Class I & V Restoration Fundamentals Flashcards
1
Q
In clinic, the first step of placing an occlusal restoration is:
A
Step 1) place liner and/or base if needed (deep caries)
2
Q
When is the placement of a base needed?
A
Deep caries
3
Q
What materials serve as a liner and/or base for an occlusal restoration?
A
- Calcium hydroxide
- Glass ionomer
4
Q
Give an example of calcium hydroxide:
A
Dycal (liner)
5
Q
Give an example of a glass ionomer:
A
Vitrebond (Resin-modified glass ionomer - liner/base)
6
Q
Calcium hydroxide (example Dycal) is a two paste system that dispenses from separate tubes and is mixed, it functions to:
A
Stimulate reparative dentin formation
7
Q
Glass ionomer (example Vitrebond) is a two paste system, dispenses from clicker, and is mixed. It requires ____ and functions to ____
A
Light cure; release fluoride over time
8
Q
Where & how should a liner and/or base be placed?
A
Place in deeper areas only, keeping away from margins; placed with Dycal instrument (tiny ball-shaped)
9
Q
What are two brand names of calcium hydroxide liners:
A
Life or Dycal
10
Q
Describe the placement of a calcium hydroxide line (Life or Dycal):
A
- Mix with spatula, end of dycal instrument
- Use dycal instrument to place over area nearest pulp
- Often cover with RMGI (Resin modified glass ionomer)
11
Q
Vitrebond is the brand name for a:
A
Resin-modified glass ionomer liner/base
12
Q
Describe placement of Vitrebond:
A
- Mix with spatula end of dycal instrument
- Use dycal instrument to place over area nearest pulp
- Often used to cover calcium hydroxide
- Light cure
13
Q
_____ is placed in thin layer over dentin
_____ is placed in a thicker layer on floor of prepared cavity
A
Liner
Base
14
Q
What is the second step in placing an occlusal restoration, following liner/base placement:
A
Step 2) seal dentinal tubules
15
Q
Is sealing the dentinal tubules always necessary on an occlusal restoration? Explain:
A
Not generally necessary- most do not require it unless it is a prep that is especially prone to sensitivity
16
Q
Describe situations in which preps may be prone to sensitivity:
A
Very young teeth, large pulp
17
Q
What product would seal dentinal tubules?
Name them
A
Desensitizers
1. Copal resin (Copalite)
2. Bonding agents
3. Gluteraldehyde & (2-hydroxyethyl)methylacrylate (HEMA) desensitizer (Gluma)
18
Q
Copal resin is a:
A
Densensitizer
19
Q
What is a specific copal resin?
What are the advantages:
What are the disadvantages:
A
Copalite
Advantages: inexpensive, quick to use
Disadvantages: Leaves a film thickness (could wash out, causing microleakage)
20
Q
Unfilled dentin bond agent is a:
A
Desensitizer
21
Q
What is a specific unfilled dentin bond agent?
A
PQ-1, Peak
Advantages: Intermediate in cost
Disadvantages: some require more than one step, invovles etching, leaves a film thickness
22
Q
Research suggests that ethcing with an acid:
A
May leave teeth more vulnerable to recurrent caries
23
Q
Gluma is a:
A
Densensitizer
24
Q
Advantages of Gluma:
Disadvantages of Gluma:
A
Advantages: No film thickness, one step to apply
Disadvantages: Expensive, caustic to soft tissues & possibly pulp in deep preps
25
Application of desensitizer copal resin:
Wipe cavity with cotton pellet soaked in resin, then gently air dry
26
Application of desensitizer dental-bonded resins:
Press resin into dentin using brush, gently air dry, light cure
27
Application of desensitizer gluma:
Apply to walls for 30 seconds, dry, rinse, dry
28
Desensitizer that is considered caustic to gingiva & possibly pulp in deep preps:
Gluma
29
Because gluma (desensitizer) is caustic to gingiva & possibly pulp in deep preps, you should minimize contact with _____ & the pulp protected using a _____ in deep preparations, prior to applying
Gingivae; liner/base
30
The current policy at UMKC regarding dentin desensitizers:
We DO NOT teach the standard use of dentin desensitizers under amalgam
31
Studies suggest that dentin desensitizers make a _____ difference in tooth sensitivity on routine cases
Negligable
32
Studies suggest that dentin desensitizers make a negligiable difference in tooth sensitivity on routine cases. The _____ will seal most dentinal tubules & after a few weeks, the _____ will seal itself with a _____
Smear layer; amalgam; oxide layer
33
Although not a standard procedure, occasionally after a consult with faculty, one might use gluma on an especially sensitive tooth, but:
Place a liner or base first in deep preparations
34
Steps in placing an amalgam restoration:
1. Place amalgam
2. Condense amalgam
3. Pre-carve burnish
4. Carve anatomy
5. Refine restoration
35
Used to mix amalgam:
Triturator
36
Prior to picking up the amalgam with the _____ it should be placed into a _____
Amalgam carrier; amalgam well
37
What end of the amalgam carrier should be used first?
