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Resto > Cavity design (3) > Flashcards

Cavity design (3) Flashcards

1
Q

Pathologic dental cavity:

A

Cavity in the tooth produced by a congenital, traumatic or pathological
processes.

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2
Q

Therapeutic cavity:

A 
Artificial cavity shaped into a tooth, to later build it up with the correct materials and techniques, in order to restore the anatomy,
function and aesthetics.
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3
Q

Extensions.

Objetives

A

specific preparation to accomplish a goal

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4
Q

Extension for caries prevention? (3)

A
  • First way to remove cavitie
  • we dont do it anymore
  • remove all the fissures even they are not affected
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5
Q

Extension for caries prevention: Nowadays

A

So we leave the unaffected fissures

Only if the surrounding tissues are defective or affected.

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6
Q

Extension for support:

A

we extend the cavity for support

  • if the caries is deeper, we just remove the caries where it is
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7
Q

Extension for retention

A

To provide mechanical lock or retention

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8
Q

Extension: amalgam (2)

A
  • for retention because does not bind to the tooth

- Converge slightly pulp-occlusally. Depth > width

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9
Q

Extension: composite

A

Composite: Adhesion (bonding to enamel better than dentin).

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10
Q

Do we need extension for composite?

A

No it sticks without

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11
Q

Bevel

A

rough the surface

For a better adhesion and aesthetics

Increase the surface etching, remove fragile enamel, expose the head of the prisms,
hide tooth restoration junction. Flat, concave, mixed

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12
Q

Extension for resistance of the material:

A

Avoid fracture of the material. Extend the margins of the cavity beyond the contact point with the antagonist tooth.

if the preparation is too thin and the preparation might break, so we have to extend the preparation a bit more

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13
Q

Extension for resistance of the teeth:

A

To avoid fracture of the remaining tooth. To resist structural failure from occlusal loading stresses. Fragile walls must be removed if mechanical conditions are not positive.

same if the tooth is too thin, so the wall is too thin, there might be a fracture, so always protect the cusp, the top of the cusp in order to protect the wall

cusp protection

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14
Q

Extension for convenience:

A

Ensure access for instrumentation, removal of defective tooth structure, insertion and finish of the restorative material.

Make the obturation easier
sometimes we have to extend the obturation to reach the caries better, if we leave it we cannot clean the caries

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15
Q

Protection of the dentin-pulp

complex:

A

Restrict depth. Axial angle more rounded to prevent pulp exposure.

During a preparation we always have to think about the pulp, always make it more round around

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16
Q

Extension for aesthetics:

A
  • bevel

- access from lingual

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17
Q

What is bevel?

A

anrauen

for the aesthetics we have the bevel (on buccal and palatal walls)

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18
Q

From where do we do the acess?

A

Access from lingual

we always do bevels when we do restauration on the anterior teeth, when we have caries on the frontal tooth, its down the contact point, we clean the surface from palatal

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19
Q

cavity elements:

A
  1. boxes
  2. walls
  3. angles
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20
Q

Boxes:

A

Well-defined spaces in the cavity that retain the material.

ex. amalgam

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21
Q

How is it called when there is more than one box?

A

Their union is calles Isthmus

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22
Q

Walls

A

Side or surface of the cavity preparation that encloses the restorative material.

around the box there is the wall, they get the name where its close to

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23
Q

How is the wall called that is close to the pulp?

A

Pulp wall or floor of the cavity/ axial wall

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24
Q

Angles

A

Where the cavity wall meet

  • Confluence of the cavity walls.
  • They can be dihedral or trihedral: line or point.
  • They take the name of the walls that form it.
  • The angle of the tooth formed by the junction of a prepared wall in the cavity and the intact tooth surfaces (outline) is called cavosurface line angle.
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25
Q

Classification

A
  1. material
  2. area
  3. location
  4. Etiology (blacks classification)
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26
Q

1.Material

A
  1. plastic
  2. rigid
  3. adhesive
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27
Q

What do we understand by plastic?

A

retentive shape. Amalgam.

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28
Q

What do we understand by rigid?

A

obturation that are made by the lab

expulsive shape, indirect technique

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29
Q

What do we understand by adhesive?

A

Obturation we shape in the special way

minimal shape, composite resins

30
Q

Area

A

According to the sides of the tooth affected (number
of surfaces affected):
just the number that is affected

  1. simple
  2. compound
  3. complex
31
Q

Whats a simple area?

A

those which occur on one surface of the tooth.

32
Q

Whats a compound area?

A

two surfaces of the tooth involved.

33
Q

Whats a complex area?

A

three or more surfaces involved.

34
Q

location

A

according to the name of the surface affected

35
Q

Whats a simple location?

A

occlusion

36
Q

Whats a compound location?

A

mesio occlusal

its just compound when the cavity join together

37
Q

Whats a complex location?

A

Mesio- occlusal- distal

38
Q

Etiology (Black`s)

A

Class I- VI

39
Q

Whats class I

A

pits and fissures

40
Q

Whats class II?

A

Proximal surfaces of posterior teeth

just for posterior teeth

41
Q

Whats class III?

A

Proximal surfaces of anterior teeth, does not involve the incisal edge.

42
Q

Whats class VI?

A

Proximal surfaces of anterior teeth involving the incisal edge.

43
Q

Whats class V?

A

Gingival third of facial or lingual surfaces

buccal or lingual but just on the surfaces

44
Q

Whats class VI?

