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composites Flashcards

1
Q

Direct restoration

A

restoration inserted as soft material

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2
Q

Indirect restoration process

A

FAbricated outside the mouth

Cemented or bonded to the tooth

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3
Q

Full coverage indirect restoration

A

Zr

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4
Q

Partial coveration indirect restorations

A

Veneers, ceramic inlays and onlays

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5
Q

Examples of Direct tooth colored restoratiosn

A

Composites

Glass Ionomer

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6
Q

Functions of tooth-colored material

A

REstorations
Bases and liners
Cemeents

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7
Q

Tooth colored materials from high fluoride to low floride

A 
Glass Ionomers
Resin Modified Glass Ionomers
Low Fluoride:
Compomers
Composites
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8
Q

Base of Composites

A

Polymer base

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9
Q

Base of Glass Ionomers

A

Water base

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10
Q

Changing of COmposites

A

Static

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11
Q

Functional roll of GI

A

Fluoride REservoir (dynamic)

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12
Q

Mech properties of Composites

A

Comparable to Amalgam

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13
Q

Mech Properties of GI

A

Decrease Mech properties

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14
Q

Wear resistance of Composites

A

Was a conern (especially for older compostes)

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15
Q

Retention of composites

A

Micromechanical retention - resin tags and hybrid layer

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16
Q

GI wear resistance

A

Good

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17
Q

Retention of GI

A

Chemically bond (ionic - not strong)

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18
Q

Where is the hybrid layer found

A

In dentin

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19
Q

Advantage of Posterior Composites

A

Esthetic
Conservation of tooth
Easier Prep

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20
Q

Disadvantage of Posterior Composites

A

Tequnique sensitive

Effect of Polymerization shrinkage

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21
Q

Indication for Posterior Composites

A

Small/moderate sized Class I and CLass II preps

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22
Q

Contraindications for Posterior Composites

A

Complete Moisture control is inadequate
Heavy occlusal stresses
LArger preps
More posterior

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23
Q

effect of Resin shrinkage

A

Won’t create microleaks, but will put stress on the polymerization

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24
Q

Why are Class II composites hard

A

Doesn’t hold itself well to be pressed due to putty consistency

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25
Q

What must be done with Class II composites

A

Restore proximal contour of posterior teeth and recreate the proximal contact

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26
Q

Resin matrix for dental compsite

A

Bis-GMA and TEGMA

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27
Q

What makes up the Filler of Dnetal composite

A

Irregular or spherical particles( ranging in size)

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28
Q

What is the Coupling agent in a dental compsite

A

Silane

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29
Q

What is the Resin matric of Composite Resin

A

Small Oligomers, Bis-GMA and TEGMA

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30
Q

How to minimize gaps in Composite

A

Incremental layering technique to reduce bulk volumetric shrinkage
Placing a low viscosity material such as flowable composite prior to composite “elastic Theory)

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31
Q

Roll of FIller in composites

A

Improve in mechanical behavor
also helps match color
With thermal coefficient

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32
Q

Result of MOre Filler in composite

A

Less resin, less polymerization shrinkage, decreaed Coefficient of thermal expansion

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33
Q

What is the Filler made of in Resin

A

Glass particles and spheroidal silical particles
Shape: spherical, irregular, combo
Size: ranges

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34
Q

Too little of filler leads to

A

Slump and sticky

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35
Q

Too much small particles of filler leads to

A

Hard to handle

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36
Q

Macrofill size

A

10-50 um

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37
Q

Microfill size

A

40-50nm

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38
Q

Hybrid fill size

A

10-50 um + 40nm

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39
Q

Nanofill size

A

5-100nm

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40
Q

Mini-fill size

A

.6-1um + 40nm

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41
Q

Midifill size

A

1-10um + 40nm

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42
Q

Examples of MAcrofill

A

Adaptic

Concise

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43
Q

Characteristic of Macrofill

A

Very large filler particles
Particles plucked out forming a rough surface
Low wear resistance

