01 Restorative Flashcards
5 Advantages of Rubber Dam
Improved Child Management Improved Working Conditions Aseptic field for pulp treatment Protection of Patient Increased Efficiency
Key Factors of Rubber Dam Use
Set up prior to seating child Obtain good local anesthesia Explain the procedure Place the rubber dam and frame as a unit Ligate with floss
What teeth is the W8A clamp designed for?
Primary molars and some smaller permanent first molars
How are the jaws of the W8A clamp oriented?
Cervically
Which clamp has wings? The W8A or the 8A
8A
W stands for wingless
Which teeth is the 14A designed for?
Permanent first and second molars which are not fully erupted
What are the two rubber dam methods used?
Slit Dam
Individual Tooth
What is the main advantage, and the main disadvantage of the slit dam technique
Faster
Less Isolation
When using the slit dam technique, which holes do you punch out in the dam?
One hole for the most posterior tooth and a second hole for the most anterior tooth
Why are modification to restorative techniques needed?
To account for anatomic differences and different restorative materials
What is the most common mistake in the restoration of primary teeth?
Over-extension of the preparation
What is the treatment of choice when caries require excessive tooth structure to be removed?
Extra coronal SSC
4 Desirable characteristics of primary preparations
Conservative
Extended sufficiently to remove all caries
Prep design should provide adequate retention for resto. material
Pulpal floor should be of uniform depth and slightly rounded
What are the two primary restorative materials used
Amalgam
Composite
Which common adult restorative material does not hold up well
Glass Ionomer
Dimensions of a typical amalgam class I
1.5 mm depth
1/3 intercuspal width
3 considerations for class II preps
The buccal and lingual walls of the prep should converge toward the occlusal surface
The portions of the prep that extend into the buccal and lingual grooves and the marginal ridge area should be PARALLEL or slightly DIVERGE to preserve tooth strength
I deal width of isthmus is 1/3 intercuspal width
What is the ideal width of the floor of the box
1 mm
Axially, how should the proximal box be designed?
Slightly into dentin, so the axial wall is slightly undercut
Should you bevel the gingival line angle?
No
Which part of the box should be beveled?
Axio-pulpal line angle
What should you do if you think your class II prep is encroaching on the pulp?
Use a base material, like glass ionomer
What is essential for class II restorations
Matrix band
What type of matrix band is made of soft material in order to readily adapt to contours
Tee Band
What is another advantage of tee bands?
No intraoral apparatus is needed
What restoration step is critical when using a Composite material
Isolation and moisture control
What are the 7 Common errors for Class II Preps/Restorations
ON TEST FOR SURE
- Failure to extend occlusal outline into all susceptible pits and fissures
- Failure to follow the outline of the cusps
- Isthmus cut too wide
- Flair of proximal walls too great
- Angle formed by the axial, buccal, and lingual walls too great.
- Gingival contact with adjacent tooth not broken
- Axial wall not conforming to the proximal contours of the tooth and the mesial distal width of the gingival floor is too great
What two burs are used for a class III restoration
No. 33.5 inverted cone OR a small round bur
Describe the shape of a class III preparation
Triangular, with the base of the triangle at the gingival area
How is retention created in the class III prep?
Via undercut by the shape of the bur
Why is dentin bonding less effective in primary teeth?
Less mineralization of tissue
When might a crown become indicated when working on a class III
If the incisal area becomes thin and you are looking at a class 4. Crowns are used instead of class IV’s
Where are class III restorations not well retained
Maxillary anterior teeth
Where are class III restorations rarely retained
Mandibular teeth
When doing anterior restorations, what type of matrix is used
Mylar
What is critical to check before finishing composite resin restorations
that the prep is completely dry and free of contaminates such as blood
When evaluating a molar for a class V, when is a crown indicated?
If the caries extends beyond the line angles of the tooth into the interproximal areas
