5. Class I Amalgam Restoration Flashcards

1
Q

Dental Amalgam :
A metal alloy consisting of a combination of ____ with a mixture of ____
Mercury is mixed with the powder and produces a plastic-like material that can be pressed into a prepared cavity prior to hardening

Dental Amalgam has a metallic silver appearance
It is primarily used for restorations where esthetics are not a major concern
Typically used in ____, ____, and ____ restorations in posterior teeth

A
mercury
silver-tin-and-copper
I
II
V
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2
Q

Dental Amalgam
Dental Amalgam has been the subject of intense research concerning mercury toxicity and environmental concerns.
Is the most thoroughly ____ and researched dental material

Most lay people (and even many dentists) are unfamiliar with the scientific dental literature
Are more easily convinced that amalgam is dangerous based on allegations from anti-amalgam activists

A

tested

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3
Q

The FDA, CDC, and WHO ALL have found ____ evidence of harm directly related to dental amalgam
Research has demonstrated:
the safety of dental amalgam
the success of amalgam restoration

Use of high volume evacuation (suction) and rubber dam should be used to isolate the patient and reduce intraoral mercury vapor present during amalgam insertion
After initial setting, the material has hardened to a solid and the released ____ drops
Proper amalgam handling and disposal procedures should be used

A

no

vapor pressure

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4
Q

Use of mask and gloves during all amalgam procedures required
Collect and dispose of all unused amalgam and capsules in designated sealed containers

Rubber dam will be used on designated procedures in the preclinical laboratory
Cannot place rubber dam(s) on the ____ and ____ arches at the same time
Rubber Dam should be used on ____ operative procedures in the Clinic

A

maxilliary
mandibular
all

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5
Q

Indications:
Amalgam is a predominantly used restorative material The material of choice for:
moderate to large Class I and Class II preparations (especially those with heavy occlusion, hard to isolate, or with margins on the root surface)
Used to overlay ____
Used for ____ restorations
Used for patients with moderate to severe caries susceptibility

A

cusps

core build up

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6
Q
Advantages:   
Strong and durable material
   Relatively easy to use
   Wears at a rate similar to \_\_\_\_ structure
   Slight amount of corrosion occurs
   decreases \_\_\_\_ at cavosurface margin
   Not time consuming to place    
Low Cost
Disadvantages:
   Not tooth colored
   Does not bond to tooth structure \_\_\_\_
   ---Needs \_\_\_\_ component    
---- Bond strength not \_\_\_\_
   Could be allergenic
   Contains mercury
   Must be handled properly
   Mercury vapor can be hazardous to practitioner and staff
A

tooth
microleakge

independently
adhesive
signficiant

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7
Q

Amalgam Restoration

Smear Layer
Unoccluded dentinal tubules– open to the environment

Smear layer – plugs the ____

A

tubules

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8
Q

Conventional Amalgam Restoration
1. cleanse cavity preparation
2. USED to: place cavity varnish to seal dentinal tubules temporarily while restoration margins seal by corrosoion( not done at SDM anymore)
3. place amalgam
____ – plug material into preparation
____ – remove excess and refine anatomy
____ – make shiny and smooth with a rubbing motion
____ – after the amalgam has hardened (at least 24 hours)

A

condense
carve
burnish
polish

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9
Q

Bonded Amalgam Restoration
1. Cleanse and ____ the cavity prep
Conditioning: Alters the internal surface layer (removes the ____ completely)
2. Place ____ to seal the dentinal tubules
3. Place amalgam as in the conventional method
____
Carve
____
Polish

A
condition
smear layer
dentin bonding agents
condense
burnish
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10
Q

Bonded Amalgam Restoration

Conditioning done with the use of an acidic solution
1.  Removes \_\_\_\_  in enamel
2.  Removes \_\_\_\_  components in dentin 
3.  Removes the \_\_\_\_ 
   \_\_\_\_  the dentinal tubules

Bonding Agent placement accomplishes:

  1. Infiltration of resin monomers into demineralized ____ and ____
  2. Replacement of the smear layer –
    - the dentinal tubules are occluded with the ____
A

hydroxyapatite
organic
smear layer
opens

enamel
dentin
adhesive resin

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11
Q

Bonded Amalgam Restoration
The Adhesive layer:
Has shown to be successful in providing a ____ seal
Significantly reduces marginal ____ Decreases post operative ____

A

dentinal tubule
microleakage
sensitivity

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12
Q

Bonded Amalgam Restoration
Bonded amalgam technique ____ show significant “bonding strength” of amalgam to preparation (3-6 megapascals)
Long term clinical studies are needed to further support the bonded amalgam restoration as a superior procedure over the traditional amalgam restoration.
CONTRAINDICATED FOR ANY INDIVIDUALS WITH SENSITIVITY TO ____

A

does not

methacrylates

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13
Q

Prime & Bond NT Dual Cure
To be left up in the front of each group
____ use ONE DROP of each component only

A

conservatively

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14
Q

Cleansing /Conditioning Cavity
Place syringe tip onto Phosphoric Acid Tooth Conditioning Gel syringe
Gently syringe the tooth conditioner into cavity preparation – WAIT ____ SECONDS
Rinse with ____ vigorously for ____ SECONDS
Air dry slightly, leaving moist
Blot dry with cotton pellet

