Fall Lecture: Foundation with Direct Restorative Flashcards

1
Q

Core build up material is aka:

A

foundation material

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2
Q

When to use core or foundation

A

caries, fracture, loss of filling, creation of access cavity for RCT

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3
Q

Core replaces:

A

pulp, lost tooth

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4
Q

Survivability of individual tooth, mostly dependent on:

A

amt of coronal and radicular tooth

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5
Q

When to asses sound structure and type of restoration:

A

before tx planning

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6
Q

ferrule:

A

band of circ material encircling cervical area of tooth restored w crown OR supragingival tooth structure remaining

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7
Q

Effective ferrule ht:

A

1.5-2mm, uniformly and circ around tooth

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8
Q

ideal core material:

A

stable in wet env, ease of use, rapid, hard set, high compressive, tensile stength, modulus of elasticity and fracture toughness, inert (no corrosion), cariostatic props, biocompatible, cheap, should not contract/expand too much

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9
Q

modulus of elasticity is related to:

A

rigidity

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10
Q

materials for foundation or core:

A

silver amalgam, composite resin, GI, and RMGI

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11
Q

Different ways composite resin can be cured:

A

chem, photo, dual

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12
Q

Indications for silver amalgam:

A

replacement of existing restos, large Class I, II, V, core build up, caries prone pts

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13
Q

Advantages of silver amalgam as core;

A

spherical high copper amals, have high 1h compressive strength (1 appt.), superior dimensional stability, minimal leakage, self sealing bc of percolation, less sensitive to moisture contamination, color contract for crown margin placement, MOE 3X higher than comp resin, great retention w amalcore, pins, posts, no expansion, slight contraction, no microleakage

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14
Q

Amalgam with high 1-h compressive strength:

A

spherical high copper amalgam

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15
Q

The lack of moisture contamination with amalgam is good for:

A

subgingival lesions, bleeding

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16
Q

Which is more rigid, amalgam or resin?

A

amalgam

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17
Q

MOE for amalgam is __ times higher than resin.

A

3

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18
Q

Disadvantages to silver amalgam as core:

A

low early strength, 15-20m setting bf crown prep, not good for esthetic zones bc of corrosion and discoloration, (EXCELLENT FOR POSTERIOR TEETH), pins can introduce stress and crazing of dentin

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19
Q

Amalgam sets by:

A

crystalization

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20
Q

Initial setting time of amalgam:

A

15-20m

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21
Q

3 types of dental amalgam alloys:

A

conventional lathe cut, spherical and admix

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22
Q

Best alloy type for core build up:

A

spherical, less time to set than the other 2, prep can be done in 20m, req less mercury bc there is less surface area, lower mercury/ alloy ratio, better props, less expansion, doesn’t stress crown

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23
Q

Spherical amalgam:

A

easily condensed, readily carved, high initial/final strength, difficult to achieve proximal contact

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24
Q

Why not to use spherical allow for Class 2 resto?

A

hard to make interproximal contact

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25
Q

1h compressive strength, highest to lowest:

A

valiant, tytin (both spherical), dispersalloy, velvaloy, phasealloy

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26
Q

24h compressive strength, highest to lowest:

A

valiant, tytin, phasealloy, dispersalloy, velvalloy

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27
Q

TF? Spherical alloy has both higher 1h and 24h compressive strength.

A

T

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28
Q

Amalcore:

A

coronal-radicular resto, uses pulp chamber and the coronal 2-3mm of each canal for retention of core material, post only if pulp chamber depth is not insufficient

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29
Q

how to overcome the fact that amalgam does not bind to prep wall?

A

bonding systems

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30
Q

Bonded amalgam technique:

A

dentin bonding system w viscous resin liner that physically mixes with amalgam, forms micromechanical union, increase retention to tooth

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31
Q

Dual cure adhesive can:

A

create locking w dentinal tubule by creating resin tag and hybrid layer, bonds w amalgam, retention with tooth surface is much higher

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32
Q

conventional amalgam:

A

no micromechanical chemical locking w tooth

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33
Q

Cx in for bonded amalgam restoration:

A

when remaining tooth structure is not enough, extensively carious post teeth where it acts as a cost effective alternative, deep bite where short clinical crown is present

34
Q

Adv of bonded am resto:

A

adequate dentinal sealing, conserv tooth prep, elimination of use of retention pin, inc res and ret form, red microl, dec post-op sensitivity, imp marginal sealing, red 2’ caries, single appt, but reduced bond strength over years, more $

35
Q

Dental amal is hydroph___

A

obic

36
Q

Hydrophilic end:

A

dentinal tube, hybrid layer

37
Q

Higher efficacy, filler or unfilled?

