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Restorative > CSAR > Flashcards

CSAR Flashcards

1
Q

what can’t an indirect restoration have?

A

undercut

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2
Q

4 disadvantages of crown?

A
  1. destructuve to tooth tissue
  2. potential for pulp damage
  3. fail eventually
  4. expensive
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3
Q

what is an inlay?

A

intra-coronal indirect restoration

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4
Q

2 types of ceramic crown?

A

Emax + zirconia

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5
Q

4 materials crowns can be made from?

A
  1. all metal
  2. ceramic
  3. PFM
  4. composite
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6
Q

can emax or zirconia be etched?

A

emax

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7
Q

2 types of cementation method?

A

mechanical - conventional

adhesive - resin cement

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8
Q

when an anterior tooth is under load what sort of force acts palatally and buccally?

A

tension palatally

compression buccally

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9
Q

what does marginal breakdown of posterior teeth lead to?

A

cuspal flexure = crack

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10
Q

3 stages of preparation for crown

A
  1. occlusal reduction
  2. axial reduction
  3. marginal configuration
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11
Q

what is the critical area of a tooth to retain tissue?

A

peri-cervical area

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12
Q

advantage of adhesive retention?

A

conservative to tooth tissue

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13
Q

main contraindication to indirect restoration

A

periodontal disease

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14
Q

5 considerations for restoring a tooth with a crown

A
  1. ability to retain core
  2. isolation ability
  3. ferrule necessary to retain indirect restoration
  4. retention/resistance form
  5. cold sensitivity
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15
Q

how much more preparation on functional cusp?

A

0.5mm more

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16
Q

what is retention form

A

prevents removal of restoration along long axis

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17
Q

what is resistance form

A

prevent removal of restoration in apical/oblique direction

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18
Q

what is minimum height a prep can be

A

~ 3-4mm

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19
Q

what is the ideal taper

A

6-12degrees

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20
Q

3 reasons margin of crown must be good

A

aesthetics
periodontal health
marginal seal = prevent microleakage

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21
Q

3 types of margin design

A

shoulder
chamfer
knife-edge

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22
Q

what type of margin for metal?

A

chamfer

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23
Q

what type of margin for porcelain?

A

shoulder

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24
Q

why should anterior margins be just subgingival?

A

aesthetics

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25
Q

what do adhesive restorations require?

A

enamel all way round tooth

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26
Q

what does an onlay require?

A

enamel all way round the tooth

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27
Q

9 steps for crown provision

A
  1. make matrix
  2. prepare tooth
  3. retraction
  4. use matrix to make provisional
  5. remove cord after 6 mins
  6. working impression
  7. jaw reg (if needed)
  8. facebow (if needed)
  9. cement provisional
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28
Q

5 reasons SA articulator may be used

A
  1. multiple restorations
  2. increasing VD
  3. reorganising occlusion
  4. removing occlusal interferences
  5. when occlusal stabilisation splint required
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29
Q

6 ways to create space for restoration

A
  1. increase OVD
  2. dahl concept
  3. enameloplasty
  4. distalisation of mandible
  5. crown lengthening
  6. Orthodontics
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30
Q

in what position is OVD measures?

A

ICP

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31
Q

definine CR

A

position of musculoskeletal stability provided by healthy TMJS when the condyles are in their most superior position within the glenoid fossa with the discs correctly interposed

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32
Q

how much unprepared axial surface below the prep needs to be recorded in the impression?

A

0.5mm

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33
Q

how does moisture effect impression material?

A

physical barrier

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34
Q

if you were making a crown but couldn’t get moisture control because of inflammation from a preexisting overhanging restoration, how would you proceed?

A
  1. prepare + place new restoration
  2. wait 3-4weeks
  3. prescrive 0.12% chlorhexidine for 2/52
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35
Q

2 types of haemostat agents used on retraction cord?

A
  1. vasoconstrictors

2. astringents

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36
Q

how do astringents work and what is an example?

A

precipitate proteins on contact with blood, physically obstruct blood vessels

e.g. ferric sulfate, aluminium chloride

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37
Q

why does ferric sulphate cause blue/black stain for 1-2 days?

A

precipitating protein contains iron

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38
Q

for adequate thickness of impression material, how wide do you need to horizontally open sulcus?

A

0.2-0.3mm

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39
Q

2 ways of opening up sulcus for impression?

A
  1. surgery

2. retraction cord

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40
Q

what is the first retraction cord you put in?

A

compression cord - finest 00 or 000
placed to depth of sulcus
to prevent haemorrhage + GCF

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41
Q

what is the second retraction cord you put in?

A

deflection cord - wide as you can fit, 0 or 1

half into sulcus

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42
Q

how long do you leave retraction cords for?

A

5-6mins

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43
Q

what instruments used to put cords in?

A

carver or Williamson probe

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44
Q

when do you remove deflection cord?

