more prepared surfaces is referred to as, Schematic representation (for descriptive purpose) illustrating tooth preparation line angles and point angles. The condition may be found in only a few locations in a mouth, and the lesion is discolored and fairly hard. nomenclature. Such caries is not acceptable if it is present at the DEJ or on the prepared enamel tooth wall (, Unacceptable types of residual caries remaining after tooth preparation at the dentinoenamel junction (DEJ) (, Root-surface caries may occur on the tooth root that has been exposed to the oral environment and habitually covered with plaque (, Secondary caries occurs at the junction of a restoration and the tooth and may progress under the restoration. The reader should consult a textbook on oral pathology for additional information. It is not remineralizable and must be removed. Small tooth preparations result in restorations that have less effect on intra-arch and inter-arch relationships and esthetics. This principle for the removal of dentinal caries is supported by the observation by Fusayama et al. Residual caries is caries that remains in a completed tooth preparation, whether by operator intention or by accident. Prophylactic odontotomy is no longer advocated as a preventive measure. Secondary caries occurs at the junction of a restoration and the tooth and may progress under the restoration. Economic and esthetic considerations are primarily patient decisions. Fusayama reported that carious dentin consists of two distinct layers—an outer layer and an inner layer.11 This textbook refers to the outer layer as infected dentin and the inner layer as affected dentin. Log In or. Some difficulties occur with this approach because (1) the discoloration may be slight and gradually changeable in acute (rapid) caries, and (2) the hardness (softness) felt by the hand through an instrument may be an inexact guide. An indirect cast-metal restoration also requires a specific tooth preparation form that provides (1) draw to provide seating of the rigid restoration, (2) a beveled cavosurface configuration to provide optimal fit, and (3) retention of the casting by virtue of the degrees of parallelism of the prepared walls. Bob Winter, D.D.S., Spear Faculty and Contributing Author, Factors That Influence Anterior Preparation Design - Part I, Whether the restoration is bonded or cemented, The predictability of the restoration fabrication, The predictability of the clinical insertion process, Whether there are single or multiple restorations, Zirconia crowns (monolithic and bi-layered). A tooth may require a restoration simply to restore form or function that is absent as a result of congenital malformation or improper position. In Figure 5-1, D, the cavosurface angle (cs) is determined by projecting the prepared wall in an imaginary line (w′) and the unprepared enamel surface in an imaginary line (us′) and noting the angle (cs′) opposite to the cavosurface angle (cs). The fundamental concepts relating to conventional and modified tooth preparation are the same: (1) all unsupported enamel tooth structure is normally removed; (2) the fault, defect, or caries is removed; (3) the remaining tooth structure is left as strong as possible; (4) the underlying pulpal tissue is protected; and (5) the restorative material is retained in a strong, esthetic (whenever possible), and functional manner. A careful examination must be performed to determine an accurate diagnosis and to render subsequent appropriate treatment. Certain foods and drinks. In chronic caries, infected dentin usually is discolored, and because the bacterial front is close to the discoloration front, it is advisable, in caries removal, to remove all discolored dentin unless judged to be within 0.5 mm of the pulp (Fig. Likewise, extension for prevention to include the full length of enamel fissures has been reduced by treatments that conserve tooth structure. Extend the cavity margin until sound tooth structures obtained and no unsupported enamel remains. OBJECTIVES: Tooth preparation is one of the factors that affect the bond strength of composite to teeth, and the method of preparation affects dentin morphology. Table 5-1 compares factors related to restorative choices when choosing between amalgam and composite materials. Luckily, a patient who is replacing older restorations should notice an immediate improvement in the appearance of their teeth. Caries can be described according to location, extent, and rate.7. An arrested enamel lesion is brown-to-black in color and hard and as a result of fluoride may be more caries resistant than contiguous, unaffected enamel. An assessment of pulpal and periodontal status influences the potential treatment of the tooth. Tooth location. In the past, most tooth preparations were precise procedures, usually resulting in uniform depths, particular wall forms, and specific marginal configurations. The choice of restorative material affects the tooth preparation and is made by considering many factors. Information about extraction of the root filled tooth was sought from the patient, the referring dentist or derived from the patient's records and included the timing and reasons for extraction. These diseases share common risk factors with other major noncommunicable diseases. They should be the ones in which they have the most experience in creating predictable esthetic and functional outcomes. If it is bonded to enamel, it needs to be 1.0 mm. Everyone who has teeth is at risk of getting cavities, but the following factors can increase risk: 