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D1 Spring > OP 1 Final > Flashcards

OP 1 Final Flashcards

1
Q

shape of the preparation itself

A

outline form

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2
Q

What do these 4 factors establish?

  1. Access to the lesion (allows to visualize extent of caries and for burs to reach all carious lesions)
  2. Extent of the lesion (the extent of the caries in the dentin is what ULTIMATELY determines the preparation size)
  3. Restorative material to be used (ie amalgam or porcelain need a 90 degree cavosurface margin but composite or gold need a beveling of the margin)
  4. Esthetics
A

Outline form

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3
Q

T/F Outline form should be made so that occlusal contact NEVER hits the margin of the restoration

A

True

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4
Q

shape given to the prep to prevent fracture of either the restoration or the tooth

A

resistance form

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5
Q

What are these 3 things examples of?

  1. adequate bulking of amalgam
  2. rounding of internal line angles
  3. horizontal pulpal and gingival floors being prepared perpendicular to the tooth’s long axis
A

resistance form

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6
Q

Why is the prep placed 0.5 mm into the dentin?

A
  1. Avoid the sensitive DEJ
  2. Provide adequate bulk of restorative material
  3. Take advantage of the dentin’s resilient nature
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7
Q

What prevents fracture?

A

Resistance form

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8
Q

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

A

retention form

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9
Q

What are these 5 things examples of?

  1. undercuts
  2. truncations
  3. grooves
  4. pins
  5. dovetails
A

Retention form

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10
Q

What prevents displacement?

A

Retention form

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11
Q

What will come from converging walls, and sometimes the dovetail?

A

Primary retention

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12
Q

What helps retain the restoration in case the primary retention fails?

A

Secondary retention

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13
Q

What are these 11 things examples of?

  1. grooves
  2. coves
  3. extensions
  4. skirts
  5. beveled margins
  6. pins
  7. slots
  8. steps
  9. amalgam pins
  10. etchants
  11. adhesives
A

Secondary retention

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14
Q

What can also sometimes be considered a secondary retention factor?

A

Dovetails

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15
Q

shape that allows the needed procedure to be performed

A

convenience form

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16
Q

what allows for vision, access, etc. and is what influences the outline form itself?

A

convenience form

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17
Q

Why do amalgam preparations tend to have to have a few extra things done to them in order to be appropriate?

A

Amalgam does not directly adhere to the tooth

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18
Q

Because amalgam does not directly adhere to the tooth, what is usually necessary in order to maintain proper strength of amalgam restorations?

A

expansions of the prep

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19
Q

T/F Although dovetails are always beneficial on any preparation, they are VERY important for amalgam

A

True

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20
Q

What do amalgam preparations for class IIs require in order to minimize undermined enamel rods?

(while with composite, it is not necessary)

A

Reverse S curve

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21
Q

What is very vital in order to have maximal strength in amalgam restorations?

A

Compacting

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22
Q

T/F Amalgam does not need to be triturated to activate

A

FALSE, amalgam must be triturated in order to activate!!

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23
Q

T/F Amalgam cannot be added onto set amalgam and must be redone if necessary

A

True

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24
Q

Amalgam cannot be polished/finished until at least ____________ after placing placing (use _________ first and then ________; on slow speed); Has _______ tensile strength.

A

24 hours; brownie; greenie; low

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25
Q

T/F Composite preparations usually have a more conservative outline

A

True

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26
Q

What is NOT necessary for class II composite preps that is necessary for class II amalgam preps?

A

Reverse S curve
Axial wall retention grooves

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27
Q

What is the retention form in class II composite preps?

A

Converging walls (primary)
Adhesive system (secondary)

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28
Q

T/F Composite restorations tend to be weaker and are not the best choice for posterior teeth

A

True

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29
Q

What is more prevalent and can progress more rapidly in composite restorations?

A

Recurrent/secondary caries

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30
Q

What is the longevity of a composite restoration in comparison to an amalgam restoration?

A

1/2 the longevity of amalgam

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31
Q

What is necessary for composite, but NOT necessary for amalgam?

A

Etching
Curing light

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32
Q

T/F Composite CAN be added to composite unlike with amalgam, and finishing/ polishing can be done immediately with composite unlike amalgam

A

True

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33
Q

the process of curing monomers being converted from an aggregate of freely flowing molecules to a rigid assembly of cross-linked polymer chains

A

polymerization

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34
Q

What results in a substantial volume contraction during curing?

A

Polymerization

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35
Q

The higher the degree of conversion, the higher the ________________ _____________

A

polymerization shrinkage

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36
Q

The higher the ___________ ____________, the lower the polymerization shrinkage

A

filler content

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37
Q

Polymerization shrinkage with bonding can cause ___________ at the restorative interface. The more tension, the higher the likelihood of ____________ _____________

A

tensions; post-op sensitivity

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38
Q

Incremental placement of composite should be done __________ to avoid opposite walls in roughly _________ increments

A

obliquely; 2mm

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39
Q

What is the exception when it comes to recommended thickness of composite increments?

