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Tim's Cards > Operative II > Flashcards

Operative II Flashcards

1
Q

After caries risk, describe the 3 Phases of Treatment Prioritization:

A

Phase I: Emergency infection, pt discomfort, prevention, gingival health, and sealants

Phase II: Simple restorations

Phase III: Complex restorations

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2
Q

What are the 7 Orderly Steps to the approach to restoring Individual Teeth?

A

Outline form

Retention form

Resistance form

Convenience form

Removal of remaining carious dentin

Finish enamel walls/cavosurfaces

Cleanse preparation

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3
Q

Opposing teeth often hit a _______, an area with a lot of function.

A

Marginal Ridge

any ridge, really

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4
Q

What is the junction between an unprepared tooth (normal tooth) and prepped tooth?

A

Cavo-surface

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5
Q

T/F

A line angle is between 2 walls/floors and a Point Angle is between any 3 walls/floor.

A

True

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6
Q

Pits and fissures of occlusal surfaces on Posterior Teeth are ______ cavity preparations.

A

Class I

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7
Q

What class are pits in the occlusal 2/3 of facial and lingual surfaces of molars?

A

Class I

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8
Q

The lingual pits of maxillary incisors in the top 2/3 of the tooth are considered what class?

A

Class I

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9
Q

The proximal surfaces of posterior teeth (premolars and molars) are what class of prep?

A

Class II

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10
Q

The proximal surfaces of anterior teeth not involving the icisal edge are what class of prep?

A

Class III

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11
Q

The proximal surfaces of anterior teeth involving the incisal edge is what class of prep?

A

Class IV

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12
Q

The surfaces of all teeth in the gingival 1/3 of facial and lingual surfaces are what class of prep?

A

Class V

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13
Q

The incisal edge of anterior teeth and occlusal cusp tips of posterior teeth are what class of prep?

A

Class VI

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14
Q

What is the diameter of an explorer?

A

1mm in 0.5 mm wide

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15
Q

Round bur #’s:

Inverted cone #:

Egg #:

Needle #:

A

Round: 1/4, 1/2

Inverted Cone: 33

Egg: 379

Needle: 135

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16
Q

Straight bur #’s:

Pear #’s:

Tapered #:

End cutting #:

A

56, 57

330, 244, 245

169

956

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17
Q

Enamel is ___% inorganic, 3% water, and ___% organic

Dentin is ____% inorganic, 20% water, and ___% organic.

A

96, 1

75, 5

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18
Q

Dentin is ___ times softer than Enamel

A

5

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19
Q

T/F
In the pain response, neuropeptides are released and vasodilation occurs, following by Odontoblastic swelling and closing of the Dentinal Tubule. From here, minor fluid changes distend odontoblasts and create pain.

A

True

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20
Q

T/F

Pulp is made up of mostly pain fibers

A

True

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21
Q

Name 4 causes of Pulpal Inflammation.

A

Dessication (drying)

Heat (bur friction)

Osmotic changes (sweets)

Bacterial (endotoxin, invasion, etc)

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22
Q

Drilling depths closer than ___ mm affect the pulp more severely.

A

2 mm

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23
Q

Where are dentinal tubules smallest?

Largest?

A

DEJ

Pulp

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24
Q

T/F

Coolants are mandatory for Diamond Burs

A

True

*abrade, cause subsurface cracks

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25
Q

T/F

25-35% of D1 students aren’t unsurable

A

True

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26
Q

T/F

Leaning forward causes 40% increase in pressure on spine

A

True

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27
Q

T/F

Your neck should be limited to a flexion of ___ degrees.

A

20

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28
Q

T/F

One reason to use a rubber dam is to reduce humidity when bonding restorations

A

True

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29
Q

T/F

Endodontic procedures may or may not use a rubber dam

A

False

*mandatory!!

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30
Q

T/F

Most dentists dam to the ipsilateral cuspid, but he contralateral cuspid is ideal (and what is used in skoo)

A

True

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31
Q

’s for rubber dam clamps on Molars

Premolar

Anterior

A

Molar: 14, W8

Premolar: 2A, W2

Anterior: 212, 9

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32
Q

You could use a symmetrical clamp for a maxillary molar, but never use ________ for a mandibular molar.

A

Assymetrical

  • Lower molars are symmetrical
  • *Upper molars are asymmetrical
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33
Q

1 hole is used for _____.

2 hole in the punch table is used for ______

A

Max incisors

Mand incisors

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34
Q

T/F

The Isolite system is an alternative to a Rubber Dam

A

True

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35
Q

Sealants can either be _____ or ______.

A

Unfilled Resin (Bis-GMA)

Filler in Resin (quartz/silica)

*filler usually less than 50%

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36
Q

Sealants 2 types of cure:

A

Chemical (auto polymerizing 2 components)

Light cured (20 seconds - held at least 1 mm from tooth)

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37
Q

What % of children 6-19 have dental caries in permanent teeth?

Of these, what’s the high risk breakdown?

