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23 Operative > 7 - Class II Silver Amalgam Restorations: General Principles, Preparation Technique and Matrix > Flashcards

7 - Class II Silver Amalgam Restorations: General Principles, Preparation Technique and Matrix Flashcards

1
Q

what is defined as restorations that involve occlusal and interproximal surface of posterior teeth

A

Class II restoration

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2
Q

Class II carious lesions start [axial, gingival] to contact

A

gingival

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3
Q

what must decay break thru to require a restoration

A

must break thru DEJ

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4
Q

when to restore a class II lesion

A
  1. fractured restoration
  2. marginal integrity defective and cannot be remedied by polishing or enameloplasty
  3. overhang
  4. poor contour
  5. weak or nonexistant proximal contact
  6. lesion on opposite proximal surface from existing class II restoration and mesial lesion on tooth with exisitng DO restoration
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5
Q

occlusal outline form of Class II

A
  • similar to Class I
  • outline to converge under cusps and diverge in grooves and marginal ridges
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6
Q

proximal outline form of Class II

A

facial and lingual extensions determined by contact position w/ adjacent tooth

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7
Q

what contacts to break when creating Class II proximal box

A

facial, lingual, and gingival contact

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8
Q

in class II prep, ideally break proximal clearance by ___

A

0.5 mm - tine of tip of explorer

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9
Q

create ___ degree cavosurface margin in proximal box of Class II

A

90 degree

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10
Q

what is the resistance to fracture

A

resistance form

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11
Q

what is the apporpriate retention features to include proximal retension grooves and convergent proximal walls

A

retention form

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12
Q

an [acute, obtuse] cavosurface margin of enamel has potential for fracture

A

acute

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13
Q

a ___ degree enamel margin on occlusal surface will withstand occlusion

A

90 degree

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14
Q

the position of proximal facial and lingual extensions are dependent on what

A

the contact position

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15
Q

proximal caries is normally located ___

A

gingival to contact

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16
Q

T/F: in most teeth, caries will be facial to the facial-lingual midline in class II

A

TRUE

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17
Q

what must you do to the proximal surface to slightly undermine enamel and establish initial proximal and gingival extensions and in most cases create axial wall

A

trenching in pendulum swing motion

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18
Q

clearance between teeth in class II is what

A

tine of explorer - 0.5 mm
must see light or pink gingiva

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19
Q

the F-L dimension of the proximal box is greater at the ___ than the ___ to provide convergence/retention for the restoration

A

gingival seat; occlusal

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20
Q

from facial to lingual, should the axial wall follow the external contour of the tooth (convex)?

A

YES

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21
Q

from gingival axial line angle to axial pulpal line angle, the axial wall should lean where? why?

A

lean toward pulp

enamel is thicker closed to occlusal surface and thinner near gingival seat. therefore angle is obtuse

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22
Q

T/F: the axial pulpal line angle should be sharp

A

FALSE! should be rounded or beveled

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23
Q

what is a common cause of isthmus fracture of Class II amalgam

A

inadequate depth at isthmus area (e.g., pulpal floor)

24
Q

T/F: axial-pulpal line must be beveled

A

TRUE!

25
Q

sharp internal line angles that project into amalgam result in what

A

unfavorable force distribution resulting in amalgam fractures

26
Q

what adds a little bulk to amalgam in area for strength

A

beveled axial-pulpal line angle

27
Q

what parts of class II prep show retention

A
  1. occlusal walls under cusps converge
  2. proximal walls from gingival seat to occlusal
28
Q

what aids in resistance form by decreasing effect of proximal box portion of silver amalgam torqueing away frmo occlusal portion during occlusal loading

A

proximal retention grooves

29
Q

T/F: proximal retention grooves on clas II fade out as axial pulpal line angle is approached

A

TRUE

30
Q

where are proximal retention grooves placed

A

1/2 mm inside DEJ

deeper at facial axial gingival and lingual axial gingival point angles and fade out occlusally

31
Q

what determines size of proximal retention grooves in class II

A

distance between facial axial and lingual axial line angles

32
Q

what must you do prior to starting class II prep

A

place wedge or guard

33
Q

what makes room for working between teeth and creates better proximal contact w final restoration

A

wedge

34
Q

when removing decay, do you move the entire affected wall to the depth of the lesion?

A

NO! remove tissue only in area of lesion. do not move entire affected wall or pulpal floor to depth of lesion

35
Q

what is a more dangerous bur: 1 mm or 1/2 mm bur?

A

1/2 mm because it is smaller so easier to penetrate pulp

36
Q

how to remove debris of instrumentation

A

washing with water

37
Q

what is placed for saliva control and help maintain a clear surgical field

A

placement of rubber dam

38
Q

do you place rubber dam before or after anesthesia is administered

A

after

39
Q

what is used for hemorrhage control

A
  1. hemostatic agents
  2. epinephrine compounds
  3. matrix band and wedge
40
Q

what part of class II prep is considered undermined or unsupported enamel

A

remaining hooks of enamel that form during preparation

41
Q

what supplies the missing wall, gives something to condense against, and develops proximal contour of restoration

A

matrix system

42
Q

what are the parts of tofflemire matrix system

A
  1. matrix retainer
  2. set screw
  3. rotating spindle
  4. slide
  5. head
  6. band
43
Q

specifications of a matrix (6)

A
  1. easy to use
  2. convenient
  3. rigid
  4. versatile
  5. proper height
  6. can be contoured
44
Q

matrix band is fitted into retainer so that the narrow/concave end of the loop is toward

A

gingival

45
Q

the matrix band should imitate what

A

the shape of the tooth

46
Q

what are the types of tofflemire retainer

A
  1. straight
  2. contra-angled
47
Q

what side to place matrix retainer? exception?

A
  • on buccal surface of tooth
  • exception: if not buccal cusps for retainer to brace, switch to lingual
48
Q

[outer, inner] nut holds matrix band to retainer

A

end/outter

49
Q

matrix band tightened onto tooth by turning [inner/outer] nut

A

inner knurled screw/nut

50
Q

where should the slots in the head of the matrix be directed

A

GINGIVALLY. NOT OCCLUSAL

51
Q

primary function of a wedge

A

tooth separation - compensates for matrix band thickness to restore proximal contact

52
Q

what adapts band against gingival seat

A

wedge

53
Q

what provides gingival tissue retraction/protection

A

wedge

54
Q

what aids in developing contour and minimize prep contamination by saliva and blood

A

wedge

55
Q

how to make sure the band lies against the adjacent tooth

A

burnish the band using a condenser or ball burnisher. make sure the band is actually touching the next door tooth

56
Q

how to remove tofflemire

A
  1. stabilize matrix band w/ finger to prevent SA fracture
  2. remove retainer leaving band and wedge in place
  3. while stabilizing band, remove wedge then carefully remove band

23 Operative (15 decks)

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