36. Restorative Dentistry Flashcards
Tetralogy of denta caries
Diet - high sucrose diet
Host - tooth
Microorg
Time - frequency(more impt) and duration
Triad of thumbsucking
Duration(most impt) - 6hrs
Frequency - am/pm
Intensity - 1 room away
Microorg in enamel caries
Strep mutans
Dentin caries
Lactobacillus acidophilus or casei
Microorg in root or cemental caries
Actinomyces viscosus
1st bacteria to colonize oral cavity (24hrs*) (or 10-12hrs)
Most numerous in oral cavity
Strep salivarius
First to colonize plaque
24-48hrs after toothbrushing
Strep sanguis
BQ: best technique for caries examination?
Visual examination
BQ: What is the adhesive used by microorg to stick to the tooth?
Dextran
BQ: What is the sugar that prevents glucose from binding to cariogenic microorganism?
Xylitol
Is caries smaller or larger in radiograph?
Smaller
Saliva prevents caries by
Remineralization
Acts as a buffer for acids
Use proteins, enzymes, antibodies that kill microorg
Wash food away
Normal ph of saliva
6.2-7.0 (weak acid)
Critical pH = dental caries
5.5
If pH in saliva is lower that 5.5
Erosion
Ig in saliva
IgA
Stretchy property of saliva
Spinnbarkeit test
BQ: Relationship of the 2 triangles in Pits and Fissure caries in the DEJ
Base to base relationship in the DEJ
BQ: Relationship of 2 triangles in smooth surface caries in the DEJ
Apex to base / Base to apex
BQ: BEST preventive measure for Pits and Fissure caries
PFS
BQ: Best preventive measure for SMOOTH SURFACE CARIES
Fluoride
BQ: Most sensitive part of the tooth during cavity prep
DEJ
Theory about tooth sensitivity
Hydrodynamic theory
BQ: most common site of proximal caries
Between contact area and gingiva
Shape or form of the conventional preparation that RESISTS DISPLACEMENT or removal of restoration
Retention form
Prevents FRACTURE of tooth and resto matl; withstand masticatory forces
Resistance form
Adequate observation, accessibility, ease of operation
Convenience form
Primary retention form of Class 1 prep
Converging Bu and Li occ = 90
Or “diverging apically”
Wall outside the preparation
Cavosurface
Resistance form of Class 1 prep (2)
PARALLEL or (diverging) Mesial and Distal walls
+ Flat pulpal floor
Shape of enamel rods/enamel prism
Key hole
BQ: Depth in pit (class 1)
1.5mm - 2mm
BQ: Depth in DENTIN (Class 1)
0.2mm*
Or to 0.5mm
Preparation/isthmus width (1/3) is for what form
Convenience form
BQ: After cavity prep, proper outline form is made and there are still carious lesions, what is the next thing to do?
Extend outline form
BQ: During occ cavity prep, which permanent teeth is mostly subjected to accidental pulp exposure?
Mn 1st premolar 🐍
BQ: APLA is bevelled or rounded?
APLA : Bevelled
Bu, Li, and Gingival walls in Class 2 proximal prep should be extended into the EMBRASURES (“spillways”) because:
For prevention of secondary caries
Self cleansing
Minimum clearance during Class II prep
0.5mm
BQ: Depth of Retentive features
1/2 the size of a 1/4 round bur
0.25mm
Retentive features of Class 2 prep are placed in:
Axiofacial LA
Axiolingual LA
Bu and Li walls
Gold:
Am:
Bu and Li walls
Gold: diverge occ (LAPJOINT)
Am: converge occ (BUTT JOINT)
MD walls
Gold:
Am:
MD walls
Gold: parallel occ
Am: parallel occ
Depth into dentin
Gold:
Am:
Depth into dentin
Gold: 0.2mm
Am: 0.2mm
Internal line angles
Gold:
Am:
Internal line angles
Gold: sharp (convenience)
Am: rounded (resistance)
Reverse bevel in Class II gold inlay is placed in the
Axiogingival LA
Occ and Prox CSM Bevel
Gold:
Am:
Occ CSM
Gold: 40 degree
Am: 90 degree
Gingival CSM of Gold
30 degree
Counterbevel of Onlay
30 degrees
Gingival CSM in Class II Am
Perm:
Deciduous:
Gingival CSM in Class II Am
Perm: 15-20 bevel
Deciduous: no bevel!
