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AU13 - Operative Final Exam > Operative Final Exam - Lectures: Basics, Instruments, and Class I Tooth Preps > Flashcards

Operative Final Exam - Lectures: Basics, Instruments, and Class I Tooth Preps Flashcards

1
Q

What is the definition of caries?

A

the demineralization and subsequent cavitation of tooth structure

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2
Q

What is the goal of restorative dentistry?

A

carefully remove the diseased tissue (cavity) in a precise manner and replace the missing part with restorative material

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3
Q

What are the 3 most common areas in which cavities occur?

A
  • occlusal pits and fissures of posterior teeth
  • interproximal areas (between teeth below contact area)
  • smooth surfaces of facial and lingual surfaces
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4
Q

Where is a Class I prep located?

A

pit and fissure preps

  • occlusal surfaces of premolars and molars
  • occlusal 2/3 of facial and lingual surfaces of molars
  • lingual surfaces of maxillary incisors
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5
Q

Where is a Class II prep located?

A

proximal surfaces of posterior teeth

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6
Q

Where is a Class III prep located?

A

proximal surfaces of anterior teeth that do not include the incisal angle

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7
Q

Where is a Class IV prep located?

A

proximal surfaces of anterior teeth that include the incisal edge

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8
Q

Where is a Class V prep located?

A

the gingival third of the facial or lingual surfaces of all teeth

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9
Q

Where is a Class VI prep located?

A

on the incisal edges of anterior teeth or occlusal cusp tips of posterior teeth

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10
Q

What are the 3 types of powered cutting equipment?

A
  • rotary (routinely used since 1960s)
  • laser (recent FDA approval for preparing teeth)
  • air abrasion
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11
Q

Which handpiece (high or slow speed) sprays water coolant to avoid tooth damage by heat?

A

high speed

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12
Q

Is a high speed handpiece angled or straight? A low speed handpiece?

A
  • high speed - angled

- low speed - angled or straight

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13
Q

What metal makes up a bur?

A

carbide steel (stiff, strong, and brittle)

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14
Q

What are the 3 anatomical parts of a bur?

A
  • head - cutting portion of bur
  • neck - connects head to shank
  • shank - part of the bur that inserts into instrument
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15
Q

What are the 5 shapes of a bur head?

A
  • round
  • inverted cone
  • straight fissure
  • tapered fissure
  • pear
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16
Q

How many flutes are found in a standard carbide bur? How many in a finishing carbide bur?

A
  • 6 flutes in a standard

- 10, 12, 20, 30 in a finishing bur (more flutes = smoother finish)

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17
Q

What is the purpose of the shank of the bur?

A

controls the alignment and concentricity

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18
Q

What are the 3 types of shanks?

A
  • friction-grip
  • latch-type
  • straight
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19
Q

Of the 4 types of diamond grits for diamond burs (coarse, medium, fine, and very fine), which are the most efficient? Which are the least efficient?

A
  • most efficient = coarse

- least efficient = very fine

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20
Q

What are the 2 cutting mechanisms of diamonds and burs?

A
  • ductile fracture

- brittle fracture

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21
Q

Which type of fracture has deformation produced by shear forces?

A

ductile fracture

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22
Q

Which type of fracture is associated with crack production from tensile loading?

A

brittle fracture

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23
Q

Which type of cutting (bur or abrasive) is more efficient for cutting brittle materials like enamel?

A

abrasive cutting

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24
Q

Which type of cutting (bur or abrasive) is more efficient for cutting ductile materials like dentin?

A

bladed or bur cutting

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25
Q

What speed (high or low speed) is used for abrasive cutting?

A

high speed

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26
Q

What speed (high or low speed) is used for bladed or bur cutting?

A

high and low speed

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27
Q

What is a round bur used for?

A
  • initial enamel penetration
  • caries removal
  • retentive grooves and holes
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28
Q

What is an inverted cone bur used for?

A

providing an undercut in a preparation

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29
Q

What is a straight fissure bur used for?

A
  • straight walls

- flat floors

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30
Q

What is a tapered fissure bur used for?

A

straight but tapered walls

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31
Q

What is a pear bur used for?

A

similar to inverted cone undercuts but has rounded ends and a longer head

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32
Q

What are 5 precautions that need to be taken into consideration when using a high-speed handpiece?

