Management of cervical and anterior restorations Flashcards
How do cervical caries appear?
Crescent shaped cavities in the cervical area
Begins at gingival margin and extend occlusally
Plaque biofilm present
There are open lesions
Chalky enamel surrounding the lesions
What is cervical caries related to?
- Lack of oral hygiene
- High sugar diet
What can mimic cervical caries on a radiograph?
abrasion and erosion
cervical burnout
Where is root caries seen?
root surfaces
where there has been connective tissue loss
Where is root caries predominantly seen?
older age groups
When does dentine start to demineralise?
6.2
higher than critical pH for enamel
What are root surfaces compared to enamel?
more vulnerable to demineralisation
How does inactive root caries appear?
Well-defined dark brown or black discolouration
Smooth and shiny
Hard surface tissue
not covered in plaque
What is the basis of management on active root caries?
- Size
- Site
- Extent
- Activity of lesion
may recontour, aim to promote remineralisation
What are the indications for restoring root caries?
Patient has symptoms
Previous attempts to arrest have failed
Cavitated lesions with active caries
There is risk of pulpal exposure
When effective plaque control is difficult
There are aesthetic concerns
Where is cervical burnout located?
At the neck of teeth
- Below is boarded by alveolar bone
- Above is boarded by enamel
How does cervical burnout appear?
Triangular in appearance and fade towards the centre
Usually, all teeth are affected
What are the advantages of composite?
Bonds well to tooth with acid etch and dentine bonding agent
Good aesthetics and shade match
Stronger than GIC
What are the disadvantages of composite?
Moisture control
Slower placement
What are the advantages of GIC?
Bonds to tooth (not as well as composite)
Faster placement
More moisture resistant
Fluoride release
What are the disadvantages of GIC?
Aesthetics and shade are not as good (but is getting better)
Weaker bond compared to composite
What is RMGIC composed of?
aluminosilicate particles +
polyacid + resin
How are RMGIC’s similar to composites?
similar monomers
contains camphorquinone - light activated photoinitator
How does RMGIC’s have improved handling properties?
command set (light cure)
improved abrasion resistance
What is traditional GIC composed of?
aluminosilicate particles and polyacid eg polyacrylic
What are some general qualities of traditional GIC?
Chemically set
Fluoride release
Low tensile strength
Low abrasion resistance
Material generally fails cohesively at the bonding surface
What do dentine and cavity conditioner do?
remove smear layer
condition enamel and dentine surface for GIC application
What is dentine conditioner made of?
10% polyacrylic acid with application time of 20 seconds
- Dentine conditioner leaves smear plugs in the tubules
What is cavity conditioner made of?
20% polyacrylic acid with application of 10 seconds
3% aluminium chloride hexahydrate to seal the dentine tubules to reduce the risk of post- operative sensitivity
