Operative Midterm Flashcards by Meghan Graham

A patient comes in claiming that their holistic doctor told him that he has an allergy to mercury and needs only white fillings. Your best response is:

A. There is no such thing as a mercury allergy: plus, there is no mercury in amalgam fillings
B. You might have a mercury allergy, but that is very rare; plus, there is no mercury in amalgam fillings
C. There is no such thing as a mercury allergy; plus, with proper isolation and technique, your exposure will be minimal
D. You might have a mercury allergy, but that is very rare; plus, with proper isolation and technique, your exposure will be minimal

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Which tooth requires special attention when preparing the occlusal aspect for a restoration?

a. Mandibular first premolar
b. Mandibular second premolar
c. Maxillary first molar
d. Maxillary first premolar

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All of the following statements are true concerning posterior composite restorations, except:

a. Posterior composites are contraindicated in patients with high caries risk
b. Posterior composites are contraindicated for cusp replacements unless a dry operating field is maintained
c. Posterior composite restorations are contraindicated in a patient with     heavy occlusion (bruxism)
d. Posterior composite restorations may be indicated for the restoration of     Class II cavities in premolar teeth where the appearance is very important,     the cavity margins are in the enamel, and the occlusal contacts are on the     enamel
e. Posterior composite restorations are frequently indicated in the treatment     of occlusal lesions that allow for conservative preparations

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Which restorative material has the lowest thermal conductivity and diffusivity?

A. Amalgam
B. Gold
C. Unfilled resin
D. Filled resin

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The physical properties of amalgam, properly placed, are sufficient to restore small to moderate sized lesions. Which of the following is the main limitation of dental amalgam in the larger cavity?

A. The difficulty in restoring full proximal and occlusal anatomy of the tooth
B. The difficulty in obtaining mechanical retentive designs in the remaining tooth structure
C. The risk of introducing additional mercury into the oral environment
D. The risk of pulpal sensitivity increases with the size of the restoration

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Because it shrinks on setting, there is always a risk of microleakage around a composite resin restoration. What is the most effective method of minimizing the effect of that shrinkage?

A. Place a dentin adhesive prior to placement of the composite resin
B. Base the cavity with a glass ionomer cement, then place the composite resin
C. Base the cavity with glass ionomer cement, place an enamel adhesive over the base and the enamel, then place the composite resin
D. Base the cavity with IRM, place a dentin adhesive over the base, place the enamel adhesive over the enamel, then place the composite resin

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Name four advantages for using dental amalgam as a restorative material.

Ease of use

High compressive strength

Excellent wear resistance

Long life

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Name three disadvantages to using dental amalgam as a restorative material.

Less conservative

Non-insulating

Non-esthetic

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Name four indications for using dental amalgam as a restorative material.

Restorations that are not in highly esthetic areas

Restorations that cannot be well isolated

Less expensive last longer

Hygiene is poor

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Name three advantages for using composite resin as a restorative material.

Can be more conservation

Insulating

Esthetic

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Name five disadvantages to using composite resin as a restorative material.

Difficult to place well

Isolation from moisture essential

Poor long-term clinical research results = shorter life

Polymerization shrinkage

Require excellent oral hygiene

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The preparation of a tooth to receive dental amalgam as a restorative material should be precise and meticulous. The placement technique of composite resin should be precise and meticulous.

a. Both statements are true
b. The first statement is true, the second statement is false
c. The first statement is false, the second statement is true
d. Both statements are false

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How do preparations for amalgam restorations differ than preparations for composite resin?

A.Preparations for dental amalgam should not have round line angles
B. Preparations for composite resin may be more conservative - the others seem incorrect
C. Preparations for composite resins do not need retentive features such as converging walls
D. All of the above

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Tofflemeir matrix bands can not be used to help restore Class II composite resins.

True
False

False

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Please put in order 1-10, the steps of use for Peak Universal bond: (5 points)

    \_\_\_\_ Rinse vigorously for 5-10 seconds
    \_\_\_\_ Lightly dry (one second of an air blast or one second of high                      volume suction over the prep or blot dry with cotton)
    \_\_\_\_ Air dry at half pressure for 10 seconds
    \_\_\_\_ Light cure for the recommended time
    \_\_\_\_ Lightly dry (one second of an air blast or one second of high                      volume suction over the prep or blot dry with cotton)
    \_\_\_\_ Begin placement of composite resin
    \_\_\_\_ Etch the enamel and dentin for 20 seconds
    \_\_\_\_ Scrub for 10 seconds
    \_\_\_\_ Apply Peak
    \_\_\_\_ Scrub in Consepsis 2% Chlorhexidine

Please put in order 1-10, the steps of use for Peak Universal bond: (5 points)

