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Operative ABGD Oral Boards > ABGD Oral Boards > Flashcards

ABGD Oral Boards Flashcards

1
Q

What are some advantages of Vital Bleaching In Office?

A
  • Immediate results
  • Jump start home technique
  • Decreases length of treatment
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2
Q

What is the difference between Fiber Post and Cast Gold Post?

A
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3
Q

What are some Adverse Soft Tissue responses to bleaching?

A
  • Free radicals
  • Cellular damage
  • Co-carcinogen
  • Burning
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4
Q

If you press or mill veneers, what materials can you use?

A

Feldspathic & reinforced ceramics (Empress, Emax)

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5
Q

What is the function of a liner?

A

Sealer with therapuetic benefit (F release, adhesion, antibacterial, promote tertiary dentin formation)

ie: Calcium hydroxide/MTA

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6
Q

What is an attractive quality of Non-Metallic Prefabricated Posts?

A
  • Similar MOE to dentin
  • More compatible with all ceramic crowns and resin systems
  • More esthetic
  • Less rigid than metal posts which leads to…
  • Fewer root fractures
  • Flexure may lead to leakage
  • Forms “monobloc” when using resin cement and core material
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7
Q

Why not use a resin as Direct Pulp Cap?

A
  • Cytotoxic to pulp
  • Poor pulpal healing
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8
Q

What is a radiographic success of endo treatment?

A

Good obturation, length, density, taper

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9
Q

What are some restorative considerations when extent of caries is pulpally within the chamber or apically relative to alveolar crest?

A
  • Can tooth be crown lengthened
  • Furcations
  • Crown/root ratio
  • Biologic Width
  • Key or Strategic Tooth?
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10
Q

For Non-Vital Bleaching, what do you place over the GP?

A
  • RMGI
  • Ramp from lingual to facial
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11
Q

What factors affect polish?

A

Hardness and Polishability

  • Resin Matrix
  • Filler Particle Size
  • Difference in wear rate between matrix and filler particle
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12
Q

What is a concern with Resin Infiltration?

A

Several in-vitro studies show resin infiltrated white spot lesions may be susceptible to increased stain retention

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13
Q

What are some good diagnostic tests for Cracked Tooth Syndrome?

A
  • Bite test
  • Transillumination
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14
Q

What are some late signs of failture for Porcelain Veneers?

A
  • Leakage/staining at margins
  • Caries
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15
Q

What is the Etiology of Post-Eruptive Tooth Discoloration?

A

Post-Eruptive

  • Trauma - calcific metamorphosis
  • Aging
  • Iatrogenic - silver, minocycline
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16
Q

What is the Mechanism of Action for Icon?

A
  • Combines erosion of enamel with resin infiltration
  • Modifies enamel optical properties
  • Resin infiltrant has refractive index (RI) similar to healthy enamel
  • Penetrates up to 450 nm
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17
Q

What are some Conraindications to doing Posterior Composites?

A
  • High Caries Risk
  • Extensive Prep Likely
  • Heavy Occlusal Function
  • Lack Enamel
  • Subgingival Margins
  • Inadequate Isolation
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18
Q

What are some ways to Isolate a Class V Non-Surgically?

A
  • Cotton roll/Retraction Cord
  • Heavy Rubber Dam/Cerivcal Retractors
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19
Q

What is the most important resistance factor in prepping a tooth for a post?

A

Ferrule!

  • Peform ideal crown preparation
  • Remove only weak, unsupported dentin
  • 2 mm doubles resistance form
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20
Q

Describe the prep design for a posterior EMAX crown…

A
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21
Q

What are Prepless Veneers called?

A

Lumineers

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22
Q

What are some differently Classifications of Cracked Tooth Syndrome?

A
  • Craze lines; (don’t treat)
  • Incomplete Cusp Fracture
  • Cracked Tooth
  • Split Tooth
  • Vertical Root Fracture
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23
Q

What are some Potential Diagnoses for Excessive Gingival Display?

A
  • Vertical Maxillary Excess
  • Short Upper Lip
  • Excessive Lip Mobility
  • Altered Passive Eruption
  • Dentoalveolar Extrusion
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24
Q

When restoring a carious Class V lesions, what is a good technique?

A

Open Sandiwch

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25
Q

What are some examples of Non-Invasive/Micro-invasive Tx Options?

A
  • Remineralization
  • Sealants
  • Resin Infiltration
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26
Q

What distance should a hyperactive lip travel?

A

6 - 8 mm

Hyperactive lip translates more than the avg distance

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27
Q

What are the Risks/Side Effects of Enamel Microabrasion?

A
  • Relatively significant loss of surface enamel (up to 300 nm)
  • Removes F rich layer of enamel
  • Operator and patient safety - high conc. of acid
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28
Q

What does research suggest in regards to the use of Icon versus F varnish in treatment of proximal caries?

A

Available evidence shows that micro-invasive treatment of proximal caries lesions arrests non-cavitated enamel and initial dentinal lesions (outer 1/3 of dentine) and is significantly more effective than fluoride varnish or HCl

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29
Q

What are some Post Prep Guidelines?

A
  • Maintain minimum 4 mm apical seal (5 mm better)
  • Limit diamter to size of existing canal
  • 2/3 length of root or 1/2 length of root in bone
  • > length of clinical crown
  • Immediate post prep ok. Heat = Rotary (heat safer)
  • Greater length = greater retention
  • Greater width does not = great retention (weakens root)
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30
Q

What chemical pre-treatment do you use for Glass Ceramics?

A

Chemical etching with HF acid

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31
Q

What is the Mechanical Etiology of a NCCL in regards to Abrasion?

A

Mechanical Etiology

  • Overzealous toothbrush
  • Medium-Hard Bristle
  • Excellent Hygiene
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32
Q

Describe a Tofflemire Band…

A
  • Rigid
  • Contoured
  • Adaptable
  • No Light Transmission
  • Band Thickness Might be an Issue
  • .03 - 0.5 mm
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33
Q

What are some factors that contribute to long term success of Porcelain Veneers?

A
  • Preparations confined to enamel only
  • Suitable luting agent, handled appropriately
  • Correct surface preparation
  • Closely adapted margins
  • No preparation design identified as superior
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34
Q

What are some Disadvantages of In Office Vital Bleaching?

A
  • Longer chair time
  • More expensive
  • Increased tooth sensitivity
  • Potential tissue burns
  • Very caustic
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35
Q

Why not use Zinc-oxide Eugenol for Direct Pulp Cap?

A
  • Poor sealing
  • Chronic Inflammation
  • Lack of dentin bridge
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36
Q

What does research say in regards to Resin Infiltration and their affect on White Spot Lesions post ortho?

A
  • Conclusion: Resin Infiltration significantly improved the clinical apearnace of White Spot Lesions and reduced their size
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37
Q

Contraindications for Direct Pulp Cap?

A
  • Symptomatic, non-vital, “stressed” pulps
  • Large carious exposure
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38
Q

What are bases?

A
  • Traditionally placed to provide thermal insultation to the pulp > 0.5 mm
  • Used as dentin substitutes & block out undercuts
  • Studies show INCREASED FRACTURE OF OVERLYING RESTORATIONS. RELATED TO LOW MODULUS OF ELASTICITY OF MATERIAL.
  • Dentin is the best base!
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39
Q

What are some early signs of Porcelain Veneer Failure?

A
  • Porcelain Fracture
  • De-bonding at cement/silane junction
  • Estehtic Failures
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40
Q

What are the guidelines for coverage of posterior endodontically treated teeth?

A
  • Posterior endodontically treated teeth require coronal coverage
  • Presence of cuspal coverage was the only significant restorative variable to predict long-term success
  • Endontically treated posterior teeth 6x more likely to survive with cuspal coverage
  • Options: Full Crown, Onlay, Cuspal Coverage Am
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41
Q

What does Pre-Wedging/Pre-Ringing accomplish?

A
  • Protects tissue, tooth, dam
  • Improves contact
  • Compensates for thickness of the matrix band
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42
Q

What is the length/width proportion for a central incisor?

A

10/8

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43
Q

For a slot prep, do you bevel the occlusal margin?

A

No!

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44
Q

Where should your Interproximal Contact area end in a Veneer Preparation?

A
  • Prep should stop F to or extend L to proximal contact
  • Easier to finish
  • Easier for lab
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45
Q

What are some techniques to reduce polymerization shrinkage stress?

