5. Posterior Composite Preparation Flashcards

1
Q

Clinical Decision Making
• The American Dental Association (ADA) indicates the appropriateness of composites for ____ and ____-sized Class I and II restorations, using modified ____ tooth preparations

A

small
moderate
conservative

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2
Q

Clinical Decision Making
• The longevity of posterior composite restorations, however, is directly related to factors such as the ____ of the restoration, the patient’s ____ risk, and operator ____

* Amalgam longer life - \_\_\_\_
* Composite plastic - \_\_\_\_
A
size
caries
technique
corrosion
wear
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3
Q
Clinical Decision Making
•  Guidelines for ideal lesion selection
•  Carefully selected Class I or Class II:
-Minimal \_\_\_\_
-Minimal MIC/MIP \_\_\_\_ contact
-No excessive \_\_\_\_
-Margins IDEALLY should be entirely on \_\_\_\_
-Should be able to be \_\_\_\_ well 
-Non involvement of \_\_\_\_
* Don't want a lot of occlusal contact bc it will \_\_\_\_
* Don't want a MODL in composite - if someone broke a cusp of it off, you'd place an \_\_\_\_ instead
A
isthmus
width
occlusal
wear/bruxism
enamel
isolated
cusps

wear
onlay

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4
Q

Clinical Decision Making

• Advantages

  • ____
  • Micromechanical bond to tooth structure
  • ____ tooth structure removal
  • Easier, less complex tooth preparation
  • Increased ____
  • Increased strength of remaining ____ structure
    • Increased retention bc ____ (tendrels?) are going into etched enamel/dentin
    • If enamel fracture, take out the restoration, take out fracture and put in composite resin - no more ____ on biting
A

esthetic
conservative
retention
tooth

resin tags
flexion

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5
Q

Clinical Decision Making
• Disadvantages

Material Related:

  • Greater ____ of restoration material
  • Improving with ____ materials and good case selection
  • Prone to fracture in ____ areas
  • ____ effects
  • ____ sensitive
    • Do not bevel in ____ areas - fracture
    • Material shrinks towards the ____ and pulls on the walls
A
wear
newer
thin
polymerization shrinkage
technique

mastication
center

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6
Q

Clinical Decision Making

In Order To Do This Procedure Successfully, you must understand:

  • Tooth Preparation -____
  • Composite Material -____
  • Proper Placement ____
A

differences
choices
technique

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7
Q
Clinical Decision Making
Careful Consideration must be given to:
•  \_\_\_\_ Location
•  Type of \_\_\_\_
•  Which \_\_\_\_ to use
A

tooth
preparation
bonding system

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8
Q

Tooth Preparation
Preparation Design

• Amalgam - “____”
• Composite - “____”
– “____ adhesive dentistry”
– Because composite is bonded to enamel and dentin, tooth preparations for composite can be very ____

• "Restrict how much to cut, but we know why"
A

extension for prevention
restriction with conviction
minimum
conservative

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9
Q

Tooth Preparation
Preparation Design:
• A composite restoration not only is retained well in the tooth, but also can strengthen the remaining ____ tooth structure

* Composite doesn't have to be as large
* [NOTES]
A

unprepared

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10
Q
Tooth Preparation
Preparation Design
-Posterior Composite Class I
vs
-Traditional Amalgam Class I

[NOTES]

A

YA

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11
Q

Preparation Design
-Conservative Composite Class II
vs
-Traditional Class II

* No \_\_\_\_ enamel, the class II can be \_\_\_\_-shaped
* No \_\_\_\_
A

unsupported
Y
s curve

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12
Q
Tooth Preparation
Preparation Design
-Slot Preparation
vs
-Composite Resin Class II
* Slot - not cutting any occlusal surface
* Slot can have a number of \_\_\_\_, as long as enamel rods are \_\_\_\_ and no \_\_\_\_ enamel
A

shapes
parallel
unsupported

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13
Q

Tooth Preparation

Tooth Preparation Procedure Involves:

  1. Creating access to the ____ and faulty structures (defective restoration, base material, if present)
  2. Removal of ____ structures
  3. Creating ____ form for the restoration
  4. Removal of any ____ enamel (resistance form)
  5. Retention form is obtained by ____ and most times not ____• Remove unsupported enamel due to ____
A
caries
faulty
convenience
faulty
unsupported
bonding
necessary

