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Operative Dentistry I > Principles of Operative Dentistry > Flashcards

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

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2
Q

Operative dentistry restores:

A

Form
Function
Esthetics

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3
Q

Enamel thickness varies by:

A
  1. Location
  2. Tooth type
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4
Q

Enamel is ____% hydroxyapatite

A

90-92%

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5
Q

Enamel can be described as both:

A

strong & brittle

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6
Q

Enamels rods are _____ diameter near the surface & _____ near the dentin borders

A

Larger; smaller

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7
Q

Enamel rods are ____ to the long axis and radiate _____

A

Perpendicular; outward

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8
Q

Can act as food/bacterial traps, leading to decay

A

Grooves & fissures

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9
Q

-Hypomineralized
-Extend into the enamel

A

Enamel tufts

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10
Q

Thin faults between enamel rod groups:

A

Enamel lamella

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11
Q

Enamel lamella extend from ____ toward ____

A

Enamel; DEJ

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12
Q

Odontoblastic process crossed into enamel:

A

Enamel spindles

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13
Q

Hypomineralized zone where dentin meets enamel:

A

Dentino-enamel junction (DEJ)

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14
Q

The DEJ, where dentin meets enamel can be described as:

A

Hypomineralized

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15
Q

Enamel becomes more soluble as you approach the:

A

DEJ

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16
Q

Lowers acid solubility:

A

Fluoride

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17
Q

What is important to remember when considering caries AND bonded restoration?

A
  1. Fluoride lowers acid solubility
  2. Enamel is more soluble as you approach the DEJ
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18
Q

Describe the pulp-dentin complex: (2)

A
  1. Strong & resilient
  2. Living tissue
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19
Q

The largest portion of the tooth is comprised of:

A

Dentin

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20
Q

Dentin is located in both ____ & ____ portions of the tooth

A

Coronal & root

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21
Q

Forms the walls of the pulp chamber:

A

Dentin

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22
Q

Dentin is formed immediately:

A

Prior to enamel

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23
Q

Describe dentin formation (timeline):

A

Continues throughout the life of the pulp

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24
Q

Canals extending from DEJ/DCJ to pulp:

A

Dentinal tubules

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25
Q

Dentinal tubules are canals extending from:

A

DEJ/DCJ to pulp

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26
Q

Dentinal tubules are lined with:

A

Peritubular dentin

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27
Q

______ is located between dentinal tubules

A

Intertubular dentin

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28
Q

Dentinal tubules are lined with ____ & _____ is between the dentinal tubules

A

Peritubular dentin; intertubular dentin

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29
Q

Where is the diameter of dentinal tubules the largest?

A

Largest at pulp

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30
Q

In dentinal tubules, the number of tubules/square mm is greatest at the:

A

Pulp

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31
Q

Reparative dentin is formed by ______ in response to ______

A

Secondary odontoblasts;
Moderate irritant

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32
Q

Secondary odontoblasts form:

A

Reparative dentin

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33
Q

Provides protection to the underlying pulp by decreasing dentin permeability:

A

Reparative dentin

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34
Q

How does reparative dentin provide protection to the underlying pulp:

A

By decreasing dentin permeability

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35
Q

Primary dentin that has changed:

A

Sclerotic dentin

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36
Q

Process of sclerotic dentin formation:

A

Peritubular dentin widens & fills with calcified material

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37
Q

Dentin hardness compared to enamel:

A

Dentin is 1/5 as hard as enamel

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38
Q

Dentin is harder near the ____ than the _____ by (___x)

A

DEJ than near pulp; (3x)

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39
Q

Dentin is ____% hydroxyapatite

A

50

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40
Q

What causes dentinal sensitivity?

A

Fluid movement in tubules

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41
Q

Describe the hydrodynamic theory of pain transmission:

A

Odontoblastic process wrapped in nerves & fluid in dentin tubules

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42
Q

When enamel/cementum is removed during preparation, the _____ is lost, causing ____ resulting ____

A

Seal is lost; causing small fluid movements in tubules which distorts nerve endings; dentin sensitivity/pain

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43
Q

Created whenever tooth is cut/prepared:

A

Smear layer

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44
Q

The smear layer plugs:

A

Dentinal tubules

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45
Q

Enamel vs. Dentin color:

Enamel:

A
  • Grey & semi-translucent
  • Color depends on the underlying dentin
  • Becomes temporarily whiter when dehydrated
  • shiny
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46
Q

