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Occlusion > GD Exam 3 > Flashcards

GD Exam 3 Flashcards

1
Q

basic structural units of enamel

A

prism rods

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2
Q

the outer most layer of enamel is aprismatic true or false

A

true. (highly acid resistant)

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3
Q

Enamel prisms are composed of several _________and has a ______ like structure

A

several hydroxyapatite crystals and has a key-hole like stucture

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4
Q

homogenous structure
predictable bonding
and excellent long-term bonding durability

are all characteristics of

A

enamel

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5
Q

Describe the steps of bonding (only) to enamel

A
  1. clean the surface
  2. Etch the enamel surface up to 30 seconds (phosphoric acid gel)
  3. Rinse for 30 sec
  4. Air-dry; look for frosty surface
  5. Application of adhesive resin (bonding)
  6. Light curing for 20-40 second
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6
Q

Whats the significance of etching enamel?

A

increases wettability, create microporosities,

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7
Q

Comeplete the statements describing the different patterns of enamel etching

type 1:
type 2:
type 3:

A

type 1: removes prism core (the center)
type 2: removes prism periphery
type 3: mixed/combination of type 1 and 2

funfact there is no difference in micro-mechanical bonding of the different etching patterns

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8
Q

describe surface prophylaxis

A

its the removal of enamel pellicle and surface debris
necessary to properly etch the enamel surface
it increases infiltration of adhesive resin/sealant
the retention of sealant at the base of the pit is increased
the use of prophylaxix decreases microleakage of sealants

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9
Q

What is the effect of active ingredients on prophylaxis

A

active ingredients in prophylatic pastes such as fluoride and ACP can reduce the bond strength of resin-based materials to uncut enamel surfaces

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10
Q

Contamination of the surface with saliva, blood, or fluid will increase the sealing ability and the bond strength

A

false. duh.

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11
Q

As the severity of dental fluorosis increases, the bonding efficacy is ______

A

reduced

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12
Q

How do you overcome dental flourosis when etching?

A

etch for additional time up to 2 min) in enamel only

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13
Q

Which part of dentin is mainly mineralized?

A

intra-peri tubular dentin

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14
Q

which part of dentin is mineral and proteins found

A

inter-tubular dentin

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15
Q

Heterogenous structure and fair-long term bonding durability is a characteristic of enamel or dentin?

A

dentin

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16
Q

define the smear layer

A

layer of debris formed during the tooth preparation

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17
Q

How long do you etch in dentin

A

less than 15 seconds

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18
Q

true or false dentin must be completely dried

A

false; must keep dentin wet

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19
Q

true or false you can rewet enamel

A

false. rewetting technique is used in dentin
you rewet for atleast 3o seconds

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20
Q

dentin bonding agent primers are hydrophilic or hydrophobic

A

hydrophillic monomers that have a high affinity for water. HEMA, 4-META, Penta, Phenyl-P

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21
Q

Dentin bonding agent adhesives are hydrophillic or hydrophobic

A

hydrophobic monomers that bond to composite resin, resin cement, sealants. Bis-GMA and TEGMA

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22
Q

dentin bonding agent solvents are what

A

water, acetone, and ethanol

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23
Q

List 3 product names of the 3 step etch and rinse

A
  1. optibond FL
  2. All bond 2
  3. Adper scotchbond
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24
Q

List 3 product names of the 2 step etch and rinse

A
  1. Optibond solo plus
  2. one-step
  3. adper single bond plus
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25
Q

What does self-etching mean ( 1 and 2 step 6th and 7th generation)

A

theres no acid etching procedure, presence of acidic monomers.
*formation of the hybrid layer which is the simultaneous deminalization and infiltration of the adhesives system into the superficial dentin

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26
Q

in self etching enamel, the use of _______ prior to application

A

use of phosphoric acid

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27
Q

low bond strength values when applied to (cut or uncut) enamel

A

uncut.
note the higher bond strength values on cut enamel but is still lower than etch and rinse systems

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28
Q

Whats the latest generation of bonding systems

A

universal bonding systems *8th generation

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29
Q

Universal bonding systems use what type of etching technique?

