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FINALS > DMS > Flashcards

DMS Flashcards

1
Q

name three extrinsic causes of tooth discolouration

A

smoking
chlorhexidine
iron supplements

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2
Q

name three intrinsic causes of tooth discolouration

A

fluorosis
tetracycline
non-vitality

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3
Q

what are the two types of tooth whitening

A

external vital bleaching
internal non-vital bleaching

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4
Q

how does bleaching work on external vital tooth whitening

A

the discolouration is caused by chromogenic products produced
bleaching oxidises the compounds
leads to smaller and less pigmented compounds

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5
Q

what is the active agent in external tooth bleaching

A

hydrogen peroxide

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6
Q

name three constituents of bleaching gel used in dentistry

A

carbamide peroxide
carbopol
urea

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7
Q

what does carbamide peroxide break down to produce

A

hydrogen peroxide and urea

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8
Q

what is the use of carbopol in tooth whitening agents

A

thickening agent so it stays on teeth

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9
Q

name four factors that affect tooth bleaching

A

time
cleanliness of tooth surface
concentration of solution
temperature

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10
Q

name four warnings to consent the patient on before undertaking tooth whitening

A

sensitivity
relapse
colour of restorations
might not work

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11
Q

what are advantages and disadvantages of in-office tooth whitening

A

controlled by dentist
can use heat/ light
expensive
results wear off

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12
Q

what is the maximum strength of home tooth whitening remedies

A

6% hydrogen peroxide

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13
Q

how short should teeth whitening thermoplastic trays stop of the gingival margin

A

1mm

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14
Q

what are the instructions for at home bleaching of teeth

A

brush and floss
load tray with 1mm dot buccally on each tooth
keep in place for at least 2 hours

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15
Q

name four examples of when tooth whitening might be indicated

A

age related darkening
mild fluorosis
post smoking cessation
tetracycline staining

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16
Q

how long does it take for sensitivity of bleaching to wear off

A

2-3 days post bleaching

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17
Q

what clinical complication does tooth whitening present

A

problem with bonding later
residual oxygen from peroxide remains on enamel

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18
Q

name three indications of internal bleaching

A

non-vital tooth
adequate RCT
no apical pathology

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19
Q

what are two contra-indications of internal bleaching

A

heavily restored tooth
staining due to amalgam

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20
Q

name a risk of internal bleaching

A

external cervical resorption due to diffusion of hydrogen peroxide through dentine into periodontal tissues

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21
Q

what has to happen to RCT treated teeth when undertaking internal bleaching

A

remove GP from pulp chamber and 1mm below ACJ
place 1mm RMGIC over the GP to seal canal

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22
Q

why is RMGIC added to RCT treated teeth in internal bleaching

A

to seal dentine and prevent root resorption

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23
Q

what is the procedure for internally bleaching teeth

A

remove filling from access cavity
remove GP from pulp chamber and 1mm below ACJ
place RMGIC over GP
remove dark dentine
etch
place 10% carbamide peroxide in cavity
cotton wool
GIC

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24
Q

how many visits does it usually take to reach desired colour with internal whitening

A

3-4 visits
after 4 visits and no change - it isn’t going to work

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25
Q

after how many years should internal bleaching be retreated

A

every 4-5

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26
Q

what is microabrasion

A

removes discolouration limited to outer layers of enamel

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27
Q

what is the procedure for microabrasion

A

clean teeth and rubber dam
18% HCl and pumice
apply to teeth with prophy cup
5 seconds per tooth
wash
repeat 10 times
polish teeth with fluoride prophy paste
apply fluoride gel

28
Q

when should microabrasion be reviewed

A

after 1 month

29
Q

name advantages of microabrasion

A

quick
easy
no long term problems

30
Q

name disadvantages of microabrasion

A

acid
sensitivity
only works for superficial staining

31
Q

what products cannot be used for anyone under 18 unless intended for preventing disease

A

0.1-6% hydrogen peroxide

32
Q

what affects your judgement for the restorability of teeth with composite

A

if tooth can be isolated well with dental dam
if subgingival = cannot achieve
sub alveolar cavities/ vertical root fractures = unrestorable

