Operative II E2 Flashcards
T/F
Porcelain veneers are strong when bonded with enamel
True
T/F
Porcelain veneers can reshape peg laterals, close diastema, or lengthen teeth
(and alleviate severe tetrycycline staining)
True
3 Advantages to Porcelain veneers
3 Disadvantages
Very aesthetic, Greater longevity, Conservative
Cost, Time, Visits
3 Types of Veneers:
Direct Composite
In-Direct composite
Porcelain
*there are a further 3 types of Porcelain
What are the 3 types of Porcelain Veneers?
Stacked
Pressed
Milled CAD/CAM
What is the advantage to Direct Composite Veneers?
Disadvantage?
Simple, single appointment
Poor stain resistance, less durable
What is the Advantage to In-Direce Composite Veneers?
Disadvantage?
Repairable, good stain resist
Multiple appointments, limited durability
Advantage of Stacked Porcelain Veneers?
Disadvantage?
Best esthetics/stain resistance
costly, difficult to duplicate
Advantage of Pressed Porcelain Veneers?
Disadvantage?
Stregth/fit
Staines placed on surface
Advantage to Milled CAD/CAM Porcelain Veneers?
Disadvantage?
Strength/convenience
Stains placed on surface
4 Contraindications to Porcelain Veneers:
If lack enough enamel to bond
Small hypoplastic spots
If Diastema closure less than 1mm
Destructive Occlusions (bruxers, class II)
What are Diagnostic Casts/Wax-ups used for in Porcelain Veneers?
Stent for temp veneers
Facial Reduction for Porcelain Veneer is a ____mm gingival chamfer
____ mm for incisal and the body
____ mm for dark teeth
- 3mm
- 5 - 0.7 mm
- 75 - 1.0 mm
In a regular (standard, traditional) Veneer prep, where does the IP margin end?
Facial to the contact
What is in the Linguo-gingival-proximal area of a Veneer prep?
What does this prevent?
S curve
dark triangle shadow between teeth
Where is the Proximal finish line in Veneers designed for a Diastema Closure?
Lingual to Contact
If Veneers are in contact with one another, prep margins….
If Veneers meet natural teeth, prep margins…
Open
maintained
Why is an Incisal Hood no longer used on Veneer preps?
Will cause fractures at tip
Minimal incisal reduction when lengthening?
1.5 - 2.0 mm
When reducing incisal edge for a Veneer prep, what to do with facial angle?
Lingual angle?
round off
leave straight (otherwise will fracture)
What do you need to do before prepping a tooth for a Veneer?
After?
Take shade
Stump shade
3 choices for Temporary Veneers:
Bonded Acrylic (lots of heat)
Direct spot-bonded composite
Bonded composite-type temp matl
Advantages of Acrylic Veneer Temp:
Disadvantages:
Strength/wear
Heat, opaque, poor retention
Advantages of Composite Veneer Temp:
Disadvantages:
Esthetic, easily repaired
Technique sensitive, brittle
In clinical setting, for Temp Veneer, do not use lube on tooth, Optibond Solo plus, bis-acryl, remove excess, polish w/ diamond bur and use what for Polish/Glaze?
Optiguard
With multiple veneers make sure they fit on a Solid model (no multiple dies) and start where?
Midline then out
Before assessing a Veneer fin on a pt, what should be done?
Anesthetize and RDI
If the Veneers do not fit well before cementing, what should be adjusted?
prep
*preferably not Veneer
How might you adjust the proximal contacts of a Veneer?
rubber porcelain polishing abrasive wheel
What Luting system do we use for Veneers?
Nexus 3
When Luting a Veneer, why don’t we need a Primer?
No contact with Dentin
*so no primer, no 5th gen w/ primer included
T/F
Optibond solo plus (or all in one) is Contraindicated with Veneers
True
What are the 2 types of Luting Resins available for Luting a Veneer?
Light cured
Dual cured
The try-in paste for Veneers is ____ soluble
What color should be used first?
water
clear
6 Layers involved in Porcelain Veneer delivery (from inside out)
*3 layers for tooth, 3 for veneer
Pumiced/etched enamel
Bonding resin (NO primer)
Luting composite
Bonding resin
Silane
Etched Veneer
Before Silane added, what to do to the etched Veneer ?
Dry completely (EtOH)
How long should the Silane be added to the etched Veneer?
1 minute
After a try-in, how do you clean a Veneer?
Ultrasound - 2 minutes, soapy water
Ivoclean 20 secs
What kind of diamonds may be used to adjust occlusion and trim excess Luting resin?
Extra Fine
Advantages to a Directly Placed Composite Veneer?
Disadvantages?
Immediate, moderate cost, flexibility
Longevity, stain, strength, maintenance, long appointments
Custom bleaching before Directly Place Composite Veneers is ___% carbamide peroxide for ___ days
Followed by __% carbamide peroxide for ___ days
10%, 10
15%, 4
What antimicrobial product was approved over 80 years ago in Japan?
Silver diamine fluoride (38%)
Silver diamine fluoride is ____% silver and ___% fluoride
25% silver
5% fluoride
5 indications for Silver Diamine Fluoride:
Caries arrest
High caries risk pts
Pts who can’t tolerate standard treatment
Geriatric and Pedo pts
Difficult area to isolate/restore
Silver diamine fluoride allows silver/protein matrix to adhere to what?
fluoride forms a veneer of ______ and closes dentinal tubules
Silver is ______
***then tooth becomes harder and bacteria are neutralized and caries becomes inactive
Carious lesion
Fluoroapatite
Bacteriostatic
What is better for caries arrest, Silver diamine fluoride, or fluoride varnish?
Silver Diamine Fluoride
T/F
Silver Diamine Fluoride is equivalent or better than glass ionomer cement
True
Annual application of silver diamine fluoride is better than fluoride varnish ___ times a year
*another study found roughly equivalent to 2x/yr varnish
4 times
The recommended Silver Diamine Fluoride is __/yr applications to carious lesions
2x/yr
3 contraindications to Silver Diamine Fluoride:
Pregnant women (1st 6 months) and Breastfeeding
Silver allergy
Esthetic areas (staining effect)
How can we reduce staining effect of Silver Diamine Fluoride?
SSKI - saturated solution potassium iodide
GI or Composite over treated area
T/F
Silver diamine fluoride affects composite bonding to noncarious dentin
False
Silver diamine fluoride _____ the bond strength of GI to the tooth with one rinse
GI
What bonding system is decreased by Silver Diamine Fluoride?
*by how much?
Resin Based Crown Cement
*1/3
What should be done to silver diamine fluoride-treated superficial dentin before cementing crowns?
Excavate