    \_\_2\_\_ Rinse vigorously for 5-10 seconds
    \_\_3\_\_ Lightly dry (one second of an air blast or one second of high                      volume suction over the prep or blot dry with cotton)
    \_\_8\_\_ Air dry at half pressure for 10 seconds
    \_\_9\_\_ Light cure for the recommended time
    \_\_5\_\_ Lightly dry (one second of an air blast or one second of high                      volume suction over the prep or blot dry with cotton)
    \_\_10\_\_ Begin placement of composite resin
    \_\_1\_\_ Etch the enamel and dentin for 20 seconds
    \_\_7\_\_ Scrub for 10 seconds
    \_\_6\_\_ Apply Peak
    \_\_4\_\_ Scrub in Consepsis 2% Chlorhexidine

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Incremental placement of composite resin is the standard we teach at the school of dentistry. A salesperson enlightens you on the advantages of using a bulk fill technique. What are some concerning questions you might have for this person? (Let’s come up with three questions)

What about polymerization shrinkage?

What is the depth of the light cure?

What is different about the composition of this material?

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Which of the following statements regarding the choice between using a composite resin or amalgam restoration is true?
A. Establishing restored proximal contacts is easier with composite.
B. The amalgam is more difficult and technique-sensitive.
C. The composite generally uses a more conservative tooth/cavity preparation.
D. Only amalgam should be used for Class II restorations.

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Rounding internal cavity preparation angles is part of what form in cavity preparation?
A. Resistance form
B. Retention form
C. Convenience form
D. Outline form

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Advantages of using silver amalgam as a restorative material include all of the following, except:

a. Long life of the restoration
b. Insulates the tooth    
c. Excellent wear-resistance
d. High compressive strength

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Advantages of using composite resin as a restorative material include all of the following, except:

a. Bonds to tooth structure
b. Esthetic
c. Great for patients with all ranges of oral hygiene
d. Can be placed in more conservatively prepared teeth

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Disadvantages of using silver amalgam as a restorative material include:

a. Difficulty of use
b. Non-esthetic
c. Occlusal wear is similar to Glass Ionomer
d. All of these

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Disadvantages of using composite resin as a restorative material include:

a. Technique sensitivity
b. Isolation is essential
c. Polymerization shrinkage
d. All of these

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Where are the three sites, on the tooth, where carious lesions most commonly begin?

Pit and Fissure
Approximal
Smooth Surface

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Which of the following is considered a reversible carious lesion?
A. The lesion surface is cavitated.
B. The lesion has advanced to the dentin radiographically.
C. A white spot is detected on drying.
D. The lesion surface is rough or chalky.

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What is the purpose of the rubber dam clamp configuration? A. Protecting the patient so they do not swallow the dam B. Easy placement and holding the dam in place C. A finger rest for the dentist D. It is arbitrary

Why is it important to have more than one tooth isolated by the dam? A. To help with color matching of composite material B. To assure proper orientation of the mouth and teeth C. To help keep proper contacts and marginal ridge height D. All of the above E. B and C

D All of the Above

``` Which of these teeth are often the most difficult to place rubber dam clamps on? A. Teeth 18 or 31 B. Teeth 8 or 9 C. Teeth 24 or 25 D. Teeth 22 or 27 ```

Why is it hard to place a rubber dam clamp on tooth #2 and #15 (assuming third molars are not present)? A. The coronoid process gets in the way when the mouth is open B. The further back in the mouth you get, the darker it gets C. Gingival hyperplasia is much more common around those particular teeth D. The unique shape of those teeth make it difficult for manufacturers to create a proper clamp to fit around them

Why are there so many different configurations of rubber dam clamps? A. Some were invented specifically to reduce reflection of lighting back into the clinician's eyes B. Teeth come in many different shapes and sizes, and so one size of clamp may be preferable to another when working with a particular tooth C. Some are made "wingless" to mitigate bulk, making working around them easier for some dentists D. Some are made with wings to provide extra retraction of the rubber dam from the field of operation E. All of the above

Tying floss to the clamp is used to help retrieve the clamp in case it comes off the tooth. The same floss is also used to push the rubber dam down into the interproximal spaces. A. The first statement is TRUE. The second statement is FALSE. B. The first statement is FALSE. The second statement is TRUE. C. Both statements are TRUE. D. Both statements are FALSE.

