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Op IV final > Hot Topics Op 4 Final > Flashcards

Hot Topics Op 4 Final Flashcards

1
Q

Where is the location of the contact between the from the facial view central incisors?

A

-junction of incisal and middle third

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2
Q

From the incisal edge view, where is the contact between the central incisors?

A

essentially in line with the incisal edge

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3
Q

The embrasures generally follow what type of contour?

A

biological contour

line angles

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4
Q

Width of contact inciso-gingivally

A

1-1.5mm

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5
Q

Main etiology of Class IV

A

Fracture (sports)
Rampant caries
Fatigue
Congenital- osteogenesis/dentinogenesis imperfecta

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6
Q

Why is composite the ideal restorative material for class IV restorations?

A
  • better sealing on enamel margins
  • better shade matching
  • smooth and polished restorative material = great esthetics
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7
Q

Type of burs to use for Class IV restorations

A

flame/small diamond

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8
Q

Bevel for cavosurface margin

A

45 degrees

width of bevel 0.5-2mm depending on missing tooth structure

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9
Q

Additional retentive features for class IV restorations

A

Bevels and chamfers

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10
Q

Occlusal considerations for class IV restorations

A

try to keep end margins out of direct contact areas
keep protrusive and incisal forces to a minimum
look at existing state of teeth- wear facets and functional habits

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11
Q

Best way to hide margins

A

Vertical and horizontal finish lines rather than oblique

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12
Q

Etching the tooth for class IV restorations process

A
  • etch for 20 sec
  • rinse for 10 sec
  • bond and light cure for 20 sec from lingual and facial surface
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13
Q

Inherently thin
Cannot be bonded like conventional temporaries
Trimming
Lack of retention form

A

Common challenges of provisionalization for veneers

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14
Q

Veneer provisional technique

A 
Prep
Impression
Diagnostic wax up
ESF
Spot etch- 35-37% phosphoric acid
Rinse and dry
NO ADHESIVE
Load ESF with Bis-acryl resin and press on prepped teeth
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15
Q

Strength of multi-unit provisional veneers

A
  • collective strength and bond to etched points on teeth

- NOT USED FOR FUNCTION

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16
Q

Veneer cementation procedure for definitive restorations

A
  • remove provisional material remaining on the etched portions of the teeth
  • Clean teeth- pumice slurry
  • rinse and dry
  • isolation- lip retraction or cotton rolls
  • retraction cord packing
  • evaluation
  • application of silane
  • etch- 20 sec, rinse and dry, bond, cure, cement, eval margins, light cure
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17
Q

This process helps to prevent contamination during try in/cementation

A

retraction cord

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18
Q

This acts as a coupling agent to form a chemical bond to increase bond strength and is applied to intaglio of veneer

A

silane coupling agent

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19
Q

What is the primary source of retention with a porcelain veneer?

A

-mechanical

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20
Q

What should you use to remove marginal excess from veneer cementation process?

A
  • # 12 blade

- fine flame diamond- carefully recontour and dress gingival margins if excess cement

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21
Q

What instrumentation is used to finish the lingual margins of the veneer?

A

-oval-shaped fine diamond

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22
Q

How to remove striations from diamonds?

A

-rounded end/bullet-shaped, 30-fluted carbide finishing bur

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23
Q

Polishing burs for veneers

A
  • abrasive rubber

- porcelain polishing cups and points

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24
Q

What kind of cement used for veneers?

A
  • resin cement (light cure due to thinness of restoration)
  • light cured for thin
  • dual cure for thick
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25
Q

Recommendations for light cured resin cement

A
  • longer working time

- thinner ceramics

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26
Q

Recommendations for dual cured resin cement

A

-thicker ceramic restorations (crowns, inlays, onlays with limited light penetration)

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27
Q

Which veneers can be repaired?

A

porcelain

composite veneers

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28
Q

Process of repairing veneers

A
  • roughen damaged margins with fine diamond
  • bevel or chamfer the veneer edges
  • chairside microetching (sandblasting) can also be effective
  • etch with HF acid if repairing ceramics and rinse
  • adhesive for composites
  • silane for porcelain margins
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29
Q

Main conservative esthetic treatment options for discolored teeth

A
  • bleaching
  • micro/macroabrasion
  • tooth recontouring (reshaping)
  • partial veneers
  • full veneers (composite/porcelain)
30
Q

best bleaching option

A

-conventional 10% carbamide peroxide system with custom trays

31
Q

This is a conservative procedure used to reduce/eliminate superficial discoloration. Requires chemo-mechanical/mechanical adjustment. Abrades stains and defect within 0.2mm of the surface.

