Operative Test 4 Flashcards by Tim Agee

Composite =

Glass + Nalgene

silica + Bis GMA

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Bis GMA has high _____ shrinkage

and limited ______ wear resistance

Polymerization

Occlusal

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T/F

Compared to Amalgam, composites have larger Proximal Extensions

True

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T/F

The cavo-surface on the occlusal needs an additional bevel in Class II composite restorations

False

*NOT - only USC teaches

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T/F

Retention points are needed in Class II composites

False

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T/F
1 mm bevels are added in the box at the cavo surface margins (3 of them) in a class II composite prep

True

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What type of Composite shouldn’t be used in Posterior?

Microhybrid, nano-composites, or microfilled

Microfilled

*too brittle

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Name 2 Microhybrid composites, 2 Nano-composited, and on Highly Filled composite:

Venus, Hurculite XRV (microhybrid)

Filtek, Premise (Nano-composite)

Helio-Molar (Highly filled composites)

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Composite Instruments (W3, Mini1, #3 Extra-Flex, TNCFIS/.M, 5A) should never be exposed to what?

Peroxide

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What type of wedge should be used for Class II composite restorations?

Plastic

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Flowable Composites are easy to apply but _______

have high polymerization shrinkage

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Microfilled composited are highly polishable and have good transparency but _______

Poor fracture strength

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Hybrid composites are the MOST used by dentists b/c they are versatile, have good over all strength, but the silica can be_____

plucked out

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Nano-composites have the least shrinkage, least resin, good wear resistance, but are ______

expensive

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Flowable Composite brand:

Micro-hybrid brand:

Glass Ionomer (RMGI) brand:

Nano-composite brand:

Tetric Flow

Herculite XRV, Venus

GC Fuji II LC Capsule

Filtek, Premise

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247 diamond is good for:

Groove anatomy

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Composite Instruments are made from:

NIAlN

Nickel Aluminum Nitride

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Tofflemire Band is better on amalgams, _____ is better for composites

Sectional Matrix

*gets tighter contact more consistently

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The Garrison Tight 3D ring we use for Class II composites brand name:

Composi-Tight 3Dfusion

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37% Phosphoric acid can have _______, an antimicrobial that extends the life of a composite restoration

BAC - benzylalkylchloride

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What type of Bonding (generation) are we using?

What brand?

Gold Standard?

Brand?

5th Gen

Optibond Solo plus

4th Gen

All Bond

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When can Chlorhexidine be added to restoration?

After etch, Pre bond

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T/F

Post etch, pre-bond can be GLUMA, HEMA, or CHX

True

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Class II composite restoration: Etch, Rinse, (gluma, hema, chx), bond, cure, _______, composite

flowable

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What is the smallest composite instrument called?

XTS Mini#1

What is the best Composite instrument for the occlusal?

XTS W-3

The last step before finishing (that we never did in lab) is a _______ flow that fills small voids

Heloimolar

Pre finish with: Polish with: Then Glaze, Check occlusion with Articulating Paper

Burs (must use water) and Instruments (DeMeo) Discs

T/F | It is necessary to remove the Transparent Layer of Dentin in a carious lesion

False *No bacteria present, de-mineralized but collagen cross-linking is intact and can be remineralized

Infected Dentin has ______ Affected Dentin has ______

bacteria bacterial by-products (and can re-mineralize)

Reparative Dentin, aka ________

Tertiary Dentin

How long does it take for Dentinogenesis (Tertiary Reparative Dentin) to take place?

20-40 days *requires healthy pulp

What Growth Factor stimulates Tertiary (reparative) dentin?

TGF-B1

What is the critical pH for demineralization/remineralization?

5.5

Caries spreads along the DEJ, undermines enamel, and follows what?

Dentinal tubules toward pulp

If an early carious lesion is limited to the surface of the enamel, what is proper Tx?

re-mineralization

T/F | White spot lesions must be restored

False *re-mineralized

Rapidly growing decay can be what color?

Same as Dentin

Acute caries are rapidly progressing, their texture is ______ and _____, their color is ______

soft moist yellow

T/F | Chronic caries are leathery and Dark

True

Sclerotic Caries are what color?

Dark brown/black *very firm, do not remove (not active)

T/F | Root caries tend to be dark/similar color to dentin

True

ICDAS:

International Caries Detection and Assessment System

ICDAS 0: (definitions) ICDAS 1: ICDAS 2: ICDAS 3: ICDAS 4: ICDAS 5: ICDAS 6:

Sound tooth Enamel change seen only after drying (90 enamel/10 dentin) Visual change (50/50) Enamel breakdown (77 in Dentin), no shadow 88 in Dentin, Dark shadow Visible Dentin (100) Dentin 100, more than 1/2 tooth surface

ICDAS 0: (Tx) ICDAS 1: ICDAS 2: ICDAS 3: ICDAS 4: ICDAS 5: ICDAS 6:

Sealant Sealant Sealant Sealant/PRR (or MIR) MIR (minimally invasive restoration) MIR MIR

What ICDAS level has Optional Sealants?

