DEN 030: Operative Dentistry I- Laboratory

Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

LESSON TITLE: SYNOPSIS OF CONSERVATIVE MATERIALS:

DENTISTRY (Part 2) Pen, paper, highlighters, and module

LESSON OBJECTIVES: REFERENCES:

At the end of the module, you will be able to: • Sturdevant’s Art and Science of
1. Review Proximal Contacts, Height of Contours and Operative Dentistry,6th Edition
Embrasures. • Gopikrishna, V. Preclinical Manual
2. Review Tooth Numbering System. of Conservative Dentistry and
Endodontics

PRODUCTIVITY TIP:
Good day stuDENTIST! You are about to start your module. Do short stretching and breathing exercises.
After you are done, sit down, be comfortable and say a short prayer. After finishing this module, explain
quickly what you’ve learned to your parents / friend / pet. Have fun learning!

A. LESSON PREVIEW / REVIEW

1) Introduction
Good day students! In the part 1 of this module, we have learned the structures of teeth and its
supporting tissues, dentition and anatomical landmarks. Part 2 will be focusing more on the detrimental
effects of undercontoured and overcontoured restorations and a review of the tooth numbering systems.
Restoring the proper anatomy of the tooth and maintaining the health of the soft tissue should be a
prime consideration during the restorative procedure.

2) Activity 1: What I Know Chart, Part 1

Instructions: On the first column of the chart below, write the answer to each question based on what
you know now. Leave the third column blank at this time. There is no need to read ahead to find
answers- the purpose of Activity 1 is to answer the questions with what you know now.
What I Know Guide Questions: What I Learned (Activity 4)
1. What do I know about
Proximal Contacts, Height of Contours
and Embrasures?

2. What are the detrimental effects of

undercontoured and overcontoured
restorations?

3. What do I know about Tooth

Numbering system?

1
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

B. MAIN LESSON
1) Activity 2: Content Notes
Read and understand the information and illustrations found in this module. Please highlight or write
down important information to aid comprehension and recall. ***This content is also found in Sturdevant’s
Art and Science of Operative Dentistry,6th Edition and Preclinical Manual of Conservative Dentistry and
Endodontics by Gopikrishna, V, 3rd Edition.

HEIGHT OF CONTOUR AND PROXIMAL CONTACT AREA

Knowledge about contacts and contours of various teeth is mandatory for understanding:
1. The predisposal factors of proximal caries, like faulty interrelationships.
2. Significance of marginal ridges, embrasures, for re-establishing form and function of the restored
teeth.
3. Periodontal aspect and health of the tooth to be restored.
Ideal Contact and Contour
• Conserves the health of the periodontium.
• Prevents food impaction.
• Makes the area self-cleansable.
• Improves the longevity of proximal restorations.
• Maintains the normal mesiodistal relationship of the teeth in the dental arch.

Height of Contour
• The area of greatest circumference on the
facial and lingual surfaces of the tooth is
called height of contour (Fig. 3.1).
• It protects the gingival tissue by preventing
food impaction.
• In the posterior teeth, the height of contour is
located in the gingival third of the facial surface Fig. 3.1 Height of contour in posterior teeth.
and in the middle one-third of the lingual surface.

Proximal Contact Area

Proximal contact area denotes the area of proximal height of contour of the mesial or distal surface of a
tooth that touches (contacts) its adjacent tooth in the same arch. Initially, after tooth eruption, there is
only one point of contact known as proximal contact point, but due to wear during physiological tooth
movement, the proximal contact point becomes proximal contact area.

Clinical Note: Location of Proximal Contact Area

• Incisal third of the approximating surfaces of maxillary and mandibular central incisors. It is positioned
slightly facial to the center of the proximal surface faciolingual.
• Proceeding posteriorly from the incisor region through all the remaining teeth, the contact area is
located near the junction of the incisal (or occlusal) and middle thirds or in the middle third.
• Proximal contact areas typically are larger in the molar region, which helps prevent gingival food
impaction during mastication.

