NEW MD OPERATIVE Flashcards

1
Q

what is the main component of enamel and dentin?

A

CHA ( carbonate substituted hydroxyapetite)

cha makes more soluble

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2
Q

what is critical PH of teeth?

A

5.5

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3
Q

what ph is demineralization?

A

below 5.5

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4
Q

after applying fluoride, what is the critical pH of teeth?

A

4.5

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5
Q

how long does dimenralization remineralization take?

A

10 minute dimeneralization

30 minutes

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6
Q

which ion causes dimeneralization

A

H+

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7
Q

what does MI paste due to remineralize tooth?

A

releases
Ca+
PO4-

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8
Q

3 components of how flupride works?

A

remineralization of tooth structure
dec. enamal solubility
interfere with caries metabolic activity

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9
Q

what are the pH of
Dentin and Cementum
Enamel
Enamel FA

A

D and C: 6.2-6.7 ( most susceptible)
enamel: 5.5
FA: 4.5

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10
Q

what is keyes-Jordan diagram

A

results of cariogenic oral flora (biofilm) with ( carbs) sugar on tooth surface overtime (host)

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11
Q

what is the shape of decay on smooth surface lesions?

A

V-shape

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12
Q

shape of decay on puits and fissures ??

A

inverted V shape

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13
Q

what is affected dentin?

A

deep, dry, leathery, demineralized decay

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14
Q

what is infected dentin

A

superficial, wet, soft, necrotic decay

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15
Q

dry, leathery dentin known as what?

A

affected dentin

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16
Q

T or F decay is irreversible

A

true

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17
Q

how long does it take for enamel cavitation

A

1-2 years

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18
Q

what are the steps of lesion progression to cavitation?

A

enamel demineralization -> dentin demineralization -> enamel cavitation (1-2 years) - > dentin cavitation

cavitation steps irreversible !!!

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19
Q

upon evaluation of tooth we see smooth surface is opaque white when air dried and disappear when wet

A

incipent !!!! reversible

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20
Q

what is a complex restoration?

A

3 surfaces MOD

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21
Q

what is a simple resotration

A

1 surface (O)

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22
Q

what is a compound restoration

A

2 surfaces MO

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23
Q

what is residual caries?

A

caries remain after tooth is prepped

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24
Q

what is secondary caries?

A

occur at junction of tooth and restoration (microleakage)

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25
Q

rapidly damaging decay that is light-colored, soft infectious called

chronic decay
acute decay
arrested decay

A

acute / fast

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26
Q

demineralized tooth structure that is almost remineralized is called what
chronic decay
acute decay
arrested decay

A

chronic / slow

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27
Q

what type of bacteria is in dentin?

A

Lactobacilus

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28
Q

what type of bacteria in enamel decay

A

strep mutans

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29
Q

what type of decay in root caries

A

actinomyces

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30
Q

what type of bacteria (+/-) is inenamel and what is the enzyme that helps it stick to a tooth

A

G+

GTF ( converts SUCROSE to glucans and fructans)

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31
Q

what carb in human body is mostly responsible for caries

A

SUCROSE

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32
Q

what are the salivary antibodies that fight against bacteria

A

sigA

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33
Q

what protein does saliva use to elimnate bacteria ?

A

GLYCOPROTEIN:

large molecules that elimante bacteria through agglutination and causes swallowing

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34
Q

this enzyme in saliva destroys cell walls

A

lysozyme

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35
Q

this protein in saliva activerly binds iron

A

lactoferrin ( iron inactivator)

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36
Q

caries that dissapear while wetting are caleld what?

A

incipient

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37
Q

T or F hypocalcification does not dissapear after wetting

A

T

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38
Q

a patient with 20% mineral loss comes to clinic for tooth #14. Radiographs are not showing anything. why is that?

A

tooth needs 30-40% loss ot be seen radiographically !!!

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39
Q

transillumination is used to detect what?