A

Incremental Fill

  • Reduces C-Factor

Control of Curing Light Irradiance

  • Soft Start
  • Pulse-delay
  • Ramp Curing

Flowable Liner

Sandwich Technique

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46
Q

What can be the Etiology of Extrinsic Tooth Discoloration?

A

Environmental - Dietary

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47
Q

What is the function of Varnish?

A
  • Copalite
  • Barrier for bacteria or irritants
  • Provides no thermal insulation
  • temporary effects…rarely used in today’s dentistry
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48
Q

What are some sequelae of Polymerization Shrinkage?

A

Biggest Problem…

  • Gap Formation
  • Microleakage
  • Marginal Staining
  • Secondary Caries
  • Tooth Fracture
  • Post-Oper Sensitivity
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49
Q

What does Pre-wedge help with?

A
  • Helps achieve contact
  • Protects RD and gingiva
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50
Q

How do Lingual and Facial bevels difer when resotring a large anterior composite?

A

Lingual Bevel

  • Functional
  • 1 mm & 45°
  • Sharp & Distinct

Facial Bevel

  • Esthetic
  • 2-3 mm/60°
  • Scalloped/irregular
  • Feathers to imperceptible margin
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51
Q

Describe the “Prema Technique” for Enamel Microabrasion…

A
  • Find diamond initial prep
  • Pre-mixed 10% HCl
  • Plastic applicator stick or mandrel
  • 1 minute/rinse/eval X 20
  • 300 microns loss at 20X
  • 10/1 gear reduction handpiece
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52
Q

What do studies show about success/failure in regards to Resin Infiltration?

A
  • Success/failure attributed to depth & activity of lesion
  • Less successful in deeper, inactive lesions
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53
Q

Describe the “Class Technique” of Enamel Microabrasion?

A
  • 18% HCL & pumice applied with wooden tongue blade
  • 10 application at 10-15 sec intervals
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54
Q

Observe Icon Resin Infiltration in Action…

A
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55
Q

What does the research say about Calcium Phosphopeptides like MI Paste?

A
  • Lack of evidence for use of MI Paste/Plus over fluoride for prevention of early dental caries
  • Low quality evidence to support use of MI Paste/Plis for treatment of ortho white spot lesions
  • No benefit to MI Paste Plus (with fluoride) over MI Paste
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56
Q

What does Potassium Nitrite do?

A

Reduces Sensitivity

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57
Q

OTC F toothpaste is how many PPM?

A

1000

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58
Q

How should you follow up with a Non-Vital Bleaching Case?

A
  • Re-evaluate weekly
  • Strive for over-bleach (relapse)
  • Remove temporary materials from chamber
  • Cleanse chamber
  • Wait 1-2 weeks
  • Restore with lightest shade of composite
  • Optimal marginal seal critical
  • Success rate - 50%
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59
Q

What are the concentrations of Carbamide Peroxide for In Office bleaching?

A
  • “Power” (assisted bleaching)
  • Office applied
  • 34 - 44% or equiv
  • Applied in bleaching tray of directly
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60
Q

What has rearch suggested in regards to Composite repair in low to moderate caries risk patients?

A

Conclusion: Repair when indicated - minimally invasive & predictable increase in restoration longevity

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61
Q

What are some conclusion about amalgam bond?

A
  • Decreased Microleakage
  • Restoration of endo tx teeth & direct pulp caps
  • Does NOT decrease posop sensitivity
  • May be of value as retentive adjunct (core build-ups) - use HPA
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62
Q

Disadvanges of Porcelain Veneers…

A
  • Preparation required
  • Limited ability to mask staining
  • Technique sensitive
  • Fragility prior to cementation
  • Lab fees/interaction
  • Multiple appointments
  • Expense
  • Resin Margins (Usual site of eventual breakdown)
  • Provisionals
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63
Q

What are 2 different types of Adhesives?

A
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64
Q

Is it easy to establish proximal contacts with composite?

A

Difficult to Establish Contact

  • Composite is not condensable
  • Some matrix systems aggravate situation
  • Finishing procedures can open contact
  • Wear can complicate matters resulting in flat surface
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65
Q

What are some disease indicators in regards to “WREC”?

A
  • W: White Spot Lesions
  • R: Restorations < 3 years
  • E: Enamel Lesions
  • C: Cavitations/Dentin
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66
Q

How long should you wait to restore teeth after bleaching?

A

Adhesive restorative procedures to enamel/dentin should be delayed for 24-48 hours after tooth whitening

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67
Q

What 3 materials make up Icon Resin Infiltration (Treatment for White Spot Lesions)?

A
  1. Icon Etch - 15% HCL acid
  2. Icon Dry - Ethyl alcohol
  3. Icon Infiltrant - low viscosity resin
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68
Q

What are 4 Incisal Preparations for Veneers?

A
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69
Q

Describe the Open Sandwhich Technique…

A
  • Resin modified GI carried toouter surface and partially veneered with resin composite
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70
Q

What is MOE?

A
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71
Q

What does research suggest in regards to best antibacterial effect of various liners vs no liner?

A

MTA - 73%

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72
Q

What are some difficulties with endo post adhesion?

A
  • Unfavorable C-factor
  • Difficulty with uniform application of primers/adhesives
  • Poor light penetration into canal space
  • Residual oxgyen from endodontic irrigants
  • Reduced bond stregnths in apical root dentin
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73
Q

How is Abrasion different than Attrition?

A
  • Abrasion (non-contact areas)
  • Attrition (contact areas)
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74
Q

What did the latest Systematic Review in 2016 conclude about endo crowns?

A
  • Clinical success rates of endo crowns = 94-100%
  • Endocrowns > conventional tx for fracture strength
    • No statistical difference for posterior teeth only
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75
Q

In a study that compared caries progression with sealaed versus non-sealed teeth, what did they find?

A

Unsealed teeth continued to show progression

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76
Q

What are the ideal propeties of a post?

A
  • Maximal protection of the root from fracture
  • Maximal retention within the root
  • Maximal retention of the core and crown
  • Maximal protection of the crown margin seal from coronal leakage
  • Pleasing estehtics, when indicated
  • High radiographic visibility
  • Retrievability
  • Biocompatibility
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77
Q

Incisal edges of maxillary teeth should follow the…

A

Curvature of lower lip…

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78
Q

Protocol for reparing a ditched am…

A
  • Air abrasion of alloy surface
  • Etch/prime/bond with DBA
  • Can’t ensure dry surface under a ditched margin so use hydrophlic primer
  • Flowable composite or sealant for repair
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79
Q

What are some indications for Cast Post/Core in the Anterior?

A
  • Coronally-flared canals
  • Multiple preps
  • Tapered roots
  • Excessively wide or ovoid canals
  • Small teeth (most incisors)
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80
Q

Any carcinogenic risk to humans via tooth whitening?

A

There is no evidence from animal experiment data of toxic and carcinogenic risk to humans from hydrogen peroxide used at exposure levels associated with tooth bleaching

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81
Q

What is C-Factor?

A
  • C = Total Bonded Area/Total Unbonded Area
  • Competition between:
  • Polymerization contraction forces
  • Strength of bonds to tooth
  • Higher C-Factor = More Stress
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82
Q

What does research suggest regarding cementing posts and optimum bond strength?

A

Highest bond strength with self-adhesive resin cement (Relyx X Unicem)

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83
Q

What do studies show regarding using CaOH vs no liners in primary teeth after caries excavation (not direct pulp caps)?

A
  • Restoring the cavity without lining did not significantly affect the risk of failure
  • Conclusion: Strong recommendations for using CaOH cavity liners are unsubstantiated, but firm evidence for omitting lining is also unavailable
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84
Q

What factors effect Wear Resistance in regards to composite?

A

Clinical Factors

  • Restoration Size
  • Location: > Molars
  • Occlusal Load
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85
Q

What is the MPa strength of Pressable Emax for Veneers?

A

400 MPa

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86
Q

What are some Protective Factors that are “SAFE” in regards to Caries Balance?

A
  • S: Saliva & Sealants
  • A: Antimicrobials
  • F: Fluoride
  • E: Effecitve Lifestyle
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87
Q

What does resarch suggest about success regarding restoring Class V lesions with RMGI versus 2 step Etch and Rinse composite on a NCCL?

A

88.% RMGI vs 52% DBA/Composite

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88
Q

Why use Dentin Bonding Agent as a Sealer?

A
  • Contain a primer and adhesive
  • Forms a hybrid layer with dentin and mechanical seal with enamel
  • Act as a barrier to bacteria and irritants
  • DOES NOT REDUCE POSTOP SENSITIVITY
  • Beneficial to augment retention of complex amalgams
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89
Q

What is the recommended occlusal reduction for Empress & EMAX?

