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Operative II > Midterm > Flashcards

Midterm Flashcards

1
Q
  • distal wall
  • facial wall
  • lingual wall
  • gingival wall

These are all:

A

external walls

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2
Q
  • pulpal floor
  • axial wall

These are both:

A

internal walls

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3
Q

What is the thickness gauge of the “heavy” dental dam (pretty sure this is the one we use)

A

.010”

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4
Q

The parts of retainers (clamps) used with a dental dam include: (4)

A
  1. bow
  2. jaws
  3. forceps holes
  4. points
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5
Q

Isolation of the operating field is extremely important because a wet field =

A

recurrent caries or failed bond

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6
Q

For isolating the operating field in a class II preparation, what teeth would show through the dental dam?

A

one tooth posterior & two teeth anterior to the tooth you’re working on

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7
Q

The tooth posterior to the tooth you’re working on that is clamped when using the dental dam is considered the:

A

anchor

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8
Q

What are your isolation options when damming anterior teeth?

A
  1. canine to canine
  2. clamp on one premolar
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9
Q

Sometimes a rubber dam will not work especially in cases with _____ medications (rarely used)

Give examples of these meds

A

Antisialogogue medications

atropine & banthine

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10
Q

What instruments are used to remove caries once outline form is achieved?

A
  1. spoon excavator
  2. round bur on slow speed handpiece
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11
Q

When refining an amalgam class II preparation, why should you plane/bevel the axiopulpal line angle?

A

reduces stress

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12
Q

When refining an amalgam class II preparation, why should you plane/bevel gingival margin?

A

This removes loose enamel rods

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13
Q

When the placing the wedge with use of a matrix band, what side should the wedge be inserted?

A

place wedge from larger embrasure

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14
Q

In a class II amalgam restoration-

  1. Fill ____ first
  2. Fill ____ above margins
  3. Carve ___ of marginal ridge using explorer
  4. Pre- _____
  5. Carve with ____
A
  1. box
  2. 1.0 mm
  3. mesial incline
  4. pre-carve burnish
  5. hollenback
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15
Q

What should you do while removing the matrix band in an amalgam class II restoration?

A

Hold condenser on marginal ridge as you gently remove the band

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16
Q

In the proximal outline form of a class II composite restoration, you must break:

A

gingival margin

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17
Q

In a class II composite restoration, where should you keep the margins when possible?

A

in enamel

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18
Q

In the proximal outline form for a class II composite restoration, the ____ contact should always be broken, while the ____ contact may or may not be broken.

A

lingual; buccal

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19
Q

Is a reverse S-curve necessary in a composite restoration?

A

no

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20
Q

What bevels are involved with a composite class II restoration?

A
  1. lingual wall bevel
  2. gingival bevel
  3. axial-pupal line angle bevel
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21
Q

In what case would you not do a gingival bevel in a class II composite prep?

A

If gingival floor is in dentin/cementum

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22
Q

It is more challenging to establish a good contact with a ____ restoration

A

composite

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23
Q

What addition steps are needed in a class II composite restoration compared to amalgam?

A
  1. etch & rinse
  2. bond
  3. incremental composite
  4. light cure each increment
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24
Q

For complete etch:

  1. Place etch on ____ first followed by ___
  2. Etch ____ for 20-30 seconds
  3. Etch ____ for 15-20 seconds
  4. Rinse and gently ____
A
  1. enamel; dentin
  2. enamel
  3. dentin
  4. air dry
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25
Q

What type of etch is typically only done with total-etch and universal bond agents?

A

complete

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26
Q

With selective etch, what is etched and how long?

A

enamel only; 20-30 seconds

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27
Q

What bond agents allow you to selectively etch?

A
  1. Universal (what we use in clinic)
  2. Self-etch
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28
Q

What is considered evidence of etched enamel?

A

whitish etched enamel surface

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29
Q

Results in collapse of collagen layer and reduced bond strengths

A

desiccation of dentin

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30
Q

what are the typically the solvents in bond agent?

(these evaporate when you gently blow air)

A
  1. acetone
  2. ethanol
  3. water
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31
Q

The most important increment in a class II composite restoration (also the first increment) is at:

A

gingival wall

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32
Q

When adding addition increments after the first composite increment (1mm) you should NOT exceed ____ mm of material per increment

A

2mm

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33
Q

By starting with 1 mm increment of composite and then not exceeding 2mm on additional increments, this method minimizes _____ placed on the material and on the tooth due to ____.

