1 Amalgam, Matrix Assembly, Rubber Dam Isolation

Question 1

An alloy made by mixing mercury (Hg) with silver-tin (Ag-Sn) dental amalgam alloy.

Answer 1

AMALGAM

Question 2

• Increases expansion
• Retards setting time
• Enhances strength
• Decreases flow
• Resists tarnish/corrosion

Answer 2

Silver (Ag)

Question 3

• Unites with Hg with difficulty
• Hastens setting time
• Increases expansion
• Increases strength and hardness
• Reduces flow
• Tarnishes readily
• Decreases creep

Answer 3

Copper (Cu)

Question 4

• Unites readily with Hg
• Retards setting time
• Improves plasticity
• Reduces expansion
• Increases flow
• Reduces strength

Answer 4

Tin (Sn)

Question 5

• Combines readily with Hg
• Causes expansion
• Increases setting time
• Increases flow
• Inhibits oxidation; scavengers of oxides
• Decreases porosity
• Delayed expansion with moisture contamination

Answer 5

Zinc (Zn)

Question 6

ROLES OF MERCURY IN DENTAL AMALGAM (3)
1. _________ with the alloy particles.
2. _______________________ or wetting of alloy particles.
3. ___________ mercury influence the __________________________ of the amalgam mass.

Answer 6

1. Reactant with the alloy particles.
2. Ease of trituration or wetting of alloy particles.
3. Pre-condensed mercury influence the degree of plasticity of the amalgam mass.

Question 7

measured during the setting of an amalgam & reflects the change in dimension of an amalgam.

Answer 7

Flow

Question 8

measured after amalgam sets, reflects the constant change in dimension.

Answer 8

Creep

Question 9

oxidation that attacks the surface of the amalgam and extends slightly below the surface.

Answer 9

Tarnish

Question 10

occurs from a chemical reaction between the amalgam and substances in saliva or food, resulting in oxidation of the amalgam

Answer 10

Corrosion

Question 11

Indications of Amalgam
1. Restoration of posterior teeth. Class _, _, _.
2. Anterior ________ surface of the teeth.
3. ______ surface of canine

Contraindication of Amalgam
Anterior teeth restorations (_, _, _)

Answer 11

Indications of Amalgam
1. Restoration of posterior teeth. Class I, II, V.
2. Anterior lingual surface of the teeth.
3. Distal surface of canine

Contraindication of Amalgam
Anterior teeth restorations (III, IV, V)

Question 12

Advantages
* Convenience on _________ and ____________ of restorative material.
* _________ to oral fluids.

Disadvantages
* Susceptible to ___________________
* _____________

Answer 12

Advantages
* Convenience on manipulation and insertion of restorative material.
* Insoluble to oral fluids.

Disadvantages
* Susceptible to Tarnish & Corrosion
* Galvanic Action

Question 13

o Forms a tin-mercury phase (gamma-2)

Answer 13

Low-Copper Amalgam

Question 14

o Greater strength
o Less tarnish and corrosion
o Less creep
o Less sensitive to handling variables
o Produce better long-term clinical results.

Answer 14

High-Copper Amalgam

Question 15

o Contains small, round alloy particles that are mixed with mercury to form the mass that is placed into the tooth preparation.

Answer 15

Spherical Amalgam

Question 16

o Contains irregularly shaped and sized alloy particles, sometimes combined with spherical shapes, which are mixed to form a mass that is placed into the tooth preparation.

Answer 16

Admixed Amalgam

Question 17

REACTION: ________________________________________

PHASES OF REACTION:
* Phase 1
― Silver-tin phase is called the _____________________, composed of ________ alloy particle.

• Phase 2
  ― Silver-mercury phase is called the _______________.
• Phase 3
  ― Tin-mercury phase is called the ___________.

Answer 17

Mercury+Silver-Tin Silver-Tin phase + Silver-mercury phase + Tin-mercury phase

PHASES OF REACTION:
* Phase 1
― Silver-tin phase is called the gamma phase, composed of unreacted alloy particle.