A

Incisal edge of anterior/ cusps of posterior teeth

45
Q

Initially (Black’s):

A
  • Caries was an aggressive process.
  • The action of fluoride or other prevention mechanisms was not known.
  • Restoration materials and instruments were limited.
  • The lesions were classified in 5 according to the location, without taking into account the size and difficulty.
46
Q

Basic principles in cavity design:

A
  • Remove tooth structure to improve access and visibility.
  • Remove all traces of affected dentin.
  • Open space to insert the restorative material.
  • Improve mechanical retention elements.
  • Extension of the cavity to self-cleaning areas to prevent recurrent caries.

Result: excessively large cavities

47
Q

Current situation:

A

it would be good to do a saliva test, when they still have caries, also mouth breather

  • Caries is a more controlled process.
  • Importance of early diagnosis and early treatment.
  • Knowledge and use of mechanisms of remineralization and prevention.
  • More and better restoration materials and instruments.
  • Adhesion to enamel and dentin.
48
Q

Current situation. Basic principles in cavity design:

A

It is not necessary to eliminate all unsupported enamel.
It is not necessary to remove the affected (non-infected) dentin.
End of the concept of extension to self-cleaning areas.

minimally invasive dentistry

49
Q

Operative methodology

objective

A
  • Replace the lost dental structure.
  • Cavity sealing: perfect adaptation to the dental structure. Prevention of recurrent caries.
    (that bacteria dont leak if we get a good seal, so the bacteria that are down will not grow)
  • Restoration: anatomy, function and aesthetics.
    (ex. if its a grinder, doesnt make sense to do a good anatomy)
  • Remaining tooth’s protection: avoid fracture.
  • Protection dentin-pulp complex: dentin tubules sealing. Biocompatible materials.
    (we want contact points that the food doesnt go through but we can still go through with the dental floss in order to clean)
  • Periodontal protection: good adaptation and contacts.
50
Q

Steps in cavity preparation:

Previous steps

A

ex. if we have an inflammed gum, treat the gum first

  • Cleaning and disinfection of the oral cavity. Anesthesia if necessary.
  • Assessment of the specific characteristics of the tooth: Reach the cavity.
  • Limits in the cavity.
51
Q

Steps in cavity preparation:

A
  • Cavity preparation (Opening and conformation).
  • Isolation.
  • Restoration.
  • Modeling.
  • Finishing
  • Polishing.
52
Q

I- Cavity preparation:

A

Different according to the material used.

  1. Opening
  2. Conformation:
    - External cavity shape.
    - Internal cavity shape.
    - Use of special forms of retention
53
Q

Cavity preparation: conformation

External shape:

A

always follow the cavity ex. if the caries is in the fissure, just follow the fissure but not go straight

Objective: Define the preparation, following the anatomical contour of the tooth.

Extension for prevention

The margin should not coincide with enamel defects and functional occlusal contact points.

54
Q

Cavity preparation: Conformation

Internal shape:

A 
Objectives: remove all the injured tissues
.
Make sure:
- Stable and long-lasting restoration. 
(we have to make the floor flat)
  • Prevent fracture of tooth and the material. - Prevent the recurrence of the disease.
  • Prevent the loss of pulp vitality
55
Q

Internal shape:

Cavity DEPTH

A
  • Use x-ray.
  • The necessary, avoid weakening the tooth. - Supported by healthy tissues.
  • Beware of the anatomy of chamber and pulp horns.
  • Avoid iatrogenesis.

(depends on how much the cavity is affected by the caries, when we accidentally expose the pulp = iatrogenic)

56
Q

Internal shape:

cavity FLOOR

A
  • Proximal boxes (gingival floor) flat to prevent rotation or displacement of restoration material. Flat surface.
  • Perpendicular to the axis of the tooth.
  • Perpendicular to the direction of the chewing forces.
57
Q

Internal shape

Cavitary walls:

A

Cavitary walls:

• Remove all the affected tissue and facilitate access, instrumentation and insertion of the restorative material.

58
Q

Internal shape

Internal angles:

A

Internal angles:

Rounded to decrease tensions.

59
Q

Isolation

A
  • complete: rubber dam
  • relative: cotton rolls

Cavity cleaning with water or chlorhexidine
which is good cause we get a better adhesion

60
Q

Restoration

A
  • Replacement of the lost tissues: Artificial dentin. Artificial enamel.
  • Restoration of: anatomy, aesthetics, function.
61
Q

Steps in cavity restoration

A
  • Insert and adapt material (composite resins: 2 mm. Incremental technique.)
  • Specific instruments.
  • Polymerization or setting time.

dont touch all the wall of the tooth with the same layer

62
Q

Modelling

A
  • Configuration required to allow the restoration to restore health, function and aesthetics.
  • Not only in occlusal surfaces.
  • Materials: brushes, spatulas, plastic instruments.
63
Q

Finishing

A

Remove excess of material.

Amalgam: manual.
Resins: Rotary instruments

64
Q

Polishing

Objektive:

A

Smooth and polished surfaces. Prevent bacterial plaque retention. Uniform light reflection.

65
Q

Polishing

Instruments

A
  • Fine and extra-fine diamond burs (red, yellow, white ring).
  • Turbine tungsten burs.
  • Polishing discs (anterior), rubber burs. Brushes and pastes.
66
Q

What should we avoid during polishing?

A

Avoid heat: Irrigate!!!!

67
Q

What colour do the polishing burs have?

A
  • pink
  • green
  • blue
68
Q

What kind of burs do we use for the cavites?

A

Diamand burs

69
Q

What colour of disks do we have?

A
  • blue
  • green
  • yellow
  • white
70
Q

What steps do we have to follow in cavity preparation?

A 
1. cavity preparation
2- Isolation
3. Restoration
4. Modelling
5. Finishing
6 Polishing

Resto (9 decks)

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