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Applied Dental Materials > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

what are the 3 classifications of dental materials

A
  1. preventative materials
  2. restorative materials
  3. therapeutic materials
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2
Q

evidence based dentistry must use (3)

what does it help do?

A

must use: scientific evidence to validate treatment, rely on clinical experience and expertise, and the patients needs/conditions/preferences

it helps the clinician make decisions on what is relavent to incorporate into practice

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3
Q

how are the decisions made regarding _______, _________, ________, that you recommend?

A

techniques
technology
products

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4
Q

ADA seal program has a ___ year length period for ONLY _____ products.

what does the review panel do

what was the first thing to recieve a seal

A

5 year; consumer products

Review Panel: Reviews product ingredients,
scientific evidence to prove clinical effectiveness

First dental product to receive Seal: Toothpaste (Colgate); over 200 products carry the seal

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5
Q

what must the manufacuer do to for consideration of a seal

A

Supply data that supports the products safety, effectiveness and claims
*Conduct clinical trials following ADA guidelines
*Provide proof that ingredients are pure and uniform
*Submit product packaging to review for accuracy

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6
Q

what are the advantages and disadvantages for teh seal

A

Advantages: public trust- 70 % of consumers
recognize the ADA Seal of Acceptance; increases sales

Disadvantages for manufacturer
* Takes time for approval (months)
* Costly to run clinical trials (millions)

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7
Q

define biocompatibilty

A

Must not impede on living tissue

Must not adversely affect living tissue

materials placed in the clients mouth should be: biocompatible, durable, nonreactive in acid or alkaline, compatible with other materials, benefit the patient, and be esthetically acceptable

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8
Q

what are the 3 types of forces/actions

A

A.Tensile Forces-forces applied in the opposite direction-when biting stretches material such as food.

B.Compressive Forces- force applied to compress such as the back teeth. Molars are suited for this.

C. Shearing Forces-when two surfaces slide against each other in a twisting or rotating motion.

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9
Q

what are the differences in compressive forces compared in enamel, amalgam, and porcelain

A

Enamel can handle high compressive stress

Dental amalgams can often handle high compressive forces

Porcelain can NOT handle as much and will
fracture if too much compressive forces are applied

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9
Q

define stress/strain

what can these forces lead to

A

stress- -the internal force of a tooth or dental material to resist applied force

strain- if a tooth or dental material can not resist force then it will distort or deform leading to strain

These forces can lead to fractures of the tooth or dental materials

*Different dental materials or parts of the tooth are better able to resist strain

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9
Q

what materials handle the most compressive strength to least (6)

A
  1. enamel
  2. amalgam
  3. dentin
  4. resin
  5. porcelain
  6. acrylic
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10
Q

how does temperature cuase dimensional changes

excessive changes cause:

which type of dental material transmit temperatures (esp. cold) much FASTER than enamel/ which material has GOOD thermal conductivity

A

Dimensional Changes-Foods and drinks can alter the temperature enough to cause the expansion or contraction of teeth or dental materials

Excessive dimensional changes due to temperature changes can cause contraction or fracture of teeth or dental materials

AMALGAMS and METAL CROWNS transmit
temperature (especially cold) much faster than enamel, (have good thermal conductivity)

*Amalgams may need insulators below them

*Tooth colored restorations will transmit temperature similarly to natural tooth structure

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10
Q

Saliva has a pH of ______ -______

food and drinks can raise or lower the pH
_________

Dental Materials/Teeth must be able to
withstand ______ exposure to ______and
_____

define solubility; should dental materials have low or high solubility

A

Saliva has a pH of 6.2-7.0- it flucuates during the day.

Food and drinks can raise or lower the pH
SIGNIFICANLY

Dental Materials/Teeth must be able to
withstand LONG-term exposure to MOISTURE and ACIDS

Solubility- ability to dissolve-Dental Materials
should have a LOW solubility

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10
Q

what is galvanism
give examples
what is a galvanic shock

A

An electric current generated between two dissimilar metals. The salts in saliva along with dissimilar metals make an electric current.

  • Bite foil between teeth when alloys or crowns are present > slight electric shock
  • Fork touching teeth
  • Scalers touching fillings or crowns
  • Gold crown contacting a silver filling > may require replacement of a restoration

when galvanism sends a shock to the pulp of the tooth

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10
Q

what is the difference between corrosion and tarnish

A

METALS suffer the effects of moisture and acidiity

Corrosion- breakdown of a dental metal cause by a chemical or electrochemical reaction with dissimilar metals in the presence of a
solution(saliva)-can be seen in amalgams but NOT with Noble metals like gold.

