Principles of Operative Dentistry Flashcards
(165 cards)
1
Q
What is operative dentistry?
A
treatment of disease/defects of hard tissues of teeth THAT DO NOT REQUIRE FULL COVERAGE RESTORATION
2
Q
Operative dentistry restores:
A
- form
- function
- esthetics
3
Q
Enamel thickness varies by:
A
- location
- tooth type
4
Q
Enamel is ____% hydroxyapatite
A
90-92%
5
Q
Enamel can be described as both:
A
strong and brittle
6
Q
Enamel rods are ___ diameter near the surface, and ____ near the dentin borders
A
larger; smaller
7
Q
Enamel rods are ____ to the long axis and radiate ___
A
perpendicular; outward
8
Q
Can act as food/bacterial traps, leading to decay:
A
grooves & fissures
9
Q
- hypomineralized
- extend into the enamel
A
enamel tufts
10
Q
- thin faults between enamel rod groups
A
enamel lamellae
11
Q
Enamel lamella extend from ___ toward ____
A
Enamel toward DEJ
12
Q
Odontoblastic process crossed into enamel:
A
enamel spindles
13
Q
Hypomineralized zone where dentin meets enamel:
A
dentino-enamel junction (DEJ)
14
Q
The DEJ, dentin meets enamel can be described as:
A
hypomineralized
15
Q
Enamel becomes more soluble as you approach the:
A
DEJ
16
Q
____ lowers acid solubility:
A
fluoride
17
Q
What is important to remember when considering caries AND bonded restorations?
A
- fluoride lowers acid solubility
- enamel is more soluble as you approach the DEJ
18
Q
Describe the pulp-dentin complex: (2)
A
- strong & resilient
- living tissue
19
Q
The largest portion of the tooth is made up of:
A
dentin
20
Q
Dentin is located in both ___ & ____ portions of the tooth
A
coronal & root
21
Q
Forms the walls of the pulp chamber:
A
dentin
22
Q
Dentin is formed immediately:
A
prior to enamel
23
Q
Describe dentin formation: (timeline)
A
continues throughout the life of the pulp
24
Q
Canals extending from DEJ/DCJ to pulp:
A
dentinal tubules
25
Dentinal tubules are canals extending:
from DEJ/DCJ to pulp
26
Dentinal tubules are lined with:
peritubular dentin
27
____ is between dentinal tubules
intertubular
28
Dentinal tubules are lined with ____ and ____ is between tubules.
pert tubular denin; intertubular dentin
29
Where is the diameter of dentinal tubules the largest?
At the pulp
30
In dentinal tubules, the # of tubules/square mm is greatest at:
the pulp
31
Reparative dentin is formed by _____ in response to ____.
secondary odontoblasts; moderate irritant
32
secondary odontoblasts form:
reparative dentin
33
Provides protecting to the underlying pulp- by decreasing dentin permeability
dentin
34
How does reparative dentin provide protection to the underlying pulp?
by decreasing dentin permeability
35
Primary dentin that has changed
sclerotic dentin
36
Process of sclerotic dentin formation:
peritubular dentin widens and fills with calcified material
37
Dentin hardness compared to enamel:
dentin 1/5 as hard as enamel
38
Dentin is harder near the ___ than near the ___ by ____x
DEJ than near pulp 3x
39
Dentin is ___% hydroxyapatite
50%
40
What causes dentinal sensitivity?
fluid movement in tubules
41
Describe the hydrodynamic theory of pain transmission:
odontoblastic process wrapped in nerves and fluid in dentinal tubules
42
When enamel/cementum is removed during preparation, ____ is lost, causing ____ resulting in ____
seal is lost; causing small fluid movements in tubules which distorts nerve endings; pain
43
Created when ever tooth is cut/prepared:
smear layer
44
The smear plugs ____
dentinal tubules
45
Enamel vs. dentin color
Enamel =
- gray, semi-translucent
- color depends on underlying dentin
- becomes temporarily whiter when dehydrated
-shiny
46
Enamel vs denin color:
Enamel becomes temporarily whiter when:
dehydrated
47
Ename vs. dentin color:
Dentin =
- yellow-white
- dull/opaque
48
Covers the root surface:
cementum
49
cementum is ____ compared to dentin
softer
50
Describe the formation of cementum:
formed continually
51
Curve or shape of something:
contours
52
Where two adjacent teeth contact:
proximal contact
53
An opening with sides flaring outward:
embrasures
54
V-shaped valleys between adjacent teeth, typically filled with gingiva:
Embrasures
55
Objectives of tooth preparation:
1. ____ form, ___ form, ___ form
2. Remove ____
3. Provide necessary ____
4. Extend restoration ___
5. ____ when chewing
6. Restore ____ & ____
1. Resistance form, retention form, convenience form
2. Defects
3. Protection to pulp
4. Conservatively as possible
5. Resist fracture
6. Esthetics and function
56
Tooth preparation should be ____ especially for ____
Precise; amalgam
57
Tooth preparation should follow the:
GV Black design and principles
58
Preparations for composite restorations incorporate:
bonding
59
When preparing a tooth, you should extend to:
sound tooth structure in all directions
60
Prep walls are designed to: (2)
1. Retain restoration
2. Resist fracture
61
The first step in a preparation is to:
remove remaining caries or old restorative material
62
Three important aspects of preparation include:
minimize ____, maximize ____, and protect ____
minimize fracture, maximize retention, protect pulp
63
The last step in preparation of a tooth includes:
final cleaning, inspection, and sealing prep
64
Factors to consider prior to restoring a tooth:
