Restorations of Caries in the Primary Dentition

Question 1

Compared to permanent teeth, primary teeth are ___ (smaller/larger) in size, have ___ (less/more) enamel support and have a unique and different anatomy.

Answer 1

small; less

Question 2

Why restore primary teeth?

Answer 2

1. prevention of pain and infection
2. needed to maintain space for adult dentition
3. aesthetics
4. function
5. speech

Question 3

What are the goals of restoring primary teeth?

Answer 3

1. restore healthy functioning dentition
2. maintain space for permanent dentition
3. treat a primary tooth ONCE in its lifetime

Question 4

Primary teeth have ___ (thinner/thicker) enamel and dentin, ___ (smaller/larger) pulp chambers, and pulp horns that are ___ (closer/farther) to/from the surface of the tooth.

Answer 4

thinner; larger; closer

Question 5

Describe the proximal contacts of primary teeth.

Answer 5

broader, flatter proximal contacts

Question 6

Primary teeth have a greater ___ constriction of the crown and a more prominent ___ contour.

Answer 6

cervical; cervical

Question 7

What clamps are used with rubber dams?

Answer 7

8 vs 8A and 14 vs 14A

A = adult

Question 8

What are the advantages to using a rubber dam?

Answer 8

1. access and visualization
2. moisture control
3. prevent aspiration or swallowing objects
4. prevent soft tissue trauma
5. keeps water out of back of mouth
6. breathe through nose - better N2O management

Question 9

When using a rubber dam, clamp at least ___ tooth behind tooth needing worked on. Do a ___ (little/much) work as possible with the dam on and use for ___ operative procedures possible.

Answer 9

1; much; ALL

Question 10

What are the indications for class I composite/amalgams?

Answer 10

1. caries confined to occlusal surface
2. no pulp or cusp involvement
3. no marginal ridge involvement
4. ability to maintain conservative preparation
5. small lesion on tooth near exfoliation

Question 11

Explain the outline form of class I composites/amalgams.

Answer 11

1. conservative preparation
2. remove caries
3. NO extension for prevention
4. Do NOT cross oblique ridge unless undermined by caries
5. seal unprepared grooves

Question 12

Explain the depth of class I composites.

Answer 12

1. remove caries
2. no extension for prevention
3. pulpal floor into dentin
4. no liners/bases

Question 13

If the pulpal floor is NOT in dentin

Answer 13

sealant

Question 14

How do you ensure that your pulpal floor is in dentin?

Answer 14

use length of #330 bur to judge depth

Question 15

Match the following

1. advantages of composites/compomers
2. advantages of amalgam
3. advantages of GI

A. less sensitive to moisture, no etch/bond, some fluoride release.
B. more esthetic, may be less prone to failure
C. less sensitive to moisture contamination, slightly quicker, likely less prone to failure.

Answer 15

1 - B
2 - C
3 - A

Question 16

Class III amalgams/composites are needed with ___ proximal lesions. Radiographically inner ___ to outer ___.

Answer 16

SMALL; enamel; dentin

Question 17

T/F. Three surface restorations are done with primary teeth.

Answer 17

False, 2 surface restorations ONLY ( NO MOD’s)

Question 18

What are the contraindications of class II composites/amalgams?

Answer 18

1. larger than ideal class II, use stainless steel crown (SSC)
2. > 2-3 years of service remaining, SSC may be a better option
3. pulpotomy

Question 19

T/F. You should prep an occlusal extension.

Answer 19

False, box-only preps (no occlusal extensions). If occlusal caries is present, outline form like class I

Question 20

For class II preps, the proximal box is ___ at cervical than occlusal, the ___ contact is broken, ___/___ contacts need not be broken, the axial wall ~ ___ mm into dentin, and there are no ___ grooves

Answer 20

broader; gingival; buccal/lingual; 0.5; retentive

Question 21

How do you make a custom sectional matrix?

Answer 21

1. start with a tofflemire matrix band
2. curl the band using an instrument handle
3. trim the band to the desired size

Question 22

Why do class II amalgams fail? composites?

Answer 22

amalgams - isthmus fracture

composites - recurrent decay at gingival margin

Question 23

What is the #1 mistake to avoid?

Answer 23

prepping the wrong tooth

Question 24

What is the #2 mistake to avoid?

Answer 24

damage to the adjacent tooth

• protect with matrix band
• wedge apart
• don’t get over confident with matrix bands