Tarnish- discoloration only of a metal due to oxidation of the surface-can also see in
amalgams

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10
Q

what is CTE

what has a large/small CTE

A
  • the expansion and contraction of the material
    with change in temperature; COEFFICIENT OF THERMAL EXPANSION
  • compostie/amalgam have a large CTE
  • enamel/dentin have a small CTE
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10
Q

what is percolation in terms of temperature

A
  • Repeated hot and cold after a restoration is placed will cause the opening and closing of the margins along the filling and the tooth
  • This leaves gaps between the tooth and the filling where fluids and bacteria can gain access
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11
Q

what is retention

adhesion

cohesion

A

How well a dental material can stay in the mouth or within a tooth chemically or mechanically; most restorations use both

Adhesion-sticking two things together-chemical
adhesion occurs when molecules of dissimilar
substances bond together-bonding things TO teeth

Cohesion-molecules of similar substances bond together-connection WITHIN the tooth

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12
Q

define microleakage

A

Space between the walls of the preparation and the restoration – interface

when the interface isnt sealed, microorganimss and fluid seep in

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13
Q

what is teh difference between direct and indirect restoration gives examples

A

Direct Restoration-is completed in ONE appointment while the patient is in the chair
- Amalgam/composite filling
- bondings
- glass ionomer cements

Indirect Restoration-final restoration is placed at another appointment.
- Crown/bridge
- gold inlays

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14
Q

how do we properly detect restorative materials

A
  • adequte lighting
  • use air, dry field
  • magnifications, loupes
  • sharp explorer > cavosurface margin
  • radiographs
  • good knowlege of materal
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15
Q

how can tooth colored restorative material be ID’d

A
  • appearance
  • location
  • tactile sensitivity (most reliable means of clinical assessment
  • radiography
    > Composites=radiopaque or radiolucent
    >Glass ionomers=radiopaque
    >Many resin-based cements & porcelain= radiopaque
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16
Q

define denstiy

hardness

ultimate strength

elasticity

stiffness

ductability

A

density: -weight measure compared with volume

hardness: - resistance to wear and abrasion

ultimate strength: -maximum stress a material will take before it breaks

elasticity: when stress is applied a material it will not permanently deform

stiffness: resistance of a material to deform > dental materials should be similar to tooth stiffness

Ductability: dimensional change without breaking > porcelain has a LOW dectability

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16
Q

What is viscosity
high viscosity =
low viscosity =
viscosity _______ as temperature _____

A

Viscosity - ability to flow. EX, mixing alginate

The higher the viscosity- resist flowing and is thick

The lower the viscosity- thin and flows more readily

Viscosity usually DECREASES as temperature INCREASES

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17
Q

mixing time

working time

final set time

A

Mixing time - for best mix (amount of time we have to mix different materials into one)

Working time- handling of material (lapse of time form when it’s mixed until it hardens)

Final set time- before material hardens

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18
Q

CDC provides ____

OSHA provides _____

A

CDC provides GUIDELINES

OSHA provides LAWS

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19
Q

what are safety data sheets

what do they provide

what do they describe/contain

A
  • Contain health and safety information about each chemical in the Dental Office or Dental Lab using an international standard of symbols
  • Provide comprehensive technical information on these chemicals
  • they describe Physical and chemical properties, Health hazards, Routes of exposure, Precautions for safe handling and use, and Emergency and first aid/spill control measures
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20
Q

what are the 16 different headings/sections of SDS

A
  • Product Name and manufacturer
  • Hazardous Identification
  • Composition
  • First Aid Measures
    -Fire fighting Product ingredients
  • Accidental Release
  • Handling and storage
  • Exposure control/Personal protection
  • Physical and Chemical Characteristics
  • Stability and reactivity
  • Toxicology
  • ecological
  • disposal
  • transportation
  • regulatory information
  • other information
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21
Q

how do hazardous chemicals enter the body (4)

A
  • Inhalation
  • Absorption through the skin
  • Ingestion (eating or drinking)
  • Invasion (directly through break in skin)
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22
Q

how can mercury get into the body

how to prevent it

A
  • Absorbed through skin
  • Inhalation of mercury vapors
  • Mercury-absorbing powder
  • Mercury sponges
  • Disposal bag
  • PPE’s – UTILITY GLOVES
23
Q

how to manage bioareosols

A
  • keep Office Air Filtration Clean
  • Use Proper Oral/Lab Evacuation Procedures
  • Wear Proper PPEs: Mask, Gloves, Safety Glasses, Protective Clothing
  • Pre-procedural Mouth Rinses
  • Have patient wear proper protection
  • Use proper high or low velocity suction
  • Keep all Containers tightly covered
24
Q

