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D1 Spring - Operative Dentistry I > 1/18: Operative Dentistry I > Flashcards

1/18: Operative Dentistry I Flashcards

1
Q

What is operative dentistry?

A

Treatment of disease/defects of hard tissues of teeth that DO NOT REQUIRE FULL COVERAGE
RESTORATION

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2
Q

What does operative dentistry restore?

A

Form, function, and esthetics

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3
Q

What are the 4 types of teeth?

A

Incisors
Canines
Premolars
Molars

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4
Q

What does enamel thickness vary based on?

A

Location
Tooth type

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5
Q

What makes up enamel?

A

90-92% hydroxyapatite

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6
Q

Describe enamel

A

Strong and brittle

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7
Q

Where are enamel rods diameter larger and smaller?

A

Larger- near surface
Smaller- near dentin borders

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8
Q

Where are enamel rods found?

A

Perpendicular to long axis, radiate outward (like spokes on a wheel)

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9
Q

_______ leave unsupported enamel

A

DO NOT

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10
Q

What can grooves and fissures act as?

A

Food/bacterial trap

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11
Q

What do grooves and fissures lead to?

A

Decay

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12
Q

Where do enamel tufts extend into?

A

Enamel from DEJ

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13
Q

What are enamel lamellae?

A

Thin faults between enamel rod groups

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14
Q

What mineralization are enamel tufts?

A

Hypomineralized

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15
Q

Where do enamel lamellae extend from?

A

Enamel toward DEJ

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16
Q

What is the DEJ?

A

Dentino-enamel junction

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17
Q

Where is the DEJ located?

A

Hypomineralized zone where dentin meets enamel

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18
Q

Where is the solubility of enamel increased?

A

As you approach DEJ

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19
Q

What does fluoride do?

A

Lowers acid solubility
*important to remember both when considering caries AND when considering bonded restoration

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20
Q

Describe the pulp-dentin complex

A

Strong and resilient
Living tissue

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21
Q

What is the largest portion of the tooth?

A

Dentin

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22
Q

Where is dentin located?

A

In both coronal and root portions of tooth

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23
Q

What does dentin form?

A

Walls of pulp chamber

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24
Q

When is dentin formed?

A

Immediately prior to enamel

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25
Q

When does dentin formation continue throughout?

A

The life of the pulp

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26
Q

What are enamel spindles?

A

Odontoblastic process crossed into enamel

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27
Q

What can enamel spindles serve as?

A

Pain receptors

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28
Q

What are dentinal tubules?

A

Canals extending from DEJ/DCJ to pulp

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29
Q

What are dentinal tubules lined with?

A

Peritubular dentin

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30
Q

What kind of dentin is between tubules?

A

Intertubular dentin

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31
Q

Where is the diameter of tubules largest?

A

At pulp

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32
Q

Where is the number of tubbules/square mm greatest?

A

At pulp

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33
Q

What is reparative dentin formed by?

A

Secondary odontoblasts

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34
Q

What do reparative dentin respond to?

A

Moderate irritant

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35
Q

What is sclerotic dentin?

A

Dentin that has changed

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36
Q

What kind of dentin widens and how?

A

Peritibular; filled with calcified material

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37
Q

The hardness of dentin averages _____ that of enamel

A

1/5

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38
Q

Where is dentin harder near?

A

DEJ than near pulp (3x)

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39
Q

What percent of dentin is hydroxyapatite?

A

50%

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40
Q

What causes dentinal sensitivity?

A

Fluid movement in tubules

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41
Q

What is the hydrodynamic theory of pain transmission?

A

Odontoblastic process wrapped in nerves and fluid in dentinal tubules

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42
Q

What happens when enamel/cementum removed during preparation?

A

Seal is lost

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43
Q

What happens during small fluid movements in tubules?

A

Distortions in nerve endings = PAIN

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44
Q

When is a smear layer created?

A

Whenever tooth is cut/prepared

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45
Q

What does a smear layer plug?

A

Dentinal tubules
- greatly reduces dentin permeability

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46
Q

Describe the color of enamel

A

Gray, semi-translucent
Color depends on underlying dentin
Becomes temporarily whiter when dehydrated
Shiny

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47
Q

Describe the color of dentin

A

Yellow-white
Dull, opaque

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48
Q

What does cementum cover?

