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Intermediate restorative skills (Den 305) > MCQs > Flashcards

MCQs Flashcards

1
Q

When planning a veneer what must be marked? And why?

A

Centric, protrusive, lateral occlusal movements must be marked
This is to prevent the veneer margins coinciding with these areas. The placement of margins on occlusal marks will cause the resin to wear and the unsupported ceramic to eventually chip and break

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2
Q

What is a veneer?

A

Thin facing fabricated either by ceramic or composite material

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3
Q

5 cases a veneer could be used for

A
  • Colour defects or abnormalities i.e. amelogenesis imperfecta, medication, fluorosis, age, trauma,extrinsic staining with infiltration of tissues
  • Abnormalities of shape i.e. microdontia, atypical tooth shape, retained deciduous teeth
  • Abnormal structure or texture i.e. dysplasia, dystrophy, erosion, attrition, abrasion, coronal fracture
  • Diastema
  • Missing teeth i.e. lateral with canine in lateral position
  • Correct anterior guidance or create canine guidance
  • Palatal erosion
  • Lengthening
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4
Q

What is NOT needed to complete a porcelain laminate veneer?

a. Resin cement
b. Acid etched enamel
c. Dentine bonding agent
d. Porcelain veneer
e. Silane coupling agent

A

Dentine bonding agent

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5
Q

What it is the significance of the foil in the foil based technique for the production of a veneer?

A

Creates space for the cement

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6
Q

When is the ‘window’ preparation useful?

A

Canine guidance

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7
Q

List 3 indications for placing a crown

A

trauma, heavily broken down teeth, hypoplastic conditions, alter occlusion, restore missing function, appearance

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8
Q

When planning for crowns, what important points would are important to make the patient aware of?

A
  1. Destructive prep and natural tooth tissue will be lost
    Pulpal exposure- especially if younger
    Complex procedure- time and patient cooperation needed
    Maintenance and good OHI necessary
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9
Q

List 3 contraindications for placing a crown

A

other more conservative restorative options, poor OH, extensive caries, periodontal condition

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10
Q
  1. What patient factors must we take into considerations when planning for crowns?
A 
Patient cooperation
Age- young have large pulp chambers, old have brittle teeth
Cost
Social history
Importance of aesthetics to patient
Patients expectations.
Patient OH
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11
Q

Which of these is not a desirable feature for an inlay & onlay preparation

a. Divergent walls
b. Undercut
c. Rounded internal line angles
d. Margins within enamel

A

B - undercut

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12
Q

Which of these factors is not a contraindication for the provision of inlays & onlays.

a. Poor oral hygiene
b. Patient with parafunctional bruxist habits
c. Small clinical crown
d. Fractured tooth

A

C - small clinical crown

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13
Q

Which of the these is not a material used for inlay & onlays construction

a. Gold
b. Stainless steel
c. Resin composite
d. Ceramic

A

B - stainless steel

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14
Q

Give three advantages of using a gold inlay to restore a tooth

A 
Excellent longevity
 Does not abrade opposing teeth
 Does not disclour over time
 Does not wear over time
 Corrosion resistance
 Coefficient of expansion is similar to the tooth
Biocompatible
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15
Q

What are the four main stages involved with restoring a tooth with an inlay/onlay

A

Tooth preparation
Impression with elastomeric material
Temporary restoration
Cement final restoration

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16
Q

List the properties of composite fillers (5)

A 
Alters properties and behaviours of materials
Reduce polymerisation shrinkage
Reduce fracture propagation
Increase wear resistance
Improve optical properties
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17
Q

What are the unwanted interactions between materials in a compound system? (3)

A

Electromechanical corrosion
Mismatch thermal expansion interface damage
Unstable dimensional form

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18
Q

Explain the mutualistic relationship in a compound system with an example? (5)

A

Porcelain bonded to metal crowns
-optical properties achieved with porcelain
-metal substructure counters fracture propagation mechanism of porcelain
-metal occlusal contacts bear side impacts
Glass-infiltration strengthens alumina matrix
-feldspathic porcelain bonded to substrate provides optical properties

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19
Q 
Which of the following is not an example of a compound system?
A.	Beta quartz inserts in composite
B.	Ceramic to dentine
C.	Composite bonded to ionomers
D.	Porcelain bonded to alumina
A

B - ceramic to dentine

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20
Q 
Which of the following is NOT a way of joining materials in a compound system?
A.	Sand-blasting
B.	Mechanical interlocking
C.	Moulding around base material
D.	Welding
A

A - sand-blasting

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21
Q

Why are endodontically treated teeth compromised?a. Reduced tensile strength following reduced blood flow, loss of structural integrity following loss of roof of the pulp chamber

b. Loss of dentine elasticity
c. Reduce compressive strength following reduced blood flow, loss of structural integrity following loss of roof of the pulp chamber
d. Reduced tensile strength following access cavity preparation, loss of integrity of the surrounding periodontium, weakened tooth due to access cavity preparation.