A

Box of a class II prep

(should be a roughly 1mm horizontal placement first before doing the standard oblique 2mm rule afterwards)

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40
Q

The interaction between two dissimilar metals and saliva; causes an electric shock to occur

A

Galvanic sensitivity/shock

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41
Q

A gold crown touching an amalgam restoration or aluminum foil touching amalgam

A

Galvanic sensitivity/shock

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42
Q

Pain, increased odds of restoration fracture AND/OR tooth fracture, increased sensitivity, periodontal issues around finished tooth, TMJ/TMD problems, root canal, unhappy patients

A

Clinical manifestations of hyperocclusion

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43
Q

Reasons for post-op sensitivity (6)

A
  1. Aggressive tooth preparation (ex: inadequate use of a cooling system, inefficient cutting instruments, & deep preps getting closer to more open dentinal tubules)
  2. Lack of adequate condensation of amalgam, ESPECIALLY with lateral condensation of proximal boxes
  3. Incorrect use of adhesive systems; ie using it for too long of a time (enamel and dentin have different etching times)
  4. Not using a liner or base when indicated
  5. Formation of microgaps from restoration shrinkage
  6. Aggressive finishing of restoration
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44
Q

Ways to prevent post-op sensitivity (3)

A
  1. Be mindful of the tooth preparation and the systems that you are using!! (for example, make sure to use etchants properly or a desensitizer solution after dentin acid etching)
  2. Add composite incrementally to reduce polymerization shrinkage
  3. Be careful with finishing/polishing restorations
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45
Q

T/F Traumatic occlusion is NOT an initiating factor, but can be a CONTRIBUTORY factor to periodontal disease

A

True

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46
Q

Trauma from occlusion has been linked to higher risk of what?

A

Furcation involvement

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47
Q

What is the main type of acid used in enamel etching?

A

Phosphoric acid (35-37%)

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48
Q

GI Conditioner is usually composed of what?

A

Polyacrylic acid

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49
Q

Composite curing is ________ activated, with dentistry using ______ light

A

light; blue

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50
Q

What occurs when light is placed on the composite?

A

Polymerization

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51
Q

Polymerization shrinkage related to bonded and unbonded surfaces follows what?

A

The cavity geometric configuration system, or C-factor

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52
Q

The higher the C-factor, the higher the __________

A

stresses

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53
Q

C-factor can be found by ?

A

Bound surfaces/unbound surfaces

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54
Q

What is the C factor in a class I?

A

5

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55
Q

What is the C factor in a class II?

A

2

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56
Q

What is the C factor in a class V or sealant?

A

0.2

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57
Q

Contraindications of resin (5)

A
  1. Allergy
  2. Replacement of cusps
  3. Large restorations on those with bruxism or where occlusal stress would be on restoration
  4. High caries risk (pt. noncompliance)
  5. When rubber dam isolation is not possible
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58
Q

Contraindications of amalgam (3)

A
  1. When esthetics are high priority
  2. Extensive destruction of tooth
  3. Cavity is small (leading to unnecessary removal of tooth structure)
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59
Q

Which material tends to show better results with posterior teeth regarding a longevity prognosis?

A

Amalgam

60
Q

There is increasing evidence that properly accomplished posterior __________ ____________ restorations can be quite durable (up to 10 years)

A

resin composite

61
Q

Etching time for cut enamel

A

15-30 seconds

62
Q

Etching time for uncut enamel

A

45-60 seconds

63
Q

Etching time for dentin

A

No more than 15 seconds

64
Q

How long should you thoroughly rinse off etch?

A

10-20 seconds

65
Q

How long should you dry the surface with an air blast after thoroughly rinsing off etch?

A

5 seconds or longer, if needed

66
Q

What are you trying to accomplish when drying the surface with an air blast after thoroughly rinsing off etch?

A

Want to remove pooled water, but keep the dentin moist

(Do NOT overdry - collapse of collagen fibers can lead to suboptimal resin infiltration)

67
Q

What is the purpose of etching?

A

To create microscopic roughness that increases surface area and potential for surface interactions with the bonding agent

68
Q

What does etching cause specifically in dentin?

A

Dentin conditioning

69
Q

Etching causing dentin conditioning, in which it exposes bundles of _________ that allows the primer to infiltrate and turn it into a __________ substrate

A

collagen; hydrophobic

70
Q

What happens once dentin conditioning takes place?

A

Bond/resin can flow through the primed dentin and locked into place with curing

71
Q

T/F Some amount of microleakage after placing a restoration is to always be expected

A

True

72
Q

Small gaps or spaces that develop between the tooth and a restorative material.

