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Operative I > Week 3 Class I and V Restorations > Flashcards

Week 3 Class I and V Restorations Flashcards

1
Q

what are the type of liners in placing an occlusal restoration

A

-calcium hydroxide
- glass ionomer

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2
Q

which liner releases fluoride over time

A

glass ionomer

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3
Q

how do you use calcium hydroxide liners

A

-mix with spatula end of dycal instrument
- use dycal instrument to place over area of nearest pulp
- often cover with RMGI

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4
Q

how do you use resin modified glass ionomer liner/ base

A

-mix with spatula end of dycal instrument
- use dycal instrument to place over area nearest pulp
- often used to cover calcium hydroxide
-light cured

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5
Q

what is the difference between a liner and a base

A

a liner is placed in a thin layer over dentin
a base is placed in thicker layer on floor of prepared cavity

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6
Q

what are the steps in placing an occlusal restoration

A
  1. place liner and/or base if needed
  2. seal dentinal tubules
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7
Q

when would you need to use a base

A

deep caries

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8
Q

when would you seal dentinal tubules

A

preps that would be especially prone to sensitivity

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9
Q

what are the types of desensitizers

A
  • copal resin
  • bonding agents
  • gluteraldehyde (gluma)
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10
Q

what are the advantages and disadvantages of copal resin

A

advatages: inexpensive, quick to use
disadvantages: leaves a film thickness

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11
Q

what are the advantages and disadvantages to unfilled dentin bond agent

A

advantage: intermediate in cost
disadvantage: some required more than one step; involves some form of etching with an acid which may leave teeth more vulnerable to recurrent caries, leaves a film thickness

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12
Q

what are advantages and disadvantages to gluma

A

advantages: no film thickness, one step to apply
disadvantages: expensive, somewhat caustic to soft tissues and possibly to the pulp in deep preparations

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13
Q

how do you apply each desensitizer

A

-copal resin: wipe cavity walls with cotton pellet soaked in resin, then gently air dry
-dentin bonded resins: press resin into dentin using brush, gently air dry, light cure
- gluma: apply to walls for 30 seconds, dry, rinse, dry again. material is caustic; minimize contact with gingivae and protect pulp with liner/base in deep preps prior to application

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14
Q

why do we not use dentin desensitizers under amalgam

A

it makes negligible difference in tooth sensitivity because smear layer will seal most dentinal tubules and amalgam will seal itself with an oxide layer

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15
Q

what are the steps in placing an occlusal amalgam restoration

A

-place amalgam
-condense amalgam
- pre carve burnish
-carve anatomy
- refine restoration

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16
Q

what technique and instruments do yo uuse in condensing amalgam

A
  • small condenser to pack firmly into all line angles at a 45 degree angle, using a pressing, wiggling motion in a step wise fashion
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17
Q

how much should you overfill the amalgam prep

A

1 mm

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18
Q

how do you do pre carve burnishing

A

-using side of the nib of the condensor or ball burnisher.
-burnish towards the margins to eliminate voids and to bring excess mercry to the surface where it can be carved away
- begin to define grooves

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19
Q

what tools do you use to carve anatomy into amalgam

A

-hollenback carver perpendicular to margins
-tip of the carver to recreate groove anatomy

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20
Q

how do you check and refine occlusion in amalgam restoration

A

-use articulating paper
-use discoid carver to remove high occlusion marks and inclined plane contacts

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21
Q

what should you try to preserve in amalgam restoration

A
  • preserve cusp seats in the bottoms of fossae
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22
Q

what tools do you use to smooth the surfacr

A

-beavertail burnisher
- cotton pellet to leave matte finish

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23
Q

does carved amalgam gain longevity from the finishing process

A

no

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24
Q

how long do you have to wait to finish/polish amalgam restoration

A

24 hours after placement for amalgam to be set up

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25
Q

what is the instrument sequence for finishing amalgam

A

-green stone (coarse)
- white stone (medium)
- 12 bladed polishing bur (medium-fine)

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26
Q

what is the instrument sequence for polishing amalgam

A

-brown (pre-polish)
- green (polish)
- green with yellow collar (superpolish)