A

1.5 - 2.0 mm to prevent fracture

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90
Q

How do you treat Dentoalveolar Extrusion?

A
  • Ortho Intrusion
  • Segmental Osteotomy
  • Functional Crown Lengthening
  • Increase Vertical Dimension
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91
Q

What are some effects of Bleaching on Restorations?

A
  • Increased surface roughness
  • Crack development
  • Marginal breakdown
  • Release of metallic ions
  • Decreases in tooth-to-restoration bond strength
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92
Q

Adjunctive methods typically yield higher sensitivity and low_____

A

Specificity

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93
Q

What are some tips when picking a shade?

A
  • Hydrated teeth
  • Natural light source
  • Evaluate underlying discoloration
  • Remember enamel contribution to color
  • Don’t forget a stumpf shade
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94
Q

What is a Metamerism?

A
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95
Q

Why do an MO & DO instead of an MOD?

A

Less chance of fracture

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96
Q

Describe the prep design for IPS Empress CAD for posterior…

A
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97
Q

What are some components to a Smile Analysis?

A
  • Gingival Display/Line
  • Incisal Edge Position
  • Incisal Plane
  • Midline Position/Cant
  • Symmetry
  • Tooth Proportions/Alignment
  • Embrasure Form
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98
Q

What are 2 types of Self-Etch Adhesives?

A
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99
Q

What are some Advanges of Porcelain Veneers?

A
  • Extremely Esthetic (Color Stability, Translucency, Texture, Vitality)
  • Conservative compared to full coverage
  • Durability
  • Bond strength
  • Biocompatibility: superior tissue response
  • Gingival esthetics
  • Low coefficient of thermal expansion
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100
Q

Overall, what does research suggest in regards to Pit & Fissure Sealants over non cavitated caries?

A

Sealing non-cavitated caries in permanent teeth is effective in reducing caries progression

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101
Q

What did studies find regarding the success of Endo-crowns vs Post/composite cores?

A

Endo Crowns had statistically higher fracture stregnth

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102
Q

Describe a Window Prep for Veneers…

A
  • Alteration of incisal edge length or shape not required
  • Least reduction to fracture resistance of tooth
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103
Q

When you have a short clinical crown that you CAN feel the CEJ in the sulcus it is…

A

Short tooth (wear)

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104
Q

How would you treat a NCCL?

A
  • Nothing
  • Symptomatic? Esthetic? Concern? Progression? Gingival Margin?

If Shallow

  • DBA/Resin Composite

If Deep

  • Closed Sandwich
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105
Q

What is the Minimal Basing Concept?

A
  • Preserve “remaining dentin thickness”
  • Minimize the extend of the base…use dentin to support
  • Minimize the thickness of base…no more than 0.5 mm
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106
Q

When you have short tooth and you CANNOT feel the CEJ in the sulcus it is…

A

Altered Passive Eruption

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107
Q

How do the embrasures between the centrals/laterals/and canines compare?

A
  • Embrasure between central is the smallest
  • Embrasure between centrals/laterals slightly bigger
  • Between laterals and canine biggest
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108
Q

What is Clearfil SE Bond best for?

A
  • Ideal for dentin adhesion
  • Selective Etch w/H3PO4 improves marginal integrity
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109
Q

How many CFUs needed to = high caries risk for salivary testing?

A

> 100k CFU/ml of SM and LB

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110
Q

Where does your Veneer Prep end when closing a Diastema?

A

Extend past contact

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111
Q

Is a Post/Core required in the Anterior?

A
  • An intact anterior tooth with conservative endodontic access and intact marginal ridges does not require a post or coronal coverage.
  • A post is of little or no benefit in a structurally sound anterior tooth and increases the chances of a nonrestorable failure
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112
Q

What are some proposed benefits of cavity liners?

A
  • Reduce viable bacteria in proximity to pulp
  • Induce development of reacitonary dentin
  • Induce remineralization of demineralized dentin
  • Provde a seal against leakage of bacteria and toxins
  • Isolate the pulp against thermal or electrical conduction
  • Protect pulp from chemical noxa
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113
Q

How do you treat a short upper lip?

A
  • No god long term data
  • Very invasive - essentially a vestibulplasty
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114
Q

What is the success rates for pulp capping?

A

Roughly 33%

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115
Q

What are some Bleaching Indications?

A
  • Discolored non-vital teeth
  • Stain due to Aging/Diet/Smoking
  • Mild fluorsis, mild tetracycline staining
  • Pre/post restorative tx
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116
Q

What types of Lasers are used for In Office Bleaching?

A
  • Argon
  • CO2
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117
Q

How does Enamel Micro Abrasion work?

A
  • Chemo-mechanical removal of superfiical enamel discoloration through the use of acid/abrasive solution with mechanical/rotary instruments

Mechanism of Action

  • Acid erosion of enamel up to 450 nm
  • Infiltration with low viscosity resin
  • Alters white spot to RI similar enamel…masks the lesion
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118
Q

What are some different Light Sources for In Office Bleaching?

A
  • Xenon
  • Halogen
  • Plasma
  • Arc
  • Curing Lights
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119
Q

How much Carbamid Peroxide is used in Vital Bleaching?

A

10-36%

breaks down to H202 + urea

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120
Q

What did studies find about prep types with a 4 mm buildup, 2 mm buildup and endo crown success rates?

A

All restoration designs survived normal range of masticatory forces

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121
Q

Describe Dycal (CaOH) as a material…

A
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122
Q

What is the difference between Acquired and Inherent Polish?

A

Acquired

  • Surface achieved by clinician at placement

Inherent

  • Surface to which composite will revert to over time
  • Function of particle size/shape
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123
Q

What are 4 Pulp Capping products?

A
  1. Calcium Hydroxide (Dycal): Historical “Gold Standard”
  2. Mineral Trioxide (MTA): The “New” Gold Standard
  3. Biodentine (Septodent)
  4. TheraCal LC (Bisco)
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124
Q

What are some example of Hematologic INtrinsic Pre-Eruptive conditions?

A
  • Erythroblastosis Fetalis
  • Thalassemia
  • Porphyria
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125
Q

What are Abrasive Rubber Polishg Points/Cups used for?

A
  • Ideal for lingual cervical areas
  • Aluminum oxide, silica carbid, diamond
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126
Q

What are some Indications for Posterior Composite Restorations?

A
  • Low Caries Risk
  • Small to Moderate Sized Class I and Class I Restorations
  • Conservative Prep
  • Margins In Enamel
  • Centric Stops on Tooth Structure
  • Absence of Excessive Wear
  • Esthetics Important
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127
Q

What are some Disadvantages of Vital Bleaching at home?

A
  • Patient compliance required
  • Longer treatment time vs. in-office bleaching
  • Tooth sensitivity
  • Gingival irritation
  • Relapse
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128
Q

What does 35% Carbamide Peroxide = in regards to exposure time?

A

30 minutes

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129
Q

What is the Etiology of Intrinsic Pre-Eruptive Tooth Discoloration?

A

Pre-Eruptive

  • Fluorosis
  • Tetracycline
  • Others (genetic, hematologic, developmental)
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130
Q

Characteristics of a conservative amalgam restoration…

A
  • Decreased buccal-lingual isthmus (1/4 to 1/3)
  • Rounded internal angles
  • Beveled axio/pulpal line angle
  • Less marginal fracture
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131
Q

What are Advantages of Bitine Ring Systems?

A

Less Matrix Thickness to Overcome

  • Only single thickness is used
  • Bands are thin

Contoured Bands Provide

  • A more natural form
  • A larger contact area

Bitine Ring Augments Wedge Separation

  • Tighter contacts are formed
  • Confirmed by multiple in-vitro studies
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132
Q

Research has found that using additional light increases incidence of ______ regarding In Office Bleaching…

A

Tooth Sensitivity

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133
Q

Describe the Apperance of Erosion of NCCL?

A
  • Amorphous, hard, matte
  • Indistinct margins
  • Shallow and diffuse
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134
Q

Observe this helpful flow chart…

A
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135
Q

What is the #1 reason Posterior Composites Fail?

A

Secondary Caries

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136
Q

What is the main reason for endo failure?

A

Inadequate restorative therapy

Need to establish a Coronal Seal following endo tx ASAP

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137
Q

What is the incisal reduction for Veneers?

