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Tim's Cards > Operative II E3 > Flashcards

Operative II E3 Flashcards

1
Q

3 general types of materials for Inlays/Onlays:

A

Direct composites

Indirect composites

Indirect Ceramics

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2
Q

Advantages to Direct Composites:

Disadvantages

A

Less cost/time, simple technique, repairable

Tech. sensitive, isolation, matls not fully set

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3
Q

Advantages to Indirect Composites:

Disadvantages:

A

Control contours, Better Wear resist, repairable, flexible

Cost/time, isolation

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4
Q

Advantages to Indirect Ceramics:

Disadvantages:

A

Control contours, Best wear resist, better bond to enamel

Most cost/time, brittle, isolation, NOT repairable

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5
Q

Indirect Composite Advantages are ______ physical/chemical properties

______ polymerization shrinkage

Predictably better ______

*also great esthetics and matl advancements

A

increased

Zero

contacts/contours

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6
Q

Indirect Composites are _______, improving pretty much all properties over Direct Composites

A

Silanated

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7
Q

A big advantage to Indirect Composites is that they are compatible with what?

A

Enamel

*Ceramics can be abrasive

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8
Q

What has better plaque resistance, composite or ceramics?

A

Ceramics

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9
Q

Describe Steps to make Indirect Composite - chairside:

A

Prep

Impression

Silicone die (Mach III)

*make composite on silicone die

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10
Q

4 Steps Lab takes to make Indirect Composite:

after Prep/Impression

A

PVS Impression

Model poured

Separating liquid

Composite placed

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11
Q

When building up an Indirect Composite, mark borders of die red and add what?

A

Color, Dentin shades in layers, then Enamel shades

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12
Q

Trim an Indirect Composite build up (on die) with what?

Then add…

Then is the final ______ cycle

A

diamond burs

stains

polymerization

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13
Q

Final polymerization of Indirect Composites is done under what?

why?

A

Vacuum

Increases hardness and polishability

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14
Q

Describe Mechanical Retention method for Delivering Indirect Composites?

A

Roughen internal surface

Sandblast

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15
Q

Describe Mechanical/Chemical retention method for Delivering Indirect Composites?

A

SiO2 impregnation

Silane

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16
Q

T/F

The fastest growing segment of the dental Tx market is All ceramic restorations - annual growth of 20%

A

True

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17
Q

All Ceramic CAD crowns have similar success rate to what?

A

PFM

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18
Q

List 4 all ceramic matls of increasing strength

A

Hand condensation

Silica CAD blocks

LiDisilicate (Emax)

Zirconia alumina

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19
Q

Ceramics are durable but ________

A

Brittle

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20
Q

T/F

Ceramics are more costly than gold

A

False

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21
Q

Ceramics have low _______ strength

A

Edge

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22
Q

3 General Ceramic choices:

w/ 3 specific products

A

High glass (silica - highly esthetic)

Low Glass (LiDisilicate - Emax)

No glass (Zirconium)

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23
Q

MCC’s (PFMs) are weak when…

A

hand layered

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24
Q

What is the main advantage of a Monolithic Restoration matl vs. a Layered?

A

Chipping can occur along layer lines.

*milled ceramic blocks are monolithic

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25
Q

Emax (LiDisilicate) has what intrinsic property allowing for increased flexural strength?

A

Large crystals

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26
Q

LiDisilicate wears similarly to what?

A

Enamel

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27
Q

What product is milled in a softer Blue State?

After milling, what is done?

A

IPS Emax CAD

Sintered, glazed, recrystallized into stronger structure

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28
Q

What all ceramic product is pressed into a Lost Wax Casting?

A

IPS Emax Press

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29
Q

Zirconia is very opaque, durable, can be made thinner,, wears _____ heavily, and is not ______, therefore there is little _______

A

Enamel

Etchable

Bonding

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30
Q

What is the advantage to bonding an all ceramic restoration?

A

Micro-mechanical bonding

AND

Chemical bonding via Silane coupler

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31
Q

Would you use Bond or Cement for all ceramics?

A

Bond

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32
Q

Should Posts be bonded or cemented?

A

Bonded - reduces fracture

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33
Q

Bonded ceramics allow us to be more_______ b/c of micromechanical bonding and Chemical bonding via silane coupler

A

Conservative w/ preps

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34
Q

All ceramic preps are similar to what 2 preps?