A

contact areas of anterior teeth
craze lines
fractures

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40
Q

a patient walks in. after examining his amalgam restoration it is found that their is a gap that is >.5 mm. does it need to be restored?

A

yes.

anything amalgam >.5 is deemed carious or caries- prone

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41
Q

amalgam looks bluish. does it need to be re-restored?

A

no. this is due to corrosion. it is not classified as defective.

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42
Q

natural tooth occluding against crown is started to become defected. what is this called>

A

abrasian

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43
Q

hypersensitivity of tooth is resukt of exposure of what?

A

dentinal tubules in root surface

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44
Q

a patient complains about sensitivty. what can you guve them to help occlude dentinal tubules?

A

GLUMA

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45
Q

what is hydrodynamic theory?

A

pain from dentinal fluid movement stimulates mechanoreceptors near predentin

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46
Q

criteria for resotring a tooth is when lesion extends where?

A

to DEJ !!!!

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47
Q

the purpose of preventitive dentistry is to encourage what?

A

REMINERALIZATION of incipient SMOOTH surface lesions

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48
Q

what is a smooth surface lesion?

A

lesion where there is no pits or grooves

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49
Q

preventitive dentistry for pits and fissures?

A

sealants

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50
Q

excavators used for what part of tooth?

enamel
dentin
calculus

A

dentin ( spoon)

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51
Q

chisels used for what part of tooth?

enamel
dentin
calculus

A

enamel

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52
Q

10-90-7-14

what does the 10 tell you?

A

width of blade ( 10=1mm)

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53
Q

10-90-7-14

what does the 90 tell you?

A

cutting angle

sometimes 90 is missing

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54
Q

10-90-7-14

what does the 7 tell you?

A

legth of blade (7= 7mm)

55
Q

10-90-7-14

what does the 14 tell you?

A

angle of blade

56
Q

what do the 4 numbers on isntrument tell you?

10-90-7-14

A

width-cutting angle- length- blade angle

57
Q

slow speed vsmed speed vs high speed RPM

A

slow: 12,000
med: 12,000 - 200,000
High : >200,000

58
Q

for cutting efficacy do you want 6 blades or 40 blades?

A

6 blades

59
Q

for smoothness do you want 6 blades or 40?

A

40

60
Q

dimensions of 245 bur and shape

A

pear shaped

3 mm x .8 mm

61
Q

dimensions and size of 330 carbide

A

pear

1.5 x .8

62
Q

tapered fissure bur is what bur

A

169L

63
Q

what is worse in terms of C factor class 4 or class 1?

A

class 1

64
Q

what are the internal prepped walls?

A

Axial

Pulpal

65
Q

what is a line angle?

A

junction of 2 walls ( step)

point angle is junction of 3 walls

66
Q

what always gets .5 mm of clearnace?

A

gingival floor

67
Q

does all demineralized enamel need to be removed?

A

yes b/c bonding agent not as affective

68
Q

resistence vs retention

A

resistence: prevention of tooth or restoration fracture from occlusal forces

retention:
prevention of displacement of restorative material

69
Q

2 primary retention features for restoration?

A

convergent walls

dovetail

70
Q

2 primary resistence forms for resotration?

A

flat pulpal gingival floor

rounded internal line angles

71
Q

restoration that has <1mm exposure and is asymtpomatic, what would you do?

A

direct pulp cap

72
Q

resoration has >1 mm exposure and symtpomatic what do you do?

A

RCT

73
Q

what is a sealer used and an example?

A

sealer used for senesitibity ( desenstitiver)

occludes dental tubules
GLUMA

74
Q

what do you use for direct or near direct exposure and example?

A

Liner

CaOH or RMGI

75
Q

what are 3 fxns of liner?

2 examples?

