class V lesion

Question 1

carious lesions

Answer 1

1) control active caries and prevent disease progression
2) remove caries and restore

Question 2

noncarious cervical lesion

Answer 2

1) treat etiological factor first
2) restore if
- pain / sensitivity
- threat to the strength and integrity of the tooth
- concerns with aesthetics

Question 3

concerns with restoring class V

Answer 3

1) difficulty treating below the gumline
- access and moisture control

Question 4

amalgam

Answer 4

1) excellent margins (no shrinkage)
2) user friendly
3) economical
4) strong and wears well
5) works in wet field if necessary
6) macromechanical retention needed
7) poor esthetics

Question 5

RMGI

Answer 5

1) direct adhesion to tooth structure
2) fluoride releasing to combat new caries
3) similar CTE of tooth
4) less polymerization shrinkage than composite
5) less technique sensitive
6) esthetics are not as good

Question 6

composite resin

Answer 6

1) very popular for class V due to
- esthetics
- good strength and resistance to wear (compared to glass ionomer)
2) but
- technique sensitive
- isolations may be difficult
- helps if margins are in enamel

Question 7

preparing class V NCCLs

Answer 7

1) place retraction cord
2) minimal dentin prep (roughen only)
3) generous bevel on enamel, starburst pattern
4) selective etch on enamel, phosphoric acid
5) self-etch primer on dentin / enamel
6) adhesive on dentin / enamel
7) light cure adhesive
8) flowable on dentin, tease into corners
9) apply dentin shade over dentin and cure
10) apply enamel over dentin and cure
11) carbide finishing burs
12) jiffy polishing kits and jiffy brushes

Question 8

restoring carious class V lesion

Answer 8

1) not enough accessibility
2) need to retract gingival tissue
3) #212 rubber dam clamp also known as butterfly clamp
- isolate #6 and #7 around #5
- bend jaws to adapt to tooth and lesion location preventing gingival trauma
- need at least 0.5 mm of sound tooth between jaw of clamp and prep margin
- hole on #5 needs to be 1-2 mm facial to the arch
- lock in with vanilla bite
4) 33 bur to access lesion and do 90 degree exit angles
- bevel enamel at 45 degrees
5) starburst pattern
5) rounded internal line angles
6) 1 mm axial depth

Question 9

different material placement technique for class V on root structure

Answer 9

1) flowable composite as the first increment in a thin layer
2) carefully along gingival margin
3) gingival floor
4) axial wall
5) remainder of prep with regular composite
- use 2 increments if prep is later than 2 mm
6) finish and polish
7) rotate clamp