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Operative > Final Exam > Flashcards

Final Exam Flashcards

1
Q

The shape of the preparation itself

A

Outline form

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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
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3
Q

Outline form should be made so that occlusal contact __

A

NEVER hits the margin of the restoration

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4
Q

The shape given to the prep to prevent fracture of either the restoration or the tooth

A

Resistance form

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5
Q

What form prevents fracture

A

Resistance form

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6
Q

Usually the prep is placed __ into the dentin to avoid the sensitive DEJ

A

0.5 mm

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7
Q

The shape that prevents the restoration from being displaced by tipping or lifting forces.

A

Retention form

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8
Q

These include undercuts, truncations, grooves, pins, dovetails etc

A

Retention form

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9
Q

This prevents displacement

A

Retention form

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10
Q

__ retention comes from the converging walls and sometimes the dovetail

A

Primary

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11
Q

__ retention helps retain restoration in place in the case of the primary retention failing

A

Secondary

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12
Q

Grooves, coves, extensions, skirts, beveled margins, pins, slots, steps, amalgam pins, etchants adhesives, etc are all examples of

A

Secondary retention

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13
Q

The shape that allows the needed procedure to be performed

A

Convenience form

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14
Q

This allows for vision, access, etc. and it is what influences the outline form itself

A

Convenience form

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15
Q

T/F: Amalgam directly adheres to the tooth

A

False

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16
Q

What is something that is very important for amalgam preparations

A

Dovetails

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17
Q

Amalgam preparations for class II’s require a __ in order to minimize undermined enamel rods

A

Reverse S curve

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18
Q

For amalgam restorations, __ is very vital in order to have maximal strength

A

Compacting

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19
Q

Amalgam needs to be __ to activate

A

Triturated

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20
Q

Amalgam __ be added onto set amalgam

A

Cannot (must be redone if necessary)

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21
Q

Amalgam cannot be polished/finished until at least __ after placing

A

24 hours (Use brownie first than greenie on slow speed)

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22
Q

T/F: Amalgam has high tensile strength

A

False ! It has low tensile strength

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23
Q

In composite preparations retention form is composed of __ and __

A

converging walls
the adhesive system

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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

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25
Q

Composite restorations are more aesthetically pleasing when compared to amalgam. On the other end they tend to be __

A

weaker (not the best choice for posterior teeth)

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26
Q

Recurrent/secondary caries are more prevalent and can progress more rapidly with

A

Composite restorations

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27
Q

Unlike with amalgam, __ is necessary for composite

A

etching

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28
Q

The longevity of composite is sometimes __ of amalgam

A

half the amount

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29
Q

T/F: You can add composite to cured composite

A

True

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30
Q

When can finishing and polishing be done with composite

A

Immediately

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31
Q

The process of curing monomers being converted from an aggregate of freely flowing molecules to a rigid assembly of cross linked polymer chains

A

polymerization

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32
Q

Polymerization results in a substantial __ during curing

A

volume contraction

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33
Q

The __ the degree of conversion, the __ the polymerization shrinkage

A

higher
higher

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34
Q

The __ the filler content, the __ the polymerization shrinkage

A

higher
lower

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35
Q

Polymerization shrinkage with bonding can cause __ at the restorative interface, more of this leads to a higher likelihood of __

A

tension
post-operative sensitivity

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36
Q

Incremental placement of composite should be done __ to avoid opposite walls in roughly __ increments

A

obliquely
2mm

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37
Q

The exception to 2mm composite increments

A

The box of a class II –> Should be a roughly 1mm horizontal placement first before doing the standard oblique 2mm rule

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38
Q

Caused by the interaction between two dissimilar metals and saliva; causes an electric shock to occur

A

Galvanic sensitivity
(Gold crown touching an amalgam restoration or aluminum foil touching amalgam)

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39
Q

Clinical manifestations of hyperocclusion

A

Pain
Increased odds of restorative fracture and/or tooth fracture
Increased sensitivity
Periodontal issues around finished tooth
TMJ/TMD problems
Root canal
Unhappy patients

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40
Q

What are some reasons for post-operative sensitivity (6)

A

-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

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41
Q

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

A

incrementally
finishing/polishing

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42
Q

Traumatic occlusion __ an initiating factor, but can be a __ factor to periodontal disease

