Chapter 3 B: Class I And II Cavities For Amalgam Restorations Flashcards

1
Q

Since when has amalgam been used in dentistry?

A

1826

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2
Q

The basic principles of tooth preparations are?

A
  1. Initial tooth preparation
  2. Final tooth preparation
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3
Q

Initial tooth preparation is:

A
  1. Outline form
  2. Primary resistance form
  3. Primary retention form
  4. Convenience form
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4
Q

Final tooth preparation is?

A
  1. Management of remaining caries
  2. Secondary resistance and retention forms
  3. Pulp protection if required
  4. Finishing of enamel margins
  5. Final inspection of the preparation
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5
Q

Extension for prevention is ?

A

All deep pits and fissures within 0.5mm of the cavity should be included

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6
Q

When would you join two cavities into one instead of making two separate preparations?

A

When the thickness of the wall between the two cavities is less than 0.5mm

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7
Q

Where should we avoid ending cavity margins?

A

In high stress areas such as cusp tips and crest of the ridges

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8
Q

The outline form means

A

Extending the preparation margins to the place that they will occupy in the final preparation

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9
Q

What should be kept in mind when making the outline form:

A
  1. Removal of all carious and defective pits and fissures
  2. Removal of all unsupported enamel
  3. Avoid ending cavity margins in high stress areas
  4. Placing margins on sound tooth structures
  5. Bur should be kept perpendicular to the long axis of the tooth and should be rotating when applied and removed
  6. Maintain the initial depth of 1.5mm, at least 0.2-0.5mm in dentin to provide strength
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10
Q

Regular, 125 µM refers to which color bur?
A: yellow
B: red
C: blue
D: green
E: black

A

C

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11
Q

X-fine, 28 µM refers to which color bur?
A: yellow
B: red
C: blue
D: green
E: black

A

A

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12
Q

Super coarse, 181 µM refers to which color bur?
A: yellow
B: red
C: blue
D: green
E: black

A

E

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13
Q

Fine, 60 µM refers to which color bur?
A: yellow
B: red
C: blue
D: green
E: black

A

B

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14
Q

Coarse, 151 µM refers to which color bur?
A: yellow
B: red
C: blue
D: green
E: black

A

D

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15
Q

Which burs are for finishing and polishing?

A

Yellow and red

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16
Q

Which burs are for preparations?

A

Blue, green, black

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17
Q

How should the bur be oriented for mesial and distal surfaces?

A

Orient it towards the respective marginal ridge that will result in a slight divergence which helps provide dentinal support for marginal ridges (95 degrees)

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18
Q

How should the external outline form be?

A

Smooth curves
Straight lines
Rounded angles

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19
Q

Resistance form is ?

A

The shape given to a preparation to enable it to withstand occlusal stresses

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20
Q

The primary resistance form should have the following features?

A
  • shape of the preparation should be like a box, with a flat floor that follows the contour of the occlusal surface
  • minimal occlusal depth of 1.5mm to provide adequate thickness of amalgam
  • cavosurface angle of 90 degrees
  • restrict the extension of the external walls to have strong marginal ridge areas with sufficient dentin support
  • round off the internal line and point angles
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21
Q

Primary retention form is?

A

The form to prevent the restoration from being displaced

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22
Q

Retention can be increased by the following:

A
  • occlusal convergence of 2-5% of the buccal and lingual walls
  • slight undercut in dentin near the pulpal wall
  • conserving the marginal ridges
23
Q

The convenience form?

A

Facilitates and provides sufficient visibility, accessibility, and ease of operation in preparation and restoration of the tooth. For amalgam, it’s the form or shape that permits access of condensing and carving instruments

24
Q

What else do we remove other than the caries in the final tooth preparation?

A
  • remaining caries
  • old restorative material
  • adjacent deep pits and fissures
25
Q

How are the soft caries in a large preparation removed?

A

Using a slow speed or spoon excavator

26
Q

What is a two-step pulpal floor?

A

Only a portion of the tooth which is affected by caries is removed, leaving the remaining floor untouched

27
Q

What does the use of pulp protectors depend on?

A

If the preparation is shallow or deep

28
Q

In a shallow preparation?

A

Pulp protection is not need as it compromises thickness and thus compressive strength of the amalgam

29
Q

In a deep preparation?

A

A base is placed on the deepest part in the thickness of 0.5 to 0.75 mm as to protect the pulp

30
Q

At what stage of the final tooth preparation are all the unsupported enamel removed?

