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DDS1-resto > rubber dam, pulp protection, class II > Flashcards

rubber dam, pulp protection, class II Flashcards

1
Q

advantages of rubber dam

A
  • isolation (moisture control)
  • retraction
  • access
  • visibility
  • patient/staff protection
  • safety, quality, efficiency
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2
Q

rubber dam for anterior teeth

A

1st pm to 1st pm

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3
Q

rubber dam for posterior teeth

A

8 (or one tooth distal) to opposite lateral incisor

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4
Q

clamp for upper left molars and lower 8

A

12A

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5
Q

clamp for upper right molars and lower 8

A

13A

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6
Q

clamp for lower molars

A

3

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7
Q

clamp for premolars

A

2

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8
Q

butterfly clamp

A
  • single tooth (eg endo)
  • class V
  • anterior premolars
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9
Q

exceptions to rubber dam

A
  • ortho

- fixed/partial dentures

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10
Q

pulp

A

loose connective tissue with many cell types, vascular network, and sensory innervation

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11
Q

functions of pulp

A
  • dentinogenesis
  • defense
  • sensation
  • nutrition
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12
Q

main factor responsible for pulpal inflammation and necrosis

A

bacteria

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13
Q

responses of pulp to noxious stimuli

A
  • inflammation (pulpitis)
  • deposition of tertiary dentin
  • degeneration and necrosis
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14
Q

vital tissues

A

respond to stimuli

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15
Q

functions of pulpal protection materials

A
  • protect pulp from thermal, chemical and bacterial stimuli
  • seal dentinal tubules and resto margins
  • reduce sensitivity
  • induce tertiary dentin
  • promote pulpal healing
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16
Q

best protection for pulp

A

healthy dentin

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17
Q

varnish is used with

A

amalgam

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18
Q

varnish function

A
  • seal dentin and reduce microleakage

- prevent dentin discolouration by amalgam

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19
Q

can you use varnish with composite resin, adhesive systems, or GI

A

NO (only amalgam!)

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20
Q

another name for calcium hydroxide

A

dycal

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21
Q

function of calcium hydroxide

A
  • inhibits bacterial growth

- promotes formation of tertiary dentin

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22
Q

pH of dycal

A

> 9 (HIGH!)

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23
Q

disadvantage of dycal

A

low resistance to compressive forces

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24
Q

when can you use ca oh2

A

amalgam, CR, GI

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25
Q

where do you apply ca oh2

A

only in select areas (deep areas)

*not to be used as a base

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26
Q

varnish is used as a

A

base (applied all over)

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27
Q

ca oh2 can be used with

A

RMGI (because CaOH2 isnt strong against compressive forces)

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28
Q

varnish should go ____ RMGI and ca(OH)2 if its amalgam resto

A

ontop

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29
Q

product name of RMGI

A

vitrebond

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30
Q

properties of RMGI

A
  • cariostatic (releases f-)
  • weak chemical adhesion to enamel and dentin
  • good compressive strength
  • minimal shrinkage
  • low pH
  • cytotoxic
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31
Q

how does RMGI polymerize

A

light cure (30 sec)

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32
Q

function of adhesive system

A
  • retention
  • seal
  • reduce microleakage
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33
Q

property of adhesive system

A

cytotoxic

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34
Q

can you use adhesive systems for both Ag and CR

A

yes

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35
Q

what makes up the adhesive system

A
  • acid etch
  • primer
  • adhesive
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36
Q

bonded amalgam

A

adhesive used instead of varnish

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37
Q

when should you use bonded amalgams

A

larger amalgam restos

38
Q

bonded MOD amalgam restos on max PM have ____ cuspal deflection

A

decreased

39
Q

IRM ingredients

A 
powder = zinc oxide and PMMA
liquid = eugenol and acetic acid
40
Q

function of irm

A

temporary filling

41
Q

how long does irm last

A

up to 10 months

42
Q

why is irm bad near pulp

A

eugenol is cytoxic

*use ca oh2 first

43
Q

can you use irm under CR

A

no

44
Q

what should you do if you expose the pulp

A
  • place caoh2
  • rmgi
  • permanent or temp filling
45
Q

what is indirect pulp capping

A

leaving some demineralized or infected dentin near pulp to avoid pulpal exposure

46
Q

shallow, Ag

liner?

A

varnish

47
Q

shallow, resin

liner?

A

adhesive

48
Q

medium, Ag

liner?

A

GI then varnish

49
Q

medium, resin

liner?

A

Gi then adhesive

50
Q

deep, Ag

liner?

A

caoh2 then Gi then varnish

51
Q

deep, resin

liner?