• Phase 2
  ― Silver-mercury phase is called the gamma one.
• Phase 3
  ― Tin-mercury phase is called the gamma two.

Question 18

(1) The solution of mercury into silver-tin particles leads to the formation of the surface of _______________ phases.

(2) The crystallization of the _______________________ phases and their subsequent growth leads to hardening of amalgam.

Answer 18

(1) Solution
Ag-Hg and Sn-Hg

(2) Crystallization
gamma1 and gamma2

Question 19

1. provides and takes the place of the proximal tooth surface that was removed to restore the proximal contours and contact to their normal shape and function.
2. Also referred to as the Tofflemire retainer. This device holds the matrix band in position.

Answer 19

1. matrix system
2. MATRIX RETAINER

Question 20

Used to tighten or loosen the spindle within the diagonal slot; this holds the matrix band securely in the retainer.

Answer 20

• Outer knob

Question 21

Used to increase or decrease the size of the matrix band loop; when placing the band over the tooth, the size of the loop circumference should be the ________ size and then tightened after placement.

Answer 21

• Inner knob
  largest

Question 22

Internal screwlike pin that fits into the diagonal slot to secure the ends of the matrix band; when assembling the retainer, the spindle point must be clear of the slot into which the band slides.

Answer 22

• Spindle

Question 23

Slot within the main body of the retainer that is used to position the ends of the matrix band into the vise; the retainer is always positioned in the mouth with this slot facing toward the ______.

Answer 23

• Diagonal slot
  gingiva

Question 24

Slots used to position the matrix band for either the left or the right quadrant.

Answer 24

• Guide slots

Question 25

1. Made of flexible stainless steel and are available in premolar, molar, and universal sizes and thicknesses. 2. * The larger circumference of the band is the ______________ and is always placed toward the occlusal surface. 3. * The smaller circumference of the band is the _____________ and it is always placed toward the gingiva.

Answer 25

1. MATRIX BAND 2. occlusal edge 3. gingival edge

Question 26

1. inserted into the lingual embrasure to position the matrix band firmly against the gingival margin of the preparation. CLASSIFICATION 1) According to size. 2) According to shape. a. ____ b. _____ 3) According to material. c. ____ d. ____

Answer 26

1. WEDGE a. Triangular b. Round c. Wooden d. Plastic

Question 27

POSITIONING OF BAND IN THE RETAINER Procedure: Try the _____ Burnish the ______________ Place the matrix band into the _________. Fit the matrix onto the _____. Place the _____. Tighten the ______________around the tooth. The ______________________________ is used in Class II restorations. The primary function of the matrix is to restore anatomic proximal contours and contact areas. A properly placed matrix should: - Be rigid against the existing tooth structure - Establish proper anatomic contour - Restore correct proximal contact relation - Prevent ______________ - Be able to be easily removed

Answer 27

wedge. matrix band. retainer tooth wedge matrix band Universal (Tofflemire) matrix system gingival overhang

Question 28

THE PALODENT SECTIONAL MATRIX SYSTEM : THE TECHNIQUE  STEP 1 - _________________________ o Place matrix o Adjust contact position.  STEP 2 - _______________________ o Gently close gingival margin w/ an anatomical wedge.  STEP 3 - __________________________ o Stretch open bow of BiTine Ring with Palodent or regular Rubber Dam Forcep.  STEP 4 - _________________________ o Position tines over proximal plane and release pressure (of forcep) o Loop can face either mesial or distal o IMPORTANT: " Should not interfere with cavity prep.  STEP 5 - ___________ o Burnish inner surface of matrix LIGHTLY to: " Seal gingival areas to avoid / minimize excess or overhanging filling, " Create better margin adaptation, " Generate proper anatomy and contact. o Recommended: Ball Burnisher

Answer 28

STEP 1 - PLACEMENT OF MATRIX STEP 2 - WEDGING OF MATRIX STEP 3 - SPREAD BITINE RING STEP 4 - PLACEMENT OF BITINE RING STEP 5 - MOLDING

Question 29

* Process of manual mixing of alloy with Hg * Done by proportioning mercury (Hg) into a mortar and grinding the mixture with a pestle. * Mixing of alloy with mercury

Answer 29

TRITURATION

Question 30

1) _____________- using mortar and pestle. 2) __________ - use of Amalgamator. 3. ____________________ – a hallow tube with rounded ends constructed as two pieces that could be friction fit or screwed together. 4. ______________________ – the components are separated in the capsule by a special diaphragm that is broken when the capsule is placed in an amalgamator.