Bonded Amalgam Restoration
Prime & Bond NT Dual Cure Adhesive
Use 1 drop of Prime and Bond NT and one drop of Self Cure Activator into small end of glass dappen dish. Replace caps tightly.
Mix together with composite brush
Scrub into the preparation vigorously for ____ seconds, keeping surfaces moist

A

15
water
10
20

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15
Q

Bonded Amalgam Restoration

 Prime & Bond NT Dual Cure Adhesive    Remove excess with air syringe for \_\_\_\_ seconds.    Surface should have a uniform \_\_\_\_ surface    If not, repeat application of adhesive and air dry

Amalgam Bonding Accessory Kit
Place one drop of Amalgam Bonding Catalyst and one Drop of Amalgam Bonding Base into clean glass dappen dish
Mix well with NEW composite brush
Apply mixture in the cavity preparation
Air syringe excess
Begin amalgam trituration

A

5

glossy

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16
Q
Preparing the Amalgam
     Tytin Double Spill
   600mg alloy + 447mg mercury    
Average \_\_\_\_-surface restorations
   Working time    \_\_\_\_ minutes
   Setting time
   \_\_\_\_ minutes

Trituration (Mixing)
Capsule is put in the amalgamator
Time and intensity of mixing is selected
Remove amalgam immediately from capsule following trituration
Should appear ____ and ____ immediately after mixing

A
two
3-3.5
4-4.5
shiny
coherent
17
Q

Placing amalgam

Keeping nozzle in contact with the tooth, a small increment is squeezed out against the pulpal wall by depressing lever
____mm –____mm thickness of amalgam

A

1 1/2

2

18
Q

Condensation

Amalgam is thoroughly condensed into retentive areas buccally and lingually
Condense with firm pressure
Rocking, wiping and sweeping motion for ____ alloy (Tytin)
Condense into all B and L line angles

Add in increments from the original mix
Condense within the cavity
These procedures are repeated until preparation is overfilled

A

spherical

19
Q

Carving and Contouring
Allow amalgam to set until sufficient crystallization has taken place to permit carving and contouring
Recontouring can be initiated with burnishers or carvers
Carving can be done with any sharp instrument ____
____

A

hollenback

discoid-cleoid

20
Q

Carving and Contouring Goal: Restore natural contour of tooth
Remove excess amalgam beyond cavosurface margin
Restore primary anatomy
Deeply carved grooves and pits are avoided
Complete carving within time of complete setting of the amalgam

Carving and contouring
   Precarve with an \_\_\_\_ Burnisher:
   Burnishing with large burnisher is a form of \_\_\_\_
   Acorn burnisher (21B)
   Use to obtain \_\_\_\_ anatomy
A

acorn
condensation
occlusal

21
Q

Carving and contouring

Always carve amalgam from tooth ____ amalgam
Carve parallel to ____ margin
Use natural tooth as a rest for the instrument and guide
Will prevent creating divots

Overcarved amalgam deep occlusal grooves

A

toward

cavosurface

22
Q

Burnishing
Burnish ____ times
First burnishing
Heavy pressure during condensation Example: ____ Burnisher 21B
Second burnishing**
Just after initial carving Example: ____ Burnisher 21B
Final burnishing**
After recarving
Example: ____ Burnisher, Ball Burnisher 26/27

A

acorn
acorn
Tball

23
Q

Burnishing
Smoothes and polishes the carved surface of amalgam with amalgam burnisher
improves ____ adaptation
smoothes surface
Lessens need to recontour during finishing and polishing
**Be Careful not to change contour by burnishing too earl

When Burnishing Complete
Verify sealed margins when amalgam is set
Verify proper occlusal anatomy
Remove Rubber Dam
Verify occlusion with articulating paper

A

marginal

24
Q

Matrix Band
Squeeze the ends of the band to form a loop

Smaller diameter
Towards ____
Larger diameter
Towards ____

Place ends of of the matrix band in the matrix holder
Maxillary Molar Amalgam Restoration

A

gingival

occlusal

25
Q

Matrix Band
Position the matrix band in the matrix holder
____ circumference will be on the same side
of matrix holder as open ends of retaining mechanism
____ circumerence
toward the closed end of the retaining device

A

smaller

larger

26
Q

Checking Occlusion
Check occlusion with articulating paper
Eliminate any high spots with a carver
Clinically: Check ____ occlusion (MAXIMUM INTERCUSPATION) and ____ movements
Clinically: Patient instructed not to chew on the side of the mouth until a few ____s later

A

centric
lateral
hours

27
Q

3 rules of occlusion

  1. The functional cusps rest in marginal ridge areas except ____ cusps of maxillary molars and ____ cusps of mandibular molars which rest in their respective opposing ____.

The occlusal markings in an ideal tooth relationship

A

mesiolingual
distobuccal
central fossa

28
Q

Why Check Occlusion?
Undercarving or leaving excess
May cause patient to touch prematurely
Feels “high” to patient
May result in occlusal trauma to tooth and
supporting structures
Frequently causes amalgam to fracture (pain)
If premature contacts are not removed
____ spot or ____ facet will appear on amalgam

A

shiny

wear