EXAM I Restorative Dentistry Flashcards
what is the term used to describe the following:
- physical obstruction of pits and grooves
- decrease viable bacterial counts in sealed occlusal fissues
- prevents new bacterial colonization
- prevents penetration of fermentable CHOs and production of acid with bacteria
cariostatic property
(the purpose of restorative dentistry)
describe the simonsen sealant study
- sealants recalled after 15 years: 69% were sound, 31% were carious or restored
- group without sealants: 83% were carious or restored, 17% were sound
a pit and fissue surface on a permanent first molar is ___x more likely to be carious or restored after 15 years
7.5
this is why sealants are so important
is it recommended to provide sealants to children even if follow-up cannot be ensured?
yes
evidence-based reviews have found that caries risk for sealed teeth that have lost some or all sealant does not exceed the caries risk for teeth that have never been sealed
what are some considerations when sealants may not be cost effective?
- well-coalesced pits and fissures (ie. NOT deep)
- caries unlikely
- poor patient cooperation
when are sealants contraindicated?
- rampant caries
- interproximal lesions are present
- decay reaches dentin
what are the properties of composite resin that make it good as a sealant material?
- insoluble, aesthetic, insensitive to dehydration, easy to manipulate
- a filler material such as silica
- a photoinitiator
- flow into pits and grooves of occlusal surfaces
- form a protective barrier
- wet-bonding - moisture tolerant resin chemistry
___ is commonly added to composite resin to achieve physical properties of flowability
dimethylglyoxime
what are the properties of ultraseal XT hydro-ultradent that make it good as a sealant material?
- 53% filled
- light cure activation
- radio-opaque thixotropic (flowable property) resin
- hydrophilic
- self-adhesive
what are the properties of glass ionomer that make it good as a sealant material?
- considered a provisional sealant
- continuous fluoride release
- deeply fissured primary molars
- wet field
- partially erupted molars
___ as a sealant material should be reevaluated and probably replaced with resin-based sealants when better isolation is possible
glass ionomer
what are the properties of silverdiamine that make it good as a sealant material?
- effective at inhibiting lesion progression
- follow-up care
- reduction of dentinal hypersensitivity
- reduce bacteria and matrix metalloproteinases (responsible for degradation of dentin)
- arrest carious lesions
- diagnostic indicator - only stains carious lesions
- one drop can be used for multiple teeth
what is silver diamine fluoride, and what percent of silver diamine sealant material is composed of silver diamine fluoride?
- a metal ammine complex of silver fluoride
- 38%
what is the recommended % acid solutions and etching time for placement of sealants?
- 30-50% acid solutions or gels
- 20-second etching time
- studies show that >50% acid solutions and/or >20 second etching time did not affect bond strength of sealants
what are two cases where teeth may need to be etched for longer periods?
primary teeth and enamel rich with fluorohydroxyapatite
which sealant material has shown 88% of the restored surfaces remain caries-free 9 years after placement?
preventive resin restorations
what are some considerations for preiodic recall of teeth with sealants?
- 5-10% need repair
- determine effectiveness, reapply if necessary
- partial loss, discolored, or defects
- remove and reevaluate, reapply if indicated
pit and fissure sealants lower the number of viable bacteria including ___ and ___ by at least 100-fold
strep mutans and lactobacilli
are self-etch or acid etch techniques better for retention?
acid etch
between acid-etch, quarter round bur, and air abrasion surface preparation, which produced the least microleakage?
bur
need to be careful with enamloplasty though - sometimes aggressive use can remove the last of the enamel overlying the dentin in deep fissures, leaving the tooth more susceptible to future caries in case of sealant loss
what is the difference in application between chemically cured sealants and light cured sealants?
chemically cured sealants typically have shorter working times
___ is an alternative procedure for restoring young permanent teeth that require only minimal tooth preparation for caries removal but also have adjacent susceptible fissures
preventive resin restoration (sealed composite resin restoration)
what is an important consideration related to restoration failures between primary teeth and permanent teeth?
primary teeth are more susceptible to restoration failures than permanent teeth, so you need to consider the length of time before the primary tooth is exfoliated
what rubber dam clamb should be used for permanent molars? what about primary molars?
- permanent molars - 14A
- primary molars 8A
what is the bur of choice for establishing outline and depth for preparations?
330
the pulpal floor should be ___mm into dentin, and about ___mm from the enamel surface
- 0.5
- 1.5
should you bevel the cavosurface margin of an amalgam preparation? what about a composite preparation?
- amalgam - no
- compositve - yes
what type of restoration is generally indicated for a primary tooth with extensive decay, like a 3-surface MOD?
SSC
what restoration is indicated when caries removal results in a pulp exposure in a primary tooth with a normal pulp or reversible pulpitis or after a traumatic pulp exposure?
pulpotomy
when completing a pulpotomy restoration, what material is the coronal pulp chamber filled with?
zinc oxide eugenol base
what is the most effective long-term restoration for primary teeth?
SSC
which size SSC is the most frequent size used in pediatric dentistry?
4