A

B - loss of dentine elasticity

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22
Q

Choose the most appropriate answer regarding high strength core-ceramic posterior crowns.

a. In preparing the tooth, ceramic margins should be a butt-joint rounded shoulder.
b. A systematic review demonstrated that premolar crowns have a higher five-year fracture rate than molar crowns.
c. All high strength ceramics should have a chamfer margin with one-millimetre in width.
d. Resistance prevents displacement of the crown in the antero-posterior direction.

A

A - shoulder margins

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23
Q

Read the following statements and choose which of the following constitute Phase II of the clinical stages of posterior crowns.

I. Tooth build-up and preparation
II. Removal of temporary crown
III. Temporisation
IV. Occlusal Record
V. Diagnostic Wax-Up
VI. Informed consent

a. V and VI
b. I and V
c. II, IV and V
d. I, III and IV

A

D - I, II, IV

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24
Q

A 32-year old male has agreed to restore his upper left first premolar with a porcelain-fused-to-metal crown. He is particularly interested in the types of alloys. Upon discussion, he discovers that there is a small amount of tin and iron in the alloy.
i. What is the most likely type of PFM alloy? (1)

ii. Why is tin and iron present in the alloy? (2)

A

i. High-noble alloys

ii. Provides a layer for oxide formation, provides a chemical bond for the porcelain to metal

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25
Q

What is the evidence for the high five-year survival-rate of all-ceramic crowns? (2)

A

Pjeturrson et al. 2007

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26
Q

What are the functions of temporary crowns?

A 
To protect the pulp
For marginal integrity
Allow healing of soft tissues after implant surgery
Provide adequate aesthetics
Facilitate plaque control
To maintain or rebuild occlusion
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27
Q

What two features of the prep can be picked up from temporaries?

A

Undercuts - when temp is locked in place

Under-prep - tearing/ perforation of the temporary

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28
Q

Difference between reorganised occlusion and conformative temporary crowns?

A

Reorganised occlusion used to increase vertical dimension with help of diagnostic wax-up
Conformative temp maintains height of prepared tooth

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29
Q

List the consequences of failed temporaries

A

Pain
Overeruption
Drifting of teeth
Damage to core prep

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30
Q

List the types of temporary crowns and give examples for each

A

Direct - GIC
Pre fabricated crowns - SS used in paeds
Custom made - ProTemp
Composite resin - laminate veneers

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31
Q

Which of the following are not done at the review stage?

a. Check for new disease
b. Temporise any teeth that need it
c. Determine recall periods
d. Check adequacy of restorations

A

B - temporise any teeth that need it

32
Q

What material can you use to repair a hole made in a crown for RCT?

a. Composite
b. GIC
c. Amalgam
d. All of the above

A

D - all of the above

33
Q

What should you plan for when prognosis is guarded?

a. Further treatment
b. Change in treatment plan
c. Failure
d. Continuous consent

A

C - failure

34
Q

Name 3 types of technical failure

A 
Fractured restorations
Marginal breakdown
Tooth fracture
Defective contour
Appearance
Retention failure
35
Q

How would you manage loss of retention of a crown?

A

Assess cause of failure
Clean tooth
Repair with cementation
-optional: you can use mechanical locking with pins and undercuts

36
Q

In which of these situations is the coefficient of thermal expansion ideal for a PFM crown?

a. The coefficient of thermal expansion of the porcelain is higher than that of the metal.
b. The coefficient of thermal expansion is the same for both.
c. The coefficient of thermal expansion of the metal is higher than that of the porcelain.
d. Coefficient of thermal expansion does not matter for the materials when making a PFM.

A

C - the coefficient of thermal expansion of the metal is higher than that of the porcelain

37
Q

What effect does increasing the copper content have on the properties of a high gold alloy?

a. Increases the yield stress and so increases the plastic deformation of the alloy.
b. Decreases the yield stress and so increases the plastic deformation of the alloy.
c. Increases the yield stress and so decreases the plastic deformation of the alloy.
d. Decreases the yield stress and so decreases the plastic deformation of the alloy.

