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operative dentistry > Class I and Class V Restoration Fundamentals: > Flashcards

Class I and Class V Restoration Fundamentals: Flashcards

1
Q

In clinic the first step of placing an occlusal restoration is:

A

Step 1- place liner and/or base if needed (deep caries)

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2
Q

When is the placement of a base needed?

A

Deep caries

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3
Q

What materials serve as a liner and/or base in occlusal restorations?

A
  1. calcium hydroxide
  2. glass ionomer
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4
Q

Give an example of calcium hydroxide:

A

Dycal (calcium hydroxide liner)

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5
Q

Give an example of a glass ionomer

A

vitrebond (resin modified glass ionomer liner/base)

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6
Q

Calcium hydroxide (example dycal) is a 2 paste system, that dispenses from separates tubes and is mixed. It function to:

A

stimulate reparative dentin formation

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7
Q

Glass ionomer (example vitrebond) is a 2 paste system, dispenses from a clicker, and is mixed. It requires ___ and functions to ___.

A

light cure; release fluoride over time

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8
Q

Where and how should a line and/or base be placed?

A
  • Place in deeper areas only, keeping away from margins
  • Placed with dycal instrument (tiny ball shaped)
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9
Q

Calcium hydroxide liners brand names: (2)

A

Life; Dycal

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10
Q

Describe the placement of a calcium hydroxide liner (life or dycal)

A
  1. mix with spatula end of decal instrument
  2. use dycal instrument to place over area nearest to pulp
  3. Often cover with RMGI (resin modified glass ionomer)
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11
Q

VItrebond is the brand name for a:

A

Resin modified glass ionomer liner/base

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12
Q

Describe the placement of Vitrebond:

A
  1. mix with spatula end of dycal instrument
  2. use dycal instrument to place over area nearest pulp
  3. often used to cover calcium hydroxide
  4. light cure
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13
Q

____ is placed in a thin layer over dentin
___ is placed in a thicker layer on floor of prepared cavity

A

liner; base

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14
Q

What is the second step in placing an occlusal restoration (after liner/base placement)?

A

Step 2: seal dentinal tubules

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15
Q

Is sealing the dentinal tubules always necessary on an occlusal restoration?

A

Not generally necessary- preps especially prone to sensitivity may

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16
Q

Describe situations where preps may be prone to sensitivity:

A

Very young teeth- large pulp

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17
Q

What product would seal dentinal tubules?

Name them!

A

desensitizers

  1. copal resin (Copalite)
  2. bonding agents
  3. Gluteraldehyde & (2-hydroxyethyl)methylacryate (HEMA) desensitizer (example GLUMA)
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18
Q

Copal resin is a ___.

A

desensitizer

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19
Q

What is a specific copal resin? What are the advantages? What are the disadvantages?

A
  • copalite
  • advantages: inexpensive, quick to use
  • disadvantage: leaves a film thickness (could wash out, causing micro leakage)
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20
Q

Unfilled dentin bond agent is a ___.

A

desensitizer

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21
Q

What is a specific unfilled dentin bond agent? What are the advantages? What are the disadvantages?

A

PQ-1, PEAK
- advantage: intermediate in cost
- disadvantage: some require more than one step, involves etching, leaves a film thickness

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22
Q

Research suggests that etching with an acid:

A

may leave teeth more vulnerable to recurrent caries

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23
Q

Gluma is a:

A

desensitizer

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24
Q

Advantages of Gluma:

Disadvantages of Gluma:

A

Advantages: no film thickness, one step to apply

Disadvantage: expensive, caustic to soft tissue & possible pulp

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25
Q

Application of desensitizer copal resin:

A

wipe cavity walls with cotton pellet soaked in resin then gently air dry

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26
Q

Application of desensitizer dental-bonded resins:

A

press resin into dentin using brush, gently air dry, light cure

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27
Q

Application of desensitizer Gluma:

A

Apply to walls for 30 seconds, dry, rinse, dry

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28
Q

Desensitizer that is considered caustic to the gingiva and possible pulp in deep preps:

A

Gluma

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29
Q

Since Gluma (desensitizer) is caustic to the gingiva and possible pulp in deep preps, you should minimize contact with _____ and the pulp should be protected using a ____ in deep preparations prior to applying

A

gingiva; liner/base

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30
Q

The current policy at UMKC regarding dentin desensitizers:

A

We DO NOT teach the standard use of dentin desensitizers under amalgam

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31
Q

Studies suggest that dentin desensitizers make a ___ difference in tooth sensitivity on routine cases

A

negligible

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32
Q

Studies suggest that dentin desensitizers make a negligible difference in tooth sensitivity on routine cases- the _____ will seal most dental tubules and after a few weeks, the ___ will seal itself with a ____.