A

stresses; polymerization shrinkage

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34
Q

A flat marginal ridge would ____ (and this is why is should be rounded)

A

shred floss

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35
Q

Finishing and polishing composites functions to:

  1. Removes ____
  2. Establishes ____
  3. Ensures ____
A
  1. oxygen inhibited layer
  2. anatomy/final shape
  3. a smooth surface
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36
Q

What is one MAJOR difference between amalgam and composite restoration steps?

A

Finishing and polishing composite

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37
Q

_____ is nearly always on the buccal side of a class II amalgam preparation

A

reverse curve

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38
Q

A reverse S curve in a class II amalgam preparation improves:

A

resistance to amalgam fracture

(because it keeps the narrowest part of prep away from the axiopulpal line angle)

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39
Q

In a class II amalgam preparation, this feature allows the preparation to break contact while allowing the buccal wall to meet the tooth surface AT A 90 DEGREE EXIT ANGLE:

A

Reverse S curve

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40
Q

Wall clearances around a class II amalgam preparation:

  1. buccal contact is open:
  2. lingual contact is open:
  3. gingival contact is open:
A
  1. (0.2-0.5mm)
  2. (0.2-0.5)
  3. at least 0.5mm
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41
Q

Enamel rods in a class II amalgam preparation box are inclined:

A

gingivally

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42
Q

In a class II amalgam preparation, an “early” reverse S curve (starts too distal) will result in:

A

weakening the cusp

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43
Q

class II amalgam preparation, a flared too mesially reverse s-curve (late reverse s) leaves amalgam:

A

prone to fracture

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44
Q

What type of S-curve error in a class II amalgam preparation leaves the narrow part of prep adjacent to axiopulpal angle; and makes box walls flare causing obtuse cavosurface angles (weakening amalgam):

A

NO reverse s-curve

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45
Q

In a class II amalgam preparation, a concave axial wall with indistinct internal line angles compromises:

A

resistance & retention form

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46
Q

what are some contraindications to composite restorations?

A
  1. occlusion?
  2. restorations extending to root surface
  3. deep subgingival margins
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47
Q

When comparing amalgam restoration to a composite restoration the _____ may be more forgiving but the _____ is not.

A

preparation more forgiving; restoration NOT

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48
Q

What type of restoration material has the disadvantage of porus and low modulus in elasticity:

A

composite

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49
Q

The sticky uncured layer left on the surface of a composite restoration:

A

oxygen inhibited layer

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50
Q

What are some new aspects you have to consider with composite (opposed to amalgam):

A
  1. inter proximal contacts (he says its harder to achieve these)
  2. voids
  3. light
  4. polymerization stress
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51
Q

What step removes the oxygen inhibited layer of a composite restoration?

A

finishing and polishing

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52
Q

What increases the longevity of a composite restoration?

A

Polishing and finishing

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53
Q

The metal adjustable twisty part of the toffelmire:

A

tofflemire retainer

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54
Q

What are the two types of tofflmire retainers?

A
  1. straight retainer
  2. contra-angle retainer
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55
Q

Inserting band into the tofflemire retainer:

  1. Turn the inner nut ___ until slot vice is about ___ from the guide channels
  2. Hold the inner and turn the outer nut ____ unit the pointed end of the spindle is free in the slot in the slot vice
  3. Double the band back on itself, forming a loop
  4. Insert into the slot vice through one of the three guide channels, then tighten spindle
A
  1. counter clockwise; 1/4 inch
  2. counter
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56
Q

When using a tofflemire matrix band, the wider opening of the loop is toward the _____.

The slot vice is toward the _____

A

toward the occlusal; toward the gingival

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57
Q

What is the most common orientation of the tofflemire band?

A

most common: retainer on buccal side

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58
Q

When carving amalgam, try, if possible, to carve anatomy so that the ____ in maxim intercuspation is in the ___. This will put ___ on the teeth.

