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Flashcards in Operative II E3 Deck (115):
1

3 general types of materials for Inlays/Onlays:

Direct composites

Indirect composites

Indirect Ceramics

2

Advantages to Direct Composites:

Disadvantages

Less cost/time, simple technique, repairable

Tech. sensitive, isolation, matls not fully set

3

Advantages to Indirect Composites:

Disadvantages:

Control contours, Better Wear resist, repairable, flexible

Cost/time, isolation

4

Advantages to Indirect Ceramics:

Disadvantages:

Control contours, Best wear resist, better bond to enamel

Most cost/time, brittle, isolation, NOT repairable

5

Indirect Composite Advantages are ______ physical/chemical properties

______ polymerization shrinkage

Predictably better ______

*also great esthetics and matl advancements

increased

Zero

contacts/contours

6

Indirect Composites are _______, improving pretty much all properties over Direct Composites

Silanated

7

A big advantage to Indirect Composites is that they are compatible with what?

Enamel

*Ceramics can be abrasive

8

What has better plaque resistance, composite or ceramics?

Ceramics

9

Describe Steps to make Indirect Composite - chairside:

Prep

Impression

Silicone die (Mach III)

*make composite on silicone die

10

4 Steps Lab takes to make Indirect Composite:

(after Prep/Impression)

PVS Impression

Model poured

Separating liquid

Composite placed

11

When building up an Indirect Composite, mark borders of die red and add what?

Color, Dentin shades in layers, then Enamel shades

12

Trim an Indirect Composite build up (on die) with what?

Then add...

Then is the final ______ cycle

diamond burs

stains

polymerization

13

Final polymerization of Indirect Composites is done under what?

why?

Vacuum

Increases hardness and polishability

14

Describe Mechanical Retention method for Delivering Indirect Composites?

Roughen internal surface

Sandblast

15

Describe Mechanical/Chemical retention method for Delivering Indirect Composites?

SiO2 impregnation

Silane

16

T/F
The fastest growing segment of the dental Tx market is All ceramic restorations - annual growth of 20%

True

17

All Ceramic CAD crowns have similar success rate to what?

PFM

18

List 4 all ceramic matls of increasing strength

Hand condensation

Silica CAD blocks

LiDisilicate (Emax)

Zirconia alumina

19

Ceramics are durable but ________

Brittle

20

T/F
Ceramics are more costly than gold

False

21

Ceramics have low _______ strength

Edge

22

3 General Ceramic choices:

(w/ 3 specific products)

High glass (silica - highly esthetic)

Low Glass (LiDisilicate - Emax)

No glass (Zirconium)

23

MCC's (PFMs) are weak when...

hand layered

24

What is the main advantage of a Monolithic Restoration matl vs. a Layered?

Chipping can occur along layer lines.

*milled ceramic blocks are monolithic

25

Emax (LiDisilicate) has what intrinsic property allowing for increased flexural strength?

Large crystals

26

LiDisilicate wears similarly to what?

Enamel

27

What product is milled in a softer Blue State?

After milling, what is done?

IPS Emax CAD

Sintered, glazed, recrystallized into stronger structure

28

What all ceramic product is pressed into a Lost Wax Casting?

IPS Emax Press

29

Zirconia is very opaque, durable, can be made thinner,, wears _____ heavily, and is not ______, therefore there is little _______

Enamel

Etchable

Bonding

30

What is the advantage to bonding an all ceramic restoration?

Micro-mechanical bonding

AND

Chemical bonding via Silane coupler

31

Would you use Bond or Cement for all ceramics?

Bond

32

Should Posts be bonded or cemented?

Bonded - reduces fracture

33

Bonded ceramics allow us to be more_______ b/c of micromechanical bonding and Chemical bonding via silane coupler

Conservative w/ preps

34

All ceramic preps are similar to what 2 preps?