A

C - increases the yield stress and so decreases the plastic deformation of the alloy

38
Q

When deciding on the shade for a crown, what sequence should you take?

a. Decide on the chroma, then value, then hue.
b. Decide on the hue, then chroma, then value.
c. Decide on the chroma, then hue, then value.
d. Decide on the value, then chroma, then hue.

A

D - VCH

39
Q

These are all indications of a veneer besides one, which one?

a. Amelogenesis imperfecta
b. Microdontia
c. Bruxism
d. Coronal fracture

A

C - bruxism

40
Q

For which of the following incisor relationships would a veneer window preparation be useful:

a. Class I
b. Class II division I and Class II division II
c. Class III and Class II division I
d. Class III and Class II division II

A

D - class III and class II div 2

41
Q

What is ‘value’ the measurement of when shade taking for crowns?

a. Colour family
b. Colour Saturation
c. Colour Translucenecy
d. Lightness

A

D - lightness

42
Q

Which of the following situations is most suitable for veneers:

a. Midline diastema in a bruxist patient
b. Midline diastema in a patient with poor oral hygiene
c. Midline diastema with fluorosis affecting the upper centrals
d. Midline diastema where teeth are outstandingly triangular

A

C - midline diastema in patient with fluorosis affecting upper centrals

43
Q

Which of the following is a contraindication to placing labial veneers :

a. Patient has amelogenesis imperfecta
b. Pulpless teeth
c. Retained deciduous teeth
d. Diastema

A

B - pulpless teeth

44
Q

Which of these is not 1 of the 5 principles of tooth preparation for crowns?

a. Retention
b. Reduction
c. Structural durability
d. Resistance

A

B - reduction

45
Q

What percentage of gold does a typical Type III alloy contain? (used for all-metal crowns and bridges)

a. 85%
b. 60%
c. 75%
d. 90%

A

C - 75%

46
Q

How long can laboratory-made temporaries last for (crowns)?

a. 1-3 weeks
b. 4-6 weeks
c. 7-9 weeks
d. No evidence available to prove it

A

B - 4-6 weeks

47
Q

Which of the following is a contraindication for veneers?

a. Atypical tooth shape
b. Tooth erosion
c. Bruxism
d. Amelogenesis Imperfecta

A

C - bruxism

48
Q

Why place a glaze on ceramic indirect restorations?

a. Improve aesthetics
b. Makes restorations more hygienic
c. Helps to prevent the restoration from fracturing
d. All of the above

A

D - all of the above

49
Q

What material is Protemp II (3M Espe) made of?

a. Polymethyl methacrylate
b. Vinyl methacrylate
c. Bis-GMA composite
d. Bis-acryl composite

A

D - bis-acryl composite

50
Q

4 features of suspected abscess

A

Red
Hot
Painful
Swollen

51
Q

Difference between periapical abscess and lateral periodontal abscess?

A

Periapical: vertical TTP, may be mobile, loss of lamina dura at apex, non-vital
Lateral: lateral TTP, usually mobile, loss of alveolar crest, vital, pus in pocket, deep pocket

52
Q

5 indications of composite

A
  • Polychromatic conformative restoration
  • Alter morphology
  • Repair failed composite/ceramic
  • Occlusal rehabilitation
  • Tooth splinting
53
Q

Advatages of using a polychromatic layered composite over ceramic veneer

A
  • Wear is similar to tooth structure
  • Can be constructed at chairside
  • Chairside repairs
  • Little/No tooth preparation
54
Q

3 components of a direct composite

A

Resin
Filler
Coupling agent

55
Q

3 temporary crown materials

  • custom made
  • prefabricated
  • direct
A

Acetate (ProTemp)
Polycarbonate shell (Directa)
Stainless steel shell

56
Q

6 functions of a temporary crown

A
  • Facilitate good plaque control
  • Marginal integrity of tooth
  • Maintain occlusal function
  • Protect dentine and pulp
  • Positional stability
  • Shape soft tissues after implant placement
  • Aesthetics
57
Q

Pt comes in with a loose temp crown, how would you manage?

A
  • Assess cause of failure – when and how
  • Check prep and temp
  • Recement if ok, or use adhesive luting agent if not
  • Clean tooth surfaces before
58
Q

28 year old rugby player comes to you with fractured upper right incisor, fracture extends into dentine, you choose to do a resin bonded crown, patient wants crown to be aesthetically good, and inconspicuous.
-What would you send to the lab in order to get good aesthetics, and how would you communicate this? (8)

A
  • Impression of preparation
  • Impression of opposite arch to take into account the occlusion
  • Photograph before fracture – good shade indicator
  • Photograph of adjacent teeth
  • Desired material for crown
  • Shape
  • Colour
  • Surface Texture
  • Translucency
  • Written Description
59
Q

How are resin bonded ceramics different to other indirect restorations?

