National medical university of LVIV department of therapeutic dentistry



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3. What from the methods of preparing of carious cavity will provide|secure| the most reliable fixing of stopping in 22nd tooth?

  1. Application of parapulpal point and creation|making| of additional cavity is on the oral surface of a tooth

  2. Creation|making| of additional cavity is on the oral and vestibular surfaces of a tooth

  3. Creation|making| of additional cavity is on the vestibular surface of a tooth

  4. Creation|making| of additional cavity is on the oral surface of a tooth

  5. Creation|making| of additional cavity on the oral surface of tooth and along a cutting edge|place|


4. On to aproximal-medial surface of 42nd tooth the deep carious cavity with the affectoin of the corner of a crown of the tooth. What class does this carious cavity belong|behave| to|by| according to the classification of Black?

  1. To the II class

  2. To the IV class

  3. And to the I class

  4. To the III class

  5. To the V class



Reference literature


  1. Nikolyshyn a.K. Therapeutic dentistry /A.K. Nikolyshyn: a textbook is for the students of dental faculties of higher medical educational establishments of IV level of accreditation in two volumes, T.I.– Poltava: Divosvit, 2005.– 392 p.

  2. Borovskiy E.V. Therapeutic dentistry: a textbook is for the students of dental faculties of higher medical educational establishments.– M.: Med. Inform. agency, 2006.– 840 p.

  3. Nikolyshyn a.K. Therapeutic dentistry /A.K. Nikolyshyn: a textbook is for the students of dentistry faculties of higher medical educational establishments of IV level of accreditation in two volumes, T.IІ.–Poltava: Divosvit, 2007.– 280 p.

  4. Preclinical course of therapeutic dentistry: course of lectures|fabric| /L.O. Tsvykh, O.A. Petryshyn, V.V. Kononenko, M.V. Hysyk.– Lviv, 2002.–159 p.

  5. The methodological manual for|by| practical of therapeutic dentistry /L.O.Tsvykh, O.A. Petryshyn, V.V. Kononenko, M.V. Hysyk.– Lviv, 2003.– 98 p.

Practical lesson No 19
Theme: The techniques of the cavity preparation are under modern filling materials: techniques of preparing (M.I.-therapy), ART-technique (non-invasive), tunnel preparing and others.


Short description of a theme
In connection with the introduction of the highly by effective programme of the prophylaxis of caries, appearance of glassionomer cements and other materials|fabric| which|what| form the chemical connection with dental tissues of a tooth and own|possess| the anticarious action|act|, possibility to decrease the volume of carving of the dental tissues has appeared.

Worthy of note is the approach which is called M.I.-therapy (from. Eng. Minimal Intervertion Treatment  minimum invasion treatment, or Minimal Invasive Dentistry  minimum invasion dentistry).

The conception of the minimal invasive treatment (MIL) consists in focusing on the maintenance of dental health of a patient and reduction|abbreviation| of requirement in invasive methods (preparing and stopping). In the basis|foundation| of conceptions three inter connected principles (FDI| Commision| project are distinguished|, 1 (1997):

1. Early detection|discovery| and estimation|appraisal| of risk factors of the appearance of caries.

2. Individual prophylaxis of caries.

3. Minimal invasive stopping of the carious affection by bioactive materials|fabric|.

The primary purpose of the MIL is|appear| to include the patient in the group with the diminished risk by the active revealing|discovery| of possible reasons|cause| of development of caries, normalization of mineral balance and priority of prophylactic measures|step|.

The introduction of the conception of the MIL into practice, predetermines a requirement in preparing and stopping of a very small|small| carious cavities. This direction is termed as micropreparation|. The series of special instruments are worked out|tool|, the size|dimension| of a working part|portion| of which|what|, as a rule, does not exceed 1 mm.

The design of the formed carious cavity is closed individually. The complete carving should be done obligatory of nonviable tissues and create the conditions for the high-quality|quality| stopping of a defect.

By putting the conception of the MIL into practice, it should be kept in mind that it is oriented on the active bilateral|two-sided| collaboration of a doctor|physician| and a patient.

