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Adult Restorative > Modification of Cavity Form for Different Materials > Flashcards

Modification of Cavity Form for Different Materials Flashcards

1
Q

Describe caries infected dentine

A
  • Deminerlisation of dentine
  • Denaturing of collagen
  • Irreversible
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2
Q

Describe caries affected dentine

A
  • Demineralisation of dentine
  • No denaturing of collagen
  • Reversible
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3
Q

What are the aims when removing enamel as you try to remove caries

A
  • Gain/widen access to caries
  • Remove unsupported prisms
  • Remove demineralised margins
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4
Q

What are the aims when removing dentine as you try to remove caries

A
  • Identify caries infected dentine
  • Identify peripheral extent to EDJ
  • Excavate CID peripherally then towards pulp (anatomical)
  • Excavate CID in depth (histological)
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5
Q

After Caries infected dentine has been removed what is the next step in caries removal

A

Considering whether more carious dentine removal is necessary

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6
Q

If you do want to remove more carious dentine what reasons might there be to do so

A
  • Poor quality peripheral enamel precluding seal
  • Inadequate moisture control at margin precluding seal (e.g. at gingival margin)
  • Symptoms of pulpitis
  • High caries risk
  • Further structural support needed
  • CONSIDER DIRECT/INDIRECT PULP CAPPING
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7
Q

Give examples of ways that we can carry out cavity modification

A
  • Rounded internal line angles
  • Increase surface area of enamel margins (bevel)
  • Chemical modification of cavity walls (acid etch/conditioners)
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8
Q

What reasons might you have to not remove any further dentine after CID removal

A
  • Remaining CAD retained
  • Good quality/quantity of peripheral enamel
  • Good moisture control at cavity margin
  • Further excavation may make tooth unrestorable
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9
Q

Why should we restore teeth

A
  • To remove diseased tissue
  • To restore integrity of tooth structure
  • To restore function of tooth
  • To restore appearance of tooth
  • To prevent recurrence of caries (microleakage)
  • To provide durability and longevity
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10
Q

What factors determine cavity design

A
  • Structure and properties of dental tissues
  • Extent and nature of dental diseases
  • Properties of proposed restorative material
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11
Q

What can we do to modify a cavity on a macroscopic level

A
  • Created using a bur

- Air rotor for slow handpieve

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12
Q

What can we do to modify a cavity on a microscopic level

A
  • Created chemically

- Tissue conditioning

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13
Q

What is retention

A

The property of a cavity/restoration that resists displacement of a restoration in the direction of its insertion

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14
Q

What is resistance

A

The property of a cavity/preparation that prevents displacement of a restoration in apical or oblique directions (other directions)

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15
Q

What is the cavo-surface angle

A

This is the angle between the internal surface of the cavity of the tooth and the surface of the tooth

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16
Q

What is a line angle

A

This is the angle between 2 surfaces

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17
Q

What is an internal point angle

A

This is where 3 sides meet

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18
Q

What kinds of external walls can there be in a cavity

A

Distal

Facial

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19
Q

What kinds of internal walls can there be in a cavity

A

Pulpal

Axial

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20
Q

What are direct and indirect restorations

A

Direct - placed directly into the tooth

Indirect - Placed, but made or fabricated in an external lab

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21
Q

What are the basic properties/features of direct restorations

A
  • Plastic
  • Mouldable
  • Various physical properties
  • Complex restorations
22
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

Made in lab and cemented/luted chairside

23
Q

Why do you want rounded internal line angles for all restorative materials

A

Reduces internal stresses and risk of crack propagation within restoration

24
Q

What cavity mods are ideal for amalgam restorations

A
  • Cavity undercuts
  • Grooves
  • Slots
  • Flat surfaces
25
Q

What do undercuts, grooves/slots and flat surfaces allow in amalgam restorations

A

Undercuts = give retention
Grooves/slots = Prevent further displacement
Flat surface = improves resistance

26
Q

What cavity modifications are ideal for composite/GICs

A

Enamel margin bevel

27
Q

What does the enamel margin bevel allow for in composite/GICs restorations

A
  • Removes unsupported enamel
  • Increases surface for bond/seal
  • Sound enamel for optimised bonding
28
Q

