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Operative Lecture > Principles of Operative Dentistry > Flashcards

Principles of Operative Dentistry Flashcards

1
Q

What is operative denistry?

A

treatment of disease/defects of hard tissue of teeth that DO NOT REAUIRE FULL COVERAGE RESTORATION

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2
Q

What does operative denistry restore?

A

Form, Function, and Esthetics

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3
Q

What varies in thickness by location and by tooth type?

A

enamel

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4
Q

What percent of the enamel is hydroxyapatite?

A

90-92%

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5
Q

What is the pattern of enamel rods?

A
  • larger diameter near surface, smaller near dentin borders
  • perpendicular to long axis, radiate outward (spokes on a wheel)
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6
Q

What can the grooves and fissures of the teeth lead to?

A

act as a food/bacterial trap and lead to decay

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7
Q

What are enamel tufts?

A

hypomineralized structures that extend into enamel from DEJ

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8
Q

What are enamel lamellae?

A

thin faults between enamel rod groups (extend from enamel toward DEJ)

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9
Q

What is the dentino-enamel junction?

A

hypomineralized zone where dentin meets enamel

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10
Q

Enamel ___________ in solubility as you approach DEJ

A

inreases in solubility

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11
Q

What can help to lower enamel acid solubility?

A

fluoride

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12
Q

What two characteristics describe pulp-dentin complex?

A
  • strong and resilient
  • living tissue
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13
Q

What is the largest portion of the tooth?

A

dentin (located in both coronal and root portions of tooth)

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14
Q

What does dentin form?

A
  • walls of the pulp chamber
  • formed immediately prior to enamel
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15
Q

Formation of what continues throughout life?

A

dentin

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16
Q

What are enamel spindles?

A

odontoblastic processes crossed into enamel (may serve as pain receptors)

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17
Q

What are dentinal tubules?

A

canals extending from DEJ/DCJ to pulp

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18
Q

What are dentinal tubules lined with?

A

peritubular dentin

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19
Q

The diameter of the peritubular dentin is largest at what?

A

the pulp

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20
Q

What forms reparative dentin?

A

secondary odontoblasts

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21
Q

What causes reparative dentin to form?

A

in response to trauma, chronic irritation, etc.

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22
Q

What is sclerotic dentin?

A
  • primary dentin that has changed
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23
Q

What does sclerotin dentin fill with?

A

fills with calcified material after the peritubular dentin widens

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24
Q

What is the average hardness of dentin compared to enamel?

A

1/5 the hardness of enamel

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25
Q

What percent of dentin is hydroxyapatite?

A

50%

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26
Q

What allows for dentinal sensitivity?

A

fluid movement in tubules

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27
Q

What is the hydrodynamic theory of pain transmission?

A
  • Odontoblastic process wrapped in nerves and fluid in dentinal tubules
  • Enamel/cementum removed during preparation = seal is lost
  • Causing small fluid movements in tubules= distortions in nerve endings = PAIN
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28
Q

What is a smear layer?

A
  • created whenever tooth is cut/prepared
  • plugs dentinal tubules
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29
Q

What is the color of enamel?

A
  • gray, semi translucent
  • depends of the underlying dentin
  • becomes temporarily whiter when dehydrated
  • shiny
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30
Q

What is the color of dentin?

A
  • yellowish white
  • dull, opaque
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31
Q

What are the characteristics of cementum?

A
  • covers root surface
  • softer than dentin
  • formed continually
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32
Q

What is the definition of contours?

A

curve or shape of something

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33
Q

What is the definition of proximal contact?

A

where two adjacent teeth contact

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34
Q

What is the definition of embrasures?

A

an opening with sides flaring outward (v-shaped valleys between adjacent teeth)

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35
Q

What are the three forms when considering tooth preparation?

A

resistance form
retention form
convenience form

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36
Q

What are the objectives of tooth preparation?

A
  • remove defects
  • provide protection to pulp
  • extend restoration as conservatively as possible
  • resist fracture when chewing
  • restore esthetics and function
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37
Q

Tooth preparation should be precise especially for…

A

amalgam

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38
Q

Preparations for composite restorations incorporate what?

A

bonding

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39
Q

Prep walls are designed to…

A
  • retain restoration
  • resist fracture
40
Q

What doing a preparation you should follow these steps…

A
  1. remove remaining caries or old restorative material
  2. protect pulp
  3. minimize fracture, maximize retention
  4. finish walls and margins
  5. final cleaning, inspection, sealing prep
41
Q

What are some factors that should be considered for preparations and restorations?

A

esthetics
economics
medical conditions
age
caries risk

42
Q

What should you consider when thinking about dental anatomy for preparation?

A
  • enamel rode orientation
  • thickness of enamel and dentin
  • size, location of pulp
  • relationship of tooth to periodontium
43
Q

Where are the locations of primary caries?

A

pit and fissure
enamel smooth surface
root surface

44
Q

What are residual caries?

A

caries left by operator (intentionally or by accident)

45
Q

When can residual caries be acceptable (very rare instance)?

A

to avoid pulp exposure

46
Q

What are recurrent caries?

A

microleakage present at the junction between restoration and tooth

47
Q

Why can recurrent caries sometimes not be seen on radiograph?

A

the caries can progress under the restoration or behind it

48
Q

What are the characteristics of acute caries?

A
  • rampant
  • light color
  • appears dull, mushy
49
Q

What are the characteristics of chronic caries?

A
  • slow or arrested
  • dark color
  • appears shiny, solid
50
Q

What is the idea of conservative dentistry?

A

using better preventative measure available such as enameloplasty, sealant, and preventative resin

51
Q

What does “extension for prevention” mean?

