MINISTRY OF HEALTH OF UKRAINE

BOGOMOLETS NATIONAL MEDICAL UNIVERSITY

Operative Dentistry Department

«Approved»

at the meeting of the Operative Dentistry department

Report № ____ of ___________ , 2017

Head of department __________ prof. А.V. Borysenko

GUIDELINES

FOR INDEPENDENT WORK OF STUDENTS

WHILE PREPARING FOR THE PRACTICAL LESSON

Academic discipline Propaedeutics of operative dentistry

Module № 1 Propaedeutics of operative dentistry

Content module № 1 The basic dental tools and equipment. The anatomical structure of the permanent teeth

Lesson Focus The principles and stages of the caries cavities

preparation. Black's classification of cavities. TheΙ and V class cariouscavitiespreparation. The choice of

instruments.

Course ІІ

Faculty Dental

Number of hours 1

Compiler: prof. Lynovitskay O.V. , ass.prof. Timokhina T.O.

Methodist: ass.prof. Kolenko Y.G.

Kyiv – 2017

THE PRINCIPLES AND STAGES OF THE CARIES CAVITIES PREPARATION. BLACK'S CLASSIFICATION OF CAVITIES. THE Ι AND

V CLASS CARIOUS CAVITIES PREPARATION. THE CHOICE OF INSTRUMENTS.

I. Actuality of theme A saprodontia is a pathological process, arising up after an odontiasis under

the action of various factors (general, local), and shows up a demineralization and destruction of hard fabrics of tooth with formation of defect as a cavity.

The basic method of treatment of carious cavities is preparing – operative treatment of tooth at which delete nonviable hard fabrics of tooth with the subsequent stopping. Therefore preparing, including forming of carious cavity – is extraordinarily important in further professional activity of doctor-stomatology. At faithful implementation of all manipulations it prevents further destruction of hard fabrics of tooth and provides the adequate fixing of stopping material. Ability it is correct to prepare carious cavities I and the V classes will provide the reliable fixing of stoppings and will prevent the origin of the second caries.

II. Educational aims of employment

General: to master general principles of preparing of carious cavities, in

particular cavities I and the V classes. Concrete: To have ((-I): general picture of preparing of carious cavities; picture of патоморфологических features of development of cariosity general picture of stomatological tool for preparing of carious cavities.

To know ((-II): classification of carious cavities on Bleku; general principles of preparing of carious cavities; stages of treatment of carious cavities; essence of principle of "biological expedience"; essence of principle of "technical rationality"; features of method of "prophylactic expansion"; principle of the "prophylactic stopping", features of preparing. ways of distribution of cariosity on the different surfaces of tooth; description of carious defects I and the V classes; method of preparing of carious cavities of the I classes; method of preparing of carious cavities of the V classes; method of forming of придесневой wall; error and complication at preparing of carious cavities I and the V classes.

Able ((-III, (-IV): to determine the class of carious defects on Blek;

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to choose a stomatological equipment and instruments depending on the stage of preparing of carious cavities, in particular I and the V classes;

to conduct the choice of stomatological tool depending on the sizes of carious cavity.

to determine I and the V classes of carious defects on Bleku; отпрепарировать different variants of carious cavities of the I classes; отпрепарировать carious cavities of the V classes.

III. Purpose of development of personality (educator aims)

During employment to develop for students sense of professional

responsibility for a timeliness and ability to prepare on phantom models carious cavities I and the V classes with the purpose of acquisition of skills before work in a clinic.

IV. Mezhdistsiplinarnaya integration

Disciplines

To know

Able

Previous disciplines

Anatomy of man

Anatomy of teeth, terms of прорезывания of teeth.

To distinguish the basic anatomic structures of the second teeth.

Histology

Features of development and histological structure of enamel, dentine, endodontium.

To distinguish the histological structures of tooth.

Biochemistry

Biochemical processes, what be going on in the period of book-mark, минерализации of teeth.

Pathoanatomy

Patomorfologicheskie features of development of cariosity.

