Class 1 composite restoration- caries removal Flashcards

1
Q

when composites were first a thing, how were they cured?

A

chemically and were used for class 3,4,5

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2
Q

whats has changed with modern composites vs older composites?

A

Filler size has reduced, and filler amounts have increased up to 70%

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3
Q

whats a nano-hybrid composite?

A

the smaller filler particles ( nano particles) are intermixed with larger glass and silica particles giving the material toughness.

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4
Q

what composite system do we use at LECOM?

A

BEAUTIFIL Nanohybrid

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5
Q

do The prep walls have to be convergent?

A

no they can be parallel to divergent

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6
Q

the prep pulpal depth should be __ past the DEJ?

A

.5 mm

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7
Q

Advantages of Composite?

A

Esthetics, conserve more tooth structure, easier preparation, insulation

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8
Q

Disadvantages of composite

A

Shrinkage, Lower fracture toughness, possible greater localized occlusal wear

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9
Q

on average the composite shrinks how much?

A

2.6-7.1 %

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10
Q

Do you want centric stops to be on composite or amalgam?

A

no, They need to be on natural teeth.

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11
Q

how wide should the isthmus be?

A

1.5mm, also dont encroach past 1/3 of the cusp tip of the cusp

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12
Q

Retention is achieved by micromechanical means which means…..

A
  1. etching of enamel and Dentin
  2. proper bonding technique
  3. placing bevels
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13
Q

Does the beutibond bond to the tooth?

A

no , the adhesive

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14
Q

What bur is best to use for entry?

A

330 or 245

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15
Q

how far pulpal should you go down?

A

~1.5 mm initially, then you can go 2mm. as you continue to drill

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16
Q

what bur can you use to smoothen the walls?

A

use a low speed 56 carbide bur

17
Q

what should the marginal thickness be?

A

Premolars is 1.5mm, molars, 2 mm.

18
Q

why dont we bevel the occlusal surface?

A

it creates a very thin and weak composite area that is prone to chipping and increases recurrent caries risk.

19
Q

where can you bevel?

A

facial or ligual of a tooth ( since its not under stress its ok)

20
Q

why do caries spread at the DEJ?

A

a lot of tubules

21
Q

what MUST be achieved before caries removal pulpally begins?

A

a stain free DEJ

22
Q

how do we distuingish between healthy and infected dentin?

A

degree of discoloration and hardness.

23
Q

who developed the caries indicator? Why is it not good?

A

Fusyama, its not specific for infected dentin and stains slightly demineralized protein matrix of affected dentin as well.

24
Q

Caries removal process

A

use spoon excavator, start with the largest spoon and move to smaller sizes if needed, Remember the stain free DEJ

25
Q

Rotary caries removal

A

start with larges removal bur with the slow speed, start to remove caries from the periphery towards the center, use 10,000 rpm with no water,Begin with a #6 caries removal bur and proceed to smaller burs until all caries is removed and there is no soft dentin.
STAINED but firm dentin is AFFECTED and can remain

26
Q

Indirect pulp cap criteria/ process

A

must be asymptomatic, a small amount of caries is left in the deepest portion of the prep, This area is covered with calcium hydroxie ( dycal), trioxide aggregate + a base, High pH of CaOH kills remaining bacteria, CaOH/MTA encourages formation of reparative dentin,

27
Q

what does Iatrogenic mean?

A

injury caused by injury

28
Q

what happens if there is an accidental pulp exposure?

A

cover it with dycal IF it is a non-carious exposure. If it is carious you need to do a root canal.( the bacteria has already entered )

29
Q

how can you prevent iatrogenic exposures?

A

check the bite wings thoroughly to make sure you know where the pulp horns are before operating.

30
Q

who has high pulp horns?

A

younger people.

31
Q

What can you do if there is a carious pulpal exposure?

A

you can do either endodontics or extraction.