A
  • electrical insulation
  • thermal protection
  • pulpal treatment (formation teritary dentin)

caoh rmgi

76
Q

this is used for METAL restorations whenever liner is used

example

A

RMGI or GI cememnt

77
Q

what does base do for protection

A

thermal protection ( amalgam or gold restorations)

78
Q

what to use for amalgam with remaining dentin thickness (RDT) of
>2mm
.5-2 mm

A

sealer
base, sealer
liner base sealer (glumma seals dent. tubes)

79
Q

what to use for composite with remaining dentin thickness (RDT) of
> .5 mm
< .5 mm

A

bond

liner, base , bond

80
Q

what to use for gold or CERAMIC with remaining dentin thickness (RDT) of
>2mm
.5-2 mm

A

cement

cement ( 2 mm thick) \liner, base, cement

81
Q

what is secondary resistence and retentive forms?

A

retentive grooves (amalgam)
beveled enamel margin
slots
pins

82
Q

dimensions of slot

A

1 mm deep
1 mm long
.5 mm inside DEJ

83
Q

type of bur to use fir smooth walls?

A

carbide

84
Q

for RETENTION on amalgam prep, does occlusion converge or diverge?

A

converege

85
Q

what degree does pin have to be for retention?

A

2

86
Q

for resistence of amalgam, what depth does it have to be for adequate thickness

A

1.5- 2 mm deep

87
Q

type of bur to use to roughen walls

A

coarse diamond

88
Q

what does composite resotration not need compared to amalgam

A

retentive, occlusalal convergence, uniform depth

89
Q

for gold onlay describe how the skirt and collar should look like

A

skirt: feather-edged
collar: beveled shoulder around capped cusp

90
Q

what is eames ratio?

A

50% mercury

50% metal alloy ( tin, copper, zinc)

91
Q
which metal helps with corrosion?
silver
tin
zinc
copper
A

tin

92
Q
which metal helps wotj strength>
silver
tin
zinc
copper
A

zilver/ copper

93
Q
which metal is a deoxidizer 
silver
tin
zinc
copper
A

zinc

94
Q

strongest type of mercury?

gamma 2, gamma 1, gamma

A

gamma 1

95
Q

trituration of mercury that comes out wet, soft is indication of what?

A

over-trituration

96
Q

trituration of mercury that comes out dull, crumble is indication of what?

A

under-trituration

97
Q

normal titration mix is supposed to look how?

A

shiny, smooth

98
Q

alloy that is low in copper has what percentage of copper and results in what gammas?

A

<12%

y, y1, y2

99
Q

alloy that is high in copper has what percentage of copper and results in what gammas?

A

> 12%

y and y1 ( less corosion and less creep)

100
Q
spherical alloy vs admixed
- which is easier to condense?
-which is stronger?
better proximal contact?
- which sets faster?
A

spherical is easier, stronger, sets faster

admixed: better proximal contact

101
Q

restorative material to use when isolation is hard?

A

amalgam

102
Q

5 reasons marginal ridge fractures?

A
axiopulpal line angle not rounded
high MR
incorrect occlusal embrasure 
improper matrix rmeoval
overzealous carving
103
Q

how are walls prepped in vlass V amalgam ?

A

divergent
four corner coves ( occlusal and gingival line angle grooves or circumfrential grooves are all equally effective for retention)

104
Q

if mercury spills how do you clean it up?

A

vacuum

SULFUR POWDER

105
Q

acute mercury toxicity symptoms

A

hypotonia
alopecia
weight loss
exhaustion

low muscle, low hair, low weight, low energy

106
Q

what is the most toxic form of mercury

elemental mercury
methlymercury
mercury salt

A

methylmercury ! ( from seafood)

107
Q

what type of mercury is in amalgam
elemental mercury
methlymercury
mercury salt

A

elemental mercury ( liquid)

108
Q

what type of mercury is inorganic
elemental mercury
methlymercury
mercury salt

A

salt

109
Q

what is more reliable, dentin or enamel bonding?

