Flashcards in Quiz on Complex Amalgam Deck (105):
Indications for complex amalgams: for a "_______" restoration of a tooth has questionable pulp or periodontium.(EXT or RCT might be needed)
Indications for complex amalgams: patient cannot ______ a crown
CONTRAindications for complex amalgams: Severe _______ problems
CONTRAindications for complex amalgams: ________ important area
CONTRAindications for complex amalgams: Cannot be restored properly due to _________ or functional considerations (contour, contacts, occlusion, inability to place a matrix)
Complex Amalgam Restorations ADVANTAGES!-- ________ tooth structure!
Complex Amalgam Restorations ADVANTAGES!-- One ________ instead of two as in a cast restoration
Complex Amalgam Restorations ADVANTAGES!-- Less ________ than indirect restorations
Complex Amalgam Restorations ADVANTAGES!-- success rate at 5 years ___%-____% for amalgam vs. ____% for cast restorations
65%-72% for amalagam vs 84% for cast...so a viable alternative
Complex Amalgam Restorations disADVANTAGES :( Its not very structurally _______
Complex Amalgam Restorations disADVANTAGES :( theres not much ______ so it can fall off
Complex Amalgam Restorations disADVANTAGES :( Difficult to develop natural ______ and function
contours (pssshh, whatev's)
Complex Amalgam Restorations disADVANTAGES :( Potential for pulp and root _______ and dentin ________ when placing pins for retention
Complex amal-PREP DESIGNS! When the isthmus exceeds ____ the distance between the facial and lingual cusp tips
Complex amal-PREP DESIGNS! When you had to remove a _____ :(
Complex amal-PREP DESIGNS! ￼￼Plus, (tip, or cap) a cusp when the facial or lingual extension exceeds _____ the distance from a primary _______ toward the cusp tip
2/3....primary groove (so when you remove 2/3 of a cusp on the interproximal extension, the cusp has to go)
Complex amal-PREP DESIGNS! ￼￼You NEED ____ retention feature PER missing cusp!
1 retention feature per missing cusp!
Complex amal-PREP DESIGNS! How much of a NON-Fxn cusp needs to be removed to support the amalgam?
greater or equal to 1.5mm
Complex amal-PREP DESIGNS! How much of a FUNCTIONAL cusp needs to be reduced to support the amalgam?
greater than 2mm (2-3mm)...shit needs to be THICK yo
If you get this wrong, I will kill you. ON the mandibular arch, the ______ cusps are the functional cusps.
If you get this wrong, I will kill you. ON the maxillary arch, the ______ cusps are the functional cusps.
Complex amal-PREP DESIGNS! Cusp reduction should be extended just below the extension of the ______ or ______ _______.
facial or lingual groove
Complex amal-PREP DESIGNS! DO NOT end the prep cavo-surface in a __________. End either BEFORE or AFTER it.
facial or lingual groove (i think i made this mistake in lab)
Complex amal-PREP DESIGNS! Opposing vertical walls should ________ slightly to the occlusal.
Complex amal-PREP DESIGNS! Pulpal and gingival floors and tipped cusps should be _____ and ________ to the long axis of the tooth.
flat and perpendicular
Complex amal-PREP DESIGNS! All _______ margins are SHARP and well defined
Complex amal-PREP DESIGNS! Axial and occlusal- gingival "____" should be developed where possible
steps (like our "shoulder" that we put into it)
Complex amal-PREP DESIGNS! All internal line angles are _______
Complex amal-PREP DESIGNS! Angle of departure is ___ degrees (no _______ enamel)
Complex amal-PREP DESIGNS! Auxiliary retention is provided by using ______, ______, or ____..... or a combination.
slots, troughs, or pins
Complex amal-PREP DESIGNS! Slot/trough placement--May be continuous or segmented, (_____ slots resist horizontal force as well as longer ones)...DEPTH of the slot is _____
shorter..the depth of the 34D (0.8mm)
Complex amal-PREP DESIGNS! All retention features are placed in ______...more specifically placed ____mm past the ____. (following the contour of the _____)
Complex amal-PREP DESIGNS! the slot you put in should have _______ walls, thank you 34D
Complex amal-PREP DESIGNS! Putting pins in _____ treated teeth is actually CONTRAINDICATED & AGAINST the Standard of Care!
