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Flashcards in Operative II Deck (113):
1

After caries risk, describe the 3 Phases of Treatment Prioritization:

Phase I: Emergency infection, pt discomfort, prevention, gingival health, and sealants

Phase II: Simple restorations

Phase III: Complex restorations

2

What are the 7 Orderly Steps to the approach to restoring Individual Teeth?

Outline form

Retention form

Resistance form

Convenience form

Removal of remaining carious dentin

Finish enamel walls/cavosurfaces

Cleanse preparation

3

Opposing teeth often hit a _______, an area with a lot of function.

Marginal Ridge

(any ridge, really)

4

What is the junction between an unprepared tooth (normal tooth) and prepped tooth?

Cavo-surface

5

T/F
A line angle is between 2 walls/floors and a Point Angle is between any 3 walls/floor.

True

6

Pits and fissures of occlusal surfaces on Posterior Teeth are ______ cavity preparations.

Class I

7

What class are pits in the occlusal 2/3 of facial and lingual surfaces of molars?

Class I

8

The lingual pits of maxillary incisors in the top 2/3 of the tooth are considered what class?

Class I

9

The proximal surfaces of posterior teeth (premolars and molars) are what class of prep?

Class II

10

The proximal surfaces of anterior teeth not involving the icisal edge are what class of prep?

Class III

11

The proximal surfaces of anterior teeth involving the incisal edge is what class of prep?

Class IV

12

The surfaces of all teeth in the gingival 1/3 of facial and lingual surfaces are what class of prep?

Class V

13

The incisal edge of anterior teeth and occlusal cusp tips of posterior teeth are what class of prep?

Class VI

14

What is the diameter of an explorer?

1mm in 0.5 mm wide

15

Round bur #'s:

Inverted cone #:

Egg #:

Needle #:

Round: 1/4, 1/2

Inverted Cone: 33

Egg: 379

Needle: 135

16

Straight bur #'s:

Pear #'s:

Tapered #:

End cutting #:

56, 57

330, 244, 245

169

956

17

Enamel is ___% inorganic, 3% water, and ___% organic

Dentin is ____% inorganic, 20% water, and ___% organic.

96, 1

75, 5

18

Dentin is ___ times softer than Enamel

5

19

T/F
In the pain response, neuropeptides are released and vasodilation occurs, following by Odontoblastic swelling and closing of the Dentinal Tubule. From here, minor fluid changes distend odontoblasts and create pain.

True

20

T/F
Pulp is made up of mostly pain fibers

True

21

Name 4 causes of Pulpal Inflammation.

Dessication (drying)

Heat (bur friction)

Osmotic changes (sweets)

Bacterial (endotoxin, invasion, etc)

22

Drilling depths closer than ___ mm affect the pulp more severely.

2 mm

23

Where are dentinal tubules smallest?

Largest?

DEJ

Pulp

24

T/F
Coolants are mandatory for Diamond Burs

True

*abrade, cause subsurface cracks

25

T/F
25-35% of D1 students aren't unsurable

True

26

T/F
Leaning forward causes 40% increase in pressure on spine

True

27

T/F
Your neck should be limited to a flexion of ___ degrees.

20

28

T/F
One reason to use a rubber dam is to reduce humidity when bonding restorations

True

29

T/F
Endodontic procedures may or may not use a rubber dam

False

*mandatory!!

30

T/F
Most dentists dam to the ipsilateral cuspid, but he contralateral cuspid is ideal (and what is used in skoo)

True

31

#'s for rubber dam clamps on Molars

Premolar

Anterior

Molar: 14, W8

Premolar: 2A, W2

Anterior: 212, 9

32

You could use a symmetrical clamp for a maxillary molar, but never use ________ for a mandibular molar.

Assymetrical

*Lower molars are symmetrical
**Upper molars are asymmetrical

33

# 2 hole in the punch table is used for ______

#1 hole is used for _____.

Max incisors

Mand incisors

34

T/F
The Isolite system is an alternative to a Rubber Dam

True

35

Sealants can either be _____ or ______.

Unfilled Resin (Bis-GMA)

Filler in Resin (quartz/silica)

*filler usually less than 50%

36

Sealants 2 types of cure:

Chemical (auto polymerizing 2 components)

Light cured (20 seconds - held at least 1 mm from tooth)

37

What % of children 6-19 have dental caries in permanent teeth?

Of these, what's the high risk breakdown?

42%

20% had 80% caries

38

T/F
Sealants are underused

True

39

The sealant prevalence on permanent teeth of children is about _____%

30

40

T/F
Sealants reduce caries 60-75% at 4 years

True

41

The detection of early lesions should be discovered via _____, not _____.

