Restorative Therapy Flashcards
Week 1/2
Caries in children under 5
Early onset & rapid progression
Early childhood caries
Sudden, rapid caries of many teeth that requires urgent intervention
Rampant caries
Slow, progressive decay process that requires regular dental intervention
chronic caries
halting of progress of decay process
arrested caries
new decay that occurs under a restoration or around
its margins
recurrent caries
caries found in the grooves and crevices of the occlusal surfaces of premolars and molars, maxillary incisor lingual pits, mandibular molar facial pits, and maxillary molar lingual grooves.
pit and fissure
caries found on the facial, lingual, mesial, and distal surfaces of the dentition.
smooth surface caries
class I caries
Pits and fissures of anterior
and posterior teeth
class II caries
proximal surfaces of posterior
teeth
class III caries
Proximal surfaces of anterior
teeth NOT involving
the incisial edge
class IV caries
proximal surfaces of anteriors,
involving the incisal
edge
class V caries
cervical third
class VI caries
incisal edge of anterior
teeth or cusp tip of posterior
teeth
simple caries
1 surface
compound caries
2 surfaces
complex caries
3 or more surfaces
detecting caries CLINICALLY
- air drying
- explorer
- radiographs
reasons why a tooth needs to be restored
- acquired tooth damage
- defective restorations
- esthetics
- occlusion
- mastication
examples of ACQUIRED TOOTH DAMAGE
abrasion
erosion
abfraction
attrition
fracture
caries
restoration material durable and compatible with the
oral environment
gold
restoration material that is the longest lasting, cost
effective, versatile.
amalgam
popular for esthetics but have a greater rate of recurrent
decay
composite resin
a viscous material placed between tooth structure and a prosthesis that hardens through chemical reactions to firmly attach the prosthesis to the tooth structure
luting agent
types of restorations
direct and indirect
direct restoration
A restoration fabricated
directly in the office
Which of the following is an example of a direct
restoration?
A) Inlay
B) Composite filling
B) Composite filling
Indirect restoration
fabricated in a lab
Which of the following is an example of an indirect
restoration?
A) Amalgam filling
B) Onlay
B) Onlay
Advantages of amalgam
cheap
longevity
easy placement
advantages of composite resins
esthetics
patient acceptance
disadvantages of glass ionomer
technique sensitive,
susceptible to water contamination,
isolation is essential,
proper powder/liquid ratio,
low tensile & shear
strength
Which of the following are placed primarily in primary anterior teeth?
A) Stainless steel crowns
B) Preformed zirconia crowns
D) Amalgam restorations
B) Preformed zirconia crowns
a stronger system for retaining and supporting the
restoration other than retentive grooves or bonding
materials
retention pins
when using retention pins ____ pin(s) is/are placed for each missing cusp.
1
indirect restoration that does NOT involve cusps
inlay
indirect restoration that covers a cusp.
onlay
indirect restoration primarily used in the posterior as
inlay, onlay, or crown.
gold alloy
indirect restoration that primarily used in ALL areas of the teeth as inlay, onlay, or crown.
porcelain
indirect restoration primarily used as all crowns
porcelain fused to metal
disadvantages of porcelain restorations
marginal seal
abrades opposing teeth
restoration placed for a SHORT TERM
intermediate restorations
A preliminary step before a final restoration is placed
intermediate restorations
intermediate restorations are also known as….
provisional
goal of isolation in restorative dentistry
moisture control
accessibility
visibility
protection
with a dental dam, the clamp is placed…
distal to the tooth being
worked on
help with retrieval if retainer breaks or dislodges
retainer ligation
steps of a dental dam
- punch holes and place clamp/frame
- place clamp on tooth
- punched holes stretched over ling jaw
- floss dam through the contacts and INVERT
purpose of intervertion for placing a dental dam
prevents saliva leakage
from the gingival sulcus
The steps of initial cavity preparation
- Outline form
- Resistance form
- Retention form
- Convenience form
Cavity prep step where the DDS decides on the design and initial depth of SOUND tooth structure
- Outline form
Cavity prep step where the DDS determines SHAPE and PLACEMENT of the cavity walls to resist displacement or removal
- Resistance form
a requirement for all restorative/operative procedures for the dentist to create sufficient access to the lesion and facilitate visibility/instrumentation
- Convenience form
rotary instruments with sharp cutting head
dental burs
some uses of dental burs
tooth prep
excavating decay
finishing cavity walls
types of burs
cutting
diamond
finishing
surgical
When discussing the “shape” of a bur, you are referring
to the contour or design of the…
head of the bur
The greater the number of cutting surfaces on the
head of a bur, the greater its….
polishing or finishing capability
final steps of cavity preparation
- caries removal
- finish enamel
- cleansing
creates a temporary interproximal wall, prevents overhangs
matrix system
what classification of caries requires a matrix?