ELASTIC MATERIALS:

  1. what is a colloid
  2. what is a hydrocolloid
  3. what is a reversible hydrocolloid EX
  4. what is an irreversible hydrocolloid EX
A

Colloid is a glue-like material composed of two or more substances with one substance not going into solution; it is suspended in another substance

Hydrocolloid: water-based colloids that function as elastic impression materials

> Reversible Hydrocolloids (Agar) used to take impressions for crowns and bridges-not commonly used. SOL – colloidal suspension – heat/increased dispersion. Can be heated and turned back into a liquid/gel.

> irreversible hydrocolloids (alginate): Alginate-most commonly used impression material (most inaccurate elastic impression material); SOL – colloidal suspension. Once it has hardened it cannot be remelted to be reused.

25
Q

ELASTIC MATERIALS
1. what are elastomers
2. what are they used for

A

Elastomers-highly accurate impression
material that has rubber-like qualities

Most commonly used for-crown / bridge
impressions, partial and implant impressions

26
Q

types of elastomers (

A
  • Polysulfides
  • Silicone Rubber
  • Polyvinyl Siloxane
  • Polyether
  • Vinyl Polyether Silicone Hybrids
27
Q

can you repour alginate?
addition silicone?
polyether?

A

no
yes
yes

28
Q

what are INELASTIC materials
examples

A

inelastic = rigid materials

EX:
- Dental Impression
Compound: softens when heated and then becomes firm at mouth temperature
- Zinc Oxide Eugenol Impression Material
- Impression Wax

29
Q

what are the key properties of impression materials

A

accuracy > material closely adapts to the tissue and picks up detail of the mouth

tear resistance > ability to remove the impression without it being damaged

dimensional stability > ability for the impression to maintain its shape after being removed

30
Q

ALGINATE
- what type is it
- is it accurate
- what are the pros
- what is the working time
- what is the setting time
- what are some common uses

A
  1. elastic irreversible hydrocolloid
  2. no, least accurate impression material
  3. inexpensive, easy to manipulate, requires no special equipment, reasonably accurate
    • regular set: 2-3 minutes
    • fast set: 1.25-2 minutes
      5.
    • regular set: 2-5 min
    • fast set: 1-2 min
  5. diagnostic casts, preliminary impression for dentures, partial dentures, OPPOSING casts for crown and bridge, provisional restorations, custom trays for flouide/bleaching, sport protectors/nightgaurds, removable orthodontic appliances
31
Q

what are the impression steps in clinic (4)

A
  1. fit tray
  2. mix alginate w cold water, smoothly to reduce bubbles
  3. set tray completely in mouth and pull lip over continuously
  4. sanitize w cavicide for 3 min
32
Q

what are the advantages of digital impressions

diadvantages

A
  • post and pre images, donesnt take up space
  • communicate w patient
  • accurate
  • no materials needed
  • more comfortable for patietn
  • cost of scanner is expensive
  • training and practice needed
  • fees
  • may be too large for patients w/ limited opening
33
Q

what are the chemical properties of gypsum

A
  • The Mineral Gypsum (Dihydrate of calcium sulfate)
  • Mined in a solid mass

-flowable

34
Q

types of gypsum depend on what?

plaster/type 2
stone/type3
diestone/type4

A
  • Types of Gypsums depend on how the initial heating/pressure process of the dihydrate is varied
  • Plaster, Type II Gypsum: often used for ortho study models
  • castone/Stone, Type III Gypsum: higher heat and pressure (USED IN OUR LAB); harder than plaster/easy to manipulate
  • Diestone, Type IV Gypsum: even higher heat and pressure plus finer grinding; gives very accurate impressions and dimensional stability
35
Q

what are the manipulation factors for gypsum
1. if you increase the water to powder ratio
2. if you decrease the water to powder ratio
3. if you increase the rate of spatulation
4. if you increase the temperature of the water
5. if you decrease the water temp

