Principles of Operative Dentistry Flashcards
1
Q
What is operative dentistry?
A
Treatment of disease/defects of hard tissues of teeth THAT DO NOT REQUIRE FULL COVER RESTORATION
2
Q
Operative dentistry restores:
A
Form
Function
Esthetics
3
Q
Enamel thickness varies by:
A
- Location
- Tooth type
4
Q
Enamel is ____% hydroxyapatite
A
90-92%
5
Q
Enamel can be described as both:
A
strong & brittle
6
Q
Enamels rods are _____ diameter near the surface & _____ near the dentin borders
A
Larger; smaller
7
Q
Enamel rods are ____ to the long axis and radiate _____
A
Perpendicular; outward
8
Q
Can act as food/bacterial traps, leading to decay
A
Grooves & fissures
9
Q
-Hypomineralized
-Extend into the enamel
A
Enamel tufts
10
Q
Thin faults between enamel rod groups:
A
Enamel lamella
11
Q
Enamel lamella extend from ____ toward ____
A
Enamel; DEJ
12
Q
Odontoblastic process crossed into enamel:
A
Enamel spindles
13
Q
Hypomineralized zone where dentin meets enamel:
A
Dentino-enamel junction (DEJ)
14
Q
The DEJ, where dentin meets enamel can be described as:
A
Hypomineralized
15
Q
Enamel becomes more soluble as you approach the:
A
DEJ
16
Q
Lowers acid solubility:
A
Fluoride
17
Q
What is important to remember when considering caries AND bonded restoration?
A
- Fluoride lowers acid solubility
- Enamel is more soluble as you approach the DEJ
18
Q
Describe the pulp-dentin complex: (2)
A
- Strong & resilient
- Living tissue
19
Q
The largest portion of the tooth is comprised of:
A
Dentin
20
Q
Dentin is located in both ____ & ____ portions of the tooth
A
Coronal & root
21
Q
Forms the walls of the pulp chamber:
A
Dentin
22
Q
Dentin is formed immediately:
A
Prior to enamel
23
Q
Describe dentin formation (timeline):
A
Continues throughout the life of the pulp
24
Q
Canals extending from DEJ/DCJ to pulp:
A
Dentinal tubules
25
Dentinal tubules are canals extending from:
DEJ/DCJ to pulp
26
Dentinal tubules are lined with:
Peritubular dentin
27
______ is located between dentinal tubules
Intertubular dentin
28
Dentinal tubules are lined with ____ & _____ is between the dentinal tubules
Peritubular dentin; intertubular dentin
29
Where is the diameter of dentinal tubules the largest?
Largest at pulp
30
In dentinal tubules, the number of tubules/square mm is greatest at the:
Pulp
31
Reparative dentin is formed by ______ in response to ______
Secondary odontoblasts;
Moderate irritant
32
Secondary odontoblasts form:
Reparative dentin
33
Provides protection to the underlying pulp by decreasing dentin permeability:
Reparative dentin
34
How does reparative dentin provide protection to the underlying pulp:
By decreasing dentin permeability
35
Primary dentin that has changed:
Sclerotic dentin
36
Process of sclerotic dentin formation:
Peritubular dentin widens & fills with calcified material
37
Dentin hardness compared to enamel:
Dentin is 1/5 as hard as enamel
38
Dentin is harder near the ____ than the _____ by (___x)
DEJ than near pulp; (3x)
39
Dentin is ____% hydroxyapatite
50
40
What causes dentinal sensitivity?