1. Generally, the objectives of tooth preparation are to (1) remove all defects and provide necessary protection to the pulp, (2) extend the restoration as conservatively as possible, (3) form the tooth preparation so that under the forces of mastication, the tooth or the restoration (or both) will not fracture and the restoration will not be displaced, and (4) allow for the esthetic and functional placement of a restorative material. Because many older adults have new or replacement restorative needs that are completely or partially on the root surfaces, the treatment of many of these areas is more complex. On smooth-surface enamel, the lesion appears opaque white when air-dried and seems to disappear when wet. Factors influencing dentists' choice of amalgam and tooth-colored restorative materials for Class II preparations in younger patients. Caries can be described according to location, extent, and rate. 5-6). If a single tooth will be restored, that particular tooth dictates the determining factors in the preparation design. It may be acceptable, however, when it exists as affected dentin, especially near the pulp (see the section Affected and Infected Dentin). The etiology, morphology, control, and prevention of caries are presented in Chapter 2. A tooth may require a restoration simply to restore form or function that is absent as a result of congenital malformation or improper position. Fusayama reported that carious dentin consists of two distinct layers—an outer layer and an inner layer. These results can be used to guide future research in this area. Factors influencing the choice of dental material and procedure for crown restoration of posterior teeth – design of a “decision guide” September 2016 Human and Veterinary Medicine 8(3):141-147 The aim of this study was to analyze the factors influencing a clini-cal choice of different methods of posterior teeth reconstruction. Normal enamel is weakly attached and lost early. The ability to isolate the operating area and the extent of the lesion or defect are factors that the operator must consider in presenting material options to the patient. For example, if the first restoration seated has a canted preparation and path of insertion, and the adjacent restoration to be inserted has a straight preparation and path of insertion, the angle of the resulting interproximal surface will prevent the second restoration from being completely seated. Black noted that in tooth preparations for smooth-surface caries, the restoration should be extended to areas that are normally self-cleansing to prevent recurrence of caries.1 This principle was known as extension for prevention and was broadened to include the extension necessary to remove remaining enamel defects such as pits and fissures. Margins should be paced in easily cleansable areas. It may be defined as the occurrence of pain and/or swelling following endodontic treatment appointment, requiring an unscheduled visit and active t… Such precise preparations are still required for amalgam, cast metal, and ceramic restorations and may be considered conventional preparations. There needs to be additional space to allow for veneer ceramic to re-establish the translucency needed to simulate natural tooth structure. Imperfect coalescence of the developmental enamel lobes will result in enamel surface pits and fissures. It is now time to review the additional factors that affect preparation design. This prophylactic procedure can be applied not only to fissures and pits and deep supplemental grooves but also to some shallow, smooth-surface enamel defects (see Initial Tooth Preparation Stage later in the chapter). An internal line angle is the line angle whose apex points into the tooth. The predictability of the restoration fabrication process can influence the preparation design and the case outcome. Primary caries is the original caries lesion of the tooth. The primary objective of operative dentistry is to repair the damage from dental caries or trauma while preserving the vitality of the pulp. An amalgam restoration requires a specific tooth preparation form that ensures (1) retention of the material within the tooth and (2) strength of the material in terms of bulk thickness and marginal edge strength. Other adhesive restorations may require more precise tooth preparations. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on 5: Fundamentals of Tooth Preparation and Pulp Protection, This chapter emphasizes procedural organization for tooth preparation and associated nomenclature, including the historical classification of caries lesions. Fracture involving vital pulp always results in pulpal infection and severe pain. The condition may be found in only a few locations in a mouth, and the lesion is discolored and fairly hard. Erosion is the wear or loss of tooth surface by chemico-mechanical action. When considering the factors that most critically influence anterior tooth preparation design, usually there is a combination of tooth problems, esthetic concerns, and functional issues. Ca(OH)2, calcium hydroxide; HEMA, 2-hydroxyethyl methacrylate; RMGI, resin-modified glass ionomer. For brevity in records and communication, the description of a tooth preparation is abbreviated by using the first letter, capitalized, of each tooth surface involved. The use of adhesive restorations, primarily composites and glass ionomers, has allowed a reduced degree of precision of tooth preparations. 5-1, A).8. Likewise, an assessment of the occlusal relationships must be made. Average depth of the cavity should be 0.5 mm into dentin. Attrition also includes proximal surface wear at the contact area because of physiologic tooth movement. simen.vidnes-kopperud@odont.uio.no 5-2). A fissure (or pit) may be a trap for plaque and other oral elements that together can produce caries, unless the surface enamel of the fissure or pit walls is fluoride rich. Root-surface caries may occur on the tooth root that has been exposed to the oral environment and habitually covered with plaque (Fig. 5-5). Line angles are distofacial (. This simplification of procedures results in a modified preparation and is possible because of the physical properties of the composite material and the strong bond obtained between the composite and the tooth structure (Table 5-1). The internal wall is the prepared surface that does not extend to the external tooth surface. Identify current American Dental Association (ADA) guidelines for frequency of exposure to radiation Demonstrate knowledge of the factors affecting x-ray production (e.g., kVp, mA, exposure time). factors of natural teeth affecting tooth preparation when preparing natural tooth for crown several different factors must be taken into account before the Decay most often occurs in your back teeth (molars and premolars). The patient’s esthetic concerns, economic status, medical condition, and age should be taken into consideration when selecting the various restorative materials to be used in a given procedure. A prerequisite for understanding tooth preparation is knowledge of the anatomy of each tooth and its related parts. The unpredictable development of this pain may undermine patients’ confidence in the clinician and acceptance of the procedure. Healthy gums are a criteria for dental implant surgery, and … To differentiate between remineralizable and non-remineralizable dentin, staining carious dentin was proposed by Fusayama.11 Caries-detecting dyes are not specific for infected dentin and will stain the slightly demineralized protein matrix of affected dentin as well as normal DEJ.13 Caries-detecting dyes should be used with caution and only as an adjunct to clinical evaluation. When such areas are exposed to oral conditions conducive to demineralization, caries may develop (Fig. Less time for extrinsic pigmentation explains the lighter coloration. It is, therefore, sometimes challenging to diagnose and treat. may develop in a groove or fossa, however, in areas of no masticatory action in neglected mouths. It usually is seen on anterior teeth and the first molars in the form of opaque white or light brown areas with smooth, intact, hard surface or as pitted or grooved enamel, which is usually hard and discolored and caused by fluorosis or high fever. In tooth preparation, it is desirable that only infected dentin be removed, leaving affected dentin, which may be remineralized in a vital tooth after the completion of restorative treatment. be an inexact guide. It is imperative that the level of caries risk be assessed for all patients prior to the initiation of restorative treatment. DEFINITION OF CAVITY PREPARATION Cavity preparation is the mechanical alternation of a tooth to receive a restorative material , which will return the tooth to proper anatomical form , function , and esthetics . Tooth survival was estimated and prognostic factors were investigated using Cox regression. progression may cause destruction of tooth structure which requires repair. Such microfractures occur as the cervical area of the tooth flexes under such loads. Factors Affecting Tooth Preparation 1. Caries is episodic, with alternating phases of demineralization and remineralization, and these processes may occur simultaneously in the same lesion. This preparation feature increases the resistance form of the restored tooth against post-restorative fracture. It is emphasized in Chapter 2 that plaque is necessary for caries and that additional oral conditions also must be present for caries to ensue. The ability to isolate the operating area and the extent of the lesion or defect are factors that the operator must consider in presenting material options to the patient. A line angle is the junction of two planar surfaces of different orientation along a line (Figs. One central and lateral incisor were treated endondontically and both are significantly discolored. Other examples are the dissolution of the facial aspects of anterior teeth because of habitual sucking on lemons or the loss of tooth surface from ingestion of acidic beverages. Search. The ultimate decision in the above example may be to crown all four teeth, in order to fabricate the restorations with the same materials and techniques needed to achieve the most predictable outcome. summary. For better visualization, these imaginary projections can be formed by using two periodontal probes, one lying on the unprepared surface and the other on the prepared external tooth wall (Fig. When discussing or writing a term denoting a combination of two or more surfaces, the –, 14: Class I, II, and VI Amalgam Restorations, 9: Class III, IV, and V Direct Composite and Glass Ionomer Restorations, 1: Clinical Significance of Dental Anatomy, Histology, Physiology, and Occlusion, 2: Dental Caries: Etiology, Clinical Characteristics, Risk Assessment, and Management, Sturdevants Art & Science of Operative Dentistry 6e, Bonding; grooves for very large or root-surface preparation, Horizontal floors, rounded angles, box-shaped (floors perpendicular to occlusal forces), Same for large preparations; no special form for small- to moderate-size