Zirconia/Gold

35

T/F
Zirconia can be bonded

False

36

List 3 prep designs for All Ceramics in increasing strength:

Full Wall defect (one wall)

Inlay (MOD)

Full Onlay (MOD and both L and F cusps reduced)

37

Where are the margins (in the Hood region) in All Ceramic Inlay/Onlay preps?

The Box margins are what?

All axial _____

All other walls ______

Facial and lingual walls diverge ____ degrees per side

Supragingival

Butt Joint Margins

Converge

Diverge

6-8 degrees

38

Onlay prep - Functional cusp reduction:

Non-functional cusp reduction:

1.5 - 2.0 mm

1.5 mm

39

Onlay Isthmus width minimum:

1.5 mm

40

The milling software will ______ the inside of a crown prep if there are sharp angles, etc

Over mill

*so it will seat

41

The milling software will _____ the marging

Under mill

*so will not seat

42

T/F
Best to have a roller coaster effect on Onlay preps

True

43

T/F
There is no retention/resistance form in on Onlay prep

True

*modern bonding allows for this

44

The butt joint in bonding an Onlay should be ____ degrees

80-90

45

Why is a 2nd plane of reduction important to in a Ceramic Onlay prep?

maintains thickness of restoration - avoids fracture

46

ACC prep design (Crown!) Anterior incisal:

Posterior fissure:

Posterior cusp:

1.5 mm

1.5 mm

2.0 mm

47

What shouldn't you use on Provisionals for All ceramic Onlays?

No eugenol

48

CAD CAM takes the place of what 3 traditional lab steps?

Models, dies, wax ups

49

Before Isolate/Bond an Onlay:

Try in

50

HF acid only works on _______

So, wouldn't work on what?

Glass

Zirconia

51

3 Bonding materials, starting with the best one:

Total Etch bonding resins

Self Etch bonding resins

Glassionomers

52

What bonding system allows for the most conservative, highly tapered prep?

1 Brand name?

Total Etch

Nexus III

53

What would you use Glass-Ionomer bonding system with?

Zirconia

54

After try-in, what has the Ceramic Onlay been contaminated with?

salivary phospholipid biofilm

55

Zirconia has a strong affinity to bind with what?

phosphate

56

To clean after Try In, use ultrasound for ___ minutes and Ivoclean for ___ seconds

2 minutes

20 secs

57

T/F
Ivoclean creates a larger surface by adding small metal oxide particles and has a high affinity for proteins

True

58

Pre-bonding, what not to use with Silica based ceramics?

Sandblasters

59

Only use sandblasters with what?

Zirconia

60

Do not clean the inside of a ceramic with _____ to remove biofilm

Use _____ to before applying Silane agent

phosphoric acid

Ethyl alcohol

61

What product has added dopants to Zirconia for better translucency?

BruxZir

62

How long should Silane be applied?

Keep excess within the ____ of the crown

60 secs

margins

63

In a Selective Etch Technique, etch enamel margins only _____ secs

Use ______


Lastly apply 1 layer of ______

20

CHS

SE primer

64

Tack cure CAD restoration for how long?

Then remove doughy flash with what?

Final cure how long?

1 second

floss

60 secs

65

What is recommended post cementation?

Radiographs

*find IP resin flash

66

Total etch systems are what generations?

Self etch systems are what generations?

4th, 5th

6th, 7th

67

4th Gen has how many steps?

5th gen?

3 - Etch, primer, bond

2 - Etch, primer/bond

68

What is the 4th Gen system we used?

Optibond FL

69

All in One Self Etch systems (6th gen), what can be lowered enough to etch undercut enamel?

What is retained?

What might be entrapped into the hybrid layer?

pH

Smear layer - this is a con

Water

70

T/F
6th gen systems are Prompt L-Pop, One-Up Bond F

True

71

The single component system (7th gen) is convenient and less technique sensitive but has what disadvantages?

Smear layer retained

Water absorbed into resin

72

T/F
There is no pH incompatibility with resin cements

True

73

Bonding Adhesive systems remove the smear layer with what?

pre conditioning gel

74

Everything we restore eventually fails due to what?

