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NBDE 2 > Operative > Flashcards

Operative Flashcards

1
Q

how long does it take for a proximal caries lesion to progress into dentin

A

average of 4 years

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2
Q

how long does it take for a pit and fissure caries lesion to progress into dentin

A

2-4 years

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3
Q

What is the main bacteria involved in caries

A

Strep Mutans

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4
Q

Besides Strep mutans what bacteria are involved in caries formation

A

S. Sobrinus
Lactobacilli
Bifidobacterium
actinomyces

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5
Q

What is the most important virulence factor in bacterial plaque

A

glucosyltransferases

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6
Q

what do glucosyltransferases do

A

synthesize water insoluble glucans from sucrose

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7
Q

what do the glucans synthesized by glucosyltransferases from sucrose do

A

they give plaque its sticky nature allowing it to adhere to the tooth

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8
Q

most commonly carious teeth

A

upper first molars

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9
Q

least commonly carious teeth

A

lower anterior teeth

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10
Q

how does saliva prevent caries

A

pH buffering
cleansing the tooth
supply of mineralizing ions

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11
Q

at what pH does decalicification occur

A

5.6

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12
Q

do infants without teeth have strep mutans

A

not until their teeth erupt

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13
Q

what does DMFT stand for

A

decayed missing or filled teeth

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14
Q

what are the benefits of fluoride

A

bacteriocidal

ions for remineralization of enamel

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15
Q

what percent of enamel is inorganic

A

96% (hydroxyapatite)

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16
Q

what percent of dentin is inorganic

A

70%
20% organic (mostly type 1 collagen and ground substance)
10% water

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17
Q

how to determine if white spot lesions are more or less than half way through the enamel clinically

A

if they are visible when the tooth is wet they are more than halfway through
if they are only visible when dry they aren’t more than halfway

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18
Q

clinical signs of arrested caries

A

white or brown
shiny surface
hard to explorer

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19
Q

clinical signs of active caries

A 
chalky
rough surface
covered in plaque
cavitated
sticky with explorer
20
Q

determining if radiographic interproximal lesions are active or arrested

A 
active if....
high caries risk
new lesion/progressing one from last X-rays
caries into dentin
inactive if.... 
no progression
low caries risk
21
Q

what is the mechanism by which caries detection dyes work

A

they are non-specific protein dyes that stain the organic matrix of less mineralized dentin (doesn’t differentiate between affected or infected dentin)

22
Q

What are the 5 phases of a comprehensive treatment plan

A 
systemic phase (general health problems)
acute phase
disease control phase
definitive phase
maintenance/monitoring phase
23
Q

what is the critical pH of fluorapatite

A

4.5 (hydroxyapatite is 5.5)

24
Q

what is CPP-ACP and what is it used for

A

casein phosphopeptides and amorphoyus calcium phosphate

used for remineralization

25
Q

what is the typical concentration of NaF varnishes

A

5% (every few weeks)

26
Q

what is the typical concentration of NaF fluoride gels trays

A

5000 ppm (1-2 x per day, 5 minutes, 2-4 months)

27
Q

what surfaces is F most effecticve

A

smooth surfacs

28
Q

what is the maximum F dose per day for adults

A

5mg/kg/day

29
Q

at what dose of F does fluorosis become possible

A

.7mg/kg/day

30
Q

Advantages of GI

A
  1. forms a chemical bond with dentin and enamel
  2. no bonding agent needed
  3. fluoride release (rechargable)
  4. strongly resistant to secondary decay
  5. adding resing increases strength
  6. acceptable but not great aesthetics
  7. less problems with water contamination
  8. conservative preps
31
Q

Disadvantages of GI

A
  1. low fracture resistance
  2. not for marginal ridges, incisal edges, cusp tips etc
  3. poor color match
  4. poor polishability
  5. dehydrate and disintegrate in low salivary flow
  6. need to be sealed to prevent microleakage
32
Q

Advantages of Composite

A
  1. excellent aesthetics
  2. can withstand moderate occlusal loads
  3. micromechanical bonding with enamel and dentin
  4. conservation of tooth structure
33
Q

Disadvantages of composite

A
  1. expensive
  2. bonding and curing required
  3. potential allergens
  4. high wear in posterior (compared to amalgam, better than GI)
  5. prone to leakage over time
34
Q

Advantages of RMGI

A
  1. some fluoride

2. better strength and wear than GI

35
Q

disadvantages of RMGI

A
  1. require bonding and curing

2. less strength and wear resistant

36
Q

Advantages of Amalgam

A
  1. inexpensive
  2. self curing
  3. durable
  4. great for high stress
    5, easy placement
  5. corrosion helps seal margins from recurrent decay
37
Q

disadvantages of amalgam

A
  1. poor aesthetics
  2. more aggressive tooth prep
  3. environmental concerns
  4. allergy potential
38
Q

preventing marginal breakdown

A
  1. keep margins away from direct occlusal loads
  2. choose right material
  3. don’t bevel occlusal resin margins
  4. 90% cavosurface margins
39
Q

what are the common causes of GI failures

A
  1. poor placement technique

2. inadequate bulk

40
Q

what are the common causes of resin failures

A
  1. poor placement technique
  2. poor moisture control
  3. inadequate cure
  4. excessive shrinkage
41
Q

causes of amalgam fractures

A
  1. inadequate retention or resistance form
  2. inadequate thickness
  3. inadequate condensation
  4. degradable (ZOE) liner
42
Q

what is the average thickness of dentin

A

3 mm

43
Q

what is added to composites to make them self curing

A

benzoyl peroxide

44
Q

what is the wavelength at which composites cure

A

468 nm

45
Q

what is pilocarpine used for (Rx)

A

xerostomia

NBDE 2 (6 decks)

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