Restorative - Week 8 PP

Question 1

Design of the cavity preparation:

Answer 1

-Provides strength within the tooth
-Helps determine how the tooth will hold the restoration in place

Question 2

Instruments in restorative dental procedures are classified into 4 categories

Answer 2

1. Examination - allow the operator to thoroughly examine the health status of the oral cavity (standard/basic - explorer, mirror..etc)
2. Hand cutting - remove decay manually and to smooth, finish and prepare the structure for a restoration
3. Restorative - allow the aperator to restor a tooth by placing, condensing, and carving a dental material
4. Accessory - Misc instruments that are used to complete a procedure

Question 3

Hand cutting insruments

Answer 3

• allows the dentist to manually remove decayed tooth structure, to smooth cavity walls and floors of the preparation, and to place any bevels or retention grooves to hold the dental material within the tooth

Which hand-cutting instruments used during a restorative procedure, if any, is up to the dentists personal preference.

Question 4

Spoon Excavator

Answer 4

one of the most versatile instruments on the tray set up. Primary used to remove carious dentin

• if decay is really close to pulp of the tooth, dentist wants to avoid using auto instruments - will use scoop to decay out of dentin

Question 5

Enamel Hatchet

Answer 5

Used to cut, clean and smooth walls in cavity preparation. Removes enamel not supported by dentin

Question 6

Angle Former

Answer 6

Used to accentuate line and point angles in internal outline and retention in cavity preparation

Question 7

Straight (anterior) chisel

Answer 7

Used to plane and cleave enamel in cavity preparation - used with a push motion

Question 8

Gingival Margin Trimmer
Mesial & Distal

Answer 8

Used to bevel cervical walls of the mesial and distal retention areas

Question 9

Cavity Sealers

Answer 9

A thin film that provides a protective layer within the prepared cavity

Question 10

Pulpal responses - types of stimuli * TEST!!!

Answer 10

Physical Stimuli - thermal or electrical

Mechanical stimuli - handpiece, traumatic

Chemical stimuli - acid from dental materials

Biological stimuli - bacteria from saliva

Question 11

Varnish is..

Answer 11

Varnish is a liquid consisting of one or more natural resins in an organic solvent

• this material is placed within the entire preparation

Question 12

Varnish accomplishes…

Answer 12

-seals dentinal tubules
-reduces micro-leakage around a restoration
-acts as a barrier to protect the tooth from highly acidic cements such as zinc phosphate

Question 13

Application of Varnishes

Answer 13

-applied with a small disposable applicator or a cotton pellet held in sterile cotton pliers
-It is important to note that when a liner is placed,
the varnish will be placed after the liner is
applied
-Because dental varnish interferes with the bonding
and setting reaction of composite resins and glass
ionomer restorations, the use of varnish is
contraindicated with these materials

Question 14

Purpose of a liner..

Answer 14

The purpose of a liner is to provide pulpal protection and dentinal regeneration.

• it also protects pulpal tissue from irritation caused by physical, mechanical, chemical and biological elements.

Question 15

Placement of a liner

Answer 15

• The health condition of the tooth being restored determines what lining agent the dentist will select.
• liner is placed prior to placement of the restorative material
• placed in the deepest surface of the preparation on the dentin.
• NOT placed on enamel or in retentive grooves of the preparation.
• placed approx 0.5-1mm in depth

Question 16

Liner Application

Answer 16

• Liners are supplied either as a two-paste system or
  as a light-cured material
• The material is placed prior to placement of the
  restorative material and with the use of a Dycal
  (calcium hydroxide) applicator
• Placed only on the deepest dentin surface of the preparation
• This material is not to be placed on enamel or in
  retentive grooves of the preparation

Question 17

Glass Ionomer Liner

Answer 17

• are indicted to form a strong bond to dentin, sealing the restoration to reduce micro-leakage and helping to reduce post op sensitivity

Question 18

Advantages of Glass Ionomer Liner

Answer 18

1. Contains fluoride - anti-cariogenic properties
2. Bonds to tooth structure - is attracted to the fluid within the dentinal tubules
3. Prolonged setting time due to it being light cured (allows for no rush!)

Question 19

Curing

Answer 19

is a setting process of a dental material that is initiated by a chemical reaction or by light in a blue wave spectrum

Question 20

auto-cure

Answer 20

or self cured materials hardens as a result of a chemical reaction of the materials once mixed together

Question 21

dual cured

Answer 21

the curing takes place as the material is mixed, however, the final cure does not occur until the material has been exposed to light

Question 22

What should you do if bleeding and or moisture
contaminated the area of liner placement?

Answer 22

1. Notify Dentist
2. Dentist will remove contaminated material
3. clean and dry area again
4. Re-apply material

Question 23

Calcium Hydroxide

Answer 23

Is one of the most frequently selected types of liner because of its unique characteristics

• protects the pulp from chemical irritation through its sealing abilities
  -stimulates the production of reparative or secondary dentin
  -is used for pulp capping of pulpal exposures and near exposure
  -is compatible with all types of restorative materials

Question 24

Bases can provide pulpal protection in the following ways..

Answer 24

Protective - thicker layer than liner! Placed when it is neccessary to protect the pulp before restoration is palced. Without protection, post-operative sensitivity and damage to the pulp may occur

Insulating - are placed in a deep cavity prep to protect the tooth from thermal shock

Sedative - helps to soothe a pulp that has been damaged by decay or has been irritated drying the procces of removing decay

Question 25

What is the purpose of a dental base?

Answer 25

-To provide additional layer when cavity is very deep,
used to protect the pulp
* When a tooth preparation becomes moderately deep or deep, the dentist will place a base under the permanent restoration
* A base is an additional layer to protect the pulp

Question 26

Where within the cavity preparation will you place the base?

Answer 26

The entire floor is covered with a base to a thickness of 1 to 2 mm

Question 27

List the advantages of Polycarboxylate

Answer 27

Bonds to tooth structure, as it is attracted to the
natural fluid within the dentinal tubules
* Contains stannous fluoride to provide anticariogenic properties
* Not acidic and does not irritate the pulp

Question 28

List the disadvantages of Polycarboxylate base

Answer 28

Has a very short working time less than 25 seconds!
* The bonding properties of the cement are lost
once the mixed material loses its glossy appearance

Question 29

What should be done to the powder before dispensing for mixing?

Answer 29

invert and fluff

Question 30

Explain the term “Smear layer”

Answer 30

When cutting a cavity preparation, there will be
dust from the enamel/dentin, as well as fluid from the dentinal tubules adhering to the inner walls – this is called the smear layer

Question 31

Application of a Base

Answer 31

• The base material is a putty-like consistency
  because it actually provides a buffer or layer
  between the pulp and the restoration
• The entire pulpal floor is covered with the base to
  a thickness of 1 to 2 mm