2
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

Embrasures (Spillways) (Fig. 3.2)

Embrasures are V-shaped spaces that originate at the proximal contact area between the adjacent
teeth forming spillway spaces. They are named for the direction toward which they radiate. These
embrasures are:
a. Facial embrasure
b. Lingual embrasure (Fig. 3.3)
c. Incisal or occlusal embrasure (Fig. 3.4)
d. Gingival embrasure (Fig. 3.5): Initially, the interdental papilla fills the gingival embrasure. When the
form and function of teeth are ideal and optimal oral health is maintained, the interdental papilla
may continue in this position throughout life. When the gingival embrasure is filled by the papilla,
trapping of food in this region is prevented. In a faciolingual vertical section, the papilla is seen to
have a triangular shape between anterior teeth, whereas in posterior teeth, the papilla may be
shaped like a mountain range, with facial and lingual peaks and the col (“valley”) lying beneath the
contact area (Fig. 3.6).

Fig. 3.2 Embrasures in anterior teeth. Fig. 3.3 Lingual and buccal Fig. 3.4 Gingival embrasures.
embrasures.

Fig. 3.5 Occlusal and gingival

embrasures.

Fig. 3.6 Relationship of ideal interdental papilla to molar

contact area. Source: (From Gopikrishna: Sturdevant‘s Art and
Science of Operative Dentistry: 2nd South Asia edition, 2018,
Elsevier).

3
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

Clinical Note
• The col, a central faciolingual concave area beneath the contact,
is more vulnerable to periodontal disease from incorrect contact
and embrasure form because it is covered by nonkeratinized
epithelium.
• Normal contour and contact area of the teeth act in deflecting the
food only to the extent that the passing food stimulates (by gentle Fig. 3.7 Proper embrasure form.
massage) the underlying gingiva (Fig. 3.7).

UNDERCONTOURED AND OVERCONTOURED RESTORATIONS

Under and overcontouring during the restorative treatment has to be
avoided as:
• Undercontouring of restorations causes (Fig. 3.8):
1. Trauma to the periodontium
2. Food impaction

Fig.3.8 Undercontoured restoration

causing improper embrasure form.

• Overcontouring of restorations causes (Fig. 3.9 and 3.10):

1. Increased plaque retention
2. Flabby, red, and chronically inflamed gingiva

Fig. 3.9 Overcontoured restoration causing improper embrasure form:

w, Improper embrasure form caused by overcontouring of restoration
resulting in unhealthy gingiva from lack of stimulation; x, Good
embrasure form; y, Frictional wear of contact area has resulted in
decrease of embrasure dimension; z, When embrasure form is good,
supporting tissues receive adequate stimulation from foods during
mastication.
Fig. 3.10 Importance of proper contour:
Contours. Arrows show pathways of food
passing over facial surface of mandibular
molar during mastication; (a) Overcontour
deflects food from gingiva and results in
understimulation of supporting tissues; (b)
Undercontour of tooth may result in irritation
of soft tissues; (c) Correct contour permits
adequate stimulation for supporting tissues,
resulting in healthy condition.

4
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

OCCLUSION
Occlusion is the relationship of cusps or masticating surfaces of maxillary and mandibular teeth.

Intercuspal position: The position of maximum intercuspation of the teeth.

Occlusal harmony: The absence of occlusal interferences, which allows mandibular movement in all
excursions (with the teeth together), and does not result in discomfort, strain, or harm to the teeth or the
masticatory apparatus (Fig. 3.11 a, b).

Fig. 3.11 (a) and (b) Occlusal harmony.

NOMENCLATURE AND TOOTH NUMBERING SYSTEM

Nomenclature is the scientific way of
naming things. It helps in better
understanding and communication (Fig.
3.12).

Fig. 3.12 Nomenclature of the maxillary arch.

5
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

The following are the commonly used tooth notation systems employed by dentists to communicate and
record data related to a particular tooth:

I. Zsigmondy—Palmer Notation System

(Fig. 3.13)
• Permanent teeth are denoted by
numbers 1−8 with central incisor
indicated as 1 and progresses on to the
third molar which is designated as 8.
• Also called as angular or grid system.
• Deciduous teeth are denoted by upper
case English alphabets A to E with A
representing central incisor and E
representing second molar.

