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operative dentistry > Principles of Operative Dentistry > Flashcards

Principles of Operative Dentistry Flashcards

1
Q

What is operative dentistry?

A

treatment of disease/defects of hard tissues of teeth THAT DO NOT REQUIRE FULL COVERAGE RESTORATION

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2
Q

Operative dentistry restores:

A
  1. form
  2. function
  3. esthetics
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3
Q

Enamel thickness varies by:

A
  1. location
  2. tooth type
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4
Q

Enamel is ____% hydroxyapatite

A

90-92%

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5
Q

Enamel can be described as both:

A

strong and brittle

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6
Q

Enamel rods are ___ diameter near the surface, and ____ near the dentin borders

A

larger; smaller

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7
Q

Enamel rods are ____ to the long axis and radiate ___

A

perpendicular; outward

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8
Q

Can act as food/bacterial traps, leading to decay:

A

grooves & fissures

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9
Q
  • hypomineralized
  • extend into the enamel
A

enamel tufts

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10
Q
  • thin faults between enamel rod groups
A

enamel lamellae

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11
Q

Enamel lamella extend from ___ toward ____

A

Enamel toward DEJ

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12
Q

Odontoblastic process crossed into enamel:

A

enamel spindles

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13
Q

Hypomineralized zone where dentin meets enamel:

A

dentino-enamel junction (DEJ)

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14
Q

The DEJ, dentin meets enamel can be described as:

A

hypomineralized

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15
Q

Enamel becomes more soluble as you approach the:

A

DEJ

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16
Q

____ lowers acid solubility:

A

fluoride

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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
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18
Q

Describe the pulp-dentin complex: (2)

A
  1. strong & resilient
  2. living tissue
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19
Q

The largest portion of the tooth is made up of:

A

dentin

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20
Q

Dentin is located in both ___ & ____ portions of the tooth

A

coronal & root

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21
Q

Forms the walls of the pulp chamber:

A

dentin

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22
Q

Dentin is formed immediately:

A

prior to enamel

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23
Q

Describe dentin formation: (timeline)

A

continues throughout the life of the pulp

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24
Q

Canals extending from DEJ/DCJ to pulp:

A

dentinal tubules

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25
Q

Dentinal tubules are canals extending:

A

from DEJ/DCJ to pulp

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26
Q

Dentinal tubules are lined with:

A

peritubular dentin

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27
Q

____ is between dentinal tubules

A

intertubular

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28
Q

Dentinal tubules are lined with ____ and ____ is between tubules.

A

pert tubular denin; intertubular dentin

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29
Q

Where is the diameter of dentinal tubules the largest?

A

At the pulp

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30
Q

In dentinal tubules, the # of tubules/square mm is greatest at:

A

the pulp

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31
Q

Reparative dentin is formed by _____ in response to ____.

A

secondary odontoblasts; moderate irritant

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32
Q

secondary odontoblasts form:

A

reparative dentin

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33
Q

Provides protecting to the underlying pulp- by decreasing dentin permeability

A

dentin

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34
Q

How does reparative dentin provide protection to the underlying pulp?

A

by decreasing dentin permeability

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35
Q

Primary dentin that has changed

A

sclerotic dentin

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36
Q

Process of sclerotic dentin formation:

A

peritubular dentin widens and fills with calcified material

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37
Q

Dentin hardness compared to enamel:

A

dentin 1/5 as hard as enamel

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38
Q

Dentin is harder near the ___ than near the ___ by ____x

A

DEJ than near pulp 3x

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39
Q

Dentin is ___% hydroxyapatite

A

50%

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40
Q

What causes dentinal sensitivity?

