Operative Final Review Based On Her Outline Flashcards
When Isolating with a rubber dam on a Class II Prep, how do you set the dam?
Class II= one tooth posterior, two teeth anterior to tooth you’re working on
Where do the retention grooves go on an Amalgam Class II restoration?
Line Angles in the box
What is so IMPORTANT ABOUT MARGINAL RIDDGE WITH THE CLASS II AMALGAM?
equal height of the adjacent tooth and rounded.
the ____ Prep is used for the following reasons:
- Root surface caries -When you can access without approaching from occlusal
- lesion is below contact
- similar to a Class III (access from facial or lingual)
Slot Prep
Preparations deeper than normal with LESS THAN 1.0mm dentin between the pulp and the restorative material= use _____ _____
RMGI liner
Preparations with ___ ____ 0.5mm of dentin between the pulp and restorative material= use thin layer of calcium hydroxide followed by a later of RMGI
LESS THAN
Preparations with a direct pulp exposure on vital pulp=____ mm thick calcium hydroxide layer followed by layer of RMGI
0.5mm`
What are the Indications for Composite
Esthetics
Light occlusal contacts
Smaller restorations
Isolation
Highest composite bonding strength in_____ third
occlusal
Lowest composite bonding Strength in_____ third
cervical
Stiffness of a material
Modulus of Elasticity
A high modulus of elasticity = _____
ridid
A low mod of Elast =
flexible
What is the name of this conservative technique where:
◦ Place composite in carious occlusal pits
◦ Seal remaining pits and fissures
Preventative Resin Restoration
For a posterior composite filling, one would opt for a composite with _____ filler. (greater or less).
greater filler
t/f: More filler= more strength =less esthetic
true
Which type of composite has larger particles. greater ability to handle stress, and rought texture
macrofill
Which Composite has small particles, smooth surface texture, less filler, and greater wear resistance.
Microfill
Which types of composite is most commonly used?
nanofill
Do you select the shade of composite before or after placing the rubber dam?
before
Where is it acceptable to leave unsupported enamel on the class III prep?
facial wall
Where are the caries most often located on class III?
◦ Usually more lingual than facial
◦ Gingival to contact area
t/f: The outline form of a Class III Preparation is perpendicular to the LA of tooth.
true
For Class III Prep on Max Central
what is the inciso-gingval length
What is the Mesial distal width
inciso-gingval length:
2.0 on maxillary central
Mesial distal width
1.5 on maxillary central
For Class III Prep on Max Lateral
what is the inciso-gingval length
What is the Mesial distal width
I-G length
1.5 on maxillary lateral
M-D Width
1.0 on maxillary lateral
Where is retention placed in Class III preps?
dentin
Do we need to state what walls?
Place a ___ mm bevel around the prep on Class III.
1.0 mm
t/f: Silane is the coupling agent that allows stress transfer from flexible matrix to higher modulus (aka less flexible) filler particle.
True
t/f: Cover very deep dentin with liner
◦ CaOH or Glass Ionomer
ture
How long do you etch enamel vs. dentin in the total etch system?
◦ enamel for 20-30 seconds
◦ dentin for 15 seconds.
◦ Apply etchant to enamel first; 15 seconds later apply it to the dentin then wash
off the enamel and dentin at the same time.
t/f: Chemical Bonding is Very limited with dissimilar materials
true
t/f: the enamel bonding mechanism is the following:
In enamel- interlocking with etched enamel rods
true
the dentin bonding mechanism is the following:
In dentin- interlocking with etched dentin collagen
true true true
_________ oriented enamel
◦ Cavosurface margins of class I preparations
◦ Bevels of class II preparations
◦ ENDS of enamel rods
PERPENDICULAR
________ oriented enamel
◦ Internal walls of occlusal preparations
◦ Gingival floor of box of class II preparations
◦ SIDES of enamel rods
PARALLEL
t/f: Deeper dentin: more fluid, more & wider tubules, & less intertubular dentin than superficial dentin. This makes bonding more challenging.
true
The smear layer is attracted to the tooth through which type of forces.
Van Der Waals.
bonding with dentin collagen and ends of enamel rods are examples of what type of force?
micromechanical
The composite and bond interaction is which force?
chemical
t/f: etching and beveling (enamel only) increases the surface area of bodning.
true
When bonding in dentins is it good for the dentin to be moist?
yes: Moist is better!
◦ Overwet:
Resin doesn’t penetrate well
Decreased bond strength
◦ Collagen fibers collapse in dry dentin
Resin cannot penetrate
Poor hybrid layer
Decreased bond strength
______ Etch Systems
Advantages
◦ More predictable, stronger bond
◦ Enamel adequately prepared
Disadvantages
◦ Collagen collapse is possible*
◦ Etched zone is often deeper than hybrid layer
◦ Exposed demineralized, collagen fibrils ◦ Post-operative sensitivity
Total Etch system
_____ -etch Systems
Advantages
◦ No separate etch: overdried, collapsed demineralized collagen not a problem
◦ Etched zone and hybrid layer comparable width; however, some exposed
collagen
◦ Low post-operative sensitivity ‘
◦ Time efficiency
Disadvantages ◦ Not compatible with self-cure, dual-cure composite ◦ Acidic monomers, low pH, “kills” the basic amine activator ◦ Will not etch unprepared enamel ◦ Self-etch primer systems ◦ Long-term bond strength? ◦ Self-etch adhesives (all-in-one) ◦ Lower bond strength ◦ Long-term breakdown? ◦ Collagen degradation over time
Selfetch Systems
Which Pin is this?