Inwardly-subject integration

Stomatological equipment Stomatological tool

Stomatological equipment and tool for each of the stages of preparing of carious cavities

- to determine the class of carious defects on Bleku;

- to choose a stomatological equipment and instruments depending

Занятие №6

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on the stage of preparing of carious cavities;

- to conduct the choice of stomatological tool depending on the sizes of carious cavity.

-

V. Table of contents of theme of employment

PREPARING OF CARIOUS CAVITIES Preparing is the medical stomatological operating on hard fabrics of

tooth with the purpose of delete of the pathologically changed fabrics and creation of form of cavity, which provides the comfortable and technological stopping, maintainance of прочностных descriptions of tooth, and also reliable fixing, durability, aesthetic and medical efficiency of the imposed stopping.

A purpose of preparing of carious cavity is creation of ретенционной (by a bar to loadings; to preventing possibility of splitting off) and резистентной (to the cooperant fixing of stopping) form of отпрепарированной cavity.

Select four basic stage of preparing of carious cavity: 1. Opening and expansion of carious cavity. 2. Necretomy. 3. Forming of carious cavity. 4. Forming of slant of enamel.

BASIC RULES OF PREPARING OF CARIOUS CAVITIES:

1. Painlessness. 2. Providing of reliable visual control during preparing. 3. Observance of the mode, governed, stages of preparing. 4. To have a clear picture of possibilities of the use and choice of instruments. 5. Observance of certain principles of preparing of carious cavity.

In the formed carious cavity on Bleku distinguish the followings elements:

• bottom • edge • walls • basic cavity • additional cavity or ground • corners

The formed carious cavities can be simple (cavities which bed on one surface of tooth) are cavities I, V classes; and difficult, when a few cavities on the

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different surfaces of teeth are united in one are cavities ІІ, ІІІ, IV classes. In difficult cavities distinguish a basic cavity and additional (supporting ground).

An important condition at preparing is a correct choice of the coniferous forest and working as a tip.

1. The coniferous forests must be: • sharp • firmly and without a vibration fastened in a tip • on the form and size to correspond the stage of the executable preparing. 2. To work it is necessary as the coniferous forest: • at the proper speed of his rotation: anymore at preparing of enamel and

intact dentine, less at the delete of the softened fabrics of enamel and dentine;

• by uneven motions (as if putting commas in the proper places cavities which are prepared), that irregularly for prevention of overburning of hard fabrics of tooth.

3. A tip during work must be reliably fixed in the hand of doctor in position of pen during a letter. On occasion, with the purpose of prevention of possible trauma of soft fabrics of cavity of mouth the additional fixing of tip is needed in the hands of stomatology. It can be carried out in number of different ways:

• holding a tip the fingers of left arm; • leaning a ring-finger and little finger of right arm on a dental row or

chin of patient; • leaning the pollex of left arm on a peccant tooth and holding the

end of tip indicatory.

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Table 6.1. CLASSIFICATION OF CARIOUS CAVITIES ON BLEKU (1915)

CLASSES CARIOUS CAVITIES

LOCALIZATION

I classes

ІІ class

ІІІ class

IV classes

V classes

VI classes (not included in

classic classification of

Bleka)

STAGGERED TEETH

chisels dog-teeth

large and small cheek-

teeth

large and small cheek-

teeth

chisels dog-teeth

chisels dog-teeth

all groups of teeth

all groups of teeth

SURFACES OF CROWN OF THE

TOOTH

language

жевательная, vestibular

pin (distal, медиальная)

pin (distal, медиальная)

pin (distal, медиальная)

vestibular, язычная/небная

жевательная, cutting an edge

ANATOMIC STRUCTURES

blind fossulas

фиссуры

–

without the defeat of

cutting edge and corner of

crown

with the defeat of cutting edge and corner of

crown

пришеечная облать

apexes of tubercles and cutting edge

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METHODS OF PREPARING OF CARIOUS CAVITIES (charts 6.1, 6.2)

At preparing of carious cavity fully all пораженые delete by a cariosity hard fabrics of tooth. Sometimes extend the area of preparing to the so-called кариесимунных areas (for example, tubercles of masticatory surface), that to those areas on which a caries develops very rarely. Recommended at one time Blekom «prophylactic expansion» of отпрепарированной cavity with plugging all фиссур of masticatory surface now use rarely in it. The more rational is consider offered I.G. Lukomskim (1948) «principle of biological expedience», when at preparing delete the hard fabrics of tooth only staggered a caries. Healthy fabrics of tooth are maximally saved thus. At the end of XX ages after appearance of compos and стеклоиономерных цементов (SITS) the method of the «prophylactic stopping was developed».

