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Learning Objectives DS 1
(SCENARIO1)
Viona SEKAR MELATI
J2A02005
Diagnosis on conservation
tooth Ryan Mahardiansyah
 Perawatan
Dilakukan
On Tooth Which
Wrong

Endanger Soul,
Distrust Patient Doctor Tooth &
Doctor Tooth Error Diagnosis
Nurse

Perawatan
Yang No
Appropriate
4
• Test Percussion
Another way to determine whether there is an abnormality is to change the direction of the
blow, from the vertical-occlusal surface to the buccal or horizontal-bucolingual surface of the
crown.

1. Teeth that respond painfully to vertical-occlusal percussion show periapical abnormalities

caused by carious lesions.
2. Teeth that respond painfully to horizontal-buccolingual percussion show periapical
abnormalities caused by periodontal tissue destruction.

The tooth that is struck is not just one but the tooth of the same type in the adjacent region.
When performing a percussion test, the doctor must also pay attention to the patient's
movements when feeling sick

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1. In teeth that have ankylosis it will sound louder (solid metallic sound) compared to healthy teeth.
2. Necrotic teeth with exposed pulp without periapical abnormalities may also produce a louder sound
due to resonance in the empty pulp chamber.
3. in teeth with periapical abscesses or cysts, the sound is fainter (dull sound) compared to healthy
teeth.
4. Healthy teeth also produce a dull sound (dull sound) because it is protected by periodontal tissue.
5. Multiroted teeth will produce a more solid sound than single rooted teeth
foundation
Sondation is an examination using a probe by moving the probe in the occlusal or incisal area to check
whether there is a cavity or not.

Pain caused by sondation of the tooth indicates the vitality of the tooth or abnormalities in the pulp. If
the tooth does not respond to a deep cavity with the pulp exposed, it indicates that the tooth is
nonvital
• Test Vitality Pulp
Test vitality tooth only can provide information that there still is network nerves
which deliver impulse sensory, no shows that pulp still normal.
Response to test this very varied and must interpreted with heart
– heart.
Inspection on tooth control (tooth manifold same contralateral or antagonist)
must done.

If patient complains existence flavor sick when drink cold so test cold is which
best done, when sick when drink hot, then test hot which done. Explain to
patient procedure who will done, and what meaning sensation which expected
from test the.

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A. Stimulation dentin By Direct
•Interpretation :
• (+) = pulp still responsive, when sensation feel sharp = pulp still contain network vital.
• (-) = no show that tooth necrosis
• Technique : must done on dentin which open. Cariesmust cleaned from debris
more formerly then do the scratch with a probe on the base pulp.

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B. Test Cavity
On tooth necrosis, when test other also no give response so do test cavity
(preparation on dentin) without anesthesia and use bur which sharp.
Pada gigi vital, test kavitUS pada permukaan email atau restorbreast
milk akan cause sensation flavor sick which sharp.
When tooth no also sick, so opening procedure roof pulp has begun with done
test this.

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C. Test Thermal Cold
Method which used
1. Ice
2. CO2 (ice dry) : most effective but need armamentarium special
3. Ingredients freezer (ethyl chlorides)
Method : tooth isolated with cotton rolls, surface tooth dried, put it
stem ice or cotton pellets which has given ethyl chloride on surface tooth.

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• Sensation sharp which is lost when excitatory discontinued = tooth vital
• Sensation sharp which no is lost or the more sick = irreversible pulpitis
• No there is sensation = necrotic pulp
• Results false negative = blockage channel root (calcific metamorphosis)
• Results false positive = ice caught tooth neighbor normal
• More Effective for tooth anterior

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D. Test Thermal Hot
• Method which worn :
1. Gutta percha which heated in fire and applied to surface labial
2. Friction in surface tooth with bur rubber cup
3. Water Hot
4. Instrument which heated (could cause injury)
• In do test hot, should use rubber dam
• Less effective for knowing vitality pulp
• Could help on patient with symptoms hot and location tooth is
known.

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• Sick which sharp and painful = tooth vital (not yet of course
normal)
• Very Sick = Irreversible pulpitis
• No there is response (together – same results test other) =
necrosis pulp

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14
E. Test Pulp electrical
• Something tool which run battery and deliver current electric frequency
tall which could different – different.
• Stimulus placed in surface tooth
• Method :
1. put pasta tooth at the end pulp tester electrode, circuit activated with clip or
held by patient.
2. End electrode placed in surface labial.
3. Current slowly raised – slow so that obtained response.
• Sensation (+) (tingling, stinging, flavor full or hot) = vital.
• Sensation (-) = necrosis pulp

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16
• Inspection Periodontal
A. Probing Periodontal
• To knowing destruction bone and network soft periodontium, level
periodontium attachments, lesson periapical which expand to cervical as well
as prognosis.
• Prognosis good :pulp necrosis with drain through pocket periodontium
• Prognosis doubt : pulp vital, destruction periodontium heavy.
• Prognosis bad : pulp necrotic, disease periodontium heavy.
• Cara : Probing sepanjang permukaan akar dan furkUSi, diukur,
dicatat dan evaluated. When need anesthetized

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18
B. Test
• To use : determine status ligament periodontium and prognosis
Mobility
• Mobility which caused lesson periapical will reduce after treated.
• Method : finger index finger placed dilingual tooth and Press end incisal or
open with handle glass mouth by together.
• Hresult PSA meragukan jika tooth dapat digerakkan lebih
dari 2-3 mm atau stressed vertical
• Consequence disease periodontium

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C. Inspection Description radiograph
• Weakness :
1. Only could detect damage which already involve bone medullari and cortical.
2. Only show description two dimensions.
3. Change Angulation can change form lesion. check existence caries, restoration which
bad and maintenance channel Root which already once done on description
radiography.

