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Operative Dentistry I > Class I & V Restoration Fundamentals > Flashcards

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)

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2
Q

When is the placement of a base needed?

A

Deep caries

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3
Q

What materials serve as a liner and/or base for an occlusal restoration?

A
  1. Calcium hydroxide
  2. Glass ionomer
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4
Q

Give an example of calcium hydroxide:

A

Dycal (liner)

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5
Q

Give an example of a glass ionomer:

A

Vitrebond (Resin-modified glass ionomer - liner/base)

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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

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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

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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)

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9
Q

What are two brand names of calcium hydroxide liners:

A

Life or Dycal

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10
Q

Describe the placement of a calcium hydroxide line (Life or Dycal):

A
  1. Mix with spatula, end of dycal instrument
  2. Use dycal instrument to place over area nearest pulp
  3. Often cover with RMGI (Resin modified glass ionomer)
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11
Q

Vitrebond is the brand name for a:

A

Resin-modified glass ionomer liner/base

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12
Q

Describe placement of Vitrebond:

A
  1. Mix with spatula end of dycal instrument
  2. Use dycal instrument to place over area nearest pulp
  3. Often used to cover calcium hydroxide
  4. Light cure
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13
Q

_____ is placed in thin layer over dentin

_____ is placed in a thicker layer on floor of prepared cavity

A

Liner
Base

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14
Q

What is the second step in placing an occlusal restoration, following liner/base placement:

A

Step 2) seal dentinal tubules

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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

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16
Q

Describe situations in which preps may be prone to sensitivity:

A

Very young teeth, large pulp

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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)

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18
Q

Copal resin is a:

A

Densensitizer

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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)

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20
Q

Unfilled dentin bond agent is a:

A

Desensitizer

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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

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22
Q

Research suggests that ethcing with an acid:

A

May leave teeth more vulnerable to recurrent caries

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23
Q

Gluma is a:

A

Densensitizer

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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

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25
Q

Application of desensitizer copal resin:

A

Wipe cavity with cotton pellet soaked in resin, then gently air dry

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26
Q

Application of desensitizer dental-bonded resins:

A

Press resin into dentin using brush, gently air dry, light cure

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27
Q

Application of desensitizer gluma:

A

Apply to walls for 30 seconds, dry, rinse, dry

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28
Q

Desensitizer that is considered caustic to gingiva & possibly pulp in deep preps:

A

Gluma

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29
Q

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

A

Gingivae; liner/base

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30
Q

The current policy at UMKC regarding dentin desensitizers:

A

We DO NOT teach the standard use of dentin desensitizers under amalgam

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31
Q

Studies suggest that dentin desensitizers make a _____ difference in tooth sensitivity on routine cases

A

Negligable

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32
Q

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 _____

A

Smear layer; amalgam; oxide layer

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33
Q

Although not a standard procedure, occasionally after a consult with faculty, one might use gluma on an especially sensitive tooth, but:

A

Place a liner or base first in deep preparations

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34
Q

Steps in placing an amalgam restoration:

A
  1. Place amalgam
  2. Condense amalgam
  3. Pre-carve burnish
  4. Carve anatomy
  5. Refine restoration
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35
Q

Used to mix amalgam:

A

Triturator

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36
Q

Prior to picking up the amalgam with the _____ it should be placed into a _____

A

Amalgam carrier; amalgam well

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37
Q

What end of the amalgam carrier should be used first?

A

Small end

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38
Q

Dispensing only a small amount of amalgam into the preparation allows for:

A

proper condensation

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39
Q

What should be used to condense the amalgam:

A

Hollenback condensor

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40
Q

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

A

Nib; firmly into all line angles, 45 degrees

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41
Q

Describe how you should fill an amalgam preparation:

A

Overfill preparation to around 1.0mm beyond margins

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42
Q

After overfilling the amalgam restoration, the next step is the:

A

Pre-carbe burnish

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43
Q

What instruments should be used for the pre-carve burnish of an amalgam restoration:

A

Condenser or large ball burnisher

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44
Q

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

A

margins; bring excess mercury to the surface

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45
Q

What instruments should be used to carve the anatomy into the amalgam?