A

Root surface

49
Q

Describe the texture of cementum compared to dentin

A

Softer than dentin

50
Q

Describe how cementum is formed

A

Continually

51
Q

What is known as the curve or shape of something?

A

Contours
overcontour vs. overcontoured

52
Q

What is known as where two adjacent teeth contact?

A

Proximal contact
vs. occlusal contact

53
Q

What is known as an opening with sides flaring outward?

A

Embrasures
V-shaped valleys between adjacent teeth
(gingival usually fills in this space)

54
Q

What are objectives of tooth preparation

A

*Resistance Form, Retention Form, Convenience form
*Remove defects
*Provide necessary protection to pulp
*Extend restoration as conservatively as possible
*Resist fracture when chewing
*Restore esthetics and function

55
Q

Tooth preparation should be _______

A

precise (especially for amalgam)

56
Q

Who developed the preparation design and principles?

A

GV black

57
Q

What do preparations for composite restorations incorporate?

A

Bonding

58
Q

Where to preparations extend to?

A

Sound tooth structure in all directions

59
Q

What are prep walls designed to?

A

RETAIN restoration
RESIST fracture

60
Q

What do you do in a preparation?

A
  • Remove remaining caries or old restorative material
  • protect pulp
  • minimized fracture, maximize retention
  • finish walls and margins
  • final cleaning, inspection, sealing prep
61
Q

What are some external factors to consider when completing a restoration?

A

Esthetics
Economics
Medical condition
Age
Caries risk

62
Q

What are some internal factors to consider when completing a restoration?

A

Dental anatomy
◦ Enamel Rod orientation
◦ Thickness of enamel and dentin
◦ Size, location of pulp
◦ Relationship of tooth to periodontium
Caries
Fractured Teeth
Improve form and function

63
Q

How should you conserve the tooth structure?

A

Repair damage but preserve vitality

64
Q

What are the three locations of primary caries?

A

Pit and fissure
Enamel smooth surface
Root surface

65
Q

What do pit and fissure caries occur from?

A

Imperfect coalescence of developmental enamel lobe

66
Q

What do enamel smooth surface occur from?

A

Area left unclean chronically

67
Q

What are the 3 types of causes for residual caries?

A

Caries left by operator
- intentionally or by accident
Never ideal to leave caries
- Especially when left at the DEJ or on prepared enamel wall
May be acceptable in rare instance
- to avoid pulp exposure
- when left as affected dentin near the pulp

68
Q

What are recurrent caries?

A
  • Microleakage present at the junction between restoration and tooth
  • may progress under the restoration or behind it so it cannot be seen with a radiograph
69
Q

What is reparative dentin formed by?

A

Odontoblasts at end of tubules at surface of pulp (in response to irritation)

70
Q

What are the two rates of caries?

A

Acute (or “rampant”)
Chronic

71
Q

Describe acute rate of caries

A

Light color
Appears dull, mushy

72
Q

Describe chronic rate of caries

A

Slow or arrested
Dark color
Appears shiny, solid

73
Q

What did dentists formally practice?

A

“extension for prevention”
this meant taking away unnecessary tooth structure and is no longer practices

74
Q

What are better preventative measures instead of “extension for prevention”?

A

Enameloplasty, sealant, and preventive resin or conservative composite restoration instead

75
Q

What are these abbreviations:
O
MO or DO or MOD
F or B
L

A

O= occlusal
MO = mesial occlusal
DO = distal occlusal
MOD = mesial-occlusal distal
F or B = facial or buccal
L = lingual

76
Q

What are the two internal walls that are prepped?

A

Axial wall
Pulpal wall or floor

77
Q

Axial wall is _____ to the long axis of the tooth

A

Parallel

78
Q

What is the cavosurface margin?

A

Margin (edge) where the prepared (cut) tooth meets the unprepared tooth

79
Q

What is the cavosurface angle?

A

Angle where prepared wall and unprepared tooth surface meet

80
Q

What is the wall closest to pulp?

A

Pulpal wall/floor

81
Q

Where is the pulpal wall/floor?

A

Perpendicular to the long axis of tooth in class I and II preparations

82
Q

What is the function of pulpal and gingival floors/walls?

A

Provide stabilizing seats for restoration
Distribute stresses in tooth

83
Q

What is a line angle?