A
  • damage to tooth from heat (need to use a coolant with vital teeth)
  • damage to soft tissue from lack of control
  • eye protection (safety glasses)
  • inhalation precautions (mask)
  • ear protection (plugs)
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33
Q

What is the difference between the primary and secondary cutting edge of a hand cutting instrument?

A
  • primary cutting edge - edge that performs the most cutting (the edge of a hatchet that would scrape the pulpal floor)
  • secondary cutting edge - edge that also performs some cutting (the edges of the hatchet that would scrape the vertical walls of the prep)
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34
Q

In an instrument formula with 3 numbers, what does each of the numbers represent?

A
  • 1st number - width of the blade in 10ths of a mm
  • 2nd number - blade length in mm
  • 3rd number - blade angle relative to long axis in centigrade
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35
Q

In an instrument formula with 4 numbers, what does each of the numbers represent?

A
  • 1st number - width of the blade in 10ths of a mm
  • 2nd number - primary cutting edge angle in centigrade (*different than with 3 numbers)
  • 3rd number - blade length in mm
  • 4th number - blade angle relative to long axis in centigrade
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36
Q

What is the difference between a chisel and a hoe?

A
  • chisel - used to push; less than 12.5 degrees

- hoe - used to pull; greater than 12.5 degrees

37
Q

What are the 3 characteristics that are used to categorize caries? What are the two subtypes of each characteristic?

A
  • location - primary or secondary (recurrent) caries
  • extent - incipient (reversible) caries or cavitated (irreversible) caries
  • rate - acute (rampant) caries or chronic (slow or arrested) caries
38
Q

What are the 3 morphologic types of caries observed clinically?

A
  • lesions originating in enamel pits and fissures
  • lesions originating on enamel smooth surfaces
  • lesions originating on root surfaces
39
Q

What is the definition of tooth preparation?

A

mechanical alteration of a defective, injured, or diseased tooth such that placement of a restorative material re-establishes normal form and function

40
Q

What is the difference between an internal and external wall?

A
  • internal wall - a prepared surface that does not extend to the external tooth structure
  • external wall - prepared surface that extends to the external tooth surface and takes the name of the surface it is adjacent to
41
Q

Is a facial wall an internal or external wall?

A

external

42
Q

Is the axial wall an internal or external wall?

A

internal

43
Q

Is the mesial wall an internal or external wall?

A

external

44
Q

Is the pulpal floor an internal or external wall?

A

internal

45
Q

What is the definition of the cavosurface margin?

A

junction of a prepared wall with the uncut tooth surface

46
Q

What is the difference between conventional preparations and modified preparations?

A
  • conventional preparations - precise preparations resulting in uniform depths and particular wall and marginal forms
  • modified preparation - without specific depths, particular wall designs or retentive features
47
Q

What type of restoration uses conventional preparations? What type uses modified preparations?

A
  • amalgam uses conventional

- composite uses modified

48
Q

What are the 4 forms that make up the principles of cavity preparation?

A
  • outline form
  • retention form
  • resistance form
  • convenience form
49
Q

What is outline form?

A
  • conservative preparation
  • margins on sound enamel
  • include defective enamel (pits and fissures)
  • depends on carious lesion or previous restoration
50
Q

What is retention form?

A

features that lock or retain the amalgam in the tooth

51
Q

What is resistance form for the tooth prep?

A

features that prevent the enamel from fracturing as a result of occlusal forces

52
Q

How is retention form seen in Class I preps?

A

slight occlusal convergence of prepared facial and lingual walls

53
Q

How is resistance from seen in Class I preps?

A
  • preservation of cusps and marginal ridges
  • pulpal floor flat and perpendicular to occlusal forces
  • rounded internal preparation angles
  • removing unsupported tooth structure
  • divergence of mesial and distal prepared walls
54
Q

What is resistance form in the amalgam?

A

features that help the amalgam resist fracture and wear under function

55
Q

How thick should amalgam be in a restoration? How far into the dentin?

A

1.5-2 mm (adequate depth of pulpal floor) which should be 0.5 mm in dentin

56
Q

Between what angles should the tooth prep be on the buccal and lingual walls for the resistance form of the amalgam?

A

80-100 degrees with an ideal angle of 90 degrees

57
Q

What is convenience form? What are some examples?