A

Hollenback carver

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46
Q

What step should the initial defining of groove occur in (amalgam restoration)

A

The pre-carve burnish step

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47
Q

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
A
  1. Perpendicular; margins
  2. Recreate groove anatomy
  3. Exactly to the margins
  4. Flash
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48
Q

When checking an refining occlusion in amalgam restoration, use the _______ to remove high occlusal marks and inclined plane contacts

A

Discoid carver

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49
Q

When checking and refining occlusion in amalgam restorations, try to _____ of fossae (______ on the teeth)

A

Preserve cusp seats in the bottoms of fossae (long axis forces on the teeth)

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50
Q

What instrument should be used to smooth the surface of an amalgam restoration?

A

Beavertail burnisher

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51
Q

Why should you avoid burnishing on amalgam that is beginning to set>

A

This could bring excess mercury to surface

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52
Q

What type of finish should the amalgam restoration initially have?

A

Matte finish

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53
Q

Is finishing & polishing amalgam always necessary?

A

No

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54
Q

When is finishing and polishing amalgam necessary?

A

Needed when something needs to be corrected (occlusion, overhang, anatomy, marginal plaque trap, contour improvement)

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55
Q

Research suggests that well condensed, well carved amalgam does not gain longevity from:

A

The finishing process

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56
Q

If you need to finish/polish an amalgam restoration, you must:

A

Wait 24 hours

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57
Q

Finishing bur sequence for amalgam:

A
  1. Green stone
  2. White stone
  3. 12-bladed polishing bur
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58
Q

Finishing burs for amalgam include:

  1. Green stone=
  2. White stone=
  3. 12-bladed polishing bur=
A
  1. Coarse
  2. Medium
  3. Medium-fine
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59
Q

Polishing bur sequence for amalgam:

A
  1. Brown (pre-polish)
  2. Green (polish)
  3. Green with yellow collar (superpolish)
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60
Q

List the finishing burs (12-bladed flutes)

A
  1. Flame
  2. Round
  3. Bullet
  4. Small round
  5. Bullet pointed
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61
Q

The finishing burs (12-bladed flutes) are all:

A

Needle point

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62
Q

What is the most important area for finishing an amalgam?

A

Cavosurface

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63
Q

What does a composite restoration require that an amalgam restoration does not?

A
  1. Etch
  2. Bond
  3. Light cure
  4. Incremental placement
  5. Finish/polish
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64
Q

When placing composite resin in an incremental fashion, the increments should placed at:

A

2mm or less

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65
Q

While condensing composite _____ may occur

A

Pull-back

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66
Q

Anatomy in an occlusal composite restoration should be placed:

A

Prior to light curing

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67
Q

What instruments should be used to create anatomy in an occlusal composite restoration?

A

Hollenback or Optrasculpt

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68
Q

Describe polishing points that are to polish a composite:

A

Latch-type, pre-impregnated with polishing paste, use water to activate

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69
Q

List the advantages of composite restorations:

A
  1. Prep can be more forgiving
  2. Esthetics
  3. Operator control of set-up time
  4. Preserve tooth structure
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70
Q

List the disadvantages of using a composite restoration:

A
  1. More technique sensitive
  2. Additional steps
  3. Longevity
  4. Strength
  5. No moisture tolerance
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71
Q

In a class V restoration _____ restorations will be more traumatic to gingiva

A

Overcontured

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72
Q

Major classes of dental materials:

A
  1. Metals & alloys
  2. Composites
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73
Q

Metals & alloys include:

A
  1. Porcelains
  2. Ceramics
  3. Polymers
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74
Q

Polymers include both:

A

Elastomeric & plastics

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75
Q

An impression material is an example of:

A

An elastomeric polymer

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76
Q

Denture bases & sealants are examples of:

A

Plastic polymers

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77
Q

Polymers with fillers:

A

Composites

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78
Q

Who regulates dental materials:

A

ADA & FDA

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79
Q

Protect the public from hazardous or ineffective medical materials and devices:

A

FDA

80
Q

In 2009 the FDA reclassified amalgam from ____ to ____

A

Class I to Class II

81
Q

FDA lowest risk class:

FDA highest risk class:

A

Class I

Class II

82
Q

Performance of all dental materials depends on their:

A

Anatomic structure

83
Q

Anatomic structure determines:

A

Mechanical & physical properties

84
Q

Types of interatomic bonds:

A
  1. Primary
  2. Secondary
85
Q

Ionic, covalent, & metallic bonds are all:

A

Primary interatomic bonds

86
Q

Hydrogen bonds & Van der Waals forces are both:

A

Secondary interatomic bonds

87
Q

Electrostatic attraction of positive & negative charges describes:

A

Ionic bonds

88
Q

Involves electron transfer between ions:

A

Ionic bonds

89
Q

List the properties of an ionic bond:

A
  1. Non-directional
  2. Strong
  3. No free electrons
  4. Good thermal & electrical insulator
90
Q

Ceramics & Gypsums are examples of materials displaying _____ bonds

A

Ionic

91
Q

When two atoms share an electron they form a:

A

Covalent bond

92
Q

List the properties of covalent bonds:

A
  1. Directional
  2. Low electrical & thermal conductivity
  3. Water insoluble
93
Q

Water, glass, polymers & composite are all example of materials that display:

A

Covalent bonds

94
Q

Cluster of positive metal ions surrounded by a gas of electrons describes:

A

Metallic bonds

95
Q

List the properties of metallic bonds:

A
  1. Non-directional
  2. High electrical & thermal conductivity
96
Q

Amalgam & gold alloys are examples of materials that display:

A

Metallic bonds

97
Q

List the classifications of material properties: (4)

A
  1. Biological
  2. Surface
  3. Physical
  4. Mechanical
98
Q

The biological response to a material when in contact with the human body:

A

Biological

99
Q

The unique properties of a material associated with its surface:

A

Surface

100
Q

Depends on the type of atoms and the bonding present in the material; size or shape have NO AFFECT:

A

Physical

101
Q

Physical properties are dependent on:

A

Type of atoms

102
Q

Reaction of a material to the application of an external force, size and shape of specimen AFFECT properties:

A

Mechanical

103
Q

A type of property that is structure sensitive:

A

Mechanical

104
Q

A type of property that is structure insensitive:

A

Physical

105
Q

Gingivitis is an example of what type of property?

A

Biological

106
Q

Optic (color, gloss), thermal (conductive) are examples of what type of property?

A

Physical

107
Q

Denture retention, and adhesive bonding are examples of what type of property?

A

Surface

108
Q

Applied force refers to:

A

Load

109
Q

When load (force) is applied to material ___develops in response:

A

Stress

110
Q

=Load per unit area

A

Stress

111
Q

Strength of material=

A

Stress at fracture

112
Q

Type of strength measured is dependent on the type of:

A

Force applied

113
Q

List the following types of force/stress:

  1. Pushing
  2. Pulling
  3. Sliding
  4. Twisting
  5. Bending
A
  1. Compressive
  2. Tensile
  3. Shear
  4. Torsion
  5. Flexure
114
Q

List the types of forces/stress depicted in the image from top to bottom:

A
  1. Compression
  2. Tension
  3. Shear
  4. Torsion
  5. Flexure
115
Q

Highest strength measure for most materials:

A

Compressive strength

116
Q

Measure of stress necessary to fracture material by two opposing forces directed toward eachother:

A

Compressive strength

117
Q

______ pushes atoms and structure closer

A

Compression

118
Q

Compression usually requires _____ loads to cause failure

A

higher loads

119
Q

Pulling force:

A

Tensile strength

120
Q

What is usually the lowest strength for most materials?

