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D2 Fall - Fixed Prosth > 9/25: Restoration of Extensively Damaged Vital Tooth > Flashcards

9/25: Restoration of Extensively Damaged Vital Tooth Flashcards

1
Q
  1. What are the central core guidelines?
A

a. Pulp and 1 mm dentin think surrounding layer should be preserved

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2
Q
  1. According to the central core guidelines, the retentive features should NOT be cut deeper than
A

a. 1.5 mm at cervical line or central fossa

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3
Q
  1. Deeper caries should be filled with
A

Base

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4
Q
  1. What happens or the Central core (Pulp chamber) as we age
A

a. Shrinks and recedes

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5
Q
  1. What are the 5 categories involved in decision making?
A

a. Deciding on type of restoration
b. Using defects as retentive features
c. Pin placement and retention
d. Base and cores
e. Tx plan procedure

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6
Q
  1. If you have extensive peripheral destruction, what restoration should you do?
A

a. Full crown

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7
Q
  1. Less destructive central lesion with isthmus destruction greater than 1⁄2 intercuspal width, you should do what restoration?
A

a. Inlay or onlay

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8
Q
  1. Large central lesion, with more than 50% of tooth structure gone and loss of cuspal support, what restoration should you do?
A

a. Full crown and possible build-up

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9
Q
  1. If you combined central and peripheral destruction, what should you do?
A

a. Build-up and crown
b. Possible RCT, build-up, crown
c. Maybe RCT, post, and crown

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10
Q
  1. When would you decide if a RCT is needed?
A

a. Pulp exposure
b. Post is needed for retention of build up

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11
Q
  1. Often a tooth preparation will need to be modified by adding retentive features to increase
A

a. Retention and resistance

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12
Q
  1. What kind of modifications can you make?
A

a. Re-orienting sloping
b. Grooves
c. Box forms
d. Adding pins with build-up

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13
Q
  1. Are there times where leaving a tooth without a build-up can help with retention?
A

a. Yes

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14
Q
  1. What can we do to increase resistance form with less than ideal tooth structure remaining?
A

a. Reduced TOC of axial walls
b. Grooves
c. Box form
d. Increase wall height

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15
Q
  1. How can you increase wall height?
A

a. Finish line more apical
b. Pin-retained core
c. Crown-lengthening
d. Orthodontic extrusion ← not intrusion

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16
Q
  1. How should you reshape axial walls for reduced TOC?
A

a. Reduce cervical 1⁄2 to make taper smaller

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17
Q
  1. Changing the slope wall after a cusp fracture or caries removal can improve
A

Retention

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18
Q
  1. How should you alter the sloped wall?
A

a. Break slope into vertical and horizontal components

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19
Q
  1. What happens if you convert a sloped wall into 1 single vertical compartment?
A

a. Weakens tooth and endangers vital core

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20
Q
  1. If you have >3mm vertical wall length apical to the fractured cusp,
A

a. Facial shoulder with axial wall reduction leaves adequate wall length for resistance form

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21
Q
  1. How should grooves be placed?
A

a. Parallel to the long axis

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22
Q
  1. What are the required dimensions for grooves?
A

a. 1mm wide and deep
b. 0.5-1 mm away from finish line
c. Spaced around the tooth

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23
Q
  1. In what kind of prep should grooves be placed?
A

a. Short wall prep

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24
Q
  1. What do the proximal grooves do to the arc of rotation?
A

a. Shorten radius

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25
Q
  1. Walls of a groove or a box are best placed how?
A

a. Perpendicular to displacing force

26
Q
  1. When should a box form be used?
A

a. You remove caries and can convert space into a box

27
Q
  1. How deep should a box form be placed?
A

a. Well within the dentin

28
Q
  1. Should you do a box form on an intact wall where there was no caries removal?
A

No

29
Q
  1. When 2 box forms are needed, less than 180 degrees of tooth circumference remain. What does this mean and what should you do?
A

a. Risk for cuspal fracture
b. Do build-up and crown

30
Q
  1. When placing the margin more apically, we must be careful of the
A

a. Biological width

31
Q
  1. How can you remove biological width restriction?
A

a. Crown lengthening

32
Q
  1. The retention for a core is often with the use of
A

Pins

33
Q
  1. A build up is needed when how much tooth surface is lost?
A

50%

34
Q
  1. If you have excessive interocclusal distance, what is indicated?
A

a. Tall crown

35
Q
  1. Amalgam core build up is
A

a. Not retentive but strong

36
Q
  1. Composite core build up is
A

a. Retentive but not strong

37
Q
  1. When is the use of pins recommended?
A

a. 1⁄2 or more clinical crown destroyed

38
Q
  1. Cusps thinner than 1⁄2 their height are
A

a. Weak and should be shortened or flattened

39
Q
  1. When using an amalgam floor, the floor and walls should be
A

a. Flattened

40
Q
  1. Crown margins should be at minimum _______ to build up material margin
A

a. 1 mm apically

41
Q
  1. What are the mechanical properties of an amalgam core?
A

a. Compressive strength
b. Dimensional strength
c. Corrosion - sealing

42
Q
  1. The amalgam core requires how much thickness?
A

a. Minimum of 2 mm

43
Q
  1. The compost core requires how much thickness?
A

a. Can be thinner than 2 mm

44
Q
  1. Pins should be placed
A

a. Non-parallel

45
Q
  1. What are the guidelines for pins?
A

a. Solid dentin required
b. Flat area
c. 0.5-1 mm from axial wall or dentin
d. 0.5mm of dentin should be surrounding
e. Best used in line angles of posterior teeth
f. 1 pin per missing cusp
g. 5mm of space between pins
h. Max of 4 pins per tooth

46
Q
  1. What should you use to make a hole for the pins?
A

a. Pilot drill

47
Q
  1. How do you create non-parallel pins?
A

a. After placing in dentin, you bend them
i. Slight angulation

48
Q
  1. Pins placed in dentin should be
A

a. 2mm deep into dentin
b. 2mm coronal into build up
c. Minimum 1mm radius of build-up around pin

49
Q
  1. What are the types of pin complications?
A

a. Fluted root shape
b. Furcation
c. Pulp penetration

50
Q
  1. What should you do if the pin gets into the pulp?
A

RCT

51
Q
  1. What should you do if the pin exits the tooth surface above bone?
A

a. Flap and smooth to tooth contour

52
Q
  1. What should you do if you have a fractured pin?
A

a. Move to another location 1.5mm away

53
Q
  1. What should you do if you have a stripped pin (loose)?
A

a. Use a larger pin

54
Q
  1. Bases are only used to protect
A

a. Pulp

55
Q
  1. Bases can be used to fill what?
A

a. Undercuts when a entire build-up is unnecessary

56
Q
  1. Are the bases and build-up the same?
A

a. No, bases are weaker

57
Q
  1. Are bases strong enough to support grooves, boxes?
A

No

58
Q
  1. What are the types of base material?
A

a. Polycarboxylate cement
b. Glass ionomer
c. Resin-modified glass ionomer cement
d. Silver-reinforced glass ionomer cement

59
Q
  1. What type of liner is there?
A

a. Dycal (CaOH)

60
Q
  1. What is the common protocol for a base?
A

a. Gluma
b. Dycal
c. Vitrebond
d. Glass ionomer
e. Restoration

61
Q
  1. What is the sequence of treatment?
A

a. Prior to prep: evaluate periodontal and endodontic health
b. Remove all caries
c. Evaluate prep
d. Do restoration

D2 Fall - Fixed Prosth (11 decks)

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