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Chart 6.1. Variants of tactic of preparing of carious cavities

Современная концепция минимальной интервенции (минимально-инвазивное лечение)

ВАРИАНТЫ ТАКТИКИ ПРЕПАРИРОВАНИЯ КАРИОЗНЫХ ПОЛОСТЕЙ

Метод “профилактического пломбирования”

Метод “биологической целесообразности"

Метод “профилактического расширения”

Химико-механический метод

Лазерный метод

Микропрепарирование

Ультразвуковое препарирование

Воздушно-абразивное препарирование

Тоннельное препарирование

Энамелопластика (профилактическая реставрация фиссур)

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Chart 6.2.

ПРИНЦИПЫ ПРЕПАРИРОВАНИЯ КАРИОЗНЫХ ПОЛОСТЕЙ

Принцип медицинского обоснования и целесообразности

Принцип щадящего отношения к тканям зуба

Принцип безболезненности всех лечебных диагностических и профилакических манипуляций

Принцип соблюдения правил асептики та антисептики.

Принцип визуального контроля и удобства работы.

Принцип сохранения целостности соседних зубов, пародонта и тканей полости рта

Принцип рациональности и технологичности манипуляций

Принцип ретенции и резистентности

Принцип биомеханического соответствия

Принцип создания условий для эстетического восстановления коронки зуба

Принцип эргономики.

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Table 6.2. FEATURES OF LEADTHROUGH OF THE STAGES OF PREPARING OF CARIOUS CAVITIES

Stages

Tool

I stages

ІІ stage

ІІІ stage

IV stages Delete of the

«old» stopping

Opening of cavity

Prophylactic expansion of

cavity

Necretomy

Forming of carious cavity

Forming of slant of enamel

Types of tips, speed office hours

Turbine (400000 об/мин.), to angular

with an enhanceable

number reduction (red marking water-cooled, to 150000

об/мин.)

Turbine (400000

об/мин.), angular tip (dark blue marking –

universal; green marking,

without the water cooling,

5-30 000 об/мин.)

Angular tip (dark blue marking – universal;

green marking,

without the water

cooling, 4,5-5 000 об/мин.)

Turbine (400000 об/мин.), angular tip (dark blue marking –

universal; green marking, without the

water cooling, 10-30 000 об/мин.)

Angular tip (dark blue marking – universal;

green marking, without the water cooling, 4,5-5

000 об/мин.)

Turbine (400000 об/мин.)

Instruments for preparing, coniferous forests

Diamond or hard-alloy coniferous

forests (фиссурний or spherical

coniferous forest)

Diamond or hard-alloy coniferous

forests

Hard-alloy spherical

coniferous forests, power-shovels

Diamond or hard-alloy coniferous forests

(фиссурные, обратноконусные).

Diamond fine-grained coniferous forests,

hard-alloy финиры.

Diamond or hard-alloy coniferous forests of

enhanceable cutting

efficiency

Criteria of self-control

Enter the coniferous forest in a carious cavity and delete

After treatment a dentine is

Walls are sheer at right angles to the bottom, or round-offs depending on

Take off burries and roughnesses of edges

of enamel

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the overhanging edges of enamel,

here motion of the coniferous forest is

directed from within outside. There are not

overhanging edges of enamel at

sounding of cavity. Walls are dense,

smooth. An enamel has an adjoining dentine along the

whole length. There is a good review (by a mirror) of

bottom and walls of carious cavity.

dense, smooth, a probe does not stay too long in him,

slides.

the type of stopping material. A bottom is

even or валикоподобное (in the case of deep caries for

prevention of perforation of cavity of tooth).

