station exam spring D1 Flashcards
Class 1 Prep
Class 2 prep
Class 3 prep
class 4 prep
class 5 prep
root caries/ senile caries
Non carious cervical lesions: erosion abrasion & abfraction
class 6 prep
cavosurface margin: external outline form
red dark line= external outline form of cavosurface margin
inside= internal outline form
isthmus width
intercuspal distance
convergent, divergent or parallel?
convergent
remaining dentin thickness: between floor of prep & pulp
left= highspeed: cuts enamel, outline + extension of prep &&& friction grip burs
right= slowspeed: wont cut enamel
caries excavation, prep refinement, retention grooves
&&& latch burs
head= cutting part, working part of bur
neck= connects head to shank shank= fits into handpiece
friction grip—high speel & can be slow speed
latch type—slow speed only
straight handpiece= lab handpiece
1-round
2-inverted cone
3-pear shaped
4-straight fissure
5-tapered fissure
round bur
- rounded preps
- 1/4 sized = for retention grooves
- slow speed round burs are for excavating caries
pear shaped
-rounded preps w/ convergent walls
inverted cone
- undercut prep wall
- sharp convergent prep
straight fissure
- parallel walls & flat floors
- not end cutting, only the sides cut
tapered fissure
-tapered walls (divergent)
finishing burs
- contour & smooth surface of restoration
- higher number of flutes= smoother surface
lab burs
- triming acrylic
- denture adjustment
- extra oral use
13-95-8-14
enamel hatchet
- not curved
- cuts enamel w/ push stroke
gingival margin trimmer
- curved
- cutting edge at angle
- refinement (esp. at gingival margin of proximal box)
- lateral scraping
spoon excavator
- caries removal
- check hardness/softness of dentin
condensers
carving instruments for anatomy
- scaler
- discoid cleoid
- half hollenback
composite placement spatula
-placememnt & shaping resin composite
amalgam carrier
-transfer of amalgam from amalgam well to the cavity prep
tofflemire matrix retainer
-used when condensing a 2 surface restoration
30 gauge
27 gauge
25 gauge
-posterior superior alveolar nerve block
-max molars (3)
-not MB root of max 1st molar
-dont enter infratemporal fossa
- *middle superior alveolar nerve block**
- pulp & buccal perio tissues
- Max 1 & 2nd premolars
- *anterior superior alveolar nerve block**
- effects anterior/middle superior alveolar nerve & infraorbital nerve
- maxillary central incisor through canine pulp, bone & perio tissues
- *greater palatine nerve**
- posterior portion of the hard palate, up to premolars
- *nasopalatine nerve**
- anterior portion of hard palate from l. to r. 1st premolars
- *inferior alveolar nerve block**
- mandibular teeth to midline, body of mandible, inferior ramus, buccal mucoperiosteum
- anterior 2/3 of tongue & floor of oral cavity
- *mental nerve**
- buccal mucosal membrane anterior to mental foramen—from 2nd premolar to midline
- lower lips & skin of chin, pulpal nerve fibers to premoalrs, canine & incisors
infratemporal fossa
- *long buccal-**–close to most distal molar
- anesthetizes soft tissue & periosteum buccal to mandibular molar
1-silicone rubber plunger
2-aluminum cap
3-diaphragm
4-mylar stop
5-aspirating
1-seals glass tube, provides way for harpoon to engage, aiding in aspiration
2-on opposite end of plunger, holds thin diaphragm in position
3-semipermeable membrane
4-provides protection if glass breaks
5-create negative pressure at site of injection to see if it is in a blood vessel…don’t pull the needle out, so only pull back 1-2 mm. if there is blood, rotate the barrel syringe 45 degrees and try again
1-Wingless Retainer
vs
2-Winged Retainer
1- retainer postioned ON tooth WITHOUT rubber dam
dam is placed over retainer
2-dam is placed ON the wings of the retainer and BOTH retainer & rubber dam are applied to abutment…1 step application
N27—small molars
13A—lower left & upper right molars
12A—lower right & upper left molars
14A—partially erupted molars
(Buccal side of tooth has the wider side of the retainer)
Anterior Retainer
Placed AFTER rubber dam
extension
1-for incisors
2-for canines
3-posterior teeth
1-from 1st premolar to other 1st premolar
2-from 1 molar to the contralateral canine
3-1-2 posterior to treatment tooth to the contralateral canine
Ball & Cone Burnisher
—contour restoration
Spatula
- for mixing cements & lining materials
- smaller end is used for transfer/placement of material into cavity prep
left= front surface right= not front surface
front surface mirrors avoid double immages bc reflective surface is at the surface of the mirror
non front surface= reflective surface is beneath a layer of glass
Amalgam
properties of:
1-silver
2-tin
3-copper
4-zinc
1-inc strength
2-controls expansion, lengthens setting time
3-inc strength, reduces corrosion, reduces creep & marginal breakdown
4-prevents oxidation
-when contaminated w/ moisture during placement Zn amalgam will have delayed expansion
Amalgam
1-indium
2-palladium
3-platinum
particle types