33
Q

what is the purpose of camphorquinone

A

releases free radicals when attacked by blue light which allows addition polymerisation in the resin

34
Q

what is the action of the resin and what material is this usually in composite

A

usually bis-GMA
allows further cross linking of the C-C double bonds which increases molecular weight, strength and viscosity

35
Q

what is the action of filler in composite

A

increases compressive strength, abrasion resistance and fracture toughness

36
Q

name two materials that filler in composite can be

A

lithium aluminosilicate
borosilicate

37
Q

what is the purpose of low-weight di-methacrylates in composite

A

used to adjust viscosity and reactivity

38
Q

what is the purpose of silane coupling agent in composite

A

bi-functional molecule that increases bond of resin and filler particles

39
Q

name the five components of composite

A

camphorquinone
silane coupling agent
filler
low weight di-methacrylates
resin

40
Q

what is the purpose of acid etching

A

37% acid which is used to remove the smear layer and allow enamel bonding

41
Q

what are millers forceps used for

A

for holding articulating paper

42
Q
A
43
Q

what is flowable composite used for

A

useful for filling small voids

44
Q

how should you choose a composite shade

A

without rubber dam (due to dehydration occurring after placement)
check shade with and without operating light
involve patient in the selection process
check contralateral and adjacent teeth

45
Q

what are the overall shades for the different letters for shade matching composites

A

A - brown
B - yellow
C - grey
D - red

46
Q

what material is used to take a putty matrix

A

polyvinylsiloxane

47
Q

what is the purpose in incorporating a bevel in a cavity

A

increases surface area for bonding - cuts dentinal tubules on their longitudinal long axis which improves bonding

48
Q

how does enamel etching work

A

selectively dissolves enamel rods to create porosities so the resin can penetrate

49
Q

what is a smear layer

A

created when dentine is cut by hand or rotary instruments - thin layer of cutting debris, saliva and bacteria

50
Q

what is the hybrid layer

A

layer created when resin infiltrates the surface layer of dentine - strong bond between resin and dentine forms when monomer penetrates dentine

51
Q

what is the function of HEMA

A

bi-functional molecule used to prime dentine

52
Q

what are the two main types of dental adhesive systems

A

etch and rinse
self etch

53
Q

what occurs in the etch and rinse systems

A

smear layer removed by acid etch exposing the dentinal tubules

54
Q

what occurs in self etch systems

A

simultaneously condition and prime enamel and dentine - smear layer is penetrated by self etch primer which infiltrates smear layer and smear plugs

55
Q

three actions of phosphoric acid

A

removes smear layer
demineralises the dentine
exposes collagen fibres

56
Q

three actions of dentine bonding agents

A

remove remaining water
prime dentine for resin infiltration (HEMA)
allow resin to fill spaces between collagen fibres

57
Q

what is the percentage of monomer to polymer conversion of composite

A

60%

58
Q

what light range is required for camphorquinone to be activated in light cure composite

A

430-490nm

59
Q

what are the free radicals in self cure composites that come as 2 pastes

A

tertiary amine
benzoyl peroxide

60
Q

what is C factor in relation to composite

A

configuration factor
ratio of bonded to unbonded surfaces in a cavity and affects shrinking stress

61
Q

name six complications of composite

A

moisture control
over manipulation
over/ under etching
polymerisation contraction shrinkage stress
low wear resistance
longer to place

62
Q

why is moisture control required when placing composite

A

resin composites are hydrophobic - if contaminated this reduces the bond strength between composite and tooth

63
Q

what is the main problem of over manipulation of composite

A

incorporates air and therefore porosities within the restoration

64
Q

what is the problem of over-etching

A

causes collapse of the collagen framework so resin cannot penetrate to full depth

65
Q

what is the problem with under etching

A

not enough enamel has been demineralised for penetration

66
Q

name three effects of polymerisation contraction shrinkage stress

A

bond failure
cuspal deflection
post op sensitivity

FINALS (25 decks)

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