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ABGD Oral Boards Flashcards

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1
Q

What are some advantages of Vital Bleaching In Office?

A
  • Immediate results
  • Jump start home technique
  • Decreases length of treatment
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2
Q

What is the difference between Fiber Post and Cast Gold Post?

A
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3
Q

What are some Adverse Soft Tissue responses to bleaching?

A
  • Free radicals
  • Cellular damage
  • Co-carcinogen
  • Burning
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4
Q

If you press or mill veneers, what materials can you use?

A

Feldspathic & reinforced ceramics (Empress, Emax)

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5
Q

What is the function of a liner?

A

Sealer with therapuetic benefit (F release, adhesion, antibacterial, promote tertiary dentin formation)

ie: Calcium hydroxide/MTA

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6
Q

What is an attractive quality of Non-Metallic Prefabricated Posts?

A
  • Similar MOE to dentin
  • More compatible with all ceramic crowns and resin systems
  • More esthetic
  • Less rigid than metal posts which leads to…
  • Fewer root fractures
  • Flexure may lead to leakage
  • Forms “monobloc” when using resin cement and core material
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7
Q

Why not use a resin as Direct Pulp Cap?

A
  • Cytotoxic to pulp
  • Poor pulpal healing
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8
Q

What is a radiographic success of endo treatment?

A

Good obturation, length, density, taper

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9
Q

What are some restorative considerations when extent of caries is pulpally within the chamber or apically relative to alveolar crest?

A
  • Can tooth be crown lengthened
  • Furcations
  • Crown/root ratio
  • Biologic Width
  • Key or Strategic Tooth?
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10
Q

For Non-Vital Bleaching, what do you place over the GP?

A
  • RMGI
  • Ramp from lingual to facial
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11
Q

What factors affect polish?

A

Hardness and Polishability

  • Resin Matrix
  • Filler Particle Size
  • Difference in wear rate between matrix and filler particle
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12
Q

What is a concern with Resin Infiltration?

A

Several in-vitro studies show resin infiltrated white spot lesions may be susceptible to increased stain retention

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13
Q

What are some good diagnostic tests for Cracked Tooth Syndrome?

A
  • Bite test
  • Transillumination
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14
Q

What are some late signs of failture for Porcelain Veneers?

A
  • Leakage/staining at margins
  • Caries
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15
Q

What is the Etiology of Post-Eruptive Tooth Discoloration?

A

Post-Eruptive

  • Trauma - calcific metamorphosis
  • Aging
  • Iatrogenic - silver, minocycline
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16
Q

What is the Mechanism of Action for Icon?

A
  • Combines erosion of enamel with resin infiltration
  • Modifies enamel optical properties
  • Resin infiltrant has refractive index (RI) similar to healthy enamel
  • Penetrates up to 450 nm
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17
Q

What are some Conraindications to doing Posterior Composites?

A
  • High Caries Risk
  • Extensive Prep Likely
  • Heavy Occlusal Function
  • Lack Enamel
  • Subgingival Margins
  • Inadequate Isolation
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18
Q

What are some ways to Isolate a Class V Non-Surgically?

A
  • Cotton roll/Retraction Cord
  • Heavy Rubber Dam/Cerivcal Retractors
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19
Q

What is the most important resistance factor in prepping a tooth for a post?

A

Ferrule!

  • Peform ideal crown preparation
  • Remove only weak, unsupported dentin
  • 2 mm doubles resistance form
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20
Q

Describe the prep design for a posterior EMAX crown…

A
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21
Q

What are Prepless Veneers called?

A

Lumineers

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22
Q

What are some differently Classifications of Cracked Tooth Syndrome?

A
  • Craze lines; (don’t treat)
  • Incomplete Cusp Fracture
  • Cracked Tooth
  • Split Tooth
  • Vertical Root Fracture
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23
Q

What are some Potential Diagnoses for Excessive Gingival Display?

A
  • Vertical Maxillary Excess
  • Short Upper Lip
  • Excessive Lip Mobility
  • Altered Passive Eruption
  • Dentoalveolar Extrusion
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24
Q

When restoring a carious Class V lesions, what is a good technique?