Radiographs

Explorers

***however, no radiograph should be given solely to determine sealant placing. Caries Risk Assessment primary.

42

A sealant can be placed if the occlusal surface of a posterior tooth has a noncavitated carious lesion with a ____________.

White demineralization line

*around margins

43

Name 6 risk factors used for sealant use criteria.

Age

Oral hygiene

Current caries or hx

Diet

Fluoride hx

Tooth type/morphology

44

T/F
Certain people have the particular tooth morphology of Deep Pits/Fissures, putting them at high caries risk

True

45

Rank Caries Susceptibility by Tooth Type dependent on Pits/Fissures:

(5)

*memorize this question

1 - Lower Molars (50%)

2 - Upper Molars (35-40%)

3 - U/L 2nd Premolars

4 - Upper Laterals and 1st Premolars

5 - Upper Centrals and Lower 1st Premolars

46

What are 3 conditions not indicated for sealants?

Occlusal/Proximal caries

Well coalesced pits/fissures

Caries free for years

47

Someone in Lowe Caries Risk has had _________, good oral hygiene/diet, regular dental visits, and adequate F exposure.

*Additionally coalesced/shallow pits/fissures

No caries in last year

48

To Apply Sealants:

1. Isolate with rubber dam

2. Cleanse pumice

3. Rinse and Dry (10 seconds)

4. Apply Acid for ____ seconds

5. Rinse and Dry (if contaminated, re-etch ____ seconds)

6. Apply sealant

7. Cure ____ seconds

87. Check retention, occlusion, and contacts

Apply Acid 20 seconds

Re-etch 15 seconds

Cure 20 seconds


**re-re etch 30 secs if needed

49

330 D

Head size:

Cutting length:

0.8 mm

2.0 mm

50

330

Head size:

Cutting length:

0.9 mm

1.6 mm

51

34 D

Head size:

Cutting length:

0.9 mm

1.0 mm

52

245

Head size

Cutting length

0.8 mm

2.8 mm

53

T/F
90% of sealants are NOT prepared with a mechanical bur (non-invasive)

True

54

Etched teeth have better...

Wettability

55

Rinsing teeth (or swiping with gauze) immediately after a sealant is placed does what 3 things:

Removed oxygen inhibited layer in sealant

Removes bad taste

Limits BPA Xenoestrogen exposure

*2-5 times lower BPA exposure than daily food/environment

56

T/F
If there are contact marks on sealant, football diamond or #7404 bur can be used to adjust occlusion.

True

57

T/F
Last step or sealant placement is flossing (insures none has run over to proximal)

True

58

If sealants fail, all or part of sealant comes off within ___ months

However, the worst failure is the sealant that _____, and eventually there will be discoloration at the margins.

3-6

leaks

59

GIC, glass ionomer sealant, releases fluoride - what is its downside?

Not as retentive as resin

*only used as interim sealants

60

T/F
GC Fuji Triage is a new product that releases 6 times the F as GIC

True

61

PRR:

Preventative Resin Restorations

62

Name 3 diagnostic tools that may determine whether a PRR is necessary.

Radiograph

Explorer

DIAGNOdent

63

T/F
There are no minimum depth or width requirements in a PRR

True

64

T/F
The 132F diamond and the 1/4 round burs can both be used in PRR

True

65

T/F
All stained dentin needs to be removed in a PRR

False

not if it is hard (just stained)

66

T/F
Undermined enamel is OK in PRR

True

67

After caries removal, the 1st step in a PRR is...

35% phosphoric acid etch for 10 seconds - to enamel

10 more seconds to dentin

*enamel therefore 20 seconds

68

T/F
After etching dentin in a PRR, it should be completely dried

False

*needs somewhat wet or collagen fibrils collapse (no more shag carpet to bond with)

69

What 2 types of bonding agent are used in PRR?

*How long are each cured?

Dentin/Enamel Bonding Agent (low viscosity resin)

Flowable (packable)

*20 seconds

70

Step 1 PRR, the low viscosity bonding agent is scrubbed for ____ seconds

Then,

Then, 20 seconds exposure to light to harden

12

Dry gently - removes solvents and water

71

Flowable composite is easier to get in tight areas, has high polymerization shrinkage, and _____ wear resistance.

Microhybrid (packable) is difficult to condense into tight areas, has lower polymerization shrinkage, and _____ wear resistance

Poor

Better

72

The microhybrid composite (packable, Step 2 PRR), should be packed incrementally no more than __ mm thick

2

*each increment cured 20-40 seconds

73

If your grooves in a PRR are only in enamel and too small for packable composite, ______ can be used.