A

Junction of two walls/surfaces along a line

84
Q

What is an internal line angle?

A

Apex points AWAY from observer

85
Q

What is an external line angle?

A

Apex points TOWARD observer

86
Q

What is a point angle?

A

Junction of three surfaces

87
Q

What is a cavosurface angle or margin?

A

Junction of PREPARED cavity wall and EXTERNAL surface of tooth
keep in mind: location of tooth, direction of enamel rods, material you will be using

88
Q

What are the types of cavosurface angle or margin?

A

Bevel
90*
Chamfer

89
Q

What is cavosurface?

A

Where prepared tooth meets unprepared tooth

90
Q

What is the CEJ?

A

Cementoenamel junction
Where cementum meets enamel

91
Q

What is enamel margin strength formed by?

A

Full length enamel rods

92
Q

What is unsupported enamel?

A

When enamel rods are not supported by sound dentin
*remove for preparation (brittle, fracture easily)

93
Q

Why operative dentistry?

A

Diagnosis
Treatment
Repair

94
Q

What is a class I preparation?

A

Occlusal surface of posterior teeth
*may include lingual/buccal grooves and pits

95
Q

What is a class II preparation?

A

Proximal surfaces of premolars and molars

96
Q

What is a class III preparation?

A

Proximal surfaces of incisors and canines
*that do not involve incisal edge

97
Q

What is a class IV preparation?

A

Same as class III, add incisal edge

98
Q

What is a class V preparation?

A

Gingival 1/3 of smooth surfaces
buccal, lingual

99
Q

What is a class VI preparation?

A

Incisal edge or cusp

100
Q

What are the stages of tooth preparation?

A

Know what your restorative material needs for adequate strength
Initial stage
Final stage

101
Q

What do you do during the initial stage of a tooth preparation?

A

Outline form
Initial depth
Primary resistance form
Primary retention form
Convenience form

102
Q

What is axial wall depth?

A

Measured from the edge of the tooth (proximal surface) to the axial wall
*it is not a typical depth measurement from the top of something to the bottom

103
Q

What is an enameloplasty?

A

Remove shallow enamel fissure or pit
*Creates smooth, saucer shaped surface = self-cleansing

104
Q

How much enamel thickness is removed in an enameloplasty?

A

No more than 1/3

105
Q

What must you do when margin exceeds 2/3 of the distance between central groove?

A

Must cap weak cusps

106
Q

What must you do when margins end 1/2 distance between central groove and cusp tip?

A

Consider capping weak cusps

107
Q

What creates less stress concentration?

A

Rounding externa lline angles

108
Q

What do flat floors prevent?

A

Movement

109
Q

When allowing for sufficient thickness of restorative material, what are minimum measurement thickness for amalgam, gold, and porcelain?

A

Amalgam 1.5mm minimum
Gold 1-2mm minimum depending on area
Porcelain 2.0mm minimum

110
Q

What does a dovetail prevent?

A

Tipping and proximal displacement

111
Q

What does a taller wall resist?

A

Pull of sticky foods

112
Q

What does convergence mean?

A

Walls slant toward eachother
*especially important with amalgam

113
Q

What do you do during the final stage of tooth preparation?

A
  • Remove remaining infected dentin
  • Remove remaining old restoration
  • Pulp protection
  • Secondary resistance and retention forms
  • Finish external walls and margins
  • Final cleaning, inspecting, and sealing
114
Q

What kind of dentin is affected dentin?

A

Demineralized
- usually discolored but NOT soft
- ok to leave in rare circumstances

115
Q

What kind of dentin is infected dentin?

A

Microorganisms present
- soft
- may or may not be stained
- must remove (THERE ARE MICROORGANISMS PRESENT)

116
Q

How to tell the difference between affected and infected dentin?

A

Not always possible

117
Q

Where should your position be when working on the buccal sides of patients UL and lingual sides of patient’s LR?

A

8:00 positioning

118
Q

Where should your position be when working on the buccal sides of patients UR and lingual sides of patient’s LL?

A

11:00 positioning

119
Q

Where should your position be when working on the patients buccal R and L anterior and lingual sides of patient’s R and L anterior?

A

12:00-1:00 positioning

D1 Spring - Operative Dentistry I (12 decks)

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