A

Open Sandiwch

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25
What are some examples of Non-Invasive/Micro-invasive Tx Options?
* Remineralization * Sealants * Resin Infiltration
26
What distance should a hyperactive lip travel?
6 - 8 mm Hyperactive lip translates more than the avg distance
27
What are the Risks/Side Effects of Enamel Microabrasion?
* _Relatively significant loss of surface enamel_ (up to 300 nm) * _Removes F rich layer_ of enamel * Operator and patient safety - high conc. of acid
28
What does research suggest in regards to the use of Icon versus F varnish in treatment of proximal caries?
Available evidence shows that micro-invasive treatment of proximal caries lesions arrests non-cavitated enamel and initial dentinal lesions (outer 1/3 of dentine) and is significantly more effective than fluoride varnish or HCl
29
What are some Post Prep Guidelines?
* Maintain minimum 4 mm apical seal (5 mm better) * Limit diamter to size of existing canal * 2/3 length of root or 1/2 length of root in bone * \> length of clinical crown * Immediate post prep ok. Heat = Rotary (heat safer) * Greater length = greater retention * Greater width does not = great retention (weakens root)
30
What chemical pre-treatment do you use for Glass Ceramics?
Chemical etching with HF acid
31
What is the Mechanical Etiology of a NCCL in regards to Abrasion?
Mechanical Etiology * Overzealous toothbrush * Medium-Hard Bristle * Excellent Hygiene
32
Describe a Tofflemire Band...
* Rigid * Contoured * Adaptable * No Light Transmission * Band Thickness Might be an Issue * .03 - 0.5 mm
33
What are some factors that contribute to long term success of Porcelain Veneers?
* Preparations confined to enamel only * Suitable luting agent, handled appropriately * Correct surface preparation * Closely adapted margins * No preparation design identified as superior
34
What are some Disadvantages of In Office Vital Bleaching?
* Longer chair time * More expensive * Increased tooth sensitivity * Potential tissue burns * Very caustic
35
Why not use Zinc-oxide Eugenol for Direct Pulp Cap?
* Poor sealing * Chronic Inflammation * Lack of dentin bridge
36
What does research say in regards to Resin Infiltration and their affect on White Spot Lesions post ortho?
* Conclusion: Resin Infiltration significantly improved the clinical apearnace of White Spot Lesions and reduced their size
37
Contraindications for Direct Pulp Cap?
* Symptomatic, non-vital, "stressed" pulps * Large carious exposure
38
What are bases?
* Traditionally placed to provide thermal insultation to the pulp \> 0.5 mm * Used as dentin substitutes & block out undercuts * Studies show INCREASED FRACTURE OF OVERLYING RESTORATIONS. RELATED TO LOW MODULUS OF ELASTICITY OF MATERIAL. * Dentin is the best base!
39
What are some early signs of Porcelain Veneer Failure?
* Porcelain Fracture * De-bonding at cement/silane junction * Estehtic Failures
40
What are the guidelines for coverage of posterior endodontically treated teeth?
* Posterior endodontically treated teeth require coronal coverage * Presence of cuspal coverage was the only significant restorative variable to predict long-term success * Endontically treated posterior teeth 6x more likely to survive with cuspal coverage * Options: Full Crown, Onlay, Cuspal Coverage Am
41
What does Pre-Wedging/Pre-Ringing accomplish?
* Protects tissue, tooth, dam * Improves contact * Compensates for thickness of the matrix band
42
What is the length/width proportion for a central incisor?
10/8
43
For a slot prep, do you bevel the occlusal margin?
No!
44
Where should your Interproximal Contact area end in a Veneer Preparation?
* Prep should stop F to or extend L to proximal contact * Easier to finish * Easier for lab
45
What are some techniques to reduce polymerization shrinkage stress?
Incremental Fill * Reduces C-Factor Control of Curing Light Irradiance * Soft Start * Pulse-delay * Ramp Curing Flowable Liner Sandwich Technique
46
What can be the Etiology of Extrinsic Tooth Discoloration?
Environmental - Dietary
47
What is the function of Varnish?
* Copalite * Barrier for bacteria or irritants * Provides no thermal insulation * temporary effects...rarely used in today's dentistry
48
What are some sequelae of Polymerization Shrinkage?
Biggest Problem... * Gap Formation * Microleakage * Marginal Staining * Secondary Caries * Tooth Fracture * Post-Oper Sensitivity
49
What does Pre-wedge help with?
* Helps achieve contact * Protects RD and gingiva
50
How do Lingual and Facial bevels difer when resotring a large anterior composite?
Lingual Bevel * Functional * 1 mm & 45° * Sharp & Distinct Facial Bevel * Esthetic * 2-3 mm/60° * _Scalloped/irregular_ * Feathers to imperceptible margin
51
Describe the "Prema Technique" for Enamel Microabrasion...
* Find diamond initial prep * Pre-mixed 10% HCl * Plastic applicator stick or mandrel * 1 minute/rinse/eval X 20 * 300 microns loss at 20X * 10/1 gear reduction handpiece
52
What do studies show about success/failure in regards to Resin Infiltration?
* Success/failure attributed to depth & activity of lesion * Less successful in deeper, inactive lesions
53
Describe the "Class Technique" of Enamel Microabrasion?
* 18% HCL & pumice applied with wooden tongue blade * 10 application at 10-15 sec intervals
54
Observe Icon Resin Infiltration in Action...
55
What does the research say about Calcium Phosphopeptides like MI Paste?
* Lack of evidence for use of MI Paste/Plus over fluoride for prevention of early dental caries * Low quality evidence to support use of MI Paste/Plis for treatment of ortho white spot lesions * No benefit to MI Paste Plus (with fluoride) over MI Paste
56
What does Potassium Nitrite do?
Reduces Sensitivity
57
OTC F toothpaste is how many PPM?
1000
58
How should you follow up with a Non-Vital Bleaching Case?
* Re-evaluate weekly * Strive for over-bleach (relapse) * Remove temporary materials from chamber * Cleanse chamber * _Wait 1-2 weeks_ * Restore with lightest shade of composite * Optimal marginal seal critical * _Success rate - 50%_
59
What are the concentrations of Carbamide Peroxide for In Office bleaching?
* "Power" (assisted bleaching) * Office applied * 34 - 44% or equiv * Applied in bleaching tray of directly
60
What has rearch suggested in regards to Composite repair in low to moderate caries risk patients?
Conclusion: Repair when indicated - minimally invasive & predictable increase in restoration longevity
61
What are some conclusion about amalgam bond?
* Decreased Microleakage * Restoration of endo tx teeth & direct pulp caps * Does NOT decrease posop sensitivity * May be of value as retentive adjunct (core build-ups) - use HPA
62
Disadvanges of Porcelain Veneers...
* Preparation required * Limited ability to mask staining * Technique sensitive * Fragility prior to cementation * Lab fees/interaction * Multiple appointments * Expense * Resin Margins (Usual site of eventual breakdown) * Provisionals
63
What are 2 different types of Adhesives?
64
Is it easy to establish proximal contacts with composite?
Difficult to Establish Contact * Composite is not condensable * Some matrix systems aggravate situation * Finishing procedures can open contact * Wear can complicate matters resulting in flat surface
65
What are some disease indicators in regards to "WREC"?
* W: White Spot Lesions * R: Restorations \< 3 years * E: Enamel Lesions * C: Cavitations/Dentin
66
How long should you wait to restore teeth after bleaching?
Adhesive restorative procedures to enamel/dentin should be delayed for 24-48 hours after tooth whitening
67
What 3 materials make up Icon Resin Infiltration (Treatment for White Spot Lesions)?
1. Icon Etch - 15% HCL acid 2. Icon Dry - Ethyl alcohol 3. Icon Infiltrant - low viscosity resin
68
What are 4 Incisal Preparations for Veneers?
69
Describe the Open Sandwhich Technique...
* Resin modified GI carried toouter surface and partially veneered with resin composite
70
What is MOE?
71
What does research suggest in regards to best antibacterial effect of various liners vs no liner?
MTA - 73%
72
What are some difficulties with endo post adhesion?