A

caoh2, then GI then adhesive

52
Q

shallow or medium, rmgi

liner?

A

no liner

53
Q

deep rmgi

liner?

A

ca oh2 only

54
Q

most common global health condition

A

untreated tooth decay

55
Q

stagnant sites

A
  • proximal spaces below contact
  • cervical below HOC
  • developmental grooves and pits
  • surface irregularities/malocclusions
  • pre existing restos
56
Q

factors of pre-existing restos to consider

A
  • finishing/polishing
  • overhangs
  • fractures
  • crowns and bridges
57
Q

when does protective pulpo-dentinal reaction to enamel lesion start

A

before bacteria invades dentin

  • pulp receives signals through enamel water and odontoblasts that lesion is forming
  • pulp makes inflammatory cytokins and odontoblasts trigger 3rd dentin
58
Q

what happens first: demin or bacteria invasion?

A

demin happens 1st, then bacteria invades after acid diffuses

59
Q

pulp starts inflammatory response when lesion is ___

A

0.5-1mm away from pulp

60
Q

lesion moves faster in which? enamel or dentin

A

dentin (5 times faster)

61
Q

zones of infected dentin

A
  • zone of destruction

- zone of bacterial penetration

62
Q

zone of affected dentin

A

zone of demineralization

63
Q

zone of destruction

A

outermost superficial dentin that is decomposed, due to acid and proteolytic enzymes

64
Q

outer carious dentin

A
  • infected
  • destroyed
  • unremineralizable (bc collagen destroyed)
  • dead
  • senseless
65
Q

inner carious dentin

A
  • affected (uninfected)
  • demineralized (not destroyed, collagen is intact)
  • remineralizable
  • alive
  • sensitive
66
Q

matrix metalloproteinases

A

proteolytic enzymes that degrade ECM

67
Q

cystein cathepsin

A

lysosomal protease that degrade ECM

68
Q

CT-K

A

triple helical collagenase activity

69
Q

local pH causes mineral dissolution, which leads to

A

enzymatic degradation of dentin organic matrix

70
Q

why is cysteine cathepsin K the most potent mammalian collagenolytic enzyme

A

has multiple triple-helical cleavage sites

71
Q

what facilitates activation of MMPs

A

cleavage of MMP prodomain

72
Q

are MMPs stable in acidic pH

A

yes, but their optimal functional pH is neutral

73
Q

steps to dentin lesion progression (wrt MMPs)

A
  1. mineral dissolution
  2. collagen exposure
  3. low pH followed by neutralization
  4. MMP activation and function
  5. collagen degradation
  6. irreversible stage
74
Q

are cystein cathepsins stable in acidic pH

A

yes, and it is not stable in neutral PH

75
Q

what is the optimal pH for cathepsin

A

5.5

76
Q

steps to dentin lesion progression (wrt cystein cathepsins)

A
  1. mineral dissolution
  2. collagen exposure
  3. low pH
  4. cathepsin activation and function
  5. collagen degradation
  6. irreversible stage
77
Q

explain distribution of cathepsin and MMP

A

cathepsin is sparse and MMP is moderate and evenly distributed

78
Q

synergistic digestive effect

A

cathepsins and MMPs work at low pH, then when neutralized, MMPs work

79
Q

inhibitor of MMP and cathepsin k

A

sodium fluoride

80
Q

what can be used to preserve collagen in dentin

A

chlorhexidine

81
Q

how far into the tooth is op intervention required

A

0.5 mm into dentin (past DEJ)

82
Q

setting reaction for low copper amalgams

A

produces gamma 1 and 2 phase

83
Q

what is the gamma 2 phase

A

Sn8Hg

84
Q

whats the disadvantage of the gamma 2 phase

A
  • low strength
  • high marginal breakdown
  • high creep
  • high tarnish and corrosion
85
Q

setting reaction of high copper amalgams

A

produces gamma 1 phase and the eta phase

86
Q

what happens if you have moisture contamination in amalgam

A
  • delayed expansion
  • voids
  • greater corrosion
  • weaker resto
87
Q

lathe-cut amalgam alloy particles

A
  • high positive pack
  • requires high packing forces
  • minimal sensitivity
  • poor packing of particles
88
Q

spherical amalgam alloy particles

A
  • lower packing pressure
  • shorter working time
  • no positive pack (poor contact and overhangs)
  • more sensitivity
89
Q

requirements for spherical amalgam alloy

A
  • varnish
  • broader packing instrument
  • more pre-carve and post-carve burnishing
90
Q

function of wedge

A
  • separation
  • prevent overhangs
  • prevent movement of matrix band
  • protect gingiva and RD

DDS1-resto (2 decks)

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