Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Operative 2 > Class III, IV, and V Composite Preparations > Flashcards

Class III, IV, and V Composite Preparations Flashcards

1
Q

Select shade before

A

placing rubber dam
◦ Dehydrating tooth affects shade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Avoid — on tooth

A

shining overhead light/loupes light directly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Unsure?

A

Cure small blob of composite on tooth to check shade
◦ Do not etch nor bond- composite will flick off easily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Class III Preparation: Shade
selection Be mindful
(2)

A

◦ At least three color esthetic zones on a tooth
◦ TAKE SHADE FROM PORTION OF SHADE GUIDE MOST SIMILAR TO THICKNESS OF RESTORATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MARK — PRIOR TO APPLYING DAM
◦ Avoid margins ending in occlusal contact areas

A

OCCLUSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Class III Preparation
Approach from the — when possible

A

lingual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Class III Preparation
Approach from the — when possible

A

lingual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Class III Preparation
Approach from the lingual when possible
◦ Acceptable to leave unsupported enamel on facial wall of preparation
(5)

A

◦ Esthetics improved
◦ Discoloration and deterioration is less visible
◦ Color match is easier
◦ Facial enamel is conserved
◦ WEDGE SHAPED PREPARATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Class III Preparation Minimal extension
Protect adjacent tooth
Where is caries?
(2)

A

◦ Usually more lingual than facial
◦ Gingival to contact area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Preserve — contact
◦ It may be acceptable to leave sound undermined enamel here

A

incisal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Remove — from margins
◦ You can’t see these- must visualize based on rod location

A

loose enamel rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Begin outline form
◦ Prepare — to long axis

A

PERPENDICULAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Inciso-gingival length
◦ — on maxillary lateral
◦ — on maxillary central

A

1.5
2.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mesial distal width
◦ — on maxillary lateral
◦ — on maxillary central

A

1.0
1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

— contact is broken
— contact is intact

A

Gingival
Incisal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Inciso-gingival height=

A

2.0mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mesio-distal width=

A

1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

— not always required
Place in dentin!
◦ Do not undermine enamel
Incisal Point
◦ Place with
Gingival groove
◦ Place with

A

Retention

½ or ¼ round bur
½ or ¼ round bur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Class III Preparation Retention
(2)

A

◦ Deeper than normal prep= avoid placing retention to avoid pulp exposure
◦ Place point and groove where they would be in an ideal prep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Class III Preparation
BEVEL
(4)

A

◦ Place 1mm bevel lingual and facial
◦ 45-60 degrees
◦ Smooth, even
◦ Flame-shaped diamond bur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Class III Preparation
Break — contact
◦ MINIMALLY

A

facial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Class III Preparation
Variations
◦ Root surface caries
◦ Same prep but

A

◦ DO NOT BEVEL on dentin or cementum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Class III Preparation
Variations
DO NOT BEVEL
◦ If there would be

A

heavy centric contact on margin
◦ Enamel wears better than composite
◦ Enamel is stronger than composite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Class III Preparations
Variations
◦ Facial approach
(4)