* Unfavorable C-factor * Difficulty with uniform application of primers/adhesives * Poor light penetration into canal space * Residual oxgyen from endodontic irrigants * Reduced bond stregnths in apical root dentin
73
How is Abrasion different than Attrition?
* Abrasion (non-contact areas) * Attrition (contact areas)
74
What did the latest Systematic Review in 2016 conclude about endo crowns?
* Clinical success rates of endo crowns = 94-100% * Endocrowns \> conventional tx for fracture strength * No statistical difference for posterior teeth only
75
In a study that compared caries progression with sealaed versus non-sealed teeth, what did they find?
Unsealed teeth continued to show progression
76
What are the ideal propeties of a post?
* Maximal protection of the root from fracture * Maximal retention within the root * Maximal retention of the core and crown * Maximal protection of the crown margin seal from coronal leakage * Pleasing estehtics, when indicated * High radiographic visibility * Retrievability * Biocompatibility
77
Incisal edges of maxillary teeth should follow the...
Curvature of lower lip...
78
Protocol for reparing a ditched am...
* Air abrasion of alloy surface * Etch/prime/bond with DBA * Can't ensure dry surface under a ditched margin so use hydrophlic primer * Flowable composite or sealant for repair
79
What are some indications for Cast Post/Core in the Anterior?
* Coronally-flared canals * Multiple preps * Tapered roots * Excessively wide or ovoid canals * Small teeth (most incisors)
80
Any carcinogenic risk to humans via tooth whitening?
There is _no evidence_ from animal experiment data of toxic and carcinogenic risk to humans from hydrogen peroxide used at exposure levels associated with tooth bleaching
81
What is C-Factor?
* C = Total Bonded Area/Total Unbonded Area * Competition between: * Polymerization contraction forces * Strength of bonds to tooth * Higher C-Factor = More Stress
82
What does research suggest regarding cementing posts and optimum bond strength?
Highest bond strength with self-adhesive resin cement (Relyx X Unicem)
83
What do studies show regarding using CaOH vs no liners in primary teeth after caries excavation (not direct pulp caps)?
* Restoring the cavity without lining did not significantly affect the risk of failure * Conclusion: Strong recommendations for using CaOH cavity liners are unsubstantiated, but firm evidence for omitting lining is also unavailable
84
What factors effect Wear Resistance in regards to composite?
Clinical Factors * Restoration Size * Location: \> Molars * Occlusal Load
85
What is the MPa strength of Pressable Emax for Veneers?
400 MPa
86
What are some Protective Factors that are "SAFE" in regards to Caries Balance?
* S: Saliva & Sealants * A: Antimicrobials * F: Fluoride * E: Effecitve Lifestyle
87
What does resarch suggest about success regarding restoring Class V lesions with RMGI versus 2 step Etch and Rinse composite on a NCCL?
88.% RMGI vs 52% DBA/Composite
88
Why use Dentin Bonding Agent as a Sealer?
* Contain a primer and adhesive * Forms a hybrid layer with dentin and mechanical seal with enamel * Act as a barrier to bacteria and irritants * DOES NOT REDUCE POSTOP SENSITIVITY * Beneficial to augment retention of complex amalgams
89
What is the recommended occlusal reduction for Empress & EMAX?
1.5 - 2.0 mm to prevent fracture
90
How do you treat Dentoalveolar Extrusion?
* Ortho Intrusion * Segmental Osteotomy * Functional Crown Lengthening * Increase Vertical Dimension
91
What are some effects of Bleaching on Restorations?
* Increased surface roughness * Crack development * Marginal breakdown * Release of metallic ions * Decreases in tooth-to-restoration bond strength
92
Adjunctive methods typically yield higher sensitivity and low\_\_\_\_\_
Specificity
93
What are some tips when picking a shade?
* Hydrated teeth * Natural light source * Evaluate underlying discoloration * Remember enamel contribution to color * Don't forget a stumpf shade
94
What is a Metamerism?
95
Why do an MO & DO instead of an MOD?
Less chance of fracture
96
Describe the prep design for IPS Empress CAD for posterior...
97
What are some components to a Smile Analysis?
* Gingival Display/Line * Incisal Edge Position * Incisal Plane * Midline Position/Cant * Symmetry * Tooth Proportions/Alignment * Embrasure Form
98
What are 2 types of Self-Etch Adhesives?
99
What are some Advanges of Porcelain Veneers?
* Extremely Esthetic (Color Stability, Translucency, Texture, Vitality) * Conservative compared to full coverage * Durability * Bond strength * Biocompatibility: superior tissue response * Gingival esthetics * Low coefficient of thermal expansion
100
Overall, what does research suggest in regards to Pit & Fissure Sealants over non cavitated caries?
Sealing non-cavitated caries in permanent teeth is effective in reducing caries progression
101
What did studies find regarding the success of Endo-crowns vs Post/composite cores?
Endo Crowns had statistically higher fracture stregnth
102
Describe a Window Prep for Veneers...
* Alteration of incisal edge length or shape not required * Least reduction to fracture resistance of tooth
103
When you have a short clinical crown that you CAN feel the CEJ in the sulcus it is...
Short tooth (wear)
104
How would you treat a NCCL?
* Nothing * Symptomatic? Esthetic? Concern? Progression? Gingival Margin? If Shallow * DBA/Resin Composite If Deep * Closed Sandwich
105
What is the Minimal Basing Concept?
* Preserve "remaining dentin thickness" * Minimize the extend of the base...use dentin to support * Minimize the thickness of base...no more than 0.5 mm
106
When you have short tooth and you CANNOT feel the CEJ in the sulcus it is...
Altered Passive Eruption
107
How do the embrasures between the centrals/laterals/and canines compare?
* Embrasure between central is the smallest * Embrasure between centrals/laterals slightly bigger * Between laterals and canine biggest
108
What is Clearfil SE Bond best for?
* Ideal for _dentin adhesion_ * Selective Etch w/H3PO4 improves marginal integrity
109
How many CFUs needed to = high caries risk for salivary testing?
\> 100k CFU/ml of SM and LB
110
Where does your Veneer Prep end when closing a Diastema?
Extend past contact
111
Is a Post/Core required in the Anterior?
* An intact anterior tooth with conservative endodontic access and intact marginal ridges _does not require a post_ or coronal coverage. * A post is of little or no benefit in a structurally sound anterior tooth and increases the chances of a nonrestorable failure
112
What are some proposed benefits of cavity liners?
* Reduce viable bacteria in proximity to pulp * Induce development of reacitonary dentin * Induce remineralization of demineralized dentin * Provde a seal against leakage of bacteria and toxins * Isolate the pulp against thermal or electrical conduction * Protect pulp from chemical noxa
113
How do you treat a short upper lip?
* No god long term data * Very invasive - essentially a vestibulplasty
114
What is the success rates for pulp capping?
Roughly 33%
115
What are some Bleaching Indications?
* Discolored non-vital teeth * Stain due to Aging/Diet/Smoking * Mild fluorsis, mild tetracycline staining * Pre/post restorative tx
116
What types of Lasers are used for In Office Bleaching?
* Argon * CO2
117
How does Enamel Micro Abrasion work?
* Chemo-mechanical removal of superfiical enamel discoloration through the use of acid/abrasive solution with mechanical/rotary instruments Mechanism of Action * Acid erosion of enamel up to 450 nm * Infiltration with low viscosity resin * Alters white spot to RI similar enamel...masks the lesion
118
What are some different Light Sources for In Office Bleaching?
* Xenon * Halogen * Plasma * Arc * Curing Lights
119
How much Carbamid Peroxide is used in Vital Bleaching?
10-36% breaks down to H202 + urea
120
What did studies find about prep types with a 4 mm buildup, 2 mm buildup and endo crown success rates?
All restoration designs survived normal range of masticatory forces
121
Describe Dycal (CaOH) as a material...
122