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44
Q

Filler size for Homogenous microfill

A

Small size filler: .04/40nm

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45
Q

Characteristic for Homogenous Microfill

A

Small fillers

Polishability and wear resistance optimal

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46
Q

Where are Homogenous Microfills Indicated

A

esthetic non-stress bearing area in young patients

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47
Q

Filler loading in Homogenous Microfills

A

25-42% vol

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48
Q

Did Homogenous Microfills work on posterior composites

A

No

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49
Q

What research was doen to try and get Homogenous Microfills to work as posterior composite

A

Increased Filler content

Increased Nanoparticles

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50
Q

Problems with High FIller Content of Posterior Homogenous Microfills

A

High-viscosity - difficult handling
Clustering/agglomeration
- large cluster compromises esthetics

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51
Q

How are HEterogenous microfills for Posterior composites made

A

Cured microfill composites then crushed and incorporated in uncured Composites

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52
Q

What does Heterogeneous Microfills for posterior composites contain

A

PPF (prepolymerized fillers)

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53
Q

Problem with using PPF with posterior composites

A

Bond between PPF and cured composite was weak leadign to debonding

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54
Q

What are Conventional Hybrids

A

Combined the micro fillers with the macrofilled

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55
Q

why were conventional hydrids used as a posterior composite

A

Improved the mechanical properties

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56
Q

Filler size for Microhybrids

A

less than 1.0 microns

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57
Q

Properties of Microhybrids

A

60% loading capacity

Good handling properties

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58
Q

where were microhybrids used

A

anterior and posterior restorations

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59
Q

Examples of Microhybrides

A

Point 4 (kerr)
Herculite XRV (Kerr)
Esthet-X (Dentsply)
TPH spectra

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60
Q

What is the Filler for Nanocomposites

A

No glass fillers

Only silica particles in the range of 5-100nm and aggregations of Silica particles (Nanoclusters)

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61
Q

Examples of Nanohybrids

A 
Herculite Ultra (kerr)
Tetric Evoceram (Ivodar)
Reflectys (Itena)
N'Durance (Septodont)
Premise (Kerr)
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62
Q

Conventional consistency

A

Putt like consistency

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63
Q

Flowable Consistency

A

Lighy Consistency

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64
Q

Packable consistency

A

Condensable/Moldable/HD

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65
Q

The Number of Carbon double bonds C=C of monomer that are converted to single bonds C-C to form polymers

A

Degree of Conversion

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66
Q

Distance of Curing tip

A

abour 1 mm

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67
Q

Thickness of Composite for Curing

A

1.5 mm

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68
Q

Bulk Fill

A

One bulk fill placement up to 5 mm

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69
Q

How do Bulk Fill Capsules engage

A

In a slow speed

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70
Q

What does the slow speed do for Bulk fill Compsites

A

Vibrates to make the material less viscous during Extrusion

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71
Q

what keeps bulk fill from pulling from cavity walls

A

Stress Relievers

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72
Q

what aids in depth of cure

A

Special photo-initiator

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73
Q

Types of Retainer System

A

Tofflemire with Circumferential bands
Retainless MAtrix system in the absence of matrix retainer
Sectional matrix

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74
Q

Roll of Rings

A

Prongs on the rings produce separation between the teeth for a class II prep

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75
Q

Pre contoured sectional matric band thickness

A

thin af .001inch

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76
Q

Materials for Circumferential bands

A

Metal

Polyester - clear or blue

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77
Q

Thickness of circumferential bands

A 
Thin: 0.0015 inch
Ultra thin (dead soft): .001inch
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78
Q

Types of Wedges

A 
Wedge wands
Wizard wedges
Anatomical wooden wedges
Light trasmitting Wedges
Wedge guard
79
Q

Roll of Wedges

A

Seal gingival margin to prevent overhand

wedges adjacent teeth to compensate for the band’s thickness

80
Q

How tall should a wedge be

A

Be of a height that does not prevent the formation of proximal contact

81
Q

Techniques for wedging

A

Piggy back- 2 wedges on top of each other
Double wedge - one wedge on each side of the tooth
wedge wedging - one at a 90 degree angle to the other