Advantages
• Simple to use
Disadvantages
• Not commonly used anymore.
• Each tooth is not denoted by a specific
number.
• No differentiation between the same
tooth present in the right and left side of
the same arch. For example, the
nomenclature is the same for both left
and right maxillary teeth and so is the
case for left and right mandibular teeth.

Fig. 3.13 Zigmondy–Palmer tooth numbering system.

Permanent Teeth

Deciduous Teeth

6
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

II. Universal Notation System or American Dental Association (ADA) System (Fig. 3.14)
• It is also known as Universal system.
• Numbering begins from maxillary right posterior
most tooth, which is designated as 1 and proceeds to
maxillary left posterior most tooth, which is
designated as 16, then to mandibular left posterior
tooth, which is designated as 17 and then proceeds
to the mandibular right posterior most tooth, which is
designated as 32.
• Permanent teeth denoted by number 1−32.
• Deciduous teeth denoted by alphabets A−T.

Advantage
• Separate number/alphabet assigned for each tooth.
Disadvantage
• Confusing and difficult to remember.

Fig. 3.14 ADA tooth numbering system.

Permanent Teeth

Deciduous Teeth

7
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

III. Federation Dentaire International (FDI) System (Fig. 3.15)

• Referred as two-digit system, where the two
digits are used to identify an individual tooth.
• First digit represents the quadrant (1−4:
permanent dentition) (5−8: deciduous dentition)
• Second digit represents the tooth (Table 3.1).

Clinical Note
The notation is pronounced individually, i.e.
the mandibular left first molar is represented
as 36. This has to be pronounced as ‘three
six’ and not as ‘thirty six’.

Advantages
• Most commonly employed notation system.
• Each tooth is denoted by a specific number.
• Simple to understand and communicate.

Disadvantages
• Can be confused with ADA numbering system.
• No provision to denote supernumerary tooth.

Fig.3.15 FDI tooth numbering system.

Permanent Teeth

Deciduous Teeth

8
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

Table 3.1 FDI Tooth Numbering System

Permanent Dentition Deciduous Dentition
FIRST DIGIT FIRST DIGIT
1 → Maxillary right quadrant 5 → Maxillary right quadrant
2 → Maxillary left quadrant 6 → Maxillary left quadrant
3 → Mandibular left quadrant 7 → Mandibular left quadrant
4 → Mandibular right quadrant 8 → Mandibular right quadrant
SECOND DIGIT SECOND DIGIT
1 → Central incisor 1 → Central incisor
2 → Lateral incisor 2 → Lateral incisor
3 → Canine 3 → Canine
4 → First premolar 4 → First molar
5 → Second premolar 5 → Second molar
6 → First molar
7 → Second molar
8 → Third molar

2) Activity 3: Skill-building Activities (with answer key)

(A) Instructions: Identify the following tooth using the Guidelines of the Universal Numbering System.
Good luck and enjoy!
____1. Permanent Maxillary Right Canine. ____11. Primary Mandibular Left Canine
____2. Permanent Mandibular Right Third Molar ____12. Primary Maxillary Left Second Molar
____3. Permanent Maxillary Left Second Molar ____13. Primary Mandibular Right Central Incisor
____4. Permanent Mandibular Right Central Incisor ____14. Primary Maxillary Left Central Incisor
____5. Permanent Mandibular Left First Molar ____15. Primary Maxillary Right First Molar
____6. Permanent Maxillary Left Third Molar ____16. Primary Mandibular Right Second Molar
____7. Permanent Mandibular Right First Molar ____ 17. Primary Maxillary Left First Molar
____8. Permanent Maxillary Left Lateral Incisor ____18. Primary Mandibular Right Lateral Incisor
____9. Permanent Maxillary Right First Premolar ____ 19. Primary Mandibular Left First Molar
____10. Permanent Maxillary Right Second Molar ____ 20. Primary Mandibular Left Second Molar

(B) Instructions: Give the complete name of the following tooth. Good luck and enjoy!
1. 46 __________________________________________
2. 55 __________________________________________
3. 16 __________________________________________
4. 61 __________________________________________
5. 23 __________________________________________
6. 81 __________________________________________
7. 35 __________________________________________
8. 72 __________________________________________
9. 44 __________________________________________
10. 51 __________________________________________

Check your answers against the Key to Corrections found at the end of this Activity Sheet. Write your
score/s on your paper.

