Intro to Surgical Tx Flashcards
accepted terminology
scientific language developed for precise and accurate communication within the profession to insure the health and wellbeing of our patients
operative dentistry
restoring damaged areas of teeth
operative dentistry restores damage to teeth caused by…(6)
caries erosion abrasion attrition fracture developmental defects
Do all caries lesions require restoration?
no
how are early caries lesions treated
risk management strategies
remineralization therapy
(non-invasive/non-surgical tx)
do all abrasion, attrition, and erosion lesions require restoration?
no
specific indications for operative intervention must be present
preparation
cutting tooth structure with the goal of shaping the cavity to receive the restorative material
Because tooth is a tissue of the human body, cutting a cavity preparation constitutes a _____
surgical procedure
purpose of dental restoration
restore form, function, esthetics
protect pulp, periodontium, remaining tooth
prevents adjacent/opposing teeth from changing position
Name the 4 types of restorative materials
provisional/temporary
definitive/permanent
direct
indirect
class I cavity
pits and fissures
class II cavity
proximal contacts of posterior teeth
class III cavity
proximal contacts of anteriors
class IV
incisal angle fracture
class V cavity
cervical - facial or lingual
inferior to COC (gingival third/infrabulge area)
ALL TEETH
a restoration consists of:
prep
restorative material
definitive restorative materials are….
permanent
direct restorative materials
placed directly into prepared cavity
amalgam
compacted gold
composite resin
indirect restorative materials
fabricated outside the mouth and subsequently cemented into place
cast gold
procelain
porcelain fused to metal
lay terms
less technical terms used in communicating with patients
archaic terms
no longer used but found in the older literature
jargon
slang, idioms, regional terms, and other innacurate communication
incipient caries lesion
reversible
tx options for incipient caries
fluoride xylitol diet counseling antimicrobial tx sealants education
what are the indications that the coronal surface of a tooth has reached the early cavity (irreversible) stage?
lesion reaches dentin
frank cavitation
what are the indications that a root surface has reached the early cavity (irreversible) stage?
surface softening penetrates deeply (> .5 mm)
cavitation
a tooth reaching the early cavity stage idicates the need for…
surgical intervention
operation
LAY TERM for surgical procedure
placing a restoration is often referred to as…(3)
operative tx
surgical intervention
restorative services
GV Black’s classifications of cavities are useful because…
lesions in similar locations on different teeth could be approached w a similar restoration design
Where are Class I cavities most commonly found
occlusal surfaces
occlusal 2/3rds of buccal and lingual surfaces of posteriors
Also - lingual surfaces of incisors
Class VI cavity
not part of the original classification by GV Black
Cusp tips/incisal edges
prep wall
surround the perimeter of prep
set limit to cavity depth
prep line angle
where prep walls intersect
cavosurface angle/margin
prep wall intersecting with a tooth surface
point angle
junction of 3 line angles
prep walls take the name of…
the surfaces toward which they are placed
pulpal floor
wall lying perpendicular to the long axis of tooth
in close relationship to the pulp
gingival wall/seat
prep wall lying perpendicular to long axis of tooth and in close proximity to the gingiva
axial wall
prep wall standing parallel to the long axis of the tooth and in close relationship to the pulp
What are the 2 conceptual divisons of class II cavity preps
occlusal portion - part crossing the occlusal surface
proximal box - portion dropping down on mesial/distal surface
proximal box
portion of a class II cavity prep that drops down on the mesial or distal surface
which walls are common to both parts (occlusal and proximal portions) of a class II cavity prep
buccal wall
lingual wall
how do you name the buccal and lingual walls of a MO or DO class II cavity prep?
buccal occlusal wall
buccal proximal wall
lingual occlusal wall
lingual proximal wall
how do you name the buccal and lingual walls of a MOD class II cavity prep?