Small end
38
Dispensing only a small amount of amalgam into the preparation allows for:
proper condensation
39
What should be used to condense the amalgam:
Hollenback condensor
40
When condensing amalgam
a) tamp into the preparation to fix amalgam in place
b) use the small condenser _____ to pack material _____ at a ______ angle, using a pressing, wiggling motion in a step-wise fashion
Nib; firmly into all line angles, 45 degrees
41
Describe how you should fill an amalgam preparation:
Overfill preparation to around 1.0mm beyond margins
42
After overfilling the amalgam restoration, the next step is the:
Pre-carbe burnish
43
What instruments should be used for the pre-carve burnish of an amalgam restoration:
Condenser or large ball burnisher
44
When pre-carve burnishing an amalgam restoration you should burnish towards the _____ to eliminate voids and to ____ where it can be carved away before beginning to define the grooves
margins; bring excess mercury to the surface
45
What instruments should be used to carve the anatomy into the amalgam?
Hollenback carver
46
What step should the initial defining of groove occur in (amalgam restoration)
The pre-carve burnish step
47
When using the hollenback carver to carve the anatomy into the amalgam:
1. It should be held _____ to the ______
2. Use the tip of the carver to ______
3. Carve _____ to the margins
4. Remove all ____ beyond the margins
1. Perpendicular; margins
2. Recreate groove anatomy
3. Exactly to the margins
4. Flash
48
When checking an refining occlusion in amalgam restoration, use the _______ to remove high occlusal marks and inclined plane contacts
Discoid carver
49
When checking and refining occlusion in amalgam restorations, try to _____ of fossae (______ on the teeth)
Preserve cusp seats in the bottoms of fossae (long axis forces on the teeth)
50
What instrument should be used to smooth the surface of an amalgam restoration?
Beavertail burnisher
51
Why should you avoid burnishing on amalgam that is beginning to set>
This could bring excess mercury to surface
52
What type of finish should the amalgam restoration initially have?
Matte finish
53
Is finishing & polishing amalgam always necessary?
No
54
When is finishing and polishing amalgam necessary?
Needed when something needs to be corrected (occlusion, overhang, anatomy, marginal plaque trap, contour improvement)
55
Research suggests that well condensed, well carved amalgam does not gain longevity from:
The finishing process
56
If you need to finish/polish an amalgam restoration, you must:
Wait 24 hours
57
Finishing bur sequence for amalgam:
1. Green stone
2. White stone
3. 12-bladed polishing bur
58
Finishing burs for amalgam include:
1. Green stone=
2. White stone=
3. 12-bladed polishing bur=
1. Coarse
2. Medium
3. Medium-fine
59
Polishing bur sequence for amalgam:
1. Brown (pre-polish)
2. Green (polish)
3. Green with yellow collar (superpolish)
60
List the finishing burs (12-bladed flutes)
1. Flame
2. Round
3. Bullet
4. Small round
5. Bullet pointed
61
The finishing burs (12-bladed flutes) are all:
Needle point
62
What is the most important area for finishing an amalgam?
