2 Charting the Adult Dentition. Black's Classification

8/12/2019 2 Charting the Adult Dentition. Black's Classification

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Several systems of tooth notation are available, but

the systems commonly used in the UK are the FDI

(Federation Dentaire International) and Palmer systems.

Tooth notation


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The mouth is divided into four quadrants and each quadrant is

given a number, starting with the upper right quadrant and

working in a clockwise direction.

For example, the upper left quadrant is 2. The teeth are then

allocated a number starting from the midline, so all centralincisors are 1 and all third molars are 8. Therefore the lower right

second premolar is 45.

Permanent teeth:

Right 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 Upper

Lower 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 Left


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In this system, sometimes called the TzigmondyPalmer system,the dentition is divided into quadrants and the teeth in eachquadrant are numbered 1 to 8 starting at the midline. Eachquadrant is separated by a vertical line for right and left and by ahorizontal line for upper and lower. Thus |6 is the upper left first

molar in the permanent dentition.Permanent teeth:

Right 8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 Upper

Lower 8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8 Left

This system works well for hand-written notes but is moredifficult for computerised notes and printed letters and thereforethe lines are sometimes replaced by two letters describing thequadrant, for example UR8 is the upper right third molar tooth.


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Conventionally, cavities are prepared using a combination ofhand instruments and rotary instruments.

Hand instruments:

(a) straight probe; (b) Briault probe;

(c) excavator; (d) ball-ended plastic;(e) flat plastic; (f) 1/2 Hollenbach;

(g) amalgam plugger; (h) gingival

Margin trimmer; (i) hatchet;

(j) Teflon-coated composite

instrument; (k) Teflon-coated

composite instrument;

(l) Amalgam carrier.


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The slow-speed handpiece is driven either by com-

pressed air or directly by an electric motor. The speed

of the handpiece ranges from 0 to 40 000 rpm. The most

efficient cutting is achieved with a straight handpiece,but this is difficult to use in the mouth and is therefore

restricted to extraoral use, such as adjusting temporary

crowns and dentures. The contra-angle handpiece is

used for the removal of caries, polishing and finishing.


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Straight handpiece

Electric motor

Contra-angled slowspeed handpiece


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The high-speed handpiece is driven by compressed air

and is sometimes referred to as an air-turbine.

It is used for cutting through enamel and dentine and

removing previous restorations. It has a speed of 250

000500 000 rpm and, to keep it cool, a water spray isdirected at the cutting part of the bur which is held in the

head of the handpiece by friction. A fibreoptic light in the

head of the handpiece aids visibility.


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Most often called burs, but also available are wheels, discs,rubber points, rubber cups and stones

Each has a particular function (cutting, polishing, finishing

or caries removal)

Are made from various materials (tungsten carbide,diamond and steel)

Can have flutes(the cutting edges)

The end of the shank determines which handpiece the

attachment will fitinto:Long straight shank straight handpiece

Latch grip conventional type/slow speed handpiece

Friction grip shank air turbine handpiece/high speed

handpiece


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(a) latch grip stainless

steel large round; (b) latch grip stainlesssteel small round; (c) latch grip superfine

diamond flame; (d) latch grip superfine

diamond football; (e) latch grip

composite finishing point; (f) latch grip

abrasive disc; (g) friction grip diamond

fissure; (h) friction grip diamond round;

(i) friction grip diamond pear; (j) friction

grip superfine diamond flame; (k) friction

grip superfine diamond tapered fissure;

(l) friction grip superfine diamond

football.


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Functions and precauti ons

An amalgam capsule contains amalgam material (contents will varydepending on the manufacturer)

Care must be taken when handling amalgam to prevent inhalation of vapours,

skin absorption and inhalation of air-borne particles

Amalgamator is used to titrate amalgam prior to use

Amalgamators must have a plastic covering over the area where the amalgamis titrated for safety in case of displacement


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When the pulp suffers

irreversible pulpitis,

the only way to retain

the natural tooth is bycomplete removal of the

pulp.


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Functions and precautions

Finger instruments

Disposed of in the sharps

container

Used to remove the intact pulp

Barbs on the broach snag the pulp to facilitate removal

They need to be used cautiously as they can bind and

break in the canalVarieties

Available in different sizes and widths


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Function, features and precaution

Finger instrument Colour coded by size. The 6 colours used most often are: size 15(white); 20 (yellow);25 (red); 30 (blue); 35 (green); 40 (black).Also available in size 6 (pink), 8 (grey) and 10 (purple)

Operator gradually increases the size of the file to smooth, shape

and enlarge canal The larger the number of the file, the larger the diameter of theworking end

Disposed of in the sharps

container

Varieties Different lengths: 21mm,

25mm and 30mm

Hedstrmfiles, Flexofiles


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Lentulo spiral filler/rotary paste filler

Function and features

Small flexible instrument

used to place materials into the canal Fits into the conventional handpiece

Use with caution as it can

be easily broken

Different sizes available


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Blacksclassificationis as follows: Class I: caries affecting pits and fissures; commonly used to

refer to caries affecting the occlusal surfaces of premolars andmolars.

Class II: caries affecting the proximal(contact) surfaces of

posterior teeth(molars and premolars). Class III: caries affecting the proximal surfaces of anterior

teeth(incisors, canines).

Class IV: caries affecting the proximal surfaces of anterior teethand also including the incisal angle(cutting edge).

Class V: caries affecting the cervical surfaces. In some American issues we can find the additional VI class

.Class VI caries-resistant zones of teeth- cusps and equatorof the tooth.


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2 Charting the Adult Dentition. Black's Classification