Wide introduction of M.I.-therapy (МІТ|) in Ukraine is restrained by a number|file| of factors:


  1. this method is for patients who|what| live in highly developed countries, wherever the middle index of KPV exceeds 4.

  2. apart from the special instruments|tool|, an additional equipment is needed: ultrasonic device with the special attachments, stomatological microscope (increase 3,5×25) or binocular lenses (increase 3,5×5,5).

  3. МІТ| (highly-skilled, author treatment, technology of which|what| requires additional time, financial and physical expenses.

  4. A method is intended for patients who possess a stable, strong motivation on saving|safety| the dental health and active collaboration with the dentist.

Second direction of development of the MIT is the ART-technique (atraumatic restorative treatment). The technique of treatment is maximally simple. A carious cavity is cleaned up by excavator, without preparing, filled with glass ionomer cement. It is used during conducting of sanation in the regions with difficult access. The ART-technique is recommended by WHO in order to render dental aid for the socially – unprotected groups of population.

The ART-technique| is|appear| a method of the minimal preparing (MMP). For the treatment, both the hand|manual| instruments|tool| and drills are used. After opening|dissection| the cavity only a demineralized enamel is carved, while it|her| remains of the edges|place| of cavity, even, if there is no support of dentine under it. A necrotic dentine is removed. As a result the cavity of pear-shaped form|shape| appears with a small entrance opening. Expedience of MMP consists in that a dental enamel remains steady|firm| and lasting in the aggressive environment|Wednesday| of the oral cavity.



The tunnel preparing (access) is an occlusal access at which the extensive carving of tissues of a tooth is conducted from a masticatory surface. The occlusive access leads to a considerable loss of tissues in occlusive surface and in the first place of the crest. The opening of the cavity in the tunnel preparing is conducted from the masticatory surface, in the area of three-cornered pit, retreating 2-2,5 mm of the edge of a tooth. The drills create a tunnel, directed to the contact carious, which is called the occlusive-aproximal. Thus, a cavity is opened, without damaging a marginal crest. The tunnel preparing is conducted with small carious damages which are localized mainly in the area of equator or a bit below (between a contact point and neck of a tooth). The drawback  is impossibility of visual control of a little quality of necrotomy, high risk of opening the cavity of a tooth (especially for young people).

Control questions to|by| practical lesson|occupation|


  1. What factors allow to apply the technique of diminishing the volume of carving the hard tissues?

  2. What does the conception of MIL consist in?

  3. What inter connected principles underlie in basis|foundation| of the conception of MIL?

  4. How is the individualized prophylaxis of caries work out?

  5. What is meant under minimal invasive filling of the carious affections by bioactive materials|fabric| and its|its| significance|importance| for efficiency of the MIL?

  6. What is the main purpose of the M.I.-Therapy?

  7. What is meant by the term micropreparation|?

  8. What are the peculiarities of the instruments|tool| for micropreparation|?

  9. How is a carious cavity formed during the micropreparation|?

  10. What is|appear| obligatory for successful performance of the principle of micropreparation|?

  11. What objective and subjective factors restrain a wide introduction of method of M.I.-Therapy?

  12. What is the ART-method|?

  13. What is the technique of treatment in ART-method|?

  14. What dental instruments|tool| are necessary for conducting ART-method|?

  15. What is the MMP-method|?

  16. How is the method of the tunnel preparing condected?

  17. What are the drawbacks of the method of the tunnel preparing?



Situation tasks and test control
1. What is the basic|main| conception of minimal invasive treatment of the carious cavities?

A. Prophylaxis

B. The new approach to the peculiarities of preparing

C. Dependence on stopping material|fabric|

D. Theoretical working-up|elaboration|
2. How many interconnected principles (FDI| Commision| project|, 1 (1997) underlie in the|foundation| conception of MIL?

A. 1


B. 3

C. 2


D. 4

E. 5
3. What is the size of|dimension| working part|portion| of the special instruments|tool| for minimal invasive treatment and stopping of the carious cavities?

A. Less than 1 mm|

B. More than|more than| 1 mm|

C. 1 mm|

D. Can be used as a classical one

E. No matters are of importance
4. If a carious cavity is within the limits of the enamel, what form|shape| should be created more often (after the method of MIL)?