What micro cavity mod is ideal for composite restorations

A

Enamel acid etch

29
Q

what does the enamel acid etch do for composite restorations

A
  • Removes the smear layer

- Selectively demineralises prisms giving micro-mechanical retention

30
Q

What micro cavity mods are ideal for GIC restorations

A

Dentine conditioner

31
Q

What does dentine conditioner allow for GIC restorations

A
  • Removes smear layer

- Prepares surface for Ca2+ chemical adhesion

32
Q

Name some of the basic properties of an amalgam restoration

A
  • High strength (2mm+)
  • Electrochemical corrosion = nice marginal seal
  • High elastic modulus
  • Dimensionally stable
  • No inherent bonding to tooth substrate
33
Q

What angle should the cavo-surface angle be for an ideal amalgam restoration

A

about 90 degrees

34
Q

What are some examples of auxillary retention cavity mods for amalgam and dat when there aren’t alot of cusps left to form the undercuts and all

A
  • Slots
  • Grooves
  • Coves
  • Locks
35
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

The amalgam slots need to be undercut as well to provide retention as well as resistance

36
Q

Do coves offer resistance and/or retention

A

Offers both in almost all directions

37
Q

What are locks

A

grooves cut in a vertical direction

38
Q

Name some basic properties/characteristics of composite restorations

A
  • Good aesthetics
  • Bonds to dental substrates
  • More conservative tooth preparation
  • No corrosion
  • Slightly less durable than amalgam
  • Lower modulus of elasticity
  • Technique sensitive
39
Q

What macroscopic cavity mods might you need for composite restorations

A

(undercuts, slots and grooves, cavosurface angle, flat surface)

ENAMEL MARGIN BEVEL

40
Q

What microscopic cavity mods might you need for composite restorations

A
  • 37% orthophosphoric acid etch + prime/bond
  • Removes smear layer in dentine
  • Selectively demineralises enamel prisms
  • Creates micromechanical undercuts for resin to engage
  • Creates one of the strongest bonds in dentistry
41
Q

What is the purpose of doing the enamel margin bevel for composite cavities

A
  • Removes unsupported enamel
  • Increases surface area
  • Aesthetics
42
Q

What does etching do to the enamel in composite cavity mods

A

Selectively demineralising some enamel prisms that creates a very rough microscopic surface that allow the composite to bond better

43
Q

What is a hybrid layer of dentine in the composite cavity mods and how is it made

A
  • Demineralised resin-impregnated dentine
  • Etching removes smear layer
  • Demineralises intertubular dentine, exposing collagen
  • Demineralises intratubular dentine
  • Allows resin to flow into the tubules
44
Q

Is the composite-dentine or the composite-enamel layer stronger

A

Composite-enamel is deffo stronger but the dentine one is still strong

45
Q

What is the sequence of processes that occur in composite cavity mods

A
  • Acid etch
  • Primer
  • Bonding
46
Q

So describe the process of acid etching in composite cavity mods

A
  • Phosphoric acid (37%)
  • Demineralises prisms and = rough surface in enamel
  • Removes smear layer in dentine and demineralises intertubular dentine and makes collagen scaffold
  • Micromechanical mods
47
Q

Describe the process of priming

A
  • EDTA/Acid based
  • Further conditions dentine
  • Optimises surface for bonding
48
Q

What are some of the properties of GICs as a restorative material

A
  • Lower fracture strength vs composite and amalgam
  • Less tough (prone to wear)
  • Poorer aesthetics
  • Inherent (chemical) bond to dental substrates
  • Fluoride release
49
Q

What does a dentine conditioner do for GIC fillings

A

Removes smear layer and optimises dentin for ion exchange to allow for chemical bonding of GIC

50
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

10% polyacrylic/citric acids

51
Q

Describe how GICs adhere to a tooth

A
  • Ions exchanged between tooth minerals and cement
  • On mixing, free polyalkenoic acid penetrates enamel/dentine
  • Displaces Ca2+ and PO4-
  • Combine with cement matrix to form ion-enriched layer between tooth and cement
  • Rich in F-

Adult Restorative (14 decks)

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