BQ: Best resto matl for Distolingual surface of Canines
Gold
BQ: Best approach in preparing class III caries?
Lingual approach
BQ: When preparing carious tooth adjacent to each other, which one is prepared first and which one is restored first?
Prepare: larger first (for convenience)
Restore: smaller first
BQ: Best rx to assess proximal caries
Bitewing
Retentive features of Class III prep are placed in
Gingivoaxial and incisoaxial LA
Class IV
Line angle:
Point angle:
Class IV
Line angle: 11
Point angle: 6
BQ: Axial wall of Class V prep
A. Convex
B. Concave
C. Flat
Convex
Walls that Follows contour of the surface of the tooth in CLASS V prep
Axial wall
Class VI:incisal edge of ant/cusp of post is named by
SIMON
BQ: Caries below the restoration
A. Recurrent caries
B. Secondary caries
RECURRENT caries
Caries that progressed just into the DEJ
Frank caries
Caries assoc with aging
Root surface caries / Senile caries
✨ Root surface caries is due to:
GINGIVAL RESORPTION
DECREASE CORONAL CARIES
BQ: What is the radiolucency found just below the cej on the root due to ANATOMICAL VARIATION or GAP between enamel and bone covering the root
Cervical burnout
BQ: Tx for cervical burnout
No tx
BQ: Zone of carious enamel (except)
“Trained Dentists=Better Salary”
Translucent zone
Dark zone
Body zone
Surface zone
Zone of carious dentin: no bacteria present
Normal dentin
Zone of carious dentin: Subtransparent + Transparent dentin
Affected dentin
Dry leathery texture
No need to remove bec it Can remineralize
Affected dentin
“Zone of bacterial invasion”
Turbid dentin
Outermost carious zone
Soft mushy texture
Removed during cavity prep
Infected dentin
Substantia adamantina
Enamel
Substantia ebornea
Dentin
Substantia ossea
Cementum
BQ: Which component is similar to bone?
A. Enamel
B. Dentin
C. Cementum
Cementum
BQ: Grasslike/ Fan shaped/ Bush of hypomineralized enamel extending from dej
Enamel tufts
Hypomineralized enamel but not radiating
Enamel lamellae
Odontoblastic processes extending into the enamel in the DEJ
Enamel spindle
BQ: Caries progress faster in enamel or dentin?
Dentin
BQ: Dead odontoblasts with Empty tubules are known as
Dead tracts
BQ: Bleaching affects enamel only, dentin only or both?
BOTH
“Time dependent” dimensional change
Creep
Components of Amalgam that both:
⬇️ Working time and creep
⬆️ Expansion
⬆️ Strength
Silver (Ag) and Copper (Cu)
Corrosion byproduct of Amalgam
Tin sulfite
Reaction of metal due to exposure in the environment
Corrosion
⬇️ Corrosion
Copper (Cu)
⬆️ working time and creep
⬆️ Expansion
⬇️strength
(Must be minimal!!)
Mercury (Hg)
BQ: Mercury-alloy ratio
1:1
Pag wala sa choices: 8:5
⬆️⬆️⬆️ Expansion of amalgam when contaminated with moisture
Zinc
Adv of Zinc
Prevents oxidation
Scavenger for oxides
BQ: Which amalgam alloy needs the most amount of mercury?