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27
Q

what are the finishing burs

A

-flame 7902
- round 7006
- bullet 7404
-small round 7002
- bullet pointed 7104

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28
Q

how do you place the finishing burs

A

-put the tip of the bur in the central groove and lay the bur across the enamel margin

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29
Q

what is the general sequence of finishing burs

A

most abrasive to the finest polishing instrument

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30
Q

what are the criteria for finished amalgam

A

-scratches and major surface irregularities should be gone
- high polish not necessary
-grooves should be definite but not deep
-no occlusal prematurities

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31
Q

what is the most important area in finished amalgam

A

-cavosurface margin

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32
Q

what circumstances would you finish an older amalgam resoration

A

-amalgam margins that have expanded beyond the caavosurface
- margins that were originally undercarved
- 1/3 of enamel thickness in localized area can be removed to extend the life of a restoration without replacing it
-margins with minimal ditching may be refined
- rough surfaces can be smoothed

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33
Q

why do we polish amalgam on slow speed

A

-rubber points may fall apart at high speeds
- tooth may overheat at high temp
-amalgam may overheat

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34
Q

what does it mean if you cant obtain a smooth surface on an amalgam restoration

A

surface was too rough to begin with, restart finishing procedure from beginning

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35
Q

what is the procedure for composite

A

-etch 2 sec, rinse
-place bond, gently air dry, light cur
- place composite increment, condense, light cure, repeat until prep is finished
-create anatomy, finish occlusal surface, light cure
-assess occlusion, refine restoration
-polish

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36
Q

what is the procedure for amalgam restoration

A

-titurate amalgam
-place amalgam
-condense amalgam
- pre-carve burinsh
-carve anatomy
-assess occlusion, refine restoration

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37
Q

what tools should use use to carve anatomy in composite restoration

A

-hollenback
- optasculpt

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38
Q

which type of restoration does the operator have more control over set up time

A

composite

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39
Q

can you polish a composite restoration in the same day

A

Yes

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40
Q

when should you finish during a composite restoration? when should you polish

A

finishing should be completed prior to light curing, polishing should be done after the restoration is finished

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41
Q

what are the advantages and disadvantages to composite

A

advantages: preparation can be more forgiving, esthetic, operator control over set up time, preserve tooth structure ( dont need to remove as much for retention)
disadvantages: restoration more technique senstivie, additional steps, may not last as long, not as strong, no moisture tolerance

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42
Q

what would be more traumatic to gingiva in a class 5 restoration: overcontouring or under contouring

A

overcontouring

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43
Q

what are the steps in placing a class v amalgam restoration

A
  • follow same guidelines as occlusal
    -use hollenback carver to remove excess amalgam
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44
Q

what are the 4 major classes of dental materials

A

-metals and alloys
- porcelains and ceramics
-polymers
-composites

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45
Q

what organizations regulate dental materials

A

american dental association and FDA

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46
Q

what does the FDA do in regulation of dental materials

A

-protect the public from hazardous or ineffective medical materials and devices

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47
Q

what happened in the 2009 FDA reclassification

A

reclassified amalgam from class 1 to class 2 where class 1: lowest risk -> class 3 highest risk

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48
Q

how does the ADA regulate dental materials

A

-specifications for dental materials, instruments, and equiptment
- restorative material specifications

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49
Q

what does performance of all dental materials depend on

A

their atomic structure

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50
Q

what are the types of interatomic bonds

A

-primary: ionic, covalent, metallic
- secondary: hydrogen bonds, van der waals forces

51
Q

what does electrostatic attraction of positive and negative charges involve

A

electron transfer between ions

52
Q

what are the properties of ionic bonds

A

-non directional, strong bonds
- no free electrons, good thermal and electrical insulators

53
Q

what are ionic bonds

A

electrostatic attraction of positive and negative charges

54
Q

what are examples of materials with ionic bonding

A

ceramics, gypsum

55
Q

what is a covalent bond

A

2 atoms share an electron

56
Q

what are the properties of a covalent bond

A

-directional bonds
- low electrical and thermal conductivity
- water insoluble

57
Q

what are examples of materials with covalent bonding

A

water, glass, polymers, composite

58
Q

what are metallic bonds

A

cluster of positive metal ions surrounded by a gas of electrons

59
Q

what are the properties of metallic bonds

A

-non-directoinal bonds
-high electrical and thermal conductivity

60
Q

what are examples of materials with metallic bonds

A

amalgam and gold alloys

61
Q

what are the classes of material properties

A

-biological
-surface
-physical
- mechanical

62
Q

what is the biological class of material properties and example

A

the biological response to a material when in contact with the human body
- ex: gingivitis

