Operative II Review

Question 1

skipped
ISOLATION OF OPERATING FIELD
* But Why?
(6)

Answer 1

• Better visualization
• Better access
• Prep walls dry and clean
• Your materials work better https://www.researchgate.net/figure/Minimally-invasive-distal-slot-preparation_fig14_237388550
• Improved properties- direct contact of varnish/liner/base with cavity walls
• Moisture affects bond as well as materials ability to set up
• Prevents injury to patient soft tissues
• Prevents aspiration and swallowing of debris

Question 2

Components of Dental Dam set up
(4)

Answer 2

• Rubber sheet, clamp, frame, punch, forceps
• Rubber sheet
• Different sizes rubber material
• Different thickness (gauges)

Question 3

• Rubber sheet
  (2)

Answer 3

• Dull side faces operator
• Shiny side against patient tongue, palate

Question 4

• Different sizes rubber material
  (2)

Answer 4

• 5x5 pediatric patients
• 6x6 adults

Question 5

• Different thickness (gauges)
  (5)

Answer 5

• Thin 0.006” (used only for very tight contacts)
• Medium 0.008”
• Heavy 0.010”
• Extra Heavy 0.012”
• Special Heavy 0.014”

Question 6

Frame
(2)

Answer 6

• Metal
• Plastic- can be radiographed

Question 7

Punch
(2)

Answer 7

• Choose appropriate hole size based on tooth size
• Anchor tooth gets largest hole

Question 8

Forceps
(2)

Answer 8

• Used to place clamp
• Holes in clamp correspond to extension in forceps

Question 9

ISOLATION OF OPERATING FIELD
* Extremely important in composite cases
(4)

Answer 9

• USE RUBBER DAM
• Bonding requires uncontaminated surface
• Technique sensitive!
• Wet field= recurrent caries or failed bond

Question 10

ISOLATION OF OPERATING FIELD
Class II=

Answer 10

one tooth posterior, two teeth anterior to tooth you’re working on
* ONE TOOTH BEHIND (anchor) and TWO TEETH IN FRONT

Question 11

ISOLATION OF OPERATING FIELD
Anteriors
(2)

Answer 11

• Canine to canine
• Or can clamp on one premolar

Question 12

ISOLATION OF OPERATING FIELD
* Pediatric-

Answer 12

only isolate teeth necessary

Question 13

ISOLATION OF OPERATING FIELD
* Endo-

Answer 13

single tooth

Question 14

ISOLATION OF OPERATING FIELD
General isolation/FDP-

Answer 14

general field isolation
* May be acceptable to cut a slit between holes

Question 15

ISOLATION OF OPERATING FIELD
(6)

Answer 15

1. Prep work
   * punch holes in rubber
   * check contacts for floss shredding
   * Smooth contacts if necessary
   * mark occlusion
2. Place clamp in dam
   * Don’t forget to tie clamp with floss
3. Place dam over tooth
   * Can do with or without frame in place
4. stretch dam through contacts
   * Floss between contacts
5. Invert dam
   * Delicately blow air around cervical area and push rubber into sulcus
   with plastic instrument
6. Ligate anterior tooth /
   * Ligate with ligatures or piece of rubber dam cut and placed
   interproximally

Question 16

Cotton rolls
(2)

Answer 16

• Placed in vestibule
• Wet when removing to avoid “cotton roll burn”

Question 17

Dry Shield (parotid shield, cellulose wafer)
(2)

Answer 17

• Blocks parotid, retracts and protects cheek
• Wet when removing to avoid “cotton roll burn”

Question 18

2x2 gauze
(2)

Answer 18

• Least effective
• Works well as throat pack

Question 19

Cotton Pellets
(2)

Answer 19

• Remove moisture from inside preparation
• Remove moisture when patient is sensitive to air and water spray

Question 20

High evacuation suction
(4)

Answer 20

• Vented is better- reduces sucking up of tongue and mucosa
• Very effective at picking up debris
• Can be used to retract tissue
• Leave room for water from handpiece to cool the tooth

Question 21

Saliva Ejector
(3)

Answer 21

• Ineffective at removing debris
• Do NOT have patient close lips around suction
• Backflow, extra gross

Question 22

Svedopter

Answer 22

• Old fashioned isovac

Question 23

Additional tools:
(3)

Answer 23

• Retraction cord
• Bite Block
• Anterior lip retractors

Question 24

— is the optimal method
* Get good at placing it!
* Fast and efficient
* Makes life easier

Answer 24

Rubber dam

Question 25

D1 (Dentin-first layer):

Answer 25

caries extends only to first third of dentin Treatment planning consideration: restore surgically or attempt to remineralize

Question 26

D2 (Dentin-second layer):

Answer 26

caries extends to middle third of dentin Treatment planning: restore surgically

Question 27

Interproximal clearance= --- Facial, lingual, and gingival

Answer 27

0.5mm

Question 28

Once ideal outline form is achieved, remove caries (2)

Answer 28

* Spoon excavator * Round bur on slow speed handpiece

Question 29

Refine prep (2)

Answer 29

* Plane axiopulpal line angle - Reduces stress * Plane gingival margin - Use margin trimmer - This removes loose enamel rods

Question 30

amalgam Good condensation is important! * Fill --- first * Fill --- above margins

Answer 30

Box 1.0mm

Question 31

Begin carving (3)

Answer 31

* Carve mesial incline of marginal ridge using explorer * Pre-carve burnish * Carve with Hollenback

Question 32

CLASS II AMALGAM MODIFICATIONS * Maxillary molars (3)

Answer 32

Do not cross oblique ridge when possible -if less than 0.5mm thick= cross ridge -preserves resistance form

Question 33

Clean tooth * w/

Answer 33

Pumice and water mixture

Question 34

Proximal outline form (3)

Answer 34

* Must break gingival margin - CARIES must be removed - Occur just below contact - Matrix band must fit passively * Keep margins in enamel when possible * Only remove carious tooth structure

Question 35

BEVELS

Answer 35

* Lingual wall bevel * Gingival bevel * Careful- enamel is thin here * If gingival floor is in dentin/cementum, NO BEVEL * Axial-pulpal line angle bevel

Question 36

* Flare on ---

Answer 36

facial