82
Q

Step

A
  1. Examine the margins of the prep, having a plan
  2. Profound Anesthic + shade selection + check occlusion
  3. Isolate
  4. Etch 37% phosphoric acid for 15 s, Rinse thoroughly, gently dry and never desiccate
  5. Apply 1‐2 coats of avadhesive, lightly dry it, cure for 20s
  6. Apply selected shade of composites in increments, cure for 20 s
83
Q

What is the etch used

A

37% phorphoric acid

84
Q

What happens to Enamel if over dried

A

Doesn’t have much collagen so it is find

85
Q

What happens to Dentin if I over dry

A

Ton of collagen so fibers collapse if over dry and adhesive won’t infiltrate
Removes water out of tubules leading to bite sensitivity

86
Q

Roll of Etching

A

Removes smear Layer and smear plugs

Opens Dentin Tubules

87
Q

Steps of Total etch system

A

Etch
Rinse
Apply Adhesive

88
Q

pH of total etch system

A

2

89
Q

When to use total etch system

A

When there is enamel margins

90
Q

2 step Total etch system

A

2 bottles,: etch, prime+bond

91
Q

3 step Conventional Total etch system

A

3 bottle etch prime, bond

92
Q

pH of self Etch adhesive

A

3.5

93
Q

TWo step self etch adhesive

A

2 bottle acidic primer, bonding agent

94
Q

1 step self etch adhesive

A

1 bottle acidic primer and bonding agent

95
Q

Total etch system

A

Optibond solo plus (Kerr)

96
Q

self etch adhesive

A

Scotch bond universal 3M

Clearfil (kuraray)

97
Q

Composite instrumers

A

Contact fomer
BBL
CVIPC
8A

98
Q

What is done after curring

A

Remove Rubber dam
Evaluate the margins - Check for excess and deficiencies
Check for Proximal contact
Check occlusion with articulating apaper and miller forceps
Adjust occlusion with rotary carbide finishing burs

99
Q

How Does RMGI seal

A

Good seal due to chemical bonds

100
Q

Mech properites of RMGI

A

Not as good as composite

101
Q

Solubility of RMGI

A

less soluble than GI

102
Q

Moisture effect on GIC

A

affected by moisture due to slow setting reaction

103
Q

Acid and GIC

A

Acid Vulnerability

104
Q

Sollubility of GIC

A

Initial solubility

105
Q

GIC strength

A

Brittle

106
Q

Moisture on RMGIC

A

Not affected by moisure

107
Q

Solubility of RMGIC

A

Initial solubility is low

108
Q

Acid and RMGIC

A

LEss acid Disintegration

109
Q

What is done first for CLass I deep cavity preps

A

Condition and Based with GI before placing the composite

110
Q

What is done with CLass II with Enamel margins

A

Use a total etch system to allow for shorter etching time for dentin
Rinse thoroughly
Lightly dry leaving damp dentin
Apply adhesive layer/air gently/cure

111
Q

how to do composite for Class II with enamel margins

A

1 layer to build up proximal contour and contact

1 layer to build up occlusal anatomy

112
Q

what technique is used with Class II with dentin margins and deep gingivally

A

Use Open Sandwich technique

113
Q

Do you add etchant to the Restorative base

A

No, it is not essential

114
Q

How different are composite restorations in preclinic

A

No different

115
Q

Criteria for Composite restoration

A

Can be v. conservative
Remove defective areas
Remove all caries
No grossly unsupported enamel in high stress bearing areas

116
Q

when can you be most conservative with composite restorations

A

if you’re first

117
Q

Advantages of Composte for inital caries

A 
Preparation conservative (only infected area
Small volume (shrinkage stress minimized
Contact area small (wear minimized)
Good Longevity ( like that of sealants or amalgams
118
Q

Composite technique

A 
Prep
Consider a base or liner
Place band
Apply adhesive
Apply composite
Finish and Composite
119
Q

Types of Matrix bands

A 
#1 Adult universal (normal)
#2 Adult MOD wide (has 2 humps in middle)
#1 Pedo universal ( has 2 humps at the side)
120
Q

