Comprehensive Final Review Flashcards
(95 cards)
1
Q
Pathologic wear occurs when exogenous or endogenous factors accelerate the process of physiologic wear and is:
A
frequently a multifactorial and variable pheomenon
2
Q
The excessive wear of just one tooth, extensive restorations, or the full dentition has been associated with:
A
- supraeruption of opposing teeth
- inclination of teeth to a contact that has been eroded
- reduction of the vertical dimension
- SOME AUTHORS ALSO BELIEVE IT CAN BE A CONTRIBUTING FACTOR TO TMD
3
Q
Etiologies of MECHANICAL wear:
A
Bs and Ps
- Brushing (inadequate technique)
- Bruxism
- Parafunctional habits
- Premature occlusal contacts
- Posterior support (loss)
4
Q
Characteristics of CHEMICAL wear:
A
- PRESENCE OF AMALGAM ISLANDS
- presence of grooves and fossae
- hypersensitivity
- no stains or color changes
- wear facets without defined periphery
5
Q
Wear and the vertical dimension:
A
- it is associated with the extensive wear of the dentition and results in a REDUCED OVD/VDO
- There is NO EVIDENCE to prove that this concept is correct
- Some authors agree that in cases where there is extensive wear of the dentition, the wear is compensated by overeruption
6
Q
Treatment options for patients with excessive occlusal wear:
A
- do nothing
- prevention of loss of additional dental structure
- restorations to reverse the effects of loss of dental structure
7
Q
Digital dentures allow for improvements in:
A
- adaptation & material properties (leading to better treatment & prognosis)
- esthetic outcomes
- improved process for operator/dentist (leading to better outcomes)
- improved experience for patients (leading to better outcomes)
8
Q
Rationale for digital dentures is due to improvements in:
A
- adaptation of the prosthesis
- retention of the prosthesis
9
Q
How is the adaptation of the prosthesis improved in digital dentures?
A
CAD/CAM produces better adaptation
10
Q
How is retention of the prosthesis improved in digital dentures?
A
Milled denture bases are significantly more retentive than heat-polymerized denture bases
11
Q
Based on material properties, list in order the strength of the denture material discussed:
A
- milled resin (strongest)
- 3D printed resin
- heat polymerized resin (weakest)
12
Q
How are digital dentures an improved process for the operator/dentist?
A
- better workflow
- fewer clinical appointments
- LESS chair time
13
Q
How are digital dentures an improved experience for the patients?
A
- better workflow
- fewer clinical appointments
- LESS chair time
14
Q
Discuss the repeatability and customization of a digital denture:
A
easy to duplicate/adjust (saved on computer system)
15
Q
Describe the clinical significance of the differences in physical attributes of a digital denture:
A
Materials with a higher flexural strength are less likely to fracture
16
Q
What does a digital denture start out as?
A
Monolithic denture puck (one block denture puck)
material throughout the puck has the same properties
17
Q
Describe the first appointment of the digital denture workflow:
A
Title: Preliminary impressions
Description: On preliminary cast, make well-fitted custom tray with a occlusal wax rim
18
Q
With digital implant impressions and restorations, both our _____ and _____ are extremely accurate but the correlation between them is the most important thing
A
planning software; what we can see in the mouth
19
Q
With digital implant impressions and restorations, both our PLANNING SOFTWARE and WHAT WE CAN SEE IN THE MOUTH are extremely accurate but:
A
the CORRELATION between them is the most important thing
20
Q
CBCT indications for implants include:
A
- pre-operative analysis
- post-operative evaluation
21
Q
Give an example of a Pre-op analysis from a CBCT for implants:
A
Pre-operative analysis
- anatomic analysis
- site development using grafts
- computer assisted treatment plan
22
Q
Give an example of post-op analysis from a CBCT for implants:
A
Post-operative evaluation:
- Diagnosing complications
- Verifying implant placement
23
Q
Requirements of implant placement in a DENTATE case:
A
- STL of intraoral scan
- DICOM volume of the site
24
Q
Can we align the intraoral scan to the CBCT?