A

preparation features that make the area more accessible or the procedure easier

  • extension of walls to provide greater access for caries removal
  • extension of walls to ensure the preparation is wide enough to fit the smallest condenser to ensure adequate condensation of amalgam
58
Q

What makes up the armamentarium of tooth preparation?

A
  • mouth mirror
  • pig-tail and sickle explorer
  • periodontal probe
  • small and large spoon excavator
  • 8-9 hatchet
  • cotton pliers
  • marginal trimmers #28 and #29
  • miller forceps
  • articulating paper
  • high/low-speed handpieces
  • burs #330, 245, 169, and 256
59
Q

What is the appearance of a #330 bur?

A

pear-shaped, normal length

60
Q

What is the appearance of a #245 bur?

A

pear-shaped, elongated

61
Q

What is the appearance of a #169 bur?

A

tapered fissure

62
Q

What is the appearance of a #256 bur?

A

straight fissure

63
Q

What is a #245 bur generally used for?

A

proximal box formation in a Class II cavity preparation

64
Q

Which bur is recommended for most conservative amalgam preparations?

A

330 bur

65
Q

What is the length and diameter of a #330 bur?

A

1.5 mm in length of cutting edge and 0.80 diameter at the tip

66
Q

True or false: During a preparation of a tooth, the angle of the bur should be parallel to the long axis of the tooth.

A

true (mandibular teeth are lingually tilted so the bur must also be angled)

67
Q

Should light, short strokes or long, heavy strokes be used while preping a tooth?

A

light, short strokes

68
Q

When prepping a tooth, should you move mesial to distal or distal to mesial?

A

distal to mesial

69
Q

In comparison to the length of a #330 bur, how deep should the pulp floor depth be? A #245 bur?

A
  • full length of a #330 bur (1.5 mm)

- half of the length of a #245 bur

70
Q

Why should the mesial and distal walls diverge?

A

to maintain resistance form by conserving the ridge supporting dentin

71
Q

True or false: The shape of a Class I prep is butterfly or dog-bone shaped.

A

true

72
Q

How deep should the axial wall depth be in a buccal or lingual extension?

A

1.5-2.0 mm (0.2-0.5 mm into dentin)

73
Q

How fast does a high speed handpiece rotate (in rotations per minute)?

A

200,000 rpm and above

74
Q

How fast does a low speed handpiece rotate (in rotations per minute)?

A

12,000 rpm and below

75
Q

Other than high, medium, and low speed handpieces, what are two alternative pieces of power equipment that can be used for removal of tooth tissue?

A

laser equipment and air-abrasion unit

76
Q

How does laser equipment work? What are some of the drawbacks?

A

produce beams of coherent and very high intensity light

  • currently expensive
  • high amount of heat generated
  • inefficient at removing large amounts of tooth structure
  • special safety precautions required
77
Q

How does air-abrasion work?

A

transfer of kinetic energy from a stream of powder particles onto tooth surface or a restoration, producing a fractured surface layer which results in roughness for bonding or disruption for cutting

78
Q

On a bur, what is the name of the side of the blade towards which the bur is cutting?

A

rake face

79
Q

On a bur, what is the name of the side of the blade away from which the bur is cutting?

A

clearance face

80
Q

On a bur, what is the name of the angle between the rake face and the radius of the head diameter?

A

rake angle

81
Q

What does a negative rake angle do?

A

minimizes fractures of the cutting edge, increasing tool life

82
Q

What is the most important design characteristic of a bur blade?

A

rake angle

83
Q

On a bur, what is the name of the angle between the rake face and the clearance face?

A

edge angle

84
Q

What does increasing the edge angle do?

A

reinforces the cutting edge and reduces likelihood for fracture of the blade’s edge

85
Q

On a bur, what is the name of the angle between the clearance face and the tooth surface?

A

clearance angle

86
Q

What type of rake angles, edge angles, and clearance angles does a carbide bur normally have?

A
  • slightly negative rake angles
  • edge angles of approximately 90 degrees
  • low clearance angles
87
Q

What are the 3 components of diamond burs?

A
  • metal blank - resembles a bur without blades (head, neck, and shank)
  • powdered diamond abrasive
  • metallic bonding material
88
Q

What are the two universal types of grasps used when holding hand instruments?

A
  • modified pen grasp

- inverted pen grasp

AU13 - Operative Final Exam (5 decks)

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