карборундовыми heads, diamond

финирами, by an enamel knife. The

edges of enamel are smooth, lean against a dentine. At treatment

of edges do the slant of enamel under the

corner of 45°.

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At preparing of carious cavities of the I classes, depending on localization and distribution of process carious cavities can acquire the following form:

- rectangular; - diamond-shaped; - cruciform; - oval; - et cetera

The formed carious cavities of the I classes have a ящикоподобную typiform with sheer walls and flat bottom. At preparing of deep carious cavities forming of flat bottom can be impossible because of danger of dissection of cavity of tooth and trauma of mash, especially in the places of projection of its horns. Therefore in such cases at preparing the bottom of carious cavity give shape, repeating the contours of cavity of tooth (пульповой chambers). Name a carious cavity located on the masticatory surface of tooth in area of фиссур central.

At two and anymore carious cavities, located on the masticatory surfaces of large and small cheek-teeth and part the areas of healthy fabric, it is necessary to prepare and stop every cavity separately. If carious cavities are divided the «membranes» of hard fabrics of tooth of doubtful durability (very thin), expedient will be their association in one cavity.

The feature of cavities of V CLASSES is that by reason of their origin,

except for a cariosity, there can be a number of other diseases of hard fabrics of teeth: wedge-shaped defects, erosions, hypoplasia, chronic trauma, caries of root et cetera

The cavities of the V classes are located very close to a gingival edge, and sometimes spread under him. From what in the process of their preparing and stopping stomatology it will be necessary to decide the row of additional tasks.

Basic features of preparing of carious cavities of the V classes: 1. As carious cavities of the V classes are placed within the limits of one surface

of tooth, then prepare them as cavities of the I classes. 2. The special attention is turned on preparing by придесневой walls, at

treatment of which the trauma of gum is possible. 3. The depth of cavity, as a rule, does not exceed 1,5 мм 4. The formed carious cavities of the V classes often require ретенционные

points from in relation to pony-size. 5. For the reliable joining of compo create the slant of enamel edge.

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Table 7.1. Variants of forming of carious cavities I and the V classes taking into account testimonies

Localization of carious cavity

Features of the formed cavity

Notes

І

to л

and with with

defeat of фиссур

form a cavity on a form staggered фиссур: cruciform, as a swalow-tail, oval, rounded

save tubercles (кариесиммунные areas)

defeat of фиссур of masticatory surface of the first large cheek-teeth of supramaxilla at the maintainance of enamel roller

form two cavity

to provide the maintainance of enamel roller

defeat of фиссур of small cheek-teeth of supramaxilla and second small cheek-teeth of lower jaw

form a cavity on all фиссуре

фиссуры excise fully, as they are staggered and not interrupted a roller

defeat of фиссуры on the cheek surface of large cheek-teeth on condition of maintainance of wall turned to the masticatory surface

form an oval cavity in staggered фиссуре without a leadingout on a masticatory surface

such form provides the reliable fixing of stopping

defeat of фиссуры on the cheek surface of large cheek-teeth at thinning of wall, turned to the masticatory

form a quadrangular cavity with a leadingout on a masticatory surface

delete the refined wall, turned to the masticatory surface

Занятие №6

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surface, and shallow cavity deep defeat with localization in area of фиссур on the cheek surface of large cheek-teeth

on a masticatory surface create ретенционные points or additional ground. Shirina of additional ground to the соответсвует width of basic cavity, a depth below than enamel-dentinal connection on 0,5-1 мм, on length a no more than 1/2 masticatory surface. The bottom of basic cavity must pass to the bottom of additional ground at right angles.

a step bottom allows to provide firmness of stopping during the vertical and horizontal loading

defeat of blind fossula of the second chisels of supramaxilla

form an oval cavity within the limits of carious cavity

provides the reliable fixing of stopping

small defeats of фиссур on the cheek and masticatory surfaces of large cheek-teeth

form the cavities of small sizes on жевательной and separately on a cheek surfaces

the sparing preparing provides the maintainance of the unstaggered fabrics of tooth

