Operative Test 4 Flashcards
Composite =
Glass + Nalgene
silica + Bis GMA
Bis GMA has high _____ shrinkage
and limited ______ wear resistance
Polymerization
Occlusal
T/F
Compared to Amalgam, composites have larger Proximal Extensions
True
T/F
The cavo-surface on the occlusal needs an additional bevel in Class II composite restorations
False
*NOT - only USC teaches
T/F
Retention points are needed in Class II composites
False
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
What type of Composite shouldn’t be used in Posterior?
Microhybrid, nano-composites, or microfilled
Microfilled
*too brittle
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)
Composite Instruments (W3, Mini1, #3 Extra-Flex, TNCFIS/.M, 5A) should never be exposed to what?
Peroxide
What type of wedge should be used for Class II composite restorations?
Plastic
Flowable Composites are easy to apply but _______
have high polymerization shrinkage
Microfilled composited are highly polishable and have good transparency but _______
Poor fracture strength
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
Nano-composites have the least shrinkage, least resin, good wear resistance, but are ______
expensive
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
247 diamond is good for:
Groove anatomy
Composite Instruments are made from:
NIAlN
Nickel Aluminum Nitride
Tofflemire Band is better on amalgams, _____ is better for composites
Sectional Matrix
*gets tighter contact more consistently
The Garrison Tight 3D ring we use for Class II composites brand name:
Composi-Tight 3Dfusion
37% Phosphoric acid can have _______, an antimicrobial that extends the life of a composite restoration
BAC - benzylalkylchloride
What type of Bonding (generation) are we using?
What brand?
Gold Standard?
Brand?
5th Gen
Optibond Solo plus
4th Gen
All Bond
When can Chlorhexidine be added to restoration?
After etch, Pre bond
T/F
Post etch, pre-bond can be GLUMA, HEMA, or CHX
True
Class II composite restoration: Etch, Rinse, (gluma, hema, chx), bond, cure, _______, composite
flowable
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?
GI
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
2
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