A

◦ When lingual access may involve only centric contact of tooth
◦ Irregular tooth alignment or rotation
◦ Extensive caries on the facial
◦ Existing defective restoration on the facial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Class III Restoration --- usually not necessary
Pulp Protection (Liner)
26
Do not use --- why?
eugenol ◦ Found in IRM ◦ interferes with polymerization reaction.
27
Do not use eugenol ◦ Found in IRM ◦ interferes with polymerization reaction. If needed, line --- wall ONLY (6)
dentin axial ◦ Use appropriate material ◦ CaOH, Glass Ionomer ◦ Avoid liner on enamel ◦ Take care to avoid liner in retention points, grooves ◦ More likely to need liner in younger patients ◦ Larger pulp
28
Matrix and Wedge Application (5)
Wedge the matrix at the gingival to hold it against the tooth. Wedge aids in separating the tooth for good contact and control seepage and moisture contamination. Minimizes finishing time. Wedge is required to prevent gingival overhangs & to stop gingival bleeding or moisture seepage. SPEND TIME ON THIS STEP!!!
29
Removing Excess Material
Let the excess restorative material extrude toward the incisal ◦ easier to finish incisally vs. gingivally
30
The Mylar Strip Finish Tighten mylar strip around restoration and cure (3)
◦ Results in smooth finish ◦ Eliminates oxygen interference ◦ Not necessary to polish this surface if it does not need contouring
31
Metal Plastic InstrumentThe instrument is metal BUT it works with
plastic material * Composite resin is plastic
32
Steps of placement (6)
Cover pulpal (axial) wall first, get in retention points/grooves Cure between increments Second layer Cure between increments Third layer Final cure (Larger preps require additional layers and vice versa)
33
Shaping and Finishing Should be shaped as much as possible prior to curing ◦ Plastic instrument, matrix band Use (3)
finishing burs Brasseler finishing discs - (coarse, then medium, then fine, then superfine) Finishing strips (strip from the gingival to the contact if necessary, do not strip and remove the contact).
34
Shaping and Finishing --- preferable when finishing lingual surface
12 bladed finishing burs (round or bullet shape)
35
--- blades smoother than --- blades (like sandpaper- higher grit= smoother)
12 6
36
Lingual excess of material Check occlusion (2) Remove composite back to the --- ◦ Remember your preparation
◦ Remove all occlusal prematurities in centric and excursions ◦ Occlusion should be on the tooth, not the restoration. cavosurface bevel
37
Flash on gingival (4)
check that there is no overhangs in this area with the explorer. If there is use a sharp gold knife to remove. Avoid by better wedge and clear matrix band placement Remove with finishing strip (if small enough) Remove with bur (if large)- Be careful not to gouge composite
38
Finishing Strips (4)
Thread below contact Use above contact Non-abrasive area in center- can “floss” through contact without removing material AVOID STRIPPING AWAY CONTACT
39
Class IV Preparation – classic “chipped tooth” Same principles as Class III BUT
the incisal angle is missing ◦ Increase in restorability difficulty level! Increase the bevel and extend beyond the bevel with the resin for more retention and a better esthetic appearance.
40
Resin Extension for large fracture A labial veneer or full coverage crown may be necessary on a
large fracture for extra retention.
41
Class V Preparation
-Carious lesion in gingival third of tooth ◦ Can be buccal or lingual
42
Curing Light
Light must have sufficient output ◦ > 550mW/cm2
43
Class V Preparations Axial Wall is --- Mesial and Distal Walls --- Incisal gingival height= --- Axial depth ---
convex diverged 1.5mm 1.0mm
44
Class V Preparation Beveled (4)
◦ USE DIAMONDS ◦ Increases surface area ◦ Increases retention ◦ Reduces microleakage
45
◦ Reduces microleakage (2)
◦ Reduces margin discoloration ◦ Eliminates white “halo” effect= better esthetics
46
Bevel ENDS of
enamel rods
47
Add
Retention grooves
48
Class V Preparation When do we NOT bevel?
◦ Below CEJ ◦ We’re in cementum then- no need to expose enamel rods for better bonding
49
Class V Preparation Modification for shallow caries or decalcified enamel adjacent to
Class V caries ◦ Basically an extended bevel
50
Class V restorations may extend onto the
root surface ◦ Polymerization shrinkage is greater than bond to cementum/dentin ◦ Causes contraction gap
51
Retention groove ◦ can minimize ---
gap
52
Consider other restorative materials (2)
