Class I and Class V Restoration Fundamentals Flashcards

Question

Placing an Occlusal Restoration: Amalgam | Step. 6:

Answer 1

Condense Amalgam using the small | Hollenback condenser.

Answer 2

a. Tamp into the preparation to fix the amalgam in place, perhaps using the larger condenser nib. b. Use the small condenser nib to pack the material FIRMLY into all line angles at a 45 ◦angle, using a pressing, wiggling motion in a step-wise fashion.

Answer 3

Overfill the Preparation | ~ 1.0 mm beyond the margins

Answer 4

Pre-carve burnishing Using the side of the nib of the condenser or a large ball burnisher. Burnish towards the margins to eliminate voids and to bring excess mercury to the surface, where it can be carved away. Begin to define grooves.

Answer 5

Carve the Amalgam

Answer 6

a. Keep correct groove anatomy in mind. b. Use the Hollenback carver held perpendicular to the margins. c. Use the tip of the carver to recreate groove anatomy. d. Carve exactly to the margins. e. Remove all flash beyond the margins.

Answer 7

Check and Refine Occlusion

Answer 8

a. Remove rubber dam b. Use articulating paper to mark occlusion(have patient close in maximum intercuspation first and then move into lateral excursions). c. Use the discoid carver to remove high occlusion marks and inclined plane contacts. d. Try to preserve cusp seats in the bottoms of fossae (long axis forces on the teeth) e. Other occluding areas should touch as usual (indicating no high spots on the restoration which open the bite)

Answer 9

Smoothing the surface

Answer 10

a. Use a beavertail burnisher to smooth surface, define grooves, and eliminate voids (Avoid heavy burnishing on amalgam that is well along in its set. This could bring excess mercury to the surface) b. Wipe with a cotton pellet to smooth surface and to leave a matte finish.

Answer 11

• Occlusion, overhang, anatomy, marginal plaque trap, contour improvement

Answer 12

•Green stone (coarse) •White stone (medium) •12 bladed polishing bur (medium-fine)

Answer 13

``` 12 bladed flutes Needle Point Flame 7902 Round 7006 Bullet 7404 Small round 7002 Bullet pointed 7104 ```

Answer 14

•Put the tip of the bur in the central groove and lay the bur across the enamel margin. •Sequence is to go from the most abrasive to the finest polishing instrument. This sequentially produces smaller and finer scratches. •Refine, don’t destroy, the groove anatomy.

Answer 15

* Scratches and major surface irregularities should be eliminated. * High polish is not necessary, can be done for esthetic reasons. * The most important area is the cavosurface margin. * Grooves should be definite but not deep. Contours should be maintained and not flattened. * No occlusal prematurities. Natural occlusal marks on the tooth should be present.

Answer 16

* All flash and overhangs should be eliminated. * The tip of an explorer should pass from the tooth surface to the restoration surface and vice versa without jumping or catching

Answer 17

* Amalgam margins that have expanded beyond the cavosurface * Margins that were originally undercarved * 1/3 of the enamel thickness in a localized area can be removed to extend the life of a restoration without replacing it * Margins with minimal ditching may be refined * Rough surfaces can be smoothed

Answer 18

esthetic | ◦ No longer considered necessary for a well-done amalgam

Answer 19

◦ Rubber points may fall apart at high speeds ◦ Tooth may overheat at high temp (May result in pulpal damage ◦ Amalgam may overheat) (Bringing mercury to the surface and increasing likelihood of future amalgam breakdown) ◦ Should obtain smooth surface after only a few seconds of polishing (If not, surface was too rough to polish. Restart finishing procedure from beginning.)

Answer 20

◦ Condense material well into preparation | ◦ Restore occlusion

Answer 21

Acid etch prepared tooth structure

Answer 22

Place bond agent into enamel and dentin Gently air dry Light cure

Answer 23

``` syringe small increments (~2mm or less) ```

Answer 24

light cured before adding the next increment. | ◦ While condensing composite, “pull back” may occur

Answer 25

hand instruments

Answer 26

composite set up time ◦ Light cure ◦ Composite is completely polymerized (set up) ◦ Ability to polish at the same appointmen

Answer 27

``` ◦ Preparation can be more forgiving ◦ Esthetic ◦ Operator control of set up time ◦ Preserve tooth structure ◦ Don’t need to remove as much for retention (bonds) or bulk of restorative material ```

Answer 28

``` ◦ Technique sensitive restoration ◦ Additional steps ◦ May not last as long ◦ Not as strong ◦ No moisture tolerance ```

Answer 29

◦ Not worried about occlusal anatomy ◦ Focus on making sure restoration is contoured to match original tooth structure ◦ Overcontoured restoration will be more traumatic to gingiva than undercontoured restoration

Answer 30

◦ 1. Follow same guidelines as occlusal (triturate, use carrier to place, condense well, over fill 1mm) ◦ With this restoration, forces will be going from the buccal surface to the axial wall ◦ 2. Use Hollenback carver to remove excess amalgam ◦ Keeping ends of carver on sound tooth structure, move instrument from distal to mesial ◦ Careful not to gouge restoration, resulting in voids ◦ 3. No need to check occlusion ◦ Polishing usually not necessary, but look how lovely this is!