What is done with matric band once wedges have been placed

A

Burnished

121
Q

initial preps are likely to encounter what

A

Tubular dentin

122
Q

Problem with the smear layer

A

Inhibits Good adhesion by keeping the resin from penetrating into the dentin

123
Q

What makes up the smear layer

A

GRound bits of HA, Collagen, Bacteria, Salivary proteins

Smear Plugs

124
Q

What is Etchants

A

INorganic acid (35% phosphoric Acid)

125
Q

Roll of Etchants

A

Completely remove smear layer and plugs
Demineralized surface Dentin
Leaves Collagen rush surface with numerous pores

126
Q

Steps of Total Etch

A

Etch and Rinse
Primer
Adhesive

127
Q

How does the Primer for Total etch feel about Water

A

Hydrophilic

128
Q

How does the adhesive in Total etch feel about water

A

Hydrophilic or Hydrophobic

129
Q

Steps of forming na hybrid layer

A

Etch enamel and dentin for 15 sec, rinse for 15 sec, gently air drying
Apply adhesive
Air thin for 3 sec, avoiding pooling, light cure
Pace composite and light cure

130
Q

What is the Hybrid layer

A

Between the unaffected dentin and adhesive resin

131
Q

Zone of the Hybrid layer

A

Interdiffusion zone

Interpenetration zone

132
Q

Photoinitiator peak absorption wave length

A

468nm

133
Q

Types of curing lights

A

Halogen lights
Plasma Arc lights
Argon Lasers
LED lights

134
Q

What type of Curing light is ideal for Composites

A

LED

135
Q

power intensity of LEDs

A

intensity similar to highest QTH but lower than lazer and xenon arc

136
Q

Benifits of LED curing lights

A

Small compact and light weight
Battery powered and cordless
Long bulb life

137
Q

Problem with LED curing units

A

Power output narrow

TIp design limited

138
Q

ideal degree of converstion

A

100%

139
Q

Maximum degree of curing

A

65%

140
Q

what is the top layer of a curred composite

A

O2 inhibition layer

141
Q

What is light intesnity proportional to

A

the distance squared

142
Q

What is the air inhibited layer

A

Unreacted double bonds avilabe for the next layer that does not cure-tacky

143
Q

The sea cretarure thing used to polish

A

Sof-lex ( i think brown first followed by purple )

144
Q

Approach to primary occlusal caries treatment in posterior teeth for composites

A

Keep prearations as small as possible

145
Q

when to do composite or amalgam on post teeth

A

Composite: small

Amalgam if large: location and patient desire also important

146
Q

Consequences of class 2

A

Adjacent tooth damage
Reduced Tooth stiffness
Introduce stress Concentration that lead to fracture
Margins in caries susceptible locations

147
Q

Percent of teeth with adjacent tooth damage for class II

A

60-100%

148
Q

Reduced tooth stiffness for MOD

A

60%

149
Q

Incidence in vital posterior teeth of stress concentrations that lead to fracture

A

70/1000

150
Q

Endo tx post teeth fracture for MOD at 7 years

A

50-60%

151
Q

where do amalgams fail

A

Margins of class II (94%) due to caries

152
Q

Where do Composites fail

A

Margins of class II (62%) due to caries

153
Q

How to prep a slot

A

330 bur
Maintain proximal contacts if possible to make it easier to restore
Break out enamel with hand instruments

154
Q

Can you bevel a tooth prep

A

Possible if non occlusal to increase retention

155
Q

What needs to be done for Restorations

A

Sensitivity free
Good proximal contacts
good margins for the perfect seal

156
Q

How to minimize sensitivty

A 
Reduce etch time on dentin
Do not over dry
Use RMGI base or liner
Apply Gluma or rewet dentin
Apply adhesive for 15 sec (diffusion)
Multiple layers of adhesive
157
Q

When would one use a base

A

Large deep restorations
Proximaal margins on cementum
High carier risk patients ( but still want tooth colored and indirect is too expensive

158
Q

why use a base with preps with proximal margins on cementum

A

best seal

159
Q

Why use RMGI as a base

A

REsists microleakage as well as any material
Release fluoride
Neutralize acid when disolved

