practical 2/clinical test case

Question 1

competency steps

Answer 1

1) lesion approval and start check
2) rubber dam is must
3) ideal prep
4) modification / extension request
5) final prep check / liner request
6) final restoration check

Question 2

differenced

Answer 2

1) pulpal depth is 1-1.5 mm

Question 3

tibber dam

Answer 3

1) for #3
2) clamp #2 and place dam to #11
3) dam must be inverted
4) must have floss ligation

Question 4

initial access to cares

Answer 4

1) prep to outline that is ideal
2) you will feel the bur drop into the caries

Question 5

asking for modification too early

Answer 5

1) only ask if you are at the maximum limit of your ideal prep criteria
2) do not ask too soon!
- you will get denied for a request

Question 6

writing your requests

Answer 6

1) start with external walls
- entire wall must be moved
2) then internal walls
- only remove carious area
- only applies to axial wall and pulpal floor
—
1) what, where, how much, why?

Question 7

where?

Answer 7

1) name of the wall
- distinguish between occlusal and proximal
2) may not combine walls in one request

Question 8

how much?

Answer 8

1) as for how much extension you think you will need to remove all the caries remaining in increments of 0.5 mm

Question 9

unsupported enamel

Answer 9

1) you cannot ask for a modification to remove unsupported enamel
2) should have been removed when you asked for the external extension

Question 10

reason?

Answer 10

1) caries
2) demineralization
3) infected dentin / affected dentin

Question 11

common errors

Answer 11

1) do not leave unsupported enamel
2) know your nomenclature
3) use mirrors to check every wall and line angle
4) remember caries spreads laterally at DEJ!!!
- remove any stain there
5) round off the external wall or remove unsupported enamel

Question 12

if buccal/lingual proximal walls are extended

Answer 12

1) move entire walls out and reestablish angles

Question 13

gingival floor extension

Answer 13

1) move entire floor down

Question 14

axial wall / pulpal floor

Answer 14

1) can remove only carious portion using a round bur in 5000 rpm

Question 15

denied modification request

Answer 15

1) amount of extension is too excessive
2) incorrect location and/or type
3) incorrect nomenclature
4) time of the request is not at the ideal dimensions specified criteria

Question 16

caries on pulpal floor can be

Answer 16

1) scooped out
2) round off sharp edges if you have those remaining

Question 17

if you are dropping the gingival floor and the axial wall deviates from ideal depth

Answer 17

1) do not extend axially, just drop it to remove caries

Question 18

final preparation frading

Answer 18

1) an caries remaining is automatic failure
- unless if it left behind for indirect/direct pulp cap
2) once grader is done, you will receive your typodont back
3) you are now ready to restore
4) put it back in the simulator and finish your restoration with RD on
5) do check occlusion when done