A. Rectangular

B. Piriform

C. Cone-shaped

D. Triangular

E. Any
5. If a carious cavity is within the limits of the dentine, what form|shape| should be created more often (after the method of MIL)?

A. Rectangular

B. Piriform

C. Cone-shaped

D. Triangular

E. Any
6. What does the technique of preparing consist in after the ART-method|?

A. A carious cavity is cleaned up by the excavator

B. A carious cavity is cleaned up by the excavator and drill

C. A carious cavity is cleaned up only by drill

D. By another means

E. Is left untreated by instruments


7. What group of patients was recommened by WHO (1994) as the choice for the ART-technique|?

A. For all patients|what| in case of certain indications

B. Socially uprotected people

C. According to the choice of a doctor|physician|

D. According to the choice of a patient

E. To be of no importance|importance|


8. What does the method of conducting the minimal cavitation, that has been developed due to the method of the ART differ from it|her|?

A. Only a dental drill is used

B. Both the dental drill and cutting instruments are used|tool|

C. Only hand|manual| cutting instruments|tool| are used

D. In general a carious cavity is not prepared |generally|

E. Lack of proper answer |absent|


9. How is a carious cavity prepared according to the method of the minimal cavitation?

A. Only a demineralized enamel is carved, the entrance opening of a small size is left |dimension|

B. An enamel is carved on the edges|place| of a cavity

C. A demineralized enamel is carved and on the edges|place| of a cavity

D. An enamel is not carved

E. To be of no particular importance |importance|


10. The variety of what access is|appear| the tunnel preparation?

A. Direct

B. Gingival

C. Vestibular or tongue

D. Occlusial
11. what is the purpose of performing the tunnel access?

A. To simplify the performing of technique of preparation

B. To save the visual control of quality of preparing

C. To save|safety| of marginal comb

D. To economize of time of a doctor|physician| and a patient

E. To decrease the risk of perforation of the tooth cavity


12. What are the indications for the benefit of choosing the access by a tunnel method?

A. Carious cavities are of large size

B. Small carious cavities with localization mainly in the area of equator or a little bit|a bit| below

C. All of carious cavities of III class according to Black

D. All of carious cavities of IV class according to Black

E. All of carious cavities of V class according to Black


13. What are the drawbacks of the method of the tunnel preparation?

A. Complication is in the subsequent|consequent| preparing of the carious cavity

B. Complication of implementation

C. Impossibility of visual control of a quality of necrectomy|

D. Considerable expense of time

E. Necessity in the special cutting instruments|tool|



Reference literature


  1. Nikolyshyn a.K. Therapeutic dentistry /A.K. Nikolyshyn: a textbook is for the students of dental faculties of higher medical educational establishments of IV level of accreditation in two volumes, T.I.– Poltava: Divosvit, 2005.– 392 p.

  2. Borovskiy E.V. Therapeutic dentistry: a textbook is for the students of dental faculties of higher medical educational establishments.– M.: Med. Inform. agency, 2006.– 840 p.

  3. Nikolyshyn a.K. Therapeutic dentistry /A.K. Nikolyshyn: a textbook is for the students of dentistry faculties of higher medical educational establishments of IV level of accreditation in two volumes, T.IІ.–Poltava: Divosvit, 2007.– 280 p.

  4. Preclinical course of therapeutic dentistry: course of lectures|fabric| /L.O. Tsvykh, O.A. Petryshyn, V.V. Kononenko, M.V. Hysyk.– Lviv, 2002.–159 p.

  5. The methodological manual for|by| practical of therapeutic dentistry /L.O.Tsvykh, O.A. Petryshyn, V.V. Kononenko, M.V. Hysyk.– Lviv, 2003.– 98 p.

Practical lesson No 20
Theme: Final module control.

A list|enumeration| of theoretical questions for preparation of students to|by| final|total| module control.


