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ABGD study > Materials > Flashcards

Materials Flashcards

1
Q

List the rank order of quality studies. best to worse

A

Systematic Reviews and Meta analysis
Randomized controlled double blind
cohort
case control
case series
case reports
ideas, editorials, opinions
animal research
in vitro research

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2
Q

Amalgam is better in posterior teeth is supported by what

A

Cochrane Summaries (OCT 2013)
Moraschini- J Dent 2015- 46% high probability of failure in composites.
Vetromill, JADA 2020- 5yr f/u

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3
Q

what convention lead the the international decision to decrease mercury waste?

A

Minamata Convention

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4
Q

Chairside traps, vacuum pump and filters remove how much of amalgam?

A

80%

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5
Q

What % of mercury entering public water treatment facilities is from dental? but how much of it is released into the enviroment?

A

50%, <1%

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6
Q

What is a requirement if you use or take out amalgam?

A

amalgam separator
(required as of JUL 2020) Office cost ~800/annually

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7
Q

How does an amalgam separator remove amalgam

A

sedimentation, filtration, and ion exchange

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8
Q

FDA recommends not to use amalgam in what individuals

A
  1. pregnant
  2. breast feeding
  3. <6yo
  4. Mercury of (silver, copper, tin zinc sensitivities)
  5. kidney or neurological dysfunction
    all with poor evidence
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9
Q

What is the gold standard in adhesive bonding agents?

A

3 step Etch and Rinse: (Etch, rinse, conditioner, primer, adhesive) 1. Optibond FL, 2. clearfil SE (selective etch)

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10
Q

For NCCLs what bonding performs the best? and 2nd best?

A
  1. two step, self etch (Clearfil SE)
  2. 3 step, etch and rinse, (optibond FL)

then GI>RMGI,>two step etch and rinse>polyacid modified composite resins >one step self etch

(Heintze, Dent Mater 2010, and Mahn J adhesive Den 2015)

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11
Q

What is the monomer developed in 1981 by Kuraray that is new to universal adhesives?

A

10-MDP monomer
(10-Methacryloyloxydecyl dihydrogen phosphate)

high bond when
compared to Bis-GMA resin composite

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12
Q

Best universal adhesive

A

Scotchbond universal- 93% retention for e&R, 88.4% w/ selective E, and 81.4- self stch.

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13
Q

Scotchbond universal- does it bond will to ceramics? Zirconia?

A

Ceramics/Emax: no, not without additional silane use.( has silane in it)
Zirconia- effective bond strength.

silane ineffective in bond bc of its low pH, weaken by dehydration self condensation.

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14
Q

What are MMPs an what inhibits them? Does it matter?

A

Matrix metalloproteinases (MMPs 2, 8, 9)
-Cysteine cathepsins
–- endogenous enzymes
–- collagenolytic
INHIBITS: CHX
Matter: no. CHX does not influence clinical outcomes

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15
Q

Gluma is?

A

5% glutaraldehyde and 35%
hydroxyethylmethacrylate (HEMA)

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16
Q

Gluma is good at?
Not supported be evidence?

A

cervical dental hypersensitivity
Not supported to be used under restorations- no decrease in sensitivity

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17
Q

Desensitizers and bond strength: what had no negative effects

A

CPP-ACP (like MI paste)
and arginine-CaCO3

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18
Q

Bond strength: CHX?

A

MAYBE preserve bond strength

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19
Q

Bond strength: EDTA and ethanol

A

positive results, but not enough research to recommend

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20
Q

Bond strength: laser, fluoridated agents, NaOCl

A

no idea. not enough evidence- so avoid it!

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21
Q

Bond strength: SDF?

A

4 studies said no difference, 4 studies said reduced,
no difference with GI bonding

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22
Q

Bond strength: Air Abrasion

A

afraid with aluminum oxide
-no negative effects on bond strength
* resin-based materials to dentin
– improved immediate bond strength
* particle size >30 um
* air pressure > 5 bar
– however, no improvement over the long term

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23
Q

Immediate Dentin Sealing (IDS)- does it work?

A

lab studies show improved bond strength, fewer gap formations, and decreased bacterial leakage.
only limited randomized clinical studies

DOES NOT reduce post op sensitivity with indirect restorations

24
Q

IDS- 3 yr clinical study (Van den Breemer J Dent 2019) showed…

A

emax press, vital teeth
no significant difference in sensitivity or anything else.

25
Q

11 yr IDS (gresnigt Dent Mater 2019)

A

feldspathic veneers.
more than 50% dentin exposure had significant increase in survival with IDS (96.4% vs 81.8%)

26
Q

Composites are classified by what?

