Class II Amalgam Restorations

Question 1

10 simplified steps of class II Ag placement

Answer 1

1. placement of tofflemire band + wedge
2. Placement of iner and/or base (pulpal protection)
3. Placement of dentinal tubules sealer or dentin adhesive system
4. amalgam is mixed (triturated)
5. Triturated Ag carried to cavity prep
6. Ag is condensed in proximal box
7. Ag is condensed into the occlusal areas and the prep is overfilled
8. The Ag is carved to reproduce the portion of the tooth that is missing
9. The proximal contact is verified and confirm the absence of gingival and axial wall overhangs
10. Rubber dam is removed and occlusion verified for light contacts in static and dynamic function

Question 2

Describe the hydrodynamic theory

Answer 2

Theory that pain results from dentinal fluid movement in the tubules that stimulates mechanoreceptors near the pre-dentin.
Pulpal fluid has a slight POSITIVE pressure that forces fluid outward toward any breach in the external seal

Question 3

Fluid shift can be caused by:

Answer 3

• temperature changes
• air drying
• dental treatment (cutting)

Question 4

what is GLUMA (HERAUS)?

Answer 4

Desensitizer placed on conservative amalgam preps which inhibits flor of fluid through tubules by:

• precipitation of tubule proteins
• decreasing dentinal permeability
• occluding tubules

Question 5

What does hemaseal do?

Answer 5

binds with dentinal protein to COAGULATE DENTINAL FLUIDS - thus prevents them from shifting

Question 6

How to apply gluma and hemaseal

Answer 6

for both, the technique involves applying the material in a rubbing motion following toileting of the prep for 30 seconds with a microbrush. Then, prep is dried and Ag is added

Question 7

Super seal

Answer 7

oxalic acid and potassium salt in water

-desensitizes via dentin tubule occlusion by calcium oxalate precipitate

Question 8

when are dentin amalgam bonding systems typically used?

Answer 8

-for more excessive tooth preparations: deep excavation, wide isthmus, remaining tooth structure prone to fracture

Question 9

Which Blacks step is improved with dentin amalgam bonding systems?

Answer 9

improved RESISTANCE form.

Only some retention form is improved, but additional preparation features are still necessary for retention

Question 10

How to form occlusal embrasure

Answer 10

• open occlusal embrasure with the explorer.
• tip of the explorer touching the band at all times
• tip held at 45 degrees to the band

Question 11

What instrument should you use to remove excess Ag from proximal walls if the Ag has hardened?

Answer 11

IPC (interproximal carver)

Question 12

Steps for removing the matrix band

Answer 12

1. remove the wedge
2. stabilize the restoration with the tip of a large condenser
3. remove the band in an oblique direction

Question 13

Ideal restoration features:

Answer 13

1. smooth surface
2. fine anatomical detail
3. flush margins
4. proper contours
5. proper proximal contacts (position, size, shape)

Question 14

Which color of articulating paper should you use to check occlusion?

Answer 14

red = static
blue = lateral excursion
green = protrusive

Question 15

At which point should you check occlusion?

Answer 15

When the amalgam is hard but still carvable, otherwise you’ll have to use handpieces and bur