A

is not
contributory

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43
Q

Trauma from occlusion has been linked to higher risk of __ involvement

A

furcation

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44
Q

The main type of acid used in enamel etching is __

A

phosphoric acid

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45
Q

GI conditioner is usually composed of __

A

polyacrylic acid

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46
Q

Composite curing is __ with dentistry using __ light

A

light activated
blue

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47
Q

When light is placed on the composite, __ occurs

A

polymerization

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48
Q

The cavity geometric configuration system or __ , the higher the __ the higher the __

A

C-factor
C-factor
stresses

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49
Q

C-factor can be found by __ divided by __ surfaces

A

bound and unbound

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50
Q

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 __

A

5
2
0.2

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51
Q

Contraindications of resin (5)

A

-Allergy
-replacement of cusps
-large restorations with bruxism or occlusal stress
- high caries risk
- when rubber dam isolation is not possible

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52
Q

Contraindication of amalgam

A
  • 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
Q

Which restorative material tends to show better results with posterior teeth regarding a longevity prognosis

A

Amalgam

54
Q

Although amalgams are top choice for posterior teeth, there is increasing evidence that properly accomplished __ restorations can be durable

A

resin composite

55
Q

For cut enamel, etching time should be

A

15-30 seconds

56
Q

For uncut enamel, etching time should be

A

45-60 seconds

57
Q

For dentin, etching should be no more than

A

15 seconds

58
Q

The purpose of __ is to create microscopic roughness that increases surface area and potential for surface interactions with the bonded agent

A

etching

59
Q

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)

A

dentin
dentin conditioning
collagen
hydrophobic substrate

60
Q

Some amount of __ after placing a restoration is to always be expected

A

microleakage

61
Q

Small gaps or spaces that develop between the tooth and a restorative material

A

Microleakage (Allows things such as bacteria, fluid, molecules or ions to flow through if the space is large enough)

62
Q

With amalgam, __ is the best way to reduce marginal leakage

A

proper condensation

63
Q

With composite, microleakage primarily occurs due to the __

A

polymerization process and shrinkage

64
Q

To help with this, appropriate application of bonding agents is necessary, proper prep and cleaning of tooth, appropriate margins, and incremental addition

A

composite microleakage

65
Q

Smooth surface inter proximal lesions are generally wider at the __ and narrow as it reaches __

A

enamel surface
dentin
(Start wide and get narrow)

66
Q

These lesion are more constricted at the enamel surface and get wider as they get towards the DEJ

A

Pit/fissure lesions
(start narrow and get wide)

67
Q

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

A

Class I

68
Q

Classes of decay are numbered by

A

how common they are

69
Q

Caries affecting proximal surfaces of molars and premolars

A

Class II

70
Q

Caries affecting proximal surfaces of central incisors, lateral incisors, and cuspids without involving the incisal angles

A

class III

71
Q

Caries affecting proximal including incisal angles of anterior teeth

A

Class IV

72
Q

Caries affecting gingival 1/3rd of facial or lingual surfaces of anterior or posterior teeth

A

Class V

73
Q

Caries affecting cusp tops of molars, premolars, and cuspids

A

Class VI

74
Q

Enamel rods tend to lead __ and flatten as you get __ (lean slightly apically toward the very end)

A

coronally
gingivally

75
Q

With occlusal preps you need __ and with class V preps you need slight __ to prevent too much undermined enamel

A

convergence
divergence
(follows enamel rods)

76
Q

What happens when a carious lesion reaches the DEJ

A

It spreads rapidly in a lateral fashion

77
Q

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

A

GI

78
Q

This dental material is typically indicated for posterior occlusal-type restorations due to their higher longevity and ability to withstand occlusal forces

A

Amalgam

79
Q

This dental material is typically indicated for restorations in the esthetic region or restorations that do not require large preps

A

Composite

80
Q

GI can be used as what 4 things

A

Liner/base
sealant
luting agent
restorative material

81
Q

The main advantage of GI

A

It releases fluoride and can be recharged

82
Q

Disadvantage of GI

A

very low flexural strength, compressive strength and tensile strength.
Usually mixed with resin to have better longevity

83
Q

What does RDT stand for

A

Remaining dentin thickness

84
Q

Most important factor in maintaining pulpal health
Why?