A

1.5 - 2.0 mm

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138
Q

What does research suggest in regards to Calcium Hydroxide vs MTA in Direct Pulp Caps?

A
  • Failure rate at 24 mos = 31.5% CaOH
  • 19.7% MTA
  • Conclusion: study provides confirmatory evidence of superior performance with MTA as direct pulp capping agent compared with CaOH
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139
Q

What are indications for Composite Fiber Post in Anterior?

A
  • All ceramic, translucent crown planned
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140
Q

What is a Closed Sandwhich?

A
  • Resin-modified GI liner
  • Veneered with resin based composite
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141
Q

What should your incremental fill measurements be when placing a composite in a Class 2 prep?

A

Incremental fill

  • 1.0 mm increment on gingival floor
  • 2.0 mm subsequent increments
  • Oblique placement
  • Minimizes cuspal deformation
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142
Q

According to the CCS, describe “Sound” regarding the extent…

A
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143
Q

Observe this helpful flowchart…

A
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144
Q

What is the MPa of Machinable Emax CAD in regards to Veneers?

A

360 MPa

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145
Q

What are indications for a Prefab post in an Anterior Tooth?

A
  • Round roots with round canals that are not coronally flared
  • Will need antirotation feature added
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146
Q

How do Proximal Contact compare between centrals/laterals/canines?

A
  • Centrals = 50%
  • CL = 40%
  • L/C = 30%
  • Moves apically towards distal
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147
Q

What is Turner’s Tooth?

A
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148
Q

What do you do if you don’t have enough ferrule?

A
  • If no vertical heigh, move the preparation finish line apically
  • If not possible, perform either orthodontic extrusion
  • Crown lengthening surgery
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149
Q

What does research suggest about Pit & Fissur sealants in combo with small amalgam restorations?

A
  • Les invasive
  • Improved marginal integrity over 10 years
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150
Q

What are some indications for Porcelain Veneers?

A
  • Mild to moderate discoloration
  • Diastema closure
  • Rotations/slight malposition
  • Enamel malformation/pitting
  • Tooth augmentation (peg lateral)
  • Replacement of inadequate resin composite veneers
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151
Q

Describe Biodentin as Pulp Capping Agent…

A
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152
Q

What are some guidelines for post/core in posterior teeth?

A
  • Posterior molars rarely require a post
  • Pin or chamber retained cores work well if have adequate tooth structure following prep

Indications for post placement in molars:

  • Posterior teeth missing 60% or more of coronal tooth structure
  • If residual pulp chamber < 4 mm of axial walls
  • If tooth is to be RDP/FDP abutment
  • Rarely needed to retain core
153
Q

Is you have an isthus > 1.2 mm in a class 2 prep, do you need retention grooves? What about < 1.2 mm?

Where do the slots go?

A
  • For wide isthmus - no grooves
  • For narrow isthmus - points
  • For slot preparations, grooves extend from gingival floor to occlusal
154
Q

What are some keys to success regarding restoring endodontically treated teeth?

A
  • Conservative endo access
  • Maintain ferrule
  • Use adhesive dentistry
  • Use P & C with physical properties close to dentin
  • Composite resin core with fiber post represent best treatment option
155
Q

What does the beveling the F & L proximal boxes help with in a slot prep?

A
  • Significantly reduces marginal leakage
  • Improves access to enamel rod ends
  • Improves access for finishing
156
Q

What did the Article “A Visual Inspecting of Caries Detection: Systematic Review and Meta-Analysis” say about the Visual Method…

A
  • Good accuracy (similar to radiography and fluorescence)
  • High specificity (few false positives)
  • Use of visual inspection alone deemed sufficeint for careis detection
  • Use of validated scoring systems improved accuracy in detecting carious lesions
157
Q

How does Dentoalveolar Extrusion Manifest?

A

One or more maxillary anterio teeth SUPRAERUPT

  • Incisal wear with compensatory eruption
  • Aleveolar Complex Follows Eruption of Teeth
  • Gingival Line is altered-concave
158
Q

High specificity means…

A

Few false positives

159
Q

What are some components of Micro Esthetics for treatment planning?

A
  • Tooth Size & Shape
  • Shade
  • Texture & Brilliance
  • Translucency
  • Opalescence & Fluorescence
160
Q

How do you diagnose Vertical Maxillary Excess?

How do you treat?

A
  • Lower face ht > Midface

Treatment

  • Max LeFort (impaction)
  • Masking (Botox)
161
Q

What are some Pathologic Factors that are “BAD” in regards to caries?

A
  • Bad bacteria
  • Absence of Saliva
  • Destructive Habits (diet & hygiene)
162
Q

5 Year survival rates for Endo-Crowns…

A
163
Q

What are some Key Factors For Success for Posts?

A
  • Ferrule
  • Antirotation Feature
  • Preserve remaining tooth structure
164
Q

How do you avoid Cervical Resorption during Non-Vital Bleaching?

A
  • Ensure adequate base/liner placed
  • Minimize use of acid etch in chamber
  • Avoid use of heat
  • Use water with sodium perborate
  • Avoid use of superoxol
  • Frequent recall
165
Q

What are some considerations when facing Sclerotic Dentin?

A
  • Mechanical removal of hypermineralized layer
  • Longer etch/conditioning time
  • Less intertubular dentin (bonding substrate) i.e. less collagen fibers
  • Cosider use of RMGIC vs DBA/resin comosite (or adhesive with MDP)
166
Q

What are signs/symptoms of Cracked Tooth Syndrome?

A
  • Wear facets
  • Pins
  • Pain upon biting/releasing
  • Non-lingering pain to cold
167
Q

What are the pros and cons of Silver Diamine Fluoride?

A
  • Pros
    • Inexpensive
    • Quick
    • No anesthesia
  • Cons
    • Silver oxide staining
      • Caries-black
      • Perioral tissues/lips - light brown
    • Doesn’t restore form/function
168
Q

What are some Surgical techniques to isolate a Class V?

A
  • Miniflap
  • Envelop Flap (Single or Double)
169
Q

How do you select a post for a pre-molar?

A
  • Pin or chamber retained core if adequate tooth structure following pre (i.e., conservative access)

Cast vs prefab depends on canal anatomy

  • Ovoid canal = cast post/core
  • Tapered canal = prefab
  • Parallel canal = prefab (parapost)
170
Q

What should you always use when prepping slots in an composite?

A

Use adequate retention locks in slot preps

171
Q

Describe the CAMBRA Protocol for Low Caries Risk…

A
172
Q

What do studies suggest regarding beveling O margins of NCCLs, and class 3’s and 4’s?

A
  • Bevleing of the occlusal margin (NCCL) did not improve the clinical result
  • Beveling had no significant influence on outcome (Class 3/4)
173
Q

In regards to anterior composites, what helps decrease marginal staining?

A

Enamel etching

174
Q

What is the active ingredient in Crest Whitestrips?

A
  • Polyethylene embeeded with
  • 6.4 & 14% H202 placed on teeth
175
Q

What should be the max thickness of composite you place when you cure?

A

2 mm thick

176
Q

What has research suggested in regards to Resin Infiltration versus sealant with Prime & Bond?

A

Icon & sealing equally effective & significantly better than placebo

177
Q

What are good cases for at home bleaching?

A
  • Yellow, orange, brown
  • Discoloration due to aging
178
Q

How can you enhance the chemical reaction of bleaching agents?

A
  • Heat
  • Light
  • Laser Energy
179
Q

Describe MTA as a material…

A
180
Q

What are some Antirotation Features?

A
  • MUST be added in form of pins, channels, keyways and other design features if not already judged clinically present
  • IMPERATIVE with round/oval single canals
181
Q

What are some patient/tooth factors that affect success in Class V Lesions?

A
  • Occlusal Stresses
  • Age (sclerotic dentin)
  • Substrate (Cervical root dentin/tuble density)
  • Habits/Hygiene
  • Location
182
Q

What has reserach found about resin cement color and effect on porcelain veneers?

A

“Resin cement color had no significant effect on final color match of cemented porcelain veneers”

183
Q

What are some indications for amalgampins?

A
  • Extensive loss of tooth structure
  • Insufficient coronal dentin remaining
  • Minimal occlusogingival height (i.e. no room for a pin)
  • Minimal fracture/extension of caries
  • Short clinical crowns
  • Young permanent molars,large pulp spaces
  • More conservative than TMS pin…only 2 mm cusp reduction required
184
Q

What does research suggest regarding Amalgam Vs. Composite in the posterior?

