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Pres Res 2 > Class II Prep Review and Amalgam Restoring Review > Flashcards

Class II Prep Review and Amalgam Restoring Review Flashcards

1
Q

Class II caries

A

proximal of post teeth

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2
Q

Another name for Class II

A

smooth surface lesion

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3
Q

Where lesions are for class II

A

• Conical penetration through enamel • At DEJ, lateral spread
• Conical penetration through the dentin (apex toward the
pulpal tissues)
Lesions typically initiate just gingival to the
contact area

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4
Q

Where Class II penetrates and shape

A

• Conical penetration through enamel • At DEJ, lateral spread
• Conical penetration through the dentin (apex toward the
pulpal tissues)
Lesions typically initiate just gingival to the
contact area

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5
Q

Diagnosis of class II visually

A

chalky, opaque but only if dry and well lit

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6
Q

Once lesion has penetrated what we do a class II

A

DEJ-some other considerations

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7
Q

Best diagnosis of Class II lesion

A

Radiographic BW is the best-but does show less caries

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8
Q

Teeth that fracture most likely do not have what line angles

A

Rounded axial line angles-so fix it

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9
Q

Class II which was previously unrestored-when to treat it

A
  • Generally, when the DEJ has been penetrated by decay
  • Modifying factors:
  • Poor OH, high caries risk, socioeconomic status and/or age (young) • May opt to restore if 2/3 the enamel has been penetrated = clinical judgment
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10
Q

Class II which was previously restored-when to treat it

5

A
  • Fractured restoration • Gingival overhang (excess)
  • Non-physiologic contours
  • Light or no proximal contact
  • Poor marginal integrity
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11
Q

Prep Class II using what vision

A

Indirect

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12
Q

terminate on cusp margins in class II?

A

NO

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13
Q

General amalgam preparation principles apply (8)

A
  • Do not terminate margins on cusp tips
  • All friable/weakened (unsupported) enamel should be removed
  • Preserve cuspal/marginal ridge/transverse ridges for strength
  • Avoid extension to unaffected fissures
  • Preserve cuspal inclines
  • Smooth curves, no sharp edges
  • Pulpal depth 1.5mm from pits/grooves
  • 90° Cavosurface margins
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14
Q

pulpal depth of Class II amalgam prep

A

1.5mm

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15
Q

Factors that contribute to Outline Form Clinically (5)

A
  • Tooth anatomy: pits & fissures
  • Adjacent structures (hard and soft tissues)
  • Buccal and Lingual embrasures
  • Gingival embrasures
  • Contacts with adjacent structures must be broken
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16
Q

How much room between contacts in class 2

A

• Approximately 0.5mm or the tine of the explorer

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17
Q

Class II Resistance Form

A

90 degree cavosurface margin angles

Internal walls placed in dentin (0.5mm)

Flat pulpal floor

Flat gingival floor/seat

“Rounded” axio-pulpal line angle (and other internal line angles)

Divergence of appropriate wall (when applicable)

Adequate pulpal depth

Preservation of unaffected structure

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18
Q

Internal walls of Class II prep depth

A

Internal walls placed in dentin (0.5mm)

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19
Q

Retention form of Class II prep- O or proximal?

A

The occlusal and proximal portions should be

independently retentive

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20
Q

Retention form of Class II (4)

A
  • Convergent occlusal walls
  • Occlusal dovetails
  • Convergent proximal walls

• “Proximal locks” = proximal retention
grooves*

—-Convergent & more prominent gingivally
because they fade out occlusally

—-Placed 0.5mm inside DEJ • *When utilized

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21
Q

when used, where are proximal locks placed

What are their walls like

A

• Convergent & more prominent gingivally

because they fade out occlusally • Placed 0.5mm inside DEJ • *When utilized

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22
Q

Always use proximal lock on class II?

A

NO-only extensive preps

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23
Q

Walls of Class II (converge, straight, diverge)??

A
  • Convergent occlusal walls
  • Occlusal dovetails
  • Convergent proximal walls

Class 1 part is just like usual

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24
Q

Convenience form of Class 2, how to obtain it?

A

• Generally obtained by cutting through the occlusal (and marginal
ridge) to access the proximal lesion

• May require additional extension for access or vision

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25
Q

More decay beyond bulk of it on class II prep, do what?

A

Only extend to caries, not all of the walls

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26
Q

Evaluate the soft tissue after a class II, what may be needed?

