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Operative II > Restoring Large and in charge (Annie) restorations > Flashcards

Restoring Large and in charge (Annie) restorations Flashcards

1
Q

An extremely sensitive part of the tooth, where enamel and dentin meet:

A

DEJ

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2
Q

Dentinal tubules are filled with ____ and wrapped in ____

A

odontoblastic processes; afferent nerves & dentinal fluid

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3
Q

When enamel or cementum is removed during cavity preparation, the ___ of dentin is lost which allows small fluid movements in the tubules, causing distraction s in the afferent nerve endings hence pain

A

external seal of dentin

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4
Q

Refer to a mike the situation when one tooth or multiple teeth at the same appointment are treated quickly by:

  1. removing the infected dentin
  2. medicating the pulp, if necessary
  3. restoring the defects with a temporary material
A

caries control restorations

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5
Q

T/F: according to caries control restorations, undermined enamel can be left to better retain the temporary material:

A

true

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6
Q

What are the steps to caries control restorations?

A
  1. removing the infected dentin
  2. medicating the pulp (if necessary)
  3. restoring the defects with a temporary material
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7
Q

Used when a deep carious lesion occurs and THERE IS NO CLINICAL OR RADIOGRAPHIC EVIDENCE OF IRREVERSIBLE PULP DAMAGE (such as history of spontaneous pain, heat sensitivity relieved by cold, or a P A,. lesion)

A

indirect pulp cap

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8
Q

In order to perform an indirect pulp cap, the tooth should be ___ or at most have symptoms consistent with ____ such as moderate cold sensitivity, with pain subsiding within about 15 seconds

A

asymptomatic; reversible pulpitis

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9
Q

T/F: Caries is typically less extensive than the radiograph shows

A

false- usually deeper than appears on radiograph

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10
Q

The objective of an indirect pulp cap is to:

A

AVOID A PULP EXPSOURE

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11
Q

A liner may be added to the:

A

deepest parts of a prep, closest to the pulp

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12
Q

When using a liner, the liner material should be kept away from:

A

away from the margin

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13
Q

Liner materials include:

A
  1. calcium hydroxide
  2. resin modified glass ionomer
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14
Q

Brand names for calcium hydroxide liners:

A

Life & Dycal

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15
Q

Indications for calcium hydroxide liners (Life & Dycal)

A

use on deepest preps- pulp capping material

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16
Q

Brand name for resin modified glass ionomer:

A

Vitrebond

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17
Q

Vitrebond must be ____ and releases ____ over time

A

light cured; fluoride

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18
Q

The “two appointment approach” of indirect pulp capping is done the the removal of all the infected (soft, leathery) dentin is most likely going to result in:

A

a pulp exposure

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19
Q

The “two appointment approach” of indirect pulp capping is done the the removal of all the infected (soft, leathery) dentin is most likely going to result in a pulp exposure:

  1. Remove:
  2. Leave:
A
  1. Remove- all caries, both affected and infected dentin from all areas EXCEPT the deepest, close to the pulp
  2. Leave- the last little bit of infected dentin, cover it with calcium hydroxide (dycal or life) and glass ionomer (vitrebond)
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20
Q

T/F: With the two appointment approach for indirect pulp capping, some infected dentin (closest to pulp) can be left

A

True

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21
Q

T/F: With the two appointment approach for indirect pulp capping, affected dentin is left while infected dentin is removed

A

False- both are removed except for the last little bit of infected dentin closest to pulp

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22
Q

T/F: with the two appointment approach for indirect pulp capping, either dycal/life or vitrebond is used:

A

False- both are used (Liner and RMGI)

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23
Q

After placing liner and RMGI with the two appointment approach to indirect pulp capping, place:

A

a temporary restoration such as IRM or ketac silver

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24
Q

According to the two appointment approach to indirect pulp capping, it is okay to:

A

leave some underlined enamel TEMPORARILY to help col dn the temporary restoration

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25
Q

How long should you wait between the first and second appointment with the two appoint approach to indirect pulp capping:

A

several weeks (perhaps 12)

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26
Q

With two appoint approach to indirect pulp capping, why should you wait several to twelve weeks between the first and second appointment?