What is the difference between Acquired and Inherent Polish?
Acquired * Surface achieved by clinician at placement Inherent * Surface to which composite will revert to over time * Function of particle size/shape
123
What are 4 Pulp Capping products?
1. Calcium Hydroxide (Dycal): Historical "Gold Standard" 2. Mineral Trioxide (MTA): The "New" Gold Standard 3. Biodentine (Septodent) 4. TheraCal LC (Bisco)
124
What are some example of Hematologic INtrinsic Pre-Eruptive conditions?
* Erythroblastosis Fetalis * Thalassemia * Porphyria
125
What are Abrasive Rubber Polishg Points/Cups used for?
* Ideal for lingual cervical areas * Aluminum oxide, silica carbid, diamond
126
What are some Indications for Posterior Composite Restorations?
* Low Caries Risk * Small to Moderate Sized Class I and Class I Restorations * Conservative Prep * Margins In Enamel * Centric Stops on Tooth Structure * Absence of Excessive Wear * Esthetics Important
127
What are some Disadvantages of Vital Bleaching at home?
* Patient compliance required * Longer treatment time vs. in-office bleaching * Tooth sensitivity * Gingival irritation * Relapse
128
What does 35% Carbamide Peroxide = in regards to exposure time?
30 minutes
129
What is the Etiology of Intrinsic Pre-Eruptive Tooth Discoloration?
Pre-Eruptive * Fluorosis * Tetracycline * Others (genetic, hematologic, developmental)
130
Characteristics of a conservative amalgam restoration...
* Decreased buccal-lingual isthmus (1/4 to 1/3) * Rounded internal angles * Beveled axio/pulpal line angle * Less marginal fracture
131
What are Advantages of Bitine Ring Systems?
Less Matrix Thickness to Overcome * Only single thickness is used * Bands are thin Contoured Bands Provide * A more natural form * A larger contact area Bitine Ring Augments Wedge Separation * Tighter contacts are formed * Confirmed by multiple in-vitro studies
132
Research has found that using additional light increases incidence of ______ regarding In Office Bleaching...
Tooth Sensitivity
133
Describe the Apperance of Erosion of NCCL?
* Amorphous, hard, matte * Indistinct margins * Shallow and diffuse
134
Observe this helpful flow chart...
135
What is the #1 reason Posterior Composites Fail?
Secondary Caries
136
What is the main reason for endo failure?
Inadequate restorative therapy _Need to establish a Coronal Seal following endo tx ASAP_
137
What is the incisal reduction for Veneers?
1.5 - 2.0 mm
138
What does research suggest in regards to Calcium Hydroxide vs MTA in Direct Pulp Caps?
* Failure rate at 24 mos = 31.5% CaOH * 19.7% MTA * Conclusion: study provides confirmatory evidence of superior performance with MTA as direct pulp capping agent compared with CaOH
139
What are indications for Composite Fiber Post in Anterior?
* All ceramic, translucent crown planned
140
What is a Closed Sandwhich?
* Resin-modified GI liner * Veneered with resin based composite
141
What should your incremental fill measurements be when placing a composite in a Class 2 prep?
Incremental fill * 1.0 mm increment on gingival floor * 2.0 mm subsequent increments * Oblique placement * Minimizes cuspal deformation
142
According to the CCS, describe "Sound" regarding the extent...
143
Observe this helpful flowchart...
144
What is the MPa of Machinable Emax CAD in regards to Veneers?
360 MPa
145
What are indications for a Prefab post in an Anterior Tooth?
* Round roots with round canals that are not coronally flared * Will need antirotation feature added
146
How do Proximal Contact compare between centrals/laterals/canines?
* Centrals = 50% * CL = 40% * L/C = 30% * Moves apically towards distal
147
What is Turner's Tooth?
148
What do you do if you don't have enough ferrule?
* If no vertical heigh, move the preparation finish line apically * If not possible, perform either orthodontic extrusion * Crown lengthening surgery
149
What does research suggest about Pit & Fissur sealants in combo with small amalgam restorations?
* Les invasive * Improved marginal integrity over 10 years
150
What are some indications for Porcelain Veneers?
* Mild to moderate discoloration * Diastema closure * Rotations/slight malposition * Enamel malformation/pitting * Tooth augmentation (peg lateral) * Replacement of inadequate resin composite veneers
151
Describe Biodentin as Pulp Capping Agent...
152
What are some guidelines for post/core in posterior teeth?
* Posterior molars rarely require a post * Pin or chamber retained cores work well if have adequate tooth structure following prep Indications for post placement in molars: * Posterior teeth missing 60% or more of coronal tooth structure * If residual pulp chamber \< 4 mm of axial walls * If tooth is to be RDP/FDP abutment * Rarely needed to retain core
153
Is you have an isthus \> 1.2 mm in a class 2 prep, do you need retention grooves? What about \< 1.2 mm? Where do the slots go?
* For wide isthmus - no grooves * For narrow isthmus - points * For slot preparations, grooves extend from gingival floor to occlusal
154
What are some keys to success regarding restoring endodontically treated teeth?
* Conservative endo access * Maintain ferrule * Use adhesive dentistry * Use P & C with physical properties close to dentin * Composite resin core with fiber post represent best treatment option
155
What does the beveling the F & L proximal boxes help with in a slot prep?
* Significantly reduces marginal leakage * Improves access to enamel rod ends * Improves access for finishing
156
What did the Article "A Visual Inspecting of Caries Detection: Systematic Review and Meta-Analysis" say about the Visual Method...
* Good accuracy (similar to radiography and fluorescence) * High specificity (few false positives) * Use of visual inspection alone deemed sufficeint for careis detection * Use of validated scoring systems improved accuracy in detecting carious lesions
157
How does Dentoalveolar Extrusion Manifest?
One or more maxillary anterio teeth SUPRAERUPT * Incisal wear with compensatory eruption * Aleveolar Complex Follows Eruption of Teeth * Gingival Line is altered-concave
158
High specificity means...
Few false positives
159
What are some components of Micro Esthetics for treatment planning?
* Tooth Size & Shape * Shade * Texture & Brilliance * Translucency * Opalescence & Fluorescence
160
How do you diagnose Vertical Maxillary Excess? How do you treat?
* Lower face ht \> Midface Treatment * Max LeFort (impaction) * Masking (Botox)
161
What are some Pathologic Factors that are "BAD" in regards to caries?
* Bad bacteria * Absence of Saliva * Destructive Habits (diet & hygiene)
162
5 Year survival rates for Endo-Crowns...
163
What are some Key Factors For Success for Posts?
* Ferrule * Antirotation Feature * Preserve remaining tooth structure
164
How do you avoid Cervical Resorption during Non-Vital Bleaching?
* _Ensure adequate base/liner placed_ * Minimize use of acid etch in chamber * Avoid use of heat * Use water with sodium perborate * _Avoid use of superoxol_ * Frequent recall
165
What are some considerations when facing Sclerotic Dentin?
* Mechanical removal of hypermineralized layer * Longer etch/conditioning time * Less intertubular dentin (bonding substrate) i.e. less collagen fibers * Cosider use of RMGIC vs DBA/resin comosite (or adhesive with MDP)
166
What are signs/symptoms of Cracked Tooth Syndrome?
* Wear facets * Pins * Pain upon biting/releasing * Non-lingering pain to cold
167
What are the pros and cons of Silver Diamine Fluoride?
* Pros * Inexpensive * Quick * No anesthesia * Cons * Silver oxide staining * Caries-black * Perioral tissues/lips - light brown * Doesn't restore form/function
168
What are some Surgical techniques to isolate a Class V?
* Miniflap * Envelop Flap (Single or Double)
169
How do you select a post for a pre-molar?
* Pin or chamber retained core if adequate tooth structure following pre (i.e., conservative access) Cast vs prefab depends on canal anatomy * Ovoid canal = cast post/core * Tapered canal = prefab * Parallel canal = prefab (parapost)
170
What should you always use when prepping slots in an composite?
Use adequate retention locks in slot preps
171