A

the TOTAL ETCH technique

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30
Q

desensitizer agents are usually used after

A

after etching procedures

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31
Q

true or false GLUMA affects the bond strength

A

FALSE. gLUMA does not affect bond strength

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32
Q

what specfic type of agents can actually affect bond strength values?

A

Oxalate based agents

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33
Q

what is sclerotic dentin?

A

dentin that has become translucent due to calcification of the dentinal tubules as a result of injury or normal agaeing.

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34
Q

how do you manage sclerotic dentin?

A

over etch the dentin for 30 seconds or roughen the dentin surface with a diamond bur

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35
Q

true or false in carries-affected and caries infected dentin the bonding procedure remains the same

A

true

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36
Q

What is a composite material

A

a solid that contains two or more distinct constituent materials or phases. mechanical properties such as elastic modulus are altered

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37
Q

Development of Bis-GMA self-curing composite?

A

in 1965 by bowen

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38
Q

in 1969 the addition of ______ lead to better wear resistance

A

filler particles.

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39
Q

List the 5 basic componenets of dental composites

A
  1. organic polymer (resin) matrix
  2. inorganic filler particles
  3. coupling agent
  4. initiator-accelerator system
  5. others
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40
Q

true or false. filler particles make up a minor portion (by volume or weight) of dental composites

A

false. they make up a major portion

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41
Q

True or false. most filler particles contain heavy-metal oxides such as barium or sinc causing radiolucency

A

false. radiopacity

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42
Q

Particle ___, __, and ___ are all used to classify dental composites

A

particle size, shape, and distribution

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43
Q

what are the functions of filler particles

A

reinforce the resin matrix
provide appropriate degree of translucency
control the shrinkage of the composite during polymerization
reduction of the thermal expansion and contraction
control workability and viscosity
decrease water sorption
IMPART RADIOPACITY

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44
Q

Coupling agents are usually what

A

organic sillicon compounds, organosilane, or silane

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45
Q

the ______ of the fillers are treated with ______ during the manufacture of the composite

A

the surfaces of the fillers are treated with silane during the manufacture of the composite (think coupling agent)

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46
Q

How do coupling agents work?

A

during the curing of the composite, its unreacted double bonds will co-polymerize with resin monomers

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47
Q

list the functions of a coupling agent

A
  1. provides bonding between the inorganic filler particles and the organic resin matrix by forming an interfacial bridge that strongly binds the fillers to the resin matrix
  2. it enhances the mechanical properties of the resin composite and minimized the plucking of the filler from the matrix during clinical wear

3, it helps with stress distribution and provides a hydrophobic environment minimizing water absorption of the composite

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48
Q

Whats the purpose of photo-initiators and how do they work

A

photosensitizers are added to the monomer mixture during the manufacturing process

camphorquinone is the most commonly used used photosensitizer

photosensitizers absorb electromagnetic energy from blue light (at a peak wavelength of about 465 nm)

free radicals are generated upon activation

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49
Q

The first step of the initiator-accelerator system is photo -initiators. whats the next step?

A
  1. photo-initiators
  2. CHEMICAL INITIATORS (an organic amine should react with an organic peroxide to produce free radicals.

organic amine = catalyst paste
organic peroxide = universal paste

the free radicals produces will attack the carbon double bonds, causing polymerization

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50
Q

list some examples of chemical initiators

A

BPO (benzoylperoxide) and TBB

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51
Q

Whats the third step of the initiator accelerator system

A
  1. DUAL-Curing (which is basically just photo+chemical initiators)
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52
Q

Whats the role of inhibitors? list some examples

A

they prevent spontaneous polymerization (and so increase shelf life and working time)

ex: Hydroquinone (MEHQ, BHT)

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53
Q

what are the 4 states of the polymerization reaction

A
  1. activation
  2. initiation
  3. propogation
  4. termination
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54
Q

What is the degree of conversion

A

a tool to evaluate how well the composite was polymerized. It calculates the rates of C double bonded to C before and after polymerization

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55
Q

most dental composites have _______ conversion rates. there is never 100% polymerization.

