Foundations of Restorative Science & Technology

Progress Report
Clinical Sciences Coordinating Committee
May 14, 1999
Members of the Foundations of Restorative Science & Technology committee:
Gordon Douglass (Chair), David Graham and Fritz Finzen


To teach the biological basis, science, techniques and psychomotor skills necessary to restore missing portions of the masticatory system to appropriate form, function and esthetics.


Developing a high level of psychomotor skills remains an important goal of dental education, and this stream assumes the primary responsibility for developing those psychomotor skills most fundamental to the restoration of teeth. The use of dental instrumentation and materials to properly prepare and restore a part or all of the dentition is still a major part of a contemporary practice in general dentistry.

The committee began by making the assumption that beginning dental students at UCSF have not yet developed a level of psychomotor skills adequate for the general practice of dentistry. It has, therefore, worked to structure this stream as a progression from clinical procedures requiring minimal skill levels and minimal invasion of tooth structure, to those requiring more extensive preparations and reconstructions. Since restorations may be either fixed or removable or a combination, this stream must also vertically integrate both types of restorations.


The foundations of restorative dentistry fall into two categories: fixed restorations and removable restorations.


The committee used all available course materials now being used in restorative dentistry to identify and then coordinate the following "units" of information with respect to each competency as noted below.

Competency 1: Restore tooth defects which warrant minimally invasive procedures. (NOTE: competency in this context is NOT meant to have the same meaning as those discussed in the Patient Centered Care Stream).

The types of dental lesions within the competency include: defective pits and grooves, smooth surface enamel defects and carious lesions, and erosions, abrasions, abfractions.

(NOTE: the use of the term "unit" below does not imply a unit of instruction (i.e., one lceture a week for a quarter) but rather a section or a body of instruction)

UNIT 1: What dental defects require restoration? Identification and classification of lesions

UNIT 2: Isolation of teeth necessary for their restoration. Mounting of teeth for laboratory procedures. Placement of sealants.

UNIT 3: Lecture material and handouts on the restoration of abfractions (placement and finishing)

UNIT 4: The restoration of abfractions

UNIT 5: Biomechanical principles of cutting tooth structure

UNIT 6: Lecture material and handouts on conservative restorations requiring the removal of tooth structure. Laboratory would follow with preparation and placement of preventive resin restorations, attrition, erosion/abrasion.

UNIT 7: Conservative Class I slot and Class II box bonded amalgam restorations. Lecture of one hour then to laboratory to perform procedure (video tape?).

Biomaterials lectures need to be brought in at this time to cover the material to date.

Competency 2: Place direct restorations for tooth defects requiring the replacement of significant tooth structure.

The types of dental lesions within the competency include: fractured teeth, carious lesions requiring enhanced retention and resistance form, replacement of defective traditional restorations and recurrent caries.

UNIT 8: Introduce material on the place of "conservative" and "traditional" in modern dental health care. Laboratory to follow with VCR tape of procedures to be accomplished ("Learn-a-Prep", Class I & 5 amalgam/composite preparation [same prep!] on typodont).

UNIT 9: Cavity (intra and extracoronal) preparations. Nomenclature, and instrumentation (rotary and hand) of cavity preparation. Laboratory: Class III composite and class IV composite preps.

UNIT 10: Outline form (VCR tape-class II prep). Laboratory: Class II amalgam prep on Learn-a-Prep and typodont

UNIT 11: Convenience retention and resistance form. Laboratory: another Class II amalgam prep

UNIT 12: Caries removal and pulp protection. Laboratory: Variations of Class II preparation for large restorations.

UNIT 13: Finishing walls, beveling, cleansing and surface preparation. Laboratory: Preparation and placement of pulpal protection.

UNIT 14: No lecture planned yet. Laboratory: Amalgam preparation (test case?).

Consider a lecture on the commonalities of materials placement such as the use of matrices.


Preliminary discussions have been completed but more time must be spent to plan this block of time. Key players: Lacy, Staninec and Eakle


UNIT 15: Class I amalgam outline, trituration, condensation, carving of amalgam. Laboratory: #30 occlusal amalgam preparation, condense and carve amalgam three times.

Biomaterials lectures need to be brought in at this time to cover the material to date.

UNIT 16: Class II amalgam preparations (bis and molar outlines), Sweeney matrix, condensation and carving. Laboratory: #30 MO amalgam preparation, Sweeney matrix, condensation and carving.

UNIT 17: Selection of spherical or lathe cut amalgam, finishing and polishing. Laboratory: tooth #5 DO, Sweeney matric, condense and carve. Finish and polish #30 from previous period.

UNIT 18: Lecture is VCR tape reviewing the process of Class II amalgam prep, matrix and carving. Laboratory: (test case of Class II amalgam prep, Sweeney matrix condense and carve?)

UNIT 19: Amalgam matrices. Laboratory: #21 & 29 DO amalgam preps, Tofflemire matrix, condense and carve.

UNIT 20: Class V and VI outline and instrumentation. Laboratory: #29 & 30 facial amalgam preps condense and carve. Finish and polish #21 & 29.