A
  • Posterior composite has 2x failure risk
  • Posterior composite has 2x risk of secondary caries
  • Risk of fracture between posterior am vs comp not significant
185
Q

What are some factors for success in posterior composites?

A
  • High caries risk pts have 2x failure risk
  • Class 1s have highest success rate
  • Incremental fill technique
  • More failures in high stress areas
  • Enamel etch with H3PO4
  • Use of Rubber Dam
186
Q

Observe results of Icon Resin Infiltration for “Natural Tooth Bleaching”…

A
187
Q

What are 2 different types of core materials?

A

Amalgam & Composite

188
Q

What is the “Gold Standard” for composite polishing?

A

Sof-Lex discs

189
Q

What is the critical time for Tetracycline to cause staining?

A

4 months in utero to 8 years

190
Q

Describe the clincal technique for non-vital bleaching…

A

Adequate endodontic treatment

  • Evaluate obturation and periradicular health
  • Establish base line shade
  • Isolation
  • Completely remove restorative materials from chamber
  • Remove highly discolored dentin and residual pulp tissue
  • Remove gutta percha to below the level of the CEJ
  • Cleanse chamber
191
Q

What are some Contraindications to Enamel Microabrasion?

A
  • Deep enamel lesions
  • Tetracycline staining of any kind
  • Dentinogenesis Imperfecta
  • Discoloration of dentinal origin
192
Q

What is the preparation for a Porcelain Veneer?

A
193
Q

What are some Advantges of Surface Sealing?

A
  • Finishing traumatizes surface of composite
  • Microcracks occur, can propagate
  • Surface sealant (unfilled resin) penetrates microcracks, surface irregularities
  • Seals tooth-restoration interface
  • Increases Marginal Integrity
  • Decreases Microleakage, marginal staining, wear
  • Enhances longevity of restoration
194
Q

Does Clearfil SE help with retention in Class V Lesions?

What does it help with?

A
  • No difference in retention rates with or without selective etch
  • Significant improvement in marginal discoloation and marginal integirty with slective etch
195
Q

What are some Advantages of at home Vital Bleaching?

A
  • Less dentin sensitivity than in-office
  • Less chair time
  • Safe and effective
196
Q

According to Summitt - Amalgam bond =

A

TMS Pins

197
Q

What are the advantages of using an Open Sandwich Technique Interproximally?

A
  • Reduced microleakage
  • Chemical bond to dentin
  • F release
198
Q

What is Icon?

A

Resin infiltration of early lesions

199
Q

What does research suggest about Calcium Phosphopeptides?

A
  • Evidence support use of CPP-ACP to augment F in inhibiting demineralization & enhancing remineralization
  • Remineralization effect of CPP-ACP equal to F… no additional benefit to fluoride
200
Q

What are 3 types of Non-Metallic posts?

A
  • Carbon Fiber
  • Ceramic
  • Fiber-Reinforced Composite
201
Q

Describe the 4 Origins according to the Caries Classification System (CCS)…

A
  1. Pit & Fissure
  2. Approximal
  3. Cervical/Smooth Surface
  4. Root
202
Q

Describe the “Advanced” stage in regards to exent in the CCS…

A
203
Q

What is the apperance of an Abfraction NCCL?

A
  • Wedge shaped
  • Sharp demarcation
  • Controversial
204
Q

What are areas to avoid for pins?

A
  • Concavities
  • Furcations
205
Q

What is the most critical part of placing a Class2 comopsite?

A
  • Gingival Margin Critical
  • 27% Satisfactory
206
Q

What are some conclusion from Literature about prep design for Class Vs?

Roughening…When to Bevel…

A
  • Superficial preparation or minimal toughening with a diamond bur is highly recommended to adhesively restore erosion lesions
  • Roughen the dentinal (and enamel) surface as this measure increases the durability of the cervical restoration
  • Beveling the enamel is still indicated when sclerotic dentin is involved
207
Q

How much tooth display should there bein repose for male/female?

A
  • 1-2 mm male
  • 3-4 mm female
208
Q

What do studies support in regards to minimal occlusal clearance for Lithium Discilicate?

A
  • The results support the clinical acceptability of lithium disilicate glass ceramic as thin as 1 mm in thickness in areas of minimal occlusal clearance
209
Q

When you increase the temperature by 10° C it _______ the rate of reaction…

A

Doubles

210
Q

What is Enamel Microabrasion?

A
211
Q

What are some ways you can treat a hyperactive lip?

A

Behavior Modification

  • Easy to do with compliant pt
  • Hard or pt to control in everyday settings

Botox

  • 6-8 month duration (more like 3-4 months)
  • Minimal amont of Botox
212
Q

What are the goals of Direct Pulp Cap therapy?

A
  • Maintain pulp vitality
  • Stimulate reparative dentin formation
213
Q

What 3 components contribute to success regarding Class V lesions and adhesives?

A
  1. Clearfil SE!
  2. Roughening dentin increased Clinical Index
  3. RD Isolation increased Clinical Index
  4. No additional benefit to enamel bevel

*Clinical Index = Retention, Marginal Discoloration, Margina Integrity

214
Q

What restorations are Optibond FL best for?

A
  • Ideal for restorations with margins in enamel
215
Q

Why not use Glass Ionomer RMGI as Direct Pulp Cap?

A
  • Cytotoxic to pulp
  • No dentinal bridge
216
Q

What is Value, Chroma, Hue?

A
  • Value: Brightness of the tooth
  • Chroma: Saturation or intensity of the hue
  • Hue: Basic color of the tooth
217
Q

What does historical data show about Enamel Microabrasion?

A
  • Historically poor results with microabrasion
  • Often penetrate deeply into enamel
  • Require significant tooth removal
218
Q

What is the bottom line with partial caries removal vs. stepwise total caries removal?

A
  • Successful vitality and restoartive outcomes for both PCR and SWT at 2 years.
  • PCR has fewer pulptal complications over a 3 year period than SWT
219
Q

What is a clinical success of Endo treatment?

A

Asymtomatic

220
Q

How does Silane work?

A
  • Improves etched veneer surface for resin adhesion
  • Provides a chemical link from porcelain to resin
  • highest resin-porcelain bond strengths acheived with HF acid and use of silanes
221
Q

How should the maxillary teeth from canine to canine align regarding CEJ’s?

A
  • Line from CEJ to CEJ of max canines should be straight
  • Central on the line
  • Laterals on line or 1/2 mm coronal to line
222
Q

What is the purpose of CAMBRA?

A
  • Identify cause of disease by assessing risk factors
  • Correct problem by addressing each risk factor
223
Q

What is C-Factor?

A
224
Q

What is the Etiology of a Class V Lesion?

A
  • Carious
  • Non - Carious Cervical Lesion
  • Abrasion
  • Erosion
  • Abfraction

*Multifactorial!*

225
Q

What are your options for treating a Carious Cervical Lesion?

A
226
Q

What are some examples of Minimally Invasive Tx Options?

A
  • Fissurotomy w/PFS
  • Preventive Resin Restorations
  • Adhesive Tooth Preps
  • Slot Preps
227
Q

When salivary flow testing, what is a normal/abnormal rate?

A
  • >1 ml/min = normal
228
Q

Pin placement…

A
229
Q

What causes Abfraction?

A

Abfraction

  • Pathologic loss of hard tissue tooth substance
  • Biomechanical loading forces: flexure/fatigue
  • Abrasion/erosion: secondary role
230
Q

According to the CCS, describe the “Initial” extent…

A
231
Q

What has research said about the use of dental Sealants?

A
  • Sealants over active, non-cavitated lesions reduced progression of caries for 5 years
  • Sealants over caries reduce viable bacteria by 100x and # of lesions with viable bacteria by 50x
  • Retention improved through use of DBA (2 step etch and rinse)
232
Q

How do you treat Altered Passive Eruption?

A

Esthetic Crown Lengthening

  • Internal bevel gingivectomy or sulcular incision
  • Remove alveolar bone 2 - 3 mm apical to CEJ
  • Apically position gingivae
233
Q

What are some Advantages of Posterior Composites?

A
  • Esthetics
  • Convservation of Tooth Structure
  • Adhesive Prep, Shallower, Narrower, Rounded Internal Line Angles
  • Low Thermal Conductivity
  • Eliminate Galvanic Currents
  • Alternative To Amalgam (No Mercury “Hazard”)
234
Q

How would you treat a carious non-esthetic Class V?

A
  • Open Sandwich
  • Amalgam
235
Q

What is Specificity?

