8. Amalgam Polishing/Clinical Caries Flashcards
Amalgam Polishing
Done AFTER restoration has completely set – at least ____ hours later
24
Amalgam Polishing
Benefit
Improves oral hygiene - ____ surface
Inhibits recurrent decay - ____ polished
Inhibits gingival irritation - marginal ____ are removed that otherwise would irritate the surrounding tissue
smoothes
margins
overhangs
Amalgam Polishing
Occlusion and occlusal anatomy can be refined further
Life of restoration is ____
Esthetics better – much more shiny
extended
Amalgam Polishing Armamentarium \_\_\_\_ speed handpiece Burs to use (in this order): \_\_\_\_ stone \_\_\_\_ stone \_\_\_\_ burs \_\_\_\_, greenie, \_\_\_\_ rubber cups and points
slow green white finishing carbide brownie super-greenie
Amalgam Polishing 2 steps FIRST: Contour the restoration - use \_\_\_\_ and then \_\_\_\_ polishing burs Gross removal of \_\_\_\_ material Eliminate \_\_\_\_ Eliminate \_\_\_\_ and overhangs Redefine anatomy
stones carbide excessive roughness marginal flash
Amalgam Polishing
2 Steps
SECOND: Shining the restoration with ____, discs, and ____
____ restoration between changes in abrasive points to remove particles
rubber points
cups
rinse
Amalgam Polishing
Precautions
Avoid excessive ____/ rise in ____
Avoid loss of contour and ____ by over-polishing
Avoid damage to surrounding hard and soft tissues
pressure
temperature
contact
Caries: From a Clinical Perspective
Detection – Caries vs Stained Fossae and Grooves
dull, chalky, flakey, explorer is sticky - ____ carious lesion
would think big lesion but look how shiny it is - very deep fissures/grooves w/o explorer getting stuck
NOT A ____
re-mineralized de-calcification
____ is stronger! - better to leave
active
lesion
re-mineralized
Clinical Caries Excavation
! Caries excavation is the control of carious lesions by removing the infected area, then restoring the tooth to optimal form, and function
! The specific clinical treatment depends on the extent of carious ____
activity/destruction
Clinical Caries Excavation
! We need to clinically determine the different types of dentin as we work
! ____ – non infected/normal
! Infected – presence of ____; dentin is ____ demineralized; must be ____
! Affected – no ____ present; dentin is demineralized, but can be ____
**how to tell b/t infected/affected: if explorer ____ it’s infected; if ____ + ____ = affected (no bacteria)
healthy bacteria irreversibly removed bacteria remineralized
sticks
stained
hard
Caries: From a Clinical Perspective
class 3 from lingual can see \_\_\_\_ area of decay
Class 3 = inter proximal lesion
open up see ____ @ DEJ which is what gives you purple color
purple
brown
Clinical Caries Excavation
! Ways we clinically detect the different kinds
of dentin
! Visual: Degree of discoloration; shiny vs dull; careful: not all ____ is caries
these are freshly extracted teeth 1 day old
this is ideal outline - shiny dentin near explorer; ____ + ____ = infected dentin
discoloration
brown
flakey
Clinical Caries Excavation
! Ways we clinically detect the different kinds of dentin
! Tactile: Hardness – detected with ____ or explorer – tugback/____/leathery
- besides explorer + color of dentin can also tell when done with spoon excavator - scoop in ____
- dentin and it will come off in ____; do it in areas where you’re afraid t take your drill
spoon excavator
sticky
infected
flakes
Clinical Caries Excavation
! Ways we clinically detect the different kinds of dentin
! Audio: Sound of the instrument on healthy dentin sounds different than the ____, infected dentin
dull
Clinical Caries Excavation
! Clinical Strategy for Caries Removal:
! Remove any dentin that appears “____, peels off in ____, or can be ____ with an explorer or spoon excavator
! More aggressive removal of stained dentin at the ____
! Less aggressive removal of stained dentin over the ____
first get ideal outline - then continue to remove any caries left over
anything dark you check to see if soft enough that you can remove with spoon excavator
extend outline of prep to make bigger
leathery flakes penetrated DEJ pulpal wall