A

To allow the body to form reparative dentin in the site of the near exposure - if we get the desired result, a dentin bridge will have formed

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27
Q

What is the desired result for waiting the several weeks between appointments with the two appoint approach to indirect pulp capping:

A

dentin bridge formation (fingies crossed)

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28
Q

With the two appointment approach to indirect pulp capping, at the end of the 12 weeks, confirm that the patient is _____ and do a ____ before anesthetizing

A

asymptomatic; vitality test

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29
Q

With the two appointment approach to indirect pulp capping, the tradition approach following the 12 weeks and confirming asymptomatic patient is:

A
  1. remove the temp restoration, glass ionomer, and CaOH
  2. carefully remove remaining infected dentin
  3. leave affected dentin
  4. place new liner of dycal and if desired, place vitrebond
  5. remove all undermined enamel & modify prep
  6. restore with permanent material
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30
Q

Soft, leathery caries=

A

infected dentin

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31
Q

dry, powdery caries

A

affected dentin

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32
Q

Is affected dentin invaded by microorganisms?

A

no

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33
Q

What is the more common approach for indirect pulp capping?

A

single appointment approach

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34
Q

Used when a small pulpal exposure occurs during cavity preparation:

A

direct pulp cap

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35
Q

For a direct pulp cap, a thin layer of ____ is floated over the exposed pulp. A layer of ____ is placed over that.

A

calcium hydroxide; glass ionomer

36
Q

For a direct pulp cap, a thin layer of CaOH is floated over the exposed pulp. A layer of RMGI is placed over that.

This may help simulate the pulp to form ____ which can produce a ____ across the exposure site.

A

secondary odontoblasts; dentin bridge

37
Q

With a direct pulp cap, it is most successful when the exposure is _____ rather than ____

A

mechanical; carious

38
Q

Direct pulp caps work better at the ____ than they do on an exposure on the ___

A

tips of pulp horns; side of a pulp chamber

39
Q

If the tooth will require a crown to adequately restore it, DO NOT RELY ON:

A

direct pulp cap

40
Q

Whether you are doing an indirect of direct pulp cap, temporary, or “permanent” restoration:

A

SEAL THE CAVITY

41
Q

When is a smear layer created?

A

whenever the dentin has been cut

42
Q

The smear layer is a few micrometers thick and is composed of:

A

denatured collagen, hydroxyapatite, and other cutting debris

43
Q

The smear layer acts like a natural bandage over the cut surface since it occludes many dentinal tubules with debris called:

A

smear plugs

44
Q

When using “total etch” systems, we do not want to:

A

bond t the smear layer

45
Q

Acid conditioners =

A

35% phosphoric acid pH=0

46
Q

Most dentin bonding systems have ____ that remove the smear layer and partially demineralize the intertubular dentin

A

acid conditioners

47
Q

Dentin without a smear layer provides a good area for:

A

micro mechanical retention

48
Q

What is the the pH or acid primers? Give an example:

A

pH= 2.5 (HEMA)

49
Q

Acid primers do not remove the:

A

smear layer

50
Q

What removes the smear layer? Acid primers or acid conditioners?

A

acid conditioners

51
Q

Resin bonding to ____ can last for many years, however the strength of resin bonding to ____ haas a limited life span

A

enamel; dentin

52
Q

How does resin bonding to dentin have a limited lifespan?

