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OPERATIVE II > class III and V sensitivity > Flashcards

class III and V sensitivity Flashcards

1
Q

class II pre-preparation

A
  1. clean the tooth
    -pumice slurry
    -consepsis: CHX, no emollients that would affect bond
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2
Q

shade selction

A

before placing rubber dam
-dehydrated tooth affects shade
-avoid shining light on tooth

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3
Q

at least 3 color esthetic zones on a tooth so

A

take shade from portion of shade guide most similar to thickness of restoration

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4
Q

shades
gingival:
middle:
incisal:

A

gingival: opaque
middle: blend of incisal and gingival
incisal: transulcent

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5
Q

class III prep occlusion

A

mark occlusion prior to applying dam
-avoid margins ending in occlusal contact areas

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6
Q

class III ___shaped preparations

A

wedge

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7
Q

where are caries in class III

A

usually more lingual than facial
gingival to contact area

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8
Q

approach from where when possible

A

lingual

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9
Q

to improve esthetics such as discoloration and deterioration less visible, color match easier and facial enamel is conserved when

A

may be acceptable to leave unsupported enamel on facial and incisal wall of preparation

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10
Q

preserve this contact in class II

A

incisal contact
-may be acceptable to leave sound enamel here NO HOOKS

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11
Q

begin outline form by preparing

A

PERPENDICULAR TO LONG AXIS

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12
Q

inciso-gingival height

A

1.5 on maxillary lateral
2.0 on maxillary central

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13
Q

this contact is broken:
this contact is intact:
this contact is MINIMALLY broken:

A

broken= gingival
intact= incisal
minimally= facial

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14
Q

mesio-distal width

A

1.5mm

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15
Q

is retention required?

A

not always

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16
Q

place prep in _____, do not undermine enamel

A

dentin

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17
Q

incisal point place with ______

A

1/2 or 1/4 round bur

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18
Q

gingival groove place with

A

1/2 or 1/4 round bur

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19
Q

place retention deeper than normal, but avoid placing retention to avoid

A

pulp exposure

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20
Q

class III bevel

A

place 1mm bevel lingual (or facial)
45 degrees
smooth and even
flame-shaped diamond bur

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21
Q

root surface caries:

A

same prep but DO NOT BEVEL on dentin or cementum

22
Q

do not bevel when

A

if there would be heavy centric contact on margin
-enamel wears better than composite
-enamel is stronger than composite

23
Q

can use this for added retention when not beveling

A

dovetail lock

24
Q

class III facial approach

A
  1. when lingual access may involve only centric contact of tooth
  2. irregular tooth alignment or rotation
  3. extensive caries on facial
  4. existing defective restoration on the facial
25
Q

class V prep

A

carious lesion in gingival third of tooth
can be buccal or lingual

26
Q

class V pre-prep

A
  1. clean tooth
  2. select shade
27
Q

isolation in class V rare instance

A

where it may be appropriate to use 212 clamp

28
Q

curing light

A

-light must have sufficient output(for all composite resins)
>550mW/cm^2
depending on composite
-darker shades need longer curing time or smaller increments

29
Q

class V prep

axial wall
M and D walls
incisal gingival height
axial depth

A
  1. axial wall convex
  2. mesial and distal walls diverged
  3. incisal gingival height= 1.5mm
    axial depth=1.0mm
30
Q

class V prep bevel

A
  1. use diamonds
  2. increases surface area
  3. increases retention
  4. reduces microleakage
    -reduces margin discoloration
    -eliminates white halo effect=better esthetics
  5. bevel ENDS of enamel rods
  6. add retention grooves
31
Q

when not to bevel with class V

A

below CEJ
-not in cementum

32
Q

class V restorations may extend onto the root surface.
polymerization shrinkage is greater than bond to cementum/dentin
this can cause

A

contraction gap

33
Q

this can minimize contraction gap

A

retention groove

34
Q

this restorative material can reduce microleakage

A

RMGI

and amalgam

35
Q

non carious cervical lesions

A
  1. abrasion- wear (toothbrush, pen chewing)
  2. erosion- caused by acid (gerd)
  3. abfraction- mechanical loss of tooth structure (loading forces in wrong spot= flexure of tooth and failure of enamel and dentin)
36
Q

bond strength to natural sclerotic dentin is ____% lower than sound to cervical dentin- REMOVE with bur

A

25-40%

37
Q

erosion

A

discuss diet (soda drinkers)
discuss medical history (acid reflux, dry mouth, bulimia)

38
Q

flexure and fatigue of enamel and dentin

A

abfraction

39
Q

caused by occlusal forces
-microfractures
-heavy occlusal force in lateral or eccentric occlusion
-stress is concentrated at cerical area of tooth causing fractures

A

abfraction

40
Q

when to treat non-carious cervical lesions

A
  1. lesion is deep enough to compromise tooth
  2. sensitivity
    -attempt non-surgical first
  3. involved in partial denture design
  4. defect in approaching pulp
  5. defect contributes to periodontal problem
    -overcontoured restorations more likely to produce perio problems
41
Q

for abrasion:

A

conservative extension
may need minimal to no prep

42
Q

pain caused by dentinal fluid movement
-from mechanical or chemical stimuli
-temp changes
-air drying
-osmotic pressure

A

hydrodynamic theory of dentin sensitivity (fluid-filled tubules)

43
Q

7 causes of tooth sensitivity

A
  1. caries or leaky restoration
  2. void-fluid flows into void (from CaOH liner having washed away)
  3. premature occlusion
  4. exposed dentin (recession or incomplete formation of CEJ)
  5. exposed cementum
  6. post-perio surgery
  7. abrasion and erosion (includes iatrogenic from polishing instruments)
44
Q

treatment options for sensitivity

A
  1. aim is to occlude tubules to stop fluid movement
  2. NONINVASIVE FIRST
    -topical fluoride
    -desensitizing dentifrices (toothpastes)
    -potassium nitrate in OTC
    -prevident 5000 sensitive (prescription)
  3. desensitizing agents
    -gluma
  4. if none of that works, restoration
45
Q

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

A

fluoride varnish

46
Q

with fluoride varnish, when can patient eat/drink and brush

A

eat and drink after
avoid hot food or sticky food
avoid brushing for at least 6 hours

47
Q

this desensitizing dentrifices toothpaste may take 1-3 months for results to be realized

A

Sensodyne (block drug company) strongtium chloride 10% and POTASSIUM NITRATE (KNO-gunpowder)

48
Q

this is placed by dentist when preparing tooth
-placed after etching for composite
-lightly dry
-place bond
-place composite

A

gluma (desensitizer)

49
Q

dentin hypersensitivity when

A

cracked tooth

50
Q

treatment for sens in class V lesions
when to restore vs when to leave

A

esthetic desire of pt
lesion >1.0mm depth and progressing
possible pulp exposure
structural integrity of tooth is threatened

51
Q

treatment for restoration that will block tubules

A

amalgam
composite
glass ionomer

52
Q

treatments why they work

A
  1. protein coagulation
  2. enzyme interference, blocking nerve impulses
  3. induction of tertiary dentin
  4. *various precipitates in dentinal tubules block fluid movement
  5. destruction of odontoblasts
  6. placebo effect

OPERATIVE II (11 decks)

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