A

before impression

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45
Q

when do you remove compression cord?

A

after impression

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46
Q

what material is used for impression for crown?

A

light bodied silicone around prep

heavy bodied around surrounding arch

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47
Q

how to critique impression

A

check finish line + material past it
no critical air blows/drags/voids
sufficient occlusal defila
sulcus captured

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48
Q

4 reasons to make provisional restoration?

A
  1. diagnostic
  2. pulpal protection - must have marginal seal
  3. gingival management - must have marginal fit + contour
  4. position stability - must have ICP contact, contact point
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49
Q

3 methods for making provisional crown?

A
  1. matrix
  2. shell
  3. freehand
50
Q

2 material choices for provisional restoration?

A
  1. acrylic e.g. Bosworth trim/snap

2. bis-acryl composite e.g. quicktemp, protemp

51
Q

properties of acrylic provisional

A 
hand mix
slow set
moderate exotherm + high shrinkage
easy to add to 
more flexible
52
Q

times you were use acrylic provisional

A

relining shell provisionals
provisionals around partial dentures
lateraling gingival contour

53
Q

properties of bis-aryl provisional

A 
automix - easier
quick set
low exotherm + low shrinkage
harder to add to
brittle/not flexible
54
Q

when would you use bis-acryl provisional

A

simple matrix provisionals

55
Q

how do you stop provisional bonding to composite core?

A

glycerine/vaseline

56
Q

2 types of temporary cements

A
  1. zinc oxide cement - temp bond

2. zinc polycarboxylate cement - polyF, durelon

57
Q

when do you use zinc oxide and when to use zinc polycarboxylate to cement provisional restorations?

A

zinc oxide = if satisfactory resistance/retention

zinc polycarboxylate = when resistance/retention lacking

58
Q

what type of temp bond is used if composite core?

A

temp bond non eugenol

59
Q

types of shell technique provisional crowns?

A

standard crown forms - polycarbonate, aluminium, stainless steel

lab made crowns - acrylic, composite

60
Q

method for placing shell technique provisional crown

A
  1. pick crown
  2. trim if necessary
  3. make hole interproximal to help achieve contact point
  4. reline with acrylic temp material
  5. fill shell with acrylic
  6. seat
  7. remove in dough stage
61
Q

if prep is occlusal stable and doesn’t need provisional how would you dress it?

A 
fluoride varnish (? - can integrate into hydroxyapatite + change surface)
 zinc phosphate covering
62
Q

what is index shrink-wrap?

A

putty made from wax up, putty filled with bis-acryl + cured straight to teeth

63
Q

how would you temporise an occlusaly unstable resin bonded bridge prep limited to enamel?

A

composite to opposing tooth

64
Q

how would you temporise veneer prep that extends through contact points?

A

composite cured to prep

65
Q

how would you temporise occlusally stable resin bonded bridge prep that extends into dentine + sensitive?

A

zinc phosphate or zinc carboxylate covering

66
Q

2 techniques for labs making indirect restorations

A
  1. lost wax technique

2. hand layered

67
Q

advantages and disadvantages of bi layered restorations

A 
\+ better aesthetics
\+ combine best 2 qualities of materials
- postnatal weak points at interfaces
-risk of chipping/fracture
- need for greater prep
68
Q

advantages and disadvantages of monolithic restorations

A 
\+ stronger
\+ more conservative
\+ cheaper
- limited aesthetics
- only character with stains
69
Q

occlusal + marginal reduction for metal crown?

A

1-1.5mm

0.1mm chamfer

70
Q

occlusal + marginal reduction for porcelain + metal areas of PFM

A

2-2.5mm

1-1.2mm

71
Q

what technique can be used to reduce margin prep in posterior teeth?

A

high strength metal collar

72
Q

what is the umbrella effect?

A

metal ceramic margin creates blueish appearance at margin

overcome by extending porcelain palatally

73
Q

what type of restoration is zirconia?

A

conventional

74
Q

difference between traditional zirconia and new high translucency zirconia

A

old - bilayered as opaque, stronger, hard to adjust

high translucency = monolithic or bilayer, weaker, easier to adjust

75
Q

what type of zirconia is used as collars?

A

bilayered high translucency

76
Q

does bilayering lead to better or worse aesthetics for zirconia?

A

better

77
Q

what is Emax?

A

lithium dislocate
etch able glass ceramic
can be cast or CADCAM

78
Q

is Emax normally monolithic or bilayered?

A

posterior teeth = normally monolithic as stronger

anterior teeth = make monolithic + then cut back and layer with feldspathic porcelain

79
Q

2 types of etchable ceramics

A

Emax

feldspathic porcelain

80
Q

advantages and disadvantages of indirect composite

A 
\+ better conversion of monomer than normal composite
\+ easier to adjust + repair
\+ cheaper 
\+ thinner section
- more flexible so weaker than emax
- problems with debond
81
Q

how are precious metal restorations made?