1. esthetics
2. economics
3. medical conditions
4. age
5. caries risk
65
The dental anatomy to consider when resorting a tooth: (4)
1. enamel rod orientation
2. thickness of enamel and dentin
3. size & location of pulp
4. relationship of tooth to periodontium
66
When considering conservation of tooth structure, repair ____ but preserve ____
repair damage but preserve vitality
67
Location of primary caries: (3)
1. pit & fissure
2. enamel smooth surface
3. root surface
68
Pit and fissures occur from :
imperfect coalescence of developmental enamel lobe
69
What area of the tooth is an area that is left unclean chronically (location of primary caries)
Enamel smooth surface
70
Caries left by the operator - may be intentionally or accidental:
residual caries
71
It is never ideal to leave caries especially when:
Left at DEJ or on prepared enamel wall
72
It may be acceptable to leave caries in a rare instance to:
avoid pulp exposure and when left as affected dentin near the pulp
73
Microleakage present at the junction between restoration and tooth causes:
recurrent caries
74
May progress under the restoration or behind it so it can not be seen with the radiograph:
recurrent caries
75
Type of caries that cannot be seen in a radiograph:
recurrent caries
76
Reparative dentin is formed by odontoblasts at:
ends of tubules at surface pulp in response to irritation
77
Light colored caries that appear dull and mushy:
acute
78
Acute caries may be also called:
rampant
79
Caries that are slow or arrested, dark color, and appear shiny/solid
chronic caries
80
Dentists formally practiced ____ meaning ____.
"extension for prevention"- meant taking away unnecessary tooth structure and is no longer practiced
81
Instead of "extension for prevention" there are better preventative measures available including:
1. enameloplasty
2. sealents
3. preventative resin
4. conservative composite resotration
82
Surfaces involved in restoration:
____= one surface involved
____= two surfaces involved
____= three or more surfaces involved
simple
compound
complex
83
Abbreviations:
O:
MO, DO, MOD:
F or B:
L:
Occlusal
Mesial occlusal, distal occlusal, medial-occlusal distal
facial or buccal
lingual
84
Internal walls in a tooth preparation include:
axial wall and pulpal wall (floor)
85
Label A and B:
A: pulpal wall
B: axial wall
86
Axial wall is ____ to the long axis of the tooth
parallel
87
Wall closest to the pulp:
pulpal wall/floor
88
The pulpal wall is ____ to the long axis of the tooth in ____ preparations
Perpendicular; Class I and Class II
89
Label the following image:
A: Pulpal floor
B: Axial wall:
C: Gingival floor
D: Buccal wall
E: Lingual wall
F: Axio-lingual line angle
G: Axio-pulpal ling angle
H: Axis-buccal line angle
I: Axioginigival line angle
90
Describe the floor in a preparation: (3)
1. prepared
2. flat
3. perpendicular to occlusal forces
91
The pulpal floor is ____ to occlusal forces
perpindicular
92
The pulpal and gingival walls of a prep provide ____ for the restoration and ____ in the tooth
Provide- stabilizing seats and distribute stresses
93
Junction of two walls/surfaces along a line:
line angle
94
In a ____ line angle, the apex points AWAY from the observer
Internal
95
In a ____ line angle, the apex points TOWARDS the observer
External
96
Junction of three surfaces:
point angle
97
Junction of PREPARED cavity wall and EXTERNAL surface of the tooth:
Cavosurface angle or margin
98
Types of cavosurfaces:
- bevel
- 90 degrees
- chamfer
99
Where cementum meets enamel:
cementoenamel junction (CEJ)
100
Enamel margin strength is formed by:
full length enamel rods
101
Enamel rods' inner ends are on:
sound dentin
102
When enamel rods are not supported by sound dentin:
unsupported enamel
103
Unsupported enamel can:
fracture easily because its brittle
104
Why operative dentistry?
- diagnosis
- treatment
- repair
105
Classifications of tooth preps are named based on:
anatomy involved
106
A preparation on the occlusal surface of posterior teeth:
Class I
107
A class 1 prep on the occlusal surface of posterior teeth may include:
lingual/buccal grooves and pits
108
A preparation on the proximal surfaces of premolars and molars:
Class II
109
A preparation on the proximal surfaces of incisors and canines, THEY DO NOT INVOLVE THE INCISAL EDGE
Class III
110
A preparation on the proximal surfaces of incisors and canines that involve the incisal edge
Class IV
111
A preparation one the gingival 1/2 of buccal and lingual smooth surfaces:
Class V
112
A preparation on the incisal edge or cusp:
Class VI
113
List the components of the initial stage of tooth preparation: (5)
1. outline form
2. initial depth
3. primary resistance form
4. primary retention form
5. convenience form
114
When visualizing the outline form, the prep should appear:
smooth and flowing
115
List what aspects make up the outline form of the initial stage of tooth preparation: (3)
1. undermined enamel is removed
2. margins placed where you can finish the restoration
3. no occlusion on margins of preparation
116
When considering the outline form of a prep:
1. _____- on cusps and marginal ridges
2. minimize extensions ____
3. connect two preps that are ___.