Enamel vs. Dentin color:

Enamel becomes temporarily white when:

A

Dehydrated

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47
Q

Enamel vs. Dentin color:

Dentin:

A
  • Yellow/white
  • Dull/opaque
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48
Q

Covers the root surface:

A

Cememtum

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49
Q

Cementum is ____ compared to dentin

A

Softer

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50
Q

Describe the formation of cementum:

A

Formed cotinually

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51
Q

Curve or shape of something:

A

Contour

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52
Q

Where two adjacent teeth contact:

A

Proximal contact

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53
Q

An opening with sides flaring outward:

A

Embrasures

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54
Q

V-shaped valleys between adjacent teeth; typically filled with gingiva:

A

Embrasures

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55
Q

Objectives of tooth preparation:

  1. _____ form, ____ form, ____ form
  2. Remove _____
  3. Provide necessary ______
  4. Extend restoration as _______
  5. ______ when chewing
  6. Restore _____ & ______
A
  1. Resistance form, retention form, convenience form
  2. Defects
  3. Protection to pulp
  4. As conservatively as possible
  5. Resist fracture
  6. Esthetics & function
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56
Q

Tooth preparation should be _____ especially for ______

A

Precise; amalgam

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57
Q

Tooth preparation should follow the:

A

GV Black- design & principles

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58
Q

Preparations for complete composite restorations incorporate:

A

Bonding

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59
Q

When preparing a tooth you should extend to:

A

Sound tooth structure in all directions

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60
Q

Preparation walls are designed to: (2)

A
  1. RETAIN restoration
  2. Resist fracture
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61
Q

The first step in a preparation is to:

A

Remove remaining caries or old restorative material

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62
Q

Three important aspects of preparation include:

  1. Minimize _____
  2. Maximize ____
  3. Protect ____
A
  1. Minimize fracture
  2. Maximize retention
  3. Protect pulp
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63
Q

The last step in preparation of a tooth is:

A

Final cleaning, inspection & sealing prep

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64
Q

Factors to consider prior to restoring a tooth: (5)

A
  1. Esthetics
  2. Economics
  3. Medical conditions
  4. Age
  5. Caries risk
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65
Q

The dental anatomy to consider when restoring a tooth include: (4)

A
  1. Enamel rod orientation
  2. thickness of enamel & dentin
  3. Size & location of pulp
  4. Relationship of tooth to periodontium
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66
Q

When considering conservation of tooth structure, repair _____ but preserve _____

A

Damage; Vitality

67
Q

Locations of primary caries:

A
  1. Pit & fissure
  2. Enamel smooth surface
  3. Root surface
68
Q

Pit & fissures occur from:

A

Imperfect coalescence of developmental lobe

69
Q

What area of the tooth is an area that is left unclean chronically (location of primary caries)

A

Enamel smooth surface

70
Q

Carries left by the operator may be intentionally or accidental:

A

Residual caries

71
Q

It is never ideal to leave caries especially when:

A

Left at DEJ or on prepared enamel wall

72
Q

It may be acceptable to leave caries in a rare instance to:

A

avoid pulp exposure and when left as affected dentin near the pulp

73
Q

Microleakage present a the junction between the restoration and tooth may cause:

A

Recurrent caries

74
Q

May progress under the restoration or behind it so it cannot be seen with a radiograph:

A

Recurrent caries

75
Q

Type of carries that cannot be seen in a radiograph:

A

Recurrent caries

76
Q

Reparative dentin is formed by odontoblasts at:

A

Ends of tubules & surface of pulp in response to irritation

77
Q

Light color caries that appear dull & mushy:

A

Acute

78
Q

Acute caries may also be called:

A

Rampant caries

79
Q

Caries that are slow or arrested, a dark color & appear shiny/solid:

A

Chronic caries

80
Q

Dentists formally practiced _____ meaning ____-

A

“Extension for prevention” - meant taking away unnecessary tooth structure & is no longer practiced

81
Q

Instead of “extension for prevention” there are better preventative measures available including: (4)

A
  1. Enameloplasty
  2. Sealant
  3. Preventative resin
  4. Conservative composite restoration
82
Q

Surfaces involved in restoration:

______- one surface involved
______- two surfaces involved
______- three or more surfaces involved

A

Simple
Compound
Complex

83
Q

Abbreviations:

O:
MO, DO, MOD:
F or B:
L:

A

Occlusal
Mesial-occlusal, distal-occlusal, mesial-occlusal-distal
Facial or buccal
Lingual

84
Q

Internal walls in a tooth preparation include:

A

Axial wall
Pulpal wall (floor)

85
Q

Label A & B in the following image:

A

A- Pulpal floor
B- Axial wall

86
Q

The axial wall is ____ to the long axis of the tooth:

A

Parallel

87
Q

Wall closest to the pulp:

A

Pulpal wall (floor)

88
Q

The pulpal wall/floor is ____ to the long axis of the tooth in ______ preparations:

A

Perpendicular; class I & II

89
Q

Label the following image:

A

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
Q

Describe the floor in a preparation: (3)

A
  1. Prepared
  2. Flat
  3. Perpendicular to occlusal forces
91
Q

The pulpal floor is _____ to occlusal forces

A

Perpedicular

92
Q

The pulpal & gingival walls of a prep provide ______ for the restoration and _____ in the tooth

A

Provide stabilizing seats & distribute stresses

93
Q

Junction of two walls/surfaces along a line:

A

Line angle

94
Q

In a ____ line angle, the apex points AWAY from the observer

A

Internal

95
Q

In a _____ line angle, the apex points TOWARDS the observer

A

External

96
Q

Junction of three surfaces:

A

Point angle

97
Q

Junction of PREPARED cavity wall & EXTERNAL surface of the tooth:

A

Cavosurface angle/margin

98
Q

Types of cavosurfaces (3):

A
  1. Bevel
  2. 90 degrees
  3. Chamfer
99
Q

Where the cementum meets the enamel:

A

Cementoenamel junction (CEJ)

100
Q

The enamel margin strength is formed by:

A

Full length enamel rods

101
Q

Enamel rods’ inner end are on:

A

Sound dentin

102
Q

When enamel rods are not supported by enamel:

A

Unsupported enamel

103
Q

Unsupported enamel can:

A

Fracture easily because its brittle

104
Q

Why operative dentistry?

A

Diagnosis, treatment & repair

105
Q

Classifications of tooth preps are named based on:

A

Anatomy invovled

106
Q

A preparation on the occlusal surface of posterior teeth:

A

Class I

107
Q

A class I prep on the occlusal surface of posterior teeth may include:

A

Lingual/buccal grooves & pits

108
Q

A preparation on the proximal surface of premolars & molars:

A

Class II

109
Q

A preparation on the proximal surfaces of incisors & canines THEY DO NOT INVOLVE THE INCISAL EDGE:

A

Class III

110
Q

A preparation on the proximal surfaces of incisors & canines that INVOLVE the incisal edge:

A

Class IV

111
Q

A preparation on the gingival 1/3 of buccal & lingual surfaces:

A

Class V

112
Q

A preparation on the incisal edge or cusp:

A

Class VI

113
Q

List the components of the initial stage of tooth preparation: (5)

A
  1. Outline form
  2. Initial depth
  3. Primary resistance form
  4. Primary retention form
  5. Convenience form
114
Q

When visualizing the outline form the prep should appear:

A

Smooth & flowing

115
Q

List what aspects make up the outline form of the initial stage of tooth preparation: (3)

A
  1. undermined enamel is removed
  2. margins placed where you can finish restoration
  3. no occlusion on margins of prep
116
Q

When considering the outline form of a prep:

  1. ______ on cusps & marginal ridges
  2. Minimize extensions _______
  3. Connect two preps that _____
A
  1. Preserve strength
  2. Faciolingually
  3. Less than 0.5mm apart
117
Q

In a class I prep, the depth of pit & fissure maximum=

A

2.0mm (in lab setting)

118
Q

In a class I prep, the depth should extend to:

A

Sound tooth structure

119
Q

In a class I prep, extend when: (2)

A
  1. Fissures cannot be eliminated by enameloplasty
  2. Two cavities have less than 0.5mm between them
120
Q

When considering outline form, do not terminate on:

A

Cusp height or ridge crest

121
Q

In a class II prep, extend gingival margins _____ extend interproximal margins to _____

A

Apical to contact; embrasures

122
Q

What is the axial wall depth in a class II preparation:

A

0.2-0.8mm INTO DENTIN

123
Q

How is axial wall depth measured?