A

enamel

110
Q

why is dentin bonding more difficult?

in terms of 
composition
structure
depth
smear layer
A

enamel: 90% mineral/ 2% organic
Dentin: 50% mineral/ 25% organic

enamel: rods parallel
Dentin: collagen bowl of spaghetti

Dentin: dentinal tubules larger and more numerous
smear layer decreasesd dentin permeability

111
Q

etch:
type of acid?
how long to etch for?
what does it do to dentin and enamel

how long to rinse for?

A

phosphoric acid/ 15 seconds

enamel: creates MICROPOROSITIES
dentin: exposes COLLAGEN , widens dentinal tubules

10 seconds. LEAVE MOIST

112
Q

more likely to get contact dermatitis from what? **

A

primer ( HEMA)

113
Q

function of primer ?

A

prevents COLLAGEN COLLAPSE

infiltrates enamel prisms and dentinal tubules

114
Q

this chemically binds to underlying primer to overlying composite resin

A

Bond/ adhesive

though MMA BOND (optibond solo pluss)

air dry to evaporate solvent and leave monomer

115
Q

what happens when you air dry bond?

A

evaporates solvent and leaves monomer( MMA bonds)

116
Q

what is the hybrid layer?

how does it function?

A

interference b/w tooth and adhesive

resin tags: adhesive resin locks into microporosities of etched enamel and intertubular dentin

117
Q

what is the key to adhesive dentistry

A

micromechanical bond

118
Q

gold standard etchant generation? how many steps?

A

4th

3 steps
acid
primer
adhesive

119
Q

what 3 things is Composite resin made of?

A
Bis-GMA ( resin matrix)
FIller particles ( silica)
coupling agent ( silane; combines top 2)
120
Q

what is better. macro fill or microfill composite?

A

macrofill
80% filler ( larger composite= more strength)

hgier filler= less water absorption

121
Q

self cure vs light cure composite?

initators ?

A

self:
2 paste system
initatior: BENZOYL PEROXIDE
activator: tertiary amine

light cuure:
single system
- photoinitiator: camphorquinone
468 nm light needed to initiate poymerization

122
Q

nm of light to initate light cure composte

A

468

123
Q

initiate for self-cure vs light cure

A

self cure: benzoyl peroxide

light xure: camphorquinone

124
Q

what is better. High C factor or lower ?

A

Higher = less bound surfaces so higher amount of shrinkage

better: low

125
Q

c factor for class 3 ?

A

3(bound): 3 (unbound) = 1

126
Q

what has the worst C factor?

A
class 1:
C factor of 5

5(bound surfaces): 1 (unbound suraface)

127
Q

what is the best C factor?

A
class 5
1:5 = cfactor of .2
128
Q
GI vs CR
made of ?
bonding?
which is stronger? 
fluoride release?
A
GI ( salt-matrix) : 
ACID. BASE !! : polyacrylic acid/ Fluorsilicate glass
self-adhesion 
CHEMICAL BOND 
fluroside release 
weaker

CR (resin matric) :
MATRIX FILLER !: Bis-GMA / silicate glass
LIGHT/ SELF CURE MICROMECHANICAL BOND
no fluoride release

129
Q

RMGI is set by what?

A

acid-base rxn ( from GI)
free-radical addition ( resin)

more rapid polymerixation thanks to free radical

130
Q

when should Compomers ( polyacid Modified resin composite) be used and how is it different thatn CR and GI

A

Orthodontics !!

it is anyhydrous ( no water!!)
slower polymerization allows more time to clean up excess
fluroide releasin

131
Q
which of the following materials are used for ortho?
GI
RMGI
Compomers
Ionomer Modified composite
A

componers

132
Q
which of the following materials has slow polymerization making it ideal to clean up excess?
GI
RMGI
Compomers
Ionomer Modified composite
A

componers

133
Q
which of the following materials has rapid polymerization?
GI
RMGI
composite 
Compomers
Ionomer Modified composite
A

RMGI ( from free radical addition polymerization from resin)

134
Q
which of the following materials has no fluroide release ?
GI
RMGI
composite 
Compomers
Ionomer Modified composite
A

CR