Describe the CAMBRA Protocol for Low Caries Risk...
172
What do studies suggest regarding beveling O margins of NCCLs, and class 3's and 4's?
* Bevleing of the occlusal margin (NCCL) did not improve the clinical result * Beveling had no significant influence on outcome (Class 3/4)
173
In regards to anterior composites, what helps decrease marginal staining?
Enamel etching
174
What is the active ingredient in Crest Whitestrips?
* Polyethylene embeeded with * 6.4 & 14% H202 placed on teeth
175
What should be the max thickness of composite you place when you cure?
2 mm thick
176
What has research suggested in regards to Resin Infiltration versus sealant with Prime & Bond?
Icon & sealing equally effective & significantly better than placebo
177
What are good cases for at home bleaching?
* Yellow, orange, brown * Discoloration due to aging
178
How can you enhance the chemical reaction of bleaching agents?
* Heat * Light * Laser Energy
179
Describe MTA as a material...
180
What are some Antirotation Features?
* MUST be added in form of _pins, channels, keyways_ and other design features if not already judged clinically present * IMPERATIVE with round/oval single canals
181
What are some patient/tooth factors that affect success in Class V Lesions?
* Occlusal Stresses * Age (sclerotic dentin) * Substrate (Cervical root dentin/tuble density) * Habits/Hygiene * Location
182
What has reserach found about resin cement color and effect on porcelain veneers?
"Resin cement color had no significant effect on final color match of cemented porcelain veneers"
183
What are some indications for amalgampins?
* Extensive loss of tooth structure * Insufficient coronal dentin remaining * _Minimal occlusogingival height (i.e. no room for a pin)_ * Minimal fracture/extension of caries * Short clinical crowns * Young permanent molars,large pulp spaces * More conservative than TMS pin...only 2 mm cusp reduction required
184
What does research suggest regarding Amalgam Vs. Composite in the posterior?
* Posterior composite has 2x failure risk * Posterior composite has 2x risk of secondary caries * Risk of fracture between posterior am vs comp not significant
185
What are some factors for success in posterior composites?
* High caries risk pts have 2x failure risk * Class 1s have highest success rate * Incremental fill technique * More failures in high stress areas * Enamel etch with H3PO4 * Use of Rubber Dam
186
Observe results of Icon Resin Infiltration for "Natural Tooth Bleaching"...
187
What are 2 different types of core materials?
Amalgam & Composite
188
What is the "Gold Standard" for composite polishing?
Sof-Lex discs
189
What is the critical time for Tetracycline to cause staining?
4 months in utero to 8 years
190
Describe the clincal technique for non-vital bleaching...
Adequate endodontic treatment * Evaluate obturation and periradicular health * Establish base line shade * Isolation * Completely remove restorative materials from chamber * Remove highly discolored dentin and residual pulp tissue * _Remove gutta percha to below the level of the CEJ_ * Cleanse chamber
191
What are some Contraindications to Enamel Microabrasion?
* Deep enamel lesions * Tetracycline staining of any kind * Dentinogenesis Imperfecta * Discoloration of dentinal origin
192
What is the preparation for a Porcelain Veneer?
193
What are some Advantges of Surface Sealing?
* Finishing traumatizes surface of composite * Microcracks occur, can propagate * Surface sealant (unfilled resin) penetrates microcracks, surface irregularities * Seals tooth-restoration interface * Increases Marginal Integrity * Decreases Microleakage, marginal staining, wear * _Enhances longevity of restoration_
194
Does Clearfil SE help with retention in Class V Lesions? What does it help with?
* No difference in retention rates with or without selective etch * Significant improvement in marginal discoloation and marginal integirty with slective etch
195
What are some Advantages of at home Vital Bleaching?
* Less dentin sensitivity than in-office * Less chair time * Safe and effective
196
According to Summitt - Amalgam bond =
TMS Pins
197
What are the advantages of using an Open Sandwich Technique Interproximally?
* Reduced microleakage * Chemical bond to dentin * F release
198
What is Icon?
Resin infiltration of early lesions
199
What does research suggest about Calcium Phosphopeptides?
* Evidence support use of CPP-ACP to augment F in inhibiting demineralization & enhancing remineralization * Remineralization effect of CPP-ACP equal to F... no additional benefit to fluoride
200
What are 3 types of Non-Metallic posts?
* Carbon Fiber * Ceramic * Fiber-Reinforced Composite
201
Describe the 4 Origins according to the Caries Classification System (CCS)...
1. Pit & Fissure 2. Approximal 3. Cervical/Smooth Surface 4. Root
202
Describe the "Advanced" stage in regards to exent in the CCS...
203
What is the apperance of an Abfraction NCCL?
* Wedge shaped * Sharp demarcation * Controversial
204
What are areas to avoid for pins?
* Concavities * Furcations
205
What is the most critical part of placing a Class2 comopsite?
* Gingival Margin Critical * 27% Satisfactory
206
What are some conclusion from Literature about prep design for Class Vs? Roughening...When to Bevel...
* Superficial preparation or minimal toughening with a diamond bur is highly recommended to adhesively restore erosion lesions * Roughen the dentinal (and enamel) surface as this measure increases the durability of the cervical restoration * Beveling the enamel is still indicated when sclerotic dentin is involved
207
How much tooth display should there bein repose for male/female?
* 1-2 mm male * 3-4 mm female
208
What do studies support in regards to minimal occlusal clearance for Lithium Discilicate?
* The results support the clinical acceptability of lithium disilicate glass ceramic as thin as 1 mm in thickness in areas of minimal occlusal clearance
209
When you increase the temperature by 10° C it _______ the rate of reaction...
Doubles
210
What is Enamel Microabrasion?
211
What are some ways you can treat a hyperactive lip?
Behavior Modification * Easy to do with compliant pt * Hard or pt to control in everyday settings Botox * 6-8 month duration (more like 3-4 months) * Minimal amont of Botox
212
What are the goals of Direct Pulp Cap therapy?
* Maintain pulp vitality * Stimulate reparative dentin formation
213
What 3 components contribute to success regarding Class V lesions and adhesives?
1. Clearfil SE! 2. Roughening dentin increased Clinical Index 3. RD Isolation increased Clinical Index 4. No additional benefit to enamel bevel \*Clinical Index = Retention, Marginal Discoloration, Margina Integrity
214
What restorations are Optibond FL best for?
* Ideal for restorations with margins in enamel
215
Why not use Glass Ionomer RMGI as Direct Pulp Cap?
* Cytotoxic to pulp * No dentinal bridge
216
What is Value, Chroma, Hue?
* Value: Brightness of the tooth * Chroma: Saturation or intensity of the hue * Hue: Basic color of the tooth
217
What does historical data show about Enamel Microabrasion?
* Historically poor results with microabrasion * Often penetrate deeply into enamel * Require significant tooth removal
218
What is the bottom line with partial caries removal vs. stepwise total caries removal?
* Successful vitality and restoartive outcomes for both PCR and SWT at 2 years. * PCR has fewer pulptal complications over a 3 year period than SWT
219
What is a clinical success of Endo treatment?
Asymtomatic
220
How does Silane work?
* Improves etched veneer surface for resin adhesion * Provides a chemical link from porcelain to resin * highest resin-porcelain bond strengths acheived with HF acid and use of silanes
221
How should the maxillary teeth from canine to canine align regarding CEJ's?
* Line from CEJ to CEJ of max canines should be straight * Central on the line * Laterals on line or 1/2 mm coronal to line
222
What is the purpose of CAMBRA?
* Identify cause of disease by assessing risk factors * Correct problem by addressing each risk factor
223
What is C-Factor?
224