``` The following is not a way to protect the lip while using a rubber dam: A. Use water soluble lubricant B. Loosen dam C. Place 2x2s there D. Shaving cream E. Tighten the rubber dam frame ```

``` Why would a dentist put a rubber dam clamp gingival to the height of the contour? A. Because it's more exciting B. So that the clamp will stay in place C. It prevents gingivitis D. B and C ```

Which answer is not a purpose of the rubber dam? A. Prevent the restorative materials from entering the mouth B. Isolate the tooth from oral fluids C. Improve bonding quality D. Prevent the patient from talking

An advantage of a winged-clamp compared to a wingless clamps is: A. Winged clamps are less painful for the patient B. Winged clamps can be used on both the maxilla and the mandible C. Winged clamps prevent tearing of the dam D. Winged clamps allow a dentist to carry the dam to the tooth and place the dam and clamp simultaneously

Why would you use floss on a clamp without wings? A. To push the clamp in between the interproximal space of two teeth B. To clean the tooth before performing restoration C. To prevent the clamp from going down the patient's throat D. To wedge between the teeth to hold the clamp more securely

What do you do if a patient comes in and they need a rubber dam for a procedure but they cannot breathe through their nose? A. Send the patient home until they can come back and breathe through their nose. B. Put the rubber dam at an angle or put 2 by 2 cotton gauze in to prop the dam. C. Don't use a dam. Just use cotton rolls wedged on all sides of the teeth you are working on. D. None of the above

When punching holes in the rubber dam, punching the holes too close together can cause the dam to _______, while punching the holes too far apart can cause the dam to __________. A. tear, bunch up B. bunch up, tear

``` The use of the rubber dam is best indicated for ______. A. Adhesive procedures B. Quadrant dentistry C. Teeth with challenging preparations D. Difficult patients E. All of the above ```

A rubber dam is inverted to A. Prevent the dam from tearing B. Prevent the underlying gingiva from accidental trauma C. Provide a complete seal around the teeth D. All of the above

The rubber dam can still be used effectively even if teeth are crowded and overlapped because the hole-punch pattern does not always have to be followed. A. Both the statement and the reason are correct and related B. Both the statement and the reason are correct, but not related C. The statement is correct, but the reason is not D. The statement is not correct, but the reason is correct E. Neither the statement nor the reason is correct

When flossing the dental dam through the contact areas, it is critical to floss both edges of the punched hole at the same time. A. True B. False

False

Cotton rolls are inadequate for isolation, in most bonding situations. a. True b. False

True

Why would you use a "wedjet" or part of the rubber dam as a wedge between teeth? A. To add thickness to the rubber dam B. To hold the rubber dam in place without a clamp C. To avoid hitting the neighboring tooth D. To make it more comfortable for the patient

It is important to use natural latex for rubber dam material. True False

False

The following condition MAY preclude the use of the rubber dam, except: A. Some respiratory issues B. Teeth that are not erupted sufficiently C. Some third molars D. Time constraints E. Severely tilted teeth

An isolight or isodry can be an acceptable isolation device for restorative dentistry. True False

True

``` Another name for the corners of the mouth is __________. A. Philtrum B. Ala C. Commisure D. Vermillion Border ```

Isolation and moisture control are major contributing factors to the long- term success of bonded composite resin restorations. a. True b. True c. All of the above

``` In the conventional Class I composite preparation, retention is achieved by which of the following features? Occlusal convergence Occlusal bevel Bonding Retention grooves ``` a. b and d b. a and c c. a and d d. b and c

B. A and C

``` Bonding of resins to dentin is best described as involving _______. A. Mechanical interlocking B. Ionic bonding C. Covalent bonding D. Van der Waals forces ```

Which of the following statements regarding the choice between doing a composite or amalgam restoration is true? A. Establishing restored proximal contacts is easier with composite. B. The amalgam is more difficult and technique-sensitive. C. The composite generally uses a more conservative tooth/cavity preparation. D. Only amalgam should be used for Class II restorations.

``` Major differences between etch-and-rinse (previously known as total-etch) and self-etching primer adhesive systems include all of the following except one. Which one is the exception? A. Time necessary to apply the materials B. Amount of smear layer removed C. Bond strengths to enamel D. Need for wet bonding ```

Where, in relation to the contact area between two teeth, is a proximal carious lesion most likely to first develop? A. At the contact area B. At and immediately below the contact area C. At and immediately above the contact area D. 1.0 to 1.5 mm below the contact area

The principle goals of bonding are ______. A. Sealing and thermal insulation B. Strengthening teeth and esthetics C.Esthetics and reduction of post-operative sensitivity D. Sealing and retention E. Retention and reduction of tooth flexure

What is a major challenge of dentin/enamel bonding?

Bonding to two different substrates

Where is the area most commonly associated with the failure of composite resin restorations?

Dentin margin

When using Peak Universal Bond, according to the manufacturer, you etch the tooth with phosphoric acid for what length of time?