A

smear layer; amalgam; oxide layer

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33
Q

Although not standard procedure, occasional after consult with faculty, one might use Gluma on an especially sensitive tooth, but:

A

place a liner or base first in deep preps

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34
Q

Steps in placing an amalgam restoration:

A
  1. place amalgam
  2. condense amalgam
  3. pre-carve burnish
  4. carve anatomy
  5. refine restoration
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35
Q

Used to mix amalgam:

A

triturator

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36
Q

Prior to picking up the amalgam with the ____, it should be placed into a ____

A

amalgam carrier; amalgam well

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37
Q

What end of the amalgam carrier should be used first?

A

small

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38
Q

Dispensing only a small amount of amalgam into the preparation allows for:

A

proper condensation

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39
Q

What should be used to condense amalgam?

A

hollenback condenser

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40
Q

When condensing the amalgam:

a: tamp into the preparation to fix amalgam in place

b: use the small condenser ___ to pack material _____, at a ____ angle , using a pressing, wiggling motion in a step-wise fashion

A

nib; firmly into all line angles; 45 degree

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41
Q

Describe how you should fill an amalgam preparation:

A

overfill preparation to around 1.0 mm beyond margins

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42
Q

After overfilling the amalgam restoration, the next step is the:

A

pre-carve burnish

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43
Q

What instruments should be used for the pre-carve burnish in an amalgam restoration?

A

condensor or large ball burnisher

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44
Q

When pre-carve burnishing an amalgam restoration, burnish towards the ____ to eliminate voids and to ____, where it can be carved away, then begin to define the grooves.

A

towards the margins; bring excess mercury to surface

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45
Q

What instruments should be used to carve the anatomy into the amalgam:

A
  • hollenback carver
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46
Q

What step should the initial defining of grooves occur in (amalgam restoration)

A

pre-carve burnish step

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47
Q

When using the hollenback carver to carve the anatomy into the amalgam:

  1. It should be held ____ to the ____
  2. Use the tip of the carver to ____
  3. Carve _____ to the margins
  4. Remove all ____ beyond the margins
A
  1. perpendicular to the margins
  2. recreate groove anatomy
  3. exactly
  4. flash
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48
Q

When checking and refining occlusion in amalgam restorations, use the _____ to remove high occlusion marks and incline plane contacts

A

discoid carver

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49
Q

When checking and refining occlusion in amalgam restorations, try to ____ of fossae (_____ on the teeth)

A

preserve cusp seats in the bottoms of fossae- long axis forces on teeth)

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50
Q

What instrument should be used to smooth the surface of an amalgam restoration?

A

beavertail burnisher

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51
Q

Why should you avoid burnishing on amalgam that has began to set?

A

This could bring excess mercury to surface

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52
Q

What type of finish should the amalgam restoration initially have?

A

matte finish

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53
Q

Is finishing and polishing amalgam always necessary?

A

No

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54
Q

When is finishing and polishing amalgam necessary?

A

needed when something needs to be corrected (occlusion, overhang, anatomy, marginal plaque trap, contour improvement)

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55
Q

Research suggests that well condense, well carved amalgam does not gain longevity from:

A

the finishing process

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56
Q

If you need to finish/polish an amalgam restoration, you must wait ___ for the amalgam to be completely set up.

A

24 hrs

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57
Q

Finish bur sequence for amalgam:

A
  1. green stone
  2. white stone
  3. 12 bladed polishing bur
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58
Q

Finishing burs for amalgam include:

  1. green stone =
  2. white stone =
  3. 12 bladed polishing bur =
A
  1. coarse
  2. medium
  3. medium- fine
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59
Q

Polishing burs sequence for amalgam:

A
  1. brown (pre-polish)
  2. green (polish)
  3. green with yellow collar (superpolish)
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60
Q

List the finishing burs (12-bladed flutes)

A
  1. flame
  2. round
  3. bullet
  4. small round
  5. bullet pointed
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61
Q

The finishing burs (12-bladed flutes) are all:

A

needle point

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62
Q

What is the most important area for finishing an amalgam?

A

cavosurface margin

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63
Q

What does a composite restoration require that an amalgam restoration does not?