◦ RMGI - May reduce microleakage ◦ Amalgam
53
Class V Considerations Non Carious Cervical Lesions (3)
◦ Abrasion- wear ◦ Erosion- caused by acid ◦ Abfraction- mechanical loss of tooth structure
54
◦ Abrasion- wear
◦ Toothbrush, pen chewing, occlusal wear from grinding
55
◦ Erosion- caused by acid
◦ Bulimia, GERD, alcoholics, extreme diet
56
◦ Abfraction- mechanical loss of tooth structure (2)
◦ Loading forces aren’t where they’re supposed to be ◦ = flexure of tooth and failure of enamel and dentin
57
Dentin wears --- times easier than enamel
25-125
58
Abrasion ◦ Discuss
habits with patient, including brushing
59
Bond strength to natural sclerotic dentin is ---% lower than to sound cervical dentin - REMOVE with bur
25-40
60
Erosion Discuss (2)
◦ Discuss diet ◦ Chew/suck on lemons ◦ Frequent soda/energy drink intake ◦ Discuss medical history ◦ Acid reflux ◦ Bulimia ◦ Dry mouth from medications ◦ Lack saliva to buffer acid
61
Class V Considerations Abfraction (5)
◦ Flexure and fatigue of enamel and dentin ◦ Caused by occlusal forces ◦ Microfractures ◦ Heavy occlusal force in lateral or eccentric occlusion ◦ Stress is concentrated at cervical area of tooth, causing fractures
62
Class V Considerations When to treat Non-carious Cervical Lesions? (5)
◦ Lesion is deep enough to compromise tooth ◦ Sensitivity ◦ Involved in partial denture design ◦ Defect is approaching pulp ◦ Defect contributes to a periodontal problem
63
◦ Sensitivity (2)
◦ Attempt non-surgical treatment of sensitivity first ◦ Toothpaste, topical fluoride, etc
64
Defect contributes to a periodontal problem
Overcontoured restorations more likely to produce perio problems
65
Class V Preparation For abrasion (2)
◦ Conservative extension ◦ May need minimal to no preparation - Patient already prepped tooth with toothbrush
66
Hydrodynamic Theory of dentin sensitivity (2)
◦ Pain caused by dentinal fluid movement ◦ From mechanical or chemical stimuli - Temperature changes - Air drying - Osmotic pressure
67
Causes of tooth sensitivity (7)
Caries or leaky restoration Void- fluid flows into void Premature occlusion Exposed dentin Exposed cementum Post- perio surgery Abrasion and erosion
68
Void- fluid flows into void ◦ Ex.
From CaOH liner having washed away
69
Exposed dentin
◦ Recession or incomplete formation of CEJ
70
Abrasion and erosion ◦ Includes
iatrogenic from polishing instruments
71
Treatment options- sensitivity Aim is to --- first
occlude tubules to stop fluid movement NONINVASIVE
72
NONINVASIVE first (4)
◦ Topical fluoride ◦ Desensitizing dentifrices (toothpastes) ◦ Desensitizing agents ◦ Resin desensitizers
73
If none of that works=
restoration
74
Treatment: Fluoride Varnish
5% NaF (Duraphat) varnish 22,600 ppm fluoride ◦ not approved for use by FDA as caries preventive but ok for desensitization. (Has been used in Europe for many years) Fluoride varnish is a sticky, yellow, semi-liquid containing 5% NaF in a resin base mixed with alcohol to dry quickly after application. Four manufacturers market the varnishes under the names. (Duraphat, Cavity Shield, Durafluor, and Fluor Protector) Apply carefully – material sticks to lips and face. ◦ Use disposable application instruments because it bakes on instruments during sterilization and is difficult to remove.
75
Treatments- fluoride toothpaste, trays (2)
Prescription toothpastes Fluoride trays - Wear overnight
76
Treatments: Desensitizing Dentrifices - Toothpaste
Toothpastes - may take 1-3 months for results to be realized. Sensodyne (Block Drug Company) Strontium chloride 10% and Potassium Nitrate (KNO- gunpowder) Most brands make a Potassium Nitrate sensitivity toothpaste
77
Gluma ◦ Placed by dentist when preparing tooth (5)
◦ place after etching (for composite restorations) ◦ Lightly dry ◦ Place bonding agent ◦ Place composite ◦ Can also be used with amalgam, but fewer steps
78
When to restore vs. when to leave (4)
Esthetic desire of patient Lesion >1.0mm depth and progressing Possible pulp exposure Structural integrity of tooth is threatened
79
Treatment- restoration Will block tubules (3)
◦ Amalgam ◦ Composite ◦ Glass Ionomer
80
Treatments- why they work (6)
Protein coagulation Enzyme interference, blocking nerve impulses Induction of tertiary dentin Various precipitates in dentinal tubules block fluid movement Destruction of odontoblasts Placebo effect (40% of patients respond to application of distilled water)

Operative 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions