By Unknown on Friday, January 28, 2011 with 0 comments

1)      The involved tooth was isolated with cotton rolls as it is easier to work in a dry environment
2)      The tooth surface was cleaned with the wet cotton wool pellet then the surface was dried using another cotton pellet. The wet cotton wool pellet removes debris and plaque from the surface for improved visibility enabling to visualize the extent of lesion and any unsupported enamel.
3)      If the entrance to the lesion was small , the working tip of the dental hatchet was place in the entrance of the cavity and rotated it backwards and forwards .The corner of the working tip was placed in the cavity first and rotated .Here the hatchet was used to replace the bur .Unsupported enamel was broken off creating an opening large enough for the small excavator to enter .when the carious lesion was sufficiently  large , there was no need for further widening  the cavity.
4)      Removal of caries : Depending upon the size if the cavity , the small or medium sized excavator was used .Caries was removed at the DEJ before removing caries from the floor of the cavity  .The soft excavated caries material was deposited on the cotton wool roll placed next to the tooth. The thin unsupported enamel was broken away carefully by placing the hatchet on the enamel and pressing  gently downwards  .The cavity was cleaned using a small cotton pellet .It was seen that all soft caries was removed and unsupported enamel was broken off and dentinoenamel junction was thoroughly cleaned to retard caries progress and obtain a good seal of the coronal part of the restoration .Any mild pain if caused during the cleaning process was limited to a few moments only .
5)      Pulp protection if necessary – This was used only for one deep cavity which was achieved by placing a setting calcium hydroxide paste covering only that part of the cavity floor where the sensation or inconvenience was felt
6)      Cleaning of occlusal surface  - All the adjoining pit and fissures were cleared of plaque and debris as much as possible using a probe and a wet cotton pellet
7)      Conditioning the cavity – A drop of dentine conditioner was used on a cotton pellet rubbing the cavity and occlusal surface for 10-15 seconds .Then conditioned surface was washed sufficiently with wet cotton wool pellets and the surface was dried using dry pellets
8)      Mixing the cement – Glass inomer  mixing was done according to the powder –liquid ratio
(this step was carried out by an assistant , who was trained for this purpose )
9)      Filling the cavity – mixed materials are inserted using the flat end of the excavator and plugged in to the corner’s of the cavity with a ball burnisher . Caution was taken to prevent the inclusion of air bubbles, the material was also placed over the adjoining pit and fissures in small amounts.
10)  Gloved finger to which was applied petroleum jelly ( bio-line) was placed on top of the entire occulsal surface and slight pressure was applied  (press finger technique ) only for a few seconds and the finger was removed by sliding pressure allowing the glass inomer to flow in to deeper parts of the pits and fissures .Any excess material which was over flowing on the occlusal surfaces was removed easily by spoon excavator .
11)  Checking of the bites – any articulating paper was placed over the filling and the child was asked to close the teeth . Any excess material was removed with the carver .Only small corrections were required .
12)  The bite was rechecked and the height of the restoration was adjusted until it was comfortable.
13)  Varnish was applied using small cotton pellet only once on the restoration
14)  The child was instructed not to eat atleast for one  hour .


Category: Conservative and Endodontics Notes , Endodontics Notes



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