A
  1. etch
  2. bond
  3. high cure
  4. incremental placement
  5. finish/polish
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64
Q

When placing composite resin in an incremental fashion, the increments should be placed at:

A

2mm or less

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65
Q

While condensing composite, ____ may occur

A

pullback

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66
Q

Anatomy in an occlusal composite restoration should be placed:

A

prior to light curing

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67
Q

What instruments should be used to create anatomy in an occlusal composite restoration?

A

hollenback or optrasculpt

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68
Q

describe polishing points that are used to polish a composite restoration:

A

latch-type, preimpregnated with polished paste, moisture activated

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69
Q

List the advantages of using a composite restoration:

A
  1. prep can be more forgiving
  2. esthetics
  3. operator control of set-up tie
  4. preserve tooth structure
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70
Q

List the disadvantages of using a composite restoration:

A
  1. more technique sensitive
  2. additional steps
  3. longevity
  4. strength
  5. no moisture tolerance
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71
Q

In a Class V restoration, ____ restorations will be more traumatic to gingiva

A

over contoured

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72
Q

major classes of dental materials:

A
  1. metals and alloys
  2. composites
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73
Q

Metals and alloys include:

A
  1. porcelains
  2. ceramics
  3. polymers
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74
Q

Polymers include both:

A

elastomeric and plastics

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75
Q

An impression material is an example of:

A

elastomeric polymer

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76
Q

Denture bases and sealants are examples of:

A

plastic polymers

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77
Q

polymer with fillers=

A

composites

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78
Q

Who regulates dental materials

A

ADA and FDA

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79
Q

Protect the public from hazardous or ineffective medical materials and devices:

A

FDA

80
Q

In 2009, the FDA reclassified amalgam from ___ to ___.

A

From class I to class II

81
Q

FDA lowest risk class=

FDA highest risk class=

A

class 1

class 3

82
Q

performance of all dental materials depends on their:

A

anatomic structure

83
Q

anatomic structure determines:

A

mechanical and physical properties

84
Q

Types of interatomic bonds:

A

primary and secondary

85
Q

Ionic, covalent, and metallic bonds are all:

A

primary interatomic bonds

86
Q

Hydrogen bonds and Van Der Waals forces are both:

A

secondary interatomic bonds

87
Q

Electrostatic attraction of positive and negative charges describes:

A

ionic bonds

88
Q

involves electron transfer between ions:

A

ionic bonds

89
Q

List the properties of ionic bonds:

A
  • non-directional
  • strong
  • no free electrons
  • good thermal & electrical insulator
90
Q

Ceramics and gypsums are examples of materials displaying:

A

ionic bonds

91
Q

When two atoms share an electron:

A

covalent bond

92
Q

List the properties of covalent bonds:

A
  • directional
  • low electrical and thermal conductivity
  • water-insoluble
93
Q

Water, glass, polymers, and composite are all examples of materials that display:

A

covalent bonds

94
Q

Cluster of positive metal ions surrounded by a gas of electrons:

A

metallic bonds

95
Q

List the properties of metallic bonds:

A
  • non-directional
  • high electrical and thermal conductivity
96
Q

Amalgams and gold allows are examples of materials that display:

A

metallic bonds

97
Q

Classifications of material properties:

A
  1. biological
  2. surface
  3. physical
  4. mechanical
98
Q

The biological response to a material when in contact with the human body:

A

Biological

99
Q

The unique properties of a material associated with its surface:

A

surface

100
Q

Depends on the type of atoms and the bonding present in the material, size of shape have NO affect

A

Physical

101
Q

Physical properties are depending on:

A

type of atoms

102
Q

Reaction of a material to the application of an external force, size and shape of specimen AFFECT properties:

A

mechanical

103
Q

A type of property that is structure sensitive:

A

mechanical

104
Q

A type of property that is structure insensitive:

A

physical

105
Q

Gingivitis is an example of what type of property?

A

biological

106
Q

Optic (color, gloss), Thermal (conductive) are examples of what type of property?

A

physical

107
Q

Denture retention and adhesive bonding are examples of what type of property?