UNIT 21: Problem solving. Laboratory: Test case: Class II amalgam preparation, Tofflemire matrix, condensation and carve.

UNIT 22: Class III amalgam preparation, VCR tape on the "60 Minuteâs" tape on amalgam controversy. Laboratory: DL amalgam prep, modified Sweeney matrix, condense and carve. Second DL amalgam prep, Tofflemire matrix, condense and carve. Finish and polish #29 & 30 Class Vs.

UNIT 23: Extracoronal amalgam preps. Laboratory: #30 MODL prep, spot welded matrix, condense and carve. Finish & polish class III amalgam.

UNIT 24: 20-20 rebuttal to amalgam controversy. MODL plus amalgam #3, spot welded matrix, condense and carve. Finish and polish #30.

Competency 3: Place indirect restorations for tooth defects which requiring the replacement of significant tooth structure (will be integrated with the composite indirect techniques).

UNIT 25: Lecture: Basic principles of tooth preparations to receive indirect intracoronal restorations (composites, castings). Laboratory: preparation of #3 MO inlay.

UNIT 26: Lectures: Basic principles of tooth preparations to receive full veneer castings and the provisionalization of prepared teeth. Laboratory: preparation and temporization of #18 FVC

UNIT 27: Lectures: "Lost wax technique" and its use in fabricating a casting (should include impression, waxing, investing and casting). Laboratory: complete acceptable preparations of #3 inlay and #18 FVC and temporize.

UNIT 28: Lecture: How to make and pour a quadrant impression and prepare a die for waxing of a restoration. Laboratory: Making an impression and preparing a die.

UNIT 29: Lecture: Biomaterials of the "lost wax technique" (waxes and investments). Laboratory: waxing of #3 inlay (direct technique) and FVC #18 (indirect).

UNIT 30: Lecture: How to prepare a wax pattern for casting (to include margin re-adaptation, spruing and investing). Laboratory: invest the #3 inlay wax pattern for casting, and finish waxing # 18 FVC.

UNIT 31: Lecture: The casting process. Laboratory: Casting of the #3 inlay, and invest and cast #18 FVC.
UNIT 32: Lecture: Finishing of a casting to a die. Laboratory: Finishing and polish of #18 casting.

UNIT 33: Laboratory: #2 FVC preparation and temporization.

UNIT 34: Lecture: Principles of partial veneer preparations for restorations that rely solely on bonding for retention on teeth with existing restorations or defects. Laboratory: PVC prep (for porcelain veneers) on 8 & 9, impression and temporaries

UNIT 35: Lecture: Principles of partial veneer preparations for restorations that rely on mechanical retention and resistance form for teeth with existing restorations or defects. Laboratory: #30 PVC prep (student designed prep based on principles given in lecture), quadrant impression and temporization.

UNIT 36: Laboratory only: Wax and invest, cast and finish #30.

UNIT 37: Laboratory: Student designed 7/8 crown prep on tooth #14 and PVC prep on #4 based upon principles of PVCs and temporization. (no waxing or casting intended)

UNIT 38: Lecture: Types of impressions and how to decide which to use (full arch vs quadrant and mounting techniques).

UNIT 39: Lecture: Biomaterials, what and how to use luting agents Physical properties and rationale for clinical selection in the use of luting agents.

UNIT 40: Cementation and finish of inlay, FVC and PVCs.

Competency 4: Restore missing posterior teeth with fixed partial dentures.

UNIT 41: Lecture: Preparation and provisional restorations for posterior cast restorations. Laboratory: Pretreatment waxing and preparation of the cast for the provisional.

UNIT 42: Lecture: Preparation design for posterior bridges. Laboratory: Preparation of teeth #3 (PVC) and #5 (PVC).

UNIT 43: No Lecture. Laboratory: Complete bridge preps #3 and #5

UNIT 44: Lecture: Provisional restoration and impressions for posterior bridges. Laboratory: Complete bridge preps.

UNIT 45: No lecture. Laboratory: prepare custom tray, make impressions for bridge, and make jaw relation records.

UNIT 46: Lecture: Non-rigid connectors for fixed partial dentures. Laboratory: Making of provisional restoration, trimming of dies and mounting of casts.

UNIT 47: No Lecture. Laboratory: Finish mounting of casts, trimming dies and begin waxing of bridge retainers.

UNIT 48: No Lecture. Laboratory: Complete waxing of bridge.

UNIT 49: Lecture: Pontic design. Laboratory: Cutting of key way, investing, casting of #5.

UNIT 50: Lecture: Resin veneers for pontic contours, and fixed partial denture assembly. Laboratory: Seat #5 casting and wax #4 attachment in #5, invest and cast #3 and #4.

UNIT 51: No lecture. Laboratory: Complete posterior bridge.

Competency 5: Restore missing anterior teeth with fixed partial dentures.

UNIT 52: Lecture: Preparation and provisional for anterior bridge #8 - #10. Laboratory: preparation of teeth #8 - #10

UNIT 53: Lecture: Biomaterials of investments for porcelain to metal restorations. Laboratory: Complete preparation of #8 - #10 bridge and start provisional.

