Ideal Class II preps

Question 1

Check gingival DEJ

Answer 1

often decaying

Question 2

Hand tools and round bur

Answer 2

Only used in dentin, no other tools here (maybe spoon).

Question 3

Outline form and initial depth

Answer 3

Outline: placing the cavity margins in the position that they will occupy in the final prep.
Initial depth - 0.2 to 0.8 mm pulpally from the DEJ usually 0.5mm

Question 4

Resistance form

Answer 4

That shpae and placement of the cavity walls that best enable both the restoration and the tooth to withstand without fracture the forces on the long axis of the tooth

Question 5

Formative

Answer 5

1 and 2 dentin

Question 6

Defensive

Answer 6

Reparative dentin

Question 7

Nutritive

Answer 7

supplies vital cells

Question 8

Sensory

Answer 8

protective (pain response)

Question 9

Functions of dentin/pulp complex

Answer 9

Formative, defensive, nutritive, sensory

Question 10

Hydrodynamic theory

Answer 10

Micro-movements of tubule fluids. Osmolarity changes, thermal changes, desiccation, pressure changes, high-speed cutting

Changes here cause pain.

Question 11

Irreversible pulpitis

Answer 11

hot tooth

Question 12

Pulp pain is usually

Answer 12

sharp

Question 13

Pulp status test

Answer 13

Cold hot test (pain or no pain, duration).

Question 14

Electric pulp test

Answer 14

+, - (pain or no pain), value 1-80

Question 15

Percussion test (perio ligament)

Answer 15

+ or - (pain/no pain)

Question 16

Liners and bases

Answer 16

Protect pulp and minimize post-op sensitivity.

• act as thermal and chemical barrier
• electrical barrier
• mechanical barrier
• controls inflammation of the pulp
• controls fluid movement

Many of our restorative materials do not have a positive pulpal response

Question 17

Liner

Answer 17

thin layers of material used to provide a barrier to protect dentin from residual reactants diffusing out of the restoration or from oral fluids that penetrate leaky tooth interfaces. Also have electrical insulation, generate some thermal protection, some formulas provide pulpal treatment

Question 18

Solution liners

Answer 18

2-5microm - copal varnish, adhesives

Question 19

Suspension liners

Answer 19

20-25 microm. Liner based on water and have suspended constituents instead of dissolved. CaOH2 (dycal)

Question 20

Cement liners

Answer 20

200-1000 microm

Question 21

Eugenol liners

Answer 21

ZOE and B&T

Question 22

Dentin bonding systems/sealers

Answer 22

Optibond solo plus/gluma

Question 23

Minimal caries

Answer 23

if RDS (remaining dental thickness) is greater than 2mm

Question 24

Copal varnish

Answer 24

10 copal resin in acetone (2-5 microm). 1 layer = 55% selaed, 2 layers = 85% sealed.

Question 25

Dentin bonding systems

Answer 25

liners with composities

Question 26

Bases:

Answer 26

Thermal protection, supplement mechanical support for the restoration by distributing local stresses.

Question 27

PDental cements mixed at higher powder/liquid ratios to increase

Answer 27

final compressive strength.

Question 28

Moderate caries

Answer 28

Ideal prep does not remove all carious tissue. Extend access opening laterally until DEJ is not carious. Remove carious dentin.

Question 29

Mixing technique - ZnPO4

Answer 29

Dispense 4-5 drops of liquid and some powder.
Divide powder into increments
Mix on a cool slab - allows for more powder to be added.
Avoid moisture (shortens set time)
Incorporate increments until you can pick up the mixture in your fingers without sticking.

Question 30

Liners - CaOH

Answer 30

mix equal portions and apply to clean dry cavity prep.

Question 31

Zinc oxide eugenol

Answer 31

Paste-paste system- equal proportions

Paste-liquid system - usually 2-3 drops of liquid per scoop of powder.

Question 32

Advantages of glass ionomer

Answer 32

Adheres to tooth surface, fluoride release, proven record of retention, dimensionally stable, bio compatible.

Question 33

GI reaction

Answer 33

condition dentin (remove smear layer.
Acid matrix of mix dissolves periphery of glass, which releases ions. Divalent Ca ions chelate with acid polymer chains.

Over the next 24-72 hours, Al3 replace Ca2, more F released.

Acid side chains can also chelate with HA.

Question 34

Extensive caries

Answer 34

Close to pulp - <0.5 mm RDT. Exposed pulp.

Question 35

Pulp capping

Answer 35

near exposure RDT<0.5mm. Indirect pulp cap
Pulp exposure = direct pulp cap

Apply CaOH2 liner

Question 36

CaOH2 liner

Answer 36

acid base rxn. Ca ions act to crosslink polyphenol groups. Insulator, high solubility, stimulates reparative dentin.

Question 37

How CaOH2 works

Answer 37

release OH ions when ionoized in low concentration

Question 38

Sedative restoration

Answer 38

for questionable pulp status or emergency treatment with limited time.

Reinforced Zoe, resin modified glass ionomer, GI.

Question 39

Reinforced ZOE

Answer 39

Oil of clove acts as obtundent (pain dull), expands when set (seals). CANNOT USE UNDER COMPOSITE, inhibits polymerization.

Question 40

Gross caries tooth asymptomatic

Answer 40

Extend access opening laterally until DEJ is non carious. Remove carious dentin. Leave small amount of caries over pulp rather than expose.

Question 41

Deep caries asymptomatic

Answer 41

If RDT<0.5mm, no exposure. CaOH2 base

Question 42

Deep caries questionable

Answer 42

If RDT<0.5mm or exposure. CaOH2, sedative fill. Seal is paramount, which is prompting some to use RMGI or GI.