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Operative II > Considerations for Operative Dentistry and Class II Review > Flashcards

Considerations for Operative Dentistry and Class II Review Flashcards

1
Q

Why should you isolate the operating field with a rubber dam?

A

◦ Better visualization
◦ Better access
◦ Prep walls dry and clean
◦ Your materials work better
- Improved properties- direct contact of varnish/liner/base with cavity walls
- Moisture affects bond as well as materials ability to set up
◦ Prevents injury to patient soft tissues
◦ Prevents aspiration and swallowing of debris
◦ Fewer aerosols

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2
Q

What are the componenets of a dental dam set up?

A
  • rubber sheet
  • clamp
  • frame
  • punch
  • forceps
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3
Q

What side of the rubber sheet faces the operator and which side faces the patient?

A
  • shiny side against patients tongue, palate
  • dull side faces the operator
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4
Q

What are the parts of a rubber dam retainer (clamp)?

A
  • bow
  • jaws
  • forceps holes
  • points
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5
Q

What cases are more important to use a rubber dam: composite or amalgam?

A

Composite
- bonding requires uncontaminated surfaces
- wet field = recurrent caries or failed bond

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6
Q

What can a wet field cause during a composite restoration?

A

recurrent caries or failed bond

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7
Q

How do you isolate the teeth during a class II procedure?

A

one tooth posterior, two teeth anterior to tooth you’re working on

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8
Q

How do you isolate the anterior teeth during a procedure?

A

◦ Canine to canine
◦ Or can clamp on one premolar, ligate between incisors or incisor/canine

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9
Q

What teeth do you isolate in a pediatric case?

A

only isolate teeth necessary

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10
Q

What teeth do you isolate in an endo case?

A

a single tooth

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11
Q

What are the steps for placing a rubber dam?

A
  1. Prep work
    ◦ punch holes in rubber
    ◦ check contacts for floss shredding
    ◦ mark occlusion BEFORE placing dam
  2. Place clamp on tooth
  3. Place dam over entire clamp
  4. Stretch dam through contacts (Floss)
  5. Invert dam
    ◦ Delicately blow air around cervical area and push rubber into sulcus with plastic instrument
  6. Ligate anterior tooth
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12
Q

If the rubber dam does not work to isolate what are other options?

A

Antisialogogue medications (RARELY USED)
◦ Atropine and Banthine

Absorbents
◦ Cotton Rolls
◦ Dry Shields
◦ 2x2 gauze
◦ Cotton pellets

Suction
◦ High evacuation suction
◦ Saliva ejector
◦ Svedopter
◦ Isovac (bolded)

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13
Q

What are the different absorbents we can use?

A
  • cotton rolls
  • dry shield
  • 2x2 gauze
  • cotton pellets
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14
Q

What is the least effective absorbent?

A

2x2 gauze (works better as a throat pack

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15
Q

What can cotton pellets be used for?

A

◦ Remove moisture from inside preparation
◦ Remove moisture when patient is sensitive to air and water spray

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16
Q

What is a dry shield?

A

◦ Blocks parotid, retracts and protects cheek
◦ Wet when removing to avoid “cotton roll burn”

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17
Q

How do you place and remove a cotton roll?

A

◦ Placed in vestibule
◦ Wet when removing to avoid “cotton roll burn”

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18
Q

What are the different types of suction?

A

◦ High evacuation suction
◦ Saliva ejector
◦ Svedopter
◦ Isovac

19
Q

What are the pros of the high evacuation suction?

A

◦ Very effective at picking up debris
◦ Can be used to retract tissue
◦ Vented is better- reduces sucking up of tongue and mucosa

20
Q

What are the cons of the saliva ejector?

A

◦ Ineffective at removing debris

21
Q

What is a svedopter?

A

old fahioned isovac

22
Q

What are some additional tools that can be used to isolate the operating field?

A
  • retraction cord
  • bite block
  • anterior lip retractors
23
Q

If caries are in the E1/E2 layer what is the treatment?

A
  • REMINERALIZE
24
Q

If caries are in the D1 layer what is the treatment?

A

restore surgically or attempt
to remineralize

  • caries extends only to first third of dentin
25
Q

If caries are in the D2 layer what is the treatment?

A

restore surgically

  • caries extends to middle third of dentin
26
Q

If caries are in the D3 layer what is the treatment?

A

Restore surgically, prepare for
possible root canal or pulp capping

27
Q

What are the very basic steps of a class II prep?

A
  • establish initial outline form and depth
  • extend proximal box
  • composite or amalgam exit angles
  • remove caries
  • refine prep
28
Q

What should the exit angles be for composite preps?

A

◦ Buccal flared >100o
◦ Lingual flared >90o

29
Q

What should the exit angles be for amalgam preps?

A

◦ Reverse S curve to achieve 90o exit angle
◦ Buccal contact must be broken

30
Q

How do you remove caries during a prep?

A

◦ Spoon excavator
◦ Round bur on slow speed handpiece

31
Q

What steps do you need to do when refining a prep?

A

◦ Plane axiopulpal line angle
◦ Plane gingival margin
◦ Bevel gingival margin

32
Q

Ideal pulpal depth in these premolar preparations is…

A

1.5mm

33
Q

In Class II preparation, if extra retention is needed, retention grooves can be placed
in the…

A

buccal-axial line angles

34
Q

How do you add retention grooves to a class II prep?

A
  1. Place flutes of the 169 bur right the buccal axial line angle of the box.
  2. Tip the bur mesially and lingually
    - Only the tip of the bur touches the tooth in the buccal-gingival-axial point angle
  3. Push the bur in a disto-buccal direction just inside the dentin
35
Q

Are retention grooves in the dentin or enamel or a combo?

A

dentin!

36
Q

What are the steps to put in a sectional matrix (palodent)?

A

Step 1:
Use provided tweezers to place
wedge or WedgeGuard PRIOR TO
PREPARATION
Step 2 (if applicable):
Remove guard using palodent tweezers
Step 3:
Place sectional matrix band using provided Palodent tweezers
Step 4:
Place ring on top of wedge.
The indentations on the ring allow for the wedge to fit in between them.

37
Q

What are the parts of the tofflemire retainer?

A
38
Q

Being placing composite material in ________ of preparation

A

box

39
Q

Form final anatomy before or after final cure

A

before if possible

40
Q

True/false: You may need to use the finishing carbides to make minor adjustments after light-curing

A

True

41
Q

With amalgam restorations begin with ____________ ________ to recreate anatomy

A

HOLLENBACK carver

42
Q

When doing an amalgam restoration you should fill _______ above margins

A

1.0 mm

43
Q

How do you end an amalgam restoration?

A

*Carve interproximal before amalgam sets up fully
*Refine anatomy
*Smooth restoration with wet cotton pellet
*Prefer a DULL, MATTE finish for this class

Operative II (11 decks)

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