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reading stuff Flashcards

1
Q

What is the best consideration for a tooth significantly weakened by extensive defects, especially in areas of heavy occlusal function where esthetics are a primary concern and why?

A

Ceramic onlays, crown, PFM crown

Bonds to tooth so good

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2
Q

What determines the lifespan of an esthetic restoration?

A 
Nature and extent of initial caries
Treatment procedure 
restorative materials and technique used
Operator skill
Patient factors (oral hygiene, occlusion, caries risk, adverse habits)
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3
Q

common reasons for failure of composites

A

Trauma
Improper prep
inferior matierals
Improper use

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4
Q

True or False: Composites can be used in almost any tooth surface or any kind of restorative procedure.

A

True

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5
Q

True or False: The ability to bond relatively strong material of composite to tooth structure (enamel and dentin) results in a restored tooth that is both well sealed and possibly regains a portion of its strength.

A

True

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6
Q

what kind of restoration is a fused (baked) Feldspathic porcelain inlay

A

Indirect ceramic restoration

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7
Q

benifit of CAD/CAM chairside ceramic restoration

A

eliminates need for impressions and temporary restoations
no ned for lab procedures and costs
less appointments

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8
Q

Types of Esthetic restorative materials

A

Ceramic inlays and onlys
Silicate Cement
Acrylic resin
Composite

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9
Q

what was the first translucent restorative material

A

Silicate cement

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10
Q

how long does silicate cement last in anterior teeth restorations

A

4-10 years

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11
Q

what lead to the belief that enamel adjacent to silicate cement was more resistant to caries

A

High fluoide content and solubility

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12
Q

what is the contempory versions of Silicate Cement

A

GIs (less soluble though)

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13
Q

how is Silicate cement made

A

Powder (acid-soluble glass)

Liquid (Phosphoric acid, water, and buffering agent)

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14
Q

How does Acrylic Resin cure

A

Self curing

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15
Q

problem with curing acrylic resin

A

Poor activator systems
high polymerization shrinkage
high linear coefficent of thermal expansions
lack of wear resistance (leakge, pulp injury, recurrent carries, color change, excessive wear)

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16
Q

when is acrylic resin not indicated

A

High stress areas (low strength and flowing under load)

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17
Q

when is acrylic resin used

A 
temporary restorations
esthetic veneer on facial of class 2 and IV
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18
Q

what is a composite

A

Polymeric resin matrix with inorganic fillers

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19
Q

roll of inorganic fillers in composite

A

Enhance physical properties (strength and reduce thermal expansion)

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20
Q

what is done to increase bond strength between organic matrix and inorganic filer in composites for increased mech properites

A

coat filler w/ silane coupling agent (increase strength, solubility and water absorption)

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21
Q

Macrofill composites

A

Convensional composites with 75-80% inorganic filler (8 micrometers) by weight

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22
Q

Characteristics of macrofill composites

A

rough surface texture
easily stained
resin matrix wears faster than filler

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23
Q

what makes up microfill compoistes

A

35-60% inorganic filler(.01-.04 micrometers of colloidal silica parties) by weight

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24
Q

use of macrofill today

A

Not used

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25
Q

properties of microfill composites

A

smoother (less stain)
less filler (inferior physical and mech properties)
highly wear resistant
low modulus of elasticity (flexes with the tooth)

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26
Q

what is hyride composites

A

75-80% inorganic filler by weight (microfiller and smaller filler particles)

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27
Q

why was hybrid composites made

A

Combine physical and mech of macro and smooth surface of micro

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28
Q

benifit of nanofill composite

A

Highly polishable (.005-.01 micrometer)

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29
Q

popular composite types

A

Nanofill and nanohybrid

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30
Q

why was packable composite made

A

easier restoration of proximal contact( increased viscosity makes marginal adaptation difficult
similar to handle like amalgam
(never reached these goals

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31
Q

where should floable composite never be placed

A

high occlusal or proximal stress (low filler so weak)

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32
Q

what acid is used with conventional GI

A

Polyacrylic acid (less soluble)

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33
Q

what is good for root surface acries

A

Conventional GI

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34
Q

when to use Conventional GI

A

in patients with high caries activity
non occlusal
permanent cementation of crowns

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35
Q

why was RMGI made

A

improve physical properrties of GI

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36
Q

properties of RMGI

A

resin makes it light curring also autocurring
easier to use
better strenth, resistance, and esthetics