4-lathe cut
5-spherical
6-ad mix
1-permite SDI= reduces creep, inc strength
2-valian phD= reduces corrosion & tarnish
3-logic+ = inc compressive & tensile strength
4-irregular shapes
5-spheres make it the most stable shape w/ lowest surface energy
6-combination of spherical & lathe cut
Spherical Amalgam vs. Admix Amalgam
Spherical Amalgam—needs less mercury & less condensation forced
- gets compressive strength earlier than lathe cute
- smooth surface texture
Admix Amalgam—needs higher condensation forces
-easier to produce proximal contact areas in proximal restorations
1-amalgam under triturated vs over triturated
1-under triturated= dry & crumbly
- insufficient matrix to hold amalgam together
- difficult to condense
- poor corrosion
over triturated= wet & soupy
- excessive expansion
- reduced strength
Comparison
1-resin composite
2-glass ionomer
3-resin modified
4-amalgam
1-esthetic, light cured, poly shrinkage
coefficient of thermal= greater than tooth
good wear resistance, no fluoride release
2-less esthetic, chemical cured, low shrinkage
coefficient of thermal= similar to tooth
low wear resistance
medium high fluoride release
3-more esthetic= conventional GI, but opaque
chemical & light cured
imrpoved wear resistance
medium high fluoride release
4-not esthetic, not conservative, not technique sensitve
- no dimensional change upon setting
- no gap formation at gingval margin from poly shrinkage
RMGI Steps
1-pumice
2-shade selection
3-isolation
4-prep tooth
5-dentin condition w/ 20% polyacrylic acid—preps dentin surfaces w/o opening tubules
6-rinse: leaves dentin moist
7-apply: RMGI
8-Cure for 20 secc
9- contour restoration w/ 30 fluted finish bur
10-etch enamel margins, rinse & dry
11-apply G coat and then cure for 20 sec
Composite Steps
1-pumice/shade selection/ isolation
2-prep
3- etch enamel for 30 sec and dentin for 15 sec w/ 30-40% phosphoric acid (removes smear layer & demineralizes dentin)
4-rinse 10 s
5- apply bonding agent—excite F & cure
6-place composite in incrememnts w/ curing for 20 sec
7-polish composite w/ enhance polishing cup using silicone carbide brush
Top:not clinically acceptable
-proximal contacts are over 1 mm—smallest condenser passes through proximal contact
Bottom: not clinically acceptable
-proximal/gingival contact isnt open
Not clinically acceptable
-isthmus width is greater than 1.6 mm
- not clinically acceptable
- walls are divergent
Not clinically acceptable
-prep tilted towards the buccal
not clinically acceptable
margins are chipped or have areas of friable enamel
left= divergent
right= convergent
1- direct restorations for amalgam
2-direct restorations for composite
3-direct restorations gold/ceramic
1-requires buccal & lingual walls that converge bc amalgam is plastic so when placed in prep it hardens
so the convergent walls= retention for material
2-can have convergent or parallel walls bc resin is bonded to the tooth structure for retention when placed in prep it hardens when exposed to curing light
3-requires buccal linguwal walls that are divergent bc restoration is fabricated outside the mouth and then cemented into palce
Steps in Cavity Prep
1-establish outline form
2-obtain resistance form
3-obtain retention form
4-obtain convenience form
5-remove remaining infected dentin/prior restorative material
6-pulp protection
7-finish enamel walls & cavosurface margins
8-clean prep
- marginal discrepancies
- excess or tooth ledge
not clinically acceptabe—marginal discrepancies
-excess or tooth ledge
not clinically acceptable
-void at the margin
not clinically acceptable
-proximal contacts are open
floss cant pass or floss shreds…proximal contact is too tight
not clinically acceptable
-contour of restoration is flat or bulky & would require replacement
not clinically acceptable
-normal occlusal anatomy is not reprouced
- not clinically acceptable
- marginal ridge is too high or low or misshaped
- not clinically acceptable
- occlusal contact is the only contact in the quadrant
top chair= height adjustment for back support
front lever=seat height adjustment arm
back lever= adjustment arm for lower back support
mandibular arch= 45
red=on/off
blue=intensity
green=color spectrum
blue= handle
red=shank
mirror=working end
1-Don
2-Doff
1-gowns, masks, eye protection, gloves
2-gloves, eyeware, mask, gown
1-provider posture
2-ergonomics & loupes
3-loupes
4-patient positioning
1-back straight, feet flat
height of stool so thighs are parallel to floot
back against backrest
2- taller people= longer working distance than shorter
3-enhance visuality + posture + comfort
working distance, declination angle & frame size
20 degrees or less neck flexion
4-patient lying with back flat
w/ maxillary, put teeth at 25 degree angle to vertical
support head rest so it supports the neck
mandibular arch the toso should be 30-45 angle to floor
adjust height of chair until patients oral cavity is treated at level of elbow w/ arms at your side and forearms perp.