A

Zirconia/Gold

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35
Q

T/F

Zirconia can be bonded

A

False

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36
Q

List 3 prep designs for All Ceramics in increasing strength:

A

Full Wall defect (one wall)

Inlay (MOD)

Full Onlay (MOD and both L and F cusps reduced)

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37
Q

Where are the margins (in the Hood region) in All Ceramic Inlay/Onlay preps?

The Box margins are what?

All axial _____

All other walls ______

Facial and lingual walls diverge ____ degrees per side

A

Supragingival

Butt Joint Margins

Converge

Diverge

6-8 degrees

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38
Q

Onlay prep - Functional cusp reduction:

Non-functional cusp reduction:

A
  1. 5 - 2.0 mm

1. 5 mm

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39
Q

Onlay Isthmus width minimum:

A

1.5 mm

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40
Q

The milling software will ______ the inside of a crown prep if there are sharp angles, etc

A

Over mill

*so it will seat

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41
Q

The milling software will _____ the marging

A

Under mill

*so will not seat

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42
Q

T/F

Best to have a roller coaster effect on Onlay preps

A

True

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43
Q

T/F

There is no retention/resistance form in on Onlay prep

A

True

*modern bonding allows for this

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44
Q

The butt joint in bonding an Onlay should be ____ degrees

A

80-90

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45
Q

Why is a 2nd plane of reduction important to in a Ceramic Onlay prep?

A

maintains thickness of restoration - avoids fracture

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46
Q

ACC prep design (Crown!) Anterior incisal:

Posterior fissure:

Posterior cusp:

A
  1. 5 mm
  2. 5 mm
  3. 0 mm
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47
Q

What shouldn’t you use on Provisionals for All ceramic Onlays?

A

No eugenol

48
Q

CAD CAM takes the place of what 3 traditional lab steps?

A

Models, dies, wax ups

49
Q

Before Isolate/Bond an Onlay:

A

Try in

50
Q

HF acid only works on _______

So, wouldn’t work on what?

A

Glass

Zirconia

51
Q

3 Bonding materials, starting with the best one:

A

Total Etch bonding resins

Self Etch bonding resins

Glassionomers

52
Q

What bonding system allows for the most conservative, highly tapered prep?

1 Brand name?

A

Total Etch

Nexus III

53
Q

What would you use Glass-Ionomer bonding system with?

A

Zirconia

54
Q

After try-in, what has the Ceramic Onlay been contaminated with?

A

salivary phospholipid biofilm

55
Q

Zirconia has a strong affinity to bind with what?

A

phosphate

56
Q

To clean after Try In, use ultrasound for ___ minutes and Ivoclean for ___ seconds

A

2 minutes

20 secs

57
Q

T/F

Ivoclean creates a larger surface by adding small metal oxide particles and has a high affinity for proteins

A

True

58
Q

Pre-bonding, what not to use with Silica based ceramics?

A

Sandblasters

59
Q

Only use sandblasters with what?

A

Zirconia

60
Q

Do not clean the inside of a ceramic with _____ to remove biofilm

Use _____ to before applying Silane agent

A

phosphoric acid

Ethyl alcohol

61
Q

What product has added dopants to Zirconia for better translucency?

A

BruxZir

62
Q

How long should Silane be applied?

Keep excess within the ____ of the crown

A

60 secs

margins

63
Q

In a Selective Etch Technique, etch enamel margins only _____ secs

Use ______

Lastly apply 1 layer of ______

A

20

CHS

SE primer

64
Q

Tack cure CAD restoration for how long?

Then remove doughy flash with what?

Final cure how long?

A

1 second

floss

60 secs

65
Q

What is recommended post cementation?

A

Radiographs

*find IP resin flash

66
Q

Total etch systems are what generations?

Self etch systems are what generations?

A

4th, 5th

6th, 7th

67
Q

4th Gen has how many steps?

5th gen?

A

3 - Etch, primer, bond

2 - Etch, primer/bond

68
Q

What is the 4th Gen system we used?

A

Optibond FL

69
Q

All in One Self Etch systems (6th gen), what can be lowered enough to etch undercut enamel?

What is retained?

What might be entrapped into the hybrid layer?

A

pH

Smear layer - this is a con

Water

70
Q

T/F

6th gen systems are Prompt L-Pop, One-Up Bond F

A

True

71
Q

The single component system (7th gen) is convenient and less technique sensitive but has what disadvantages?

A

Smear layer retained

Water absorbed into resin

72
Q

T/F

There is no pH incompatibility with resin cements

A

True

73
Q

Bonding Adhesive systems remove the smear layer with what?