20s for enamel, 10 for dentin

Which of the following statements is not true regarding bonding systems? A. Although dentin bonding occurs slowly, it results in a stronger bond than to enamel. B. Enamel bonding occurs quickly, is strong, and is long lasting. C. One-bottle dentin bonding systems may be simpler but are not always better. D. Dentin bonding is still variable because of factors such as sclerosis, tubule size and tubule location.

``` Which one of the following acids is generally recommended for etching tooth structure? A. Maleic acid B. Polyacrylic acid C. Phosphoric acid D. Tartaric acid E. Ethylenediamine tetra-acetic acid ```

The smaller the contact angle of the drop of adhesive, the greater the wetting of the substrate, and thus the greater potential for adhesion. True False

True

Factors that affect the success of dentin bonding include all of the following except one. Which one is the exception? A. Dentin factors such as sclerosis, tubule morphology, and smear layer B. Tooth factors such as attrition, abrasion, and abfraction C. Material factors such as compressive and tensile strengths D. C-factor considerations

Place the following steps for the application of an etch-and-rinse (total-etch) three-step dental adhesive in correct sequence. Apply adhesive ____ Rinse etchant and leave surface moist____ Complete tooth preparation ____ Apply two to three layers of primer ____ Etch enamel and dentin with phosphoric acid for 15 to 30 seconds ____ Light-cure ____

Place the following steps for the application of an etch-and-rinse (total-etch) three-step dental adhesive in correct sequence. Apply adhesive __5__ Rinse etchant and leave surface moist__3__ Complete tooth preparation __1__ Apply two to three layers of primer __4__ Etch enamel and dentin with phosphoric acid for 15 to 30 seconds __2__ Light-cure __6__

``` Acid etching enamel prior to placement of a composite restoration is required for all of the following reasons, except: A. Conserves tooth structure B. Increases esthetics C. Provides micromechanichal retention D. Increases bonding potential ```

``` Enamel etching is typically completed with: A. 35-37% phosphoric acid B. 13% phosphoric acid C. 37% hydrochloric acid D. 7% hydrofluoric acid ```

An enamel bonding agent that bonds enamel to composite is termed a “cohesive joint”; this is because there are three materials involved. A. Both the statement and the reason are correct and related B. Both the statement and the reason are correct, but not related C. The statement is correct, but the reason is not D. The statement is not correct, but the reason is correct E. Neither the statement nor the reason is correct

Dental bonding and dental adhesion are synonymous terms. True False

True

When answering a board question about the need for mechanical retention in a preparation for a composite resin material, less does not mean, none. True False

True

The advantage of using lasers to prepare a tooth to receive a composite resin restoration is that the provider can often prepare the tooth without the need of anesthesia. The other advantage is that the laser will increase the ability to bond to the tooth structure. A. Both statements are true B. Both statements are false C. The first statement is true, but the second statement is false D. The first statement is false, but the second statement is true

Cotton rolls are inadequate for isolation, in most bonding situations. True False

True

Place the following steps for the application of an etch-and-rinse (total-etch) two-step dental adhesive in correct sequence. Etch enamel and dentin with phosphoric acid for 15 to 30 seconds ___ Complete tooth preparation ____ Apply primer/bonding agent for 30 seconds ____ Rinse etchant and leave surface moist _____ Light-cure ____ Air thin_______

Place the following steps for the application of an etch-and-rinse (total-etch) two-step dental adhesive in correct sequence. Etch enamel and dentin with phosphoric acid for 15 to 30 seconds _2__ Complete tooth preparation __1__ Apply primer/bonding agent for 30 seconds __4__ Rinse etchant and leave surface moist __3___ Light-cure __6__ Air thin___5____

``` Place the following steps for the application of an etch and dry (self-etching) two-step dental adhesive in correct sequence. Etch enamel for 15 seconds_______ Apply adhesive______ Complete tooth preparation_____ Actively apply self-etching primer_____ Rinse etchant________ Air thin________ Light cure_______ ```

``` Place the following steps for the application of an etch and dry (self-etching) two-step dental adhesive in correct sequence. Etch enamel for 15 seconds__2_____ Apply adhesive__6____ Complete tooth preparation__1___ Actively apply self-etching primer___4__ Rinse etchant___3_____ Air thin____5____ Light cure___7____ ```

Place the following steps for the application of an etch and dry (self-etching) one-step dental adhesive in correct sequence. Air thin_____ Light cure____ Rinse etchant______ Apply several layers of etch, prime, and bond_____ Complete tooth preparation______ Etch enamel for 15 seconds_______

Place the following steps for the application of an etch and dry (self-etching) one-step dental adhesive in correct sequence. Air thin___5__ Light cure_6___ Rinse etchant___3___ Apply several layers of etch, prime, and bond___4__ Complete tooth preparation___1___ Etch enamel for 15 seconds___2____

Operative Midterm Flashcards

(73 cards)