Flashcards in Operative Test 4 Deck (95):
Glass + Nalgene
(silica + Bis GMA)
Bis GMA has high _____ shrinkage
and limited ______ wear resistance
Compared to Amalgam, composites have larger Proximal Extensions
The cavo-surface on the occlusal needs an additional bevel in Class II composite restorations
*NOT - only USC teaches
Retention points are needed in Class II composites
1 mm bevels are added in the box at the cavo surface margins (3 of them) in a class II composite prep
What type of Composite shouldn't be used in Posterior?
(Microhybrid, nano-composites, or microfilled)
Name 2 Microhybrid composites, 2 Nano-composited, and on Highly Filled composite:
Venus, Hurculite XRV (microhybrid)
Filtek, Premise (Nano-composite)
Helio-Molar (Highly filled composites)
Composite Instruments (W3, Mini1, #3 Extra-Flex, TNCFIS/.M, 5A) should never be exposed to what?
What type of wedge should be used for Class II composite restorations?
Flowable Composites are easy to apply but _______
have high polymerization shrinkage
Microfilled composited are highly polishable and have good transparency but _______
Poor fracture strength
Hybrid composites are the MOST used by dentists b/c they are versatile, have good over all strength, but the silica can be_____
Nano-composites have the least shrinkage, least resin, good wear resistance, but are ______
Flowable Composite brand:
Glass Ionomer (RMGI) brand:
Herculite XRV, Venus
GC Fuji II LC Capsule
247 diamond is good for:
Composite Instruments are made from:
Nickel Aluminum Nitride
Tofflemire Band is better on amalgams, _____ is better for composites
*gets tighter contact more consistently
The Garrison Tight 3D ring we use for Class II composites brand name:
37% Phosphoric acid can have _______, an antimicrobial that extends the life of a composite restoration
BAC - benzylalkylchloride
What type of Bonding (generation) are we using?
Optibond Solo plus
When can Chlorhexidine be added to restoration?
After etch, Pre bond
Post etch, pre-bond can be GLUMA, HEMA, or CHX
Class II composite restoration: Etch, Rinse, (gluma, hema, chx), bond, cure, _______, composite
What is the smallest composite instrument called?
What is the best Composite instrument for the occlusal?
The last step before finishing (that we never did in lab) is a _______ flow that fills small voids
Pre finish with:
Then Glaze, Check occlusion with Articulating Paper
Burs (must use water) and Instruments (DeMeo)
It is necessary to remove the Transparent Layer of Dentin in a carious lesion
*No bacteria present, de-mineralized but collagen cross-linking is intact and can be remineralized
Infected Dentin has ______
Affected Dentin has ______
bacterial by-products (and can re-mineralize)
Reparative Dentin, aka ________
How long does it take for Dentinogenesis (Tertiary Reparative Dentin) to take place?
*requires healthy pulp
What Growth Factor stimulates Tertiary (reparative) dentin?
What is the critical pH for demineralization/remineralization?
Caries spreads along the DEJ, undermines enamel, and follows what?
Dentinal tubules toward pulp
If an early carious lesion is limited to the surface of the enamel, what is proper Tx?
White spot lesions must be restored
Rapidly growing decay can be what color?
Same as Dentin
Acute caries are rapidly progressing, their texture is ______ and _____, their color is ______
Chronic caries are leathery and Dark
Sclerotic Caries are what color?
*very firm, do not remove (not active)
Root caries tend to be dark/similar color to dentin
International Caries Detection and Assessment System
ICDAS 0: (definitions)
Enamel change seen only after drying (90 enamel/10 dentin)
Visual change (50/50)
Enamel breakdown (77 in Dentin), no shadow
88 in Dentin, Dark shadow
Visible Dentin (100)
Dentin 100, more than 1/2 tooth surface
ICDAS 0: (Tx)
Sealant/PRR (or MIR)
MIR (minimally invasive restoration)
What ICDAS level has Optional Sealants?
Low Risk: 0, 1, 2
Moderate Risk: 0
*all else follows pattern: Sealants 0-2, PRR/Sealant/MIR 3, MIR 4-6
Likelihood of cavitation: E1
What measures Fluorescence?