Cavosurface
63
What does a composite restoration require that an amalgam restoration does not?
1. Etch
2. Bond
3. Light cure
4. Incremental placement
5. Finish/polish
64
When placing composite resin in an incremental fashion, the increments should placed at:
2mm or less
65
While condensing composite _____ may occur
Pull-back
66
Anatomy in an occlusal composite restoration should be placed:
Prior to light curing
67
What instruments should be used to create anatomy in an occlusal composite restoration?
Hollenback or Optrasculpt
68
Describe polishing points that are to polish a composite:
Latch-type, pre-impregnated with polishing paste, use water to activate
69
List the advantages of composite restorations:
1. Prep can be more forgiving
2. Esthetics
3. Operator control of set-up time
4. Preserve tooth structure
70
List the disadvantages of using a composite restoration:
1. More technique sensitive
2. Additional steps
3. Longevity
4. Strength
5. No moisture tolerance
71
In a class V restoration _____ restorations will be more traumatic to gingiva
Overcontured
72
Major classes of dental materials:
1. Metals & alloys
2. Composites
73
Metals & alloys include:
1. Porcelains
2. Ceramics
3. Polymers
74
Polymers include both:
Elastomeric & plastics
75
An impression material is an example of:
An elastomeric polymer
76
Denture bases & sealants are examples of:
Plastic polymers
77
Polymers with fillers:
Composites
78
Who regulates dental materials:
ADA & FDA
79
Protect the public from hazardous or ineffective medical materials and devices:
FDA
80
In 2009 the FDA reclassified amalgam from ____ to ____
Class I to Class II
81
FDA lowest risk class:
FDA highest risk class:
Class I
Class II
82
Performance of all dental materials depends on their:
Anatomic structure
83
Anatomic structure determines:
Mechanical & physical properties
84
Types of interatomic bonds:
1. Primary
2. Secondary
85
Ionic, covalent, & metallic bonds are all:
Primary interatomic bonds
86
Hydrogen bonds & Van der Waals forces are both:
Secondary interatomic bonds
87
Electrostatic attraction of positive & negative charges describes:
Ionic bonds
88
Involves electron transfer between ions:
Ionic bonds
89
List the properties of an ionic bond:
1. Non-directional
2. Strong
3. No free electrons
4. Good thermal & electrical insulator
90
Ceramics & Gypsums are examples of materials displaying _____ bonds
Ionic
91
When two atoms share an electron they form a:
Covalent bond
92
List the properties of covalent bonds:
1. Directional
2. Low electrical & thermal conductivity
3. Water insoluble
93
Water, glass, polymers & composite are all example of materials that display:
Covalent bonds
94
Cluster of positive metal ions surrounded by a gas of electrons describes:
Metallic bonds
95
List the properties of metallic bonds:
1. Non-directional
2. High electrical & thermal conductivity
96
Amalgam & gold alloys are examples of materials that display:
Metallic bonds
97
List the classifications of material properties: (4)
1. Biological
2. Surface
3. Physical
4. Mechanical
98
The biological response to a material when in contact with the human body:
Biological
99
The unique properties of a material associated with its surface:
Surface
100
Depends on the type of atoms and the bonding present in the material; size or shape have NO AFFECT:
Physical
101
Physical properties are dependent on:
Type of atoms
102
Reaction of a material to the application of an external force, size and shape of specimen AFFECT properties:
Mechanical
103
A type of property that is structure sensitive:
Mechanical
104
A type of property that is structure insensitive:
Physical
105
Gingivitis is an example of what type of property?
Biological
106
Optic (color, gloss), thermal (conductive) are examples of what type of property?
Physical
107
Denture retention, and adhesive bonding are examples of what type of property?