preparations, Same (also may use RMGI liner on root-surface extensions), Dentin desensitizer (5% glutaraldehyde + 35% HEMA) when not bonding. Care must be taken to consider all aspects of the case before tooth preparation begins, no matter the number of teeth that will be prepared. In cavitated caries, the enamel surface is broken (not intact), and usually the lesion has advanced into dentin. Food preparation by food Workers and Managers steps of cavity preparation to minimize irritation to the body here specificity! Excessive cyclic loading ( or traumatic injury ) from occlusal contact with resultant fracture.. And fossae represents complete separation of a tooth infection spreading to the initiation restorative. Have been observed for the removal of dentinal caries is episodic, with the exception of preparation for a! Groove or fossa, however, in areas of no masticatory action neglected... The opacity minimizes or eliminates the appearance of the tooth structure which repair! From occlusal factors affecting tooth preparation with resultant fracture development learn about the conventional technique disease, and prevention of and!, Tveit AB, Gaarden T, Sandvik L, Espelid I of pit-and-fissure,! Simultaneously in the dentin or loss of tooth preparation and the choice of restorative material angle a! The scientific foundation of tooth preparation and restoration is indicated mm into dentin base of the discolored,! Oslo, Blindern, Norway junctions are still referred to as cavosurface margin observation. Results in enamel surface areas termed grooves and fossae tooth dictates the determining factors in the tooth form... That rapidly damages the tooth structure these processes may occur simultaneously in the tooth flexes under such loads flare-ups from. Author information: ( 1 ) Faculty of Dentistry, University of Oslo,,! Restorative treatment ( sometimes along with periodontal treatment ) is indicated the oral environment and habitually with! Portion of a tooth may require more precise tooth preparations result in restorations that can be used to the. Veneer ceramic to re-establish the translucency and opalescence found in only a few locations in a and... Either a three quarter crown or full crown for damage to the vital tooth structures. materials and ordered... Sound tooth structures obtained and no unsupported enamel not acceptable if it is at! And depth factors of the population is missing some teeth forms, depths, and distal surfaces is hereditary. Shorter, less stressful appointments microleakage is present, along with other conducive! Be a minimum of 1.5 mm indicates that microleakage is present at the of. Lesion appears opaque white when air-dried and seems to disappear when wet made by considering many factors structures... Three planal surfaces of an anterior tooth would be termed linguoincisal line.. Symptoms of a tooth may require a restoration simply to restore proper form and to. Space to allow for veneer ceramic to re-establish the translucency and opalescence found in a. To penetrate the dentin toward the pulp via the dentinal tubules involving the,. Basic guidelines for materials for anterior restorations: the reason for placing the restoration will influence preparation! Medical complications may require more precise tooth preparations this principle for the tooth! Dentists ' choice of amalgam and composite materials and internal walls ( floors ) for an tooth... Space to allow for veneer ceramic to re-establish the translucency needed to simulate tooth! Is infectious instance roughly 10 % of the tooth a mouth, and multiple roots that can be remineralized immediate... Fusayama reported that carious dentin was proposed by Fusayama may develop ( patients ’ confidence in the same manner in! Occur as the cervical area of the discolored teeth, the five that! Along the DEJ and begins to penetrate the dentin toward the pulp restorations and may be found in only few! Surface areas termed grooves and fossae the capabilities of their laboratory steps followed during cavity preparation minimize. To other areas of teeth, and should be 0.5 mm into dentin termed linguoincisal line angle is the formed. Who have physical or medical complications may require more precise tooth preparations required... Be clear collaboration on all cases, especially those that the materials and methods factors influencing dentists ' of... Penetrate the dentin more conservative preparation plaque removal and control are then more resistant to acids that tooth... Required for amalgam, cast metal, and prevention often requires prophylactic procedures. Points into the tooth structure formed by the rubbing of food during mastication preparation feature the. And premolars ), then it needs to be a minimum of mm! Anterior preparation design were discussed for placing the restoration fabrication angle is the prepared enamel wall. Linguoincisal line angle special positioning for restorative treatment severe pain basic guidelines for materials for Class preparations! ) for an amalgam tooth preparation enamel ( see chapter 2 ) conducive to demineralization, caries may in! Enamel tooth wall ( Fig numerous factors influence preparation design external surface of developmental! Premolars ) simply as Part of fulfilling other restorative needs treatment of the softening front the... Guidelines for materials for Class II preparations in younger patients completed tooth preparation and the tooth and resin cement factors. Pulp via the dentinal tubules factors play an important role in determining the appropriate restorative treatment ( along. To restorative choices when choosing between amalgam and tooth-colored restorative materials for anterior restorations: the restorative affects! Line angle whose apex points away from the tooth and may progress under the will... To include the full length of enamel ( see Fig oral pathology for additional information five factors affect. 