Class II Composite Resin Restorations

Question 1

List the 5 steps to a composite restoration

Answer 1

1. Rubber Dam
2. Removal of Caries
3. Remove Unsupported tooth structure
4. Prepare margin
5. Restore

Question 2

What must be considered when using amalgam versus composite when preparing the preparation?

Answer 2

Amalgam preparations must have retention incoorperated due to inability to bond to tooth structure

Question 3

Biggest contra-indication for using composite restoration and WHY

Answer 3

Isolation of the operating field – composite will not bond to tooth structure if wet!

Question 4

Second biggest contra-indication for composite restorations

Answer 4

Patients with high caries risks!

Question 5

DEPTH of restoration material

Amalgam?

Composites and Sealants?

Answer 5

Minimum of 1.5mm - amalgam

Can be very thin! <1.5mm or even larger - composites and sealants

Question 6

What can happen if an amalgam restoration had a depth of 1.2mm?

Answer 6

Subject to fracture (ideal = 1.5 mm)

Question 7

Amalgam outline form must be atleast ___ mm into the DEJ @axial wall

Answer 7

0.5mm

Question 8

___ ___ is a mechanism used for added retention in a proximal box for an amalgam restoration

Answer 8

Retention lock

Question 9

CAVOSURFACE MARGIN -amalgam

Enamel must have a marginal configuration of ___* or GREATER and the ____ must have the SAME!

Answer 9

90*

Amalgam restoration

Question 10

Terms used if there are failures to the cavosurface margin of the amalgam restoration

Answer 10

1. Open Margin
2. Sub-margin
3. Overhang

Question 11

PRIMARY RETENTION FORM for an amalgam restoration is incorperated via…

Answer 11

1. Converging buccal and lingual walls
2. <90* line angles of the open margins B&L

Question 12

Term – Helps the restoration and tooth resist fracture due to occlusal forces

Answer 12

Primary Resistance Form

Question 13

Amalgam restorations must me ____ locked inside the tooth

Answer 13

mechanically

Question 14

Composite restorations are held in place by ___-________ retention of the bonding agent

Answer 14

micro-mechanical

Question 15

Primary Resistance Form is accomplished by what 4 things?

Answer 15

1. Conserving tooth structure, preserving cusps and ridges
2. Preparing pulpal and ginigval walls perpendicular to the occlusal forces
3. Rounding internal preparation angles

Question 16

Term– makes the procedure easier / area more accessible

Answer 16

Convenience Form

Question 17

By providing clearance from the adjacent teeth and extension of the other walls to provide greater access for caries excavation is and EXAMPLE of—

Answer 17

Convenience Form

Question 18

For COMPOSITE restorations…

1. pulpal and axial depths are dictated only by _____ (DO NOT need to be uniform)
2. Proximal extensions are dictated by the _____

Answer 18

Depth of the lesion

Extent of the lesion

Question 19

True or False?

You do not need to remove the undermined enamel cavo-surface margin for a composite resoration prep

Answer 19

FALSE!

ALWAYS remove unsupported enamel!

Question 20

Sealants are a type of composite-resin and are appplied to..?

Answer 20

Pits and Fissures

Question 21

True or False?

You do NOT always need to prep a pit/fissure before placing a sealant

Answer 21

True

Question 22

After etching the entire occlusal surface and applying composite, what can be placed in the small occlusal grooves on top of the composite?

Answer 22

Flowable Composite

Question 23

Is it necessary for the floor of the preparation to be smooth for composite to properly bond to the tooth structure?

Answer 23

NO

Question 24

What can be placed under a composite is the prep is rather deep?

Answer 24

Insulated Liner - Dycal (CaOH)

Glass Ionomer - releases fluoride

Question 25

How do you detect interproximal caries?

Answer 25

Bitewing radiographic examination Transillumination

Question 26

Incipient caries means that...

Answer 26

there are adjacent interproximal caries

Question 27

Instead of using radiation to detect interproximal, an ______ can be used without radiation

Answer 27

Endo-Lite Guide (Transillumination)

Question 28

Proximal caries will have an ______ white appearance compared to the rest of the enamel

Answer 28

Opaque or darkened

Question 29

COMPOSITE - BOX - PREP Qualifications:

Answer 29

- Small interproximal lesion - no occlusal lesions - proximal contact does not need to be achieved

Question 30

COMPOSITE - SLOT - PREP Qualifications:

Answer 30

- lesion is accessible from facial or lingual side of tooth - final cavity design does not undermine the marginal ridge - think of Class V below CEJ (slot prep will have supported enamel) - common procedure to have if patient has gum recession

Question 31

4 Devices used to achieve contact for composite proximal restorations

Answer 31

1. Tofflemire 2. AutoMatrix 3. Original Palodent 4. Advanced Sectional Matrix System

Question 32

What type of device will be acceptable to use if the proximal box does not break contact?

Answer 32

Tofflemire Retainer with a STRONG wedge

Question 33

Major problem with using a tofflemire band and wedge for composites:

Answer 33

Poor contouring; difficult to achieve anatomically correct contours with wooden wedges

Question 34

What device may be acceptable to use if there is little to none remaining tooth structure or adjacent tooth structure?

Answer 34

Automatrix -- lacks proper contouring as well

Question 35

Components of the Advanced Matrix System and their duty: 1. Wedge 2. Ring

Answer 35

Wedge - holds the band in place Ring - separates adjacent tooth from the prep so optimal proximal contours are created

Question 36

If the composite you are using is NOT a bulk fill composite, the _____ method is used in increments to cure properly

Answer 36

Layering