1. Class III and V Composite Preparations Flashcards by J L

Class III Lesions

____ surface caries;
Similar to Class ____ and Class ____
Located below ____ points of anterior teeth

smooth
II
V
contact

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Class III Caries
Size of preparation depends on extent of:
____
____

caries

defective restoration

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Class III Caries

Cones of decay have an “____” relationship

apex to base

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Class III Caries Diagnosis
____
____

radiograph

transillumination

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Class V Carious Lesions
Originates in the ____ thirds of teeth
Occurs on ____ surfaces of tooth
____ surfaces - most common

cervical (gingival)
smooth
facial

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Class V Carious Lesions
Also ____ surface lesions
Also ____ relationship at the DEJ

smooth

apex to base

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Class III and Class V Composite Resin Preparations

Composite vs Amalgam:

OUTLINE FORM:
____ extension for prevention
• Preserve as much ____ as possible

RESISTANCE FORM:
Axial wall can be of varying ____ (does not need to be ____ for “bulk thickness of material - to resist fracture of material)

minimal
enamel
depth
uniform

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Class III and Class V Composite Resin Preparations

RETENTION FORM:
Enamel ____ part of preparation
• To increase ____ area
* ALSO: Eases blending ____ at marginal area

Preparation walls are left ____
• Increases ____ area for bonding
• Use ____ burs vs carbides

bevel
retention/surface
shade

rough
surface
diamond

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Principles of Class III Preparation for Composite
Restoration

\_\_\_\_ access:
   Maintains/preserves facial enamel
   Maintains natural appearance
   Easier \_\_\_\_ matching
   Eventual discoloration or
breakdown of restoration less visible

lingual

color

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Principles of Class III Preparation for Composite
Restoration

General Outline Form:
Lingual Approach   
\_\_\_\_ Shape
   Incisal and gingival wall \_\_\_\_ to the
long axis and \_\_\_\_ to
each other
   Axial wall parallel to \_\_\_\_

rectangular
perpendicular
parallel
long axis

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Principles of Class III Preparation for Composite
Restoration

General Outline Form:
Lingual Approach
   incisal margin \_\_\_\_ to contact point
• keep contact \_\_\_\_ 
• \_\_\_\_ inciso-
gingivally
   smooth and flowing outline form

apical
intact
1.5mm-2mm

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Principles of Class III Preparation for Composite
Restoration

General Outline Form:
From proximal:
____
Facial cavosurface margin ____ with facial contour of tooth

trapezoid

parallel

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Principles of Class III Preparation for Composite
Restoration

General Outline Form:
  From proximal:
   Correct facial-lingual depth of
preparation
• \_\_\_\_ facial-lingually
   Smooth and flowing outline form

1.5mm-2mm facial-lingully

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Principles of Class III Preparation for Composite
Restoration

Retention Form:
1. ____ outline of preparation is wider than the ____ outline

Clinically, removal of decay that has spread out at the ____->prep is wider internally than externally

internal
external
DEJ

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Principles of Class III Preparation for Composite
Restoration

Retention Form:
2. ____ and bonding resin to enamel and dentin
Composite resin bonds to tooth structure
____ forms of retention are usually not needed
Place a ____ on enamel margin

etching
traditional
bevel

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Principles of Class III Preparation for Composite
Restoration

Retention Form:
Composite resin bonds to tooth structure;
therefore, traditional forms of retention are
usually not needed

Exception: ____ surface preparation
no ____ support for strong bond strengths

root

enamel

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Principles of Class III Preparation for Composite
Restoration
Optional Retentive Grooves:

IF placed:
retentive groove along
____ wall
retentive point at ____ line angle

gingival

incisal axial

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Principles of Class III Preparation for Composite
Restoration

Resistance Form:
All walls of the cavity preparation should initially form a ____o angle at cavosurface margins - butt joint
No ____ enamel rods

unsupported

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Principles of Class III Preparation for Composite
Restoration

Resistance Form:
Internal line angles should be slightly ____ to minimize stress concentration in the restoration

rounded

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Principles of Class III Preparation for Composite
Restoration

Marginal integrity:
____ and bonding of the enamel surface reduces ____ at the cavosurface margin

etching

leakage

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Principles of Class III Preparation for Composite
Restoration

Marginal integrity:
Bevel – increases ____ surface to be etched

enamel

Class III Preparation
Facial Approach

   IF decay begins on \_\_\_\_ surface    
IF on \_\_\_\_ teeth    
IF decay extends onto \_\_\_\_ surface from proximal and lingual surface is intact
   IF teeth are \_\_\_\_ aligned
making lingual access undesirable

facial
mandibular anterior
facial
irregularly

Class III Preparation

Begin preparation with pear shaped ____ bur
Enter lingual surface just beneath contact point
Hold handpiece with tip of bur perpendicular to tooth

diamond

Class III Preparation

Move bur in an ____ direction to create trough
Extend trough gingivally to provide access for instrumentation (about ____ inciso-gingivally)
gingival margin kept ____

incisogingival
1.5mm-2mm
supragingival

Class III Preparation Clinically, extent of ____ will determine size of outline form Maintain ____ in natural tooth

decay | incisal contact

Class III Preparation Leave thin shell of enamel along ____ surface by working ____ tooth, not inward (axially) from proximal surface Gradually thin with the diamond bur until paper-thin Use excavator to break away enamel

proximal | within

Class III Preparation ____ outline form is refined and axial wall established with side of diamond bur Refine and remove any ____ enamel

lingual | unsupported

Class III Preparation Prepare axial wall ____ mm within dentin, ____ to long axis of tooth Preparation will be deeper ____ than ____, because of greater enamel thickness along incisal wall

