Final Exam Flashcards
1
Q
The shape of the preparation itself
A
Outline form
2
Q
Factors that are used in establishing the outline form are
A
- Access to the lesion
- Extent of the lesion ( what ultimately determines the prep)
- Restorative material to be used
- Esthetics
3
Q
Outline form should be made so that occlusal contact __
A
NEVER hits the margin of the restoration
4
Q
The shape given to the prep to prevent fracture of either the restoration or the tooth
A
Resistance form
5
Q
What form prevents fracture
A
Resistance form
6
Q
Usually the prep is placed __ into the dentin to avoid the sensitive DEJ
A
0.5 mm
7
Q
The shape that prevents the restoration from being displaced by tipping or lifting forces.
A
Retention form
8
Q
These include undercuts, truncations, grooves, pins, dovetails etc
A
Retention form
9
Q
This prevents displacement
A
Retention form
10
Q
__ retention comes from the converging walls and sometimes the dovetail
A
Primary
11
Q
__ retention helps retain restoration in place in the case of the primary retention failing
A
Secondary
12
Q
Grooves, coves, extensions, skirts, beveled margins, pins, slots, steps, amalgam pins, etchants adhesives, etc are all examples of
A
Secondary retention
13
Q
The shape that allows the needed procedure to be performed
A
Convenience form
14
Q
This allows for vision, access, etc. and it is what influences the outline form itself
A
Convenience form
15
Q
T/F: Amalgam directly adheres to the tooth
A
False
16
Q
What is something that is very important for amalgam preparations
A
Dovetails
17
Q
Amalgam preparations for class II’s require a __ in order to minimize undermined enamel rods
A
Reverse S curve
18
Q
For amalgam restorations, __ is very vital in order to have maximal strength
A
Compacting
19
Q
Amalgam needs to be __ to activate
A
Triturated
20
Q
Amalgam __ be added onto set amalgam
A
Cannot (must be redone if necessary)
21
Q
Amalgam cannot be polished/finished until at least __ after placing
A
24 hours (Use brownie first than greenie on slow speed)
22
Q
T/F: Amalgam has high tensile strength
A
False ! It has low tensile strength
23
Q
In composite preparations retention form is composed of __ and __
A
converging walls
the adhesive system
24
Q
T/F: For composite preparations on a class II, the axial wall retention grooves and reverse S curve are not necessary
A
True
25
Composite restorations are more aesthetically pleasing when compared to amalgam. On the other end they tend to be __
weaker (not the best choice for posterior teeth)
26
Recurrent/secondary caries are more prevalent and can progress more rapidly with
Composite restorations
27
Unlike with amalgam, __ is necessary for composite
etching
28
The longevity of composite is sometimes __ of amalgam
half the amount
29
T/F: You can add composite to cured composite
True
30
When can finishing and polishing be done with composite
Immediately
31
The process of curing monomers being converted from an aggregate of freely flowing molecules to a rigid assembly of cross linked polymer chains
polymerization
32
Polymerization results in a substantial __ during curing
volume contraction
33
The __ the degree of conversion, the __ the polymerization shrinkage
higher
higher
34
The __ the filler content, the __ the polymerization shrinkage
higher
lower
35
Polymerization shrinkage with bonding can cause __ at the restorative interface, more of this leads to a higher likelihood of __
tension
post-operative sensitivity
36
Incremental placement of composite should be done __ to avoid opposite walls in roughly __ increments
obliquely
2mm
37
The exception to 2mm composite increments
The box of a class II --> Should be a roughly 1mm horizontal placement first before doing the standard oblique 2mm rule
38
Caused by the interaction between two dissimilar metals and saliva; causes an electric shock to occur
Galvanic sensitivity
(Gold crown touching an amalgam restoration or aluminum foil touching amalgam)
39
Clinical manifestations of hyperocclusion
Pain
Increased odds of restorative fracture and/or tooth fracture
Increased sensitivity
Periodontal issues around finished tooth
TMJ/TMD problems
Root canal
Unhappy patients
40
What are some reasons for post-operative sensitivity (6)
-Aggressive tooth preparation ( no cooling system, wrong cutting instruments, deep preps close to dentinal tubules)
- Lack of adequate condensation of amalgam (Especially with lateral condensation of proximal boxes)
- Incorrect use of adhesive systems ( etching for too long)
- Not using a liner or base when indicated
- Formation of microgaps from restoration shrinkage
- Aggressive finishing of restoration
41
To prevent post-operative sensitivity, be mindful of the tooth preparation and the systems that you are using; with composite make sure to add __ to reduce polymerization shrinkage as well as to be careful with __ on restorations
incrementally
finishing/polishing
42
Traumatic occlusion __ an initiating factor, but can be a __ factor to periodontal disease