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• Characteristic – characteristic lesson periapical :
1. Lost lamina dura in region apical.
2. Lesions radiolucent permanent is at in apex tooth although angulation changed
3. Generally lesson shaped water eye.
Biasanya lesson perhepikal berhubungan dengan pulpa noakrosis. Bila
lesson found on tooth vital = no lesson endodontic, structure normal

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Test – Test Special
Only done on situation where diagnosis Certain not yet could
established, that is disposal caries, anesthesia selective and
translumination.
When procedures in on finished done but diagnosis not yet can
enforced then explain to patient, You need more many sign and
symptoms to determine tooth where which need treated and type
maintenance what which need done

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• Bakar, A., 2013, Clinical Dentistry, 2nd edition, Quantum, Yogyakarta.

• Burns, CR, Cohen, S.,2015, Pathways of The Pulp, 6th Ed, Mosby-Year
Book, Philadelphia.

• Grosman, L.I., Seymour, O., Carlos, E., D., R., 2016, Endodontic Science
in Practice, eleventh edition, EGC, Jakarta.

• Miloro, M, 2015, Peterson's Principles of Oral and Maxillofacial Surgery,

BC Decker Inc Hamilton LondonTarigan, R., 1994, Dental Pulp Treatment
(Endodontic), Widya Medika, Jakarta.

• Tarigan, R., 2017, Dental Pulp Treatment (endodontic), EGC, Jakarta.

• Walton, RE, Torabinejad, M., 2016, Principles & Practice of Endodontia,

EGC, Jakarta.
 DIFFERENCES IN DENTAL CONSERVATION DIAGNOSIS
Wedagama D M1, IGAA Hartini.2016. Nursing in Conservation Dentistry.
Dental Conservation Department, Faculty of Dentistry, Mahasaraswati
University, Denpasar

Dental conservation is a field of dentistry that includes the restoration of function and
aesthetic restoration of dental hard tissues related to the science and art of dentistry
which includes the diagnosis, treatment, and prognosis of a defect in the hard tissues
of the teeth and requires a correction in the form of dental restoration.
There are 2 types of diagnosis in dental conservation, namely:
1. Pulpitis, which is divided into 2: reversible pulpitis & irreversible pulpitis
2. Necrosis, namely partial necrosis and total necrosis
Different diagnosis, then different treatment. There is conservation of filling teeth,
there are endodontics.
Restoration of filling teeth includes GIC, composite, amalgam, inlay, onlay, and
crown fillings.
While endodontic treatment includes pulp capping, pulpotomy, pulpectomy, root
canal treatment (root canal treatment), and also apexification and apexogenesis.

Pulp cappingIt is the simplest endodontic treatment. This procedure is performed to

protect the pulp from inflammation, and is performed on teeth that are still vital, on
teeth with deep caries (the pulp is covered with a thin layer of dentin), or in
perforated deep caries (the pulp is already exposed). This treatment is not performed
if there are spontaneous complaints (irreversible pulpitis). Drugs used: Calcium
Hydroxide, Zinc Oxide Eugenol, and Corticosteroids.
Type restoration network hard tooth
Dental restorations aim to restore physiological function and aesthetic function
of teeth.Post root canal treatment, tooth needs restoration finish that has good
retention and resistanceforlong-lasting restoration. Final restoration planning is
usually determined before duct treatment root. The operator must know the
type of restoration what end will be made in order to get optimal treatment
results
Not all teeth post root canal treatment requires restoration with a full crown. If the
rest of the network there are still a lot of hard teeth, then the teeth can be restored
directly using composite resins to get satisfactory results. Along with the
development of technology both in materials and restoration techniques in the field
of conservation of teeth, the use of composite resins as a Posterior dental
restorations are widely used because: has many advantages such as minimal dental
hard tissue preparation, processing time short, restoration color like natural teeth
and cost more affordable.
Fiber Reinforced Composite (FRC) has high flexibility and fatigue strength, modulusof
elasticity close to dentin good aesthetics, non-corrosive, biocompatible and can
distribute more pressure evenly when under pressure so that it can prevent fracture.
Addition of fiber to the base MOD restoration of teeth after root canal treatment
lead to greater fractureresistancehigher than the restoration without the addition of
fiber
Source
Tarigan R. Dental pulp treatment. Jakarta: EGC; 1994.
Mondelli RFL, Ishikiriam SK, Philho O, Mondelli J. Fracture resistance of weak teeth
restoration with condenbaleresin with and without cusp coverage. J.appsoral Sci.
2008; 17(3): 161-165.
Heymann HO, Swift EJ, Ritter AV. Sturdevant'sart and science of operative dentistry.
6th Ed. Mosby Elsevier Inc; 2013.
Xu HH, Schumacher GE, Eichmiller FC, Peterson RC, Antonucci JM, Mueller HJ.
Continouos fiberperform reinforcement of dental resin composite restoration. Dent
mater. 2003; 19 (60): 523-530.
AL-QURAN VERSES ACCORDING TO
THE SCENARIO