160
Q

Liner used

A

Vitrebond

161
Q

How to prep a liner

A

Powder/liquid hand mixed

162
Q

Base used

A

Fuji 2 LC

163
Q

How to prep a base

A

Activated Capsule
Amalgamator 11-14 secs
Apply by injections

164
Q

What kind of cure is done for REsin Ionomer set reaction

A

TRipple cure

165
Q

Parts of the Cure of Resin Ionomer

A

Resin component LC, SC - free radical rxn occurs rapidly

GI component acid-base reaction - slow

166
Q

Part of the tooth most susceptible to recurrent decay

A

Deep Proximal Margins

167
Q

Why Deep proximal Margins are the most susceptible to recurrent decay

A

No enamel
Poor bonding potential
Difficult to wedge without collapsing band

168
Q

Why use the open sandwich

A

Good seal around high risk area
Layer minimizes shrinkage stress on box floor
Good tissue response
Helps to achieve good contacts and form

169
Q

NEgative consequences of Open sandwich

A

If not well adapted can leave bacterial niche

Some increase sirk of composite fractue

170
Q

Elastic modulus (stiffness of Dentin, Composite, RMGI

A

Dentin:16-18 Gpa
Composte: same as dentin
RMGI: lower than composite or dentin (6-10GPa)

171
Q

How does GI and RMGI adhere to tooth

A

Water based materials that use an acid base set reaction to adhere directly to the tooth

172
Q

How does Compomers and Composites adhere to the tooth

A

Polymer based materials that work by a free radical set reaction and require adhesives

173
Q

What are Conditions

A

Mild organc acids

174
Q

Roll of Conditioners

A 
Solubizes smear layer
Removes smear layer
Leaves smear plugs intact
Does not demineralize dentin or enal
Cleans surface
175
Q

Acid difference between Etchand and conditioner

A

Etchant: strong acid 35% H2PO4
Conditioner: weak acid of 10% polyacrylic acid

176
Q

Penetration depth of Etchant vs Conditioner

A

Etch penetrates much farther

177
Q

Effect of Etchant vs Conditioner on Dentin

A

Etchant: cleans smear layer, Removes smear plugs and demineralized Dentine
Conditioner: Cleans smear layer, leaves intact dentin

178
Q

What is Found in GI and RMGI powder

A

CaFAIsiO2, glass CalciumFluoroaluminosilicate
Acid Soluble glass
Non-silanated

179
Q

What is found in GI liquid

A

50% water
50% polyacid copolymers (Long chain polymers, Carboxylic acid reactive groups)
pH=1

180
Q

How are GI and Resin Polymers different

A

GI: polymers are hydrophilic and can chelate with metal ions

181
Q

What is Found in RMGI LIquid

A

35% water
35% MEthacryltae modified polyacid copolymers (long chain polymers, Carboxylic acid reactive groups, Methacrylate reactive groups )
30% HEMA
ph=2

182
Q

Glass Ionomer Reaction

A

Acid MAtrix dissolves periphery of glass
Glass releases ION (Ca, Al, F)
Divalent Ca ions quickly chelate with acid polymer chains
Next 24-72 Hours: Al replaces Ca to increase strength and F released
Acid side groups also can chelate with glass and with HA

183
Q

Speed of GLass Ionomer reaction

A

Slow

184
Q

GI’s sensitivity to Moisture

A

Very sensitive early stages giving a soluble and rough appearance

185
Q

Appearance of GI

A

opaque

186
Q

RMGI reaction

A

Acid MAtric dissolves periphery of glass

GLass releases Ion (Ca, Al, F

187
Q

Reseasons for size changes of RMGI

A

Polymerization shrinkage

Swelling from water sorption

188
Q

What is used to aid in proximal contact formation

A

Sectional matrix

189
Q

Problem with Composite in High caries risk patient

A

4x greater risk of recurrent decay

190
Q

Problem with Adhesive

A

Can sometimes lead to sensitivity

191
Q

What rubber dam clamp would you use to isolate a class V

A

212

192
Q

what increases strength of composites

A

More filler

Smaller filler

193
Q

What type of composite for Class I and Class II

A

Nanofilled/Nanohybride Composites

composites (1 decks)

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