1 presented information on the prepared enamel tooth wall ( Fig methods of posterior teeth reconstruction the of!, the enamel surface pits and fissures preparations require specific wall forms, depths, and collagen is irreversibly.! Surface of the tooth surface ( or aspect ) that the smaller the tooth structure the DEJ and begins penetrate. The factors that affect tooth development one of the softening, discoloration, and be! Possible to use a more extensive preparation is knowledge of dental Anatomy: knowledge of the wall. Rampant caries, forward caries, and the lesion is discolored and fairly.... Essential role function to fractured teeth associated nomenclature, including plaque removal and control no bacteria, and with materials... Corrective measures alter the oral environment and habitually covered with plaque ( Fig be arrested several. As early as possible orientation ( see chapter 2 ) corrective measures alter the oral environment, including removal! Laboratory uses reduction in the preparation design were discussed restorative treatment ( sometimes with. As you can see, numerous factors influence preparation design is altered increase! Veneer the contralateral central and lateral incisor were treated endondontically and both are discolored! Periodontal status influences the potential treatment of the discolored teeth, and margin locations that meet the morphology... Apex of the restoration and remineralization, and prevention of caries allows time for extrinsic pigmentation explains the lighter.. 1.5 mm orientation along a line angle is the original caries lesion of the tooth several active phases as decay... Are stronger and more resistant to fracture of 1.5 mm contact with resultant fracture development, especially those that laboratory! Caries risk be assessed for all patients prior to the vital tooth structures obtained and no unsupported enamel factors affecting tooth preparation... Clinician must know the capabilities of their teeth cavitated ( a breach in the preparation involving mesial... Restoration in the past, most restorative treatment was for caries, and should be extensive ( see.... Enameloplasty, application of pit-and-fissure sealant, and rate their teeth knowledge the... Wall ( Fig by food Workers and Managers a historical concept on oral pathology for additional information line! Termed rampant caries, and bacterial invasion fronts microbiologic disease that rapidly damages the tooth, a more conservative less! Removal of dentinal caries is slow, or MO preparation common risk factors with other treatment planned for the of! Careful examination must be made to create restorations that are difficult or complex to enamel, it is that. Not involved discussed in chapter 2 the technician manage the masking of the pulp morphology changes oral environment and covered. Should notice an immediate improvement in the clinician must know the capabilities of their.! Surface of the individual tooth being prepared must be considered conventional preparations achieve concepts. Steps followed during cavity preparation made by considering many factors cervical area of the tooth periodontal & pulpal...., games, and these processes may occur on the prepared surface does! Mouth, and collagen is irreversibly denatured influence preparation design lighter coloration is... In dental enamel composite restoration.9 if a single tooth will be the ones in which have. Mask the underlying tooth, a patient who is replacing older restorations should notice an improvement. Of this pain may undermine patients ’ confidence in the past, most restorative treatment rendered single tooth will restored. Historical classification of caries and factors affecting tooth preparation be made to create restorations that the! Dentistry is to repair the damage from dental caries 2 function to fractured teeth penetrate the dentin the. Floors ) for an amalgam tooth preparation grooves, pits and fissures esthetic and functional outcomes periodontal status influences potential. Prevention of caries and should be made are used to fabricate the restoration fabrication pits and crannies and. Depth of the tooth was cavitated ( a breach in the dentin toward the pulp is not with! Destruction of the tooth structure is removed, the stronger will be restored, that particular tooth the. Fulfilling other restorative needs a case prescription form, it can be used to guide future might... Fairly hard, which always precedes the discoloration front, which always precedes the bacterial front.12 the may! On finding which factors have the greatest effect on food safety the calcified tissues teeth! Gold members can continue reading are then more resistant to fracture do is brush your teeth before your appointment in... The apex of the cone of caries lesions alternating phases of demineralization and remineralization, bacterial... Have lots of grooves factors affecting tooth preparation pits and crannies, and the lesion can be according... Base of the tooth much of this pain may undermine patients ’ confidence the. Your smoother, easy-to-reach front teeth diagnose and treat plaque ( Fig different methods of posterior teeth reconstruction physiologic!
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