A

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
Q

ZOE stands for

A

zinc oxide eugenol

86
Q

This is used as a base in pulpal protection procedures

A

ZOE

87
Q

ZOE is __ strength and a __ base

A

low
high solubility

88
Q

ZOE can be used for indirect pulp capping under __ or __ restorations

A

amalgam
GI

89
Q

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

A

no occlusal contacts
14

90
Q

Do not use ZOE -

A
  • under composite
  • with adhesive dentistry
  • as a first layer for direct pulp capping (only for indirect pulp capping)
91
Q

Dycal is a __and is used to assist in __

A

liner
reparative dentin formation

92
Q

Dycal should be applied in a very thin layer of less than __

A

0.5mm

93
Q

T/F: Dycal is needed when secondary dentin is present or sclerotic changes have occured

A

False (this is when it is not needed)

94
Q

When is Dycal needed

A

when within 1mm of pulp chamber or when exposure has occurred or possibly occurred (pink dentin)

95
Q

Due to being weak, Dycal needs to be covered with a stronger material such as __

A

GI

96
Q

Most accepted theory of pain transmission

A

Hydrodynmic theory

97
Q

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

A

Hydrodynamic theory

98
Q

What can be used for a temporary restoration

A

ZOE/IRM (inhibits setting of composite bonded materials)
GI, composite amalgam can be used

99
Q

When might you place a temporary restoration (4)

A
  • 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
Q

Functions of temporary restorations (8)

A

Protect enamel, dentin and pulp
Reduce sensitivity
Protect soft tissues
Maintain occlusal relationships
Prevent drifting/ tilting/movement
protect gingiva
Maintain esthetics
Protect margins

101
Q

Remineralized enamel is __ to decay

A

more resistant ( due to larger crystals with higher amounts of fluoride)

102
Q

The shape that prevents the restoration from being displaced

A

Retention form

103
Q

Examples of retention form

A

undercuts
truncations
grooves
pins
dovetails
etc

104
Q

Shape given to the prep to prevent fracture of either the restoration or the tooth

A

Resistance form

105
Q

Examples of resistance form

A

Adequate bulking
rounding of internal line angles
horizontal pulpal/gingival floors

106
Q

Usually the resistance form is placed about __ into the dentin to avoid DEJ sensitivity and to take advantage of dentin resistance

A

0.5mm

107
Q

Reasons for fractured restorations and teeth (6)

A

-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
Q

The location of decay in contact areas will ALWAYS be just __

A

apical to the interproximal contact point

109
Q

Features that are necessary for all preps regardless of outlines

A

primary retention

110
Q

What is the primary retention for an amalgam preparation

A

Converging walls and retention grooves (if needed)

111
Q

For composite, converging walls are still necessary, but there is an __ that amalgam lacks

A

Adhesive system

112
Q

Dovetails can be considered primary if it is a part of __

A

Inclusion of buccal/lingual grooves

113
Q

Helps retain a restoration in the case the primary retention fails

A

Secondary retention

114
Q

Examples of secondary retention

A

Grooves, coves, extensions, skirts, beveled margins, pins, slots, steps, amalgam pins, etchants, adhesives, and sometimes dovetails

115
Q

Identify walls/ floors correctly

A

Distal wall
Buccal wall
Lingual wall
Pulpal wall
buccal proximal wall
lingual proximal wall
axial wall
gingival wall

116
Q

Caries formula

A

Sugar + bacteria = decrease in pH/increase in acidity
(Acidity can cause tooth decay if high enough)

116
Q

Dental caries are a __ disease

A

Site specific

117
Q

The process of removing surface defects or scratches created during the contouring process using cutting or grinding instruments

A

Finishing

118
Q

The most refined of the finishing processes, removing the finest surface particle

A

Polishing

119
Q

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

A

Lathe-cut

120
Q

Disadvantages of lathe-cut

A

It requires a higher mercury amount
Needs early condensation with a small condenser
Needs higher packing forces during condensation

121
Q

This requires a lower condensation pressure to achieve the same strength

A

Spherical alloy

122
Q

Disadvantages of spherical alloy

A

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
Q

What also needs a varnish or alternative dentin sealer and greater burnishing

A

Spherical alloy

124
Q

Spherical alloy is typically only good for __ cores or places where __ are preferred

A

amalgam
lower condensation forces

125
Q

Mixture of both lathe-cut and spherical types of amalgam

A

Admixed alloy ( the best of both geometries)

126
Q

Although high packing pressures with small condensers still being required with admixed alloy it does obtain __

A

Positive interproximal contacts

127
Q

Admixed alloy has a slightly faster __ and has a low __

A

setting time
post-operative sensitivity

Operative (2 decks)

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