Lecture 3 Flashcards
Placement of dam:
2 teeth behind the tooth of interest to the contralateral incisor
Ist molar hole
second largest hole
premolar hole
3rd largest hole
Clamp size for tooth #15
3
of points of contact you should have with clamp:
4
line up bow:
parallel to the lines on the dam
lubricant we use
Every Man Jack shaving cream
to get rubber dam bw teeth
Reach waxed tape - very thick
Hook this side on the dam first:
top
On which tooth does the first clamp attach?
2 behind the tooth you are working on and one on the actual tooth as well.
Function of bow clamp:
Retracts gingival tissue for facial/cervical
4 parts of clamp
bow (arch), pinch, wing, jaws
W2:
Premolare
W3:
Flat jawed
W8:
normally erupted max molars
W8a:
small/partially erupted molars (jaws angle down)
212:
double bowed clamp - class 5 lesion, small lower teeth
on which side is the clamp more gingival, lingual or buccal?
buccal to retract tissue more to fill the Class V restoration
How do you have to punch the hole for the 212 clamp for a Class 5 cervical lesion?
slightly out of alignment to the buccal
Operative teeth that need to be isolated:
quadrants
Endodontics teeth that need to be isolated:
single tooth
Steps previous to dam placement:
- anesthesia
- Check inter-proximal contacts
- Check occlusal contacts
- shade selection in esthetic restoration
6.
7. - Select retainer
- Retainer is ligated (attach floss)
T or F? Always restore tooth to an anatomically perfect tooth if restoring.
F. Reproduce the restoration as the occlusal contact wee before you started
Dam lubricants we can use:
water soluble/ vaseline
Steps for placement:
- selection of teeth to be isolated
- select retainer
- cut orifices
- lubricate rubber dam
- place clamp
- pass ligature flow through dam most posterior orifice
- stretch rubber dam over the retainer sealing it on the distal (double punched sometimes)
- Distribute orifice on each tooth
- Wedjet to fix anterior end (rubbery material)
- place fram and napkin
- Floss dam
- Inversion of dam
Dam removal:
- cut septa bw teeth
- remove ant/pos anchorage
- remove dam and fram
- verify all has been removed (lie dam flat on surface)
When might we not use dam
anterior, if we do - canine to canine
Ligature use benefits:
- keep dam inverted
- improve access
- controls filtration
When not to use dam:
- partially erupted that clamp won’t hold on to
- some 3rd molars
- very malpositioned teeth
- pts w/ asthma
- psychological reasons
- latex allergies (non-latex is available)
Isolation types
cotton rolls, gauze, iso-shield, saliva ejectors, spandex, retraction cords
when to use retraction cords:
sub gingival caries and ?
When is RD isolation evaluated?
every practical procedure
T or F? Push RD through the teeth from posterior to anterior.
F. Anterior to posterior
To cut, plane and cleave tooth structure:
Hand instruments
Instruments used to cut and shape tooth structure in the school classification:
A series
Examples of instruments used to cut and shape tooth structure:
hatchets, hoes, chisels, and spoons
Instruments used to place restorative materials in the school classification
B series
Examples of instruments used to place restorative materials
amalgam condensers and plastic instruments
Instruments used to shape and finish restorative materials in the school classification:
C series
Examples of instruments used to shape and finish restorative materials:
Hollenback carvers, cleoid discoids and various other carvers
Primary cutting edge may be:
monobeveled or bibeveled
connects blade to handle:
shank
T or F? All hand instruments have secondary cutting surfaces.
F.
What do the numbers represent in Black’s 3 Number Formula?
width of blade in tenths of a millimeter, length of blade in millimeters, angle of the long axis of the blade (degrees centigrade)
1st digit of Black’s classification system of 15 is how long?
1.5 mm
25 degrees centigrade corresponds with how many degrees?
90
Black’s 4 # formula
width of blade in tenths of a millimeter, angle of cutting edge of the blade with the handle (degrees centigrade), length of blade in millimeters, angle of the long axis of the blade (degrees centigrade)
What is the 2nd digit in Black’s 4 digit numbering system?
angle of cutting edge of the blade with the handle (degrees centigrade)
Rotary cutting instruments:
burs, diamonds, and drills (end cutting inst. only)
Which is more effective as a side cutting instrument. bur or drill?
bur
What is a bur?
multi bladed rotary milling cutters
direction of bur spinning
counter clockwise (when viewed form cutting end)
How are burs classified?
shape and diameter of the cutting end of the bur
Burs can have as many as ___ blades, but usually have.