V classes

form a cavity as a prolate oval or подковообразной form according to the form of carious cavity; lateral walls and wall, turned to the crown of the tooth, form at right angles to the bottom, придесневую – under an acute angle. A bottom is protuberant, repeats the form of mash.

it is necessary to avoid excision of mash

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VI. Plan and organizational structure of employment № п/п

Basic stages of employment, their functions and maintenance

Educational aims are in the levels of

mastering

Methods of control and обучния

Materials of the methodical providing

Distributing of time (in minutes)

I. Preparatory stage

1 Organizational measures

–

Greeting, verification of presence of students and necessary educational materials, original appearance and others like that.

Academic magazine

2 minutes

2 Raising of educational aims and motivation

–

–

"Educational aims", "Actuality of theme".

2-3 minutes

3 Control of initial level of knowledges, skills, abilities:

20 minutes

3.1. Classification of carious cavities on Bleku.

ІІ

Individual theoretical questioning. Decision of typical tasks ІІ mastering level. Decision of test tasks ІІ mastering level. Writing theoretical control.

Question. Tables, pictures, sliding seats, structural-logical chart, pictures. Typical tasks ІІ mastering level. Test tasks ІІ mastering level. Writing theoretical tasks.

3.2. General principles of preparing of carious cavities. 3.3. Stages of treatment of carious cavities. 3.4. Principle of "biological expedience". 3.5. Principle of "technical rationality". 3.6. Features of method of "prophylactic expansion".

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3.7. Principle of the "prophylactic stopping", features of preparing. 3.8. Description of carious defects I and the V classes. 3.9. Method of preparing of carious cavities of the I classes. 3.10. Method of preparing of carious cavities of the V classes. 3.11. Method of forming of придесневой wall. 3.12. Error and complication at preparing of carious cavities I and the V classes.

II. Basic stage

4 Formings of professional skills and abilities:

90 minutes

4.1. To determine the class of carious defects on Bleku.

ІІІ

The professional training is in the decision of offtype clinical situations.

Algorithm for forming of professional abilities. Plaster casts, equipment. Text offtype situatioonal tasks.

4.2. To choose a stomatological equipment and instruments depending on the stage of preparing of carious cavities, in particular I and the V classes. 4.3. To conduct the choice of stomatological tool depending on the size of carious cavity.

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4.4. Otpreparirovat' different variants of carious cavities of the I classes. 4.5. Otpreparirovat' carious cavities of the V classes.

ІII. Final stage

5 Control and correction of level of professional skills and abilities.

III

Individual control of skills or their results. Decision of offtype situatioonal tasks, test control.

Job performances. Text situatioonal tasks of the IV levels. Tests of the IV levels

20 minutes

6 Working out the totals of employment (theoretical, practical, organizational).

–

Evaluation of success of student (diagnostics of level of knowledges, skills and abilities).

–

7 Home task

–

–

Reference map for independent work with literature.

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VII. Materials of the methodical providing

VII.1. Control materials for the preparatory stage of employment VII.1.1. Theoretical questions ((-II)

1. Will transfer general principles of preparing of carious cavities. 2. Name classification of carious cavities on Bleku. 3. Will transfer the stages of treatment of carious cavities. 4. Cut out principle of "biological expedience". 5. Cut out principle of "technical rationality". 6. Name the features of method of "prophylactic expansion". 7. Name the features of preparing at application of principle of the

"prophylactic stopping". 8. Give description of carious defects I and the V classes. 9. Cut out the method of preparing of carious cavities of the I classes. 10. Cut out the method of preparing of carious cavities of the V classes. 11. Cut out the method of forming of придесневой wall. 12. Name error and complication at preparing of carious cavities I and the V

classes. VII.1.2. Tests ((-I)

№1. In the case of application of compos the edge of enamel it is necessary to mow under a corner:

A. 45?; B. 90?; C. 35?; D. 65?; E. 55?.

Answer: And №2. What instrument conduct a necretomy:

A. by a flatter; B. by a probe; C. by the spherical coniferous forest of largeness and power-shovel; D. by the spherical coniferous forest of pony-size; E. by the фиссурным coniferous forest of largeness.