A

due to deteriorating of the hybrid layer

53
Q

Often the bond of restorations that rely exclusively on resin bonding to dentin will be severely weakened after about:

A

four years

54
Q

Regardless of if etching to dentin or not, the enamel:

A

MUST be etched with 35% phos[horic acid, with total-etch or self etch

55
Q

Adhesive bone strengths to ____ dentin are greater than those for ____ dentin

A

superficial; deep

56
Q

dentin with more tubules:

A

deep dentin

57
Q

Dentin with the larger diameter of tubules

A

deep dentin

58
Q

Deep dentin has a ____ amount of intertubular dentin in deep areas

A

reduced amount

59
Q

_____ dentin is more permeable than ____ dentin

A

deep; superficial

60
Q

The defensive function of the pulp is related to:

A

its response to irritation by mechanical, thermal, chemical, or bacterial stimuli

61
Q

Why might the inflammation of pulp become irreversible leading to death?

A

Because the confined rigid structure of the dentin limits the inflammatory response

62
Q

The size of the pulp cavity ____ with age

A

decreases

63
Q

What are more reparative? Younger or older pulps?

A

younger

64
Q

a primary objective during operative procedures must be the ____. All _____ except in the event of an indirect pulp cap.

A

preservation of the health of the pulp; caries must be removed

65
Q

Usually manifests as cold sensitivity, and sometimes spontaneous pain, in the maxillary posterior teeth. Often hard to isolate to a single tooth:

A

maxillary sinusitis

66
Q

Usually manifests as cold sensitivity or a sudden, usually unreproducible pain when chewing. Can be evaluated with a tooth sleuth, or fiber optic light. These teeth require crowning:

A

Cracked tooth

67
Q

Usually manifests as cold sensitivity, or pain in chewing. slight tooth movements when the teeth are clenched and then moved from side to side may be seen, but not always. This is called fremitis. Pain can often be relieved by occlusal adjustments

A

occlusal trauma

68
Q

slight tooth movements when the teeth are clenched and then moved from side to side may be seen, but not always

A

fremitis (seen with occlusal trauma)

69
Q

Cementum is slightly softer than dentin and consists of about ____ to ___% of inorganic material by weight

A

45-50%

70
Q

What has the highest fluoride content of all the mineralized tissues:

A

cementum

71
Q

In about 10% of teeth, enamel and cementum do not meet and this can result in:

A

a sensitive area

72
Q

Regarding tooth contours, ____ is the WORST and results in flabby red-colored, chronically inflamed gingiva and increased plaque retention.

___ results in trauma to the gingival tissues:

A

overcontouring

undercontouring

73
Q

Where are proximal contacts located in max and mand central incisors?

A

incisal third

74
Q

Where is the proximal contacts in teeth posteriorly to the central incisors?

A

junction of occlusal and middle third (creates larger occlusal embrasure)

75
Q

Marginal ridges should be the same height to prevent:

A

food impaction

76
Q

Proximal contacts are sightly ____ to the center of the proximal surface FL

A

slightly facial

77
Q

Regarding periodontal concerns, what is extremely important to important to preserve in the restorative process?

A

attached keratinize tissue

78
Q

t/f: If recurrent caries extends gingivially n the box area, it is acceptable and preferable to have a “box within a box” rather than deepening the entire bo gingival unless caries require it

A

true

79
Q

Liners should be added to the:

A

deepest parts of the preparation close to the pulp

80
Q

Keep liners away from:

A

margins of the restoration

81
Q

Liner materials are ____

Brand names are ____

A

calcium hydroxide (dycal & life)

resin modified glass ionomer (vitrebond)

82
Q

What type of liner is used on the deepest preps (and is a pulp capping material)

A

CaOH (life or dycal)

83
Q

What type of liner is light cured?

A

RMGI (vitrebond)

84
Q

What type of liner releases fluoride over time?

A

RMGI (vitrebond)

85
Q

Restorations should be supported by atleast:

A

a tripod of natural structure

86
Q

DO NOT have the entire floor the restoration covered by ____. Why?

A

calcium hydroxide (CaOH is too soft to support the restoration)

87
Q
A

Operative II (6 decks)

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