40, 6-8
Which part the bur adapts to the handpeice?
shaft (friction grip, latch type)
We primarily use these burs:
330 (pear) and 245 (long inverted cone)
plural depth we most often need:
1.5-1.6mm (330 = 1.6mm)
Parallel sided bur, #’ed 55 1/2 to 60, multipurpose bur:
straight fissure bur
cross cuts (notches), 556-560, to improve cutting efficiency (not really anymore), same basic shape as straight bur:
cross cut straight fissure bur
33 1/3 -40, develop retentive features, smooth walls,sharpen angles of prep, sides of bur converge toward shank:
inverted cone bur
168-171, develop initial stages of prep and tapered wall forms, sides of bur converge toward end of bur:
tapered fissure bur
1/16th - 11, used to develop retentive features and to remove caries
rough bur (1/4 round and 1/2 round in this course)
diamond particles are attached to a metal black - size and shape of the diamond particles determine the abrasiveness:
diamond bur
How are sextents divided?
bw the canines and the 1st premolars
Where are the marginal ridges of ant teeth?
m and d borders of the lingual surfaces
Common cause of fissures:
lack of fusion of the enamel of adding dental cusps or lobes
axial wall:
wall adjacent or nearest to the pulp chamber or pulp canals, approx parallel to the long axis of the tooth
What is the wall of the occlusal portion of a prep?
pulpal wall
Shape of lingual and facial walls for amalgam placement:
parallel or convergent for retention
Shape of lingual and facial walls for resin composite:
can be divergent since bonding will occur to dentin or enamel
T or F? The line angles for bonded restorations must be well defined.
F. may not be well defined, often rounded
Another name for margins:
cavosurface angles
What are cavosurface angles?
jxn of a cavity wall and an external tooth surface
T or F? in a normal, healthy individual the clinical down is typically smaller than the anatomical.
T
On which surfaces do Class I lesions occur?
facial, lingual, an occlusal
Class I lesions most often occuur on these teeth:
lateral incisors
These ant teeth rarely get Class I lesions.
Canines
T or F? A lesion in a pit on the facial surface of an anterior tooth is a Class I restoration.
T
Class 5 lesions may include involvement of what type of tooth structure?
cementum, dentin, and/or enamel
Do Class 5 lesions include lingual surface or only refer to buccal and labial surfaces?
Both
Bonded, tooth-colored restorations require neither:
mechanical or undercut retention.
The shape or outline of the cavity prep:
cavity form
The shape of cavity prep needed to obtain access for instruments:
conveinience form
The shape of cavity prep needed to provide retention for the material:
retention form
The shape of cavity prep required to resist stress on the restoration and the tooth from forces:
resistance form
Blacks’ steps of cavity preparation:
- Establish outline form
- Obtain resistance form
- Obtain retention form
- Obtain convenience form
- Remove remaining carious dentin
- FInish enamel walls and cavosurface margins
- Clean the prep
T or F? Improperly placed restoration may lead to tooth fracture of the tooth restored.
T
How is retention obtained?
mechanical shaping and/or bonding procedures
Why are unsupported enamel overhangs more prone to fracture after restoration placement?
polymerization shrinkage
Preferred hand instrument metal:
stainless steal (iron, chromium {corrosion resistance}, carbon {hardness}, and maybe nickel)
The working end of the blade should be within:
2-3mm of the axis of the handle
Does a longer or shorter blade require more force to be used?
longer
The name for when an instrument is angles so as to bring the working end within 2-3mm of the long axis of the handle:
contra-angled ( 2 or more angles)
Diameter of standard metal handle:
1/4 inch (6.4mm)
T or F? Larger handled instruments are said to be more ergonomic.
T
Black called all cutting instruments used for tooth preps:
excavators
Up to how many angles may shanks have?
4
Instruments in which the blade and cutting edge are on a plane with the long axis of the handle:
hatchet
Instruments with a blue that is either aligned with the handle, slightly angled, or curved from the long axis of the handle, with the working end at ta R angle to the handle:
chisel
What type of instrument is a Wedelstaedt?
chisel
This type of instrument has a cutting edge that is at a R angle to the handle with a blade at an angle greater than 12.5 centigrades from the long axis of the handle than a chisel:
hoe
The blade of a hoe must be at an angle to the long axis of the handle greater than __ degrees (not centi-grades)
45 degrees
The blade of a chisel must be at an angle to the long axis of the handle less than ____ degrees.
45 degrees (12.5 centigrades)
T or F? The cutting edge of a spoon is parallel to eh handle of the instrument.
T
This instrument has a blade that is curved and the bevel for the cutting surface edge at the end of the blade is always on the outside of the curve:
gingival margin trimmer
This instrument has a blade rotated 45 degrees from the plane oath long axis of the handle:
off-angle hatchet
Which angle of the off-angle hatchet is meant of use?
acute angle
On which side of the blade is the bevel in an off-angle hatchet?
back
Puling strokes with a double-ended hoe are done with this end:
beveled end or end with distal bend
Pushing strokes with a double-ended hoe are done with this end:
contra bevel end or end with mesial bevel
Are most cutting instruments single or double beveled?
single
What instrument is useful for placing retention points in some direct girl (gold foil) filings?
bi-beveled cutting edge of off-angle hatchet
When is the 3-numbered system used?
instruments in which the primary cutting edge is at a R angle to the long axis of blade
In margin trimmers a cutting edge angle of greater than __ centigrades is intended for distal gingival margins:
90
In margin trimmers a cutting edge angle of __ centigrades or less is intended for mesial gingival margins:
85