A

cast

82
Q

how are non-precious metal restorations made?

A

cast of CADCAM

83
Q

how are lithium disilicate restorations made?

A

cast or CADCAM

84
Q

how are zirconia restorations made?

A

CADCAM

85
Q

how are feldspathic poreclain restorations made?

A

hand layered or CADCAM

86
Q

how are resin based restorations made?

A

hand layered or CADCAM

87
Q

how does translucency of material affect aesthetics?

A

the more translucent = more potential

when core not favourable - must leave room for technicians

88
Q

4 types of passive cements

A
  1. zinc phosphate
  2. zinc carboxylate
  3. GIC
  4. RMGIC
89
Q

how do strength and translucency relate to each other?

A

as strength increases, become less translucent

90
Q

order of crown materials from most strong (most opaque) to least strong (most translucent)

A
  1. metal
  2. zirconia
  3. high translucency zirconia
  4. emax
  5. feldspathic porcelain
91
Q

advantages and disadvantages of adhesive indirect restorations

A

+ more conservative
+ less reliant on resisitance/retention form
+ advantages when limited crown height
- harder to temporise
- need to isolate
- bond is unpredictable
- cementation much more technique sensitive

92
Q

what must you check on patient before trying in crown?

A

occlusion - find holding contacts with shim stock

check dynamic for reference

93
Q

if bonding precious metal, why must you always use primer?

A

precious metals don’t have oxide layer to easily bond to

sulphur group f VBATDT in alloy proimer bonds to metal

94
Q

what is a cantilever bridge?

A

attached on one side

95
Q

3 types of conventional bridge?

A

cantilever, fixed-moveable, fixed-fixed

use crowns as retainers

96
Q

2 types of adhesive/resing bonded bridge?

A

cantilever, fixed-fixed

97
Q

approx longevity of conventional + resin bonded bridges?

A

conventional ~10yrs - take abutment with

resin bonded ~5yrs - abutment spared

98
Q

if using a fixed-fixed conventional, what must both abutment teeth have? how can this be overcome?

A

common path of insertion

use fixed-moveable

99
Q

structure of a fixed movable conventional bridge?

A

major retainer - rigid connector - Pontic - moveable connector - minor retainer

100
Q

advantages + disadvantages of adhesive bridge?

A 
\+ conservative
\+ impression easier 
\+ failure less destructive
- don't last as long
- cannot shape abutment teeth 
- can discolour if thin
- need enamel 
- technique sensitive
101
Q

what is antes law?

A

total periodontal membrane of abutment teeth must equal or excess that of tooth to be replaced

now evidence to suggest as long as good perio + maintenance more extensive bridges can be successful

102
Q

what should occlusion of a Pontic be?

A

contact in ICP but not In excursion

103
Q

where are fixed-fixed and cantilever preferred and why?

A 
posterior = vertical forces = fixed-fixed
anterior = lateral forces = cantilever
104
Q

what is the optimum and minimum crown:root ration for abutment teeth?

A

optimum 2:3

minimum 1:1

105
Q

how does a big span effect the Pontic?

A

bigger the span = more bending/flexion of Pontic

+ increased load of abutment teeth

may lead to fracture, debonding of one retainer

106
Q

what is minimum thickness of RBB retainer to prevent flexion?

A

0.7mm

107
Q

2 features of anterior RBB prep

A

cingulum rest

finish line

108
Q

3 features of posterior RBB prep

A

rest seat
guide plane - remove bulbosity to help with seating
finish line

109
Q

what should existing restorations be replaced with (if not already) before RBB?

A

composite

110
Q

3 types of periodontitis

A
  1. marginal
  2. apical
  3. both - perio/endo
111
Q

to have apical perio what must the pulp be?

A

non-vital

112
Q

how to treat perio-eondo lesion with communication?

A

endo first

perio after 1 month to allow some bony infill

113
Q

what type of cells are responsible for resorption of dentoalveolar hard tissues?

A

giant cells - derived from mononuclear phagocytes

114
Q

how long does transient resorption happen for and why?

A

2-3weeks

no constant stimulation of giant cells

115
Q

what stimulates giant cells?

A

pressure + infection

116
Q

3 systemic disorders linked with root resorption?

A
  1. hypo/hyperparathyroidism
  2. pagets disease
  3. benign/malignant tumours - causes pressure
117
Q

how is resorption prevented after RSI?

A

epithelium migration

118
Q

what is cervical resorption?

A

type of progressive external inflammatory resorption

lesions begin in cervical region + communication with mouth

119
Q

what is richwil crown remover?

A

toffee like substance, chewed to remove crown

120
Q

what is a masserran kit?

A

removes threaded post in anticlockwise direction

121
Q

how do you remove gutta percha?

A

size 10 file + sodium hypochlorite

my need solvent - chloroform, eucalyptus + orange oils

Restorative (10 decks)

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