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BDS3 OSCE > Operative techniques > Flashcards

Operative techniques Flashcards

1
Q

What are the principles of cavity preparation

A
  • dentify and remove carious enamel
  • Remove enamel to identify the maximal extent of the lesion at the ADJ & smooth the enamel margins
  • Progressively remove peripheral caries in dentine - from the ADJ first then circumferentially deeper and only then remove deep caries over the pulp
    • This is to ensure that if there is a pulpal exposure that the caries does not fall into the pulp and so gives a better prognosis
  • Outline form modification
    • Enamel finishing
      • Remove any unsupported enamel
      • Occlusion
      • Requirements of the restorative material
  • Internal design medication
    • Internal line and point angles
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2
Q

What are indications for crowns

A
  • Protect weakened tooth structure
  • Improve or restore aesthetics
  • For use as a retainer for fixed bridge
  • When indicated by RPD design
  • Restore tooth function
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3
Q

What are principles of crown preparation (that can be used to evaluate a crown)

A

PRS MPA

  • preservation of tooth structure
  • retention and resistance
  • structural durability
  • marginal integrity
  • preservation of periodontium
  • aesthetic considerations
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4
Q

What are we looking at when preserving tooth structure

A
  • Has it been over or under prepared?
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5
Q

What do we need to do to provide retention and resistance in a crown prep

A
  • Is it tapered? Want taper of 6 degrees
  • How long are the walls? Want longer walls for retention
  • Want limited number paths of insertion
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6
Q

How do we provide structural durability in a crown prep

A
  • Has enough been removed so there is adequate room for bulk of material
    • Occlusal reduction
    • Functional cusp bevel
    • Axial reduction
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7
Q

How do we ensure marginal integrity in a crown prpe

A
  • What is the finish line? Shoulder or chamfer?
  • Chamfer more aesthetic
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8
Q

How do we preserve the periodontium in a crown prep

A
  • Margins of restoration should be
    • Smooth and full exposed to a cleansing action
    • Placed where the dentist can finish them and px can cleen them
    • Placed at gingival margin whenever possible
    • Dont want to impinge on supracrestal attachment (junctional epithelium + connective tissue)
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9
Q

What are aesthetic considerations for a crown prep

A
  • Does it work for px smile line
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10
Q

What is the axial reduction for a metal crown: full veneer gold crown

A

0.5mm

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11
Q

What is the axial reduction for ceramic crowns (traditional porcelain)

A

1mm

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12
Q

What is the axial reduction for a metal ceramic crown

A

1.3

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13
Q

What is the axial reduction for an all ceramic crown (porcelain bonded to alumina or zirconia framework

A

1.5

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14
Q

What is the occlusal reduction for the functional and non functional cusps for a metal crown (full veneer gold crown)

A

F - 1.5mm

NF - 0.5mm

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15
Q

What is the occlusal reduction for the functional and non functional cusps for a ceramic crown (traditional porcelain)

A

F - 1.5mm

NF - 1mm

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16
Q

What is the occlusal reduction for the functional and non functional cusps for a metal ceramic

A

F - 1.8mm

NF - 1.3mm

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17
Q

What is the occlusal reduction for the functional and non functional cusps for a all ceramic crown (porcelain bonded to aluminia or zirconia framework)

A

F - 2mm

NF - 1.5mm

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18
Q

What is the finish line for a metal crown (full veneer gold crown)

A

chamfer

.5

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19
Q

What is the finish line for a ceramic crown (trad porcelain)

A

shoulder

1mm

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20
Q

What is the finish line for a metal ceramic crown

A

chamfer 0.5 where only metal required

shoulder 1.3mm for where metal and porcelain required

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21
Q

What is the finish line for all ceramic crowns (porcelain bonded to zirconia/alumina)

A

chamfer

1-1.5mm

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22
Q

What are the types of inlays

A
  • Gold
  • Composite
  • Porcelain
  • Ceromeric
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23
Q

What are the uses of inlays

A
  • Occlusal cavities
  • occlusal/interproximal cavities
  • Replace failed direct restorations
  • Minor bridge retainers
24
Q