polymerization shrinkage

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14
Q

Tooth Preparation
Preparation Procedure Guidelines

–  Use preparation diamonds
–  \_\_\_\_ internal line angles
–  Include \_\_\_\_ lesion(s)
–  Remove any \_\_\_\_ enamel
–  Remove any \_\_\_\_ enamel
* Diamonds - rough internal finish on floor and walls that will enhance adhesiveness and bonding
* rounded internal line angles - when blowing the bonding agent, it dissipates and goes into the whole prep better - you just want a thin layer of it everywhere (sharp angles would result in \_\_\_\_)
* Bonding is not \_\_\_\_ to hypocalcified enamel - less mineral and bond strength
A

rounded
carious
decalcified (hypocalcified)
unsupported

pooling
strong

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15
Q

Tooth Preparation
Preparation Procedure

  • SELECT SHADE ____ TO PREPARATION
  • Evaluate occlusal markings in ____
  • Place rubber dam
  • Remove all of the caries or fault as ____ as possible
  • Other less involved, or at-risk, pit and fissure areas can be ____ as part of the conservative preparation technique
    • Take articulating paper before they get ____
    • Want MIC markings all on tooth structure/composite, don’t want a ____ margin where you get a marking
A

prior
MIC
conservatively
sealed

numb
cavosurface

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16
Q

Tooth Preparation

Preparation procedure - Class I

* "\_\_\_\_" - if there's a higher part of enamel and the rest is in dentin - as long as it's \_\_\_\_mm thick so the composite doesn't break
* [NOTES]
A

islands of enamel

1

17
Q

Tooth Preparation

Preparation procedure - Class I

* Premolar: \_\_\_\_mm thickness for marginal ridge
* Molar: \_\_\_\_mm of thickness for marginal ridge
* Measuring from height of \_\_\_\_ to the \_\_\_\_
A

1.5-1.6
2
contour
mesial/distal pit

18
Q

Tooth Preparation
Preparation Procedure – Class II

  • ____ (allows a more conservative preparation)
  • Place a wedge interproximally for Class II to achieve ____ orthodontic separation
  • Prepare the box: break the contact to just the tip of the explorer clearing contact ____ the wedge in place (____)• Small hatchets for box width - convex axial wall
A

prewedge
subtle
with
0.25-0.5

19
Q

Tooth Preparation

-PREWEDGE - allows very conservatively contact opening ____, ____, and ____

A

buccal
lingual
gingival

20
Q

Tooth Preparation
Preparation Procedure – Class II

  • NO ____ ON ANY ____ CAVOSURFACE
  • Research has shown that bevels placed on the occlusal or proximal surfaces show no benefit and the ____ areas are prone to fracture
A

bevel
enamel
thin

21
Q

Tooth Preparation
Preparation Procedure – Class II

Three Kinds:
• Class II Preparations (in order of invasiveness)
1. ____ Preparation:
- resembles the proximal portion of a conventional preparation without any involvement of the ____

• Least \_\_\_\_ prep
A

slot
central groove
invasive

22
Q

Tooth Preparation
Preparation Procedure – Class II

• Class II Preparations (in order of invasiveness)

  1. Conservative Class II Preparation:
    - The proximal caries lesion is eliminated with a ____ preparation
    - The occlusal surface is prepared following lesions into ____ only as necessary
    - The preparation preserves as much occlusal tooth structure as is practical
    - The remaining ____ may be sealed
    • Occlusal slightly involved - ____mm depth, and isthmus is ____mm because groove was carious
    • “Islands of enamel”
A

proximal slot
dentin
pits/fissures

1-1.5
1

23
Q

Tooth Preparation
Preparation Procedure – Class II

• Class II Preparations (in order of invasiveness)

  1. Conventional Class II Preparation:
    - Resembles a Class II preparation for ____ but much more conservative
    - The occlusal fissures has caries involvement so they are minimally ____
    - The isthmus dimension is as ____ as possible
    - The box is prepared as the ____ and the conservative ____ preparation would be• No ____ needed for a premolar
A
amalgam
prepared
narrow
slot preparation
class II

dovetail

24
Q

Procedure
• Conventional Composite Class II Preparation
#19 MO and #5 MO:

  • ____ mm depth pulpally
  • Small isthmus width (large end 1P condenser ____)
  • Minor extentions into major grooves of molar #19 (large end 1P condenser ____)
  • No ____ on premolar #5
  • Minimal contact breakage .25 without the wedge in place;
    or .5 with the ____ in place
  • ____ mm gingival floor width #19; ____ mm #5
  • No ____ enamel
  • No ____ needed
A
1.5
tight
tight
dovetail
wedge
1.5
unsupported
s curve
25
Q

Procedure
• Class II Composite Slot Preparation #3 M:

  • ____ mm depth
  • Minimal contact breakage .25 without wedge in place; or ____ with the wedge in place
  • ____ mm gingival floor width for molar #3, ____ mm for premolar
  • No ____ enamel
A

1.5
0.5
1.5
1.0
unsupported