Conservative Dentistry — 30-Min Notes

1. Dental Caries

• Definition: Localized destruction of tooth structure by acidic by-products of bacterial fermentation.

• Types: Pit & fissure, smooth surface, root caries.

• High-yield: Streptococcus mutans → initiates caries; Lactobacillus → progression

• Tip: Early detection via ICDAS or radiographs improves prognosis.

2. Pulpal Diseases

• Pulpitis: Inflammation of dental pulp; reversible → pulp can heal, irreversible → necrosis likely.

• Clinical features: Sharp pain (reversible), lingering pain (irreversible), spontaneous pain → necrosis.

• High-yield: A-delta fibers → sharp pain; C fibers → dull pain

• Tip: Early pulpitis → conservative treatment (vital pulp therapy), irreversible → RCT.

3. Restorative Materials

• Amalgam: High strength, long-lasting; used in stress-bearing posterior teeth.

• Composite resin: Esthetic, bonds to enamel/dentin; polymerization shrinkage → marginal gap risk.

• Glass Ionomer Cement (GIC): Fluoride release, chemical bond to tooth; weaker than composite.

• Tip: Sandwich technique → GIC base + composite for deep cavities.

• High-yield: Bonding to enamel stronger than dentin

4. Cavity Preparation Principles

• Retention: Mechanical or adhesive; prevents dislodgement.

• Resistance: Prevent fracture; flat pulpal floor, rounded internal angles.

• Convenience form: Accessibility for restoration placement.

• Removal of caries: All infected dentin removed; affected dentin may be preserved for pulp protection.

• Tip: Bevel enamel margins in anterior teeth for better esthetic bonding.

5. Endodontic Access

• Principle: Direct access to pulp chamber and canals without weakening tooth.

• High-yield: Conservation of pericervical dentin → improves long-term tooth strength

• Access cavity shapes: Triangular (anterior), Oval (posterior), Modified for multi-rooted teeth.

• Tip: Straight-line access minimizes instrument stress and procedural errors.

6. Isolation & Rubber Dam

• Purpose: Moisture control, infection control, safety, visibility.

• High-yield: Improves bond strength of adhesives

• Components: Frame, clamp, dam sheet, punch, forceps.

• Tip: Clamp selection depends on tooth size, shape, and condition.

7. Adhesive Dentistry

• Etch-and-rinse: Acid etch enamel → resin infiltration → bond.

• Self-etch: Acid + primer combined; less postoperative sensitivity.

• High-yield: Enamel etch → 37% phosphoric acid; Dentin → wet bonding to prevent collapse

• Tip: Incremental composite placement → reduces polymerization shrinkage.

8. Finishing & Polishing

• Purpose: Smooth restoration surface → esthetics, plaque resistance, patient comfort.

• Tools: Carbide burs, discs, points, abrasive strips.

• High-yield: Polishing after 24h of polymerization → optimal hardness

• Tip: Avoid over-trimming → pulp exposure risk in deep restorations.

9. High-Yield Repeated Points (NEET MDS)

• Streptococcus mutans → initiation, Lactobacillus → progression

• Reversible pulpitis → pulp can heal; irreversible → RCT required

• Enamel etch → 37% phosphoric acid; Dentin → wet bonding

• Retention & resistance form → prevent restoration failure

• Incremental composite placement → reduces shrinkage

• Rubber dam → essential for bonding and isolation

• Preserve pericervical dentin → improves long-term tooth strength