A

occlusal stop; bottom of the fossa; long axis forces

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59
Q

Bonding mechanism in which penetration and formation of resin tags within the tooth surface:

A

mechanical bonding

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60
Q

Bonding mechanisms in which chemical bonding to the inorganic components (hydroxyapatite) or to the organic components (mainly type I collagen) of tooth structure:

A

adsoprtion bonding

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61
Q

Bonding mechanisms in which precipitation of substances on the tooth surface to which resin monomers can bond mechanically OR chemically:

A

Diffusion bonding

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62
Q

Acid etching of enamel for 15 second with 37% ____ is considered enamel bonding, also known as ____

A

phosphoric acid; adhesion

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63
Q

What is the fundamental mechanism of enamel bonding?

A

the formation of resin micro tags within the enamel surface (roughing up the surfaces making high surface energy)

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64
Q

Primarily relies on the penetration of adhesive monomers into the filigree of collagen fibers left exposed by etching with 37% phosphoric acid for 15 seconds:

A

Dentin bonding (adhesion)

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65
Q

Compare the strength of dentin bonding to enamel bonding:

A

dentin bonding is weaker

66
Q

Smear layer = cut ____ surface composed of debris of hydroxyapatite crystals and denatured collagen:

A

smear layer

67
Q

The smear layer decreases dentin permeability by:

A

85%

68
Q

Types of etching

  1. No phosphoric acid
  2. phosphoric acid on enamel
  3. phosphoric acid on enamel & dentin
A
  1. self-etch
  2. selective-etch
  3. total-etch
69
Q

When you use total etch (on enamel & dentin) , you remove the smear layer and this can something cause:

A

sensitivity

70
Q

Self etch & selective etch leave the ___ in place because you are not etching the dentin

A

smear layer

71
Q

The state in which two surfaces are held together by INTERFACIAL FORCES which may consist of valence or interlocking forces or both

A

adhesion

72
Q

A material, frequently a vicious fluid, that joins two substrates together by solidifying and transferring a load from one surface to another:

A

adhesive

73
Q

The measure of the load-bearing capacity of an adhesive joint:

A

adhesive strength

74
Q

What factor of adhesion allows the availability of substrate to interact with adhesive?

A

clean substrate

75
Q

What factor of adhesion allows the adhesive to maintain intermolecular contact with dental surface

A

wetting ability

76
Q

Acid etching = increases surface free- energy =

A

improves surface wetting

77
Q

Spreading capacity of adhesive onto dental surface:

A

viscosity

78
Q

Viscosity depends ont he surface tension of:

A

tension of liquid (adhesive)/ solid (substrate)

79
Q

Surface roughness- irregular surface increases the bonding ability by: (2)

A
  1. increases area for bonding
  2. increases adhesive interlocking
80
Q

increases the surface available for bonding and intermolecular contact for adhesive:

A

acid etching

81
Q

Penetration of resin adhesive and formation of hybrid layer/ or resin tags within the tooth surface after polymerization- entanglement=

A

mechanical bonding

82
Q

micro mechanical interlocking within the tooth surface:

A

resin tags

83
Q

Chemical bonding to the inorganic component (hydroxyappntitie) or organ components (mainly type I collagen) of tooth structure:

A

chemical/adsoprtion bonding

84
Q

Precipitation of the substances on tooth surfaces to which resin monomers can bond mechanically or chemically:

A

diffusion bonding

85
Q

What are the mechanisms of bonding? (4)

A
  1. mechanical
  2. chemical/adsorption
  3. diffusion
  4. combo of all
86
Q
  • 97% mineral (mainly hydroxyappetite)
  • 1-2% organic (amelogenin and enamelin)
  • 2% water
A

composition of enamel

87
Q

Origin of enamel:

A

epithelial

88
Q

The structure of enamel is:

A

prisms

89
Q

Enamel can be described as a ____ substrate

A

homogenous

90
Q

The bond strength of dentin can be described as:

A

unpredictable

91
Q

The origin of dentin:

A

conjunctive

92
Q
  • ~55% mineral (mainly hydroxyapatite)
  • 30% organic (mainly type I collagen)
  • 15-20% water
A

composition of dentin

93
Q

structure of dentin:

A

tubular

94
Q

Dentin can be described as a ____ substrate:

A

very heterogeneous (challenging)

95
Q

chemical drilling=

A

acid etching

96
Q

Fundamental mechanism of adhesion:

A

micromechanical bond

97
Q

type of etching pattern on enamel described as “honeycomb” and accomplished through dissolution of prism cores:

A

Type 1

98
Q

type of etching pattern on enamel described as cobblestone and accomplished through dissolution of prism peripheries:

A

Type II

99
Q

Occlusal and Middle thirds of teeth is where what types of etching patterns are best accomplished?