A

-micro/macro abrasion

32
Q

This is the composition of the chemo-mechanical slurry

A

-6.6% HCl slurry with silicon carbide microparticles

33
Q

This conservative procedure helps to improve appearance and function. Some esthetic problems can be corrected conservatively without the need for restoration. Rounding of the sharp angles can be considered a prophylactic measure to reduce stress, prevents chipping and fracture of the incisal edges.

A

Enamel recontouring

34
Q

What conservative procedure would you suggest?

  • Localized intrinsice discolorations or defects
  • One appointment
  • White spot lesions
  • surface defects
A
  • Direct partial veneer with composite

- or micro/macro abrasion

35
Q

Advantages of direct composite veneers

A
  • one appointment
  • little or even no prep
  • dentist controls the process
  • less expensive
  • useful in young patients
36
Q

Disadvantages of direct composite veneers

A
  • more maintenance
  • difficult to manage
  • time consuming/fatiguing
  • patient management
  • changes over time
  • technique sensitive
37
Q

These are indications for which kind of conservative esthetic procedure?

  • teeth with malformed surfaces- severe hypoplasia
  • Discolored teeth
  • teeth with severe abrasion or erosion
  • teeth with significant faulty restorations
  • diastemas/tooth-arch size discrepancies
A

Direct full/indirect veneers

Potential ortho and restorative

38
Q

These are advantages of what conservative esthetic technique?

  • Lab controlled contours
  • stable appearance over time
  • biomemetic
  • multiple tooth restorations
  • potential to last a long time
A

-Indirect porcelain laminate veneers

39
Q

These are disadvantages of what conservative esthetic technique?

  • 2 appts
  • 3-5x more expensive
  • technique sensitive bonding
A

Indirect porcelain laminate veneers

40
Q

What kind of restoration is this process for?

  1. Intra-enamel prep
  2. Supra-gingival margins if possible or sub-gingival if in esthetic zone
  3. Window, butt-joint, or lap prep incisally
A

Indirect porcelain laminate veneers

41
Q

What kind of incisal edge prep?

For teeth that require no shape modifications/no incisal wear present

A

Window prep

42
Q

What kind of incisal edge prep?

For most teeth that need some incisal modification due to wear

A

Butt-joint

43
Q

What kind of incisal edge prep?

For teetht hat have extensive incisal wear and need considerable lengthening. Adds F-L retention form.

A

Incisal lapping preparation

44
Q

Characteristics of what type of veneer prep?
Chamfer margin: 0.4-0.6mm wide
Location of margin: 0.5mm from free gingival margin
Extends lingual to the M & D line angles at 1mm or more
Visually in contact, and proximally extends lingual to mid point of contact
Don’t break contact!
Facial reduction: 0.5mm uniform
Incisal reduction: 1.0mm
Round off incisal- facial line angles – no sharp areas
Incisal lingual line angle – 90 degree cavosurface junction

A

Incisal butt joint preparation

45
Q

This is a fixed intracoronal restoration made outside of a tooth to correspond to the form of the prepared cavity which is then luted into the tooth

A

-inlay

46
Q

Indications for what kind of restoration?

  • Large failing restorations
  • Teeth at risk of fracture
  • Endodontically treated teeth
  • Diastema closure
  • Occlusal plane correction
  • RPD abutment
A

cast metal restoration (inlay/onlay)

47
Q

Contraindications for what kind of restoration?

  • High caries rate
  • Young patients
  • Esthetics
  • Small restorations
A

-Cast metal restorations (inlay/onlay)

48
Q

Advantages of what kind of restoration?

  • Superior strength
  • control of contour and contacts
  • biocompatibility
  • low wear
  • no discoloration
A

-cast metal inlay/onlay

49
Q

Disadvantages of what kind of restoration?

  • Chairside time
  • appts
  • gold color/cost
  • provisionals
  • technique sensitive
  • splitting forces
A

-cast metal inlay/onlay

50
Q

Indications for what kind of restoration?

  • Esthetic restorations
  • Proximal margins not in enamel
  • Large defects or previous restorations
  • multiple teeth/multiple surfaces
A

-indirect tooth colored inlay/onlay

51
Q

Contraindications for what kind of restorations?

  • Heavy occlusal forces
  • Isolation issues
  • Deep sub-G preps
A

-indirect tooth colored inlay/onlay

52
Q

Advantages of what kind of restoration?