What is the Etiology of a Class V Lesion?
* Carious * Non - Carious Cervical Lesion * Abrasion * Erosion * Abfraction \*Multifactorial!\*
225
What are your options for treating a Carious Cervical Lesion?
226
What are some examples of Minimally Invasive Tx Options?
* Fissurotomy w/PFS * Preventive Resin Restorations * Adhesive Tooth Preps * Slot Preps
227
When salivary flow testing, what is a normal/abnormal rate?
* \>1 ml/min = normal
228
Pin placement...
229
What causes Abfraction?
Abfraction * Pathologic loss of hard tissue tooth substance * Biomechanical loading forces: flexure/fatigue * Abrasion/erosion: secondary role
230
According to the CCS, describe the "Initial" extent...
231
What has research said about the use of dental Sealants?
* Sealants over active, non-cavitated lesions reduced progression of caries for 5 years * Sealants over caries reduce viable bacteria by 100x and # of lesions with viable bacteria by 50x * Retention improved through use of DBA (2 step etch and rinse)
232
How do you treat Altered Passive Eruption?
Esthetic Crown Lengthening * Internal bevel gingivectomy or sulcular incision * Remove alveolar bone 2 - 3 mm apical to CEJ * Apically position gingivae
233
What are some Advantages of Posterior Composites?
* Esthetics * Convservation of Tooth Structure * Adhesive Prep, Shallower, Narrower, Rounded Internal Line Angles * Low Thermal Conductivity * Eliminate Galvanic Currents * Alternative To Amalgam (No Mercury "Hazard")
234
How would you treat a carious non-esthetic Class V?
* Open Sandwich * Amalgam
235
What is Specificity?
* Percentage of patients without the disease that reecive a negative result * Percentage chance that the test will correctly identify a person who is disease free
236
What was the conclusion between Biodentine Vs. MTA in regards to mechanical pulp exposures?
* Conclusion: No statistical difference in clinical radiographic, or histologic results
237
Describe the Bitine Ring/Segmental Matrix...
* Act to separate teeth * Single thickness of band * Contoured * Good gingival adaptation
238
Prior to bleaching treatment...ALWAYS...
* Establish preliminary shade * Have pre-op radiographs * Informed Consent
239
Describe the CAMBRA Protocol for High Caries Risk...
240
What are some bleaching risks/side effects?
* Tooth sensitivity * Effects on enamel * Systemic effect from ingestion * Possible mutagenic effects * Occlusal alterations with long term tray wear
241
Indication for using cavity liner like Dycal/Vitrabond?
* Fluoride relase * Adhesion to tooth * Antibacterial action * Promote dentin bridging
242
What are the 2 Best Performing Adhesives?
* Clearfil SE Bond * Optibond FL
243
For Non-Meallic Prefabricated Posts, describe Glass Fiber Reinforced Composite Posts...
* _Glass fibers embedded resin matrix_ * Attempt to match the flexure of the post to that of the root for best stress distribution (monobloc) * Key advantage over metal or ceramic...much easier to remove * Almost all are tapered * Generally recommended for use with resin core materials and resin cements
244
What are some indication to place a CT graft over a NCCL?
* Shallow, NCCL * Anterior Esthetic Case * Symptomatic * Previously unrestored
245
What is Partial Caries Removal?
* Intentional incomplete removal of caries to avoid pulp exposure * Commonly known as "indirect pulp cap" * Primarily affected vs infected dentin remains
246
\_\_\_\_\_\_% reduction in pulp exposurs regarding Partial Caries Removal vs complete caries removal...
* 98% * Results in a reduction of postoperative pulpal symptoms
247
Describe the 4 "Extents" of caries accoridng to the CCS...
* Sound * Initial * Moderate * Advanced
248
What does resarch suggest about the best type of margin to place for a veneer? What had the most fractures?
* Butt joint margin had highest strength * Chamfer prep had most veneer fractures
249
Indications for a Direct Pulp Cap?
* Asymtomatic, vital pulp * Traumatic pulp exposure * Iatrogenic/Mechanical Pulp exposure * Young patient vs elderly
250
What are some appearling qualities to an Endo-crown/Endo Onlay?
* Conservative approach to restoring endo-treated teeth * Utilize pulp chamber for adhesive retention * Maintains maximum tooth structure in the cervical third of the tooth
251
What are you doing when you are "Polishing" a composite?
* Shine * Luster * Gloss * Enhanced Light Reflectance
252
Describe the Jordan & Boksman Classification of Tetracycline Staining...
* Frist degree - light stain, no banding * Second degree - dark stain, no banding * _Third degree - any stain with banding_ * Fourth degree - severe banding
253
Tooth whitening has been known to cause what to the pulp?
Reversible pulpitis; _no irreversible_ pulpal effects reported in studies
254
What is the pH of Calcium Hydroxide?
11
255
How many ppm in 5% NaF Varnish?
22,600 ppm
256
Indications for Single Envelope Flap...
* Lesions estending past line angles * Lesions on adjacent teeth * Intrasulcular incision * Etending to distal line angles of involved teeth
257
Describe Mylar Matrix System...
* Lacks ridgidity * Difficult wedging * Transparent * Can't burnish * Contact difficult * Really thick: 0.75 mm
258
What is a chemical pre-treatment for metal alloys and Zirconia?
Air-abrasion w/50 micon alumina particles
259
At what distance do you want to place a cavity liner like Dycal/Vitrabond?
\< 0.5 mm
260
How does bleaching effect enamel and dentin?
Bleaching products induce clinically insignificant alterations to enamel & dentin
261
What is the success rate of Feldspathic Veneers? Non Feldspathic?
96% at 20 years (Meta-analysis) Non Feldspathic = 90% at 5 years
262
When you use this, what are you doing?
* Chromatic layering * Varying opacities of Vita Based Shades
263
How does Erosion happen as a NCCL?
Chemical Dissolution of Tooth * Dietary: lemon sucking, citric acid drinks, acidic drinks * Endogenous: gastic reflux, eating disorders * Environmental: batter plant, swimmer
264
What are the Reduction depths for Veneer Preparations?
* 0.3 mm gingival * 0.5 mm midfacial * 0.7 mm incisal \*Use depth cuts!\* * Use mock-ups to preserve enamel
265
What is the Etiology/Predisposing Factors of Cracked Tooth Syndrome?
* Large restoration * Bruxism * Trauma
266
What does the Evidence say about Fluoride?
* F gel effective in caries prevention * No benefit to F gel in low caries risk * Evidence support 4 min application * F varnish q 6 months effective caries prevention * 2+ F varnish applications effective for high risk
267
What is the chemical of choice when performing non-vital bleaching? How do you apply it?
* Sodium Perborate/water * Slurry into chamber (wet sand consistency) * Clean access opening margins * Palce interim restoration (Cavity, IRM, Flowable Composite)
268
Describe "Moderate" in regards to exent in the CCS...
269
What are some Disadvantages to placing Posterior Composites?
Technique Sensitive * 35% more placement time * Meticulous operative procedure * Isolation critical * Polymerization Shrinkage (1-6%) * Decreased Wear Resistance
270
What type of discoloration is Fluorosis?
Intrinsic Pre-Eruptive
271
What is the degree of failure for veneers when bonding to dentin vs enamel?
10x greater risk of failure!
272
What are Disadvantages of Incremental Fill?
* May actually increase stress in tooth * Due to incremental buildup of cuspal deflection and subsequent stress * Potential for incorporation of voids * Takes time * Microleakage not significantly better, regardless of filing technique
273
What are examples of cavity liners?
* Calcium Hydroxide * Vitrebond
274
Why do Color Mock Up?
* Verify color match to adjacent teeth * Trial Run * Uses silicone putty matrix * Compoisite layered without bonding resis
275
What is critical in success of parital caries removal?
Seal of restoration is critical to success
276
When do you bevel the gingival margin of a slot prep?
Only if wide band of enamel present
277
Describe the Incisal But Joint regarding Veneer Preparation...
* Most indicated design * Allows alteration of incisal edge * Most resistant to veneer fracture
278
What are 4 etiological factors for White Spot Lesions?