Class II MOD
CLass III MD, B, L
Class IV incisal
also called a Tofflemire retainer
universal retainer
why is the smaller side of a tofflemire retainer placed towards the gingival margin?
will follow the curvature of the teeth
holds matrix firmly against margin of prep
wedges
what will happen with the improper placement of a
wedge?
overhang or cupping
what is the most crucial step of a wedge placement
pushing the side of the
matrix band against the
tooth
*Clear plastic matrix used for composite resin, glass
ionomer
*Clear plastic allows curing light to penetrate
anterior matrix systems
no retainer needed place plastic matrix and wedges
class 3 or 4
Clear plastic bands =
celluloid or mylar strip
inserted into the lingual embrasure to hold the matrix band firmly against the gingival margin of the preparation
wedge
produce tight anatomic contact for composite resin materials in class II restorations, however not commonly used consist of a palodent-type matrix band and tension ring
sectional matrices
Placed in the deepest areas of the cavity prep
Examples: Glass ionomer cement, zinc phosphate cement
bases
Thin coating applied to the internal portion of the cavity prep
examples: Glass ionomer, calcium hydroxide
liner
Used to seal dentinal tubules to protect the pulp
Examples: Bonding resins, liners, varnish
sealers
remains an acceptable restorative material for posterior teeth.
amalgam
The reputation of amalgam is based on decades of
clinical evaluation during which it has proven to be
a……
durable material even
when placed in compromised
circumstances
the longevity of amalgam is related directly to…..
proper cavity prep
attention to basic principles
of manipulations
dental amalgam is a compound of an ________, mixture of silver, copper, tin and zinc
alloy
makes up approx. 50% of the amalgam mixture
mercury
Amalgam that show marked improvement in stability,
strength, and margin integrity
current-generation,
low-copper
Which of the following is likely to occur with amalgam?
A) Fluoride release
B) Esthetic discoloration
C) Polymerization shrinkage
D) Microleakage
D) Microleakage
required to be installed in central vacuum systems
when handling mercury
amalgam separators
prevents the release of mercury in a significant quantity.
combination of mercury
with an alloy
isolation method that provides the best control of the
working area when using mercury
dental dam
the mercury in amalgam is safe for use in dental applications.
a) true
b) false
a) true
why is the mercury in amalgam safe for use in dental
applications
the mercury is chemically
bound to the other metals
to make it stable.
Causes microleakage around the amalgam filling
thermal expansion
Occurs when dental dam is not used and the particles of amalgam are flung by the bur into the gingival tissues where they remain embedded, become fibrous tissue encapsulated, and corrode to form black corrosion products
Amalgam tattoo
*Start process of amalgam restoration
*Mixes encapsuled alloy and Hg
*Shiny, homogeneous, easily manipulated
Triturator
*shape AM into anatomic form to restore function
*Sharp cutting instruments
*Many shapes and sizes
Carvers
used in parallel strokes to perfect occlusal margins of
amalgam
sharp carver
smooths amalgam after condensing
ball burnisher
matrix of a dental composite resin
polymer: bis-GMA
combine activation by light curing and chemical reaction
to be used where light cannot penetrate, such as
in an endodontic canal.
dual-cure composites
coated with silane for adhesion and coupling to prevent dislodging of particles. Including silicate glass, quartz, zirconium.
filler particles
allow for minimally invasive dentistry, the removal of minimal tooth structure to access and remove decay while maintaining the ability to bond to enamel and support a restoration.
composite preparations
roughens the surface during composite prep, preparing
it for bonding
acid etching
Compared with enamel bonding, _____ bonding is far
less predictable.
dentin
Because restorative resins are incompatible with
moisture (hydrophobic), numerous _________ _______
that tolerate minimal amounts of water (hydrophilic) have been developed to chemically unite the composite with the moist dentin surface.
adhesive systems
the bond between the dentin and the composite material.
Hybridization bonding
steps of a composite filli
- shade selection
- matrix and wedge are placed
- cavity prep is etched,
rinsed, and dried. - prime + bond is applied
and light cured - Composite is placed in
increments, shaped with
PFI, and light cured. - matrix is removed and
finishing burs are used to
shape and polish - Polish and rinse
- Occlusion checked with
articulating paper
when should the tooth shade be selected for a comp filling
BEFORE anesthetic is administered