Answer 30

1. Hand or manual 2. Mechanical 3. Reusable capsule 4. Precapsulated (preproportioned)

Question 31

Sources of Mercury Hazards 1. Mercury vapors released from ____________________. 2. Amalgamator ________. 3. _____________ during restoration procedure. 4. Amalgam removal and _________. 5. Amalgam _____ on cotton rolls. 6. Amalgam and mercury in __________________ 7. Amalgam _______container. 8. Mercury trapped in ____________ .

Answer 31

stored materials aerosols Spillage replacement waste plumbing and sewerage. System. scrap tiles and carpeting

Question 32

* Adapts the amalgam to the preparation walls and matrix. * Produce a restoration free of voids. * Lowers the mercury content in the restoration to improve strength and decrease corrosion.

Answer 32

Condensation

Question 33

* Adapts the amalgam to the preparation walls and matrix. * Produce a restoration free of void. * Lowers the mercury content in the restoration to improve strength and decrease corrosion.

Answer 33

Carving

Question 34

ADJUST OCCLUSION 1) To check occlusion, have the patient bring his/her teeth together lightly, check for a _____ area on the restoration and remove the premature contact with a carver. 2) Check the occlusion again with articulating paper. Have patient lightly tap teeth together, carve ____________ until any contact with the restoration occurs simultaneously with other centric contacts on the tooth and the adjacent teeth. This step may need to be repeated to get even contact. 3) Next, with articulating paper, have the patient to make _________________ movements and reduce any interferences present.

Answer 34

shiny prematurities lateral and protrusive

Question 35

EXAMINE THE RESTORATION * Double- check the interproximal for amalgam debris, rubber dam material, or overhangs. * Remove any _________ or debris. * Check interproximal contact visually to make sure that no _____ passes through the contact. Hold the mirror on the lingual and facial aspects of the teeth and check at different angles. * Then check with dental floss, making sure there is ___________ when the floss passes through the contact area.

Answer 35

overhangs light resistance

Question 36

POST-OPERATIVE INSTRUCTIONS 1) Instruct patient not to chew on the new restoration for at least 2 hours. 2) If patient was given anesthesia, remind him/her to be careful not to bite a lip or tongue. 3) Inform the patient that he or she may experience postoperative sensitivity to hot or cold for a few days. 4) If the patient feels that occlusion (bite) is too high after anesthesia wears off, have him/her contact the office for occlusal adjustment. 5) Have the patient schedule a return appointment after _____ to finish and polish the restoration.

Answer 36

24 hours

Question 37

* _________ placement allows the clinician to achieve a dry field by isolating the tooth (or teeth) indicated for treatment from oral fluids and other oral tissues (lips, cheeks, tongue, and gingiva). * This protects the patient from swallowing or aspirating (drawing into the lungs) debris and dental objects that are used during the procedure. * It also protects the tissues from irritating materials used for the procedure such as acids for etching enamel. * It is contraindicated for patients who are __________, suffer from _______________, or have trouble breathing through their nose. * Other contraindications include patients with teeth that are not fully _______ as the clamp may not be stable and patients who cannot tolerate the clamp without anesthesia.

Answer 37

Rubber dam claustrophobic, severe asthma erupted

Question 38

PREPARING THE RUBBER DAM MATERIAL 1. Stamp the _______________. 2. Punch the holes. 3. Prepare the ______. " Selection of the correct clamp. 4. _________ the clamp. 5. Place the _____ of the clamp into the hole in the rubber dam sheet. 6. Use the ______ to stretch open the clamp in the dental dam and position at the ________ region of the tooth. 7. Place the _________________.

Answer 38

rubber dam sheet Clamp Flossing wings forceps; cervical rubber dam frame