A

From edge of tooth (proximal surface) to axial wall

124
Q

Is not a typical depth measurement from the top of something to the bottom:

A

Axial wall depth

125
Q

Removes shallow enamel fissure or pit, creating a smooth, saucer shaped surface:

A

Enameloplasty

126
Q

A smooth, saucer shaped surface created by an enameloplasty is:

A

Self-cleansing

127
Q

In an enameloplasty, no more than ______ enamel thickness should be removed:

A

1/3

128
Q

List the four aspects of resistance form:

A
  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
Q

When is resistance form compromised?

A
  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
Q

Resistance form is compromised when the margin extends 2/3 the distance of the central groove and you:

A

Must cap weak cusps

131
Q

Resistance form is compromised when the margins end 1/2 distance between central groove and cusp tip and you:

A

Consider capping weak cusps

132
Q

-Internal line angles slightly rounded
-External line angles slightly rounded
-Flat floors

These all contribute to:

A

Resistance form

133
Q

Slightly rounded external line angles leads to:

A

Less stress concentration

134
Q

Flat floors of a preparation prevent:

A

Movement

135
Q

Resistance form includes allowing for sufficient _____ of restorative material:

A

Thickness

136
Q

In order to contribute to resistance form, bevels are needed to:

A
  1. Remove unsupported enamel
  2. Reduce stress concentration
137
Q

In order to contribute to resistance form, the margins in amalgam should be:

A

90 degrees

138
Q

The objective of retention form is to:

A

Retain the restoration (keep restorations in the tooth)

139
Q

Method contributing to retention form in which it prevents tipping and proximal displacement:

A

Dovetails

140
Q

What is the goal of a dovetail?

A

Prevents tipping & proximal displacement

141
Q

What are the three components of retention form?

A
  1. Wall length
  2. Convergence
  3. Parallelism
142
Q

Having a taller wall in a preparation will:

A

Resist pull of sticky foods

143
Q

Describe convergence in retention form:

A

Walls slant toward each other, especially important with amalgam

144
Q

Describe retention form in bonded restorations:

A

Microchemical retention between adhesive & tooth

145
Q

Form that allows you to access the defect:

A

Convenience form

146
Q

Convenience form allows you to:

A

See what you are doing

147
Q

Once outline form, primary resistance, & primary retention form are complete, _____ may remain & its important to _____

A

Caries may remain; remove the caries

148
Q

In the final stage of tooth preparation:

  1. Remove remaining ______
  2. Remove remaining ____
  3. ____ protection
  4. _____ & _____ forms
  5. Finish ____ & ____
  6. Final ____, ____ & _____
A
  1. infected dentin
  2. old restoration
  3. pulp
  4. secondary resistance & retention form
  5. external walls & margins
  6. cleaning, inspecting & sealing
149
Q

Affected dentin is _____ and usually _____ but NOT _____

Is this okay to leave or does it need to be removed?

A

Demineralized; discolored; soft

Ok to leave

150
Q

Affected dentin is _____ while infected dentin _____

A

Okay to leave; must be removed

151
Q

Describe infected dentin:

A

Microorganisms present
Soft
May or may not be stained
Must remove

152
Q

Why must infected dentin be removed?

A

Because microorganisms are present

153
Q

How do you tell the difference between affected & infected dentin?

A

Not always possible

154
Q

Secondary retention includes:

A

Retention grooves & points

155
Q

Areas for restorative material to “lock” into, resulting in improved retention:

A

Retention groove/points

156
Q

Secondary retention includes having fewer _____

A

Extensions

157
Q

A bevel for rounded axiopulpal line angles is an example of:

A

Secondary resistance

158
Q

Allows for the increase bulk of restorative material & dispersal of concentration of forces:

A

Bevel for rounded axiopulpal line angles

159
Q

Position slightly to the patients right & in front:

A

8:00

160
Q

When should an 8:00 position be used?

A
  1. Buccal sides of patients UL
  2. Lingual sides of patient LR
161
Q

Position slightly to the patients right & behind:

A

11:00

162
Q

When should an 11:00 position be used?

A
  1. Buccal sides of patients UR
  2. Lingual sides of patients LL
163
Q

Position slightly to the patients left & behind:

A

12:00-1:00

164
Q

When should a 12:00-1:00 be used?

A
  1. Buccal sides of patients R & L anterior
  2. Lingual sides of patients R & L anterior

Operative Dentistry I (6 decks)

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