Answer: With №3. To what class it is necessary to take a carious cavity which is located on a vestibular surface 16 tooth in a blind fossula:

A. V classes; B. IV classes; C. III classes; D. II classes; E. I classes.

Answer: Е №4. A carious cavity is in a fossula on a cheek surface 48 tooth. What class this cavity belongs to on classification of Bleka?

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And. ІІ V. I P. ІІІ D. V E. ІV

Answer: V. №5. On a language surface in the fossula of a 31 tooth carious cavity within the limits of околопульпарного dentine. What class this cavity behaves to?

And. I V. ІІ P. ІІІ D. IV E. V

Answer: And. №6. On a palatal surface 12 tooth carious cavity within the limits of cloak dentine with a narrow ingate. What class this cavity belongs to in obedience to classification of Bleka?

And. ІІІ V. V P. IV D. I E. ІІ

Answer: D. VII.1.3. Tests ((-II)

№1. What instruments use on the stage of necretomy at preparing of carious cavities:

а) конусовидные coniferous forests; б) wheel-shaped coniferous forests; в) spherical coniferous forests; г) cylindrical coniferous forests; д) power-shovels; е) обратноконусные coniferous forests; є) фиссурные coniferous forests; ж) all answers are faithful.

Answer: in, д. №2. Name the third stages of preparing of carious cavities:

а) necretomy; б) opening of cavity; в) smoothing out of edges of enamel; г) expansion of cavity; д) forming of cavity; е) polishing; є) excision of некротизированных fabrics; ж) there are not right answers.

Занятие №6

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Answer: and, є. №3. What requirements to the formed carious cavity of the V classes:

а) form of cavity as a swalow-tail; б) a придесневой edge has a form of half moon; в) bottom of cavity – protuberant; г) lateral walls – under an obtuse angle to the bottom; д) bottom of cavity – flat; е) the bottom of cavity forms a direct corner with lateral walls; є) form of cavity as a prolate oval.

Answer: б, in, є, е. №4. What features of preparing of carious cavities I and the V classes depending on the chosen stopping material:

Stopping material

Features of preparing

Amalgam

Tsementy

Composition material of chemical polymerization

Composition material of light polymerization

Note: the features of preparing are inscribed by a student.

Занятие №6

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VII.2. Materials of the methodical providing of the basic stage of employment VII.2.1. Reference map for forming of professional abilities and skills

Educational

task

Sequence of implementation

Warning in relation to self-control

To conduct preparing of carious cavity

1.1. To conduct opening of carious cavity.

A purpose is providing of the best access to the staggered fabrics and finding out of volume of cariosity. Conduct this stage spherical or by the фиссурными coniferous forests at high-rate of their rotation.

1.2. To conduct expansion of carious cavity.

A purpose is prevention of development of recurrent caries. Conduct конусовидным, пламеневидным or фиссурным coniferous forests medium-sized. Even the edges of enamel, the staggered excise the caries of фиссуры.

2. To conduct a necretomy.

Purpose – to delete the некротизированный softened dentine. Conduct This operation power-shovels or spherical coniferous forests of different size at small speed of rotation. Delete the most softened dentine a power-shovel.

3. To conduct forming of carious cavity.

Consists in creation of such form of cavity which will be instrumental in the best fixing of stopping material. And depends on a clinical situation (in particular, class on Bleku et cetera) and chosen stopping material.

Занятие №6

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4. To conduct treatment of edges of enamel.

Conduct, to provide the reliable regional adjoining and prevent development of the second caries. During preparing foresee creation on the edge of cavity of slant (фальца) under the corner of 45°. Smooth out the edges of enamel and create a slant by the diamond coniferous forests of пиквидной, пламевидной or конусовидной form, at high-rate of rotation, with the use of the water cooling.

To conduct preparing of carious cavities I and the V classes

1.1. Opening of carious cavity.

I classes: expose a carious cavity the spherical or конусовидным coniferous forest with the size of working part a few less than, than ingate of carious cavity. V classes: there is not a necessity considerably to expose a carious cavity.