1-mandibular posterior occlusal
2-mandibular posterior buccal
3-maxillar posterior occlusal
4-maxillary & mandibular lingual
1-right handed= 7
left handed= 5
2-right= 9 left= 3
3-right=11
left=1
4-right & left= 12
blush
pulp exposure
tetric evo ceram—80% weight 70% volume
Bonding Agent—45% filled: excite F
Pulp Protection Materials
1-varnishes, dentin sealers & dentin desensitizers= thin layer of material to seal dentinal tubules
2-bases= .75 mm of material to serve as a seal, thermal insulator & mechanical support of overlying restoration
3-liners= .5 mm material used to stimulate formation of reparative dentin
1- direct pulp capping
2-indirect pulp capping
1-there is NO RDT, more successful in younger patients
- attempt to repair small direct pulp exposure
- D3110
2-.5 or less of RDT
- incomplete caries removal
- no direct pulp exposure but attempt to stimulate reparative dentin growth
- D3120
1-What to check before restoring a tooth w/ a large lesion
1-assess & test the pulp to determine if there is:
- *vitality** & reversibility of inflammation (pulpitis)
- if the tests are both neg then the situation will not be improved by any direct restorative procedure
1-liners
1-have CaOH
- antibacterial properties
- soft material so use a harder material (base) over it before the restorative material
- helps allow the pulp to heal/repair
1-Varnishes
2-dentin sealers/desensitizers
3-bases
1-solution liners—physical barrier to passage of materials through dentinal tubulues, reducing procedural sensitivity
-cant be used under resin restoration, bc they will block the bond between resin & tooth
2-prevents penetration of bacteria & liquids during amalgam restoraton by sealing off dentinal tubulues
3-used when there is a concern regarding the restoration transmitting temp to the pulp, need to cover a softer material, or a need to provide a better seal to prevent microleakage
-usually use glass ionomers for this
Top line= EITHER
adhesive bonding system (composite)
or dentin desensitizer(amalgam)
middle line= base
bottom line= calcium hydroxide (CaOH)
1-Shallow Amalgam Restoration
2-Moderate Amalgam Restoration
3-Deep Amalgam Restoration
1-RDT 2mm +
No/No/ Dentin Desensitizer
(only DD on the top layer is needed)
2-RDT .5-2 mm
No/ + or -Base/ DD
(only base in the middle layer & dentin desensitizer on the top layer)
3-RDT 0.5 or less
CH/Base/DD
(Calcium Hydroxide on the bottom layer[liner], base in the middle, & Dentin desensitizer on the top layer)
1-Shallow Composite Restoration
2-Moderate Composite Restoration
3-Deep Composite Restoration
1-RDT 2mm
No/No/ABS
(only adhesive bonding system on the top layer)
2-RDT 0.5-2 mm
No/No/ABS
(Only adhesive bonding system on the top layer)
3-RDT 0.5 mm or less
CH/Base/ABS
(calcium hydroxide on the bottom layer [liner], base in the middle layer, & adhesive bonding system on the top layer)
polish w/ green DCIM then gray DCI—rinse between 2 points
Enhance point…
use either this or the DCIM/DCI dont use both
silicone carbide= obtaining high polish
pit & fissure sealant
kavo quattro care unit
implant
abutment
crown
titanium, gold, zirconia, ceramic
external hex
internal trilobe
internal hex morse taper
perio probes—measure crevice depths, clinical attachment levels, width of keratinized giniva, bleeding, pus, & size of oral lesions
UNC 12= 1-12 mm individual markings
Goldman Fox= rectangular in cross section: 1, 2, 3-5, 7, 8, 9, 10 (3-5) are combined
furcation probe—Nabers 2N
-curved blunt tipped to get into furcation areas
double ended
WHO probe or CPI probe
Calculus & amalgam overhang are likely to collect bacterial pathogens that contribute to progression of perio diseases
large deposits around the necks of the teeth
overcontoured crown
tipping/open contacts
root fracture
root caries
recurrent caries= radiolucent area under restoration
restorations: amalgam/gold= radioopaque
composites= radioopaque, unless it is old then it is radiolucent
creep
open end of head is towards gingiva
closed end is towards occlusal
—use .0015 matrix bands: smaller circumference holds against cervical area of the tooth
butt joint
material over margin—flash/excess
submarginal deficiency= ledge
open margin- pit/void