A

surface

108
Q

Applied force refers to:

A

load

109
Q

When load (force) is applied to material, ____ develops in response

A

stress

110
Q

= load per unit area

A

stress

111
Q

strength of material =

A

stress at fracture

112
Q

Type of strength measured is dependent on the type of:

A

force applied

113
Q

List the following types of forces/stress:

  1. pushing
  2. pulling
  3. sliding
  4. twisting
  5. bending
A
  1. compressive
  2. tensile
  3. shear
  4. torsion
  5. flexure
114
Q

Label this photo from top to bottom:

A
  1. compression
  2. tension
  3. shear
  4. torsion
  5. flexure
115
Q

highest strength measure for most materials:

A

compressive strength

116
Q

Measure of stress necessary to fracture a material by 2 opposing forces directed toward each other:

A

compressive strength

117
Q

____ pushes atoms and structure closer:

A

compression

118
Q

Compression usually requires _____ loads to cause failure

A

higher loads

119
Q

pulling force:

A

tensile strength

120
Q

What is usually the lowest strength for most materials?

A

tensile

121
Q

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

A

tensile strength

122
Q

____ pulls the atoms and structure apart

A

tension

123
Q

Failure of this type of strength occurs at lower loads:

A

tensile strength

124
Q

sliding force:

A

shear strength

125
Q

Typically, an intermediate strength between compressive and tensile:

A

shear strength

126
Q

Stress necessary to rupture a material by 2 opposing parallel forces directed toward each other but not in the same plane

A

shear strength

127
Q

Describe a clinical situation with shear force/ shear strength:

A

implant-bone interface

128
Q

Twisting force:

A

torsion strength

129
Q

What motion is used on a wrench to place dental implants:

A

torque

130
Q

What type of strength is not relevant to direct or indirect dental restorations?

A

torsion

131
Q

Bending force:

A

flexural strength

132
Q

measure of stress to cause failure in bending:

A

flexural strength

133
Q

What type of test is used to determine flexural strength?

A

3-point bend test

134
Q

The three-point bend test takes into account:

A
  1. compressive load
  2. combination of compressive and tensile stress
135
Q

_____ strength is relevant in numerous clinical situations

A

flexural stress/strength

136
Q

Type of strength vital to occlusal load:

A

flexural strength

137
Q

Flexural strength is vital to occlusal load on both:

A
  1. direct restorations
  2. indirect/removable
138
Q

Protrusive movement is an example of dental stress on _____ teeth.

A

anterior teeth

139
Q

flexure load on incisors=

A

protrusive movement

140
Q

chewing = ____ load

A

compressive

141
Q

Posterior occlusion is an example of:

A

compressive load

142
Q

posterior occlusion occurs at:

A

marginal ridge contact areas & fossa

143
Q

equation for occlusal stress:

A

occlusal stress= occlusal load / occlusal contact area

144
Q

Allows for distribution of occlusal load across maximum area resulting in minimized stress:

A

tripodized occlusal contracts

145
Q

Premature contact resulting in:

A

decreased area

146
Q

With a premature contact, the patients occlusal force _____, but the occlusal stress is ____.

A

stays the same; increased

147
Q

The DEFORMATION that occurs in a material when force is applied to the material:

A

strain

148
Q

Equation for strain:

A

strain = change in strength (deformation) / unit original strength

149
Q

____ and ___ are interrelated, if you have one, you will have the other:

A

stress and strain

150
Q

An example of a stress strain curve would be:

A

someone on a diving board

151
Q

temporary distortion of a material by applied force:

A

elastic strain

152
Q

In elastic strain, strain is:

A

BELOW elastic limit

153
Q

In elastic strain, once force is removed:

A

material revert to original form

154
Q

Example of elastic strain:

A

rubber band

155
Q

PERMANENT distortion of a material:

A

plastic strain

156
Q

in plastic strain, strain is:

A

beyond elastic limit

157
Q

In plastic strain: ____ portion of strain is recovered, while ____ portion of strain is NOT recovered

A

elastic; plastic

158
Q

In plastic strain, once the force is removed:

A

shape remains changes

159
Q

Example of plastic strain:

A

bending a paper clip

160
Q

Amalgam is placed in a ____ state, and carved before it hardens

A

plastic

161
Q

Amalgam alloy composition:

Elements that make it up and their percents:

A
  1. Ag- 70%
  2. Sn-16%
  3. Cu- 13%
    Zn-1%
162
Q

What principal function do the following elements of amalgam contribute to:

  1. silver:
  2. tin:
  3. copper:
  4. zinc:
A
  1. strength
  2. expansion
  3. strength
  4. deoxidizer
163
Q

Amalgam is an allow of ______, and is mixed with ___ to form an alloy that can be packed into a dental restoration.

A

silver, copper, tin, and zinc; mercury

164
Q

Amalgam in capsule = _____. It is mixed with ___ in ___.

