class III and V sensitivity

Question 1

class II pre-preparation

Answer 1

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

Question 2

shade selction

Answer 2

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

Question 3

at least 3 color esthetic zones on a tooth so

Answer 3

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

Question 4

shades
gingival:
middle:
incisal:

Answer 4

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

Question 5

class III prep occlusion

Answer 5

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

Question 6

class III ___shaped preparations

Answer 6

wedge

Question 7

where are caries in class III

Answer 7

usually more lingual than facial
gingival to contact area

Question 8

approach from where when possible

Answer 8

lingual

Question 9

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

Answer 9

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

Question 10

preserve this contact in class II

Answer 10

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

Question 11

begin outline form by preparing

Answer 11

PERPENDICULAR TO LONG AXIS

Question 12

inciso-gingival height

Answer 12

1.5 on maxillary lateral
2.0 on maxillary central

Question 13

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

Answer 13

broken= gingival
intact= incisal
minimally= facial

Question 14

mesio-distal width

Answer 14

1.5mm

Question 15

is retention required?

Answer 15

not always

Question 16

place prep in _____, do not undermine enamel

Answer 16

dentin

Question 17

incisal point place with ______

Answer 17

1/2 or 1/4 round bur

Question 18

gingival groove place with

Answer 18

1/2 or 1/4 round bur

Question 19

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

Answer 19

pulp exposure

Question 20

class III bevel

Answer 20

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

Question 21

root surface caries:

Answer 21

same prep but DO NOT BEVEL on dentin or cementum

Question 22

do not bevel when

Answer 22

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

Question 23

can use this for added retention when not beveling

Answer 23

dovetail lock

Question 24

class III facial approach

Answer 24

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

Question 25

class V prep

Answer 25

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

Question 26

class V pre-prep

Answer 26

1. clean tooth 2. select shade

Question 27

isolation in class V rare instance

Answer 27

where it may be appropriate to use 212 clamp

Question 28

curing light

Answer 28

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

Question 29

class V prep axial wall M and D walls incisal gingival height axial depth

Answer 29

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

Question 30

class V prep bevel

Answer 30

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

Question 31

when not to bevel with class V

Answer 31

below CEJ -not in cementum

Question 32

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

Answer 32

contraction gap

Question 33

this can minimize contraction gap

Answer 33

retention groove

Question 34

this restorative material can reduce microleakage

Answer 34

RMGI and amalgam

Question 35

non carious cervical lesions

Answer 35

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)

Question 36

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

Answer 36

25-40%

Question 37

erosion

Answer 37

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

Question 38

flexure and fatigue of enamel and dentin

Answer 38

abfraction

Question 39

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

Answer 39

abfraction

Question 40

when to treat non-carious cervical lesions

Answer 40

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

Question 41

for abrasion:

Answer 41

conservative extension may need minimal to no prep

Question 42

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

Answer 42

hydrodynamic theory of dentin sensitivity (fluid-filled tubules)

Question 43

7 causes of tooth sensitivity

Answer 43

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)

Question 44

treatment options for sensitivity

Answer 44

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

Question 45

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

Answer 45

fluoride varnish

Question 46

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

Answer 46

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

Question 47

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

Answer 47

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

Question 48

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

Answer 48

gluma (desensitizer)

Question 49

dentin hypersensitivity when

Answer 49

cracked tooth

Question 50

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

Answer 50

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

Question 51

treatment for restoration that will block tubules

Answer 51

amalgam composite glass ionomer

Question 52

treatments why they work

Answer 52

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