1.2. Expansion of carious cavity.

I classes: conduct конусовидным, пламевидным or фиссурным coniferous forests medium-sized. Even the edges of enamel, the staggered excise the caries of фиссуры. V classes: prepare a cavity in медиально-дистальном direction to округлостям crowns. Pridesnevuyu a wall is extended to the level by gums or on 0,1-0,3 мм under it.

2. Necretomy.

I classes: conduct power-shovels or spherical coniferous forests of different size at small speed of rotation. At first prepare walls, then bottom. V classes: conduct the delete of all staggered fabrics the spherical or pear-shaped coniferous forest at small speed of rotation.

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3. Forming of carious cavity.

I classes: it is necessary to lick into a carious cavity a ящикоподобную shape. Walls must be parallel each other and perpendicular to the bottom. The bottom of cavity, usually, is flat, turned to mash. V classes: conduct preparing the non-aggressive spherical or pear-shaped coniferous forests at small speed of rotation (sometimes oval) bottom of cavity – protuberant.

4. Treatment of edges of carious cavity.

Conduct for providing of the reliable regional adjoining of stopping material and prevention of development of the second caries. On an edge cavities create фальц of slant under the corner of 45°.

Занятие №6

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VII.3. Control materials for the final stage VII.3.1. Offtype situatioonal tasks ((-IV)

№1. In a 26 tooth a deep carious cavity of the I classes is on Bleku. Formed the bottom of cavity the spherical coniferous forest of the first sizes by a turbine drill. As a result of preparing there was a perforation of vault of пульповой chamber. That entailed the origin of this complication? What stage an error was sufferet on? What actions of doctor must be?

Right answer: At first, a doctor wrong picked up the coniferous forest for forming of bottom of cavity – it is needed it was to choose the spherical coniferous forest of greater size. Secondly, it is necessary it was to prepare on small speed. Or a necretomy can it was be carried out by a power-shovel.

№2. For the patient of 42 years in a пришеечной area 36 tooth a carious cavity is located. Except for it, on a masticatory surface another carious cavity of largenesses is located. Properly to form carious cavities?

Right answer: if the carious cavity of the V classes is dissociated from a cavity І class by the skim of uncrippled hard fabrics of tooth, then cavities unite and form on ordinary rules. If cavities are separated one from other the thick enough layer of enamel and dentine, then each of them process separately.

VII.3.2. Situatioonal tasks ((-II) Task №1. On the masticatory surface of sixth overhead right teeth in area of

фиссур am two close расположеные carious cavities. Properly to form the cavity of the I classes?

Answer. Carious cavities in area of фиссур on the masticatory surface of teeth at their near location at preparing unite in one cavity of rectangular, полуовальной or three-cornered forms with sheer walls.

Task №2. Properly to form a carious cavity, if carious cavities are placed on a masticatory surface and in the furrow of cheek surface at the level of equator?

Answer. Depending on the sizes of carious cavities on the masticatory and cheek surfaces of teeth: small cavities form each separately, unite large cavities in one.

VII.3.3. Classification test ((-IV) Will fill a table: "Tool for preparing of carious cavities".

Stages of препари-рования

Stomatolo-gicheskie the coniferous forests

Opening of carious cavity

Expansion of carious cavity

Necretomy

Forming of carious cavity

Formirova-nie of slant of

enamel

Diamond

Konusovidnye

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Answer:

Spherical

Spear-shaped

Pear-shaped

Fissurnye

Cylindrical

Finiri

Poliry

Wheel-shaped

Obratnokonusnye

Stages of препари-рования

Stomatolo-gicheskie the coniferous forests

Opening of carious cavity

Expansion of carious cavity

Necretomy

Forming of carious cavity

Formirova-nie of slant of

enamel

Diamond

+ +

Konusovidnye

+

Spherical

+ + +

Spear-shaped

+

Pear-shaped

+

Fissurnye

+ +

Cylindrical

+ +

Finiri

+

Poliry

Wheel-shaped

+

Obratnokonusnye

+

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VІI.4. Materials of the methodical providing

самоподготовки of students VII.4.1. Reference map for organization of independent work of students with

educational literature on the topic: «Principles and stages of preparing of carious cavities. Classification of

carious cavities on Bleku. Preparing of carious cavities I and the V classes. Choice of instruments»

Educational task

Pointing

Notes

To learn:

1. Give determination of term «preparing» of teeth.

To expose the concept of preparing of teeth.