mesio-buccal proximal wall mesio-lingual proximal wall disto-buccal proximal wall disto-lingual proximal wall buccal occlusal wall lingual occlusal wall
line angles are named for…
the 2 walls forming them
first - axial
last - pulpal/gingival
cavosurface angles are named by…
the wall forming them
ex. distal cavosurface margin
point angles are named for…
the 3 walls forming them
axio-linguo-gingival point angle
linguo-gingivo-cavosurface point angle
name the 7 basic principles of cavity preparation (usually performed somewhat in this order)
- outline form
- resistance form
- retention form
- convenience form
- caries removal
- finish of the enamel walls
- cleansing the cavity
outline form
the final extent (position and dimensions) and configuration (shape) of the cut face of the cavity prep
what are the two parts of outline form
external outline form
internal outline form
external outline form
perimeter of the prepared cavity
configuration of the enamel cavosurface margin following cavity preparation
internal outline form
inner dimension and details (depth, shape) of the prep
Factors that affect outline form (4)
extend of the caries lesion
proximity of lesion to other defects
relationship of adjacent and opposing teeth
esthetic considerations
the extent of the caries lesion will affect the outline form of the cavity prep - what are the requirements of the prep in order for it to be successful? (4)
- remove all tooth structure destroyed by caries process
- include unsupported enamel
- include contiguous pits, fossae, deep grooves, existing restorations, and fissures to terminate margins on smooth tooth structure
- avoid sound cusps and marginal ridges
resistance form
form of prep that aids in prevention of fracture of tooth/restorative material during function
features that resist biting forces (vertical, lateral)
retention form
form of prep that protects restoration against displacement
Undercuts, etc. to lock restoration into tooth structure
convenience form
Form of cavity that allows adequate vision and access for instrumentation/insertion of restorative material
Usually obtained while developing outline form
caries removal (general principle of cavity prep)
removal of any carious tissue that has extended beyond the optimal cavity form established
finish of the enamel walls (general principles of cavity prep)
Refinements to prep
cleansing the cavity (general principles of cavity prep)
Removal of moisture and debris prior to placement of the restorative material
set up
set of instruments and supplies necessary to carry out a given procedure
armamentarium
Complete supply of instruments, equipment, and supplies available to a clinician in a given office/clinical setting
instruments used in preparing cavities and placing restorative materials can be broadly classified into _____ and _____
Rotary instruments
Hand instruments
Hand instruments can be further categorized into ________ and ______
hand cutting instruments
Non-cutting instruments
Hand cutting instruments are ______ and have ______ blades to resist dulling
Double ended
Carbide
1st # on hand cutting instruments
width of blade (tenths of mm)
2nd # on hand cutting instruments
length of blade (mm)
3rd # on hand cutting instruments
Angle of blade to long axis of handle (centigrades)
4th # on hand cutting instruments
Not always present
If present - between 1st and 2nd #s
Angle the cutting edge formes with long axis of handle (centigrades)
gingival margin trimmers, angle formers
Hand cutting instruments can be divided into types according to their overall shape and purpose, including…
chisels hatchets hoes gingival margin trimmers spoon excavators, etc.
Non cutting hand instruments include…
Amalgam condensers
Burnishers
Carvers
Material placement instruments, etc.
Hand cutting instruments are used to…(4)
Cleave enamel
Smooth outline form
Planes walls
Refine cavosurfaces
What are 2 ways to test the sharpness of a hand cutting instrument?
- place primary cutting edge against thumbnail and gently drag - if it is dull, it will not engage nail
- look head on at primary cutting edge under bright light - if light reflected from the cutting edge, this means there is a bevel = dull
The primary cutting edge is designed with a ____ degree angle
45 degree
for most instruments, the primary cutting edge is at a ____ angle to the long axis of the blade
90 degree
sharpening technique
- wear gloves
- place cutting face (bevel that creates cutting edge) flat against sharpening stone
- cutting face should be maintained at a 45 degree angle to the rest of the blade
- firm forward, light backward (½ the stone) 20x
Cutting face
bevel that creates the cutting edge
during sharpening, the cutting face should be maintained at a _____ angle to the rest of the blade
45 degrees
How many cycles of the sharpening technique of firm forward, light backwards should be performed
20
pen grasp
provides stability, control for refinement
action - down and away from DDS
reverse pen grasps (inverted pen grasp)
pen grasp with wrist turned clockwise until palm is up
action - up and toward DDS
Used in Mx arch
Palm-thumb grasp
More secure grasp where power is needed
Primary used on Mx
