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Operative II > Class III and V Composite Preparations > Flashcards

Class III and V Composite Preparations Flashcards

1
Q

What is a class three prep?

A

interproximal areas in the anteriors

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2
Q

What is the first part of a class III pre-prep?

A

Clean the tooth!
◦ Pumice slurry
◦ Consepsis
◦ CHX
◦ No emollients that would affect bond

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3
Q

When should you select the shade of composite?

A

before placing the rubber dam
- dehydrating the tooth affects the shade

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4
Q

What do you do if you are unsure of what shade of composite to use?

A

Cure small blob of composite on tooth to check shade
- don’t etch and bond and the composite will flick off

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5
Q

What are the three color esthetic zones of the tooth?

A
  • gingival = opaque
  • middle = blend of incisal and gingival
  • incisal = translucent
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6
Q

TAKE SHADE FROM PORTION OF SHADE GUIDE THAT IS…

A

MOST SIMILAR TO THICKNESS OF RESTORATION

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7
Q

When should you mark occlusion?

A

before applying the rubber dam

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7
Q

What is the shape of the class III prep?

A

wedge shape

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7
Q

Avoid margins of prep ending in…

A

occlusal contact areas

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8
Q

Where are the caries for a class III prep?

A

◦ Usually more lingual than facial
◦ Gingival to contact area

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9
Q

Where should you approach from doing a class III prep?

A

lingual

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10
Q

Why do you approach from the lingual on a class III prep?

A

◦ Caries tend to be more lingual
◦ Esthetics improved
◦ Discoloration and deterioration is less visible
◦ Color match is easier
◦ Facial enamel is conserved
◦ May be acceptable to leave unsupported enamel on facial and incisal wall of prep

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11
Q

Do you drill the incisal edge for a class III prep?

A

NO, Preserve incisal contact
◦ It may be acceptable to leave sound undermined enamel here

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12
Q

How should you do a class III prep?

A

Begin outline form
◦ Prepare PERPENDICULAR to long axis
Inciso-gingival height
◦ 1.5 on maxillary lateral
◦ 2.0 on maxillary central
Mesial distal width
◦ 1.0 on maxillary lateral
◦ 1.5 on maxillary central

Gingival contact is broken
Incisal contact is intact

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13
Q

For a class III prep you enter _________ to the long axis of the tooth

A

perpendicular

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14
Q

What should the inciso-gingival height be for the class III prep?

A

◦ 1.5 on maxillary lateral
◦ 2.0 on maxillary central

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15
Q

What should the mesial distal width be for the class III prep?

A

◦ 1.0 on maxillary lateral
◦ 1.5 on maxillary central

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16
Q

Where is the incisal point retention for a class III prep?

A

incisal portion of prep
- place with a 1/2 or 1/4 round

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17
Q

Where is the gingival groove retention for a class III prep?

A

at the gingival-axis line angle
- place with a 1/2 or 1/4 round

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18
Q

How deep are the retention points/grooves for the class III prep?

A

◦ Place point and groove where they would be in an ideal prep (even if the prep is deep)

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19
Q

Where do you bevel for a class III prep?

A

gingival and lingual boxes
◦ Place 1mm bevel lingual (or facial)
◦ 45 degrees
◦ Smooth, even
◦ Flame-shaped diamond bur

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20
Q

How much contact to you break facially?

A

minimally

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21
Q

If you would have heavy contact on the margin of a class III prep what can you do?

A

dovetail
- don’t bevel
◦ Enamel wears better than composite
◦ Enamel is stronger than composite

21
Q

What do you do if caries are on the facial for a class III prep?

A

◦ Facial approach
◦ When lingual access may involve only centric contact of tooth
◦ Irregular tooth alignment or rotation
◦ Extensive caries on the facial
◦ Existing defective restoration on the facial

21
Q

What is the root surface caries class III?

A
  • same class III prep but do not bevel on dentin or cementum
22
Q

What is a class V prep?

A

-Carious lesion in gingival third of tooth
◦ Can be buccal or lingual

23
Q

What are the first things you do for a class V prep?

A
  • clean the tooth
  • select the shade
24
Q

You mightuse a _____ clamp for class V preparation

A

212 clamp

25
Q

What amount of light is required for sufficient output for composite?

A

more than 550 mW/cm^2

26
Q

What is the axial wall of a class V preparation?

A

convex

27
Q

What are the mesial and distal walls of the class V prep?