UNIT 54: Lecture: Biomaterials of alloys used for porcelain to metal restorations. Laboratory: Complete provisional bridge.

UNIT 55: Lecture: Framework design and casting of porcelain to metal restorations. Laboratory: Cut back wax pattern, invest and cast.

UNIT 56: Lecture: Finishing of metal for the application of porcelain and the application of opaque porcelains. Laboratory: Finish metal and apply opaque porcelain.

UNIT 57: Lecture: Modification of porcelain opaques and the application of body porcelains, finish and glazing. Laboratory: Porcelain application and contouring.

UNIT 58: Lecture: Variations of porcelain to metal restorations. Laboratory: Complete anterior bridge.

Competency 6: Restore severely compromised vital and non-vital teeth.

UNIT 59: Lecture: The build-up of vital posterior teeth (auxiliary retention and resistance form). Laboratory: Pin, troughs, grooves, boxes, pulpal protection and their use in the building up vital posterior teeth. Laboratory: Pulpal protection, and the pin and trough retained bonded amalgam restoration.

UNIT 60: Lectures: Endodontic procedures for anterior teeth. Laboratory: Access openings, instrumentation, and obturation of anterior teeth.

UNIT: 61: Lecture: Pre-endodontic protection and provisionalization of posterior teeth.

Laboratory: The use of bands, amalgam, composites for pre-endodontic treatment of posterior teeth.

UNIT 62: Lectures: The preprosthetic build-up endodontically treated teeth. Laboratory: Direct and indirect cast dowel and core, and fiber reinforced resin post and core. Consider a debate on the issue of cast vs. fiber reinforced dowel and core.

UNIT 63: Lectures: Endodontic procedures for posterior teeth. Laboratory: Access openings, instrumentation, and obturation of posterior teeth.

UNIT 64: Lectures: The preprosthetic build-up of endodontically treated posterior teeth. Laboratory: Amalgam build-up utilizing the canal space. 


The following "subject units" encompass existing courses RD 121A, 125.01A, 121B, 125.01B, 121C, and 125.01C.

Competency 7: Fabricate complete dentures for a completely edentulous patient.

Introduction to the theory, clinical practice, and laboratory procedures for the fabrication of complete dentures

UNIT 1: Lecture: Introduction to complete dentures. Laboratory: Make record bases using Orthodontic resin and the Triad materials.

UNIT 2: Lecture: What it means to be edentulous. Laboratory: Using the Hanau 183 Wide View Articulator.

UNIT 3: Lecture: Anatomy and Physiology of Complete Dentures. Laboratory: Mounting edentulous casts

UNIT 4: Lecture: Biomechanics of Complete Dentures and Edentulous Impressions. Laboratory: Make occlusal plane guide.

UNIT 5: Lecture: Recording Maxillomandibular Relations and Setting Anterior Teeth. Laboratory: Setting anterior teeth .

UNIT 6: Lecture: Tooth Selection and Arrangement. Laboratory: Setting posterior teeth.

UNIT 7: Lecture: Alternate Occlusal Forms and Relationships. Laboratory: Wax contouring of complete dentures.

UNIT 8: Lecture: Processing, Delivery and Adjustment. Set up case for processing.

Competency 8: Fabricate tissue borne complete and partial dentures for patients transitioning into partial and complete edentulism.

Introduction to the theory and fabrication of stayplates, transitional and immediate dentures.

UNIT 9: Lecture: The Lingualized Occlusal Concept. Laboratory: Remounting of complete dentures, the remount index, and placing of names in denture bases.

UNIT 10: Lecture: The Use of Stayplates (Mucosa Borne Removable Partial Dentures). Laboratory: Make a stayplate.

UNIT 11: Lecture: Transitional Complete Dentures and Tissue Conditioners. Laboratory: Add tooth wire clasps to a stayplate.

UNIT 12: Lecture: Immediate Complete Dentures. Laboratory: Repair of broken dentures.

UNIT 13: Lecture: Complete Denture Relining. Laboratory: Replace broken or lost denture teeth.

UNIT 14: Lecture: The Theory and Use of Overdentures.

Competency 9: Restore the partially edentulous patient with a tooth and tissue borne removable partial denture.

Introduction to the basic principles of partial denture design and fabrication.

UNIT 15: Lectures: Design Concepts for Removable Partial Dentures, Surveying for Rest Seats, Guide Planes and Clasp Designs. Laboratory: Surveying, rest seat preparation, guide plane preparation.

UNIT 16: Lectures: Designing and Work Authorizations for Removable Partial Dentures. Laboratory: Design RPDs for the most common clinical presentations.

UNIT 17: Lectures: Direct and Indirect Retainers for Removable Partial Dentures. Laboratory: RPD set-up, wax contours.

UNIT 18: Lectures: Alloys Used to Fabricate Removable Partial Dentures and Processing of RPDs. Laboratory: Set-up RPD for processing.

UNIT 19: Lecture: Abutment Crowns for Removable Partial Dentures.

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