A
  1. INCREASING WATER-POWDER RATIO WILL:
    - increase working time
    - decrease viscosity
    - decrease strength
  2. DECREASING WATER-POWDER RATIO WILL:
    - decrease working time
    - increase viscosity
    - increase strength
  3. INCREASING RATE OF SPATULATION WILL:
    - decrease working time
    - increase viscosity
    - not affect the strength
  4. INCREASING WATER TEMPERATURE WILL:
    - decrease working time
    - increase viscosity
    - no affect on strength
  5. DECREASING WATER TEMPERATURE WILL:
    - increase the working time
    - decrease the viscosity
    - have no affect on strength
36
Q

what are bruxism mouth gaurds used for

A
  • Parafunctional Habits
  • Movements of the mandible
  • Clenching
  • Bruxism (forceful grinding)
  • Thumbsucking (alternative appliance)
  • Rocking of the Teeth
37
Q

what is abfraction

A
  • ONGOING flexion, tension, and compression forces exerted in the cervical area of a tooth resulting in cracking/fracturing/loss of cervical tooth structure leading to a V-shaped notch at the cervical area of the tooth.
  • hypothetical condition > Conflicting evidence about whether this actually occurs due to compression
  • Most of these area are due to
    toothbrush ABRASION
38
Q

what are periodontal splints for
what patients receive them
what is a challenge with them
what must the hygienist do
What are some additional homecare aides

A
  • protect and stabilize mobile
    teeth to prolong their presence in
    the mouth
  • Used in patients with severe
    bone loss and mobility
  • Can make cleaning a challenge
  • Hygienist must adapt treatment
    and individualize patient’s oral
    hygiene if periodontal splints are
    present; AND EDUCATE THE PATIENT ON MAITNENCE
  • InterDental Brush, Floss Threaders, Water Irrigation, Electric Toothbrushes
39
Q

what are the two types of bleaching material

A

1.Hydrogen peroxide
- Works more rapidly

  1. Carbamide Peroxide
    - Is a more stable type and breaks down into hydrogen peroxide and urea when exposed to water
    - USED IN OUR CLINIC
40
Q

what is the difference between intrinsic and extrinsic stains

A

Extrensic- caused by foods, beverages, and tobacco products >coffee, wine, smoking, tobacco
-Some can be totally or partially polished off or removed with ultrasonics

Intrinsic- internally incorporated into the tooth structure > fluorides, tetracycline
-Can often be difficult or complete removal may not be possible

41
Q

what are the over the counter bleaching products

A
  • Bleaching Strips
  • Paint on Pastes
  • Bleaching Gels in stock trays
  • Toothpastes

*Lower concentration of bleaching material than in office or with use in prescribed bleaching
*(6-10% hydrogen peroxide or carbamide peroxide versus 15-30%)

42
Q

what is in office bleaching

A
  • greater concentration of matrial used (15-30%)
  • isolate the gingiva before use
  • light activated systems
  • bleaching trays
  • prescribed home bleaching
43
Q

what are the side effects of bleaching

A

1= Tooth sensitivity

  • Caused by bleach penetrating the enamel and reaching into the dentinal tubules
  • Fluoride, Sodium Nitrate or other Desensitizers can be added to bleaching materials
44
Q

what are the bleaching effects on restorative materials

A
  • Seal all cavities and broken restorations prior to bleaching
  • May need to wait several weeks after bonding of teeth to start bleaching
  • Restorative material will NOT be lightened but surrounding teeth will
  • Allow 2 weeks for color to stabilize prior to tooth colored restorations being placed in anterior region and to prevent damage to anterior composite restorations
45
Q

what are the contraindictions to bleaching

A
  • Patients with extremely sensitive teeth (cold)
  • Patients with allergies to bleaching components
  • Patients with multiple colored restorations
  • Significant decay in teeth to be whitened / carious lesions / heavy calculous deposits / untreated periodontal disease
  • severe untreated periodontal disease in the area of bleaching
  • younger than 18
  • patints w/ extensive intrinsic stains
  • pregenant or breastfeeding
46
Q

what is the accepted optimal level of flouride in drinking water

A

0.7-1.2 mg/L or ppm

47
Q

what is fluorosis, how does it occur

A
  • Consumption of excess fluoride during formation of the teeth.
  • high concentration in drinking water.
  • excess fluoridated toothpaste swallowed by child
  • topically applied by dental personnel
48
Q

what is systemic fluoride

A
  • REMINERALIZATION: replacing minerals lost from the tooth surface
  • Fluoride in the saliva surrounding the tooth is
    incorporated into the surface of enamel crystals during remineralization to form a
    surface veneer containing FLUORAPATITE
  • Fluorapatite has much lower solubility than the original tooth mineral.
49
Q

what is erosion

A
  • bacteria is NOT involved
  • acidic food/drinks wear down the tooth minerals
  • Fluoride provides protection against
    erosion, HOWEVER…repeated attacks
    will overcome beneficial effects
  • caused by some medical conditions such as acid reflux, anorexia, bulimia
50
Q