◦ Pin hole larger than pin (0.001 - 0.002” larger than pin)
◦ Cemented with zinc phosphate cement
◦ Pin must be 3-4mm in length for adequate retention
◦ Least retentive of available pins
Cemented
◦ Pin hole is 0.001” smaller than the pin
◦ Pin is tapped to place - resiliency of dentine
retains pin
◦ 2-4mm long pin hole
◦ 2-3 times as retentive as cemented pins
◦ Dentin exhibits signs of stress
Friction Lock
Pin hole is 0.002” smaller than pin Pins self threads into dentin
◦ Use hand wrench or
◦ Latch grip on slow speed 5-6 times as retentive as the cemented pin High crestal and apical stresses; Crazing and microleakage
◦ Greater stresses in dentin
There should be at least 1.0 mm dentin around pin hole
Used at UMKC most frequently
Self-threading.
t/f: Pins should be placed 5mm apart from each other, but at lease a MINIMUM of 3 mm apart
true
t/f: Pins should be 1mm from wall of prep
but at least a MINIMUM 0.5mm from wall
true
Pin should be__ mm deep into the dentin
2mm
What factors affect the Pin’s retention capabilities?
- depth: 2 mm
- distance from walls and enamel: 0.5 to 1 mm
- Vertifcal orient: along LA of tooth
- # of pins: up to a limit
- diameter of pin= greater diameter = retention.
t/f: Aluminum shank on twist drill acts as a heat absorber
true
Please consider all of the following when placing ____.
Pulpal anatomy
External tooth anatomy
Age (old =brittle) (young= large pulp)
pins
t/f: Best site for placement are at the line angles (DF, DL, MF, ML)
with one pin per cusp.
true
this area is a risk for what?
Mesio facial corner of Max and Mand 1st molar
Pulp exopse
this area is a risk for what?
Distal mand molars and max lingual of molars
pulp expose
this area is a risk for what?
Mid-facial, mid-mesial and mid-distal furcations of Max 1st & 2nd
molars
pulp exposure
this area is a risk for what?
Mesial concavity over Max 1st PM
perforation into PDL
this area is a risk for what?
Mid-lingual and mid-facial of Mand 1st and 2nd molars
perforation into PDL
this area is a risk for what?
Mid-facial, mid-mesial and mid-distal furcations of Max 1st & 2nd molars
perforation into PDL
true vs false
Increase Distance if Planning to Place Crown 1.0-1.5 mm inside DEJ
◦ Want to avoid exposing the pin
during future crown preparation
treu
at a ph of 5.5 ____ will begin to demineralize.
enamel
At a ph of 6.5 ____ will begin to demineralize.
dentin
Caries is a_____ disease
◦ Diet, microflora, susceptible tooth
Multifactorial
Caries requires for things inorder to occur. What are they?
- susceptible host
- bacteria
- food source
- time
What current Thoery
◦ Biofilm is responsible for the disease
◦ Plaque is pathogenic when disease is present
◦ Specific Microbes are the cause
◦ Strep Mutans
◦ Lactobacillus and Actinomyces V. (acid producers, can live in acid)
◦ Control the pathogens= control the disease
Specific plaque hypothesis
t/f: strep mutans are the initial bacteria to cause disease, then lactobacillus is primarily responsible for progression of caries.
ture
______ Dentin must be removed
◦ Bacteria present ◦ VERY rarely may leave in order to avoid pulp exposure
◦ Must place indirect pulp cap and seal caries in
Infected dentin
______ Dentin
- Soft, no bacteria present
- can be left and sealed, but most often removed.
affected
What is the treatment for initial carious lesions?
Treat with fluoride varnish, oral hygiene instructions
What is the best prevention for pit and fissure caries?
sealance
t/f: Using Ferric Sulfate (Astringedent®) hemostatic agent will stain the margins.
true
t/f: Aluminum Chloride (Hemodent®) will not cause staining.
true
E.max restorations are comprised of what material?
Lithium Discilicate
When margin exceeds ___ of the distance between central groove and cusp tip MUST CAP WEAK CUSPS
2/3
When margins end ___ distance between central groove and cusp tip CONSIDER CAPPING WEAK CUSPS
½
When placing a MO Gold inlay, you bevel which of the following surfaces?
- occlusal
- axial pulpal line angle
- gingival wall
- All above
all above
______ prevents distal displacement
Dovetail
With a ceramic inlay, do you bevel the gingival?
no sir
which cusps have a greater bevel?
Reverse bevel of 1-2 mm on cusps supporting occlusion; 1/2
mm on cusps not supporting occlusion
Do porcelain onlays have gingival bevel?
Bulk of Porcelain at margins – NO BEVEL
T/f: Occlusal evaluation and adjustments are delayed until after cementation because of the fragility of porcelain restorations
Occlusal evaluation and adjustments are delayed until after cementation because of the fragility of porcelain restorations
t/f: for porcelain veneers terminates at the gingival crest or 0.3-0.5 sub-gingivally
for esthetics.
true
t/f: For porcelain veneers: Minimum 1.0 -2.0 mm reduction for material bulk or NO reduction of incisal if lengthening incisal edge
True
Adjust occlusion_____ veneers have been bonded
after
The following are ______ for indirect restorations:
- Conserve tooth structure
- Better control of the contours
- strength
advantages
Gingival third is ______ than the middle and incisal thirds.
darker, More opaque
IDK why she used darker in review, I like opaque more.
The following are indications for ______.
•Large carious lesions or existing defective
restorations •Cracked Teeth •Endodontically treated teeth
onlays
the following are indications for _____.
•Teeth with minimal caries and strong buccal and lingual cusps •Acceptable (normal) occlusion
inlays
t/F: ceramic inlay is more tapered than the gold inlay.
true