2. Name classification of carious cavities on Bleku.

To give classification of carious cavities on Bleku.

3. Specify the basic variants of tactic of preparing of carious cavities.

To offer the basic variants of tactic of preparing of carious cavities.

4. Specify the methods of preparing of carious cavities.

To describe the methods of preparing of carious cavities.

5. Name basic principles of preparing of carious cavities.

To transfer basic principles of preparing of carious cavities.

6. Name the stages of preparing of carious cavities.

To name the stages of preparing of carious cavities.

7. Give description of carious defects I and the V classes.

To give description of carious defects I and the V classes.

8. Specify the method of preparing of carious

To describe the method of preparing of carious cavities of

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27

cavities of the I classes.

the I classes.

9. Describe the method of preparing of carious cavities of the V classes.

To describe the method of preparing of carious cavities of the V classes.

10. Specify the method of forming of придесневой wall.

To explain the method of forming of придесневой wall.

11. Specify error and complication at preparing of carious cavities I and the V classes.

To name error and complication at preparing of carious cavities I and the V classes.

VІІІ. Literature on the topic of employment

Basic 1. Practical work of з терапевтичної стоматології (фантомний course) /

A.V.Borisenko, L.F.Sіdel'nіkova, M.Yu.antonenko, Yu.g.kolenko, O.O.Shekera. – Kiїv, 2011. – 512 p.

2. Danilevs'kiy M.F., Borisenko A.V., Polіtun A.M., Sіdel'nіkova L.F., Nesin O.F. Terapevtichna стоматологія: Pіdruchnik; At 4 т. – Fantomniy course / M.F.Danilevs'kiy, A.V. Borisenko, A.M. Polіtun, L.F. Sіdel'nіkova, O.F. Nesin – Kiїv: Medicine, 2007. – 304 p.

3. Danilevskiy N.F., Borisenko A.V., Politun A.M., Sidel'nikova L.F., Nesin A.F. Therapeutic stomatology: Textbook; In 4 т. – Propedevtika of therapeutic stomatology. it is Kiev: Medicine, 2011. – 400 p.

4. Borovskiy E.V., Ivanov V.S., Banchenko g.v. and other Therapeutic stomatology. – M.: the Medical agency of news, 2004. – 840 p.

5. Nikolaev A.I., Tsepov l.m. Practical therapeutic stomatology. – M.: MEDpress-inform, 2007. – 928 p.

Additional 1. Magid E.A., Mukhin n.a. the Phantom course of therapeutic stomatology. –

M.: Medicine, 1987. – 304 p. 2. Nikolaev A.I., Tsepov l.m. the Phantom course of therapeutic stomatology.

– M.: MEDpress-inform, 2010. – 432 p. 3. Terapevtichna стоматологія: Pіdruchnik for студентів стоматологічних

факультетів вищих медичних навчальних закладів IV рівня акредитації at двох volumes / After ред. проф. A.K. Nіkolіshina. it is T. І. it is Poltava: Divosvіt, 2005. – 392 p.

Electronic sources

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1. http://www.medicus.ru/stomatology/specialist/preparirovanie-karioznyh-polostej-po-bleku-posobie-dlya-studentov-pamyatka-dlya-vrachej-21772.phtml

2. http://www.youtube.com/watch?v=ZdjEKBAI6ns 3. http://medical-diss.com/medicina/kliniko-laboratornoe-obosnovanie-vybora-vida-borov-dlya-

preparirovaniya-tverdyh-tkaney-zubov 4. http://www.stomvest.ru/lnks/orthoped_100.shtml