  • Improved physical properties
  • Variety of materials and techniques
  • reduces polymerization shrinkage
  • reduced microleakage over direct composite
  • more precise control of contours and contacts
  • support of remaining tooth structure
  • wear resistant
  • biocompatible
  • increased auxiliary support
A

-indirect tooth colored inlay/onlay

53
Q

Disadvantages of what kind of restoration?

  • chairside time/cost
  • difficult try in/delivery
  • brittleness of ceramics
  • wear of opposing dentition/restorations
  • low potential for repair (ceramic)
  • short clinical track record
A

-indirect tooth colored inlay/onlay

54
Q

What kind of prep?

  • all walls tapered 2-5* diverging to occlusal
  • No undercuts
  • Primary and secondary flares
  • gingival bevel
  • occlusal bevel
A

Metal inlay/onlay replacing large amalgam

55
Q

What kind of prep?

  • 2.0mm in central fossa
  • 2.0mm in F-L dimension isthmus
  • 1.25-1.5mm axial depth
  • 6-10* divergent taper
  • Rounded internal line angles
  • Smooth transitions/rolling margins
  • 90* cavosurface exit angle
  • 1mm clearance
  • No bevels/avoid undercuts
A

-Esthetic inlay prep

56
Q

This is tooth failure/fracture due to a single event of biting on something hard. Rare

A

-Single cycle overload

57
Q

This is tooth failure/fracture due to cyclic loading well below fracture forces. Slow crack propagation over time

A

-Fatigue

58
Q

How often do endo teeth fracture?

A

50-60% fracture in 7 years

59
Q

What material is E. Max?

A

Lithium disilicate

60
Q

What material is Empress, Paradigm C?

A

Leucite-reinforced glass ceramics

61
Q

What kind of material is in the Lava Ultimate?

A

Composite blocks

62
Q

What kind of restoration?

  • Restore 1+ cusps and or adjoining occlusal surfaces
  • Can restore entire occlusal surface
  • Made outside of the mouth and then bonded to the tooth
A

-Onlay

63
Q

When should you cap a cusp?

A

-when preparation is greater than 1/2-2/3 the intercuspal distance

64
Q
  • Fermit N - Ivoclar/Vivadent
  • light curing single component composite resin
  • stays soft, doesnt lock in
  • easy to remove with spoon or sickle explorer
  • Trim/Jet- needs cementation, more difficult to use
  • Bis-Acryls composite resin with non-eugenol
  • Dura seal- more flexible polymer (like Jet/Trim)
A

Good temporizing materials for inlays/onlays

65
Q

What kind of prep?

  • including inlay prep requirements
  • 2mm reduction of functional cusp
  • 1.5mm reduction of non-functional cusp
  • 1-1.5mm collar preparation
  • path of withdrawal for whole restoration
  • No bevels/undercuts
A

-Esthetic onlay preparation

66
Q

How does a digital impression system work?

A
  • 3D picture of preparation
  • surfaces are illuminated under a specific light (laser or projected pattern)
  • light interaction with surfaces = plot of distances from camera
  • computer processes distances plotted –> 3D digital model of area scanned
67
Q

What are the different kinds of acquisition methods?

A
  • 3D in motion video
  • 2D pictures
  • with or without powder
68
Q

Why do we use powder?

A
  • camera requires a uniformly reflective surface to capture optical images, this is established by the powder
  • tooth structure tends to reflect the incident light and glare causing smearing artifacts
  • enamel is translucent
69
Q

What is in the powder spray?

A
  • finer particle titanium dioxide
  • blue color for visibility
  • spearmint flavor
70
Q

Process for packing cord

A
  • soak in hemostatic solution
  • squeeze dry in gauze prior to packing
  • do not dab hemostatic solution around tissue
  • leave cord in place through entire procedure, even bonding
71
Q

CAD/CAM fabrication steps

A
  • prep tooth
  • pack cord
  • bite registration- trim to tooth
  • spray with powder if needed
  • optical impression- 3 pictures- path of insertion, images of adjacent teeth present (8mm of overlap and same angulation)
  • spray bite registration
  • select antagonist- 3 images with bite registration
  • hit next and save restoration
  • mark margins
  • design restoration
  • adjust proximal, occlusal contacts and contours
  • mill restoration
72
Q

Diastema closure process

A
  • evaluate space to make sure you don’t need ortho
  • measure teeth and space
  • lightly prep and etch each tooth separately
  • restore teeth 1 at a time
  • shape interproximals with soflex finishing discs and strips
  • make sure you have recreated embrasures and then treat like a class III or IV (margins, flash etc.)
  • polish with green wheel 5000 rpm
  • polish with gray wheel 4000 rpm

Op IV final (3 decks)

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