Low Risk: 0, 1, 2 Moderate Risk: 0 *all else follows pattern: Sealants 0-2, PRR/Sealant/MIR 3, MIR 4-6

Likelihood of cavitation: E1 E2 D1 D2 D3

0% 10.8% ?? 40.9% 100%

What measures Fluorescence?

Diagnodent Laser

0.5% fuchsin in propylene glycol can delineate what?

Outer irreversibly denatured dentin Inner reversibly affected dentin (infected/affected)

When is the Incomplete Removal of caries justified? *Indirect Pulp Cap (involved CHX and liner

No Hx spontaneous pain Vital pulp

Thin layer CaOH or MTA:

Direct Pulp Cap

T/F | Dentin gets softer on the way to the pulp, and if carious gets much harder due to Sclerosis (remineralization)

True

What pulp protectant inhibits the setting of Composites? Which releases fluoride and is acid soluble? Which is Basic, is used in Direct Pulp Cap, and breaks down quickly? Which is Basic, sterile, hydrophilic, and Expensive?`

Zinc Oxide Eugenol GI CaOH paste MTA - Mineral Trioxide Aggregate (EndoSequence)

In a Direct Pulp Cap procedure, what goes over the CaOH (Dycal) paste?

T/F ASDOH Direct Pulp Cap Technique involved EndoSequence (CaOH), which takes 20 minutes to harden, then liner (do not light cure - chemically sets)

True

Principles of Class III design: _____ mm bevel ____ degrees *bevel for color, lesion doesn't include contact

1 45

Class III minimal gingival separation:

1/2-1 mm

T/F | The outline of a perfect Class III prep is a circle

False *oblong increases retention, etc.

An area of deep decay may require a ______ of _______ Brand name:

Liner GI GC Fuji II LC

GC Fuji II LC provides ____ insulation, _____ release, and _____ resistance

thermal fluoride caries

Etchant opens enamel _____ and allows resin to flow into the _______ to create ________ retention with resin tags

prisms tubules micro-mechanical

What is the purpose for Etchant in Dentin?

Demineralizes, removes smear *exposes collagen matrix which resins binds

Bonding agent (OptiBond Solo plus) is ruined by what?

Water/moisture contamination *re-apply

What are the Diamond Football burs?

379 F and EF *good for trimming lingual composites

The scalpel used to trim interproximal composite:

#12

A surface reflecting back light of a different wavelength depending on the source describes what?

Metamerism

What type of filling materials tend to be opaque? What tend to be translucent?

Hybrid, heavily filled, macro particles pure microfilled, nano-hybrids

What color changes occur when a composite is cured? (2)

More translucent Shifts to grays (decrease in tone/value)

Class IV's can be the result of habits, sports, time, and interesting stories

True

The big composite instrument: The little:

XTS #3 XTS Mini #1

If the edge is translucent, use _______ shades If the edge is opaque, use _______ shades

Enamel Dentin

When building _____ scaffold do not fold When building _____ scaffold folding is optional

lingual facial

According to Dr Huang, the most commonly missed step in Class IV composites is what?

Drying and checking with explorer after pre-finishing *don't pre-finish well enough

What zone preserves the dentin bond to composite?

Interdiffusion zone

What bonding resin is the gold standard? Brand?

4th generation Bisco All Bond + D/E resin/OptiBond FL *requires 5-6 applications

C Factor = High C factor means what?

bonded resin surface/un-bonded shrinkage

Because of polymerization shrinkage, darker shades need to be less than _____ mm thick

5th Generation Bonding - what 2 steps?

Etch OptiBond Solo plus

OptiBond Solo plus has what in it that acts as an elastic layer?

Nano-filled particles

6th Generation bonding is the best seller in the US and is called?

Clearfil SE (mod pH)

7 Generation (Huang doesn't recommend) is an all in one called what?

i-Bond, Xeno IV

"Bonding" step has a ___ and a ____

GI Conditioner (weak acid, removes smear)

Aside from being technique sensitive (like Gen 4), 5th generation bonding (OptiBond solo +) is sensitive to what?

moisture

Under-etching will inhibit ____ bonding Over-etching will inhibit _____ bonding

Enamel Dentin

T/F | Ceramic is similar in hardness to quartz at 7 Mohs and both are harder than steel at 6.5 Mohs

True

T/F | Polishing theory includes Scratch, Ductile flow, and Chemo-mechanical

True

What is the measurable surface strain created by scratches during polishing?

Twyman effect *different from poly shrinkage

The Twyman Effect is large in _____ and ______ theory. Small in _____.

Scratch, Ductile Flow Chemo-mechanical *b/c chemically react at surface for latter

The Hammer Effect occurs in prefinishing with _____ burs

Carbide

Diamond is _____ times harder than composite or carbide burs

1167

T/F | Diamond burs w/o water create more heat/strain than carbide w/o water

True

F and EF burs are ___ and ___ micron diamonds

30 15

Soflex discs contain _____ oxide

alumina

Polishing involves scratch theory

False *Plastic ductile/chemo-mechanical

``` T/F If resin (Glaze) is used in place of a final polish, your practice will suffer ```

True