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Operative > Midterm > Flashcards

Midterm Flashcards

1
Q

Four number instrument formula is for -

A

margin trimmers

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2
Q

What does each number mean of the four number instrument formula

A

15 = 1.5 mm width
98 = angle of edge to long axis of handle
10 = 10 mm blade length
14 = angle of blade to long axis

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3
Q

Composition of hand instruments

A

Stainless steel:
Resists corrosion
Dulls easily (need to keep instruments sharp)

Carbon steel:
Corrodes
Holds sharpness

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4
Q

most common excavator used

A

Spoon excavator

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5
Q

Hand cutting instruments

A

Includes: chisels, hatchets, hoes, gingival margin trimmers, excavators, carvers

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6
Q

Straight or curved
1, 2, or 3 angles

A

Chisels

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7
Q

Cutting edge = in plane parallel with handle
1 or more angles
Do not use with too much force or twist (can easily break)

A

Hatchets

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8
Q

Cutting edge is ⟂ to handle

A

Hoes

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9
Q

Similar to hatchet, but has curved blades
Cutting edge is at angle to length of blade

A

Gingival margin trimmer

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10
Q

Remove caries

A

Excavators

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11
Q

Place anatomy

A

Carvers (Hollenback, cleoid, discoid)

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12
Q

Used to place, condense, and carve restorative materials back to normal anatomy of teeth
Primarily made of stainless steel

A

Restorative instruments

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13
Q

Restorative instruments

A

Includes: amalgam carrier, condensers, burnishers, carvers, amalgam knife, composite placement instruments

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14
Q

Can be used to carry pliable restorative material to prepped cavity, although typically placed directly by composite gun
Used to shape material

A

Plastic instruments

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15
Q

Shaft/handle can be

A

Small, medium, large
Smooth or serrated

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16
Q

Shank

A

Connects handle to blade
Straight or angled
(Angled for access and stability)

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17
Q

Blade

A

Working part of the instrument
Beveled to create cutting edge-Can have 3 bevels
Primary cutting edge on end
Secondary cutting edge on sides

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18
Q

Ends to Hand instruments

A

double ended, or long handle with one working end
(Some probes, explorers, and mirrors have a single working end)

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19
Q

3 categories of sterilization types:

A

critical, semi-critical, non-critical

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20
Q

Critical =

A

penetrates soft tissue or bone
(Example: forceps)
Autoclave (most commonly used heat sterilizer in dentistry)

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21
Q

Semi-critical =

A

do not penetrate, but contacts mucous membranes or non-intact skin
(Example: mirrors)
Autoclave or use high level EPA sterilant/disinfectant

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22
Q

Non-critical =

A

comes in contact only with intact skin
Example: blood pressure cuff
Intermediate or low level disinfectant

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23
Q

Class I caries =

A

most prevalent
Caries affecting pits and fissures on:
Occlusal ⅓ of molars and premolars
Occlusal ⅔ of B & L surfaces of molars and premolars
L surface of upper anterior teeth
Any other unusually located pit or fissure

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24
Q

Pit/fissure lesions are more constricted at enamel surface and wider toward DEJ

A

Class I caries

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25
Q

Class II caries:

A

Caries affecting proximal surfaces:
Molars and premolars

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26
Q

Smooth surface interproximal lesions are generally wider at enamel surface

A

Class II caries

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27
Q

Class III caries

A

Caries affecting proximal surfaces of:
Central and lateral incisors
Cuspids without involving incisal angles

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28
Q

Class IV caries

A

Caries affecting proximal surfaces including incisal angles of anterior teeth

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29
Q

Class V caries

A

Caries affecting gingival ⅓ of facial or lingual surfaces of:
Anterior teeth
Posterior teeth

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30
Q

Class VI caries =

A

least prevalent
Caries affecting cusp tips of:
Molars
Premolars
Cuspids

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31
Q

Tooth surface loss from frictional forces

A

Abrasion

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32
Q

Tooth surface loss from chemico-mechanical action

A

Erosion

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33
Q

Mechanical wear from opposition teeth (grinding)

A

Attrition

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34
Q

Cervical, wedge-shaped defects as result of strong eccentric occlusal forces

A

Abfraction

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35
Q

Can be most difficult and challenging defects in teeth to diagnose and treat
Can be considered incomplete or complete; involving pulp or not involving pulp

A

Fracture

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36
Q

Loss of mineral from tooth structure, resulting from a chemical process (can be from caries, acid, diet, or gastric)

A

Demineralization

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37
Q

Breakdown of surface integrity that can be detected using optical or tactile methods

A

Cavitation

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38
Q

Can be confined to enamel or extend into dentin via tubular invasion
Can include differing layers of infected and affected dentin
Caries penetrate in a narrow or cone shaped channel to DEJ then spread laterally

A

Cavitation

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39
Q

Irreversible, demineralized, and denatured layer with bacterial invasion
Very soft, moist, and easy to remove with spoon excavator

A

Infected dentin

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40
Q

Partially demineralized
leathery/softer than normal
Collagen is not denatured
Contains minimal to no bacteria

A

Affected dentin

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41
Q

Outline =

A

external shape of prep

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42
Q

Visualize extent of caries
Allows bur to reach all carious dentin
Creates space for instrumentation and vision

A

Access to lesion

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43
Q

Extend outline to include all unsupported enamel
Enamel rods must be supported by sound dentin!

A

Extent of lesion

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44
Q

Carious dentin can have sound overlying dentin
Undermined enamel is usually removed

A

Lateral spread of caries at DEJ

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45
Q

Extent of caries in dentin determines

A

preparation size

46
Q

Brittle materials require

A

90° cavosurface margin (amalgam or porcelain)

47
Q

Ductile materials require

A

beveling of margin (composite or gold)

48
Q

Do not leave – on margin of restoration EVER

A

occlusal contact
(Thereshould not be a contact mark on the margin if the margin is enamel)

49
Q

= shape that allows access (allows needed procedure to be performed) (Influences outline form also)

A

Convenience form

50
Q

= shape given to prep to prevent fracture of either the restoration or tooth
Examples: adequate bulk of amalgam, rounding of internal line angles, horizontal pulpal and gingival floors prepared ⟂ to tooth’s long axis

A

Resistance form

51
Q

Margins, 90 degrees to tooth -
Pulpal floor 1.5-2.0 mm -
Rounded internal angle -

A
  • resists fracture at cavosurface margin
  • helps resist restoration fracture
  • resists internal stress
52
Q

Prep is placed – into dentin (not including enamel) for 3 reasons:

A

0.5mm
Avoid sensitive DEJ
Provide adequate bulk of restorative material
Take advantage of dentin’s resilience

53
Q

= shape that prevents restoration from being displaced by tipping or lifting forces

A

Retention form
(Includes undercuts, truncation, grooves, pits, dovetails, etc)

54
Q

Primary retention
Comes from

A

converging walls (sometimes dovetail)

55
Q

Secondary retention
Helps retain restoration in case primary retention fails
Includes:

A

grooves, coves, extensions, skirts, beveled margins, pins, slots, steps, amalgam pins, etchants, adhesives (sometimes dovetail)

56
Q

Note: must ALWAYS have –; – is needed when indicated

A

primary retention
secondary retention

57
Q

In many respects, – and - are accomplished at the same time

A

retention form
resistance form

58
Q

= touches uncut surface/cavosurface margin

A

External wall

59
Q

= does NOT touch uncut surface/cavosurface margin

A

Internal wall

60
Q

= rotary cutting instrument with bladed cutting head

A

Bur

61
Q

Bur: Most have carbide head to steel neck
Carbide =
Steel =

A

-stiffer and stronger than steel; holds up better at high speeds, less prone to dull
- allows for decreased cost of fabrication and freedom in design

62
Q

What has an Arbitrary 2 part numeral code indicating size and shape

A

Bur

63
Q

What type of bur

Initial entry into tooth
Expansion of prep
Retention features
Caries removal

A

Round

64
Q

What type of bur

Rapidly tapered cone with apex of cone directed toward shank
Head length = head diameter
Undercuts in tooth prep

A

Inverted cone

65
Q

What type of bur

Slightly tapered cone with small end of cone directed toward shank
245 = elongated bur for amalgam preps
330 = small version of 245

A

Pear

66
Q

What type of bur

Elongated cylinder

A

Straight fissure

67
Q

What type of bur

Slightly tapered cone with small end of cone directed away from shank
Used for indirect restorations

A

Tapered fissure

68
Q

Parts of bur

Fits into handpiece
Accepts rotary mutation from handpiece
Provides bearing surface to control alignment and concentricity of instrument

A

Shank

69
Q

5 classes of shanks, but 3 are important to us:

A

Straight
Right angle latch
friction grip

70
Q

Class of shank

Rarely used for prepping teeth
Used for oral surgery
Used for polishing indirect restorations

A

Straight

71
Q

Class of shank

Used in slow speed handpieces
Fits into D-shaped socket at bottom of bur tube instead of a chuck

A

Right angle latch

72
Q

Class of shank

Used in high speed handpieces
Small size allows for improved access with molars
Held in place using friction between shank and chuck within handpiece

A

Friction-grip

73
Q

Part of bur

Intermediate portion that connects head to shank
Tapers from shank diameter to smaller size adjacent to head
Function = transmits rotational and translational forces
Smaller toward head to improve access and visibility

A

Neck

74
Q

Part of bur

Working part of instrument
Cutting edges or points that perform desired shaping of tooth structure
Greatest area of variability based on intended application and technique

A

Head

75
Q

Primary retention feature for amalgam =
Secondary retention feature for amalgam =

A

converging B and L walls
retention grooves and dovetails

76
Q

Class I prep design
Class I =

A

pit and fissure prep

77
Q

Dovetails = retentive feature
Considered primary if–
Considered secondary if -

A

part of inclusion of B/L grooves
not part of initial prep design, but as part of extension feature

78
Q

Class I prep design
Width = – of intercuspal distance
Minimizes tooth structure loss
Facilitates carving for amalgam restorations
Minimizes occlusal interferences

A

⅕ to ¼ (1.0 mm)

79
Q

Class I prep design
Centered on central groove (–)
B to L width = no more than 1.0 - 1.5 mm (–)
Marginal ridges = 1.5 mm (–)
Pulpal floor is flat and ⟂ to long axis of tooth (–)

A

outline form
outline form
outline form
resistance form

80
Q

Pulpal floor is flat and ⟂ to long axis of tooth (resistance form)
At right angle to direction of occlusal forces
Helps resist–

A

fracturing/shearing forces

81
Q

Narrow anatomic part/passage connecting 2 larger structures
Created by preparing occlusal width/outline
Faciolingual extension
Contributes to retention and resistance form

A

Isthmus

82
Q

Class I prep
Pulpal floor is deep enough to allow at least –of restorative material (resistance form)

A

1.5mm

83
Q

Class I prep
Placed just into dentin to avoid sensitivity at –
Need minimum of –to prevent fracturing of restoration
Lesions shallower than 1.5 mm are generally – (cavitation vs no cavitation)
Lesions extending 1.5mm indicates it has reached –
Need at least 1.5mm of restorative material, or it may not resist occlusal force (may fracture!)

A

DEJ
1.5mm
enamel-only lesions
DEJ

84
Q

Class I prep
All cavosurface angles should be at a

A

right angle (90°)

85
Q

Class I prep
All line and point angles should be – to avoid stress concentrations (resistance form)

A

rounded, but defined,

86
Q

Class I Prep
B and L walls – (retention form)
Creates acute angle with pulpal floor
Provides primary retention

A

CONVERGE pulpo-occlusally
(Approximately 6° convergence)

87
Q

Class I prep
M and D walls –(resistance form)
Creates obtuse angle with pulpal floor
Prevents undermining of marginal ridge

A

DIVERGE pulpo-occlusally

88
Q

Once you start carving, you – add to amalgam

A

CANNOT

89
Q

Instruments used for amalgam occlusal anatomy
Steps

A

Condenser
Egg burnisher
Acorn burnisher
Cleoid/discoid
Refine with acorn burnisher

90
Q

3 P’s of prevention

A

Postural awareness
Positioning strategies (dentist, patient and light)
Periodic stretching and exercise

91
Q

– are soft-tissue injuries caused by sudden or sustained exposure to repetitive motion, force, vibration, and awkward positions
These disorders can affect the muscles, nerves, tendons, joints and cartilage in your upper and lower limbs, neck and lower back

A

Musculoskeletal disorders (MSDs)

92
Q

Pro/Con
Lathe-cut

A

Irregular in shape so higher packing forces needed during condensation
Minimal material related post op sensitivity

93
Q

Pro/Con
Spherical alloy

A

Lower condensation pressure require to achieve same strength
Shorter working time, fast set, and high early strength
Greater risk of post op sensitivity

94
Q

Advantage: you could work on the tooth the same day after restoring it with this type of amalgam

A

spherical alloy

95
Q

Pro/con
Admixed (lathe-cut + spherical alloy all together)

A

This is the type of amalgam we have!
Combine best of both geometries
High Packing pressure with small condensers still required
Positive interproximal contact obtained
Slightly faster setting
Low post op sensitivity

96
Q

Overall disadvantages of alloy

A

Not esthetic
Low tensile strength in thin sections under masticatory forces
It does not bond to tooth structure
Utilizes mercury

97
Q

= metallic restorative material composed of a mixture of silver-tin alloy and mercury

A

Dental amalgam

98
Q

Mercury in amalgam, and if it creates medical issue for patients

A

FDA says “Removing intact amalgam fillings results in unnecessary loss of healthy tooth structure and a temporary increase in exposure due to additional mercury vapor released during the removal process”
Subject of intense research and been found to be safe and beneficial as a direct restorative material

99
Q

Benefits of amalgam as a restorative material

A

Successful as long lasting restorative material
More resistant to recurrent caries as compared to bonded composite resin restorations
Ideal for large restorations and when subsequent addressing of pulpal health is needed before a definitive restoration
Used as a foundation/core for badly broken down teeth that need extra retention and resistance forms in anticipation of crown placement
High mechanical properties - compressive strength, rigidity, and wear resistance
Packable insertion to provide positive proximal contact and intimate cavity adaptation
Carvable with hand instruments after insertion to provide optimal contour, surface, and occlusion
Self sealing properties over time

100
Q

Purpose of – to preserve the cusp and and triangular ridge and also facilitates the formation of a 90 degree cavosurface margin that creates a place of limited undermined enamel

A

reverse S curve

101
Q

Where are class II carious lesions found in relation to contact point?

A

Class II caries are located just apical to contact point

102
Q

Purpose and functions of matrix bands

A

For class II, matrix band replaces the missing proximal wall

103
Q

– slightly separates teeth to compensate for thickness of matrix band
Protects gingival tissue/rubber dam during prep
Seals matrix against gingival floor to avoid overhang of amalgam

A

Wedge

104
Q

Parts of Tofflemire matrix retainer: Use outer nut to –
Use inner nut to –
Matrix band is placed through one of the –

A

lock matrix into retainer
adjust size of matrix
slotted guides

105
Q

Tofflemire matrix retainer should

A

parallel the arch

106
Q

– = achieves smooth surface (pre-polish)
– = creates lustrous polish
– = creates high polish

A

Brownie polisher
Greenie polisher
Supergreenie polisher

107
Q

– = process of removing surface defects/scratches created during contouring process through use of cutting or grinding instruments (or both)
– = most refined of the finishing processes; removes finest surface particle

A

Finishing
Polishing

108
Q

How to cause mercury to rise to surface of amalgam restoration

A

During polishing, heat is created
Heat brings mercury to the surface of the restoration, which results in a dull, cloudy surface, and a surface that is more susceptible to corrosion

109
Q

How long should you wait before finishing and polishing amalgam restorations?

A

At least 24 hours after it has been placed and carved

110
Q

What is required for the development of caries?

A

Primary modifying factors + secondary modifying factors + host + cariogenic biofilm + time + fermentable carbohydrates = caries

111
Q

Bacteria responsible for caries formation

A

Streptococcus mutans

Operative (2 decks)

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