is not
contributory
43
Trauma from occlusion has been linked to higher risk of __ involvement
furcation
44
The main type of acid used in enamel etching is __
phosphoric acid
45
GI conditioner is usually composed of __
polyacrylic acid
46
Composite curing is __ with dentistry using __ light
light activated
blue
47
When light is placed on the composite, __ occurs
polymerization
48
The cavity geometric configuration system or __ , the higher the __ the higher the __
C-factor
C-factor
stresses
49
C-factor can be found by __ divided by __ surfaces
bound and unbound
50
A class I would have a C factor of __, a class II would have a C factor of __, a class V (or sealant) would have a C factor of __
5
2
0.2
51
Contraindications of resin (5)
-Allergy
-replacement of cusps
-large restorations with bruxism or occlusal stress
- high caries risk
- when rubber dam isolation is not possible
52
Contraindication of amalgam
- when esthetics are priority
- extensive destruction of tooth
- if the cavities are very small and using amalgam would lead to needing to remove unnecessary tooth structure
53
Which restorative material tends to show better results with posterior teeth regarding a longevity prognosis
Amalgam
54
Although amalgams are top choice for posterior teeth, there is increasing evidence that properly accomplished __ restorations can be durable
resin composite
55
For cut enamel, etching time should be
15-30 seconds
56
For uncut enamel, etching time should be
45-60 seconds
57
For dentin, etching should be no more than
15 seconds
58
The purpose of __ is to create microscopic roughness that increases surface area and potential for surface interactions with the bonded agent
etching
59
With __, etching can cause __ in which it exposes bundles of __ that allows the primer to infiltrate and turn it into a __ (once this is done the bond/resin can flow through the primed dentin and lock into place with curing)
dentin
dentin conditioning
collagen
hydrophobic substrate
60
Some amount of __ after placing a restoration is to always be expected
microleakage
61
Small gaps or spaces that develop between the tooth and a restorative material
Microleakage (Allows things such as bacteria, fluid, molecules or ions to flow through if the space is large enough)
62
With amalgam, __ is the best way to reduce marginal leakage
proper condensation
63
With composite, microleakage primarily occurs due to the __
polymerization process and shrinkage
64
To help with this, appropriate application of bonding agents is necessary, proper prep and cleaning of tooth, appropriate margins, and incremental addition
composite microleakage
65
Smooth surface inter proximal lesions are generally wider at the __ and narrow as it reaches __
enamel surface
dentin
(Start wide and get narrow)
66
These lesion are more constricted at the enamel surface and get wider as they get towards the DEJ
Pit/fissure lesions
(start narrow and get wide)
67
Caries affecting pits and fissures on occlusal third of molars and premolars, occlusal 2/3rds of molars and premolars, and lingual part of anterior teeth
Class I
68
Classes of decay are numbered by
how common they are
69
Caries affecting proximal surfaces of molars and premolars
Class II
70
Caries affecting proximal surfaces of central incisors, lateral incisors, and cuspids without involving the incisal angles
class III
71
Caries affecting proximal including incisal angles of anterior teeth
Class IV
72
Caries affecting gingival 1/3rd of facial or lingual surfaces of anterior or posterior teeth
Class V
73
Caries affecting cusp tops of molars, premolars, and cuspids
Class VI
74
Enamel rods tend to lead __ and flatten as you get __ (lean slightly apically toward the very end)
coronally
gingivally
75
With occlusal preps you need __ and with class V preps you need slight __ to prevent too much undermined enamel
convergence
divergence
(follows enamel rods)
76
What happens when a carious lesion reaches the DEJ
It spreads rapidly in a lateral fashion
77
This dental material is indicated for class III restorations that are out of occlusion and do not pose esthetic concerns, pediatric dentistry, and class V restorations that do not pose esthetic concerns
GI
78
This dental material is typically indicated for posterior occlusal-type restorations due to their higher longevity and ability to withstand occlusal forces
Amalgam
79
This dental material is typically indicated for restorations in the esthetic region or restorations that do not require large preps
Composite
80
GI can be used as what 4 things
Liner/base
sealant
luting agent
restorative material
81
The main advantage of GI
It releases fluoride and can be recharged
82
Disadvantage of GI
very low flexural strength, compressive strength and tensile strength.
Usually mixed with resin to have better longevity
83
What does RDT stand for
Remaining dentin thickness
84
Most important factor in maintaining pulpal health
Why?