Fluid movement in tubules
41
Describe the hydrodynamic theory of pain transmission:
Odontoblastic process wrapped in nerves & fluid in dentin tubules
42
When enamel/cementum is removed during preparation, the _____ is lost, causing ____ resulting ____
Seal is lost; causing small fluid movements in tubules which distorts nerve endings; dentin sensitivity/pain
43
Created whenever tooth is cut/prepared:
Smear layer
44
The smear layer plugs:
Dentinal tubules
45
Enamel vs. Dentin color:
Enamel:
- Grey & semi-translucent
- Color depends on the underlying dentin
- Becomes temporarily whiter when dehydrated
- shiny
46
Enamel vs. Dentin color:
Enamel becomes temporarily white when:
Dehydrated
47
Enamel vs. Dentin color:
Dentin:
- Yellow/white
- Dull/opaque
48
Covers the root surface:
Cememtum
49
Cementum is ____ compared to dentin
Softer
50
Describe the formation of cementum:
Formed cotinually
51
Curve or shape of something:
Contour
52
Where two adjacent teeth contact:
Proximal contact
53
An opening with sides flaring outward:
Embrasures
54
V-shaped valleys between adjacent teeth; typically filled with gingiva:
Embrasures
55
Objectives of tooth preparation:
1. _____ form, ____ form, ____ form
2. Remove _____
3. Provide necessary ______
4. Extend restoration as _______
5. ______ when chewing
6. Restore _____ & ______
1. Resistance form, retention form, convenience form
2. Defects
3. Protection to pulp
4. As conservatively as possible
5. Resist fracture
6. Esthetics & function
56
Tooth preparation should be _____ especially for ______
Precise; amalgam
57
Tooth preparation should follow the:
GV Black- design & principles
58
Preparations for complete composite restorations incorporate:
Bonding
59
When preparing a tooth you should extend to:
Sound tooth structure in all directions
60
Preparation walls are designed to: (2)
1. RETAIN restoration
2. Resist fracture
61
The first step in a preparation is to:
Remove remaining caries or old restorative material
62
Three important aspects of preparation include:
1. Minimize _____
2. Maximize ____
3. Protect ____
1. Minimize fracture
2. Maximize retention
3. Protect pulp
63
The last step in preparation of a tooth is:
Final cleaning, inspection & sealing prep
64
Factors to consider prior to restoring a tooth: (5)
1. Esthetics
2. Economics
3. Medical conditions
4. Age
5. Caries risk
65
The dental anatomy to consider when restoring a tooth include: (4)
1. Enamel rod orientation
2. thickness of enamel & dentin
3. Size & location of pulp
4. Relationship of tooth to periodontium
66
When considering conservation of tooth structure, repair _____ but preserve _____
Damage; Vitality
67
Locations of primary caries:
1. Pit & fissure
2. Enamel smooth surface
3. Root surface
68
Pit & fissures occur from:
Imperfect coalescence of developmental lobe
69
What area of the tooth is an area that is left unclean chronically (location of primary caries)
Enamel smooth surface
70
Carries left by the operator may be intentionally or accidental:
Residual caries
71
It is never ideal to leave caries especially when:
Left at DEJ or on prepared enamel wall
72
It may be acceptable to leave caries in a rare instance to:
avoid pulp exposure and when left as affected dentin near the pulp
73
Microleakage present a the junction between the restoration and tooth may cause:
Recurrent caries
74
May progress under the restoration or behind it so it cannot be seen with a radiograph:
Recurrent caries
75
Type of carries that cannot be seen in a radiograph:
Recurrent caries
76
Reparative dentin is formed by odontoblasts at:
Ends of tubules & surface of pulp in response to irritation
77
Light color caries that appear dull & mushy:
Acute
78
Acute caries may also be called:
Rampant caries
79
Caries that are slow or arrested, a dark color & appear shiny/solid:
Chronic caries
80
Dentists formally practiced _____ meaning ____-
"Extension for prevention" - meant taking away unnecessary tooth structure & is no longer practiced
81
Instead of "extension for prevention" there are better preventative measures available including: (4)