A
No- CBCTs only visualize hard tissue, so there is no way to align a soft tissue scan
25
Designed for the specific implant, and used similarly to impression copings for single implants:
Scan bodies
26
Scan bodies are used similarly to ____ for single implants
impression copings
27
T/F: Many studies have shown acceptable accuracy with intraoral scanning for single implants
True
28
What are the limitations of scan bodies?
With full-arch prosthesis, intraoral scanning studies have shown MARGINAL DISCREPENCIES GREATER THAN 150 MICROMETERS, which ultimately lead to future complications
29
What post-operative evaluations for endodontics may benefit from use of CBCT?
1. Documenting success of treatment
2. Evaluating healing
30
MOD indirect onlay parameters (composite or porcelain):
1. Diverge the walls
- 5-15 degrees
- more divergence than gold inlay
-axial walls CANNOT be underut
2. Break buccal contact
3. Smooth gingival margin
- NO bevels
4. Have enough clearance for model & die work
5. Internal line angles are ROUNDED
6. Exit angles are 90 DEGREES
31
Describe the walls for an MOD indirect onlay (porcelain or composite):
1. DIVERGE walls 5-15 degrees (more than gold inlay prep)
2. axial walls CANNOT be undercut
32
What contact should be broke for an MOD indirect onlay (porcelain or composite):
Buccal contact
33
Describe the gingival margin for an MOD indirect onlay (porcelain or composite):
smooth gingival margin, no bevels
34
For an MOD indirect onlay (porcelain or composite) there needs to be enough clearance for:
model & die work
35
Describe the internal line angles and exit angles for an MOD indirect onlay (porcelain or composite):
Internal line angles = rounded
Exit angles = 90 degrees
36
Indication for onlay restoration:
When restoration replaces more than 2/3 the intercuspal distance
37
Describe the main benefit to placing an onlay:
Strength (little possibility of fracture or marginal breakdown over time)
38
Describe the "conservative" preparation of an onlay:
much more tooth structure is conserved compared to a full coverage crown
39
Describe the cementation of an onlay:
Can be cemented with fluoride-releasing glass ionomer cement
40
Describe the longevity of an onlay:
lasts longer than most other restorations
41
What are the disadvantages of an onlay:
1. cost- not routinely covered by insurance providers
2. time- requires two patient visits due to lab fabrication
42
When to lay a cusp for an onlay:
1. whenever the BL width of the cavity prep is 1/2 way between the central groove and the cusp tip
2. 2/3 the way between the central groove and the cusp tips
3. cusps are undermined after caries removal
43
List the indications for placement of a base or liner for an onlay restoration:
1. placed only on axial wall and pulpal floor as needed
2. the CaOH liner (Dycal) is placed only in the deepest part of the prep to protect the pulp
3. glass ionomer (Vitrebond) is placed as a based to build the prep to the ideal depth and form
44
CaOH liner:
Dycal- placed in the deepest part of the prep
45
Glass ionomer:
Vitrebond- placed as base builder
46
Both types of provisional restorations can be cemented with:
Tempbond or IRM
47
When cementing a provisional restoration, ____ does not interact well with acrylic
Eugenol
48
When cementing a provisional restoration eugenol does not interact well with acrylic so a better choice would be:
Tempbond NE or other non-eugenol temp cements
49
What cement should be used to cement a provisional restoration if retention is an issue:
Durelon
50
With a provisional onlay, what instructions might you tell the patient for homecare?
1. Floss only in the gingival direction
2. Pull floss through to the buccal below the contact area
3. Avoid sticky foods
4. Avoid hard foods
51
An onlay should be cemented with:
Any permanent crown & bridge cement
-Zinc oxide
-Relyx
-Speedcem
-Glass ionomer (released fluoride ions)
52
Polymers and application for aligners includes:
Tooth movement related to _______ recovery during wire or aligner
ELASTIC STRAIN
53
Unlike ortho wires, aligners are significantly:
affected by stress relaxation
54
Aligner properties are affected by:
1. material chemical structure
2. material thickness
55
Give an example of how are aligner properties is affected by material chemical structure:
Increased cross-linking and ring structures = less flexible/lower elasticity
56
Increased cross-linking and ring structures =
less flexible/lower elasticity
57
Give an example of how aligner property is affected by material thickness:
Thicker is stiffer (Higher modulus)
58
Patients must wear aligners atleast:
20 hours/day (22 is preferable)
59
List the potential concerns with aligner therapy:
1. eluted polymer breakdown products are released into the oral cavity
2. nano & microplastic particles (NMP) ingestion & inhalation
60
Because eluted polymer breakdown products are released into the oral cavity (potential concern) ____ polymers may be preferred
Phalate-free polymers
61
Resins for printing are morecytotoxic compared to:
thermoforming polymers
62
What reduces toxicity with aligner therapy?
