Class II Composite Resin Restorations Flashcards
List the 5 steps to a composite restoration
- Rubber Dam
- Removal of Caries
- Remove Unsupported tooth structure
- Prepare margin
- Restore
What must be considered when using amalgam versus composite when preparing the preparation?
Amalgam preparations must have retention incoorperated due to inability to bond to tooth structure
Biggest contra-indication for using composite restoration and WHY
Isolation of the operating field – composite will not bond to tooth structure if wet!
Second biggest contra-indication for composite restorations
Patients with high caries risks!
DEPTH of restoration material
Amalgam?
Composites and Sealants?
Minimum of 1.5mm - amalgam
Can be very thin! <1.5mm or even larger - composites and sealants
What can happen if an amalgam restoration had a depth of 1.2mm?
Subject to fracture (ideal = 1.5 mm)
Amalgam outline form must be atleast ___ mm into the DEJ @axial wall
0.5mm
___ ___ is a mechanism used for added retention in a proximal box for an amalgam restoration
Retention lock
CAVOSURFACE MARGIN -amalgam
Enamel must have a marginal configuration of ___* or GREATER and the ____ must have the SAME!
90*
Amalgam restoration
Terms used if there are failures to the cavosurface margin of the amalgam restoration
- Open Margin
- Sub-margin
- Overhang
PRIMARY RETENTION FORM for an amalgam restoration is incorperated via…
- Converging buccal and lingual walls
- <90* line angles of the open margins B&L
Term – Helps the restoration and tooth resist fracture due to occlusal forces
Primary Resistance Form
Amalgam restorations must me ____ locked inside the tooth
mechanically
Composite restorations are held in place by ___-________ retention of the bonding agent
micro-mechanical
Primary Resistance Form is accomplished by what 4 things?
- Conserving tooth structure, preserving cusps and ridges
- Preparing pulpal and ginigval walls perpendicular to the occlusal forces
- Rounding internal preparation angles
Term– makes the procedure easier / area more accessible
Convenience Form
By providing clearance from the adjacent teeth and extension of the other walls to provide greater access for caries excavation is and EXAMPLE of—
Convenience Form
For COMPOSITE restorations…
- pulpal and axial depths are dictated only by _____ (DO NOT need to be uniform)
- Proximal extensions are dictated by the _____
Depth of the lesion
Extent of the lesion
True or False?
You do not need to remove the undermined enamel cavo-surface margin for a composite resoration prep
FALSE!
ALWAYS remove unsupported enamel!
Sealants are a type of composite-resin and are appplied to..?
Pits and Fissures
True or False?
You do NOT always need to prep a pit/fissure before placing a sealant
True
After etching the entire occlusal surface and applying composite, what can be placed in the small occlusal grooves on top of the composite?
Flowable Composite
Is it necessary for the floor of the preparation to be smooth for composite to properly bond to the tooth structure?
NO
What can be placed under a composite is the prep is rather deep?
Insulated Liner - Dycal (CaOH)
Glass Ionomer - releases fluoride
How do you detect interproximal caries?
Bitewing radiographic examination
Transillumination
Incipient caries means that…
there are adjacent interproximal caries
Instead of using radiation to detect interproximal, an ______ can be used without radiation
Endo-Lite Guide (Transillumination)
Proximal caries will have an ______ white appearance compared to the rest of the enamel
Opaque or darkened
COMPOSITE - BOX - PREP
Qualifications:
- Small interproximal lesion
- no occlusal lesions
- proximal contact does not need to be achieved
COMPOSITE - SLOT - PREP
Qualifications:
- 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
4 Devices used to achieve contact for composite proximal restorations
- Tofflemire
- AutoMatrix
- Original Palodent
- Advanced Sectional Matrix System
What type of device will be acceptable to use if the proximal box does not break contact?
Tofflemire Retainer with a STRONG wedge
Major problem with using a tofflemire band and wedge for composites:
Poor contouring; difficult to achieve anatomically correct contours with wooden wedges
What device may be acceptable to use if there is little to none remaining tooth structure or adjacent tooth structure?
Automatrix – lacks proper contouring as well
Components of the Advanced Matrix System and their duty:
- Wedge
- Ring
Wedge - holds the band in place
Ring - separates adjacent tooth from the prep so optimal proximal contours are created
If the composite you are using is NOT a bulk fill composite, the _____ method is used in increments to cure properly
Layering