Irregular
BQ: Which amalgam alloy needs the least amount of mercury
Spherical
Strongest phase of am
Corrodes least
SILVER + TIN
Gamma phase
Phase: Silver + Mercury
Gamma One phase
Weakest phase; Corrodes most
Tin + Mercury
Gamma Two phase
Low copper amalgam = % of copper?
<6% or <10% copper
Eliminates gamma two phase rxn
>9-30% copper or 10%-30% copper
High copper amalgam
“Contraction” or “expansion” of a material
Dimensional change
BQ: Corrosion byproducts of amalgam has what advantage?
Tin sulfite = improves SEAL; Prevents secondary caries
BQ: Setting of amalgam : what process
Crystallization process
BQ: Setting time of amalgam
24hrs
BQ: Used to polish Am
Tin oxide
BQ: Used to polish Composite
Aluminum oxide
BQ: Used to polish GOLD
Iron oxide
Ideal resto for HIGH CARIES RATE
Amalgam
Ideal resto for PERIO
Gold
Ideal resto for ESTHETICS
Adults: co
Pedo: GI
Amalgam discoloration on GINGIVA
Amalgam tattoo
Amalgam discoloration on TOOTH
Amalgam blues
BQ: Which of the ffg is true about mulling?
CONTINUATION OF TRITURATION PROCESS
BQ: Which do you prefer, Overtriturated or Undertriturated amalgam?
Overtriturated
BQ: What is the procedure in which the amalgam is rubbed using the first finger and the thumb?
Mulling
BQ: Most common cause of amalgam chipping during carving
Carving after setting
BQ: When there is ditching of am resto, when is it indicated for replacement?
If ditch is >0.5mm
BQ: During amalgam carving, you can prevent ditching by;
Resting the sharp instrument on the cusp while carving
Distance from the margin of the mesial and distal wall to the prox surface must not be less than:
Pm =
Molars =
Premolars: 1.6mm
Molars: 2mm
BQ: Most difficult tooth to adapt a matrix band
Mx 1st PM (mesial developmental depression)
BQ: Why is the matrix band extended occ when restoring class II cavities?
For overfilling
BQ: Reasons for using WEDGE
Boards: to make the band taut (tight)
- prevent overhang
- for sep of tooth
Working end of Non cutting instrument
Nib
Four unit formula (W-A-L-A)
- Blade width (/10)
- Cutting edge Angle
- Blade length
- Blade angle
THREE UNIT FORMULA (W-L-A)
- Blade width
- Blade length
- Blade angle
BQ: Omitted in 3 unit formula because it is immed 90 degrees or “perpendicular to the blade”
Cutting edge angle
Modification of enamel hatchet
GMT
Process of Setting of composites
Polymerization
Most common filler of composites
Colloidal silica
Fluid content of composites
Matrix
Most common matrix
BIS-GMA
bisphenol-A glycidyl methacrylate
Bis-gma is introduced by
Bowen 1962
Binds filler to matrix
Coupling agent
Most common coupling agent
Silane
Darker shade/ ⬆️chroma (A 3.5) needs LESS or MORE curing time?
More curing time
BQ: Proper way to apply light cure
From afar then gradually go nearer
Are used to produce Radiopacity of Composite which serves as contrast for secondary caries
Barium, Zinc, boron, zirconium, yttrium
BQ: what inhibits polymerization
Cavity varnish (short term) Eugenol
BQ: greatest disadv of polymerization
Shrinkage
Ratio of bonded surfaces to the unbound surfaces
Configuration factor
⬆️ highest configuration factor : ⬆️ Shrinkage
Class 1 and 5
Introduced etching or conditioning
Buonocore 1955
Most common etchant
37% phosphoric acid for 15s (enamel)
Most impt fnx of etchant
Reduces microleakage
BQ: After etching, tooth becomes contaminated with saliva, what to do?
Re etch
Retention of composites is by
Micromechanical retention
BQ: All of the ffg are fxns of etchants EXCEPT:
Improves esthetics