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37
Q

when is RMGI usually used

A 
Class V in adult with high risk
class I and II for primary teeth no requiring long term service
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38
Q

what are compomers

A

composites with some GI components

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39
Q

LInear Coefficient of thermal expansion

A

Rate of dimensional change of material per unit change in temperature

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40
Q

How does Composite Linear coeffieicnt of thermal expansion differ from a tooth

A

3x tooth LCTE

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41
Q

How to decrease the negative effects of LCTE

A

bond composite to etched tooth surfcace

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42
Q

water sorptions

A

amount of H2O material absorbed over time

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43
Q

how to decreased water sorptions

A

increase filler

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44
Q

what has better wear resistance composite or amalgam

A

Amalgam

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45
Q

where is smoothness needed for composite

A

close to gingival tissues for heath

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46
Q

what has the smoothest surface

A

Microfill (nanohybrid and nanofill also good)

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47
Q

why is radiopacity important

A

so recurrent caries around or under restoration can be seen easily on the radiograph

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48
Q

modulus of elasticity

A

stiffness (higher means more stiff

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49
Q

pros and cons of low modulus of elastisity

A

allows bending of restoration with tooth, protecting interface
lower mech and physical properites

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50
Q

solubility of composites

A

like none

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51
Q

how to minimize effects of polymerization shrinkage

A

load in steps
using adhesives
using RMGI before composite to reduce microleakage and gap fomation

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52
Q

when is shrinkage of composites a problem

A

at the root surface (force of polymerization >initial bond)

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53
Q

configuartion factor

A

ratio o bonding surface to undbonded surfaces

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54
Q

greater configuration factor means

A

greater potentional for bond disruption via polymerization

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55
Q

pros and cons of self cured composites

A

greater risk for air inclusions
working time restricted
color instability
direction of polymerization generally centralized for better marginal adpatation and prevention of microleaks

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56
Q

pros and cons of Light cure

A

increased working time
less finishing time
better color stability (better bonding, improved properties
more success and economical

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57
Q

INdications of composite

A 
CLASS i-vi
Core buildups
sealants and preventative rstorations
parital and full veneers
tooth contour mods
diastema closure
cements
temporaries
Perio splinting
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58
Q

contraindications of composites

A

bad isolations
all the occlusaion on the restorative material
restorations with extensions on the root surface

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59
Q

advantage of composites

A 
esthetics
conservative
less complex preps
insulating to heat
bond to tooth
repairable
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60
Q

disadvantage of composites

A 
gap formation on the root
more costly and time consuming
technique sensitive
isolation
LCTE
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61
Q

True or False: If a void is detected immediately after insertion of composite but before contouring, more composite can be added directly to void area

A

True: must re-etch though

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62
Q

cause and solution of white line adjacent to halo

A

trama during contouring or finishing, inadequat ethcin, excessive polymerizations
re-etch, prime and bond, being ldightly, leaving a monitor for leaks

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63
Q

where is the exchange zone

A

over the chest under the chin

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64
Q

should the operator move eyes during tool exchange

A

No

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65
Q

Goal of isolation

A

Moisuter control
retraction and access
harm prevention (spray from handpiece can alarm patient)

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66
Q

benifits of the rubber dam

A 
Dry, clean field
acess and visibility
improved properties of dntal materials
protects patients and operator
efficiency (patient doesn't talk or get in the way)
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67
Q

when to not use a rubber dam

A

teeth have no erupted sufficiently
3rd molars
badly malpositioned teeth
can’t breath through nose

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68
Q

thin vs thick rubber dams

A 
Thin: easier to place
thick: better retracting gingiva and more tear resistant (class V)
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69
Q

what side of the rubber dam should be used

A

the dull side (less reflective)

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70
Q

what should be done after the rubber dam is removed

A

massage gingiva to increase blood flow

71
Q

how should retainers be placed on children

A

More gingivally due to short clinical crown

72
Q

what retainers are used in priamry and young permant teeth

A

27: primary
w14: perminant

73
Q

what drug is rairly used to decrease salivary flow when not using a rubber dam

A

Atropine

74
Q

characteristics of air rotary power cutting instruments

A

head is smaller, weigh less, have more vibration

75
Q

characteristics of electric rotary power cutting instruments

A

cut with higher torque and little stalling, high-precision cutting, higher initial expense and the weight and balance of it will confuse older clinicians, quieter and smoother cutting

76
Q

low speed handpiece

A

12,000 rpm ( for cleaning, caries, finishing and polishing

77
Q

high speed handpiece

A

200,000 rpm (preps and removal of old restoration

78
Q

the part of the handpiece that goes into the rotary instrument

A

Shank

79
Q

the cutting part

A

Head

80
Q

negative rake angles

A

rake face ahead of radius of bur

81
Q

possitive rake angles r

A

rake face behind the radius of the bur

82
Q

rake angle

A

the angle between the rake face and the axis of bur

83
Q

edge angle

A

the angle between the rake face and the clearnace face

84
Q

clerance angle

A

the angle between the clearance face and the cut surface

85
Q

the rake face

A

the face of the bur that does the cutting

86
Q

the clearance face

A

clears chips (right after the rake face)