A

monomer type and particle type

27
Q

Composite monomer types?

A

Methacrylate: Bis-GMA, UDMA, TEGMA

28
Q

Composite particle types

A

macrofill, microfill, hybrid, nano

29
Q

Particle size in macrofil

A

10-50 um

30
Q

Particle size in microfill

A

40-50 um

31
Q

Particle size in hybrid

A

10-50um + 40nm

32
Q

Particle size in nanofill

A

5-100nm

33
Q

Particle size in minifill

A

0.6-1um +40nm

34
Q

Particle size in midifill

A

1-10um +40nm

35
Q

nanohybrid is made of:

A

nanofill and minifill

36
Q

microhybrid is made of

A

??

37
Q

which size is better for posterior restorations?

A

nano vs nanohybrid vs hybrid

38
Q

what does yttrium do to zirconium crystals?

A

stabilizes poly crystals

39
Q

Waht does the aluminum do to zirconium

A

prevents water corrosion

40
Q

What are phases of zirconia and which is the strongest

A

Cubic-most translucent
Tetragonal - STroNGEST
monoclinic- largest

41
Q

What is the difference between 3, 4, and 5mol % yttria?

A

3 mole: STRONGEST because it has 85% in tetragonal phase
4 mol: 75% tetragonal, 25% cubic
5 mol: 50% tetragonal, 50% cubic = more translucent/esthetic but weaker

42
Q

What is transformation toughening?

A

Zirconia tetragonal particles transform to monoclinic (bigger) particles to prevent crack propagation. seen more in 3Y because of the higher tetragonal configuration.

43
Q

What is GLUMA and with is its composition?

A

Desensitizer=
5% Gluteraldehyde, 35% HEMA (hydroxyethylmethacrylate)

44
Q

What is SDF, %, ppm, and what it is for?

A

38% Silver diamine fluoride
44,800 ppm
FDA = for hypersensitivity
Off label- caries arresting

45
Q

side effects of SDF?

A

dark color change

46
Q

What does a higher filler particle do for composite?

A

improve mechanical properties
decrease polymerization shrinkage
decrease thermal expansion

47
Q

What are the phases of amalgam?

A

Gamma: Silver Tin, 30% of volume, strongest phase
Gamma 1: silver mercury, 60% of volume, major matrix phase in set amalgam
Gamma 2: Tim Mercury: 10% of volume, weakest and softest phase that corrodes easily

Eutectic: copper tin.

copper prevents gamma2

48
Q

What does higher concentration of copper do for amalgam?

A

eliminates the Gamma 2 phase which is the weakest.
increases corrosion resistance
greater strength
less tarnish
greater longevity

49
Q

Describe the phase reaction of high copper amalgam alloys

A

Silver enters mercury from silver-copper spherical eutectic particles
both silver and tin enter mercury from stagnant silver particles
tin diffuses to the surface of silver-copper particles
it reacts with copper to form a copper/tin around the unconsumed silver-copper particles

Gamma 1: particles surround the copper compound with tin (ETA phase) and alloy particles

Gamma 2: alloy particles are replaced by copper tin particles

50
Q

What is the argument against amalgam?

A

-Public perception (mercury)
-Esthetics
-Environment
-Safety

51
Q

How is amalgam discharged into the environment?

A

-Wastewater discharge
-Chairside traps, vacuum pump filters to remove up to 80% of amalgam particles discharged into sewers
-Main source of publicly owned tx works
-its less than 1% of mercury released into the environment from man-made sources
2020 EPA ruling makes it mandatory

52
Q

What are amalgam rules in the EU?

A

No amalgam on deciduous teeth,
kids under 15,
pregnant or breastfeeding women

EU parliament exploring ending amalgam use by 2030

53
Q

What is the FDA’s stance on amalgam?

A

2019: insufficient evidence of a relationship between clinically detectable adverse health outcomes and dental amalgam mercury exposure

no Amalg for preg/breastfeeding, children under 6, CKD, or brain issues due to mercury localizing there

54
Q

What are the most common used crown materials?

A

Zirconia- 58%
Glass ceramics: 18%
PFM: 17%
Gold 5%
Resin ceramics: 0.9%

55
Q

Which two methods have the best performance and lowest failure rates in treating NCCLs?

A

2 step SELF E and R (Clearfil SE): best performance

3 Step E and R (Optibond FL): lowest annual failure rate

56
Q

What is IDS and is it effective?

A

Immediate dentin sealing- seal dentin tubules immediately after prep

somewhat equivocal regarding benefit. if >50% exposed dentin, significant increase in survival rate with IDS.

ABGD study (15 decks)

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