A
  • Percentage of patients without the disease that reecive a negative result
  • Percentage chance that the test will correctly identify a person who is disease free
236
Q

What was the conclusion between Biodentine Vs. MTA in regards to mechanical pulp exposures?

A
  • Conclusion: No statistical difference in clinical radiographic, or histologic results
237
Q

Describe the Bitine Ring/Segmental Matrix…

A
  • Act to separate teeth
  • Single thickness of band
  • Contoured
  • Good gingival adaptation
238
Q

Prior to bleaching treatment…ALWAYS…

A
  • Establish preliminary shade
  • Have pre-op radiographs
  • Informed Consent
239
Q

Describe the CAMBRA Protocol for High Caries Risk…

A
240
Q

What are some bleaching risks/side effects?

A
  • Tooth sensitivity
  • Effects on enamel
  • Systemic effect from ingestion
  • Possible mutagenic effects
  • Occlusal alterations with long term tray wear
241
Q

Indication for using cavity liner like Dycal/Vitrabond?

A
  • Fluoride relase
  • Adhesion to tooth
  • Antibacterial action
  • Promote dentin bridging
242
Q

What are the 2 Best Performing Adhesives?

A
  • Clearfil SE Bond
  • Optibond FL
243
Q

For Non-Meallic Prefabricated Posts, describe Glass Fiber Reinforced Composite Posts…

A
  • Glass fibers embedded resin matrix
  • Attempt to match the flexure of the post to that of the root for best stress distribution (monobloc)
  • Key advantage over metal or ceramic…much easier to remove
  • Almost all are tapered
  • Generally recommended for use with resin core materials and resin cements
244
Q

What are some indication to place a CT graft over a NCCL?

A
  • Shallow, NCCL
  • Anterior Esthetic Case
  • Symptomatic
  • Previously unrestored
245
Q

What is Partial Caries Removal?

A
  • Intentional incomplete removal of caries to avoid pulp exposure
  • Commonly known as “indirect pulp cap”
  • Primarily affected vs infected dentin remains
246
Q

______% reduction in pulp exposurs regarding Partial Caries Removal vs complete caries removal…

A
  • 98%
  • Results in a reduction of postoperative pulpal symptoms
247
Q

Describe the 4 “Extents” of caries accoridng to the CCS…

A
  • Sound
  • Initial
  • Moderate
  • Advanced
248
Q

What does resarch suggest about the best type of margin to place for a veneer?

What had the most fractures?

A
  • Butt joint margin had highest strength
  • Chamfer prep had most veneer fractures
249
Q

Indications for a Direct Pulp Cap?

A
  • Asymtomatic, vital pulp
  • Traumatic pulp exposure
  • Iatrogenic/Mechanical Pulp exposure
  • Young patient vs elderly
250
Q

What are some appearling qualities to an Endo-crown/Endo Onlay?

A
  • Conservative approach to restoring endo-treated teeth
  • Utilize pulp chamber for adhesive retention
  • Maintains maximum tooth structure in the cervical third of the tooth
251
Q

What are you doing when you are “Polishing” a composite?

A
  • Shine
  • Luster
  • Gloss
  • Enhanced Light Reflectance
252
Q

Describe the Jordan & Boksman Classification of Tetracycline Staining…

A
  • Frist degree - light stain, no banding
  • Second degree - dark stain, no banding
  • Third degree - any stain with banding
  • Fourth degree - severe banding
253
Q

Tooth whitening has been known to cause what to the pulp?

A

Reversible pulpitis; no irreversible pulpal effects reported in studies

254
Q

What is the pH of Calcium Hydroxide?

A

11

255
Q

How many ppm in 5% NaF Varnish?

A

22,600 ppm

256
Q

Indications for Single Envelope Flap…

A
  • Lesions estending past line angles
  • Lesions on adjacent teeth
  • Intrasulcular incision
  • Etending to distal line angles of involved teeth
257
Q

Describe Mylar Matrix System…

A
  • Lacks ridgidity
  • Difficult wedging
  • Transparent
  • Can’t burnish
  • Contact difficult
  • Really thick: 0.75 mm
258
Q

What is a chemical pre-treatment for metal alloys and Zirconia?

A

Air-abrasion w/50 micon alumina particles

259
Q

At what distance do you want to place a cavity liner like Dycal/Vitrabond?

A

< 0.5 mm

260
Q

How does bleaching effect enamel and dentin?

A

Bleaching products induce clinically insignificant alterations to enamel & dentin

261
Q

What is the success rate of Feldspathic Veneers?

Non Feldspathic?

A

96% at 20 years (Meta-analysis)

Non Feldspathic = 90% at 5 years

262
Q

When you use this, what are you doing?

A
  • Chromatic layering
  • Varying opacities of Vita Based Shades
263
Q

How does Erosion happen as a NCCL?

A

Chemical Dissolution of Tooth

  • Dietary: lemon sucking, citric acid drinks, acidic drinks
  • Endogenous: gastic reflux, eating disorders
  • Environmental: batter plant, swimmer
264
Q

What are the Reduction depths for Veneer Preparations?

A
  • 0.3 mm gingival
  • 0.5 mm midfacial
  • 0.7 mm incisal

*Use depth cuts!*

  • Use mock-ups to preserve enamel
265
Q

What is the Etiology/Predisposing Factors of Cracked Tooth Syndrome?

A
  • Large restoration
  • Bruxism
  • Trauma
266
Q

What does the Evidence say about Fluoride?

A
  • F gel effective in caries prevention
  • No benefit to F gel in low caries risk
  • Evidence support 4 min application
  • F varnish q 6 months effective caries prevention
  • 2+ F varnish applications effective for high risk
267
Q

What is the chemical of choice when performing non-vital bleaching?

How do you apply it?

A
  • Sodium Perborate/water
  • Slurry into chamber (wet sand consistency)
  • Clean access opening margins
  • Palce interim restoration (Cavity, IRM, Flowable Composite)
268
Q

Describe “Moderate” in regards to exent in the CCS…

A
269
Q

What are some Disadvantages to placing Posterior Composites?

A

Technique Sensitive

  • 35% more placement time
  • Meticulous operative procedure
  • Isolation critical
  • Polymerization Shrinkage (1-6%)
  • Decreased Wear Resistance
270
Q

What type of discoloration is Fluorosis?

A

Intrinsic Pre-Eruptive

271
Q

What is the degree of failure for veneers when bonding to dentin vs enamel?

A

10x greater risk of failure!

272
Q

What are Disadvantages of Incremental Fill?

A
  • May actually increase stress in tooth
  • Due to incremental buildup of cuspal deflection and subsequent stress
  • Potential for incorporation of voids
  • Takes time
  • Microleakage not significantly better, regardless of filing technique
273
Q

What are examples of cavity liners?

A
  • Calcium Hydroxide
  • Vitrebond
274
Q

Why do Color Mock Up?

A
  • Verify color match to adjacent teeth
  • Trial Run
  • Uses silicone putty matrix
  • Compoisite layered without bonding resis
275
Q

What is critical in success of parital caries removal?

A

Seal of restoration is critical to success

276
Q

When do you bevel the gingival margin of a slot prep?

A

Only if wide band of enamel present

277
Q

Describe the Incisal But Joint regarding Veneer Preparation…

A
  • Most indicated design
  • Allows alteration of incisal edge
  • Most resistant to veneer fracture
278
Q

What are 4 etiological factors for White Spot Lesions?

A
  • Fluorosis
  • Pre-Eruptive Trauma
  • Demineralization associated with early caries
  • Post orthodontic bracket removal
279
Q

What are some examples of Micro Esthetics on a central incisor?

A
280
Q

What is the rule of “two’s”?

A
  • 2 mm of pin in dentin
  • 2 mm of pin in amalgam
  • 2 mm of amalgam above the pin

*Need 4 mm of cuspal reduction to place pin!*

281
Q

What is the MPa strength of Stacked Feldspathic Veneers?

A

110 - 150 MPa

Opaque, dentin, body, incisal porcelains

282
Q

How is Glazes/Polished EMAX/Zirconia to opposing occlusion?

A

Similar to enamel for opposign wear

283
Q

When is a crown indicted for the Anterior?

A
  • Inadequate remaining coronal tooth structure
  • Missing/carious marginal ridges
  • FDP/RDP abutment
  • Unaccpetable esthetics
284
Q

What are Diamond Finihsing Strips good for?

A
  • Great for removing overhangs cervically
  • Much more aggressive than Al02 polishing strips
285
Q

What are preferred areas for pins?