87
Q

roll of Silicate glass particles in a composite

A

mech reinforement

light transmission and scattering (esthetics)

88
Q

roll of acrylic in composoites

A

fluid and moldable

89
Q

roll of the matrix phase of a composite

A

adapt to tooth prep

penetrate into micromech spaces of the etched enamel or dentin

90
Q

what are bonding systemes made of

A

unfilled acrylic monomer mixes

91
Q

what does a sbonding system do

A

fomrs a 1-5 micrometer film on etched surfaces to interlock mechanically to seal walls and co polymerizes with compsoite restorative material that fills the tooth prep

92
Q

what is unfill sealance

A

unfilled acrylics (2% filler modified sealants)

93
Q

pros and cons of high filler content

A

high filler improves all properties but fluidity

94
Q

75% silica by weight is how much by volume

A

50%

95
Q

for hybrid composites how are they named

A

named based on the largest filler in them

96
Q

when is a composite homogeneous

A

when it consists of filler and uncured matrix

97
Q

when is a composite heterogeneous

A

also has precurred composite and unusual filler

98
Q

when is a composite modified

A

has novel filler modifications

99
Q

how do heterogeneous microfills work

A

precured particles chemically bond to the new material

100
Q

how is collloidal silica made

A

chemically precipitated from a liquid solution as amorphorus particles

101
Q

how is pyrogenic silica made

A

precipitated from gaseous amorphous microfillers

102
Q

what happens to light output as you decrease the fiber optic tip size

A

the light output decreases

103
Q

how much will the pulp have to increase in temp for ti to die

A

5-8 degrees celcius

104
Q

what causes curing light to scatter

A

filler particles

105
Q

what absorbs more light, darker or lighter colorants

A

darker absorbs more

106
Q

how much composite normal goes from monomer to polymer

A

55-65%

107
Q

what leads to higher stress light composites or autocurred

A

light (higher energy curing light makes the problem bigger in addition to higher filling)

108
Q

when would you want low and high elastic modulus

A

low: more retention
high: MOD to prevent tooth bending

109
Q

CFA wear

A

wear due to food and not teeth usually found on small occlusal preps

110
Q

what is CFA wear resistance related to

A

filler spacing not composite mech strength(microprotection)

111
Q

Microprotection

A

when filler is close together so it protects the resin from wearing

112
Q

what does color matching consist of

A

current colors and colors over the course of tie

113
Q

should the tooth be wet or sry when color matching

A

wet (if dry will look too wet)

114
Q

what type of material is more likely to yellow

A

Ante-rior restorative materials with high matrix contents that are self cured

115
Q

what proceedure makes color matching difficult

A

bleaching (wait till tratment is done)

116
Q

How can one make the difference between enamel and composite color less noticable

A

Bevel the edge

117
Q

where do secondary caries occur most often

A

proximal and cervical margins

118
Q

what is the biggest concern for posterior composites

A

posterior wear

119
Q

cytotoxicty of unpolymerized materials

A

concern for post opperative sensitivty
but poorly solube in water, and polymerized intoa bound state
low amount does escapte

120
Q

what are glass ionomers

A

materials consisting of ion-cross-linked polymer matricies surrounding glass-reinforcing filler particles

121
Q

what are glass ionomers made of

A

aluminosilicate powder from silicates

polyacrylic acid liquid of polycarbs

122
Q

water of glass ionomers and composites

A

GI: philic
Composites: phobic

123
Q

pros and cons of ceramic metals (cermet) mixtures

A

much stronger than normal GI, but poor esthetics and not modified

124
Q

uses of cermets

A

as cores

125
Q

what is atrauamic restorative treatment

A

done when no professional available. remove caries without using instruments and then place GI in hole and have the person bite on it to make it the right shape

126
Q

How does GI hold into the prep

A

Chem and mechanical means (good mech is better than good chem)

127
Q

recharging of GI

A

when you place high levels of fluoride on the tooth and it goes back into the GI

128
Q

Adhesion

A

the state in which 2 surfaces are held together by interfacial forces which may consist of valence and interlocking forces

129
Q

mechanical adhesion

A

interlocking with irregularities in the surface

130
Q

adsorption adhesion

A

chemical bonding between adhesive and the adhered (primary: ionic and covalent) (secondary: h bonds, dipole, van der waals)