A

42%

20% had 80% caries

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38
Q

T/F

Sealants are underused

A

True

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39
Q

The sealant prevalence on permanent teeth of children is about _____%

A

30

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40
Q

T/F

Sealants reduce caries 60-75% at 4 years

A

True

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41
Q

The detection of early lesions should be discovered via _____, not _____.

A

Radiographs

Explorers

***however, no radiograph should be given solely to determine sealant placing. Caries Risk Assessment primary.

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42
Q

A sealant can be placed if the occlusal surface of a posterior tooth has a noncavitated carious lesion with a ____________.

A

White demineralization line

*around margins

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43
Q

Name 6 risk factors used for sealant use criteria.

A

Age

Oral hygiene

Current caries or hx

Diet

Fluoride hx

Tooth type/morphology

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44
Q

T/F

Certain people have the particular tooth morphology of Deep Pits/Fissures, putting them at high caries risk

A

True

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45
Q

Rank Caries Susceptibility by Tooth Type dependent on Pits/Fissures:

(5)

*memorize this question

A

1 - Lower Molars (50%)

2 - Upper Molars (35-40%)

3 - U/L 2nd Premolars

4 - Upper Laterals and 1st Premolars

5 - Upper Centrals and Lower 1st Premolars

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46
Q

What are 3 conditions not indicated for sealants?

A

Occlusal/Proximal caries

Well coalesced pits/fissures

Caries free for years

47
Q

Someone in Lowe Caries Risk has had _________, good oral hygiene/diet, regular dental visits, and adequate F exposure.

*Additionally coalesced/shallow pits/fissures

A

No caries in last year

48
Q

To Apply Sealants:

  1. Isolate with rubber dam
  2. Cleanse pumice
  3. Rinse and Dry (10 seconds)
  4. Apply Acid for ____ seconds
  5. Rinse and Dry (if contaminated, re-etch ____ seconds)
  6. Apply sealant
  7. Cure ____ seconds
  8. Check retention, occlusion, and contacts
A

Apply Acid 20 seconds

Re-etch 15 seconds

Cure 20 seconds

**re-re etch 30 secs if needed

49
Q

330 D

Head size:

Cutting length:

A
  1. 8 mm

2. 0 mm

50
Q

330

Head size:

Cutting length:

A
  1. 9 mm

1. 6 mm

51
Q

34 D

Head size:

Cutting length:

A
  1. 9 mm

1. 0 mm

52
Q

245

Head size

Cutting length

A
  1. 8 mm

2. 8 mm

53
Q

T/F

90% of sealants are NOT prepared with a mechanical bur (non-invasive)

A

True

54
Q

Etched teeth have better…

A

Wettability

55
Q

Rinsing teeth (or swiping with gauze) immediately after a sealant is placed does what 3 things:

A

Removed oxygen inhibited layer in sealant

Removes bad taste

Limits BPA Xenoestrogen exposure

*2-5 times lower BPA exposure than daily food/environment

56
Q

T/F

If there are contact marks on sealant, football diamond or #7404 bur can be used to adjust occlusion.

A

True

57
Q

T/F

Last step or sealant placement is flossing (insures none has run over to proximal)

A

True

58
Q

If sealants fail, all or part of sealant comes off within ___ months

However, the worst failure is the sealant that _____, and eventually there will be discoloration at the margins.

A

3-6

leaks

59
Q

GIC, glass ionomer sealant, releases fluoride - what is its downside?

A

Not as retentive as resin

*only used as interim sealants

60
Q

T/F

GC Fuji Triage is a new product that releases 6 times the F as GIC

A

True

61
Q

PRR:

A

Preventative Resin Restorations

62
Q

Name 3 diagnostic tools that may determine whether a PRR is necessary.

A

Radiograph

Explorer

DIAGNOdent

63
Q

T/F

There are no minimum depth or width requirements in a PRR

A

True

64
Q

T/F

The 132F diamond and the 1/4 round burs can both be used in PRR

A

True

65
Q

T/F

All stained dentin needs to be removed in a PRR

A

False

not if it is hard (just stained)

66
Q

T/F

Undermined enamel is OK in PRR

A

True

67
Q

After caries removal, the 1st step in a PRR is…

A

35% phosphoric acid etch for 10 seconds - to enamel

10 more seconds to dentin

*enamel therefore 20 seconds

68
Q

T/F

After etching dentin in a PRR, it should be completely dried

A

False

*needs somewhat wet or collagen fibrils collapse (no more shag carpet to bond with)

69
Q

What 2 types of bonding agent are used in PRR?

*How long are each cured?

A

Dentin/Enamel Bonding Agent (low viscosity resin)

Flowable (packable)

*20 seconds

70
Q

Step 1 PRR, the low viscosity bonding agent is scrubbed for ____ seconds

Then,

Then, 20 seconds exposure to light to harden

A

12

Dry gently - removes solvents and water

71
Q

Flowable composite is easier to get in tight areas, has high polymerization shrinkage, and _____ wear resistance.

Microhybrid (packable) is difficult to condense into tight areas, has lower polymerization shrinkage, and _____ wear resistance

A

Poor

Better

72
Q

The microhybrid composite (packable, Step 2 PRR), should be packed incrementally no more than __ mm thick

A

2

*each increment cured 20-40 seconds

73
Q

If your grooves in a PRR are only in enamel and too small for packable composite, ______ can be used.