A

most have 45-60% conversion rates

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56
Q

true or false: polimerization shrinkage 2-5,5%

A

true

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57
Q

polimerization shrinkage occurs towards the _____ portion of the material (NOT towards the light source)

A

towards the INNER portion of the material

-it induces stresses at the bonded interface
-creates gaps at the interfaces (enamel and dentin)

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58
Q

C factor is

A

ratio of bonded to unbonded surface

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59
Q

class I has a c factor of

A

5

5 bonded, 1 unbonded

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60
Q

class II has a c factor of

A

2

4 bonded, 2 unbonded

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61
Q

nonfilled composites allow higher volume of fillers and helps to overcome

A

polymerization shrinkage

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62
Q

Packable (high viscosity) are designed for

A

posterior teeth since they are opaque

also:
1. low polymerization shrinkage
2. difficult to obtain marginal adaptation
3. studies show high microleakage values

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63
Q

flowable (low viscosity) can easily adapt to

A

all areas of the preparation
highly porous
studies show no significant advantages regarding marginal seal and adaption compared to hybrid composites

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64
Q

Silorane is a new formulation that is an advancemnet in material compoisiton that helps to _____

A

overcome polymerization shrinkage

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65
Q

what are bulk fill composites

A

its a new formulation in composition to overcome polymerization shrinkage, It can actually result in incomplete polymerization at bottom of cavity and high polymerization shrinkage stress

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66
Q

What are the three classes of dental polymer-based restorative materials

A

class 1: materials whose setting is done by mixing and inititaor and activator (self curing)

class 2: materials whose setting is done by the application of energy from an external source such as blue light

class 3: dual cure: which basically is curing by the application of external energy and also have a self-curing mechanism present

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67
Q

what has a higher compressive strength, enamel or dentin

A

enamel

68
Q

what has higher tensile strength, enamel or dentin

A

dentin

69
Q

what has a higher elastic modulus, enamel or dentin

A

enamel (84)

70
Q

strengths increase lineraly with the volume fraction of

A

fillers

71
Q

true or false microhybrid has a higher compressive strength than microfilled

A

true

72
Q

higher filler content = higher ______

A

higher hardness

73
Q

The more resin content, the _____ the linear coefficient of expansion

A

more resin = higher linear coeff of thermal expansion

74
Q

Photo-initiation light curing uses camphoroquinone and _______

A

a tertiary amine

about 468 nm

75
Q

whats the max amount of degree of conversion

A

about 70%

76
Q

Incident radiance is what

A

incident on the material surface
the amount of light that your dental composite will receive is always lower

77
Q

radiant exitance or radiant emittance is what

A

the light emitted from the light curing tip

78
Q

Spectral emission from the light curing unit and spectral absorption requirements of the photocurable material should be _______ for optimal ______!

A

Should be matched for optimal polymerization

79
Q

true or false: you should increase curing time with decreasing distance from material.

A

false.
increase curing time with increasing the distance from the material

80
Q

t or f sealants are applied after acid etching to coalescenced areas

A

F. its applied to NON-coalescenced (meaning pits and fissures) after acid etching.

81
Q

Sealants protect against _____% of cavities for 2 years and continue protect against ___% of cavities for up to 4 years.

A

80% for 2 years and then 50% for up to 4 years

82
Q

List the indications of placing sealants for adults and children

A
  1. deep developmental grooves and pits
  2. moderate or high risk for caries
  3. evidence of initial occlusal carious lesions
83
Q

In children, sealants are most effective when placed with _____ immeditetly after eruption of permanent posterior teeth and occlusal surfaces are fully exposed

A

with proper isolation

84
Q

What type of sealants require a dry field

A

Renin-based sealants

85
Q

if a dry field cannot be maintained for a renin-based sealant, what do you do

A

use a different material like GI, RMGI, or poly-acid modified resin

86
Q

what should you clean teeth with first to remove oral debris, smear layer, and potential surface contaminants before placing a sealant

A

clean teeth with slurry pumice

87
Q

The slurry pumice should be free of ingredients that would effect ______

A

free of ingredients that would affect enamel bonding.

no occlusive or remineralize agents that would affect enamel demineralization during etching

no fluoride, calcium, essential oils, or flavoring agents

88
Q

In 2008 the ADA said sealant retention can be improved if the clinician applies a bonding agent that contains both an adhesive and a primer between the previosuly acid-etched enamel surface and the sealant material.