A

powder; liquid mercury; triturator

165
Q

Lower copper amalgam, similar to G.V. Black’s original formula:

A

conventional amalgam

166
Q

Amalgam that contains 9-30% copper, superior form, what we use in U.S.

A

High copper amalgam

167
Q

The presence of copper in high copper amalgam nearly ____, resulting in ___.

A

nearly eliminates the gamma-2 phase; stronger restoration

168
Q

The presence of ____ in a high copper amalgam nearly eliminates the gamma-2 phase

A

copper (9-30%)

169
Q

Phases of amalgam setting include:

A
  • gamma
  • gamma-1
  • gamma-2
170
Q

Describe the gamma phase of amalgam setting:

A

tin and silver react with mercury, forms silver-mercury (gamma-1) and tin-mercury (gamma-2)

171
Q

The gamma phase of amalgam setting can be described as:

A

strong-corrosion resistant

172
Q

Describe gamma-1 phase of amalgam setting:

A

silver- mercury, weaker and susceptible to corrosion

173
Q

Describe the gamma-2 phase of amalgam setting:

A

tin-mercury, weakest, most susceptible to corrosion

174
Q

Adding copper to amalgam setting creates:

A

Copper-tin phase (eta), eliminates tin-mercury gamma-2 pahse

175
Q

The following equation describes:

gamma+ mercury –> gamma + gamma-1 + gamma-2

A

low copper amalgam

176
Q

The following equation describes:

gamma+ copper + mercury –> gamma + gamma-1 + CuSn

A

high copper amalgam

177
Q

List the shape of amalgam particles:

A
  1. lathe
  2. admixed
  3. spherical
178
Q
  • outdated- particles formed by cutting block of allow with a lathe
  • results in large, irregular particles
A

Lathe

179
Q
  • lathe type particles mixed with small spheres
  • requires more condensation force
  • most commonly used type of amalgam
  • low early strength (1 hr)
A

admixed

180
Q
  • spherical shape
  • higher early strength, and higher 24hr strength
  • may be more difficult to achieve inter proximal contact
  • requires less condensation force
A

spherical

181
Q

Which type of amalgam particles have have low early strength?

A

admixed

182
Q

All the types of amalgam particles have:

A

similar clinical success, different handling properties

183
Q

What are the variables to amalgam manipulation (4)?

A
  1. mercury-alloy ratio
  2. trituration
  3. condensation
  4. carving and finishing
184
Q

When considering the mercury to allow ratio:

Less mercury to final restoration is:

A

superior

185
Q

Most critical variable in amalgam restoration:

A

condensation

186
Q

Most common error made by dentists in amalgam manipulation:

A

undercondensation

187
Q

Why should we not remove amalgam due to mercury concerns?

A
  1. unwarranted loss of tooth structure
  2. unnecessary expense
  3. limited longevity when replaced
188
Q

Amalgam has ____ compressive strength and ___ tensile strength

A

high compressive; low tensile

189
Q

amalgam is ___ in small bulk

A

brittle

190
Q

am requires ___ of material to avoid breaking

A

minimal thickness (1.5-2.0 mm)

191
Q

Why can the isthmus be 1.0mm minimal thickness when the floor must be (1.5-2.0) thickness in an amalgam restoration?

A

Because chewing forces are not directed at isthmus width

192
Q

Amalgam is sensitive to:

A

moisture contamination during placement

193
Q

when ____ reacts with ____ in the amalgam, it causes an eventual expansion of the allow out of the prep

A

water with zinc

194
Q

Can amalgam corrode?

A

yes

195
Q

disadvantages of amalgam: (6)

A
  1. poor esthetics
  2. need for good mercury hygiene
  3. removal of more tooth structure (for adequate bulk)
  4. no bonding
  5. thermal conductor (leads to sensitivity)
  6. may ditch at margins after time
196
Q

Advantages of amalgam: (6)

A
  1. more forgiving for moisture control
  2. high wear resistance & compressive strength
  3. less timely/lower cost
  4. long-lasting
  5. regenerates seal
  6. less prone to recurrent decay
197
Q

Indications for amalgam: (8)

A
  1. moderate to large class 1 and 2 restorations
  2. heavy occlusal wear
  3. high caries rates
  4. difficult isolation
  5. gingival margins on root
  6. class V restorations on non-esthetic zones
  7. temporary restorations on teeth with questionable prognosis
  8. buildups on crowns for extensively damaged teeth

operative dentistry (5 decks)

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