A

pre conditioning gel

74
Q

Everything we restore eventually fails due to what?

A

Hydrostatic pressure

75
Q

Dentin Bonding Primers denature what?

A

Collagen

76
Q

Resins have what relationship with water?

A

Hydrophobic

77
Q

Because Intertubular dentin is the majority of Dentin Bonding, seal with what to avoid water/hydrostatic pressure?

*peritubular dentin more mineralized

A

GI liner

78
Q

What is in the smear layer?

Can you rinse it away?

A

Debris, bacteria

NO

79
Q

What removes the smear layer?

What bonding system does not?

A

Etch and rinse steps

Self etch

80
Q

What binds the restorative matl to normal dentin?

A

Hybrid layer

81
Q

T/F

Over time water trees develop

A

True

82
Q

What activity increases hydrolysis of Collagen, causes Gap Separation?

A

MMP

83
Q

What can you decrease MMP wit to increase bonding longevity?

A

CHX

84
Q

T/F

Polymerization shrinkage can lead to restoration failure

A

True

85
Q

Bonded resin surface / un-bonded resin surface

A

C factor

86
Q

What does a high C factor mean?

A

more shrinkage/strain

87
Q

T/F

Composite curing pulls away from the tooth

A

True

88
Q

The filler in Optibond solo plus makes it milky and does what?

A

Increases elasticity

89
Q

Why don’t you wet your instrument with a bonding agent during placement?

A

Resins contain HEMA - will discolor composite

90
Q

For deep restorations, what 4 steps?

A

Liner

Etch

Gluma - 20 secs

Optibond solo plus - 15 secs

91
Q

Gluma is a ________ made specifically for ______

A

desensitizer

dentin

92
Q

T/F

Gluma is made from glutaraldehyde

A

True

93
Q

Research reveals the 2 most important things to do when curing are:

A

Correct light placement

Finger rest

94
Q

4 curing light systems by cure time (start with fastest)

A

Lasers

Xenon Plasma Arc

Metal Halide

LED

95
Q

3 ways to reduce internal stresses:

A

soft-start polymerization

Incremental additions

Stres breaking liner

96
Q

A modified flowable composite that can fill the entire gingival and pulpal floor before being cured:

*up to 4 mm

A

Bulk Fill Composites

97
Q

If Bulk Fill is the new paradigm, why are we still doing layered technique?

3 reasons

A

Wear resistance is poor

Shrinkage greater than conventional composites (increases C factor)

Microleakage greater

98
Q

What is the main advantage to Bulk Fill (up to 4mm) technique?

A

Best marginal adaption

99
Q

T/F

Best technique is still to use Flowable 1st, then add layers - will get best marginal adaption

A

True

100
Q

What are the BioActive restoratives?

A

Giomers

101
Q

Giomers have a surface property that does what?

A

Is bio-reactive

*neutralizes acids, etc

102
Q

T/F

The future may be Giomers with Surface Sealers with nano-fillers

A

True

103
Q

Each tooth should appear ____ times narrower than its mesial neighbor from the frontal view

_____ in California

A
  1. 618

1. 4

104
Q

The top of the smile line:

A

Zenith

105
Q

Face height is the Rule of…

A

1/3rds

106
Q

Lower Face height is the rule of …

A
  1. 3rds

* upper lip 1/3, lower lip to chin 2/3

107
Q

T/F

Youthful teeth have Prikymata and Mamelons

A

True

108
Q

T/F

A rounded face will have wider teeth proportionally and a longer face will have narrower teeth proportionally

A

True

109
Q

Esthetic inclinations: CI’s

LI’s:

Canines:

A

vertical

mesially inclined

vertical

110
Q

T/F

Primary planes align with the long axis of the tooth and have a slight mesial prominence

A

True

111
Q

T/F

With a normal smile, pts maxillary incisal edge should just lightly touch or miss lower lip

A

True

112
Q

T/F

The Zenith of each tooth should be slightly distal to the center

A

True

113
Q

Tx sequence basics Perio Health:

Caries Control:

TMJ/Occlusal Stability:

Specialty Tx:

Color:

Fixed/removeable Tx:

Ceramics:

Composites:

Maintenance:

A

Phase 1

Phase 1

Phase 2

Phase 2

Phase 3

Phase 4

Phase 5

Phase 5

Phase 6

114
Q

The Smear Layer may reduce dentin permeability be as much as ___%

A

86

115
Q

What bur creates a very thick smear layer?

A

Diamond

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