Designs for Class I lesions

Question 1

What factors affect our treatment recommendations?

Answer 1

1) Stress on tooth (i.e occlusion, grinding, and wear)
2) Size of lesion
3) Aesthetics
4) Pt’s out of pocket expenses
5) Pt’s CRA
6) Amount of enamel remaining
7) Ability to isolate

Question 2

How can you diagnose the put and groove pattern?

Answer 2

1) Visual exam
2) Radiograoh
3) tactile explorer
4) diagnodent laser
5) exploratory–bur (Fissuratomy # 132 FD)

Note: If no decay sealant applicable!

Question 3

Class I amalgam restorations?

Answer 3

1) Pit & fissures of occlusal surfaces of posterior teeth
2) Pits in occlusal 2/3 of F & L surfaces of molars
3) Lingual pits of max. incisors in top 2/3 of tooth

Question 4

Which 2 ridges do you want to avoid cutting into?

Answer 4

1) Transverse (cut 2 separate preps for LOWER 1st PRE-molars)
2) Oblique (UPPER max. molars)

Question 5

What is a cavo-surface?

Answer 5

Junction between prep and uncut enamel (outline of prep)

Question 6

Isthmus?

Answer 6

• Narrowest part of prep.
• Because the tooth can crack if too big.
• Always between triangular ridges

Question 7

When prepping tooth outline what guidelines should you follow?

Answer 7

1) Avoid making marginal ridge too thin
2) Avoid cutting into the triangular ridges
3) Avoid having cavo-surface end at opposing contacts
4) Keep cavo-surface sharp and well defined
5) Outline at the proximal should be parallel to the marginal ridge

Question 8

During a prep pulpal floor should be _________and _________ or ___________

Answer 8

Smooth
Flat
slightly rounded

Question 9

Need a minimum of __________ depth starting fro mthe central groove of your amalgam carving. (This applies to amalgam only)

Answer 9

1.5mm

Question 10

The Facial and Lingual walls at the cavo-surface may be deeper closer _________

Answer 10

2mm

Question 11

Normally we are into the DEJ but _________ may remain as long as we are at minimum depth

Answer 11

enamel islands

Question 12

Lower 1st premolars: The pulpal floor is __________ to a plane between the _______ and ________ cusps

Answer 12

Parallel
Facial
Lingual

Note: One exception lower 1st premolars pulpal floor is SLANTED and all other teeth floors are flat (follows DEJ)

Question 13

Isthmus follows ______ but should be __________ in the tooth when possible.

Answer 13

Decay

Centered

Question 14

Facial & lingual walls:

Wall should be ________ and _________ _________. All internal line angles need to be ________

Answer 14

Smooth
Slightly convergent
rounded

Question 15

Facial & lingual walls:
Critical to have ________ enamel rods.
________ enamel will fracture

Answer 15

supported

undermined

Question 16

Facial & lingual walls:

A ____________ isthmus allows for ________ convergence

Answer 16

Smaller

Greater (due to the orientation of enamel rods)

Question 17

______& ______ walls are straight or even slightly divergent.

Answer 17

Mesial

Distal

Question 18

Why must proximal walls need to be more divergent the THINNER the marginal ridge is?

Answer 18

Because the enamel rods diverge more the CLOSER we get the PROXIMAL surface of the tooth

Question 19

The __________ has a strong mesial concavity and therefore the mesial wall may need to be slightly more _________

Answer 19

First premolar

Divergent

Question 20

With Maxillary Molars OL:

• The occlusal outline is ______ to the ________ ridge.
• Axial pulpal line angle is ________
• Lingual floor is a ________ design
• Retention grooves _____ the M& D walls in dentin

Answer 20

Parallel 
oblique
beveled or rounded 
min-box 
undermine

Question 21

Max incisors:

• Walls are cut ______ to the surface of tooth
• Avoid cutting through the ______ or ________ ridges
• For lingual surfaces prep can be ____ or _______

Answer 21

• perpendicular
• cingulum or marginal
• 1mm or 1.25

Question 22

Mandibular molars B pit:

• ___________ _____________ grooves commonly decayed
• Walls are _______ to retain amalgam
• Prep is centered on the ___________ groove
• Minmium depth to the ________ (can be as short as_____)

Answer 22

• Incompletely coalesced
• convergent
• buccal groove
• DEJ (1mm)

Question 23

Mandibular second premolar:

• The center of the prep is closer to the _____ groove
• Greater morphological variance occurs in the ___ and _____ pattern
• 3 types of outlines are ___ ____ or ___ type
• Pulpal floor is _______ or may ______ slightly linually depending on F & L cusp height.

Answer 23

• Central
• pit and groove
• U, Y, H
• level
• incline

Question 24

Mandibular 1st pre-molar:
Do not cut thru the ______ ridge unless caries undermines ridge

• Small ________ and ______ preps made if only each individual out is carious
• The pulpal floor is _______ lingually since the lingual cusp is much smaller

Answer 24

• Transverse
• Mesial and Distal
• INCLINED (due to pulp horns)

Question 25

Composite is help by __________ _________ to enamel and dentin.
________ _______ dictates prep outline

Answer 25

micro-mechanical

• Caries
• removal

Question 26

composite is a misxyture of _____ + ______ and _____ + _____

Answer 26

• Glue
• filler
• resin
• ceramic