A

read

89
Q

what are the advantages to using dental composite

A

esthetics
-conservative tooth prep (less extension, no minimum depth, mechanical retention usually not necessary)
-low thermal conductivity
-universal use
-adhesion to the tooth
-repairability

90
Q

What are the indications for using composite

A
  1. class 1-6 restorations
  2. core buildups
  3. sealant and preventive resin restorations
  4. esthetic procedures
  5. temporary procedures
  6. periodontal splinting
91
Q

what are the contraindications for using composite

A
  1. if youre not able to obtain proper islotation
  2. occlusal considerations
  3. extension of the restoration on the root surface
  4. operator factors
92
Q

when using composite, a flat pulpal floor is necessary

A

no

and theres no specified thickness/depth required either unlike amalgam

93
Q

compared to amalgam, the width of a composite prep should be

A

very minimal

94
Q

whats the clinical significance of C Factor

A

the higher the c factor, the higher the potential for polymerization shrinkage stress

post operative pain

and poor prognosis

95
Q

Dental composites exhibit volumetric shrinkage of ______%

A

2-5%

96
Q

What can a clinician do to minimize shrinkage

A
  1. use an INCREMENTAL technique
  2. choose appropriate restorative materials
    3, Possible use of RMGI liner
97
Q

Preventative resin restoration or conservative composite restoration techniques?

A
  1. limit prep to carious pits and fissures, no extension
  2. Combine compite and fissure sealant in restoration
98
Q

conservative composite restoration was referred to originally as _____

A

preventive resin restoration (PRR)

99
Q

The composite outline form and depth is determined by the

A

extent of the decay

100
Q

true or false: dental sealant material may be used in combination with the composite to help reduce the risk of future disease

A

TRUE

101
Q

True or false. You should lightly air dry to thin the bonding agent and expose it to curing light for 10 seconds

A

YES

102
Q

The jiffy composite polishing brush is impregnanted with _______

A

silicon carbide

103
Q

The initial development of the glass ionomer was in ______ by _____

A

1972 by Wilson and Kent

104
Q

Define glass ionomer

A

glass ionomer is a generic name of a group of materials that use silicate glass powder and an aqeuous solutions of polyacrylic acid.

glass ionomers are water-based and self-adhesive restorative materials and can be used as liners, bases, luting agents, sealants, and temporary and final restorations

105
Q

List and describe the 4 classifications of glass ionomer cements

A

Type I: luting crowns, bridges, and orthodontic brackets

type IIa: esthetic restorative

type IIb: reinforced restorative

type III: lining cements, base

106
Q

What is the composition of the conventional glass ionomer (GI)

A

basic composition- only acid-base reaction (a chemical reaction)

107
Q

What is the composition of resin modified glass ionomer (RMGI)

A
  1. HEMA and/or other polymers added to the liquid component and/or silicate glass of composite added

DUAL setting a) resin polymerization (light cured)
b) acid-base reaction (chemical reactionO

108
Q

what liquid is used in glass ionomers (GI)

A

Polycarboxylic/ polyacrylic acid IS THE LIQUID

109
Q

what powder is used in glass inomers (GI)

A

Fluoroaluminosilicate (FAS) glass IS THE POWDER

110
Q

Is water added in the composition of GI?

A

Yes, its helps with ion transport in the acid-base reaction and fluoride release.

111
Q

Whats the function of tartaric acid in GI

A

tartaric acid helps to control the working time and the setting characteristics

112
Q

what are the key players of the acid base reaction in GI>

A

the acid-base reaction takes place by the liquid and the powder.

The liquid is the polycarboxylic acid and the powder is the FAS glass.