0.5 parallel incisally gingivally

Class III Preparation The Incisal Wall: Width: Measures ____ mm Mesio-Distally at a 90 ̊ angle to the proximal surface Depth: Measures ____ mm Facially at a 90 ̊ angle to the Lingual surface

1. 5 | 1. 5

Class III Preparation The Gingival Wall: Width: Measures ____ mm Mesio-Distally at a 90 ̊ angle to the proximal surface Depth: Measures ____ mm Facially at a 90 ̊ angle to the Lingual surface

1 | 2

Class III Preparation The Axial Wall: Length: Measures ____mm Parallel to the long axis of the tooth The Facial Wall: ____ to the facial surface of the tooth

1.5-2 | parallel

Class III Preparation Retention Grooves ONLY WHEN ____ Gingival Retention Shallow, but distinct groove in gingival ____ wall, F-L Entirely within ____ Not only in ____ wall

required dentinal dentin axial

Class III Preparation Retention Grooves ONLY WHEN required Incisal Retention Slightly larger than the size of ____ At ____ point angle Angled toward ____ wall to minimize potential fracture of incisal edge

bur inciso-axial-facial axial

Class III Preparation Finishing cavosurface margins Place a ____ degree bevel at least ____mm wide on accessible enamel margins - use angled diamond bur Prefer ____ mm Bevel only ____

45 0.5 1 enamel

Class III Preparation Advantages of bevel Removes ____ external enamel to expose more ____ subsurface enamel Provides well-defined marginal ____ to finish

acid resistant reactive periphery

Class V Composite Resin Preparation ``` Clinically, Class V composite preparations conservatively follow the Class V amalgam preparation ____ EXCEPT size determined by the ____ ____ cavosurface margins are beveled to 45 degrees, ____mm long ```

outline lesion enamel 0.5-1

Class V Composite Preparation Axial wall ____ - parallel to the external surface of the tooth Axial wall is just within ____ All ____ enamel removed

curves dentin unsupported

Class V Composite Preparation Incisal and gingival walls ____ to enamel rods Axial wall ____ to long axis of tooth Gingival wall ____mm Incisal/Occ wall ____mm Understand Why

parallel parallel 1.0 1.5

Class V Composite Preparation Mesial and distal walls ____ toward cavosurface to parallel enamel rods

diverge

``` Class V Composite Preparation Mechanical Retention (NOT ____) if lesion confined above the CEJ... ``` Because we are using a bonding technique that ____ very well to enamel and all the ____ of the preparation are in enamel

necessary adheres walls

Class V Preparation Convenience Form If access or visibility is difficult, you may need to extend the preparation a little ____

larger

Class V Composite Resin Preparation Above the CEJ External Outline: External Outline: Include the existing carious lesion ____ and ____ and ALL ____ enamel Follow the contour of the classic CL V lesion, but keep ____ Depth: Measures ____ mm into dentin at a 90 ̊ angle to the facial surface ____ the bevel

``` M-D O-G decalcified conservative 0.5 before ```

Class V Composite Resin Preparation Above the CEJ ``` The Bevel: Width: ____ mm long FOR ENAMEL ONLY(above CEJ) Understand Why ```

0.5-1

Summary - Class V Composite Resin Bevel ____ the CEJ No extension onto ____ surface (Bevel present ____)

above root circumferentially

Class V Composite Resin Preparation Below CEJ External Outline: External Outline: Same as previous Most likely need a ____ if there is not gingival recession Depth: Same as previous

gingival clamp

Class V Composite Resin Preparation Below CEJ ``` The Bevel: On ____ only Width: ____ mm long only where enamel exists NO bevel on ____ ```

enamel 0.5-1 cementum

Class V Composite Resin Preparation Below CEJ Mechanical Retention needed Bonding to cementum and dentin is not as great as ____ Place retention grooves in ____ line angle below ____ only

enamel gingival/axial CEJ

Class V Composite Resin Preparation- Root Caries Same preparation as previous but, NO ____ Retention grooves would be placed both ____ and ____

bevel incisally/occlusally gingivally

Non-carious Class V Lesions Can be above or below ____ Ditched cervical areas on facial surfaces Tooth Brush ____ Chemical ____ ____

CEJ abrasion erosion abfraction

Non-carious Class V Preparation Width/Height: Size of existing ____ M-D and O-G Depth: Depth of existing ____ Retention: Place a ____ (if in enamel) Place retention grooves where in ____

defect defect bevel cementum