Amalgam-Kaur

Question 1

Amalgam History

Answer 1

• Metallic restorative material
• Composed of:
  
  • Silver
  • tin
  • copper alloy
  • mercury
• Primary restorative material for >150 years
• Safe for use in dentistry

Question 2

Amalgam Restorations today

Answer 2

• Decreased Popularity due to:
  
  • reduced caries rate and increased esthetic concerns (MAIN)
  • not preferred to due more tooth structure removed
  • enviromental concerns
• Still a preferred material due to chance of secondary caries under composites
• Safe Restorative material

Question 3

Types of Amalgam?

Answer 3

• low copper
• high copper
• Admixed
• Spherical

Question 4

Amalgam Restoration: General Rules

Answer 4

Tooth prep:

• uniform minimum thickness for strength
• 90 degree amalgam angle at margin
• mechanically retained to tooth

Not followed-dislodge or fracture

Question 5

Amalgam Indications:

Answer 5

• Occlusal Factors
  
  • heavy occlusal functioning
  • Full occlusal coverage
• Isolation factors:
  
  • when isolation is an issue
• Operator ability & commitment factors:
  
  • prep requirements
  • but restoration is easier

Question 6

Amalgam contraindications:

Answer 6

• Allergy-alloy components
• Esthetic area
• When composite resin offers better sonservation of tooth and equal clinical performance

Question 7

Amalgam Advantages:

Answer 7

• Ease of use
• High compressive strength
• Excellent wear resistance
• Cost effective
• User friendly
• Self sealing
  
  • corrosion products–> self seal and reduce microleakage

Question 8

Amalgam Disadvantage

Answer 8

• Non-insulating
• Non esthetic
• Less conservative
• More difficult to prep tooth
• Initial marginal leakage

Question 9

Preparation mindset

Answer 9

Lesion driven

Question 10

Directinon of Enamel Rods:

Answer 10

• Thickness of enamel/dentin
• Size and position of pulp
• relationship of tooth to supporting tissue

Question 11

Enamel

Answer 11

• Hardest in the body
• highly mineralized
• mainly composed of hydroxyapatite crystals and water

Question 12

Dentin

Answer 12

• Tissue that lies between enamel/cementum and pulp of tooth
• consists of an organic matrix
  
  • where mineral salts are deposited

Question 13

Cementum

Answer 13

• Thin layer of calcified tissue
• covers dentin of the root

Question 14

Hatchet:

Answer 14

1mm edge

Question 15

Different ways of isolation in dentistry?

Answer 15

• Rubber Dam
• Retraction cords
• Cotton rolls/Gauze
• Celulose wafers
• Retractors
• Some drugs (Atropine)
• High volume excuators and saliva suction

Question 16

330 burr

Answer 16

• Blade length (Shank)
  
  • 1.5-1.8 mm
• Pear shaped
  
  • helps in retention form
• Rounded corners
  
  • resistance form

Question 17

When is amalgam weak?

Answer 17

• Think sections
• Sharp angles

Question 18

Cavosurface angle of amalgam preps?

Answer 18

• 90 degress to allow sufficient bulk of material at margin

Question 19

Amalgam Prep requirements

Answer 19

• Optimize strenght of restoration
  
  • bulk material
  • cavosurface margin=90 degress
• Protect tooth structure:
  
  • mesial/distal walls divergent
• Retentive factorss
  
  • buccal/lingual walls convergent
• Depth:
  
  • 1.5-2mm

Question 20

Purpose of retentive grooves in amalgam prep?

Answer 20

• Increase retention and resistance
• Increase fracture resistance
• Counter proximal displacement

Question 21

Goals of Condensation

Answer 21

• adapt to prep
• create dense mass without porosity
• minimal mercury in final restoration
• Reduce marginal leakage
• enhance marginal integrity
• decreasing corrosion

Question 22

Condensation pressure applied

Answer 22

• 8-10lbs

Question 23

Rubber dam isolates?

Answer 23

• Saliva
• Tongue
• Mandible
• Lips and Cheeks
• Gingival Tissue
• Buccal and Lingual Vestibule
• Floor of the mouth
• Adjacent teeth and restorations
• Respiratory moisture

Question 24

Rubber dam: How does rubber dam help?

Answer 24

• Retracting and better access
  
  • retract soft tissue
  • provide access and visibility
• Moisture control
  
  • saliva, blood, cervicular fluid
• Prevents harm
  
  • spray, debris, small items

Question 25

Ticker vs Thinner Dams

Answer 25

• Thicker
  
  • retracting tissue
  • most resistant to tearing
  • Class V lesions
• Thin:
  
  • tight contacts

Question 26

When should we use rubber dam?

Answer 26

Most restorative procedures:

• quadrant dentistry
• Teeth with hard preps
• Teeth that are hard to isolate
• Difficult patients

Question 27

When should we not use rubber dam?

Answer 27

• partial erupted anchor teeth
• Malpositioned teeth
• latex allergy (latex free available)
• Severe patient phobias
• Asthma
• Mouth Breathers