* Fluorosis * Pre-Eruptive Trauma * Demineralization associated with early caries * Post orthodontic bracket removal
279
What are some examples of Micro Esthetics on a central incisor?
280
What is the rule of "two's"?
* 2 mm of pin in dentin * 2 mm of pin in amalgam * 2 mm of amalgam above the pin \*Need 4 mm of cuspal reduction to place pin!\*
281
What is the MPa strength of Stacked Feldspathic Veneers?
110 - 150 MPa Opaque, dentin, body, incisal porcelains
282
How is Glazes/Polished EMAX/Zirconia to opposing occlusion?
Similar to enamel for opposign wear
283
When is a crown indicted for the Anterior?
* Inadequate remaining coronal tooth structure * Missing/carious marginal ridges * FDP/RDP abutment * Unaccpetable esthetics
284
What are Diamond Finihsing Strips good for?
* Great for removing overhangs cervically * Much more aggressive than Al02 polishing strips
285
What are preferred areas for pins?
Line Angles
286
How many ppm does it take for Fluorosis to manifest?
Fluorid exposure exceeds 1-2 ppm
287
How do you define a normal lip legnth for male/female?
* Females: 20-22 mm * Males: 22-24 mm
288
What are some techniques when placing interproximal composites?
* Condense with instrument lightly wetted with resin adhesive * Cure from B and L toward margins, 40 seconds * Careful control of final increment will minimize final adjustments * If metal matrix is used, remove and cure from B & L
289
Repairing, recontouring, refurbishing amalgams and composites is a viable option and comparable success to replacement restorations... T/F?
True! Therefore repairing can be a more conservative option with equal clinical success
290
What are some landmarks to consider when assessing the Midline?
* Parallel to facial midline * Coincident with Cupid's bow * Within 2-4 mm of facial midline
291
What is the MPA strength of Empress?
160 - 182 MPa Leucite Reinforced
292
What is unique angulation of the long axis of teeth in the esthetic zone?
Distal inclination of long axis
293
What has more compressive strength, Amalgam or Composite?
Amalgam \> Composite Clinically not as significant...
294
What is the problem with using the Open Sandwhich technique interproximally?
* Problem with wahout longer-term * _Minimize gingival increment to 1mm_
295
What are some Contraindications to bleaching?
* Dark gray or black discoloration * Multiple/large anterior restorations * Unrealistic patient expectations * Known allergies to bleaching agent * Pregnant or nursing patient
296
What is Sensitivity?
* Percentage of patiets with the disease that receive a positive result * Percentage chance that the test will correctly identify a person who actually has the disease
297
10% Carbamide Peroxide = ? Hydrogen Peroxide?
3%
298
35% Caramide Peroxide = ? Hydrogen Peroxide?
10%
299
What is a recommended bonding agent for cementing veneers?
* 3 step etch & rinse (Optibond FL) * Omit primer if bonding to all enamel * Carefully thin to avoid pooling and light cure adhesive prior to cementation
300
What are some examples of Intrinsic Pre-Eruptive Genetic conditions?
Genetic * Dentinogenesis Imperfecta (hereditary opalescent dentin) * Amelogenesis Imperfecta
301
What are some examples of Finishing & Polishing Instruments?
* Diamone & Carbid burs * Scalpel blades * Flexible polishing disks * Abrasive polishing points & cups * Metal & plastic finishing strips * Polishing pastes
302
What has the latest systematic review said about Pit and Fissure sealants?
* Sealants effective in preventing/arresting PF caries of pirmary/permanent molars - 76% reduction in caries incidence * Sealants effective in minimizing progression of non-cavitated occlusal caries * Sealants more effective than F varnish for preventing/arresting PF caries - low quality evidence * Unable to make recommendations on choice of sealant material
303
How does Coefficient of Thermal Expansion of composite compare to that of tooth structure?
Composite 4x tooth structure
304
For anterior composites, does beveling matter?
Beveling of enamel margins had no significant influence
305
What have studies concluded regarding pulpal reponse with deep cavities receiving CaOH vs RMGI?
Conclusion: No conclusive statement about the superiority of either type of material can yet be made
306
What determines success of Direct Pulp Cap?
* Degree of bacterial contamination * Indirect pulp caps preferable to direct pulp caps * 96% successful in traumatically fractured teeth with open apex * 85% successful for indirect pulp cap and 75% for indirect pup cap at one year * 80% failure of carious exposures tx'ed with direct pulp caps at 10 years
307
What are some Disadvantages of a Traditional Mylar Matrix?
* Wedne needed * Mylar strip very stiff/thick * Difficult to achieve tigh contact * Difficult to establish cervical contour
308
What is the success rate relativ eto complete caries removal?
* Equal * Dentin is remineralized/caries is arrested * Success predicated on achieving adequate seal
309
Describe TheraCal as a Pulp Capping Agent...
310
When do you place a post in an anterior tooth?
* Prepare anterior tooth first, and then make the decision whether there is enough tooth structure left. If not, then place a post * Anterior teeth function very differenlty from posterior teeth * Forces are typically lateral shearing type forces
311
When would you not treat a NCCL?
* Shallow NCCL * Not an esthetic concern or symptomatic * Tx limited to preventive education
312
What is the function of a cavity sealer?
Provide protective coating for fresh cut dentin ie: Varnish/Dentin Bonding Agents
313
Low specificity leads to...
High false positives Overtreatment
314
Why use Calcium Hydroxide (Dycal) as Direct Pulp Cap?
* Anti-bacterial (high ph = 12.5) * Long term tract record of success * Stimulates release of bioactive molecules which stimulate odontoblasts * Soluble/poor seal/tunnel defect in dentinal bridge
315
Describe the "Lesion Activity" according to the CCS...
* Inactive or arrested * Active Examples: * #19 O, P & F, Adv, Active * #3 F, Cervical, Mod, Arrested
316
What % F is in Silver Diamine Fluoride? What is the zombie effect?
* Bactericidal * 38% Fluoride (44,800 ppm) * 25% Silver particles * Zombie Effect * Silver particles remain in dead bacteria which kills consuming bacteria
317
What are some Diadvantages of Porcelain Veneers?
* Preparation required; irreversible/invasive procedure * _Limited ability to mask staining_ * Technique sensitive * Fragility prior to cementation * Lab fees/interaction, multiple appointments, espense * "Costmet" dentists charging $1000 - $2000/tooth * _Resin margins, usual site of eventual breakdown_
318
What are you accomplishing when you are "Finishing" a composite?
* Margination * Contouring * Smoothing
319
What % of H202 is used for Vital Bleaching?
3-10%
320
What is the new required occlusal thickness for Ivoclar E.MAX preps?
* Flexural Strength = 500 MPa * 1 mm occlusal thickness required (not 1.5)
321
Contraindicaitons for Veneers...
* Extremely dark tooth discoloration * Lack of enamel * Severe bruxism/anteiror wear * Patient desires revesible procedure * Cost issues * Severe crowding * Heavily restored teeth * Caries active patient * Deciduous teeth
322
How much F is in ACT?
.05%
323
When comparing Non-Invasive, Micro-Invasive, and Minimally Invasive tx, what have Systematic Reviews said?
* Micro-invasive tx (PFS) efficacious in preventing invasive retreatment but required "other retx" (resealing) more often than non-invasive or minimally (slots, PRR,) invasive tx options * Non-invasive tx better than control for avoid invasive treatment * Micro-invasive better than non-invasive for avoiding invsaive retreatment
324
How many mm of gingival display should show in full smile?
0-2 mm
325
What are some post/core indications in pre-molars?
* Uniquely subject to both vertical and shear forces Post indicated when: * The remaining coronal tooth structure is inadequate ( \< 3 remaining walls) * Group Function * Tooth serves as an RDP abutment
326
What are the 2 purpose of a post?
* Retain core material * Redistribute lateral forces along long axis of root