1. Enameloplasty
2. Sealant
3. Preventative resin
4. Conservative composite restoration
82
Surfaces involved in restoration:
______- one surface involved
______- two surfaces involved
______- three or more surfaces involved
Simple
Compound
Complex
83
Abbreviations:
O:
MO, DO, MOD:
F or B:
L:
Occlusal
Mesial-occlusal, distal-occlusal, mesial-occlusal-distal
Facial or buccal
Lingual
84
Internal walls in a tooth preparation include:
Axial wall
Pulpal wall (floor)
85
Label A & B in the following image:
A- Pulpal floor
B- Axial wall
86
The axial wall is ____ to the long axis of the tooth:
Parallel
87
Wall closest to the pulp:
Pulpal wall (floor)
88
The pulpal wall/floor is ____ to the long axis of the tooth in ______ preparations:
Perpendicular; class I & II
89
Label the following image:
A-pulpal floor
B- Axial wall
C- Gingival floor
D- Buccal wall
E- Lingual wall
F- Axio-lingual line angle
G- Axio-pulpal line angle
H- Axio-buccal line angle
I- Axio-gingival line angle
90
Describe the floor in a preparation: (3)
1. Prepared
2. Flat
3. Perpendicular to occlusal forces
91
The pulpal floor is _____ to occlusal forces
Perpedicular
92
The pulpal & gingival walls of a prep provide ______ for the restoration and _____ in the tooth
Provide stabilizing seats & distribute stresses
93
Junction of two walls/surfaces along a line:
Line angle
94
In a ____ line angle, the apex points AWAY from the observer
Internal
95
In a _____ line angle, the apex points TOWARDS the observer
External
96
Junction of three surfaces:
Point angle
97
Junction of PREPARED cavity wall & EXTERNAL surface of the tooth:
Cavosurface angle/margin
98
Types of cavosurfaces (3):
1. Bevel
2. 90 degrees
3. Chamfer
99
Where the cementum meets the enamel:
Cementoenamel junction (CEJ)
100
The enamel margin strength is formed by:
Full length enamel rods
101
Enamel rods' inner end are on:
Sound dentin
102
When enamel rods are not supported by enamel:
Unsupported enamel
103
Unsupported enamel can:
Fracture easily because its brittle
104
Why operative dentistry?
Diagnosis, treatment & repair
105
Classifications of tooth preps are named based on:
Anatomy invovled
106
A preparation on the occlusal surface of posterior teeth:
Class I
107
A class I prep on the occlusal surface of posterior teeth may include:
Lingual/buccal grooves & pits
108
A preparation on the proximal surface of premolars & molars:
Class II
109
A preparation on the proximal surfaces of incisors & canines THEY DO NOT INVOLVE THE INCISAL EDGE:
Class III
110
A preparation on the proximal surfaces of incisors & canines that INVOLVE the incisal edge:
Class IV
111
A preparation on the gingival 1/3 of buccal & lingual surfaces:
Class V
112
A preparation on the incisal edge or cusp:
Class VI
113
List the components of the initial stage of tooth preparation: (5)
1. Outline form
2. Initial depth
3. Primary resistance form
4. Primary retention form
5. Convenience form
114
When visualizing the outline form the prep should appear:
Smooth & flowing
115
List what aspects make up the outline form of the initial stage of tooth preparation: (3)
1. undermined enamel is removed
2. margins placed where you can finish restoration
3. no occlusion on margins of prep
116
When considering the outline form of a prep:
1. ______ on cusps & marginal ridges
2. Minimize extensions _______
3. Connect two preps that _____
1. Preserve strength
3. Faciolingually
3. Less than 0.5mm apart
117
In a class I prep, the depth of pit & fissure maximum=
2.0mm (in lab setting)
118
In a class I prep, the depth should extend to:
Sound tooth structure
119
In a class I prep, extend when: (2)
1. Fissures cannot be eliminated by enameloplasty
2. Two cavities have less than 0.5mm between them
120
When considering outline form, do not terminate on:
Cusp height or ridge crest
121
In a class II prep, extend gingival margins _____ extend interproximal margins to _____
Apical to contact; embrasures
122
What is the axial wall depth in a class II preparation:
0.2-0.8mm INTO DENTIN
123
How is axial wall depth measured?
