Restorations of extensively damaged vital teeth

Question 1

Pulp and ____ mm thick surrounding layer of dentin

should be preserved if possible

Answer 1

1 mm

Question 2

Central Core (Pulp Chamber) ______ as we age

Answer 2

shrinks and recedes

Question 3

Which anterior tooth has less shrinkage of pulp chamber ?

Answer 3

Canine

Question 4

If there is extensive peripheral destruction in a tooth, what is the best restoration?

Answer 4

Full Crown

Question 5

If Isthmus destruction greater than ½

intercuspal width, what restoration should you select?

Answer 5

– Crown or Onlay

Question 6

If More that 50% of tooth structure is gone

and loss of cuspal support, what restoration?

Answer 6

– Crown (and

likely a core build up too)

Question 7

If Combined Central and Peripheral destruction, what restoration?

Answer 7

-Core Build up and Crown

Question 8

Increased axial reduction in the _____ of the preparation wall will
reduce taper and create more retention and greater resistance form.

Answer 8

cervical 1/2

Question 9

Sloping surfaces left after cusp fracture or caries

removal need retention, what should you do for crown prep?

Answer 9

Break slope into vertical and horizontal

components

Question 10

Grooves placed ____ to the long

axis of the tooth

Answer 10

parallel

Question 11

Grooves used in short preparation 
walls with minimal occlusal 
clearance:
-\_\_\_\_ grooves shorten the 
radius of the arc of rotation –

Answer 11

Proximal

Question 12

Walls of a groove or a box are
best placed ______ to the
displacing force

Answer 12

perpendicular

Question 13

When two boxes are needed, less than 180 degrees of tooth
circumference remains.
-This poses a great risk for cuspal fracture
What do you do?

Answer 13

-Use a Build Up and full crown to protect against fracture

Question 14

What are the 4 ways to increase wall height?

Answer 14

Place margin more apically
Add materials to build up tooth
Crown lengthening
Orthodontic extrusion

Question 15

Replaces lost tooth structure to improve
retention of a crown
A core must be anchored firmly to the tooth
and not just placed to fill the void
Retention for a core is often with the use of
pins

Answer 15

Core Build up

Question 16

A Build Up is needed when more than

______ of the tooth structure is lost

Answer 16

50%

Question 17

Use of pins recommended if ____ or more of the

clinical crown has been destroyed.

Answer 17

½

Question 18

Mechanical properties
Compressive strength
Dimensional stability
Isolation less technique sensitive
Matrix placement can be difficult 
if tooth is severely broken down.
Often used in RCT teeth into 
canal for strength
Limitations:
Matrix placement can be difficult if 
tooth is severely broken down
Slow setting material (10-15 minutes 
before band removal)
No bonding or natural retention
Requires at least 2mm thickness
Color shows through some ceramic 
crowns
Final crown prep occurs another day
Not used to a great extent 
any longer.

Answer 18

Amalgam core buildup

Question 19

Mechanical properties
Bonds to tooth structure
Still needs help with pins
Quick setting
Tooth prep at same visit
Ease of manipulation
Can be thinner than 2mm
Color of material aids in crown 
matching
Limitations
Technique sensitive
Microleakage 
possible as material 
shrinks when cured
Isolation can be 
challenging

Answer 19

Composite core build up

Question 20

____ are helpful to support the Build
Up material when residual tooth
structure does not provide adequate
retention itself.

Answer 20

Pins

Question 21

T/F: Pins shouldnt be placed parallel

Answer 21

True

Question 22

\_\_\_\_\_are used only to protect pulp in 
teeth that are have excavations that 
are deep and near the pulp.
- can be used to fill in undercuts 
when an entire Build up is not needed.
- are weaker materials that do not 
provide strength like a Build up.
Bases are not strong enough to support 
grooves, boxes or other retentive 
features.

Answer 22

Bases

Question 23

What are the 5 steps for applying bases?

Answer 23

1. Gluma (Gluteraldehyde)
   - 2x60 second coats
2. Dycal / Calcium Hydroxide
3. Vitrebond
4. Glass Ionomer?
5. Routine restoration steps