A

Type I and II

100
Q

type of etching pattern on enamel which is a combination of type I and II:

A

Type III

101
Q

type of etching pattern on enamel that can be described as “pitted”

A

type IV

102
Q

type of etching pattern on enamel that can be described as “prism less” and flat and smooth:

A

Type 5

103
Q

____ & ____ enamel allows for bonding performance to have stronger retention and be more predictable:

A

Incisal third & middle third

104
Q

Location of prism less enamel- where there are fewer and shorter resin tags after bonding:

A

cervical third

105
Q

Gingival floor beveling in enamel in class II preparations allows for the reduction of:

A

micro leakage at cervical and ascending walls

106
Q

T/F: You want to bevel the gingival floor in a deep class II prep

A

False- probably no enamel present once you get deep

107
Q

When do we not bevel the gingival floor?

A

deep class II preps

108
Q

Critical area to bond to enamel includes:

A
  1. perpendicular prisms
109
Q

As we known perpindicular prisms are a critical area to bond to enamel, where might we find these?

A
  1. cavosurface margins of class I prep
  2. bevels of class II preps
  3. ends of enamel rods
110
Q
  • fluid filled
  • enclosed cellular extension (odontoblasts)
  • connect pulp to DEJ
A

dentin tubules

111
Q

What type of dentin is being described?

  • higher organic content
  • collagen rich zone
A

intertubular dentin

112
Q

What type of dentin is being described?

  • surrounding the tubules
  • highly mineralized
A

peritubular dentin

113
Q

Dentin tubules get larger as you near the:

A

pulp

(because more fluids and less intertubular dentin)

114
Q

Impairs effective bonding and must be removed with acid etch:

A

smear layer

115
Q

After acid etching, ___ are exposed

Adhesive penetrates the encapsulates of ____

A

collagen fibrils (for both)

116
Q

After polymerization of collagen fibrils by adhesive this creates an intermingled layer of collagen + resin called the:

A

hybrid layer

117
Q
  • the key for dentin bonding
  • the base for all composite restorations
A

hybrid layer

118
Q

stability and longevity of composite restorations relies on the stability of:

A

hybrid layer (collagen + adhesive resin)

119
Q

agents that bond (micro mechanically and/or chemically), the restorative material (or luting agent) to tooth substrate through an interface:

A

adhesive systems

120
Q

What adhesive technique would you use for a class I-VI carious lesion, traumatic defects and the esthetic restorations such as full or partial resin veneers

A

direct restoration

121
Q

The primer in an adhesive system is _____ while the adhesive bonding resin/agent is ___

A

hydrophilic; hydrophobic

122
Q

In the polymerization process, what are the 3 steps?

A
  1. adhesive/primer (involves a chemical reaction)
  2. reaction (activator converts initiators into a free radical that starts the polymerization reaction)
  3. Light
123
Q

Our light activator in the polymerization process is _____ and our initiator is ___ & ___

A

activator= blue light

initiator- camphoquinone (photosensitized) and DMAEMA (amine)

124
Q

self-etch (compared to etch and rinse) is good for:

A

dentin

125
Q

self etch is not chemically compatible with:

A

dual cure composites

126
Q

A material containing atlas two components (phases) with distinct chemical and physical properties that after blended show unique and SUPERIOR properties as compared to the individual components:

A

Composite

127
Q

Tooth-colored restorative material containing an organic resin matrix phase (monomers) reinforced by dispersed filler particles phase bound to the resin by a silane coupling agent and initiator-accelerator system:

A

Dental composite

128
Q

What is the coupling agent in dental composite?

A

silane

129
Q

What is the organic phase of dental composite?

A

resin matrix

130
Q

What is the inorganic phase of dental composite?