what is the most common form of fluoride in the dental practice

A

FLUORIDE VARNISH
USED IN OUR CLINIC

51
Q

what are the indications of self applied fluoride

A
  • individuals who are at moderate to high risk for dental caries.
  • Orthodontic patients.
  • Elderly patients who take medications that dry up their salivary flow are at high risk for root caries.
52
Q

what is silver diamine fluoride

A
  • composed of silver, ammonia, sodium fluoride, 38% silver diamine fluoride
  • anti-microbial that limits the reinvasion of cariogenic biofilm
  • shown to be effective in preventing and arresting dental caries, and treating pain associated with dentin hypersensitivity
  • 65% of active carious lesion reduction with
    one application per year; 90% of active carious lesion reduction with two applications per year
53
Q

what are the indication of silver diamine fluoride

A
  • Patients at high risk for dental caries
  • Patients with numerous carious lesions that
    cannot be treated in a single visit
  • Patients who are behaviorally or medically-
    challenged
  • Patients without access to proper dental care
  • Young children waiting for hospital-based dental treatments
  • Non-invasive treatment of deciduous teeth about to exfoliate
    Patients reporting pain from dentinal hypersensitivity
54
Q

what are sealant for

whats the purpose

what are the indications

A

unfilled or lightly filled resins that are used
to seal the non-carious pits and fissures of deciduous and permanent teeth

to prevent dental caries in the pits and fissures. Most caries (about 88%) in children is found in pits and fissures.

  • age, oral hygiene, caries risk, diet, fluoride history, and tooth type and morphology
  • Teeth with steep cuspal inclines and deep, sticky fissures
  • Molars decay three to four times more frequently than premolars.
  • Occasionally maxillary central and lateral incisors have deep pits on the palatal surface
55
Q

what are desensitizing agents

what are causes of tooth sensitivity

A
  • Professionally applied or OTC materials applied to the teeth by the patient to reduce or eliminate sensitivity. EX: toothpaste, fluoride gel/varnish, inorganic salt solutions, nitrate, resin primers, bonding agents, mineralizing agents

causes of sensitivity
- gingival recession
- Toothbrush abrasion
- Erosion by acids
- Abfraction associated with bruxism.
- Scaling and root planning.
- Dental caries.
- Cracked teeth.
- Leaking restorations

56
Q

BRANNSTROM’S HYDRODYNAMIC THEORY

A
  • explains how dentin hypersensitivity and tooth sensitivity occurs; relationship of sensitivity to exposed dentin
  • fluid movement within the dentinal tubules stimulates nerve endings, leading to the sensation of pain or discomfort
57
Q

define alloy and amalgam

A

Alloy: a mixture of 2 or more metals
- uses primarily silver but also copper and tin are added

Amalgam: when a silver based alloy is mixed with mercury, this reaction occurs and the resulting product is called a dental amalgam

58
Q

what are the advantages of amalgam

disadvantages?

A
  • inexpensive
  • Ease of use
  • Proven track record
  • Less allergies
  • not esthetic
  • more tooth structure removed to retain restoration
  • can’t withstand chewing immediately after
  • temperature sensitive
  • galvanic reactions
  • mercury involved
59
Q

what are the components of amalgam

A

silver (Ag), Tin (Sn), Copper (Cu), Zinc (Zn)

60
Q

what is trituration

A
  • process of mixing mercury and amalgam alloy powder to create a dental amalgam
  • over triturated = too wet
  • under triturated = crumbly
  • perfect = satin/puddy like
61
Q

describe the placement of amalgam

A
  • ALWAYS over fill cavity prep then carve excess into shape
  • working time 2-5 min
  • no biting for several hours
  • MECHANICAL RETENTION
62
Q

what are the suspectable properties of amalgam

A

tarnish: oxidation at the surface resulting from oxygen/chloride/sulfides, dark appearance, rougher surface with more tarnish, polish after 24 hrs reduces tarnish

creep: gradual change in the shape from compression of opposing arches during chewing

63
Q

T/F high copper alloys have less distortion, less corrosion, and higher strength

A

TRUE

64
Q

how does mercury enter the body

what mercury hygiene should we use for the patient

A
  • ingestion, direct contact, or inhalation
  • use a rubber dam, high volume evacuation, and lots of water
65
Q

what are some mercury safety procedures

A
  • never heat instruments contaminated with mercury above 800 degree celcius
  • well ventilated office and sterile room
  • wear PPE
  • easy to clean floors, NO carpet
  • amalgam capsules
  • store scrap amalgam water in sealed containers
  • use traps/filters in evacuation systems
  • dont buy in bulk

Applied Dental Materials (2 decks)

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