A

Tensile

121
Q

Measure of the stress necessary to fracture a material by two opposing forces directed away from eachother:

A

Tensile strength

122
Q

_____ pulls the atoms & structure apart

A

Tension

123
Q

Failure of this type of strength occurs at lower loads:

A

Tensile strength

124
Q

Sliding force:

A

Shear strength

125
Q

Typically an intermediate strength between compressive & tensile:

A

Shear strength

126
Q

Stress necessary to rupture a material by two opposing parallel forces directed toward eachother but not in the same plane:

A

Shear strength

127
Q

Describe a clinical situation with shear force/strength:

A

Implant-bone interface

128
Q

Twisting force:

A

Torsion strength

129
Q

What motion is used on a wrench to place dental implants?

A

Torque

130
Q

What type of strength is not relevant to direct or indirect dental restorations?

A

Torsion strength

131
Q

Bending force

A

Flexural strength

132
Q

Measure of stress to cause failure in bending:

A

Flexural strength

133
Q

What type of test is used to determine flexural strength?

A

3-point bend test

134
Q

The 3-point bend test takes into account:

A
  1. Compressive load
  2. Combination of compressive & tensile stress
135
Q

______ strength is relevant in numerous clinical situations:

A

Flexural stress/strength

136
Q

Type of strength vital to occlusal load:

A

Flexural strength

137
Q

Flexural strength is vital to occlusal load on both:

A
  1. Direct restorations
  2. Indirect/removable
138
Q

Protrusive movement is an example of dental stress on _____ teeth

A

Anterior

139
Q

Flexure load on incisors=

A

Protrusive movement

140
Q

Chewing= _____ load

A

Compressive

141
Q

Posterior occlusion is an example of:

A

Compressive load

142
Q

Posterior occlusion occurs at:

A

Marginal ridge contact areas & fossae

143
Q

Equation for occlusal stress:

A

Occlusal stress= (occlusal load) / (occlusal contact area)

144
Q

Allows for distribution of occlusal load across maximum area, resulting in minimized stress

A

Tripodized occlusal contacts

145
Q

Premature contact results in:

A

Decreased area

146
Q

With a premature contact the patient’s occlusal force _____ but the occlusal stress is ____

A

stays the same; increased

147
Q

The DEFORMATION that occurs in a material when forces is applied to the material:

A

Strain

148
Q

Equation for strain:

A

Strain= (change in strength) / (unit original strength)

149
Q

____ & ____ are interrelated, if you have one you have the other

A

Stress & strain

150
Q

Example of stress & strain curve:

A

Someone on a diving board

151
Q

Temporary distortion of a material by an applied force:

A

elastic strain

152
Q

In elastic strain, strain is:

A

Below the elastic limit

153
Q

In this type of strain, once force is removed:

A

Materials revert to original form

154
Q

Example of elastic strain:

A

Rubber band

155
Q

Permanent distortion of any material:

A

Plastic strain

156
Q

In plastic strain, strain is:

A

Beyond the elastic limit

157
Q

In plastic strain:

____ portion of strain is recovered while ____ portion of strain is NOT recovered

A

Elastic; plastic

158
Q

In this type of strain, when force is removed, shape remains unchanged:

A

Plastic strain

159
Q

Example of plastic strain:

A

Bending a paper clip

160
Q

Amalgam is placed in a _____ state and carved before it hardens:

A

Plastic state

161
Q

Amalgam alloy composition:

Elements that make it up and their percents:

A
  1. Ag- 70%
  2. Sn- 16%
  3. Cu- 13%
  4. Zn- 1%
162
Q

What principle properties do the following elements of amalgam contribute:

  1. Silver
  2. Tin
  3. Copper
  4. Zinc
A
  1. Strength
  2. Expansion
  3. Strength
  4. Deoxidizer
163
Q

Amalgam is an alloy of _____ , ____, ____& ____
& is mixed with _____ to form an alloy that can be packed into a dental preparation

A

Silver, copper, tin & zinc

Mercury

164
Q

Amalgam in capsule= ______. It is mixed with _____ in _____

A

Powder; liquid mercury; triturator

165
Q

Low copper amalgam similar to G.V. Black’s original formula:

A

Conventional amalgam

166
Q

Amalgam that contains 9-30% copper, superior form & what we use in the U.S

A

High copper amalgam

167
Q

The presence of copper in high copper amalgam nearly ______ resulting in _____

A

Nearly eliminates the gamma-2 phase; stronger restoration

168
Q

The presence of _____ in a high copper amalgam nearly eliminates the gamma-2 phase

A

Copper (9-30%)

169
Q

Phases of amalgam setting include:

A

-Gamma
-Gamma-1
-Gamma-2

170
Q

Describe the gamma phase of amalgam setting:

A

Tin & silver react with mercury, forms silver-mercury (gamma-1) and tin-mercury (gamma-2)

171
Q

The gamma phase of amalgam setting can be described as:

A

Strong, corrosion resistant

172
Q

Describe gamma-1 phase of amalgam setting:

A

Silver-mercury, weaker & susceptible to corrosion

173
Q

Describe the gamma-2 phase of amalgam setting:

A

Tin-mercury, weakest, most susceptible to corrosion

174
Q

Adding copper to amalgam setting creates:

A

Copper-tin phase (eta), eliminated tin-mercury gamma-2 phase

175
Q

The following equation describes:

Gamma+mercury –> gamma+gamma-1+gamma-2

A

Low copper amalgam

176
Q

The following equation describes:

Gamma+copper+mercury –> gamma+gamma-1+CuSn

A

High copper amalgam

177
Q

List the shape of amalgam particles

A
  1. Lathe
  2. Admixed
  3. Spherical
178
Q

-Outdated
-particles formed by cutting block of alloy with a lathe
-results in large, irregular particles

A

Lathe

179
Q

-Lathe type particles mixed with small spheres
-requires more condensation force
-most commonly used type of amalgam
-low early strength (1 hour)

A

Admixed

180
Q

-Spherical shape
-higher early strength (1 hour) & higher 24-hour strength
-may be more difficult to achieve interproximal contact
-requires less condensation force

A

Spherical

181
Q

Which type of amalgam particles has a low early strength?

A

Admixed

182
Q

Between all the types of amalgam particles they have:

A

Similar clinical success but different handling properties

183
Q

What are the variables to amalgam manipulation (4)

A
  1. Mercury to alloy ratio
  2. Trituration
  3. Condensation
  4. Carving & finishing
184
Q

When considering the mercury to alloy ratio:

Less mercury in final restoration is:

A

Superior

185
Q

Most critical variable in amalgam restoration:

A

Condensation

186
Q

Most common error made by dentist in amalgam manipulation:

A

Under condensation

187
Q

Why not remove amalgam due to mercury concerns?

A
  1. Unwarranted loss of tooth structure
  2. Unneccesary expense
  3. Limited longevity when replaced (new restoration)
188
Q

Amalgam has ____ compressive strength & _____ tensile strength

A

Compressive; tensile

189
Q

Amalgam is ____ in small bulk

A

Brittle

190
Q

Amalgam requires _____ of material to avoid breaking:

A

Minimal thickness (1.5-2.0mm)

191
Q

Why can the isthmus be 1.0 mm minimal thickness of amalgam when the floor must be 1.5-2.0mm?

A

Because chewing forces are not directed at isthmus width

192
Q

Amalgam is sensitive to _____ during placement

A

Moisture contamination

193
Q

When ____ reacts with _____ in amalgam it causes an eventual expansion of the alloy out of the preparation

A

water; zinc

194
Q

Can amalgam corrode?

A

Yes

195
Q

Disadvantages of amalgam include: (6)

A
  1. Poor esthetics
  2. Need for good mercury hygiene
  3. Remove more tooth structure
    4 . No bonding
  4. Thermal conductor (leads to sensitivity)
  5. May ditch at margins after time
196
Q

Advantages of amalgam include (6):

A
  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
Q

Indications for amalgam: (8)

A
  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

Operative Dentistry I (6 decks)

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