327
What are bases?
Dentin replacement materials ie: Zinc Oxide Eugenol, Zinc phosphate cement, glass ionomer
328
How many microns are the red/yellow/white diamond finishing burs?
* Red: 30 micron * Yellow: 15 micron * White: 8 micron
329
Describe HO Bands...
* Thin .001 * Dead Soft * Easily burnished
330
What does Carbopol do regarding Vital Bleaching?
* Acidic thickening agent * Increases active peroxide releasing time 1-3 hours
331
What types of burs should you use to "finish" composite?
Multi-fluted carbides & micron diamonds * Used to contour and marginate restoration * Inherently cause damage to matrix * Contours should be achieved in unpolymerized material * _Micron diamonds cause less damage than carbides but leave a rougher surface_ * Light pressure, brush strokes
332
Describe your surgical techique for a Gingival Miniflap?
* Incision starts at line angles * At right angle to free gingival margin * 2nd incision directed apically * Confined to attached tissue * Full thickness * Usually doens't require sutures
333
Describe the CAMBRA Protocol for Extreme High Caries Risk Patients?
334
Describe how to Provisionalize Veneers...
* Vacuum formed stent from wax-up * Spot etch * Fill stent with resin (Integrity) * Spot cure/remove stent * Trim * Polish
335
Regarding Prefab Posts, what are 3 types of Metallic Posts?
* Passive Tapered * Passive Parallel * Active
336
What are 3 factors to consider when repairing a restoration?
* Carisk risk status * Size and location of the defect (will increase 71-75% surface area if replaced) * Access (69% of adjacent tooth surface damaged during preparation)
337
How do you prep for an Amalgampin?
* Round end/pear shaped bur * 0.8 - 1 mm in diameter * Prepared in dentin * 1.0 - 2.0 mm deep * Parallel external surface of tooth * Bevel at cavosurface margin (Use #8 round bur)
338
When would you want to do an Open Sandwich Technique Interproximally?
* Use RMGI (Fuji II LC) when _cerivcal margin in dentin_ or within 1 mm of CEJ
339
What is Color Mapping?
Used to diagram and record selected shades
340
What is the critical period of exposure of Fluoride?
1-4 years of age
341
Incisal plane should parallel horizon of the _____ \_\_\_\_
Interpupillary Line
342
What veneers are "stacked" what material are they most likely using?
Feldspathic Porcelain Platinum foil technique/Refractory die
343
What are 2 types of Etch & Rinse Adhesives?
344
Descrive the appearance of Abrasion NCCLs...
* Smooth, shiny - sclerotic * Relatively distinct margins * Various depths
345
The ADA recently came out with some guidance for nonrestorative treatment for caries. What are the main 2 guidelines they have set?
* 5% Fluoride varnish primary treatment for non-cavitated lesions * 38% Silver Diamine Fluoride primary treatment for cavitated lesions
346
Advantages of MI Paste...
* Increses calcium and phosphate ions in saliva and dental plaque to enhance remineralization of enamel
347
How does fracture toughness compare between Amalgam and Composite?
Amalgam = Composite Most clinically significant physical property
348
What are some treatment options for Cracked Tooth Syndrome?
* Cuspal Coverage Amalgam * Crown * Endo * Extraction
349
What are some indications for pins?
* Extensive loss of tooth structure * Insufficient coronal dentin remaining to provide retention * Insufficient remaining heigh of pulp chamber (4 mm) * Antirotational feature with posts
350
What colors can Fluorosis present as?
White, yellow, brown, or black
351
What chemical has been known to cause Cervical Resorption in Non-Vital Bleaching Cases?
* 30% H202 (Hydrogen Peroxide) Etiology * Unknown * Diffusion of H202 , heat, trauma
352
What are some Etiologic Factors for Excessive Gingival Display?
* Facial Height * Lip Length * Lip Mobility * Gingival Line * Tooth Length * Location of CEJ
353
Describe an Incisal Chamfer in regards to a Veneer Preparation...
* Most likely to cause veneer fracture * Indicated when _incsial edge alteration needed & butt joint would end in MI contact area_
354
With patient who are low and moderate caries risks, what has research suggested about repair versus replacing class 1 versus class 2 amalgam restorations?
Conclusion: "Repaired and replaced amalgam restorations showed SIMILAR SURVIVAL OUTCOMES regarding marginal defects and secondary caries in patients with low and mediuim caries risk"
355
What are the effects of Calcium Silicate Cements on Dental Pulp Cells?
* ALL commercially available CSCs are biocompatible * ALL exhibit comparable and favorable effects on dental pulp cells * No specific CSCs can be recommended
356
What are some advantages of a Sandwhich Technique?
* Chemical bond to tooth * Chemical bond to resin * Antiariogenic effects * Volume reduction of resin
357
How does dentinal thickness relate to pulpal reaction?
* 0.5 mm of RDT reduces toxicity to 75% * 1.0 mm of RDT is 90% protective * 2.0 mm of RDT produces minimal pulpal reaction * Problem: difficult to determine RDT intraoperatively \*\*\*DENTIN IS YOUR FRIEND!\*\*\*
358
Describe the Resin Infiltration Clinical Technique?
359
What does Trolamine do regarding Vital Bleaching?
* Neutralizing Agent * Improves bleaching by inhibiting salivary peroxidase
360
What are Flexible Discs used for ideally?
* Ideal for smooth/flat surfaces (labial) * Silicon carbid or aluminum oxide * Soft/flexible or thin/rigid plastic backing * Thin rigid disks for interproximal embrasures * 4 disks of varying gritsused in sequence
361
What does the evidence say about Xylitol?
* Low quality evidence to suggest that F toothpaste contain xylitol may be more effective than F only toothpaste for preventing caries * Low quality and is insufficient to determine whether any other xylitol-containing products can prevent caries
362
How long will pit and fissure sealants IN COMBINATION with small composite restorations arrest caries for?
10 years
363
What are some Indications for Enamel Microabrasion?
* Enamel fluorosis: especially brown lesions * Superficial enamel hypoplasia or hypocalcification * Lesion less than 200 microns in depth * Most brown defects * 25-50% of white lesions are too deep
364
What extent of caries can you use Icon?
* Interproximal (up to D1) * Contraindicated for D2 lesion or greater * White spot smooth surface (in enamel only)
365
Why use MTA as Direct Pulp Cap Agent?
* Release CaOH * Similar advantages to Dycal * Provides better seal * Long setting time
366
What does CAMBRA stand for?
CAries Managment By Risk Assessment
367
4 reasons to Choose CEREC...
* Low caries risk * Equal or Supra-gingival margins * Favorble occlusion * Favorale tooth alignment
368
What is this condition?
Tetraycline Staining
369
What should your preference of porcelain be in regards to translucency?
Low Translucency
370
What has the latest Systematic Review found regarding Fluroide varnish application?
* F varnish effective for arresting enamel lesions in primary/permanent teeth * 4 applications at weekly intervals or 2 applications over 4 months were effective
371
Describe a Conservative Adhesive Prep?
* No reverse s-curve * Rounded internal line angles * Occlusal width 1/3 ICD * Avoid centric stop
372
What are the typical Bleaching Agent Concentraiton in At Home Bleaching?
* H202: 10 - 15% * Carbamide Peroxide: 10 - 35%
373
What are your restorative options for treating a NCCL?
374
What are some material factors that affect success for Class V Lesions?
* MOE * C-Factor * Prep Design (Bevels) * Choice of adhesives * Polymerization stress * Difficult Isolation
375
Describe the CAMBRA Protocol for Moderate Caries Risk...
376
What is the average length of a Central Incisor?
10.5 - 11.5 mm
377
What are 4 benefits of using Vitrebond?
* F release * Remineralizes dentin * Bonds to tooth and resin * Minimal basing concept \*No need to cover all exposed dentin\*
378
How does Tetracycline cause staining?
* Chelates with Ca++ in hydroxyapatite to form TCN - orthophophate * Discoloration changes from yellow to gray upon photo-oxidation by exposure to sunlight

Operative ABGD Oral Boards (2 decks)

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