What are the indications of inlays

A
  • premolars/molars
  • Occlusal
  • Narrow MODs
  • MOs/DOs
25
Q

What are advantages of inlays

A

Better materials and margins

26
Q

What are the tools for inlay and onlay prep

A

handpiece

burs (no 170L, 169L, flame)

enamel hcahets

binangle chisel

gingival magin trimmers

27
Q

What is the inlay preparation for a ceramic inlay

A
  1. 5mm-2mm isthmus
  2. 5mm depth
  3. 5-2mm proximal box

1mm shoulder/chamfer margin

28
Q

What is the inlay preparation for a gold inlay

A

1mm istmus width

1.5mm depth

1mm proximal box

0.5mm chamfer margin

29
Q

What degree of tapered walls do we want for inlay

A

4-6 degrees

30
Q

Where do we want our shoulder chamfer margins for an inlay

A

supra gingival

31
Q

Where must the margins be for an inlay

A

clear of occlusal contact points

32
Q

What sort of bevel do we want for inlays

A

none for ceramic

15-20 degrees bevel in upper ⅓ isthmus wall

33
Q

What features do we want in an inlay

A

occlusal key/dovetail

grooves for retention (optional)

34
Q

How are onlays differnet to inlays

A
  • Similar to inlays but have cuspal coverage and so require some cuspal preparation
35
Q

What are types of onlays

A
  • Gold
  • Composite
  • Porcelain
  • Ceromeric
36
Q

What are indications of onlays

A
  • Sufficient tooth substance loss
  • Remaining tooth substance weakened
  • Wide MODs
37
Q

When are onlays preferable to a large amalgam

A
  • when higher strength is needed and significant tooth recontouring is required
38
Q

What are uses of onlays

A
  • ooth wear cases
    • Increase OVD
  • Fractured cusps
  • Restoration of root treated teeth
  • Replace failed direct restoration
  • Less destructive than crowns
39
Q

What is the occlusal reduction for a porcelain onlay

A

non working cusp - 1.5mm

working cusp -2mm reduction

40
Q

What is the occlusal reduction for a gold onlay

A

non working cusp - 0.5mm

working cusp -1mm reduction

41
Q

how big should the proximal box be for a gold onlay

A

1mm

42
Q

How big should a proximal box be for a ceramic onlay preparation

A

2mm

43
Q

What are the margins for a porcelain onlay

A

1mm

shoulder or chamfer

44
Q

What is the margins for a gold onlay

A

0.5mm chamfer

45
Q

What are features of a onlay prep

A

no bevels for ceramic - butt joint CSM

bevels for gold - 15/20 degree bevel for upper ⅓ of isthmus wall

margins clear of occlusal CP

4-6 degree tapered walls

46
Q

What is the first appointment for an inlay and onlay

A

LA

reduction template

impression for temp

tooth prep

make temp

impressions, bite registration and record shade

cement temp

47
Q

What is the second appointment for inlays and onlays

A

remove temp

isolate, clean and dry prepared tooth

try in

cement

minor occlusal adjustment if needed

48
Q

What are the types of veneers

A
  • Ceramic
  • Composite
  • Gold
49
Q

What are indications for veneers

A
  • Aesthetic
  • Change teeth shape/contour
  • Correct peg shaped laterals
  • Reduce or close proximal spaces and diastemas
  • Align labial surfaces of instanding teeth
  • Enamel defects
  • Discoloration (intrinsic or bleach doesnt work for it)
50
Q

What are contraindications for veneers

A
  • Poor OH
  • High caries rate
  • Gingival recession
  • Root exposure
  • High lip lines
  • Extensive prep needed
51
Q

What is the cervical reduction for veneer

A

0.3mm

chamfer margin

within enamel

supragingival or slightly sub

52
Q

What is the midfacial reduction for a veneer

A

0.5mm

within enamel

53
Q

What is the incisal reduction for a veneer

A

1-1.5mm

54
Q

What is the first appointment for a veneer

A

if tooth prep required

  1. LA
  2. putty index
  3. impression for temp
  4. tooth prep
  5. make temp
  6. impression, bite reg, record shade
  7. cement temp
55
Q

What is the second appointment for a veneer

A
  1. remove temp
  2. isolate, clean and dry tooth
  3. try in and assess fit, adaption and occlusion
  4. cement
56
Q

What are alternatives to veneers

A
  • Bleaching/tooth whitening
  • Microabrasion
  • Direct composite restorations
  • crowns

BDS3 OSCE (65 decks)

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