1. post-curing and processing
2. time (toxicity decreases over time)
63
- increased particle release with increased wear time
- higher levels in the placenta than in the blood
NMP (Nano & microplastic particles)
64
- Phalate-free particles may be preferred
- resins for printing are more cytotoxic compared to thermoforming polymers
- post-curing and processing reduce toxicity
- toxicity decreases with time
Eluted polymer breakdown
65
Potential concerns related to aligners:
Environmental impact of aligner therapy
66
Aligners are considered:
Medical waste
67
List the orthodontic pollution:
1. 3D printed models (casts)
2. Discarded aligners
3. Leftover aligners
4. Leftover aligner waste
5. Water waste
6. Plastic cases
68
Advantages of dental ceramics:
1. esthetics
2. biocompatibility
3. preservation of tooth structure
69
What is one of the primary indications for dental ceramics in restorations?
Esthetics!!!
70
What makes ceramics so esthetics?
1. mimic the optical properties of natural tooth structure
2. translucency
71
What makes ceramic translucent?
Light can penetrate the material
72
Enamel is ____ translucent
Dentin is ____ translucent
Enamel = 70
Dentin = 30
73
Ceramic is considered:
Biocompatible (bio-inert)
74
What do we mean when we say ceramic is biocompatible?
1. No cellular or tissue response
2. Low affinity for attracting and retaining plaque
75
Describe the preparation of all-ceramic restoration compared to a metal-ceramic restoration:
All ceramic = more conservative preparations
76
All ceramic restorations may be contraindicated in cases with:
limited occlusal space
77
Desribe the composition categories of dental ceramics:
1. predominantly glass
2. particle-filled glass ceramics
3. polycrystalline ceramics
78
Predominantly glass ceramic is:
Feldspathic (60-70 MPa)
79
Particle-filled glass ceramics:
Leucite (120 MPa)
Lithium discilicate/eMax (360 MPa)
80
Polycrystalline ceramics:
Alumina (600-700 MPa)
Zirconia (1120 MPa)
81
Order of strength of different types of ceramics:
1. Feldspathic (weakest)
2. Leucite
3. Lithium discilicate
4. Zirconia (strongest)
82
What is important with an anerior tooth preparation?
NO FEATHER EDGES
83
Possible reasons for failure/fracture of all ceramic preparations:
-10% higher mismatch in CTE (thermal exapansion) between core ceramic & veneering porcelain
-residual stresses within the ceramic
-inadequate material thickness
-inadequate planning
84
Describe the residual stresses in the ceramic that lead to failure:
fast cooling or aggressive adjustments adter sintering
85
RMGI:
Resin-modified glass ionomer (fluoride release)
86
What is required with an adhesive resin cement?
bonding agent & primer
87
T/F: Adhesive resin cement is STRONGER than self-adhesive
True
88
What is a drawback of adhesive resin cements?
Limited shade selection
89
Adhesive resin cements may also be known as:
1. multilink (Ivoclar)
2. Panavia 21 (Kuraray)
3. Relax Ultimate (sM)
90
An interim cement with a higher strength than ZOE:
Zinc polycarboxylate
91
Why does Zinc polycarboxylate have a higher strength than ZOE?
Due to solubility
92
Desribe the chelation of zinc polycarboxylate:
Bonds to Ca ions
93
Cement that:
-contains polyacrylic acid
-causes minimal pulp irritation
-bonds to calcium ions
Zinc polycarboxylate
94
Zinc polycarboxylate brand names:
Duralon, Ultratemp
95