This can allow things such as bacteria, fluids, molecules or ions to flow through if the space is large enough

A

Microleakage

73
Q

What is the best way to reduce marginal leakage in amalgam restorations?

A

Proper condensation

74
Q

What is the best way to reduce microleakage in composite restorations? (3)

A
  1. Proper application of bonding agents
  2. Proper preparation and cleaning of the tooth
  3. Incremental addition of material
75
Q

What are the main reasons that microleakage occurs in composite restorations?

A

Polymerization process and shrinking

76
Q

What is the most ideal contact angle of adhesive?

A

0 degrees

77
Q

Smooth surface interproximal lesions are generally ___________ at the enamel surface and ____________ as it reaches dentin

A

wider; narrower

78
Q

Pit/fissure lesions are ___________ at the enamel surface and __________ as they get towards the DEJ

A

narrower; wider

79
Q

Caries affecting pits and fissures on occlusal 1/3 of molars and premolars, occlusal 2/3 of molars and premolars, and lingual part of anterior teeth

A

Class I

80
Q

Caries affecting proximal surfaces of molars and premolars

A

Class II

81
Q

Caries affecting proximal surfaces of central incisors, lateral incisors, and cuspids without involving the incisal angles

A

Class III

82
Q

Caries affecting proximal including incisal angles of anterior teeth

A

Class IV

83
Q

Caries affecting gingival 1/3 of facial or lingual surfaces of anterior and posterior teeth

A

Class V

84
Q

Caries affecting cusp tips of molars, premolars, and cuspids

A

Class VI

85
Q

Which caries classification is most and least common?

A

Most common = class I
Least common = class VI

86
Q

Enamel rods tend to lead ___________ and flatten as you get ___________(and ultimately slightly leaning apically towards the very end)

A

coronally; gingivally

87
Q

Occlusal preps need _____________ while with Class V preps you need slight ____________ (to prevent too much undermined enamel)

A

convergence; divergence

88
Q

What does lateral expansion of decay mean?

A

When a carious lesion reaches the DEJ, it will rapidly spread in a lateral fashion across it

89
Q

When do you use GI? (3)

A
  1. Class III restorations out of occlusion and do not pose esthetic concerns
  2. Pediatric dentistry
  3. Class V restorations that do not pose esthetic concerns
90
Q

When do you use amalgam? Why?

A

Posterior-occlusal restorations due to high longevity and ability to withstand occlusal forces

91
Q

When do you use composite?

A
  1. Restorations in esthetic regions
  2. Restorations that do not require large preps
92
Q

What can be used as a liner/base, sealant, luting agent, or as a restorative material?

A

GI

93
Q

What is the advantage of GI?

A

Releases fluoride and can be recharged

94
Q

What are the disadvantages of GI?

A

Low flexural strength, compressive strength, and tensile strength

95
Q

What is GI usually mixed with in order to have better longevity?

A

Resin

96
Q

What does RDT stand for?

A

Remaining dentin thickness

97
Q

What is the MOST important factor in maintaining pulpal health?

A

RDT (remaining dentin thickness)

98
Q

Why is RDT the most important factor in maintaining pulpal health?

A

Dentin has a very good buffering capacity (so no more than necessary should be removed!)

99
Q

The larger the RDT, the less likelihood of …

A

bacteria reaching the pulp

100
Q

What does ZOE stand for?

A

Zinc oxide eugenol

101
Q

What is ZOE used as?

A

A base in pulpal protection procedures

102
Q

ZOE is a _______ strength and _________ solubility base

A

low; high

103
Q

What can ZOE be used for?

A

Indirect pulp capping under amalgam or GI

104
Q

T/F ZOE can have occlusal contacts as a sedative restoration

A

FALSE

105
Q

What material can be left as a base if the tooth is asymptomatic for 14 days and be restored over with amalgam or GI?

A

ZOE

106
Q

T/F ZOE can be used under composite restorations

A

FALSE, it can NEVER be used under composite!!!

107
Q

Can ZOE be used in conjunction with adhesive dentistry?

A

NO

108
Q

Can ZOE be used a first layer for direct pulp capping?

A

NO, it can only be used for indirect pulp capping!

109
Q

What material is a liner used to assist in reparative dentin formation?

A

Dycal

110
Q

How should Dycal be applied?

A

In a very thin layer, less than 0.5 mm

111
Q

When is Dycal NOT needed?

A
  1. When secondary dentin is present
  2. Sclerotic changes have occurred
112
Q

When is Dycal needed?

A
  1. When you are within 1mm of pulp chamber
  2. When a pulp exposure has occurred
  3. When a pulp exposure has possibly occurred (pink dentin)
113
Q

T/F Dycal is a weak material and must be covered with a stronger material such as GI

A

True

114
Q

What is the most accepted theory of pain transmission?