A

Line Angles

286
Q

How many ppm does it take for Fluorosis to manifest?

A

Fluorid exposure exceeds 1-2 ppm

287
Q

How do you define a normal lip legnth for male/female?

A
  • Females: 20-22 mm
  • Males: 22-24 mm
288
Q

What are some techniques when placing interproximal composites?

A
  • Condense with instrument lightly wetted with resin adhesive
  • Cure from B and L toward margins, 40 seconds
  • Careful control of final increment will minimize final adjustments
  • If metal matrix is used, remove and cure from B & L
289
Q

Repairing, recontouring, refurbishing amalgams and composites is a viable option and comparable success to replacement restorations… T/F?

A

True!

Therefore repairing can be a more conservative option with equal clinical success

290
Q

What are some landmarks to consider when assessing the Midline?

A
  • Parallel to facial midline
  • Coincident with Cupid’s bow
  • Within 2-4 mm of facial midline
291
Q

What is the MPA strength of Empress?

A

160 - 182 MPa

Leucite Reinforced

292
Q

What is unique angulation of the long axis of teeth in the esthetic zone?

A

Distal inclination of long axis

293
Q

What has more compressive strength, Amalgam or Composite?

A

Amalgam > Composite

Clinically not as significant…

294
Q

What is the problem with using the Open Sandwhich technique interproximally?

A
  • Problem with wahout longer-term
  • Minimize gingival increment to 1mm
295
Q

What are some Contraindications to bleaching?

A
  • Dark gray or black discoloration
  • Multiple/large anterior restorations
  • Unrealistic patient expectations
  • Known allergies to bleaching agent
  • Pregnant or nursing patient
296
Q

What is Sensitivity?

A
  • Percentage of patiets with the disease that receive a positive result
  • Percentage chance that the test will correctly identify a person who actually has the disease
297
Q

10% Carbamide Peroxide = ? Hydrogen Peroxide?

A

3%

298
Q

35% Caramide Peroxide = ? Hydrogen Peroxide?

A

10%

299
Q

What is a recommended bonding agent for cementing veneers?

A
  • 3 step etch & rinse (Optibond FL)
  • Omit primer if bonding to all enamel
  • Carefully thin to avoid pooling and light cure adhesive prior to cementation
300
Q

What are some examples of Intrinsic Pre-Eruptive Genetic conditions?

A

Genetic

  • Dentinogenesis Imperfecta (hereditary opalescent dentin)
  • Amelogenesis Imperfecta
301
Q

What are some examples of Finishing & Polishing Instruments?

A
  • Diamone & Carbid burs
  • Scalpel blades
  • Flexible polishing disks
  • Abrasive polishing points & cups
  • Metal & plastic finishing strips
  • Polishing pastes
302
Q

What has the latest systematic review said about Pit and Fissure sealants?

A
  • Sealants effective in preventing/arresting PF caries of pirmary/permanent molars - 76% reduction in caries incidence
  • Sealants effective in minimizing progression of non-cavitated occlusal caries
  • Sealants more effective than F varnish for preventing/arresting PF caries - low quality evidence
  • Unable to make recommendations on choice of sealant material
303
Q

How does Coefficient of Thermal Expansion of composite compare to that of tooth structure?

A

Composite 4x tooth structure

304
Q

For anterior composites, does beveling matter?

A

Beveling of enamel margins had no significant influence

305
Q

What have studies concluded regarding pulpal reponse with deep cavities receiving CaOH vs RMGI?

A

Conclusion: No conclusive statement about the superiority of either type of material can yet be made

306
Q

What determines success of Direct Pulp Cap?

A
  • Degree of bacterial contamination
  • Indirect pulp caps preferable to direct pulp caps
  • 96% successful in traumatically fractured teeth with open apex
  • 85% successful for indirect pulp cap and 75% for indirect pup cap at one year
  • 80% failure of carious exposures tx’ed with direct pulp caps at 10 years
307
Q

What are some Disadvantages of a Traditional Mylar Matrix?

A
  • Wedne needed
  • Mylar strip very stiff/thick
  • Difficult to achieve tigh contact
  • Difficult to establish cervical contour
308
Q

What is the success rate relativ eto complete caries removal?

A
  • Equal
  • Dentin is remineralized/caries is arrested
  • Success predicated on achieving adequate seal
309
Q

Describe TheraCal as a Pulp Capping Agent…

A
310
Q

When do you place a post in an anterior tooth?

A
  • Prepare anterior tooth first, and then make the decision whether there is enough tooth structure left. If not, then place a post
  • Anterior teeth function very differenlty from posterior teeth
  • Forces are typically lateral shearing type forces
311
Q

When would you not treat a NCCL?

A
  • Shallow NCCL
  • Not an esthetic concern or symptomatic
  • Tx limited to preventive education
312
Q

What is the function of a cavity sealer?

A

Provide protective coating for fresh cut dentin

ie: Varnish/Dentin Bonding Agents

313
Q

Low specificity leads to…

A

High false positives

Overtreatment

314
Q

Why use Calcium Hydroxide (Dycal) as Direct Pulp Cap?

A
  • Anti-bacterial (high ph = 12.5)
  • Long term tract record of success
  • Stimulates release of bioactive molecules which stimulate odontoblasts
  • Soluble/poor seal/tunnel defect in dentinal bridge
315
Q

Describe the “Lesion Activity” according to the CCS…

A
  • Inactive or arrested
  • Active

Examples:

  • # 19 O, P & F, Adv, Active
  • # 3 F, Cervical, Mod, Arrested
316
Q

What % F is in Silver Diamine Fluoride?

What is the zombie effect?

A
  • Bactericidal
    • 38% Fluoride (44,800 ppm)
    • 25% Silver particles
  • Zombie Effect
    • Silver particles remain in dead bacteria which kills consuming bacteria
317
Q

What are some Diadvantages of Porcelain Veneers?

A
  • Preparation required; irreversible/invasive procedure
  • Limited ability to mask staining
  • Technique sensitive
  • Fragility prior to cementation
  • Lab fees/interaction, multiple appointments, espense
  • “Costmet” dentists charging $1000 - $2000/tooth
  • Resin margins, usual site of eventual breakdown
318
Q

What are you accomplishing when you are “Finishing” a composite?

A
  • Margination
  • Contouring
  • Smoothing
319
Q

What % of H202 is used for Vital Bleaching?

A

3-10%

320
Q

What is the new required occlusal thickness for Ivoclar E.MAX preps?

A
  • Flexural Strength = 500 MPa
  • 1 mm occlusal thickness required (not 1.5)
321
Q

Contraindicaitons for Veneers…

A
  • Extremely dark tooth discoloration
  • Lack of enamel
  • Severe bruxism/anteiror wear
  • Patient desires revesible procedure
  • Cost issues
  • Severe crowding
  • Heavily restored teeth
  • Caries active patient
  • Deciduous teeth
322
Q

How much F is in ACT?

A

.05%

323
Q

When comparing Non-Invasive, Micro-Invasive, and Minimally Invasive tx, what have Systematic Reviews said?

A
  • Micro-invasive tx (PFS) efficacious in preventing invasive retreatment but required “other retx” (resealing) more often than non-invasive or minimally (slots, PRR,) invasive tx options
  • Non-invasive tx better than control for avoid invasive treatment
  • Micro-invasive better than non-invasive for avoiding invsaive retreatment
324
Q

How many mm of gingival display should show in full smile?

A

0-2 mm

325
Q

What are some post/core indications in pre-molars?

A
  • Uniquely subject to both vertical and shear forces

Post indicated when:

  • The remaining coronal tooth structure is inadequate ( < 3 remaining walls)
  • Group Function
  • Tooth serves as an RDP abutment
326
Q

What are the 2 purpose of a post?

A
  • Retain core material
  • Redistribute lateral forces along long axis of root
327
Q

What are bases?

A

Dentin replacement materials

ie: Zinc Oxide Eugenol, Zinc phosphate cement, glass ionomer

328
Q

How many microns are the red/yellow/white diamond finishing burs?

A
  • Red: 30 micron
  • Yellow: 15 micron
  • White: 8 micron
329
Q

Describe HO Bands…

A
  • Thin .001
  • Dead Soft
  • Easily burnished
330
Q

What does Carbopol do regarding Vital Bleaching?

A
  • Acidic thickening agent
  • Increases active peroxide releasing time 1-3 hours
331
Q

What types of burs should you use to “finish” composite?