63
Q

what is the surface class of material properties and example

A

the unique properties of a material associated with its surface
-denture retention, adhesive bonding

64
Q

what is the physical class of material properties and example

A

depend on the type of atoms and the bonding present in material; size or shape have no affect
- optic (color, glass), thermal (conductive)
-structure insensitive

65
Q

what is the mechanical class of material properties

A

reaction of a material to the application of an external force, size, and shape of specimen affect properties
- structure sensitive
-applied force referred to as load

66
Q

what develops in response to load

A

stress

67
Q

what is the relationship between stress and load

A

stress = load per unit area

68
Q

strength of material =

A

stress at fracture

69
Q

type of strength measured is dependent on type of ___

A

force applied

70
Q

what are the types of force/stress

A

-compressive (pushing)
- tensile (pulling)
- shear (sliding)
- torsion (twisting)
- flexure (bending)

71
Q

what is compressive strength

A

measure of the stress necessary to fracture a material by 2 opposing forces directed toward each other

72
Q

what does compression push together

A

atoms and structure

73
Q

what is the highest strength measure for most materials

A

compressive strength

74
Q

what is the lowest strength for most materials

A

tensile strength

75
Q

what is tensile strength

A

-pulling force
- measure of the stress necessary to fracture a material by 2 opposing forced directed away from each other

76
Q

what loads cause failure in compression

A

higher loads

77
Q

what loads cause failure in tensile strength

A

lower loads

78
Q

what is shear strength

A

sliding force
- stress necessary to rupture a material by 2 opposing parallel forces directed towards each other but not in the same plane

79
Q

what is a clinical situation with shear force/ strength

A

implant bone interface

80
Q

what is the intermediate strength between compression and tensile

A

shear strength

81
Q

what is torsion strength

A

-twisting force

82
Q

what are examples of torsion strength in dentistry

A

-torque wrench w dental implants
- torsion test of implant bone interface stability/strength of osseointegration
- torsional fatigue of endodontic rotary files
-not relevant to direct or indirect dental restorations

83
Q

what is flexural strength

A

-bending force
-measure of stress to cause failure in bending

84
Q

what is the 3 point bend test

A

-compressive load
-combination of compressive and tensile stress

85
Q

where is flexural strength vital in dentistry

A

-on direct restorations (amalgam and composite)
- indirect/removable restorations

86
Q

what are examples of dental stress

A

-protrusive movement
-posterior occlusion

87
Q

what is involved in protrusive movement

A

anterior teeth
-flexure load on incisors

88
Q

where is the compressive load from chewing distributed

A

at marginal ridge contact areas, at fossa areas

89
Q

what is the formula for occlusal stress

A

occlusal load/ occlusal contact area

90
Q

what are tripodized occlusal contacts

A

allows distribution of occlusal load across maximum area for minimized stress

91
Q

what does premature contact result in

A

decreased area
-patients occlusal force stays same but occlusal stress is increased

92
Q

what is strain

A

the deformation that occurs in a material when force is applied to the material

93
Q

what is the formula for strain

A

change in length (deformation)/ unit original length

94
Q

what is the relationship between stress and strain

A

if you have one you will have the other

95
Q

what is elastic strain

A

temporary distortion of material by applied force
-strain is below the elastic limit

96
Q

when force is removed in elastic strain what happens to material

A

reverts to original form

97
Q

what is plastic strain

A

permanent distortion of a material
-strain is beyond the elastic limit
-elastic portion of strain recovered
- plastic portion of strain not recovered

98
Q

what happens when force is removed in plastic strain

A

shape remains changed

99
Q

what are the benefits to amalgam

A

-easy to manipulate
- can be placed in plastic state and carved before it hardens
- excellent physical properties (strong, predictable, self sealing, good barrier against recurrent caries)
-cost effecting