A

Flowable composite

*layer and cure

74
Q

If the preparation is large enough in a PRR, use only ______ composite.

A

Microhybrid

*multiple layers

75
Q

Trimming excess PRR can be accomplished with _____ football diamond bur, and the normal anatomy can by re-established with a ______ bur

A

397 F

247 EF diamond

76
Q

To polish the PRR, 1st use ____ color, then use _____ color

3rd use____

A

Green

Yellow

Brush

77
Q

What is the unfilled resin used to reseal margins at the end of a PRR

Is this a substitute for polishing?

Do you have to re-etch?

A

Glaze

No

Yes

78
Q

What is the major disadvantage to sealants?

A

Longevity

79
Q

What is the avg lifespan of PRR composite?

Amalgam?

A

5 years

10 years

80
Q

Why isn’t amalgam as technique sensitive as other options?

A

Corrosion self seals at borders

81
Q

Why don’t you want to cut into triangular/marginal ridges?

A

Structural integrity of tooth

82
Q

T/F
When cutting outline, avoid making marginal ridge too thin and cutting into triangular ridges

Also, cavo surface shouldn’t end at opposing contacts

A

True

83
Q

Do not cut across the Transverse ridge of the _______

or the Oblique Ridge of the _______

A

Lower 1st Premolars

Upper permanent Molars

84
Q

What is the minimum depth starting at the Central Groove for class I occlusal amalgam preparation?

A

1.5 mm

85
Q

How wide should an isthmus be in an amalgam prep?

Ideally, the isthmus should be ______ in the tooth.

A

1.0 mm

centered

86
Q

Why should internal line angles be rounded?

A

Protects by reducing stress across the area

87
Q

The smaller the isthmus, the ____ the convergence can be

A

Greater

88
Q

In Mandibular molars, the center of an amalgam prep should be off-centered in which direction?

The Mandibular 2nd premolar position should be…

The 1st premolar…

A

Slightly facial

centered

Don’t cut across Transverse Ridge

89
Q

What are 5 Factors Determining outline form?

A

Conservation tooth structure

Caries

Undermined enamel

Decalcified enamel

Extension for Restorability

90
Q

What are 5 Modifying Factors of Outline Form?

A

Type of restorative matl used

Esthetic requirement

The patient

Occlusion

Tooth position/size

91
Q

What matl can have a curved angle of departure?

A

Gold

92
Q

Why is a small amount of undermined enamel ok in composite?

A

Bonds to tooth

93
Q

What are the design features that lock a restoration and prevent failure?

A

Retention form

94
Q

Amalgam bonding resin, slots, pins, are examples of…

A

Increasing retention form

95
Q

How many mm’s are required to retain a crown?

A

4 mm

96
Q

The 1.5 mm minimum required height at the central groove for an amalgam prep is how high at the walls (cavo-surface)?

A

2 mm

97
Q

Minimum Axial depth in a slot prep is ___ for bicuspids and ____ for molars.

A

1 mm

1.2 mm

98
Q

T/F

The larger the isthmus the greater chance for cusp fracture

A

True

*but still needs 1mm min.

99
Q

T/F

Amalgam creates a lot of internal strain via thermal expansion

A

True

100
Q

What is the exception to floors being perpendicular to occlusal surfaces?

A

Lower 1st premolar

*pulp extends high

**If tooth was very lingually inclined, drill nearly horizontal

101
Q

In what scenario would you make the bevel on the Axio-pulpal line angle larger (class II prep)?

A

Pulpal floor shallow and proximal very deep.

*otherwise can lead to fracture

102
Q 
T/F
The rationale for good separation in class 2 (0.5 mm) is convenience bases

(place band, avoid damage adjacent, access to carve amalgam)

A

True

103
Q

Can we maintain contact on proximal extensions?

A

Yes

Class III’s

104
Q

What is the rationale behind conservative slot preps and their designs?

A

Amalgam strength improvement

105
Q

What is the Old amalgam with 388 compressive strength?

What is New amalgam with 545 compressive strength?

A

Velvalloy

Tylin

106
Q

Retention grooves are added with a _____ bur in a slot prep.

A

1/4 round

107
Q

Why are retention grooves not cut into the axial wall?

cut into facial/lingual wall

A

Avoid pulp

108
Q

Axial extension of the slot prep is ___ mm premolars

___ mm molars

A

1 mm

1.2-1.5 mm

109
Q

If amalgam exits the enamel at more than 90 degrees….

If amalgam exits the enamel at less than 90 degrees…

A

Amalgam too thin = fracture

Enamel undermined = fracture

110
Q

T/F

Fully cleaning and disinfecting are key steps before placing amalgam

A

True

*Gluma scrubbed 30-60 secs

111
Q

T/F

Before placing amalgam, dry tooth of excess moisture, but don’t over-dry dentin (can reduce bonding)

A

True

112
Q

T/F

Pt head should be above belly button to mid thorax

A

True

113
Q

T/F

Finger rests can be across the same arch, but never on different arches.

A

True

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