A

fillled

38
Q

Resin tags enter:

A

dentinal tubules

39
Q

Type of resin to use for bonded am resto

A

self or chem bonding system

40
Q

Fxn of circumferential slots:

A

increase retention of complex amal restos

41
Q

segmental cicm slot: are aka:

A

cleats

42
Q

Amalgapins:

A

retention tech, circular channels, vertically into dentin, depth: 1.5-3mmm, diameter: 1mm, never done in enamel

43
Q

Burs that can be used to amagains:

A

1156, 1157, 330, 56

44
Q

TF? Resistance to displacement provided by amalgapin is similar to that provided by self threaded pins.

A

T

45
Q

Down side of threaded pins:

A

sig amt of dentinal crazing or fracture

46
Q

This end of the adhesive bonds with the tooth structure:

A

hydrophilic end bonds w the hybrid layer, phobic bonds with the amalagam

47
Q

When to condense the amalgam for a bonded amal resto:

A

while the resin is in viscous liquid form

48
Q

This increases the retention of the bonded amal resto:

A

fingerlike resin tags incorporated with amal and dentinal tubules

49
Q

Does bonded amal resto inc or dec post op sensitivity?

A

dec, but more expensive

50
Q

Which type of curing system to use with bonded amal resto:

A

self curing or chem activated, bc light can’t get there

51
Q

Is bonding a satisfactory method of retaining amal restos replacing cusps compared to pin-retained amal restos?

A

yes (current research)

52
Q

Bur to make circ slots:

A

33 1/2 inverted cone bur

53
Q

The resistance to displacement provided by amalgapins is similar to that provided by:

A

self threaded pins

54
Q

Benefit of amalgapin over self threaded:

A

eliminates the risk of dentinal crazing caused by threaded pins

55
Q

Define crazing:

A

fracture

56
Q

cemented stainless steel pins:

A

extensively damaged tooth for complex amal, not going into pulp chamber

57
Q

Negative to cemented stainless steel pins:

A

vertical root fracture or dentinal crazing

58
Q

Do amalgam cores expand causing tooth frature?

A

no, many have net contraction

59
Q

net contraction of many modern high copper amalgams is due to:

A

low mercury alloy ratio, smaller mercury/alloy ratio, use of mechanical amalgamator (removes excess mercury from the field)

60
Q

The more mercury removed from the field,

A

the more contraction of the amalgam

61
Q

contraction or expansion: spherical, admixed, fine lather cut

A

spherical: slight contraction, admixed: slight expansion, fine lather cut: significant contraction

62
Q

Do amal and resin based composite resto cause cusp fracture?

A

no sig dif

63
Q

Core build up material for esthetic zone:

A

composite resin

64
Q

Adv of composite resin as core build up:

A

high compressive strength, bind to tooth when used with an adhesive, ease of use, light cure, dual cure and self cure formulations, available as tooth colored for use in esthetic zone and also as color contrasting material for use with metallic or opaque ceramic crowns, fracture toughness is similar to amalgam

65
Q

Disadv to composite resin as core:

A

polymerization shrinkage and stress at the adhesive interface, dimensional expansion in wet env (water sorption can prevent proper fit of crown), long term water sorption by core can cause loss of material bc of this solubility, lower fatigue resistancethan amalgam, resin bond may weaken w time and fxn

66
Q

How to eliminate the shrinkage gap due to polymerization shrinkage of resin:

A

use incremental tech

67
Q

List the composite resins that are best for core build up

A

light cure resins: Clear Fill Photo core, Encore SuperCure, Rebilda LC, Bis-Core, CoreReestore

68
Q

List the composite resins not to use for core bc of shrinkage:

A

Ti-Core, Core Paste, Core-Flo

69
Q

Light cure rc are not

A

sensitive to dentin bonding agents

70
Q

Adv of Gi or RBGI as core build up:

A

bonds to tooth, ease of manip, corrosion resistance, biocompatability, fluoride release, just “initial burst’ in 24h only, then decreases thereafter

71
Q

Disad of GI or RMGI as core build up:

A

brittle, very low compressive and tensile strength high water solubility, dimensional instability (polymerization and volumetric shrinkage), not good for core build up

72
Q

When to use GI or RBGI for core build up:

A

only as ‘block out’ material but not as extensive cores

73
Q

Best choice for core build up on posterior teeth:

A

spherical silver amal

74
Q

Core material to use in esthetic zone:

A

light cure resin composite

75
Q

Care to use when making a composite resin core build up:

A

isolation, incremental addition and proper adhesive use

76
Q

TF? GI’s are good for extensive core build up materials.

A

F

77
Q

When to use bonded amal resto:

A

extensively carious pos teeth , very little remaining tooth, deep bite with short clinical crowns, core of foundation build up,

78
Q

Bonding system used for bonded amal restos:

A

4 META (4-methacryloyloxyethy trimellitate anhydride) (amalgabond +, fine metacrylic powder as filler, other has liner)

79
Q

Adv of light cure comp resin for core:

A

not sensitive to any dentinal bonding system, not as much shrinkage as self curing

80
Q

TF? Circumferential slots give you as much retention as a pin.

A

F