Class V Scenarios & Technique Flashcards
If a pt has recurrent decay around existing composite what prep design & restorative material do you use?
- GI + composite (sandwich technique)
- Add fluoride to recharge GI
Which restorative material has relatively poor wear ?
GI > Resin Ionomer > Composite > Amalgam
What are the steps for GI placement?
1) Cut defect at the CEJ (1 mm)
2) Use tooth dentin conditioner (REMOVES biofilm & smear layer) for 20 SEC
3) Rinse & dry, DON’T DESICCATE DENTIN (surface moist)
4)
When is GI used?
1) As an intermediate restorative material (as it is NOT as strong as composite, but LESS technique sensitive than composite)
2) Used in TX of non-cavitiated lesions, such as abrasions & abfractions
What are the steps for GI placement?
1) Cut defect at the CEJ (1 mm)
2) Use tooth dentin conditioner (REMOVES biofilm & smear layer) for 20 SEC
3) Rinse & dry, DON’T DESICCATE DENTIN (surface moist)
4) Shake capsule and tap 3 times
5) Titrate the GIC capsule for 10 seconds
6) Place capsule in applicator clicking 2X to begin dispensing.
7) Wipe istrument w/ alcohol
8) Work quickly b/c work time = 1 min form start of mix
9) You can cover w/ matrix to shape restoration
10) Light cure for 20 SEC (if CHEMICAL cured material, set time = 6 min)
11) GIC is SOFT when it is SET. Therefore use finishing fur on SLOW SPEED to avoid under-contouring
12) CLEAR RESIN may be applied over GI for polish & seal!
Before applying GI to tooth, make sure you squeeze out a little first to make sure _______________
it is not too wet (PA acid)
Place the tip the ____________ part of the prep and over full the prep by about _________.
- Deepest
- 20%
What are the steps for GI placement?
1) Cut defect at the CEJ (1 mm)
2) Use tooth dentin conditioner (REMOVES biofilm & smear layer) for 20 SEC
3) Rinse & dry, DON’T DESICCATE DENTIN (surface moist)
4) Shake capsule and tap 3 times
5) Titrate the GIC capsule for 10 seconds
6) Place capsule in applicator clicking 2X to begin dispensing.
7) Wipe PLASTIC instrument w/ alcohol
8) Work quickly b/c work time = 1 min form start of mix
9) You can cover w/ matrix to shape restoration
10) Light cure for 20 SEC (if CHEMICAL cured material, set time = 6 min)
11) GIC is SOFT when it is SET. Therefore use finishing fur on SLOW SPEED to avoid under-contouring
12) CLEAR RESIN may be applied over GI for polish & seal!
Swipe the excess Resin Ionomer __________ from the tooth
-away
Moisture contamination must be __________
-controlled
Limited working time depending on _______ & ___________.
Once gel state reached, DO NOT ___________.
- Temperature
- Mix rate (3-5 min) see manufacturer details
- Manipulate
What can you use to trim set Resin Ionomer ?
Making sure you do not what?
- 135 F diamond w/ water spray and ALWAYS end w/ 135 EF diamond.
- Cut into the root or cementum
Get your explorer to make sure there are no _______ or _________ Resin ionomer
- VOIDS
- EXCESS
What do you use to start and end polishing?
-Start w/ a FINE softflex disc and end with SUPERFINE
What are patient home care instructions?
1) Wait till anesthesia gone before eating
2) Apply neural NAF rinse every night to recharge the Resin Ionomer
A 45 yr old complains of severe gum recession. He brushes his teeth properly and has no contributing medical history. He grinds his teeth. What would you look for in his dental exam and what would you recommend?
- Diagnossis? Abfraction pt brushing too hard
- Tx Plan: First graft & then composite & occlusal adjustment or mouthguard(if all teeth involved)
- Preparation Design: Class V Composite w/ gingival retention grooves
- Materials used: Restore w/ internal layer of flowable composite & exterior w/ paste composite
What are the steps to filling tooth w/ composite?
1) FIRST: flowable composite layer placed in retention groove & gingival margin first
2) SECOND: Fills the axial wall w/ dentin colored paste composite
3) THIRD: Final layer is enamel colored paste composite that covers entire surface
What is the filling technique?
1) Use colored gel etchant
2) apply to enamel first then dentin for 20 SEC
3) Immediately rinse w/ water & air spray for 30 sec–leave barely moist
4) Apply bonding resin and blow thin w/ dry air
5) Light cure for 20 seconds using eye filter
6) Apply your 1st layer of flowable composite and cure for 20 SEC
7) Apply remaining paste composite in increments and cure for 20 sec
Always direct the instrument from _______ to _______ when filling
- Composite
- Tooth
What is the filling technique?
1) Use colored gel etchant
2) apply to enamel first then dentin for 20 SEC
3) Immediately rinse w/ water & air spray for 30 sec–leave barely moist
4) Apply bonding resin and blow thin w/ dry air
5) Light cure for 20 seconds using eye filter
6) Apply your 1st layer of flowable composite and cure for 20 SEC
7) Apply remaining paste composite in increments and cure for 20 sec
8) Lastly light cure for 60 SEC
When using 135 EF (15 micron grit size) diamond, ALWAYS go from ________ towards ____________, using a feathering action.
- Tooth
- Composite
What are other alternatives used for polishing?
-Impregnated rubber tips or composipro
What are the steps to applying the final glaze?
- Reapply etchant over the composite for 20 seconds
- Apply Opti-guard w/ applicator, blow thin and light cure for 20 sec
- DONT forget to floss :)
28 yr old has large carious lesion and multiple lesions throughout his mouth. CRA is high and he is very concerned about aesthetics. When he smile, his lips lift over 3 mm above the crest of his gingivae.
-What materials and prep design should be used?
- Not amalgam.
- GI & composite
- In aesthetic areas, you may bevel to the line angles
Describe the step in the sandwich technique ?
-Is there a special technique for deep vs normal depth ?
1) Inner layer is filled w/ GI (Fuji IX) if DEEP OR Resin Ionomer (Fuji II LC) if NORMAL depth
2) 2nd later fills axial wall w/ dentin colored paste composite
3) Final layer is enamel colored paste composite that covers entire surface
The glass or resin ionomer layer is placed on _______ with normal GI technique but only filled as a _________ on the _______ wall and or gingival margin.
- first
- liner