A

Multi-fluted carbides & micron diamonds

  • Used to contour and marginate restoration
  • Inherently cause damage to matrix
  • Contours should be achieved in unpolymerized material
  • Micron diamonds cause less damage than carbides but leave a rougher surface
  • Light pressure, brush strokes
332
Q

Describe your surgical techique for a Gingival Miniflap?

A
  • Incision starts at line angles
  • At right angle to free gingival margin
  • 2nd incision directed apically
  • Confined to attached tissue
  • Full thickness
  • Usually doens’t require sutures
333
Q

Describe the CAMBRA Protocol for Extreme High Caries Risk Patients?

A
334
Q

Describe how to Provisionalize Veneers…

A
  • Vacuum formed stent from wax-up
  • Spot etch
  • Fill stent with resin (Integrity)
  • Spot cure/remove stent
  • Trim
  • Polish
335
Q

Regarding Prefab Posts, what are 3 types of Metallic Posts?

A
  • Passive Tapered
  • Passive Parallel
  • Active
336
Q

What are 3 factors to consider when repairing a restoration?

A
  • Carisk risk status
  • Size and location of the defect (will increase 71-75% surface area if replaced)
  • Access (69% of adjacent tooth surface damaged during preparation)
337
Q

How do you prep for an Amalgampin?

A
  • Round end/pear shaped bur
  • 0.8 - 1 mm in diameter
  • Prepared in dentin
  • 1.0 - 2.0 mm deep
  • Parallel external surface of tooth
  • Bevel at cavosurface margin (Use #8 round bur)
338
Q

When would you want to do an Open Sandwich Technique Interproximally?

A
  • Use RMGI (Fuji II LC) when cerivcal margin in dentin or within 1 mm of CEJ
339
Q

What is Color Mapping?

A

Used to diagram and record selected shades

340
Q

What is the critical period of exposure of Fluoride?

A

1-4 years of age

341
Q

Incisal plane should parallel horizon of the _____ ____

A

Interpupillary Line

342
Q

What veneers are “stacked” what material are they most likely using?

A

Feldspathic Porcelain

Platinum foil technique/Refractory die

343
Q

What are 2 types of Etch & Rinse Adhesives?

A
344
Q

Descrive the appearance of Abrasion NCCLs…

A
  • Smooth, shiny - sclerotic
  • Relatively distinct margins
  • Various depths
345
Q

The ADA recently came out with some guidance for nonrestorative treatment for caries. What are the main 2 guidelines they have set?

A
  • 5% Fluoride varnish primary treatment for non-cavitated lesions
  • 38% Silver Diamine Fluoride primary treatment for cavitated lesions
346
Q

Advantages of MI Paste…

A
  • Increses calcium and phosphate ions in saliva and dental plaque to enhance remineralization of enamel
347
Q

How does fracture toughness compare between Amalgam and Composite?

A

Amalgam = Composite

Most clinically significant physical property

348
Q

What are some treatment options for Cracked Tooth Syndrome?

A
  • Cuspal Coverage Amalgam
  • Crown
  • Endo
  • Extraction
349
Q

What are some indications for pins?

A
  • Extensive loss of tooth structure
  • Insufficient coronal dentin remaining to provide retention
  • Insufficient remaining heigh of pulp chamber (4 mm)
  • Antirotational feature with posts
350
Q

What colors can Fluorosis present as?

A

White, yellow, brown, or black

351
Q

What chemical has been known to cause Cervical Resorption in Non-Vital Bleaching Cases?

A
  • 30% H202 (Hydrogen Peroxide)

Etiology

  • Unknown
  • Diffusion of H202 , heat, trauma
352
Q

What are some Etiologic Factors for Excessive Gingival Display?

A
  • Facial Height
  • Lip Length
  • Lip Mobility
  • Gingival Line
  • Tooth Length
  • Location of CEJ
353
Q

Describe an Incisal Chamfer in regards to a Veneer Preparation…

A
  • Most likely to cause veneer fracture
  • Indicated when incsial edge alteration needed & butt joint would end in MI contact area
354
Q

With patient who are low and moderate caries risks, what has research suggested about repair versus replacing class 1 versus class 2 amalgam restorations?

A

Conclusion: “Repaired and replaced amalgam restorations showed SIMILAR SURVIVAL OUTCOMES regarding marginal defects and secondary caries in patients with low and mediuim caries risk”

355
Q

What are the effects of Calcium Silicate Cements on Dental Pulp Cells?

A
  • ALL commercially available CSCs are biocompatible
  • ALL exhibit comparable and favorable effects on dental pulp cells
  • No specific CSCs can be recommended
356
Q

What are some advantages of a Sandwhich Technique?

A
  • Chemical bond to tooth
  • Chemical bond to resin
  • Antiariogenic effects
  • Volume reduction of resin
357
Q

How does dentinal thickness relate to pulpal reaction?

A
  • 0.5 mm of RDT reduces toxicity to 75%
  • 1.0 mm of RDT is 90% protective
  • 2.0 mm of RDT produces minimal pulpal reaction
  • Problem: difficult to determine RDT intraoperatively

***DENTIN IS YOUR FRIEND!***

358
Q

Describe the Resin Infiltration Clinical Technique?

A
359
Q

What does Trolamine do regarding Vital Bleaching?

A
  • Neutralizing Agent
  • Improves bleaching by inhibiting salivary peroxidase
360
Q

What are Flexible Discs used for ideally?

A
  • Ideal for smooth/flat surfaces (labial)
  • Silicon carbid or aluminum oxide
  • Soft/flexible or thin/rigid plastic backing
  • Thin rigid disks for interproximal embrasures
  • 4 disks of varying gritsused in sequence
361
Q

What does the evidence say about Xylitol?

A
  • Low quality evidence to suggest that F toothpaste contain xylitol may be more effective than F only toothpaste for preventing caries
  • Low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries
362
Q

How long will pit and fissure sealants IN COMBINATION with small composite restorations arrest caries for?

A

10 years

363
Q

What are some Indications for Enamel Microabrasion?

A
  • Enamel fluorosis: especially brown lesions
  • Superficial enamel hypoplasia or hypocalcification
  • Lesion less than 200 microns in depth
  • Most brown defects
  • 25-50% of white lesions are too deep
364
Q

What extent of caries can you use Icon?

A
  • Interproximal (up to D1)
  • Contraindicated for D2 lesion or greater
  • White spot smooth surface (in enamel only)
365
Q

Why use MTA as Direct Pulp Cap Agent?

A
  • Release CaOH
  • Similar advantages to Dycal
  • Provides better seal
  • Long setting time
366
Q

What does CAMBRA stand for?

A

CAries Managment By Risk Assessment

367
Q

4 reasons to Choose CEREC…

A
  • Low caries risk
  • Equal or Supra-gingival margins
  • Favorble occlusion
  • Favorale tooth alignment
368
Q

What is this condition?

A

Tetraycline Staining

369
Q

What should your preference of porcelain be in regards to translucency?

A

Low Translucency

370
Q

What has the latest Systematic Review found regarding Fluroide varnish application?

A
  • F varnish effective for arresting enamel lesions in primary/permanent teeth
  • 4 applications at weekly intervals or 2 applications over 4 months were effective
371
Q

Describe a Conservative Adhesive Prep?

A
  • No reverse s-curve
  • Rounded internal line angles
  • Occlusal width 1/3 ICD
  • Avoid centric stop
372
Q

What are the typical Bleaching Agent Concentraiton in At Home Bleaching?

A
  • H202: 10 - 15%
  • Carbamide Peroxide: 10 - 35%
373
Q

What are your restorative options for treating a NCCL?

A
374
Q

What are some material factors that affect success for Class V Lesions?

A
  • MOE
  • C-Factor
  • Prep Design (Bevels)
  • Choice of adhesives
  • Polymerization stress
  • Difficult Isolation
375
Q

Describe the CAMBRA Protocol for Moderate Caries Risk…

A
376
Q

What is the average length of a Central Incisor?

A

10.5 - 11.5 mm

377
Q

What are 4 benefits of using Vitrebond?

A
  • F release
  • Remineralizes dentin
  • Bonds to tooth and resin
  • Minimal basing concept

*No need to cover all exposed dentin*

378
Q

How does Tetracycline cause staining?

A
  • Chelates with Ca++ in hydroxyapatite to form TCN - orthophophate
  • Discoloration changes from yellow to gray upon photo-oxidation by exposure to sunlight

Operative ABGD Oral Boards (2 decks)

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