0.5% fuchsin in propylene glycol can delineate what?
Outer irreversibly denatured dentin
Inner reversibly affected dentin
When is the Incomplete Removal of caries justified?
*Indirect Pulp Cap (involved CHX and liner
No Hx spontaneous pain
Thin layer CaOH or MTA:
Direct Pulp Cap
Dentin gets softer on the way to the pulp, and if carious gets much harder due to Sclerosis (remineralization)
What pulp protectant inhibits the setting of Composites?
Which releases fluoride and is acid soluble?
Which is Basic, is used in Direct Pulp Cap, and breaks down quickly?
Which is Basic, sterile, hydrophilic, and Expensive?`
Zinc Oxide Eugenol
MTA - Mineral Trioxide Aggregate (EndoSequence)
In a Direct Pulp Cap procedure, what goes over the CaOH (Dycal) paste?
ASDOH Direct Pulp Cap Technique involved EndoSequence (CaOH), which takes 20 minutes to harden, then liner
(do not light cure - chemically sets)
Principles of Class III design: _____ mm bevel
*bevel for color, lesion doesn't include contact
Class III minimal gingival separation:
The outline of a perfect Class III prep is a circle
*oblong increases retention, etc.
An area of deep decay may require a ______ of _______
GC Fuji II LC
GC Fuji II LC provides ____ insulation, _____ release, and _____ resistance
Etchant opens enamel _____ and allows resin to flow into the _______ to create ________ retention with resin tags
What is the purpose for Etchant in Dentin?
Demineralizes, removes smear
*exposes collagen matrix which resins binds
Bonding agent (OptiBond Solo plus) is ruined by what?
What are the Diamond Football burs?
379 F and EF
*good for trimming lingual composites
The scalpel used to trim interproximal composite:
A surface reflecting back light of a different wavelength depending on the source describes what?
What type of filling materials tend to be opaque?
What tend to be translucent?
Hybrid, heavily filled, macro particles
pure microfilled, nano-hybrids
What color changes occur when a composite is cured? (2)
Shifts to grays (decrease in tone/value)
Class IV's can be the result of habits, sports, time, and interesting stories
The big composite instrument:
XTS Mini #1
If the edge is translucent, use _______ shades
If the edge is opaque, use _______ shades
When building _____ scaffold do not fold
When building _____ scaffold folding is optional
According to Dr Huang, the most commonly missed step in Class IV composites is what?
Drying and checking with explorer after pre-finishing
*don't pre-finish well enough
What zone preserves the dentin bond to composite?
What bonding resin is the gold standard?
Bisco All Bond + D/E resin/OptiBond FL
*requires 5-6 applications
C Factor =
High C factor means what?
bonded resin surface/un-bonded
Because of polymerization shrinkage, darker shades need to be less than _____ mm thick
5th Generation Bonding - what 2 steps?
OptiBond Solo plus
OptiBond Solo plus has what in it that acts as an elastic layer?
6th Generation bonding is the best seller in the US and is called?
Clearfil SE (mod pH)
7 Generation (Huang doesn't recommend) is an all in one called what?
i-Bond, Xeno IV
"Bonding" step has a ___ and a ____
Conditioner (weak acid, removes smear)
Aside from being technique sensitive (like Gen 4), 5th generation bonding (OptiBond solo +) is sensitive to what?
Under-etching will inhibit ____ bonding
Over-etching will inhibit _____ bonding
Ceramic is similar in hardness to quartz at 7 Mohs and both are harder than steel at 6.5 Mohs
Polishing theory includes Scratch, Ductile flow, and Chemo-mechanical
What is the measurable surface strain created by scratches during polishing?
*different from poly shrinkage
The Twyman Effect is large in _____ and ______ theory.
Small in _____.
Scratch, Ductile Flow
*b/c chemically react at surface for latter
The Hammer Effect occurs in prefinishing with _____ burs
Diamond is _____ times harder than composite or carbide burs
Diamond burs w/o water create more heat/strain than carbide w/o water
F and EF burs are ___ and ___ micron diamonds
Soflex discs contain _____ oxide
Polishing involves scratch theory