113
Q

List the steps of the setting reaction in GI

A
  1. Dissolution
  2. Gelation and inital setting
  3. hydration and maturation
114
Q

What is the mechanism of adhesion in glass ionomers (GI)

A

well enamel and dentin both undergo a chemical interaction with dental structures. The mechanism of adhesion is ionic (chemical) due to bonds between carboxyl groups and calcium from hydroxyapatite

115
Q

whats the difference in composition between RMGI and GI?

A

Theyre both the same up until the tartaric acid.

RMGI has two more things
1. Hydrophillic methacrylate monomers: photo-initiated/redox reaction
2. Free radical initiors- trigger curing of metharcylate groups

116
Q

T or F, in RMGI the FAS (the powder) reacts with water-soluble methacrylate components into an aqueous solution of polyacrylic acid (the liquid)

A

yes

117
Q

What are the mechanisms of adhesion in RMGI

A

there are two mechanisms:
1. Micro-mechanical interlocking
2. Ionic bonds between the carboxyl groups and calcium from hydroxyapatite

118
Q

t or f: does polyacrylic acid increase the sealing ability and bond strength to enamel and dentin?

A

yes!

119
Q

t or f: ALL TYPES OF GI ARE NOT indicated for stress bearing areas in permanent dentition

A

true.

120
Q

does GI and RMGi have higher or lesser solubility when compared to resin composite?

A

higher solubility

121
Q

between GI and RMGI which one has higher wear and solubility

A

GI has poor mechanical properties but HIGh wear and solubilty

122
Q

release of flouride in resin modified materials has what kind of effect?

A

anticariogenic effect

123
Q

What are class V lesions?

A

defects or lesions at the cervical third- facial or lingual of anterior or posterior teeth

124
Q

Tooth-colored materials: the use of composite as a restorative material for _________ predominates in areas of esthetic concern

A

cervical caries lesions

125
Q

Whats the etiology of cervical lesions?

A
  1. dental caries
  2. Non carious cervical lesions (NCCLs)
    -abrasion
    -abfraction
    -erosion
  3. Multifactorial

KEY*: assigning a cause to the problem is necessary in order to determine the proper treatment (prep and restorative material to use) for class V defects

126
Q

What are non carious cervical lesion?

A

these are multifactorial and can be intrinsic and extrinsic. this includes erosion/biocorrosion, abrasion, abfraction.

causative factrs must also be addressed.

127
Q

how can you prevent root caaries (primary prevention)?

A

in office fluroide varnihs/prevident at home, diet counseling, OHI

128
Q

How can you arrest root caries (secondary prevention)?

A

silver diamine fluroide for caries arrest

129
Q

How can you restore root caries (tertiary prevention):

A

restorative material: conventional GI
RMGI, atraumtic restorive treatment

130
Q

For Class V lesions, what are the indications for amalgam?

A

poor isolation, esthetics not being a primary concern, difficult access for placement and finishing

131
Q

For Class V lesions, when is GI indicated?

A

extensive carious involvement!
1. a patient with high caries risk
2. root caries
3. multifactorial cervical lesions

*Fluroide releasing restorative materials help to control and prevent recurrence of cervical decay

132
Q

Did you know newer RMGI materials have good levels of fluoride release over longer periods. This is termed as capability of recharging (to prolong fluoride release. Recharching occurs with continued use of fluoride containing toothpastes

A

read

133
Q

material selection for abfraction lesions should have a ______ modulus of elasticty

A

low modulus of elasticity

it is believed that the restorative material should be somewhat flexible or a stress reducing liner should be used to help resist the tendency for displacement of the restoration due to flexure of the tooth

134
Q

list the material selection for abfraction lesions

A

microfilled resin, filled adhesive, flowable composite

135
Q

what clamp should you should for gingival retraction for rubber dam isolation

A

212 gingival retraction clamp

136
Q

different etiologies result in different restorative options

for caries: restore with ______
due to abfraction: restore with ________

A

caries: restore with GI
Abfraction: restore with mcrofill composite

137
Q

for Class V preps, the depth should be uniform from mesial to distal BUT the depth should be greater as you move more

A

incisally/occlusally

axial wall is convex

138
Q

You should change the orientation of the handpiece for class V as your progress from mesial to distal. Why?