A

fluid movement in tubules

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41
Q

Describe the hydrodynamic theory of pain transmission:

A

odontoblastic process wrapped in nerves and fluid in dentinal tubules

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42
Q

When enamel/cementum is removed during preparation, ____ is lost, causing ____ resulting in ____

A

seal is lost; causing small fluid movements in tubules which distorts nerve endings; pain

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43
Q

Created when ever tooth is cut/prepared:

A

smear layer

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44
Q

The smear plugs ____

A

dentinal tubules

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45
Q

Enamel vs. dentin color

Enamel =

A
  • gray, semi-translucent
  • color depends on underlying dentin
  • becomes temporarily whiter when dehydrated
    -shiny
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46
Q

Enamel vs denin color:

Enamel becomes temporarily whiter when:

A

dehydrated

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47
Q

Ename vs. dentin color:

Dentin =

A
  • yellow-white
  • dull/opaque
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48
Q

Covers the root surface:

A

cementum

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49
Q

cementum is ____ compared to dentin

A

softer

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50
Q

Describe the formation of cementum:

A

formed continually

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51
Q

Curve or shape of something:

A

contours

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52
Q

Where two adjacent teeth contact:

A

proximal contact

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53
Q

An opening with sides flaring outward:

A

embrasures

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54
Q

V-shaped valleys between adjacent teeth, typically filled with gingiva:

A

Embrasures

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55
Q

Objectives of tooth preparation:

  1. ____ form, ___ form, ___ form
  2. Remove ____
  3. Provide necessary ____
  4. Extend restoration ___
  5. ____ when chewing
  6. Restore ____ & ____
A
  1. Resistance form, retention form, convenience form
  2. Defects
  3. Protection to pulp
  4. Conservatively as possible
  5. Resist fracture
  6. Esthetics and function
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56
Q

Tooth preparation should be ____ especially for ____

A

Precise; amalgam

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57
Q

Tooth preparation should follow the:

A

GV Black design and principles

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58
Q

Preparations for composite restorations incorporate:

A

bonding

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59
Q

When preparing a tooth, you should extend to:

A

sound tooth structure in all directions

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60
Q

Prep walls are designed to: (2)

A
  1. Retain restoration
  2. Resist fracture
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61
Q

The first step in a preparation is to:

A

remove remaining caries or old restorative material

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62
Q

Three important aspects of preparation include:

minimize ____, maximize ____, and protect ____

A

minimize fracture, maximize retention, protect pulp

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63
Q

The last step in preparation of a tooth includes:

A

final cleaning, inspection, and sealing prep

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64
Q

Factors to consider prior to restoring a tooth:

A
  1. esthetics
  2. economics
  3. medical conditions
  4. age
  5. caries risk
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65
Q

The dental anatomy to consider when resorting a tooth: (4)

A
  1. enamel rod orientation
  2. thickness of enamel and dentin
  3. size & location of pulp
  4. relationship of tooth to periodontium
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66
Q

When considering conservation of tooth structure, repair ____ but preserve ____

A

repair damage but preserve vitality

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67
Q

Location of primary caries: (3)

A
  1. pit & fissure
  2. enamel smooth surface
  3. root surface
68
Q

Pit and fissures occur from :

A

imperfect coalescence of developmental enamel lobe

69
Q

What area of the tooth is an area that is left unclean chronically (location of primary caries)

A

Enamel smooth surface

70
Q

Caries left by the operator - may be intentionally or accidental:

A

residual caries

71
Q

It is never ideal to leave caries especially when:

A

Left at DEJ or on prepared enamel wall

72
Q

It may be acceptable to leave caries in a rare instance to:

A

avoid pulp exposure and when left as affected dentin near the pulp

73
Q

Microleakage present at the junction between restoration and tooth causes:

A

recurrent caries

74
Q

May progress under the restoration or behind it so it can not be seen with the radiograph:

A

recurrent caries

75
Q

Type of caries that cannot be seen in a radiograph:

A

recurrent caries

76
Q

Reparative dentin is formed by odontoblasts at:

A

ends of tubules at surface pulp in response to irritation

77
Q

Light colored caries that appear dull and mushy:

A

acute

78
Q

Acute caries may be also called:

A

rampant

79
Q

Caries that are slow or arrested, dark color, and appear shiny/solid

A

chronic caries

80
Q

Dentists formally practiced ____ meaning ____.