From edge of tooth (proximal surface) to axial wall
124
Is not a typical depth measurement from the top of something to the bottom:
Axial wall depth
125
Removes shallow enamel fissure or pit, creating a smooth, saucer shaped surface:
Enameloplasty
126
A smooth, saucer shaped surface created by an enameloplasty is:
Self-cleansing
127
In an enameloplasty, no more than ______ enamel thickness should be removed:
1/3
128
List the four aspects of resistance form:
1. Resistance to fracture
2. Need to resist or withstand occlusal forces
3. Conservative extension- leave tooth strong
4. Preserve cusps and marginal ridges
129
When is resistance form compromised?
1. When margin exceeds 2/3 of the distance between the central groove
2. When margins 1/2 the distance between the central groove and cusp tip
130
Resistance form is compromised when the margin extends 2/3 the distance of the central groove and you:
Must cap weak cusps
131
Resistance form is compromised when the margins end 1/2 distance between central groove and cusp tip and you:
Consider capping weak cusps
132
-Internal line angles slightly rounded
-External line angles slightly rounded
-Flat floors
These all contribute to:
Resistance form
133
Slightly rounded external line angles leads to:
Less stress concentration
134
Flat floors of a preparation prevent:
Movement
135
Resistance form includes allowing for sufficient _____ of restorative material:
Thickness
136
In order to contribute to resistance form, bevels are needed to:
1. Remove unsupported enamel
2. Reduce stress concentration
137
In order to contribute to resistance form, the margins in amalgam should be:
90 degrees
138
The objective of retention form is to:
Retain the restoration (keep restorations in the tooth)
139
Method contributing to retention form in which it prevents tipping and proximal displacement:
Dovetails
140
What is the goal of a dovetail?
Prevents tipping & proximal displacement
141
What are the three components of retention form?
1. Wall length
2. Convergence
3. Parallelism
142
Having a taller wall in a preparation will:
Resist pull of sticky foods
143
Describe convergence in retention form:
Walls slant toward each other, especially important with amalgam
144
Describe retention form in bonded restorations:
Microchemical retention between adhesive & tooth
145
Form that allows you to access the defect:
Convenience form
146
Convenience form allows you to:
See what you are doing
147
Once outline form, primary resistance, & primary retention form are complete, _____ may remain & its important to _____
Caries may remain; remove the caries
148
In the final stage of tooth preparation:
1. Remove remaining ______
2. Remove remaining ____
3. ____ protection
4. _____ & _____ forms
5. Finish ____ & ____
6. Final ____, ____ & _____
1. infected dentin
2. old restoration
3. pulp
4. secondary resistance & retention form
5. external walls & margins
6. cleaning, inspecting & sealing
149
Affected dentin is _____ and usually _____ but NOT _____
Is this okay to leave or does it need to be removed?
Demineralized; discolored; soft
Ok to leave
150
Affected dentin is _____ while infected dentin _____
Okay to leave; must be removed
151
Describe infected dentin:
Microorganisms present
Soft
May or may not be stained
Must remove
152
Why must infected dentin be removed?
Because microorganisms are present
153
How do you tell the difference between affected & infected dentin?
Not always possible
154
Secondary retention includes:
Retention grooves & points
155
Areas for restorative material to "lock" into, resulting in improved retention:
Retention groove/points
156
Secondary retention includes having fewer _____
Extensions
157
A bevel for rounded axiopulpal line angles is an example of:
Secondary resistance
158
Allows for the increase bulk of restorative material & dispersal of concentration of forces:
Bevel for rounded axiopulpal line angles
159
Position slightly to the patients right & in front:
8:00
160
When should an 8:00 position be used?
1. Buccal sides of patients UL
2. Lingual sides of patient LR
161
Position slightly to the patients right & behind:
11:00
162
When should an 11:00 position be used?
1. Buccal sides of patients UR
2. Lingual sides of patients LL
163
Position slightly to the patients left & behind:
12:00-1:00
164
When should a 12:00-1:00 be used?
1. Buccal sides of patients R & L anterior
2. Lingual sides of patients R & L anterior