100
Q

what is the basic amalgam composition

A

-70% Ag
-16% Sn
- 13% Cu
-Zn 1%
-silver, copper, tin zinc

101
Q

what is conventional amalgam

A

low copper

102
Q

what is high copper amalgam and benefits over conventional amalgam

A

higher copper amount, results in stronger restoration

103
Q

what are the phases of amalgam setting and what happens in each

A

-gamma: tin and silver react with mercury, forms silver- mercury and tin- mercury. strong, corrosion resistant
-gamma-1: silver-mercury. weaker, suscpetible to corrosion
-gamma-2: tin-mercury. weakest, most susceptible to corrosion

104
Q

what happens when you add copper to amalgam

A

creates a copper-tin phase, eliminates tin-mercury gamma-2 phase

105
Q

what are the phases of low copper amalgam? high copper?

A

-low: gamma + mercury -> gamma + gamma-1 + gamma-2
-high: gamma + copper + mercury -> gamma + gamma-1 + CuSn

106
Q

what are the shapes of amalgam particles:

A

-lathe
-admixed
-spherical

107
Q

what is lathe

A

outdated-particles formed by cutting block of alloy with a lathe
-results in large irregular particles
w

108
Q

what is admixed

A

-lathe type particles mixed with small spheres
-reqiures more condensation force
- most commonly used type of amalgam
-low early strength (1 hr)

109
Q

what is spherical

A

-spherical shape
-higher early strength (1 hr) and higher 24 house strength than admixed
-more difficult to achieve interproximal contact
-require less condensation force

110
Q

what are the variables in amalgam manipulatoin

A

-mercury to alloy ratio
- trituration
- condensation
-carving and finishing

111
Q

what is the ideal mercury to alloy ratio

A

-less mercury in final restoration better strength and corrosion resistance
-admixed alloys ~50% mercury

112
Q

longer and faster trituration = ___

A

sets faster

113
Q

what is the most critical variable in amalgam manipulation

A

condensation

114
Q

is undercondensation or overcondensation the most common error made by dentists

A

undercondensation

115
Q

why not remove amalgam due to mercury concerns

A

-unwarranted loss of tooth structure
-unnecessary expense
-limited longevity when replaced with inappropriate tooth colored restoration

116
Q

what are the properties of amalgam

A
  1. high compressive strength and low tensile strength
  2. sensitive to moisture contamination during placement
  3. amalgam corrodes
117
Q

how does water react with amalgam

A

reacts with the zinc in the amalgam and causes an eventual expansion of the alloy out of the preparation

118
Q

how does amalgam create and regenerate a seal between itself and the tooth

A

the oxides expand and fill tiny voids and prevent microleakage

119
Q

what are the disadvantages of amalgam

A

-poor esthetics
-need for good mercury hygiene
-remove more tooth structure for adequate bulk of material
-doesnt bond to tooth structure
-thermal conductor, need liner or base to prevent post op sensitivity on deeper restorations
-eventually may ditch at the margins, collecting plaque in that area

120
Q

what are the advantages to amalgam

A

-more forgiving in areas where moisture control is hard
- high wear resistance and compressive strength
-can be placed in less time than other options
-relatively long-lasting
- regenerates its seal
-is less prone to recurrent decay than bonded composite resin restorations

121
Q

what are the indications for amalgam

A
  • moderate to large class 1 and 2 restorations
    -heavy occlusal wear
    -high caries rate
    -difficult isolation
    -gingival margins on root
  • class 5 restorations in non-esthetic zones
    -temporary restorations on teeth with questionable prognosis
  • buildup under crowns for extensively damaged teeth
121
Q

what are the indications for amalgam

A
  • moderate to large class 1 and 2 restorations
    -heavy occlusal wear
    -high caries rate
    -difficult isolation
    -gingival margins on root
  • class 5 restorations in non-esthetic zones
    -temporary restorations on teeth with questionable prognosis
  • buildup under crowns for extensively damaged teeth
122
Q

what are the indications for amalgam

A
  • moderate to large class 1 and 2 restorations
    -heavy occlusal wear
    -high caries rate
    -difficult isolation
    -gingival margins on root
  • class 5 restorations in non-esthetic zones
    -temporary restorations on teeth with questionable prognosis
  • buildup under crowns for extensively damaged teeth

Operative I (12 decks)

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