A

“extension for prevention”- meant taking away unnecessary tooth structure and is no longer practiced

81
Q

Instead of “extension for prevention” there are better preventative measures available including:

A
  1. enameloplasty
  2. sealents
  3. preventative resin
  4. conservative composite resotration
82
Q

Surfaces involved in restoration:

____= one surface involved

____= two surfaces involved

____= three or more surfaces involved

A

simple
compound
complex

83
Q

Abbreviations:

O:
MO, DO, MOD:
F or B:
L:

A

Occlusal
Mesial occlusal, distal occlusal, medial-occlusal distal
facial or buccal
lingual

84
Q

Internal walls in a tooth preparation include:

A

axial wall and pulpal wall (floor)

85
Q

Label A and B:

A

A: pulpal wall
B: axial wall

86
Q

Axial wall is ____ to the long axis of the tooth

A

parallel

87
Q

Wall closest to the pulp:

A

pulpal wall/floor

88
Q

The pulpal wall is ____ to the long axis of the tooth in ____ preparations

A

Perpendicular; Class I and Class II

89
Q

Label the following image:

A

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
Q

Describe the floor in a preparation: (3)

A
  1. prepared
  2. flat
  3. perpendicular to occlusal forces
91
Q

The pulpal floor is ____ to occlusal forces

A

perpindicular

92
Q

The pulpal and gingival walls of a prep provide ____ for the restoration and ____ in the tooth

A

Provide- stabilizing seats and distribute stresses

93
Q

Junction of two walls/surfaces along a line:

A

line angle

94
Q

In a ____ line angle, the apex points AWAY from the observer

A

Internal

95
Q

In a ____ line angle, the apex points TOWARDS the observer

A

External

96
Q

Junction of three surfaces:

A

point angle

97
Q

Junction of PREPARED cavity wall and EXTERNAL surface of the tooth:

A

Cavosurface angle or margin

98
Q

Types of cavosurfaces:

A
  • bevel
  • 90 degrees
  • chamfer
99
Q

Where cementum meets enamel:

A

cementoenamel junction (CEJ)

100
Q

Enamel margin strength is formed by:

A

full length enamel rods

101
Q

Enamel rods’ inner ends are on:

A

sound dentin

102
Q

When enamel rods are not supported by sound dentin:

A

unsupported enamel

103
Q

Unsupported enamel can:

A

fracture easily because its brittle

104
Q

Why operative dentistry?

A
  • diagnosis
  • treatment
  • repair
105
Q

Classifications of tooth preps are named based on:

A

anatomy involved

106
Q

A preparation on the occlusal surface of posterior teeth:

A

Class I

107
Q

A class 1 prep on the occlusal surface of posterior teeth may include:

A

lingual/buccal grooves and pits

108
Q

A preparation on the proximal surfaces of premolars and molars:

A

Class II

109
Q

A preparation on the proximal surfaces of incisors and canines, THEY DO NOT INVOLVE THE INCISAL EDGE

A

Class III

110
Q

A preparation on the proximal surfaces of incisors and canines that involve the incisal edge

A

Class IV

111
Q

A preparation one the gingival 1/2 of buccal and lingual smooth surfaces:

A

Class V

112
Q

A preparation on the incisal edge or cusp:

A

Class VI

113
Q

List the components of the initial stage of tooth preparation: (5)

A
  1. outline form
  2. initial depth
  3. primary resistance form
  4. primary retention form
  5. convenience form
114
Q

When visualizing the outline form, the prep should appear:

A

smooth and flowing

115
Q

List what aspects make up the outline form of the initial stage of tooth preparation: (3)

A
  1. undermined enamel is removed
  2. margins placed where you can finish the restoration
  3. no occlusion on margins of preparation
116
Q

When considering the outline form of a prep:

  1. _____- on cusps and marginal ridges
  2. minimize extensions ____
  3. connect two preps that are ___.
A
  1. preserve strength
  2. faciolingually
  3. less than 0.5 mm apart
117
Q

In a class 1 prep, the depth of pit and fissure maximum =

A

2.0 mm (in lab setting)

118
Q

In a class I prep, the depth should extend to:

A

sound tooth structure

119
Q

In a class I prep, extend when:

A
  • fissures cannot be eliminated by enameloplasts
  • two cavities have less than 0.5 mm between them
120
Q

When considering outline form, do not terminate on:

A

cusp heigh or ridge crest

121
Q

In a class II prep, extend gingival margins ____ , extend interproximal margins to ___.

A

apical to contact; embrasures

122
Q

What is the axial wall depth in a class II prep:

A

0.2-0.8mm INTO DENTIN

123
Q

How is axial wall depth measured?