Surface
108
Applied force refers to:
Load
109
When load (force) is applied to material ___develops in response:
Stress
110
=Load per unit area
Stress
111
Strength of material=
Stress at fracture
112
Type of strength measured is dependent on the type of:
Force applied
113
List the following types of force/stress:
1. Pushing
2. Pulling
3. Sliding
4. Twisting
5. Bending
1. Compressive
2. Tensile
3. Shear
4. Torsion
5. Flexure
114
List the types of forces/stress depicted in the image from top to bottom:
1. Compression
2. Tension
3. Shear
4. Torsion
5. Flexure
115
Highest strength measure for most materials:
Compressive strength
116
Measure of stress necessary to fracture material by two opposing forces directed toward eachother:
Compressive strength
117
______ pushes atoms and structure closer
Compression
118
Compression usually requires _____ loads to cause failure
higher loads
119
Pulling force:
Tensile strength
120
What is usually the lowest strength for most materials?
Tensile
121
Measure of the stress necessary to fracture a material by two opposing forces directed away from eachother:
Tensile strength
122
_____ pulls the atoms & structure apart
Tension
123
Failure of this type of strength occurs at lower loads:
Tensile strength
124
Sliding force:
Shear strength
125
Typically an intermediate strength between compressive & tensile:
Shear strength
126
Stress necessary to rupture a material by two opposing parallel forces directed toward eachother but not in the same plane:
Shear strength
127
Describe a clinical situation with shear force/strength:
Implant-bone interface
128
Twisting force:
Torsion strength
129
What motion is used on a wrench to place dental implants?
Torque
130
What type of strength is not relevant to direct or indirect dental restorations?
Torsion strength
131
Bending force
Flexural strength
132
Measure of stress to cause failure in bending:
Flexural strength
133
What type of test is used to determine flexural strength?
3-point bend test
134
The 3-point bend test takes into account:
1. Compressive load
2. Combination of compressive & tensile stress
135
______ strength is relevant in numerous clinical situations:
Flexural stress/strength
136
Type of strength vital to occlusal load:
Flexural strength
137
Flexural strength is vital to occlusal load on both:
1. Direct restorations
2. Indirect/removable
138
Protrusive movement is an example of dental stress on _____ teeth
Anterior
139
Flexure load on incisors=
Protrusive movement
140
Chewing= _____ load
Compressive
141
Posterior occlusion is an example of:
Compressive load
142
Posterior occlusion occurs at:
Marginal ridge contact areas & fossae
143
Equation for occlusal stress:
Occlusal stress= (occlusal load) / (occlusal contact area)
144
Allows for distribution of occlusal load across maximum area, resulting in minimized stress
Tripodized occlusal contacts
145
Premature contact results in:
Decreased area
146
With a premature contact the patient's occlusal force _____ but the occlusal stress is ____
stays the same; increased
147
The DEFORMATION that occurs in a material when forces is applied to the material:
Strain
148
Equation for strain:
Strain= (change in strength) / (unit original strength)
149
____ & ____ are interrelated, if you have one you have the other
Stress & strain
150
Example of stress & strain curve:
Someone on a diving board
151
Temporary distortion of a material by an applied force:
elastic strain
152
In elastic strain, strain is:
Below the elastic limit
153
In this type of strain, once force is removed:
Materials revert to original form
154
Example of elastic strain:
Rubber band
155
Permanent distortion of any material:
Plastic strain
156
In plastic strain, strain is:
Beyond the elastic limit
157
In plastic strain:
____ portion of strain is recovered while ____ portion of strain is NOT recovered
Elastic; plastic
158
In this type of strain, when force is removed, shape remains unchanged:
Plastic strain
159
Example of plastic strain:
Bending a paper clip
160
Amalgam is placed in a _____ state and carved before it hardens:
Plastic state
161
Amalgam alloy composition:
Elements that make it up and their percents:
1. Ag- 70%
2. Sn- 16%
3. Cu- 13%
4. Zn- 1%
162