A

diverged

27
Q

What is the axial depth of a class V prep?

A

1.0 mm

28
Q

What is the incisal gingival height?

A

1.5 mm

29
Q

What burs should you use to bevel a class V prep?

A

DIAMONDS

30
Q

Where do you not bevel on a class V prep?

A

below CEJ

31
Q

What is the modification for shallow caries or decalcified enamel ajacent to class V caries?

A

extend the bevel

32
Q

What should you know about class V prep bevels?

A

◦ Increases surface area
◦ Increases retention
◦ Reduces microleakage
◦ Reduces margin discoloration
◦ Eliminates white “halo” effect= better esthetics
◦ Bevel ENDS of enamel rods
◦ Add Retention grooves

33
Q

What are reasons for a class V prep besides caries?

A
  • abrasion (wear with toothbrush, grinding)
  • erosion (caused by acid; bulimia, GERD)
  • abfraction (mechanical loss of tooth structure)
33
Q

What can happen with a class V restoration on root surface?

A
  • Polymerization shrinkage
  • Causes contraction gap
  • adding a retention groove can help
  • maybe use other materials (amalgam, RMGI)
34
Q

If someone needs class V preps for abrasion what do you tell patient?

A

◦ Discuss habits with patient, including brushing
◦ Bond strength to natural sclerotic dentin is 25-40% lower than to sound cervical dentin- REMOVE with bur

35
Q

If someone needs class V preps for erosion what do you tell patient?

A

Discuss diet
◦ Chew/suck on lemons
◦ Frequent soda/energy drink intake

Discuss medical history
◦ Acid reflux
◦ Bulimia
◦ Dry mouth from medications
◦ Lack saliva to buffer acid

36
Q

What causes abfraction?

A

◦ Flexure and fatigue of enamel and dentin
◦ Caused by occlusal forces (Microfractures, Heavy occlusal force in lateral or eccentric occlusion)
◦ Stress is concentrated at cervical area of tooth, causing fractures

37
Q

When do you treat non-carious cervical lesions?

A

◦ Lesion is deep enough to compromise tooth
◦ Sensitivity
◦ Involved in partial denture design
◦ Defect is approaching pulp
◦ Defect contributes to a periodontal problem

38
Q

What is the hydrodynamic theory of dentin sensitivity?

A

◦ Pain caused by dentinal fluid movement
◦ From mechanical or chemical stimuli
◦ Temperature changes
◦ Air drying
◦ Osmotic pressure

39
Q

What are the causes of tooth sensitivity?

A
  • Caries or leaky restoration
  • Void- fluid flows into void
  • Premature occlusion
  • Exposed dentin (Recession or incomplete formation of CEJ)
  • Exposed cementum
  • Post- perio surgery
  • Abrasion and erosion
40
Q

What are noninvastive treatments for sensitivty?

A

◦ Topical fluoride
◦ Desensitizing dentifrices (toothpastes)
—Potassium nitrate in OTC
—Prevident 5000 Sensitive (prescription)
◦ Desensitizing agents (Gluma)

41
Q

What is the goal of treatment for sensivity?

A

Aim is to occlude tubules to stop fluid movement

41
Q

What is fluoride varnish?

A

a sticky, yellow, semi-liquid containing 5% NaF in a resin base mixed with alcohol to dry quickly after application

42
Q

Patient should avoid brushing teeth for at least __ hours after application

A

6 hours

43
Q

Densensitizing toothpastes may take ____ months for results to show

A

1-3

44
Q

What is in sensodyne?

A

Strontium chloride 10% and Potassium Nitrate (KNO-gunpowder)

45
Q

What is the process of applying gluma?

A

◦ Place after etching (for composite restorations)
◦ Lightly dry
◦ Place bonding agent
◦ Place composite
◦ Can also be used with amalgam, but fewer steps

46
Q

If you have sensitivity in class V lesions when do you restore?

A
  • Esthetic desire of patient
  • Lesion >1.0mm depth
  • Possible pulp exposure
  • Structural integrity of tooth is threatened
47
Q

Why does treatment/restorations for sensivity work?

A

blocks tubules

48
Q

Why do treatments work to stop sensivity?

A
  • Protein coagulation
  • Enzyme interference, blocking nerve impulses
  • Induction of tertiary dentin
  • Various precipitates in dentinal tubules block fluid movement
  • Destruction of odontoblasts
  • Placebo effect (40% of patients respond to application of distilled water)

Operative II (8 decks)

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