Identifying and Charting Restorations

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Identifying and Charting Restorations

• Marcia Espinoza, Reina Ligeralde, Dorinda Thomas
• DEH 21
• 5.13.08

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Common Dental Materials

• Amalgam
• Composite
• Porcelain

• Sealant
• Veneer
• Post

• Fixed Partial Denture
• Inlay
• Onlay

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Amalgam

• An alloy that consists chiefly of silver mixed
  with mercury and variable amounts of other metals
• Appears radiopaque radiographically

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Amalgam Appearances

• Clinical

Radiographic
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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)

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Composite Appearance
Clinical
Radiographic
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Porcelain

• Produced by mixing ceramic powder with distilled
  water
• Appears radiopaque radiographically

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Porcelain Appearances

• Clinical

Radiographic
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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

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Sealant Appearances

• Clinical

Radiographic

• Not seen but possibly a faint radiopacity on
  occlusal surface

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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

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Veneer Appearances
Clinical
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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

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Post and Crown Radiograph
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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.

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FPD aka Bridge Appearance
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Inlay vs. Onlay
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Inlay vs. Onlay Clinical Appearances
Inlay
Onlay
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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

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Surface Restoration Appearances

• Clinical

Radiographic
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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.

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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.

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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.

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Test YOUR Knowledge!

• Identify 3 incorrect charted restorations.

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Amalgam or Stain?

• Name two ways you can tell if your patient has an
  amalgam or a stain.

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Composite or Sealant?

• What is the difference between the two?

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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.

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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.

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Questions?