The most frequently used pin is the ________ type. They are the MOST _______!
SLOTS VS PINS- There is ________ in the retention provided by slots and pins in vitro and in vivo
NO SIGNIFICANT DIFFERENCE
SLOTS VS PINS-_______ retention is used in preparations lacking vertical walls for steps or boxes
SLOTS VS PINS- _____ are used in preparations with short clinical crowns and in cusps that have been reduced 3-4 mm for amalgam
SLOTS VS PINS- ____ are less likely to create micro-fractures than are _____.
SLOTS VS PINS-____ remove more tooth structure
SLOTS VS PINS- Failure of slot in ______ retained amalgam will be IMMEDIATE LOSS of the amalgam!
SLOTS VS PINS-_______ elicited an inflammatory pulpal response if placed within ___mm of the pulp; ____ placed in the same location did not!
SLOTS VS PINS-_____ are more likely to result in perforations of the pulp or side of the tooth
SLOTS VS PINS-Failure of a pin retained amalgam can be slip or fracture at first (but not fall out) and later very catastrophic due to ______ beneath it!
SLOTS VS PINS- Amalgam TENSILE and HORIZONTAL strength is weakened by ____
SLOTS VS PINS-Believe it or not: _____ are NOT analogous to steel rebar reinforced concrete
SLOTS VS PINS- ______ of the restoration increases as the number of pins increases, but an excessive number of pins can ______ the tooth and significantly weaken the amalgam (more is not necessarily better)
Pin Placement Technique: The pin hole goes ___mm past the DEJ.
Pin Placement Technique: Pin hole prepared on a _____ surface
Pin Placement Technique: Provide a minimum ____ mm CLEARANCE around the circumference of the pin for adequate amalgam condensation
Pin Placement Technique: 1 pin per missing _______
AXIAL LINE ANGLE, place it at the line angle!
Anatomical Features to AVOID when placing pinholes!!! The PROMINENT M concavity of the _______ (tooth perforation)
max 1st PM
Anatomical Features to AVOID when placing pinholes!!! Midfacial and midlingual BIFURCATIONS of _______ (tooth perforation)
Anatomical Features to AVOID when placing pinholes!!! Mid facial, midmesial, and middistal FURCAITONS of _______ (tooth perforation)
Anatomical Features to AVOID when placing pinholes!!! MF CORNERS of _____ AND ______ (possible pulpal penentration)
maxillary and mandibular molars
MORE Pin Placement Technique! Start with a _____ bur PILOT hole where you want the pin to start
1/4 round bur
MORE Pin Placement Technique! Use a ______ to align drill before placement
MORE Pin Placement Technique! _______ placement of pins enhances the retention of the amalgam...interesting!
MORE Pin Placement Technique! Rotate at _______ speed (300-500 rpm) and apply pressure preparing the pinhole in one or two insertions until the depth- limiting portion is reached (____mm)..oh and USE ______
low speed...(2.0mm)...USE WATER!
MORE Pin Placement Technique! NEVER _____ the drill in the pinhole...Never _______ the drill unless only used to half the depth the first time
Can you bend pins?
yes, with a "special instrument"
Pin placement ERRORS :O Sudden loss of RESISTANCE to the pin twist drill and the evidence of _____ IN the pinhole means you _______!
Pin placement ERRORS :O When do I inform the patient?
At the end of the appointment
Pin placement ERRORS :O Whats next? Ideally ______ treatment should be done on compromised teeth if the pulp is exposed.
Pin placement ERRORS :O Whats next? ________ may be placed over the pinhole and another hole prepared ___-__ _ mm away.
CaOH ( Dycal or Life)....1.5-2.0mm away
Pin placement ERRORS :O Perforations occlusal to the gingival attachment: 1. _____ the pin off FLUSH with the tooth surface. 2. Same as in 1 and extend a ____ restoration beyond the perforation 3. Remove the pin, ENLARGE the hole and restore with ______
Pin placement ERRORS :O Perforations APICAL to the attachment: 1.Surgical ____, remove bone, enlarge hole and place amalgam or ____ 2. _________ surgery and extend a cast restoration below the perforation
flap...MTA(portland cement!)...Crown lengthening
You can use amalgam for a endo treated tooth for a crown build up when the pulp chamber height is ___-___mm. Do you need a post?