A

From edge of tooth (proximal surface) to axial wall

124
Q

Is not a typical depth measurement from the top of something to the bottom

A

axial wall depth

125
Q

Removes shallow enamel fissure or pit, creating a smooth, saucer shaped surface

A

enameloplasty

126
Q

A smooth saucer shaped surface created by an enameloplasty is:

A

self-cleansing

127
Q

In an enameloplasty, no more than ___ enamel thickness should be removed:

A

1/3

128
Q

List the 4 aspects of resistance form:

A
  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
Q

When is resistance form compromised? (2)

A
  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
Q

Resistance form is compromised when the margin extends 2/3 of the distance between the central groove, and you:

A

must cap weak cusps

131
Q

Resistance form is compromised when the margins end 1/2 distance between central groove and cusp tip and you:

A

consider capping cusp tips

132
Q
  • Internal line angles are slightly rounded
  • External line angles slightly rounded
  • Flat floors

These are all aspects of:

A

Resistance form

133
Q

Slightly rounding external line angles leads to:

A

Less stress concentration

134
Q

Flat floor of a preparation prevent:

A

movement

135
Q

Resistance form includes allowing for sufficient ____ of restorative material

A

thickness

136
Q
A
137
Q

In order to contribute to resistance form, bevels are needed to: (2)

A
  1. remove unsupported enamel
  2. reduce stress concentration
138
Q

In order to contribute to resistance form, the margin in amalgam should be:

A

90 degrees

139
Q

The objective of retention form is to:

A

retain the restoration (keep restorations in the toooof)

140
Q

Method contributing to retention for that prevents tipping and proximal displacement:

A

dovetails

141
Q

What is the goal of a dovetail?

A

prevents tipping and proximal dispacement

142
Q

What are the three components of retention form?

A
  1. wall length
    2, convergence
  2. parallelism
143
Q

Having a taller wall in a preparation will:

A

resist pull of sticky foods

144
Q

Describe convergence in retention form:

A

Walls slant toward each other, especially important with amalgam

145
Q

Describe retention form in bonded restorations:

A

microchemcial retention between adhesive and tooth

146
Q

Form that allows you to axis the defect:

A

convenience form

147
Q

Convenience form allows you to:

A

see what you’re doing

148
Q

Once outline form, primary resistance, and primary retention form are complete, ___ may remain and its important to ___.

A

caries may remain; remove the caries

149
Q

In the final stage of tooth preparation:

  1. remove remaining ____
  2. remove remaining ____
  3. ____ protection
  4. ____ & ____ forms
  5. Finish ___ & ___
  6. FInal ___, ____ & ____
A
  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
Q

Affected dentin is ____ and usually ____ but not ___.

Is this okay to leave or does it need to be removed?

A

demineralized. usually discolored but NOT soft

OK to leave

151
Q

Affected dentin is ____ while infected dentin ___

A

okay to leave; must remove

152
Q

Describe infected dentin:

A
  • microorganisms present
  • soft
  • may or may not be stained
  • must remove
153
Q

Why must you removed infected dentin?

A

Bc microorganisms are present

154
Q

How do you tell the difference between affected and infected dentin?

A

Not always possible

155
Q

Secondary retention includes:

A

retention groove and points

156
Q

Areas for restorative material to “lock” into, resulting in improved retention

A

retention groove and points

157
Q

Secondary retention includes have fewer ____

A

extensions

158
Q

A bevel for rounded axiopulpal line angles is an example of:

A

secondary resistance

159
Q

Allows for the increase bulk of restorative material and disperses concentration of forces:

A

bevel for rounded axiopulpal line angle

160
Q

Position slightly to the patients right and in front:

A

8:00

161
Q

When should an 8:00 position be used?

A
  1. buccal sides of patient UL
  2. Lingual sides of patients LR
162
Q

Position slightly to the patient right and behind:

A

11:00

163
Q

When should an 11:00 position be used?

A
  1. buccal sides of patients UR
  2. Lingual sides of patients LL
164
Q

Position slightly to the patients left and behind:

A

12:00-1:00 position

165
Q

When should a 12:00-1:00 position be used?

A
  1. buccal sides patients R and L anterior
  2. Lingual sides of patients R and L anterior

operative dentistry (5 decks)

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