1. preserve strength
2. faciolingually
3. less than 0.5 mm apart
117
In a class 1 prep, the depth of pit and fissure maximum =
2.0 mm (in lab setting)
118
In a class I prep, the depth should extend to:
sound tooth structure
119
In a class I prep, extend when:
- fissures cannot be eliminated by enameloplasts
- two cavities have less than 0.5 mm between them
120
When considering outline form, do not terminate on:
cusp heigh or ridge crest
121
In a class II prep, extend gingival margins ____ , extend interproximal margins to ___.
apical to contact; embrasures
122
What is the axial wall depth in a class II prep:
0.2-0.8mm INTO DENTIN
123
How is axial wall depth measured?
From edge of tooth (proximal surface) to axial wall
124
Is not a typical depth measurement from the top of something to the bottom
axial wall depth
125
Removes shallow enamel fissure or pit, creating a smooth, saucer shaped surface
enameloplasty
126
A smooth saucer shaped surface created by an enameloplasty is:
self-cleansing
127
In an enameloplasty, no more than ___ enamel thickness should be removed:
1/3
128
List the 4 aspects of resistance form:
1. resistance to fracture
2. need to resist or withstand occlusal forces
3. conservative extension- leave tooth strong
4. preserve cusps and marginal ridges
129
When is resistance form compromised? (2)
1. when margin exceeds 2/3 of the distance between the central groove
2. When Marin ends 1/2 the distance between central groove and cusp tip
130
Resistance form is compromised when the margin extends 2/3 of the distance between the central groove, and you:
must cap weak cusps
131
Resistance form is compromised when the margins end 1/2 distance between central groove and cusp tip and you:
consider capping cusp tips
132
- Internal line angles are slightly rounded
- External line angles slightly rounded
- Flat floors
These are all aspects of:
Resistance form
133
Slightly rounding external line angles leads to:
Less stress concentration
134
Flat floor of a preparation prevent:
movement
135
Resistance form includes allowing for sufficient ____ of restorative material
thickness
136
137
In order to contribute to resistance form, bevels are needed to: (2)
1. remove unsupported enamel
2. reduce stress concentration
138
In order to contribute to resistance form, the margin in amalgam should be:
90 degrees
139
The objective of retention form is to:
retain the restoration (keep restorations in the toooof)
140
Method contributing to retention for that prevents tipping and proximal displacement:
dovetails
141
What is the goal of a dovetail?
prevents tipping and proximal dispacement
142
What are the three components of retention form?
1. wall length
2, convergence
3. parallelism
143
Having a taller wall in a preparation will:
resist pull of sticky foods
144
Describe convergence in retention form:
Walls slant toward each other, especially important with amalgam
145
Describe retention form in bonded restorations:
microchemcial retention between adhesive and tooth
146
Form that allows you to axis the defect:
convenience form
147
Convenience form allows you to:
see what you're doing
148
Once outline form, primary resistance, and primary retention form are complete, ___ may remain and its important to ___.
caries may remain; remove the caries
149
In the final stage of tooth preparation:
1. remove remaining ____
2. remove remaining ____
3. ____ protection
4. ____ & ____ forms
5. Finish ___ & ___
6. FInal ___, ____ & ____
1. infected dentin
2. old restoration
3. pulp
4. secondary resistance and retention forms
5. finish external walls and margins
6. final cleaning, inspecting and sealing
150
Affected dentin is ____ and usually ____ but not ___.
Is this okay to leave or does it need to be removed?
demineralized. usually discolored but NOT soft
OK to leave
151
Affected dentin is ____ while infected dentin ___
okay to leave; must remove
152
Describe infected dentin:
- microorganisms present
- soft
- may or may not be stained
- must remove
153
Why must you removed infected dentin?
Bc microorganisms are present
154
How do you tell the difference between affected and infected dentin?
Not always possible
155
Secondary retention includes:
retention groove and points
156
Areas for restorative material to "lock" into, resulting in improved retention
retention groove and points
157
Secondary retention includes have fewer ____
extensions
158
A bevel for rounded axiopulpal line angles is an example of:
secondary resistance
159
Allows for the increase bulk of restorative material and disperses concentration of forces:
bevel for rounded axiopulpal line angle
160
Position slightly to the patients right and in front:
8:00
161
When should an 8:00 position be used?
1. buccal sides of patient UL
2. Lingual sides of patients LR
162
Position slightly to the patient right and behind:
11:00
163
When should an 11:00 position be used?
1. buccal sides of patients UR
2. Lingual sides of patients LL
164
Position slightly to the patients left and behind:
12:00-1:00 position
165
When should a 12:00-1:00 position be used?
1. buccal sides patients R and L anterior
2. Lingual sides of patients R and L anterior