4-6mm, no post needed!
For an amalgam core build up, get ___-___mm into the canal orifice below the CEJ
Which type of amalgam do I use when making a crown buildup? Why?
Megalloy-it is STRONGER and SETS FASTER than dispersalloy!
Which is higher, composite bonded to enamel or amalgam bonded to enamel?
Composite to enamel bond strength is 20-25 MPa, amalgam bonded to enamel is 3-10 MPa...BOOM
Bonding resin may interfere with the self ______ capability of amalgam
complex amalgam-THE MATRIX: When using a Tofflemire placed from a facial approach, keep the slot in the _____ of the tooth, and the slot is going to be opposite of the ______.
complex amalgam-THE MATRIX: When needing to place the Tofflemire Lingually, use an ______ Tofflemire and place wedges on _______ sides.
complex amalgam-THE MATRIX: What do I use when my Tofflemire slot is exposed?!
Freak out! Life is over!! Jk. Cut a matrix band and place it over the slot
complex amalgam-THE MATRIX: What type of matrix can I use in lieu of the Tofflemire?
a Garrison PINCH matrix!
LETS DROP SOME KNOWLEDGE: Which amalgam is Spherical?
LETS DROP SOME KNOWLEDGE: Which amalgam is AD-Mixed?
LETS DROP SOME KNOWLEDGE: Which amalgam has LESS condensation pressure?
LETS DROP SOME KNOWLEDGE: which amalgam has MORE condensation pressure?
LETS DROP SOME KNOWLEDGE: Which amalgam has LESS mercury?
LETS DROP SOME KNOWLEDGE: Which amalgam has MORE mercury?
LETS DROP SOME KNOWLEDGE: Which amalgam sets faster?
LETS DROP SOME KNOWLEDGE: which amalgam sets slower?
LETS DROP SOME KNOWLEDGE: Which amalgam has NO ZINC? What does this mean?
Megalloy...no delayed expansion and no H2 Gas
LETS DROP SOME KNOWLEDGE: which amalgam has ZINC? what does this mean?
dispersalloy....NO WET environments!
LETS DROP SOME KNOWLEDGE:Which amalgam is stronger?
Amalgam Selection: Unable to place RD and isolation is poor...
Megalloy---dispersalloy has ZINC and is therefore not comparable with WET invironments
Amalgam Selection: Strong Contacts are going to be difficult.
Dispersalloy-didnt give a good reason
Amalgam Selection: I need amalgam to fill in the intricate grooves and slots
Amalgam Selection: I need to prepare the crown on the same build-up appointment
Amalgam Selection: It’s my first time and I’m worried about the amalgam hardening on me before I complete the carving.....!
What is the KEY move in forming the cusp in our bulk amalgam?
form the cusp with the DOUBLE ENDED PLASTIC INSTRUMENT
What instrument do I use to make the occulsal embrasures?
What instrument do I use to REBURNISH the amalgam where the missing cusp is?
double ended plastic instrument
OUR complex amalgam preps #14: Isthmus is ___mm wide and ____ mm deep
OUR complex amalgam preps #14: ___ to ___mm contact separation
0.5 to 1.0mm
OUR complex amalgam preps #14: ___mm on the ML cusp removal
OUR complex amalgam preps #14: Retention trough placed along mesial-lingual line angle ___ mm away from exterior surface of enamel and ____ mm deep.
1.0mm (which was 0.5mm in our lecture?!?!)...1.0 mm deep (depth of 34D)
OUR complex amalgam preps #14: Extend prep BEYOND the _____ groove
OUR complex amalgam prep #30: Pulpal floor at least ___ mm deep
OUR complex amalgam prep #30: Lingual cusps removed to level of _____ floor
OUR complex amalgam prep #30: Lingual SHOULDER placed ___ mm below pulpal floor
OUR complex amalgam prep #30: Small circular cut into lingual axial wall to make space for ____, and there is AT LEAST ____mm of space between pin and axial wall.