A

the orientation of the enamel rods changes

139
Q

In class V sclerotic dentin, what do you do?

A

Add extra retention! how? more grooves

where do you add the grooves? axiogingival and axioincisal line angles

140
Q

for abfraction, you want to fracture away enamel at the cervical area due to flexure of the tooth under occlusal stress. do you or do you NOT bevel?

A

Yes, enamel margins are beveled.

141
Q

which one do you bevel for . RMGI or resin composite

A

resin composite. no beveling for rmgi

142
Q

What are non carious lesions?

A

erosion, abrasion, attrition, abfraction, dentin hypersensitivty

143
Q

The loss of surface tooth structure by chemical action in the continued presence of demineralizing agents (acids)

A

Erosion

144
Q

What is a chelating agent?

A

chelating agents can bind freed calcium ions after surface loss and prevent remineralization.

citric acid is a chelating agent

145
Q

where does erosion most commonly occur

A

occlusal surfaces, predominantly mandibular first molars

and then facial surfaces of the anterior maxillary teeth

also maxillary incisors and canines

146
Q

first sign of minimal erosion may include a _____

A

dull appearance

147
Q

foods that are acidic but high in calcium do NOT lead to _____

A

do not lead to demineralization

148
Q

what are salivas protective mechanisms against erosion

A

-dilution and clearance of acid
-buffering and neutralization
-providing calcium and phosphate

patients with salivary flow impairment demonstrate a higher risk for erosion (sjogrens syndrome)

149
Q

In uncontrolled bulumia, do you or do you not brush immediately right after vomiting

A

do NOT

150
Q

what is perimylolysis?

A

It is the erosion wear of the lingual surfaces of the maxillary anterior and posterior teeth. It is most frequent in maxillary incisors. second is maxillary molars.

151
Q

physical wear as a result of mechanical processes involving foreign substances or objects

A

abrasion

152
Q

how does abrasion appear in cervical areas?

A

v shaped grooves

153
Q

the physical wear as a result of the action of opposing tooth to tooth contact

A

attrition

154
Q

how does attrition appear clinically?

A

facets with well-defined margins

155
Q

Physical wear of teeth as a result of tensile or shear stress in the cervical portion of the tooth

A

abfraction

usually due to occlusal interference or eccentric forces

156
Q

what is dentin hypersensitivity

A

response to stimulus on exposed dentin

short, sharp pain arising from exposed dentine in response to stimuli

157
Q

what is most common site of dentin hypersensitivty

A

cervical-buccal area is the most common site

canines and premolars are most affected

158
Q

what is the mechanism of dentinal sensitivity

A

its the exposure and opening of dentinal tubules but the HYDRODYNAMIC THEORY explains that the presence and movement of fluid inside the dentinal tubules activates the nerve endings at the pulp-dentin complex

159
Q

stimuli which tend to move the fluid away from the pulp-dentin complex produce more pain true or false

A

true
cooling, drying, evaporation,

160
Q

pulpul dentin the tubulus are ___% surface area compared to surface dentin tubules with are ___%

A

pulpal dentin tubules: 22% of surface area
surface dentin tubules = 1% of surface area

161
Q

adhesive resins can seal ______ effectively by forming a hybrid layer

A

can seal dentinal tubules

162
Q

oxalate reacts with calcium ions and froms calcium oxalate crystals inside the dentinal tubules as well on the dentinal surface. whats the effect of this

A

reduces permeability and occludes dentinal tubules

163
Q

GLUMA contains what two important things

A

HEMA and gluteraldehyde

164
Q

what two reactions does GLUMA carry out for desensitization?

A
  1. Gluteraldehyde causes coagulation of albumin in the dentinal fluid which causes protein precipitation
  2. HEMA polymerization forms resin tags and occludes the dentinal tubules
165
Q

t of f. Gluma affects bond strenth

A

false. it does not affect it

166
Q

retentive grooves are placed in ____

A

dentin

Occlusion (2 decks)

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