What principle properties do the following elements of amalgam contribute:
1. Silver
2. Tin
3. Copper
4. Zinc
1. Strength
2. Expansion
3. Strength
4. Deoxidizer
163
Amalgam is an alloy of _____ , ____, ____& ____
& is mixed with _____ to form an alloy that can be packed into a dental preparation
Silver, copper, tin & zinc
Mercury
164
Amalgam in capsule= ______. It is mixed with _____ in _____
Powder; liquid mercury; triturator
165
Low copper amalgam similar to G.V. Black's original formula:
Conventional amalgam
166
Amalgam that contains 9-30% copper, superior form & what we use in the U.S
High copper amalgam
167
The presence of copper in high copper amalgam nearly ______ resulting in _____
Nearly eliminates the gamma-2 phase; stronger restoration
168
The presence of _____ in a high copper amalgam nearly eliminates the gamma-2 phase
Copper (9-30%)
169
Phases of amalgam setting include:
-Gamma
-Gamma-1
-Gamma-2
170
Describe the gamma phase of amalgam setting:
Tin & silver react with mercury, forms silver-mercury (gamma-1) and tin-mercury (gamma-2)
171
The gamma phase of amalgam setting can be described as:
Strong, corrosion resistant
172
Describe gamma-1 phase of amalgam setting:
Silver-mercury, weaker & susceptible to corrosion
173
Describe the gamma-2 phase of amalgam setting:
Tin-mercury, weakest, most susceptible to corrosion
174
Adding copper to amalgam setting creates:
Copper-tin phase (eta), eliminated tin-mercury gamma-2 phase
175
The following equation describes:
Gamma+mercury --> gamma+gamma-1+gamma-2
Low copper amalgam
176
The following equation describes:
Gamma+copper+mercury --> gamma+gamma-1+CuSn
High copper amalgam
177
List the shape of amalgam particles
1. Lathe
2. Admixed
3. Spherical
178
-Outdated
-particles formed by cutting block of alloy with a lathe
-results in large, irregular particles
Lathe
179
-Lathe type particles mixed with small spheres
-requires more condensation force
-most commonly used type of amalgam
-low early strength (1 hour)
Admixed
180
-Spherical shape
-higher early strength (1 hour) & higher 24-hour strength
-may be more difficult to achieve interproximal contact
-requires less condensation force
Spherical
181
Which type of amalgam particles has a low early strength?
Admixed
182
Between all the types of amalgam particles they have:
Similar clinical success but different handling properties
183
What are the variables to amalgam manipulation (4)
1. Mercury to alloy ratio
2. Trituration
3. Condensation
4. Carving & finishing
184
When considering the mercury to alloy ratio:
Less mercury in final restoration is:
Superior
185
Most critical variable in amalgam restoration:
Condensation
186
Most common error made by dentist in amalgam manipulation:
Under condensation
187
Why not remove amalgam due to mercury concerns?
1. Unwarranted loss of tooth structure
2. Unneccesary expense
3. Limited longevity when replaced (new restoration)
188
Amalgam has ____ compressive strength & _____ tensile strength
Compressive; tensile
189
Amalgam is ____ in small bulk
Brittle
190
Amalgam requires _____ of material to avoid breaking:
Minimal thickness (1.5-2.0mm)
191
Why can the isthmus be 1.0 mm minimal thickness of amalgam when the floor must be 1.5-2.0mm?
Because chewing forces are not directed at isthmus width
192
Amalgam is sensitive to _____ during placement
Moisture contamination
193
When ____ reacts with _____ in amalgam it causes an eventual expansion of the alloy out of the preparation
water; zinc
194
Can amalgam corrode?
Yes
195
Disadvantages of amalgam include: (6)
1. Poor esthetics
2. Need for good mercury hygiene
3. Remove more tooth structure
4 . No bonding
5. Thermal conductor (leads to sensitivity)
6. May ditch at margins after time
196
Advantages of amalgam include (6):
1. More forgiving for moisture control
2. High wear resistance & compressive strength
3. Less timely/lower cost
4. Long lasting
5. Regenerates seal
6. Less prone to recurrent decay
197
Indications for amalgam: (8)
1. Moderate to large Class I & II restorations
2. Heavy occlusal wear
3. High caries rate
4. Difficult isolation
5. Gingival margins on root
6. Class V restorations in non-esthetic zones
7. Temporary restorations on teeth with questionable prognosis
8. Buildups on crowns for extensively damaged teeth