A

fillers

131
Q
  • tooth-colored restorative material (direct or indirect restorative technique)
  • bonding agents (filler may be present)
  • composite resin luting agents (cement)
  • resin-modified glass ionomer materials
  • light -activated liner mateirals
  • CAD/CAM blocks
  • resin endo sealers
A

reasons you would use dental composite

132
Q

Components of dental composite include: (5) RFCAP

A
  1. resin matrix
  2. filler particles
  3. coupling agent
  4. activator-initiator system
  5. pigments and other components
133
Q

Bis-GMA and UDMA are types of:

A

resin matrix

134
Q

Describe resin matrixes Bis-GMA and UDMA: (3)

A
  1. high molecular weight monomers- diluents necessary (bisGMA)
  2. low viscosity
  3. low flexibility
135
Q

TEGDMA is a resin matrix that is a high fluid monomer and used as a diluent for high molecular monomers such as BisGMA.

The amount of TEGDMA =

A

polymerization shrinkage

136
Q

Bis-GMA, UDMA, and TEGDMA are all:

A

difunctional monomers

137
Q

The 2 reactive ends of difunctional monomers (Bis-GMA, UDMA, and TEGDMA) all for:

A

cross-linking

138
Q
  • Crystalline silica (quartz)
  • Ba
  • Li
  • Al silicate glass
  • amorphous silica

These are all

A

filler particles

139
Q
  • dispersed resin matrix
  • distribution varies depending on the material
  • percent expressed by weight or by volume
A

filler particles

140
Q

The benefits for filler particles include:

  1. reinforcement of ___
  2. DECREASED ____
  3. DECREASED ___ and ____
  4. ______ control
  5. DECREASED ____
  6. INCREASED ____
A
  1. resin matrix
  2. polymerization shrinkage
  3. thermal expansion and contraction
  4. viscosity
  5. water sorption
  6. radiopacity
141
Q

Bond between the two phases of the composite:

A

coupling agent

142
Q

Silane functions as:

A

coupling agent

143
Q

strongly binds the filler to the resin matrix:

A

interfacial bridge (from coupling agent)

144
Q

Allows for better stress distribution between resin matrix and filler particles:

A

coupling agent (silane)

145
Q

Improves the mechanical properties and decreases the water sorption along filer-resin interface:

A

coupling agent (silane)

146
Q

Composites must be converted from monomers to polymers, and this processes is triggered by ____ from ____

A

free radicals from chemical activation, heat or light

147
Q

Activator = tertiary amine
Initiator = benzoyl peroxide

together these = free radicals

A

chemical or self-cure

148
Q

activator= blue light (465nm)
initiator= camphorquinone (photosensitized) and DMAEMA (amine)

together these = free radicals

A

light-cured

149
Q
  • prevents spontaneous polymerizaton
  • stops polymerization from brief room light exposure (reacts with free radicals)
A

Polymerization inhibitor

150
Q

Once the blue light is used, all the inhibitor is quickly consumed =

A

polymerization chain reaction starts

151
Q

What increases the shelf-life of the composite resins?

A

polymerization inhibitor

152
Q

Butylated hydroxytoluene (BHT) and Hydroquinone are both:

A

polymerization inhibitors

(BHT is a food preservative that reduces oxidation)

153
Q

Optical modifiers = (2)

A

pigments and opacifiers

154
Q

metal oxides=

A

pigments

155
Q
  • titanium an aluminum oxide
  • control opacity or translucency
  • brand difference
  • dentin vs. enamel composite shades
A

opacifiers

156
Q

Composites are classified based on:

A
  1. filler particle size and distribution
  2. handling characteristics
  3. type of polymerization
157
Q

Classification by filler wise and distribution (categories: 4)

A
  1. macrofill
  2. midfill
  3. microfill
  4. hybrids
158
Q

The hybrids of fillers =

A
  1. midi-micro hybrid
  2. mini-micro hybrid
  3. mini-nano hybrid
159
Q

What category of fillers are not really used much today due to rough surface finish, not good size distribution, and prone to staining:

A

macro & midfill composites

160
Q
  • 0.01-0.1 micrometers, colloidal silical 40-60% weight
  • excellent finish
  • low mechanical hardness surface properteis
  • use for esthetic, low-stress sites (class 3, layer over hybrid, kit systems)
A

Microfill composite

161
Q
  • high strength
  • universal composites for anterior and posterior
A

hybrid composites

162
Q
A

Operative II (6 decks)

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