9
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

3) Activity 4: What I Know Chart, Part 2

Now that we’re done with our main discussions, please go back to “What I know chart” and answer the
“What I Learned” column. Use a spare paper if space is not enough.

4) Activity 5: Check for Understanding

Instructions: Encircle the letter of the best answer. Please answer the short quiz as honestly as you
can.
1. The most commonly used tooth numbering system
A. FDI System B. ADA System
C. Universal system D. Zsigmondy—Palmer Notation System

2. When two teeth in the same arch are in contact, their curvatures adjacent to the contact areas form
spillway spaces called
A. Facial embrasure B. Lingual embrasure
C. Incisal or occlusal embrasure D. All of the Above
E. None of the Above

3. It is the interrelationship between the incising and occlusal surfaces of the maxillary and mandibular
teeth.
A. Occlusion B. Intercuspal distance
C. Intercuspal position D. Occlusal harmony

4. Proximal contact areas of maxillary anterior teeth are located

A. Near the incisal third of the teeth B. Near the middle third of the teeth
C. Near the cervical third of the teeth D. None of the above

5. Proximal contact areas of mandibular posterior teeth are located

A. Near the incisal third of the teeth B. Near the middle third of the teeth
C. Near the cervical third of the teeth D. None of the above

Stop and check your answers against the Key to Corrections found at the end of this Activity Sheet.
Write your score/s on your paper.

C. LESSON WRAP-UP
1) Activity 6: Thinking about Learning
A. Work Tracker
You are done with this session! Let’s track your progress. Shade the session number you just
completed.

B. Think about your Learning:

Please answer the following questions:
1) Please rate your activity today by placing a check mark (/) before a choice. Please explain your
choice on the blank space beside the table:

10
This document is the property of PHINMA EDUCATION
 DEN 030: Operative Dentistry I- Laboratory
Student Activity Sheet #3

Name: _____________________________________________________ Class Number: _________

Section: __________________________ Schedule: _________________ Date: ________________

1. Boring
2. Not informative
3. Challenging
4. Fair
5. Fun

2) “What details in the content and/or activities were not clear to you?”
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

FREQUENTLY ASKED QUESTIONS

1. What is an overhanging restoration?
Overhanging dental restorations (ODR) are a major dental health problem. An ODR is defined as an
extension of restorative material beyond the confines of a cavity preparation. They have been strongly
implicated as an etiologic factor in the progression of periodontal disease and are alarmingly prevalent.
2. What happens if a tooth is restored and it has an overhanging restoration?
If the restoration is built too large, or the margins overhang the edge of the tooth, food and bacterial
plaque can accumulate along the margins, leading to inflammation and tooth decay (caries). Plaque
accumulation in such areas can produce a bad taste and bad breath (halitosis).

KEY TO CORRECTION
Activity 3: A (1 point for each correct answer) B (1 point for each correct answer)
1. 6 11. M 1. Permanent Mandibular Right First Molar
2. 32 12. J 2. Primary Maxillary Right Second Molar
3. 15 13. P 3. Permanent Maxillary Right First Molar
4. 25 14.F 4. Primary Maxillary Left Central Incisor
5. 19 15.B 5. Permanent Maxillary Left Canine
6. 16 16.T 6. Primary Mandibular Right Central incisor
7. 30 17. I 7. Permanent Mandibular Left Second Premolar
8. 10 18. Q 8. Primary Mandibular Left Lateral Incisor
9. 5 19. L 9. Permanent Mandibular Right First Premolar
10. 2 20. K 10. Primary Maxillary Right Central Incisor

Activity 5: (2 points for each correct answer)

1. A 2. D 3. A 4. A 5. B

11
This document is the property of PHINMA EDUCATION