A

Hemorrhage control may be necessary

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27
Q

Isthmus width of class II

A

Isthmus width at ¼ the

intercuspal distance

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28
Q

Axial wall contour of class II

A

Axial wall follows the external

contour of the tooth

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29
Q

gingival floor seat dimension is what on class II

A

Gingival floor/seat dimension is
1.0-1.5mm axially • Maintain marginal ridge width
for strength

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30
Q

Tofflemire Matrix System

used for

A

Used for amalgam restorations

• Generally NOT used for composite resin restorations*

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31
Q

Components of Tofflemire Matrix System

A

Two main components: retainer & bands

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32
Q

Tofflemire Retainer

components (4)

A

Head
-U-shaped, has three guides or slots
for the position of the band

Locking Vise
-sliding body that holds the band

Long Knob
-changes the diameter of the loop

Short Knob
-locks the band in place within the sliding body

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33
Q

Head function on Tofflemire retainer

A

-U-shaped, has three guides or slots

for the position of the band

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34
Q

Locking vise tofflemire retainer

A

-sliding body that holds the band

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35
Q

Long knob of tofflemire retainer

A

-changes the diameter of the loop

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36
Q

Short knob of tofflemeir

A

-locks the band in place within the sliding body

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37
Q

Tofflemire Matrix Bands

• Uses and Purposes

A

• To restore a proximal surface or surfaces of teeth (Primarily for Class II Restorations)

Aid development of proper contact
Aid development of proper contour
Confine restorative material
Reduce amount of excess restorative material

• Protect teeth adjacent to tooth being prepared
band adjacent teeth

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38
Q

Matrix Bands
• Desirable Properties

(6)

A
  • Easy to apply and remove, convenient
  • Extend below gingival margins of preparation
  • Extend above the marginal ridge height
  • Resist deformation (rigidity) during material placement
  • Ability to be contoured
  • Versatility (size/shape)
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39
Q

• Note: May burnish the contact area with a burnisher after placement to help obtain proper contact

A

.

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40
Q

Matrix Bands

• What’s with the bumps?

A 
There are different band sizes,
shapes and thickness depending on application
-Universal bands
-MOD band
-Pediatric bands
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41
Q

3 types of matrix bands

A
  • Universal bands
  • MOD band
  • Pediatric bands
42
Q

The band arch of the matrix band goes towards

A

the O

43
Q

The band arch of the matrix band does NOT go towards the? Hence the open end is where?

A

NOT apical

Open end is supposed to be apical

44
Q

The orientation of the matrix band in the retainer is the same for which two quadrants (use Upper right as reference)

A

The orientation of the matrix band in the retainer is the same for the Maxillary (Upper) Right and Mandibular (Lower) Left quadrant.

45
Q

Orientation of matrix band is the same for the Maxillary (Upper) Left and _______

A

Mandibular (Lower)Right quadrant.

46
Q

Tofflemire Placement - Summary

• Band to Retainer Relationship-Narrow end of loop towards????

A

Narrow end of the loop that is formed should be toward the

neck of the tooth (gingival aspect)

47
Q

Matrix band System to Tooth Relationship

—The band is Oriented so the retainer is on the ______ side of the teeth

A

Buccal

**sometimes this will not work so do L

48
Q

The band of the retainer is placed on the B unless what

A

missing buccal tooth structure = no support

USE L

49
Q

Slot (opening) of retainer should be toward the _____ of the tooth

Why?

A

Facilitates removal

Slot (opening) of retainer should be toward the neck of the
tooth (gingival aspect)

50
Q

Wedges: Uses and Purpose

A

Helps compress matrix band against the tooth structure to

create a tighter seal

51
Q

Why do we use wedges to help compress matrix band

against the tooth structure (2)

A

to create a tighter seal and prevent gingival overhangs

52
Q

Wedge should compensate for thickness of

A

matrix band

53
Q

Material types of wedges (2)

A

Wood and plastic

54
Q

Types of plastic wedges (3)

A
  • Anatomic
  • Fender
  • Others
55
Q

Anatomic wedges

A

Triangle on one side and square on the other-built in contous

56
Q

Type of wood used for matrix wedges?

A

Most made of sycamore

wood

57
Q

Con of plastic wedges vs wood

A 
• Most made of sycamore
wood
• When they get wet, they
expand and conform to
the interproximal area
• Plastic wedges cannot
do this
58
Q

Pro of wood wedges

A 
• Most made of sycamore
wood
• When they get wet, they
expand and conform to
the interproximal area
59
Q

How do plastic wedges compensate for not expanding like wood ones

A

conform to tooth

60
Q

Fender

A

Separates tooth being worked on from adjacent

61
Q

Fender has built in what

A

Fin of Silver matrix

62
Q

Why we got rid of fenders

A

Sharp-they cut people

63
Q

Wedge function considering gingival tissue (2-3)

A

Retraction of the gingival tissue
• Occupying space in the gingival
embrasure
• Sealing the seat

64
Q

A wedge placed in the wrong place or wrong size

A

A wedge placed in the wrong position (too occlusally) or the wrong
sized wedge (too large) can hinder the development of a physiologi
contact area

65
Q

A wedge placed in the wrong position (too ______) or the wrong
sized wedge (too ____) can hinder the development of a physiologi
contact area