A

Finishing of the enamel walls and margins

31
Q

Having a cavosurface margin of 90 degrees butt joint type provides?

A

Bulk to the restoration and provides maximum strength

32
Q

What do we have to preserve in the maxillary first molar?

A

Oblique ridge

33
Q

What do we have to preserve in the mandibular first premolar?

A

Transverse ridge

34
Q

Buccal and lingual have to be?

A

Convergent

35
Q

Mesial and distal have to be?

A

Divergent

36
Q

What changes have to be made when making a preparation on the occlusal surface with buccal or lingual extension:

A
  • extend the pulpal floor in the same plane to include the caries
  • make a box type preparation with mesial and distal walls parallel
  • place retention grooves in the mesial and distal walls
  • remove all unsupported enamel by using a slow speed

Tilt, inclination

37
Q

Clinical sequence of amalgam class I preparation:

A

Perpendicular to occlusal surface
Round bur to make the shape
Cylindric bur to make the floor flat

38
Q

Can you have a class II that has buccal and lingual surfaces involved?

A

Yes

39
Q

The different designs for class II cavities are?

A

Simple, compound, complex

40
Q

How is a class II preparation initiated?

A

Same as the class I, through the occlusal surface

41
Q

The outline form of a class II preparation is:

A
  1. Same as class I but extended proximally *mesial or distal depending on the caries
  2. Keep long axis of the bur parallel to the long axis of the tooth and maintain the initial depth of 1.5-2.0mm
  3. Extend the outline to include the central fissure
  4. Make isthmus width as narrow as possible but not wider than 1/4 the intercuspal tip distance
  5. Occlusal convergence
  6. Extend the preparation towards the contact area ending short by 0.8mm of cutting through the marginal ridge
  7. Proximal cutting is deep into the dentin (0.5-0.6mm) so that retentive locks are prepared
  8. Widen the preparation faciolingually to clear contact areas
  9. Proximal cut is occlusally convergent
  10. Clearance of facial and lingual margins of the proximal box are 0.2-0.5mm from the adjacent tooth
42
Q

What provides favourable retention for amalgam

A

Occlusal convergence to facial, lingual walls

43
Q

When do you make a reverse curve?

A

In teeth with broader contacts

Curve the walls inwards to the contact aras

44
Q

What are the advantages of the reverse curve?

A
  • conserves the sound tooth structure
  • preserves the triangular ridge of the affected cusp
  • 90 degree angle outer tooth surface —> increase resistance for tooth and material
45
Q

How do you fracture the slide of enamel left in the contact area?

A

With a small chisel or enamel hatchet

46
Q

Primary resistance form in class II preparation is achieved by ?

A

Box with flat pulpal and gingival floor

47
Q

Primary retention form in class II cavities is achieved by?

A

Occlusal convergence of 2-5% of buccal and lingual walls

48
Q

Bevelling of the enamel portion of gingival walls is done with ?

A

Gingival marginal trimmer

49
Q

What are the modifications in class II preparations?

A
  1. Slot preparation
  2. Simple box preparation
  3. Conservative preparation for mandibular first PM and maxillary first molar
50
Q

Indications for slot preparation:

A
  • Proximal root caries in geriatric patients with gingival recession.
  • When adjacent tooth is missing.
51
Q

Design features of a slot preparation?

A
  • preparation is normally approached from the facial aspect to a limited depth axially (0.75-1.25 mm).
  • When margins are in enamel, go 0.5mm inside the dentin. Prepare 90 degree cavosurface margins, give retention grooves
52
Q

Indications for a simple box preparation ?

A
  • Small proximal caries, not involving the occlusal surface.
  • Proximal surface caries with narrow proximal contact.
  • Proximal caries in attrited teeth. (Bruxism patients).
53
Q

Design feature of simple box preparation?

A
  • prepare proximal box only with minimum facial and lingual extensions.
  • For retention, converge facial and lingual extensions. Proximal retention locks are made for added retention in the proximal box. These have 0.5 mm depth gingivally and 0.3 mm occlusally.
54
Q

What’s the difference between resistance and retention and one thing you can do to achieve them?

A
  • resistance is: shape given to allow the restoration to withstand occlusal stresses. By: box with flat floor, rounded internal angles, cavosurface 90
  • retention is: prevents the restoration from being displaced. By: occlusal convergence of 2-5% of buccal and lingual walls, undercut in dentin, conserving marginal ridges