Flowable composite

*layer and cure

74

If the preparation is large enough in a PRR, use only ______ composite.

Microhybrid

*multiple layers

75

Trimming excess PRR can be accomplished with _____ football diamond bur, and the normal anatomy can by re-established with a ______ bur

397 F

247 EF diamond

76

To polish the PRR, 1st use ____ color, then use _____ color

3rd use____

Green

Yellow

Brush

77

What is the unfilled resin used to reseal margins at the end of a PRR

Is this a substitute for polishing?

Do you have to re-etch?

Glaze

No

Yes

78

What is the major disadvantage to sealants?

Longevity

79

What is the avg lifespan of PRR composite?

Amalgam?

5 years

10 years

80

Why isn't amalgam as technique sensitive as other options?

Corrosion self seals at borders

81

Why don't you want to cut into triangular/marginal ridges?

Structural integrity of tooth

82

T/F
When cutting outline, avoid making marginal ridge too thin and cutting into triangular ridges

Also, cavo surface shouldn't end at opposing contacts

True

83

Do not cut across the Transverse ridge of the _______

or the Oblique Ridge of the _______

Lower 1st Premolars

Upper permanent Molars

84

What is the minimum depth starting at the Central Groove for class I occlusal amalgam preparation?

1.5 mm

85

How wide should an isthmus be in an amalgam prep?

Ideally, the isthmus should be ______ in the tooth.

1.0 mm

centered

86

Why should internal line angles be rounded?

Protects by reducing stress across the area

87

The smaller the isthmus, the ____ the convergence can be

Greater

88

In Mandibular molars, the center of an amalgam prep should be off-centered in which direction?

The Mandibular 2nd premolar position should be...

The 1st premolar...

Slightly facial

centered

Don't cut across Transverse Ridge

89

What are 5 Factors Determining outline form?

Conservation tooth structure

Caries

Undermined enamel

Decalcified enamel

Extension for Restorability

90

What are 5 Modifying Factors of Outline Form?

Type of restorative matl used

Esthetic requirement

The patient

Occlusion

Tooth position/size

91

What matl can have a curved angle of departure?

Gold

92

Why is a small amount of undermined enamel ok in composite?

Bonds to tooth

93

What are the design features that lock a restoration and prevent failure?

Retention form

94

Amalgam bonding resin, slots, pins, are examples of...

Increasing retention form

95

How many mm's are required to retain a crown?

4 mm

96

The 1.5 mm minimum required height at the central groove for an amalgam prep is how high at the walls (cavo-surface)?

2 mm

97

Minimum Axial depth in a slot prep is ___ for bicuspids and ____ for molars.

1 mm

1.2 mm

98

T/F
The larger the isthmus the greater chance for cusp fracture

True

*but still needs 1mm min.

99

T/F
Amalgam creates a lot of internal strain via thermal expansion

True

100

What is the exception to floors being perpendicular to occlusal surfaces?

Lower 1st premolar

*pulp extends high

**If tooth was very lingually inclined, drill nearly horizontal

101

In what scenario would you make the bevel on the Axio-pulpal line angle larger (class II prep)?

Pulpal floor shallow and proximal very deep.

*otherwise can lead to fracture

102

T/F
The rationale for good separation in class 2 (0.5 mm) is convenience bases

(place band, avoid damage adjacent, access to carve amalgam)

True

103

Can we maintain contact on proximal extensions?

Yes

Class III's

104

What is the rationale behind conservative slot preps and their designs?

Amalgam strength improvement

105

What is the Old amalgam with 388 compressive strength?

What is New amalgam with 545 compressive strength?

Velvalloy

Tylin

106

Retention grooves are added with a _____ bur in a slot prep.

1/4 round

107

Why are retention grooves not cut into the axial wall?

(cut into facial/lingual wall)

Avoid pulp

108

Axial extension of the slot prep is ___ mm premolars

___ mm molars

1 mm

1.2-1.5 mm

109

If amalgam exits the enamel at more than 90 degrees....

If amalgam exits the enamel at less than 90 degrees...

Amalgam too thin = fracture

Enamel undermined = fracture

110

T/F
Fully cleaning and disinfecting are key steps before placing amalgam

True

*Gluma scrubbed 30-60 secs

111

T/F
Before placing amalgam, dry tooth of excess moisture, but don't over-dry dentin (can reduce bonding)

True

112

T/F
Pt head should be above belly button to mid thorax

True

113

T/F
Finger rests can be across the same arch, but never on different arches.

True

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