A

taking away unnecessary tooth structure to prevent spread of caries (this is no longer practiced)

52
Q

What do the following abbreviations mean for tooth preparation?

O
MO or DO or MOD
F or B
L

A
  • O = occlusal
  • MO or DO or MOD = mesial occlusal or distal occlusal, mesial-occlusal distal
  • F or B = facial or buccal
  • L = lingual
53
Q

What are the two terms for the internal walls?

A

axial wall
pulpal wall or floor

54
Q

The axial wall is _________ to the long axis of tooth

A

parallel

55
Q

Cavosurface is a (noun, verb, or adjective)

A

adjective

56
Q

What is the definition of cavosurface?

A

margin (edge) where the prepared (cut) tooth meets the unprepared tooth

57
Q

What is the definition of cavosurface angle?

A

angle where prepared wall and unprepared tooth surface meet

58
Q

What wall is closest to the pulp?

A

pulpal wall/floor

59
Q

The pulpal wall/floor is _________ to the long axis of the tooth in class I and II preps?

A

perpendicular

60
Q

What are the characteristics of the floor?

A
  • prepared (cut) walls
  • flat
  • perpendicular to occlusal forces
61
Q

What do the pulpal and gingival floors/walls provide?

A
  • stablizing seats for restoration
  • distribute stresses in tooth
62
Q

What is a line angle?

A

Junction of two walls/surfaces along a line

63
Q

What is a point angle?

A

junction of three surfaces

64
Q

What are the three types of cavosurface angles?

A
  • bevel
  • 90 degrees
  • chamfer (not in this class)
65
Q

What is the CEJ?

A

where cementum meets enamel

66
Q

What is unsupported enamel?

A

when enamel rods are not supported by sound dentin

67
Q

What is a class I prep?

A
  • Occlusal surface of posterior teeth
  • May include lingual/buccal grooves and pits
68
Q

What is a class II prep?

A

Proximal surfaces of premolars and molars

69
Q

What is a class III prep?

A

Proximal surfaces of incisors and canines (do not involve in incisal edge)

70
Q

What is a class IV prep?

A

class III but the incisal edge instead
- Proximal surfaces of incisors and canines

71
Q

What is class V prep?

A

Gingival 1/3 of smooth surfaces
◦ Buccal, lingual

72
Q

What is class VI prep?

A

incisal edge or cusp

73
Q

What are the stages of tooth prep?

A
  • GV Black principles
  • know what your restorative material needs for adequate strength
  • initial stage
  • final stage
74
Q

What is the initial stage of preparation?

A
  • outline form
  • initial depth
  • priary resistance form
  • primary retention form
  • convenience form
75
Q

How should the outline form look?

A
  • smooth and flowing
  • undermined enamel removed
  • margins placed where you can finish restoration
  • no occlusion on margins of prep
76
Q

What are the rules of outline form?

A
  • preserve strength
  • minimize extensions faciolingually
  • connect two preps that are <0.5 mm apart
77
Q

What are the rules for a class I prep in outline form?

A
  • Extend to sound tooth structure
  • Extend when (Fissures cannot be eliminated by enameloplasty and Two cavities have <0.5mm between them)
  • Do not terminate on cusp height or ridge crest
  • Allow sufficient access for placement and finishing
78
Q

What are the rules for a class II prep outline form?

A

extend gingival margins apical to contact, extend interproximal margins to embrasures

79
Q

How is axial wall depth measured?

A

Class II - measured from proximal marigin to axial wall
Class V - measured from marigin to axial wall

80
Q

What is an enameloplasty?

A
  • remove shallow enamel fissure or pit and create a smoother shape (self-cleansing)
  • no more than 1/3 enamel thickness removed
81
Q

What does resistance form mean?

A

resistance to fracture against occlusal forces

82
Q

When is the resistance form compromised?

A

margin exceeds 2/3 of the distance between central groove

83
Q

What should the resistance form have?

A
  • internal line angles slightly rounded
  • external line angles slightly rounded
  • flat foors
84
Q

What does the resistance form allow for?

A

suffiecient thickness of restorative material

85
Q

What is the minimum thickness for amalgam, gold, porcelain?

A

amalgam - 1.5 mm
gold - 1-2 mm
porcelain 2.0 mm

86
Q

What should the margins of the resistance form be for amalgam?

A

90 degrees

87
Q

What are the objectives for the retention form?

A
  • retain the restoration
  • dovetail to prevent tipping and proximal displacement
88
Q

What are the key aspects of the retention form?

A
  • wall length
  • convergence
  • parallellism
89
Q

What type of wall is better for retention (tall or short)?

A

tall

90
Q

What are the final stage steps of tooth prep?

A
  • Remove remaining infected dentin
  • Remove remaining old restoration
  • Pulp protection
  • Secondary resistance and retention forms
  • Finish external walls and margins
  • Final cleaning, inspecting, and sealing
91
Q

What does affected/demineralized dentin appear like?

A
  • usually discolored by not soft
  • ok to leave in rare circumstances
92
Q

What does infected dentin appear like?

A
  • soft
  • may or may not be stained
  • MUST BE REMOVED
93
Q

What is secondary retention?

A
  • retention grooves, points
  • areas for restorative materials to “lock” into
  • results in fewer extensions
  • increase bulk of restorative material to disperse forces
94
Q

Where should you position yourself to do lingual side of patients lower right and buccal side of patients upper left?

A

8:00

95
Q

Where should you position yourself to do lingual side of patients lower left and buccal side of patients upper right?

A

11:00

96
Q

Where should you position yourself to do buccal side of patients anteriors and lingual side of patietns anterior?

A

12:00-1:00

Operative Lecture (17 decks)

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