131
Q

Diffusion adhesion

A

interlocking between mobile moleulces

132
Q

electrostatic adhesion

A

double layer of electrical at the interface of a metal and polymer

133
Q

how are resins bound to toooth

A

Mech
adsoprtion
Diffusion

134
Q

what is needed for good adhesion

A

glose contact

surface tension of adhesive lower than that of substrate

135
Q

the major problems for bonding resins

A

resins shrink so adhesives must provide a strong initial bond to resist stresses of shrinkage

136
Q

type I enamel etching pattern

A

Dissolution of prism cores without dissolution of prism peripheries

137
Q

type II enamel etching pattern

A

dissolution of prism peripheries without dissolution of prism cores

138
Q

type III enamel etching pattern

A

has patterns without prism morphology

139
Q

what makes up enamel etchants

A

Phosphoic acid at 37% (30-40%)

140
Q

bond strength of enamel etchants

A

20-50 megapascals

141
Q

what is harder to bond

A

dentin or enamel

142
Q

what in the smear layer allows for diffusion of the dentinal fluid

A

submicron porosity

143
Q

what is the configuration factor

A

ratio of number of composite bonded surfaces to unbonded surfaces

144
Q

what is water absorption by the resin related to

A

resin content

145
Q

3 step etch steps

A
  1. Phosphoric acid etchant that is rinsed off
  2. A primer containing reactive hydrophilic monomers in alcohol, ethanol, acetone, or water
  3. Unfilled or filled resin bonding agent (adhesive) that contains hydrophobic monomers (Bis GMA) and hydrophilic molecules (HEMA)
146
Q

purpose of primer in 3 step etch

A

increase surface tension of dentin

147
Q

what happens when primer and bounding resin are applied to etched dentin

A

they penetrate the intertubular dentin and form and interdiffusion zone (hybrid layer) and polymerize the open tubules to form resin tags

148
Q

2 step self etch

A

uses self etch primers containing phosphonated resin molecules that etch and prime dentin and enamel
no rinse

149
Q

what happens to the resin tags in 2 step etch

A

smear plugs in the resin tags for less post op sensitivty

150
Q

etching efficiency of two step etch

A

do not etch as well as enamel

151
Q

what is in1 step self-etch adhesives

A

contain uncured ionic monomers that contact the compsote material directly

152
Q

how do 1 step eself-etch adhesivess work

A

semi-permeable membranes, resulting in hydrolytic degradation

153
Q

roll of water in self-etch adhesives

A

solubilize ca and p ions that form from the interaction of the monomers with dentin and enamel

154
Q

patial removal of what protein may enhance remineralization

A

phosphoproteins

155
Q

collagen not encased in resin can do what which is bad

A

vulnerable to degradation by matrix metalloproteins

156
Q

microleakage

A

passage of bacteria and toxins between restoration and tooth walls

157
Q

when does microleakage matter

A

pulpal irritiation by bacteria not chemical toxicity of restorative material

158
Q

nanoleakage

A

small porosities in the hybrid layer or at the transition between the hybrid layer and the mineralized dentin for minuscule particles

159
Q

what type of dentin is more resistant to acid etching

A

sclerotic dentin

160
Q

what type of composites have a low elastic modulus

A

Microfilled composites

161
Q

what area of the tooth is most hypersensitive

A

Cervical area

162
Q

what does GLUMA work

A

reduced dentin sensitivty through a protein denaturation process

163
Q

what must be done for cermanic and zirconia restorations

A

etched with HF acid for 1-2 minutes to create retentive microporosities
then rinsed
coupling agent applied
primer used with phosphonic acid monomer or carboxylate monomer to improve resin bonding

164
Q

when is it best to place selants

A

in perminant teeth of children

165
Q

how long to etch for a sealant

A

15-30 second

166
Q

do carbide or diamond make a thicker smear layer

A

diamond

167
Q

how far is needed to be left in the marginal ridge to not make a proximal box

A

1.5mm

168
Q

when to use a RMGI base or CaOH liner

A

between .5-1.5 RDT use RMGI

less than .5 mm CaOH then RMGI base

169
Q

stress in relation to C factor

A

higher stress from higher c factor: more walls bound

170
Q

what can be added to reduce the effects of polymerization shrinkage

A

RMGI liner or flable composite due to favorable elastic modulus

171
Q

the sandwich technique

A

when composite is placed over RMGI

172
Q

advantage of the composite technique

A

RMGI binds to dentin without opening tubules (reduced sensitivity)
RMGI released fluoride
favorable elastic mdoulus

173
Q

what surface does composite not bind to well

A

the root surface (dentin)

operative 3 (4 decks)

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