        1. Dentistry as a science. History of its development.

        2. Basic|main| tasks|task| of therapeutic dentistry.

        3. Intercommunication|relationship| of therapeutic dentistry is with other special and medical disciplines.

        4. The role of the scientists of Ukraine in the development of therapeutic dentistry.

        5. Purpose and task of phantom course.

        6. Scientific organization of working conditions of a dentist.

        7. Structure|building| of a tooth. Topography of tissues. Histology of the enamel.

        8. Structure|building| of a tooth. Topography and histology of the cement and dentine.

        9. Structure|building| of the pulp and periodontium|. Age|age| changes|changing|.

        10. Concept|notion| of the periodontium|, its|its| function.

        11. Saliva, mouth liquid: composition|storage|, properties|virtue|, functions.

        12. Dental formula. Signs of teeth.

        13. Clinical anatomical features of the structure|building| of incisors of the upper and lower|bottom| jaws.

        14. Clinical anatomical features of the structure|building| of canines of the upper and lower|bottom| jaws.

        15. Clinical anatomical feature of the structure|building| of premolars of the upper and lower|bottom| jaws.

        16. Clinical anatomical features of the structure|building| of molars of the upper and lower|bottom| jaws.

        17. Organization and equipment of dentistry clinic|study|. Drills, handpieces, governed exploitation. Accident prevention. Concept|notion| of ergonomics.

        18. Dental instruments|tool|, their settings|purpose|. Cutting instruments|tool|. Governed sterilization.

        19. Ways of distribution of cariosity in hard tissues of a tooth.

        20. Ways of distribution of cariosity in hard tissues of a tooth on its|its| different|diverse| surfaces.

        21. Classification of carious cavities is on Blekom.

        22. Principles and mode|regime| of the classical preparing.

        23. Features of preparing of the carious cavities of the I class according to Black.

        24. Preparing of carious cavities of the II class according to Black

        25. Features of preparing of the carious cavities of the III class according to Black.

        26. Features of preparing of carious cavities of the IV class according to Black.

        27. Features of preparing of carious cavities of the V class according to Black.

        28. A method of preparing of the carious cavities by modern stoppings materials|fabric| (M.I.-terapiya).

        29. A method of preparing of the carious cavities by means of modern stoppings materials|fabric| of ART-tecnique (non-invasive|).

        30. Method of the tunnel preparing and others.



A list|enumeration| of mastering manual skills for final|total| module control


  1. To capture skills of interpretation of qualitative |quality| and quantitative composition of saliva.

  2. Be ready to write a dental formula for temporal and permanent|constant| bites.

  3. To represent the anatomical features of the structure|building| of incisors of the upper and lower|bottom| jaws (drawing |).

  4. To represent the anatomical features of the structure|building| of canines of the upper and lower|bottom| jaws (drawing |).

  5. To represent the anatomical features of the structure|building| of premolars of the upper and lower|bottom| jaws (drawing |).

  6. To represent the anatomical features of structure|building| of molars of the upper and lower|bottom| jaws (drawing|).

  7. To learn|study| the groups of dental instruments|tool|. To represent the form|shape| of working part|portion| of cutting instruments|tool| (drawing|).

  8. To learn|study| the methods of sterilization of dental instruments|tool|.

  9. To make two models of a crown of the first premolar of the lower|bottom| jaw and on one of them to form a carious cavity of the I class according to Black.

  10. To make preparation on a phantom carious cavity of I class according to Black.

  11. To make two models of a crown of the first premolar of the upper jaw and on one of them to form the carious cavity of the V class according to Black.

  12. To make preparation on a phantom carious cavity of the Vclass according to Black.

  13. To make two models of a crown of the second molar of the lower|bottom| jaw and on one of them to form the carious cavity of the II class according to Black.

  14. To make preparation on a phantom carious cavity of the III class | according to Black.

  15. To make two models of a crown of the upper canine and on one of them to form the carious cavity of the III class according to Black.

  16. To make preparation on a phantom carious cavity of the III class according to Black.

  17. To make two models of a crown of the upper|top| central incisor and on one of them to form the carious cavity of the IV class according to Black.

  18. To accomplish the preparation on a phantom carious cavity of the IVclass| according to Black.

  19. To master and reproduce|recreate| the technique of minorinvasion therapy on a phantom (МІТ|).

  20. To master and reproduce|recreate| the method of ART-tecnique| on a phantom (non-invasive|).

  21. To master and reproduce|recreate| the method of the tunnel preparing on a phantom.


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