A

O

large

66
Q

Wedges can be placed on which side of tooth

A

B or L

67
Q

When a matrix band is used on the buccal, the buccal area is difficult to access due to

A

the retainer

Therefore, you may have to place the wedge from the
lingual

68
Q

used to place wedges

A

• Place wedges with your cotton forceps or

hemostat

69
Q

Amalgam Condensation Overview

Goals (3)

A
  1. Compact the alloy
    • Increase density
    • Eliminate voids
  2. Adaptation to the preparation walls and internal line angles/point angles
  3. Reduce excess mercury
    • Forces any excess liquid to the surface, which will later be removed (during carving)
70
Q

Compacting amalgam does what (3)

A

Increase density

Eliminate voids

Reduce excess mercury
-Forces any excess liquid to the surface, which will later be removed (during carving)

71
Q

When choosing a condenser, the face of the nib should ____

A

fit into all

areas of the preparation

72
Q

Condensation pressure and the relation to the size of the nib

A
  • Directly related to the load applied
  • Indirectly related to the area of the nib

***Thus smaller nibs produce more Force (smaller S.A)

73
Q

Condensation force used on amalgam

A

Condensation force:
• Ideally 6-10lbs of force

(10lbs of force with a 2mm diameter condenser = 2000 psi)

• Vertical & lateral condensation is required

74
Q

(10lbs of force with a 2mm diameter condenser = ____ psi

A

2000psi

75
Q

Directions of condensation on class 2

A

Vertical and horizontal!!!`

76
Q

The critical factor in placement technique for amalgam prep (especially class II)

A

Condensing

77
Q

Condensation: Technique

3

A

Condensation: Technique 1. Should be orderly and overlapping
• Add incrementally • Generally, use smaller condenser first (NOTE: Larger will be used as
preparation becomes more filled) • Deepest part of preparation first!
2. Overfilling / Overpacking
• Assures Hg rich layer will be removed
• Aids in closed margins 3. Time
• Too long = increased voids
• 1 minute beyond manufacturer’s recommendation results in >30% increase
in residual Hg

78
Q

Goal of amalgam carving

A

Reproduce anatomy that results in proper form & function

79
Q

How to prevent flash

A

SHARP INSTRUMENT

80
Q

Flash

A

Flash is an extension of the restorative material beyond the preparation
margins
• Thin & brittle = prone to fracture

81
Q

When should carving be initiated?

A

Carving should be initiated before the amalgam has reached its initial set

82
Q

Pre-check what before preparation for amalgam

A

Occlusion

83
Q

Before you carve amalgam you do what

A

burnish-to remove overpack and approach margins

84
Q

Anatomy to consider on tooth when carving

A

Think grooves, cuspal incline, ridges, fossa

85
Q

When carving amalgam-if the grooves are too deep (3)

A

Thin amalgam = prone to fracture

Potential for exposure of preparation walls

Difficult to finish (or polish when necessary)

86
Q

Use what to check occlusion? (product)

A

accufilm

87
Q

Use accufilm with what for accuracy

A

accufilm ribbon

88
Q

Over carving in a amalgam prep can lead to what

A

Over-carving may lead to an under-contour having a poor effect on soft
tissues (buccal, lingual, proximals)

89
Q

Check occlusal contacts in which 2 directions

A

Check occlusal contacts in centric

• Check occlusal contact in lateral excursions

90
Q

Post prep—Instruct patients to avoid chewing _____ or _____ foods on new restorations for the
first____hrs (chew on other side) to allow
full set of amalgam

A

hard or chewy foods for 24 hours

91
Q

Sensitivity to hot or cold sometimes

occurs. (If symptoms last longer than ______ or are severe, they should call your
office. )

A

2 weeks

92
Q

Contour marginal ridge on amalgam with what on class 2 with band

A

explorer

93
Q

First thing to do on amalgam carving of class II with band

A

get embrasure with band on

94
Q

First area to work on in a class II prep once the matrix band is removed

A

• Check for overhangs

first!

95
Q

when to check for overhang in class II amalgam prep

A

First thing after removing band while material is more soft!

96
Q

Detach amalgam from matrix band using the ______

• This will also help to shape the occlusal embrasure

A

tip of the explorer

97
Q

If only one proximal is being restored, remove the ____ side first -> then the ___ -> then the ___

A

opposite

wedge

side being restored

98
Q

Wedge should be removed with

A

hemostat or cotton pliers

99
Q

Matrix band should be removed how?

Why?

A

Matrix band should be removed vertically, but at 45 degrees

• Help maintain contact

100
Q

Potential Problems During Matrix Band Removal

A

• Fracture of the restoration
• If the marginal ridge fractures below the cavosurface of the preparation, the
restoration must be removed • Replace matrix system & wedge • Re-restore the preparation

Pres Res 2 (4 decks)

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