Hydrostatic pressure

75

Dentin Bonding Primers denature what?

Collagen

76

Resins have what relationship with water?

Hydrophobic

77

Because Intertubular dentin is the majority of Dentin Bonding, seal with what to avoid water/hydrostatic pressure?

*peritubular dentin more mineralized

GI liner

78

What is in the smear layer?

Can you rinse it away?

Debris, bacteria

NO

79

What removes the smear layer?

What bonding system does not?

Etch and rinse steps

Self etch

80

What binds the restorative matl to normal dentin?

Hybrid layer

81

T/F
Over time water trees develop

True

82

What activity increases hydrolysis of Collagen, causes Gap Separation?

MMP

83

What can you decrease MMP wit to increase bonding longevity?

CHX

84

T/F
Polymerization shrinkage can lead to restoration failure

True

85

Bonded resin surface / un-bonded resin surface

C factor

86

What does a high C factor mean?

more shrinkage/strain

87

T/F
Composite curing pulls away from the tooth

True

88

The filler in Optibond solo plus makes it milky and does what?

Increases elasticity

89

Why don't you wet your instrument with a bonding agent during placement?

Resins contain HEMA - will discolor composite

90

For deep restorations, what 4 steps?

Liner

Etch

Gluma - 20 secs

Optibond solo plus - 15 secs

91

Gluma is a ________ made specifically for ______

desensitizer

dentin

92

T/F
Gluma is made from glutaraldehyde

True

93

Research reveals the 2 most important things to do when curing are:

Correct light placement

Finger rest

94

4 curing light systems by cure time (start with fastest)

Lasers

Xenon Plasma Arc

Metal Halide

LED

95

3 ways to reduce internal stresses:

soft-start polymerization

Incremental additions

Stres breaking liner

96

A modified flowable composite that can fill the entire gingival and pulpal floor before being cured:

*up to 4 mm

Bulk Fill Composites

97

If Bulk Fill is the new paradigm, why are we still doing layered technique?

3 reasons

Wear resistance is poor

Shrinkage greater than conventional composites (increases C factor)

Microleakage greater

98

What is the main advantage to Bulk Fill (up to 4mm) technique?

Best marginal adaption

99

T/F
Best technique is still to use Flowable 1st, then add layers - will get best marginal adaption

True

100

What are the BioActive restoratives?

Giomers

101

Giomers have a surface property that does what?

Is bio-reactive

*neutralizes acids, etc

102

T/F
The future may be Giomers with Surface Sealers with nano-fillers

True

103

Each tooth should appear ____ times narrower than its mesial neighbor from the frontal view

_____ in California

1.618

1.4

104

The top of the smile line:

Zenith

105

Face height is the Rule of...

1/3rds

106

Lower Face height is the rule of ...

2.3rds

*upper lip 1/3, lower lip to chin 2/3

107

T/F
Youthful teeth have Prikymata and Mamelons

True

108

T/F
A rounded face will have wider teeth proportionally and a longer face will have narrower teeth proportionally

True

109

Esthetic inclinations: CI's

LI's:

Canines:

vertical

mesially inclined

vertical

110

T/F
Primary planes align with the long axis of the tooth and have a slight mesial prominence

True

111

T/F
With a normal smile, pts maxillary incisal edge should just lightly touch or miss lower lip

True

112

T/F
The Zenith of each tooth should be slightly distal to the center

True

113

Tx sequence basics Perio Health:

Caries Control:

TMJ/Occlusal Stability:

Specialty Tx:

Color:

Fixed/removeable Tx:

Ceramics:

Composites:

Maintenance:

Phase 1

Phase 1

Phase 2

Phase 2

Phase 3

Phase 4

Phase 5

Phase 5

Phase 6

114

The Smear Layer may reduce dentin permeability be as much as ___%

86

115

What bur creates a very thick smear layer?

Diamond

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