A
  • Minimal preparation of the tooth
  • Tooth is core structure
  • Good aesthetics – translucency and tooth showing through
  • Cementation via an aesthetic dual cure resin
60
Q

Prescribing for a patient with toothache

A 
Ibuprofen: 2 x 400mg TDS
Paracetamol: 2 x 500mg QDS (not exceeding 4g/ 24hrs)
Co-codamol: 2 x 500mg QDS
-8/500 and 15/500 preparations OTC
-30/500 must be prescribed
61
Q

Define hue, value and chroma

A

Hue is described with the words we normally think of as describing color: red, purple, blue, etc. Value (lightness) describes overall intensity to how light or dark a color is. It is the only dimension of color that may exist by itself. Chroma (saturation) may be defined as the strength or dominance of the hue.

62
Q

Pulp vitality and crowns

A

15-20% go non-vital

63
Q

5 advantages of composite over GIC

A
  1. Better wear resistance (similar to tooth structure)
  2. Better aesthetics - shade match
  3. Better bond to tooth structure
  4. Better polishability
  5. Command set - longer working time
64
Q

Temporary Restorations – loose temp management (3), reasons why it’s loose (4), types of temp for posterior (3), 6 functions (6)

A

Management: remove crown, assess cause, check preparation, correct, recement if cause corrected
Reasons: marginal integrity, prep too thin, incorrect cement strength, solubility of cement, poor technique e.g. not under moisture control
Posterior: preformed metal crown, ProTemp, Snap
Functions: aesthetics, diagnosis, space maintainer, mastication, facilitate plaque control, protection, assess tooth reduction, provide coronal seal between RCT appointments, assess prognosis, control/ customise emergence profile

65
Q

Indications for use of GIC

A
  1. Base and liner
  2. Temporary restoration
  3. Restoration with poor moisture control e.g. in children
  4. Cementing crowns
  5. Sealing endo access cavity
  6. Blocking out undercuts
  7. Fissure sealants in indicated teeth
  8. Abrasion and erosion lesions
  9. Class III lesions with exposed dentine
  10. Atraumatic restorative treatment
66
Q
  1. Ceramics – 3 types (3), how substructure affects (6), dentine bonding precautions (5)
A

Types: alumina, zirconia, glass ceramics e.g. lithium disilicate
Feldspathic ceramic is weak, can be supported by metal substructure, high strength ceramic core or if bonded to the tooth it uses tooth as substructure
Precautions: weak so only use in anterior region, refractory model production may compound errors, fragile restoration (especially margins) due to lack of supporting structure
ENSURE YOU HAVE MOISTURE CONTROL, DO NOT DESSICATE TOOTH, ENSURE YOU HAVE ACID ETCHED, ENSURE YOU DON’T GET BOND ON ADJACENT TEETH, CARE WITH DRYING

67
Q

Components of composite

A 
Filler: silica (SiO2)
Matrix: bisGMA
Photoinitiator
-HEMA
-UDMA
-TEGDMA
-most commonly camphorquinone
68
Q

Amalgam failure most commonly due to

A

Tooth fracture

69
Q

Setting reaction of zinc polycarboxylate

A

Cross-linking to form a salt (acid-base reaction)

70
Q

Buccal width of a PFM

A

1.2-1.4mm

71
Q

4 principle dentine adhesive systems

A

3 stage system: etch with dentine conditioner (phosphoric acid), prime with bifunctional monomer, seal with unfilled resin
-drying makes this technique sensitive
Etch and rinse, then prime and seal e.g. Scotchbond 1
-have to dry
-worse bond
Self-etching primers e.g. Clearfil SE bond
-etch and prime with acidic monomer, then bond
-no drying gives more consistent results
-weak etching of enamel can lead to marginal staining
All-in-one system e.g. XenoIII
-simplest system but weakest bond strength

72
Q

Reaction to amalgam on soft tissues adjacent

A

Lichenoid

73
Q

What happens if the CSA of amalgam is reduced?

A

Enamel margin fracture

74
Q

Which class of cavity does C factor affect the most?

A

Class 1

75
Q

AgP affects which cell?

A

Polymorphonucleocyte

76
Q

List 3 ways you can bond composite to precious metal

A

Metal primers
Silica coating
Tin plating

77
Q

Which 3 materials can you use as a high strength core in ceramic restorations

A

Zirconia
Alumina
Spinnel

Intermediate restorative skills (Den 305) (16 decks)

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