RDT (remaining dental thickness)
Dentin has a very good buffering capacity and no more than necessary should be removed --> the larger the RDT the less the likelihood of the bacteria reaching the pulp
85
ZOE stands for
zinc oxide eugenol
86
This is used as a base in pulpal protection procedures
ZOE
87
ZOE is __ strength and a __ base
low
high solubility
88
ZOE can be used for indirect pulp capping under __ or __ restorations
amalgam
GI
89
ZOE as a sedative restoration,so it can not have any __. It can later be left as a base if asymptomatic after __ days and restore over with amalgam or GI
no occlusal contacts
14
90
Do not use ZOE -
- under composite
- with adhesive dentistry
- as a first layer for direct pulp capping (only for indirect pulp capping)
91
Dycal is a __and is used to assist in __
liner
reparative dentin formation
92
Dycal should be applied in a very thin layer of less than __
0.5mm
93
T/F: Dycal is needed when secondary dentin is present or sclerotic changes have occured
False (this is when it is not needed)
94
When is Dycal needed
when within 1mm of pulp chamber or when exposure has occurred or possibly occurred (pink dentin)
95
Due to being weak, Dycal needs to be covered with a stronger material such as __
GI
96
Most accepted theory of pain transmission
Hydrodynmic theory
97
Dentinal tubules are filled with odontoblastic processes and dental fluid. Small fluid movements arising from cutting, drying, pressure changes, osmotic shifts, or temperature changes distort odontoblasts and stimulate nerves and only pain is felt
Hydrodynamic theory
98
What can be used for a temporary restoration
ZOE/IRM (inhibits setting of composite bonded materials)
GI, composite amalgam can be used
99
When might you place a temporary restoration (4)
- If pt is going the need a root canal and the restoration is going to be removed
- Pulp exposure / trauma
-Fractured posterior tooth
- immediate symptomatic relief
- temp crown / displaced crown with post
100
Functions of temporary restorations (8)
Protect enamel, dentin and pulp
Reduce sensitivity
Protect soft tissues
Maintain occlusal relationships
Prevent drifting/ tilting/movement
protect gingiva
Maintain esthetics
Protect margins
101
Remineralized enamel is __ to decay
more resistant ( due to larger crystals with higher amounts of fluoride)
102
The shape that prevents the restoration from being displaced
Retention form
103
Examples of retention form
undercuts
truncations
grooves
pins
dovetails
etc
104
Shape given to the prep to prevent fracture of either the restoration or the tooth
Resistance form
105
Examples of resistance form
Adequate bulking
rounding of internal line angles
horizontal pulpal/gingival floors
106
Usually the resistance form is placed about __ into the dentin to avoid DEJ sensitivity and to take advantage of dentin resistance
0.5mm
107
Reasons for fractured restorations and teeth (6)
-High contact on restoration
- Margins/walls are not 90 degrees to tooth
- pulpal floor is not deep enough
- internal angles are not slightly rounded
- buccal/lingual walls are not converging
- incorrect/ insufficient condensing of amalgam
108
The location of decay in contact areas will ALWAYS be just __
apical to the interproximal contact point
109
Features that are necessary for all preps regardless of outlines
primary retention
110
What is the primary retention for an amalgam preparation
Converging walls and retention grooves (if needed)
111
For composite, converging walls are still necessary, but there is an __ that amalgam lacks
Adhesive system
112
Dovetails can be considered primary if it is a part of __
Inclusion of buccal/lingual grooves
113
Helps retain a restoration in the case the primary retention fails
Secondary retention
114
Examples of secondary retention
Grooves, coves, extensions, skirts, beveled margins, pins, slots, steps, amalgam pins, etchants, adhesives, and sometimes dovetails
115
Identify walls/ floors correctly
Distal wall
Buccal wall
Lingual wall
Pulpal wall
buccal proximal wall
lingual proximal wall
axial wall
gingival wall
116
Caries formula
Sugar + bacteria = decrease in pH/increase in acidity
(Acidity can cause tooth decay if high enough)
116
Dental caries are a __ disease
Site specific
117
The process of removing surface defects or scratches created during the contouring process using cutting or grinding instruments
Finishing
118
The most refined of the finishing processes, removing the finest surface particle
Polishing
119
This has a high positive pack handling quality to provide good proximal contact (it is crunchier) and it causes minimal material-related post-operative sensitivity
Lathe-cut
120
Disadvantages of lathe-cut
It requires a higher mercury amount
Needs early condensation with a small condenser
Needs higher packing forces during condensation
121
This requires a lower condensation pressure to achieve the same strength
Spherical alloy
122
Disadvantages of spherical alloy
Requires a larger condenser
Shorter working time (BUT this leads to a higher early strength)
No positive pack capability (poor contacts, more overhangs)
Greater risk of post op sensitivity
123
What also needs a varnish or alternative dentin sealer and greater burnishing
Spherical alloy
124
Spherical alloy is typically only good for __ cores or places where __ are preferred
amalgam
lower condensation forces
125
Mixture of both lathe-cut and spherical types of amalgam
Admixed alloy ( the best of both geometries)
126
Although high packing pressures with small condensers still being required with admixed alloy it does obtain __
Positive interproximal contacts
127
Admixed alloy has a slightly faster __ and has a low __
setting time
post-operative sensitivity