A

Hydrodynamic theory

115
Q

What are dentinal tubules filled with?

A

Odontoblastic processes and dental fluid

116
Q

Small fluid movements arising from cutting, drying, pressure changes, osmotic shifts, or temperature changes distort odontoblasts and stimulate nerves

A

Hydrodynamic theory

117
Q

When are some clinical examples of when temporary restorations are needed? (6)

A
  1. Emergency patients when there is limited time
  2. When a restoration is needed, but will need removal soon for additional procedures to be done (such as with a root canal)
  3. Temporary crown to wear while final crown is being made
  4. Displaced crown with post/core
  5. Trauma including pulp exposure
  6. Fractured posterior tooth
118
Q

What can be used to maintain space and occlusal relationships?

A

Interim partial/complete dentures

119
Q

What are some functions of temporary restorations? (8)

A
  1. Protect enamel, dentin, and pulp
  2. Protect gingiva
  3. Protect soft tissues
  4. Protect margins
  5. Prevent drifting/tilting/movement
  6. Maintain occlusal relationships
  7. Maintain esthetics
  8. Reduce sensitivity
120
Q

What has a positive influence on tooth structure when given at low doses?

A

Fluoride

121
Q

Prior to tooth eruption, __________ can be incorporated as __________during the mineralization process

A

fluoride; fluorapatite

122
Q

Hypomineralization of enamel

A

Fluorosis (too much fluoride)

123
Q

As a topical treatment, fluoride has a ________ uptake by the tooth and helps to __________ demineralization and ___________ remineralization

A

rapid; inhibit; promote

124
Q

What kind of enamel is more resistant to decay?

A

Remineralized enamel

125
Q

Why is remineralized enamel more resistant to decay? (4)

A
  1. Has larger crystals with higher amounts of fluoride
  2. Interferes with microorganisms
  3. Reduces solubility of enamel
  4. Seals dentinal tubules to alleviate hypersensitivity
126
Q

Fluoride is __________ in high concentrations

A

bactericidal

127
Q

What are the reasons for fractured restorations and teeth? (6)

A
  1. Restoration has high contact
  2. Margins/walls are not 90 degrees to tooth
  3. Pulpal floor is not deep enough
  4. Internal angles are not slightly rounded
  5. Buccal/lingual walls are not converging
  6. Incorrect/insufficient condensing of amalgam (if applicable)
128
Q

Where is the location of decay in contact areas?

A

ALWAYS just apical to the interproximal contact point

129
Q

Features that are necessary for all preps regardless of outlines

A

Primary retention features

130
Q

What are the primary retention features of an amalgam prep?

A
  1. Converging walls
  2. Retention grooves (if needed)
131
Q

What are the primary retention features of a composite prep?

A

Converging walls

132
Q

What feature is considered primary retention if it is a part of buccal/lingual grooves?

A

Dovetails

133
Q

Caries formula

A

Sugar + bacteria = decrease in pH/increase in acidity

Acidity causes tooth decay if high enough

134
Q

Dental caries are a ___________ disease

A

site-specific

135
Q

What bacteria are caries linked to?

A

S. mutans

136
Q

Process of removing surface defects or scratches created during the contouring process using cutting or grinding instruments

A

Finishing

137
Q

Most refined of the finishing processes, removing the finest surface particle

A

Polishing

138
Q

Which alloy?

Disadvantages = requires a higher mercury amount, needs early condensation with a small condenser, and needs higher packing forces during condensation

A

Lathe-cut

139
Q

Which alloy?

Advantages = high positive pack handling quality to provide good proximal contacts (it is crunchier) and it causes minimal material-related post-operative sensitivity.

A

Lathe-cut

140
Q

Which alloy?

Disadvantages = requires a larger condenser, has a shorter working time (BUT it leads to a higher early strength so that aspect can be an advantage), no positive pack capability (poorer contacts and more overhangs) and there is a greater risk of post-operative sensitivity

A

Spherical alloy

141
Q

Which alloy?

Advantages= requires a lower condensation pressure to achieve the same strength.

A

Spherical alloy

142
Q

Which alloy needs a varnish or alternative dentin sealer and greater burnishing?

A

Spherical alloy

143
Q

Which alloy is typically only good for amalgam cores or places where lower condensation forces are preferred?

A

Spherical alloy

144
Q

Which alloy is a mixture of both the lathe-cut and spherical types of amalgam and combines the best of both geometries?

A

Admixed alloy

145
Q

Which alloy has high packing pressures with small condensers still being required, but obtains positive interproximal contacts?

A

Admixed alloy

146
Q

Which alloy has a slightly faster setting time and low post-operative sensitivity?

A

Admixed alloy

D1 Spring (47 decks)

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