Bp Esthetics Basic Procedures In Aesthetic Dentristry

Front 1

What are the available methods to detect dental caries?

Back 1

1. Visual
2. Touch and Feel
3. Imaging
4. Dyes

Front 2

What classification involves the proximal surfaces of anterior teeth?

Back 2

Class III

Front 3

Which classification involves the gingival 1/3 of facial or lingual surfaces regardless of which tooth it is on?

Back 3

Class V

Front 4

What classification involves proximal and incisal edge of anterior teeth?

Back 4

Class IV

Front 5

What instruments are used for smoothing floors of cavity preps?

Back 5

Chisel
Hatchet
Margin Trimmer

Front 6

Which instrument is good to detect and remove decay when close to pulp?

Back 6

Spoon Excavator

Front 7

Which instrument is good to detect and remove decay when close to pulp?

Back 7

Spoon Excavator

Front 8

What does the first number on the hand instrument indicate?

Back 8

How Wide the Cutting Edge is in 10ths of mm
i.e. 13 = 1.3 mm

Front 9

What is the cutting head shape of these burs?
1/4, 1/2, 2, 4, 6, 8

Back 9

Round

Front 10

What is the cutting head shape of these burs?
33 1/2, 34, 35

Back 10

Inverted Cone

Front 11

What are two different types of Straight fissure (cylinder) burs?

Back 11

Cross Cut (556, 557, 558)
Non cross cut (56, 57, 58)

Front 12

What is the cutting head shape of these burs?
330 & 245

Back 12

Pear Shaped

Front 13

What is the cutting head shape of these burs?
7104, 7404, 7801

Back 13

Finishing burs

Front 14

What is the fastest speed you can polish with?

Back 14

40,000 RPM

Front 15

What are polishing discs useful and NOT useful for?

Back 15

Cannot do class II. Not good for grooves.
Good for composite veneers. Useful for line angles

Front 16

What is the polishing order?

Back 16

Coarse, Medium, Fine, Superfine
Green, Yellow, White
Use goat hair brush with diamond last

Front 17

What determines the design of a cavity preparation?

Back 17

Location of caries
Dental material used

Front 18

What is the definition of outline form?

Back 18

The outline of the cavity as it meets the external surface. Determined by the extent of caries.

Front 19

Define Retention form

Back 19

Resist forces that tend to dislodge or draw the restoration along the long axis of the tooth (tensile forces)

Front 20

What method of retention do grooves, converging walls, dovetails, and pins provide?

Back 20

Mechanical Retention

Front 21

What type of retention is provided by bonding/adhesion as in Composite Resin?

Back 21

Micromechanical

Front 22

What type of retention is provided by glass ionomer?

Back 22

Chemical retention

Front 23

Define Resistance form

Back 23

Resistance form resist forces that tend to displace the restoration by torquing or tipping.
The ability of the preparation and tooth structure to resist fracture

Front 24

What does convenience form allow for?

Back 24

Caries removal
Visibility
Preparation and restoration

Front 25

What are the steps in cavity preparation?

Back 25

...

Front 26

T/F
When curing composite the outermost layer does not cure completely if it is not covered by the mylar strip.

Back 26

True
This is called the air inhibited layer or the oxygen inhibited layer

Front 27

What is a benefit of the air inhibited layer of composite?

Back 27

You may add more composite to this layer without bonding

Front 28

What are the factors affecting adhesion to tooth structure?

Back 28

1. Physiochemical properties of the adherend and the adhesive (good wetability, good curing light)
2. Surface contaminants (clean substrate)
3. Oral environment

Front 29

What are the contents of the smear layer?

Back 29

Smear Layer (0.5 - 5.0 um)
1. Pulverized hydroxyapatite
2. Altered collagen
3. Bacteria
4. Saliva

Front 30

How does the smear layer affect bonding to the tooth?

Back 30

The smear layer will NOT provide a good bond to the tooth, so it needs to be removed

Front 31

What is the purpose of acid etch?

Back 31

Decalcifies - creates mechanical undercuts
Cleans - Phosphate detergent, removes smear layer

Front 32

What do we use to etch teeth?

Back 32

Phosphoric acid 35%

Front 33

What are the Objectives of Bonding agents?

Back 33

1. Minimize tooth preparation
2. Reduces microleakage
3. Reinforces tooth structure
4. Sealing

Front 34

What are the Characteristics of ideal dentin bonding agents?

Back 34

...

Front 35

What are the indications for bonding agents?

Back 35

...

Front 36

What is the composition of dentin bonding agents?

Back 36

Hydrophilic resins & Solvent carrier (acetone or alcohol)

Front 37

What is the bonding mechanism for bonding agents?

Back 37

Mostly Micromechanical

Front 38

T/F
No matter the bonding agent, you will always have a hydrophilic and hydrophobic part.

Back 38

True

Front 39

What is the hybrid layer?

Back 39

Resin interlocking with collagen fiber

-when you etch, you'll expose collagen fibers. adhesives will inflitrate and interlock with collagen fibers. This is what gives us our micromechanical retention. When it infiltrates, there is a layer that is adhesive and tooth structure (organic, collagen fibers). This is a hybrid of tooth and material. The more stable hybrid layer the stronger the bond)

Front 40

What does the primer do?

Back 40

Primer transforms the hydrophilic dentin surface into a hydrophobic state that allows the adhesive resin to penetrate into collagen network.

Front 41

What does the adhesive resin/bonding agent?

Back 41

1. Hydrophilic and hydrophobic properties
2. Stabilize the hybrid layer
3. Forms the resin tags for retention

Front 42

How should the dentin be prior to application of bonding agent?

Back 42

moist from water (but no blood or saliva)

Front 43

When, why and where do we place a bevel?

Back 43

Class V - incisal/occlusal cavosurface line angle - 0.5-1.0 mm bevel (note: never apply a bevel on the gingival, because the enamel is very thin. You want at least 2.0 mm)

Class II - Facial and Lingual Proximal surface - 0.5 mm - 45 deg

Front 44

What are the advantages and disadvantages of Three step Total Etch system?

Back 44

Excellent enamel and dentin bond
But, takes longer to do and primer is very hydrophilic, so you need 20-30 seconds to allow the solvent to evaporate.

Front 45

What are the advantages and disadvantages of Two Steps Total Etch?

Back 45

Good enamel and dentin bond, primer & adhesive mixed into one bottle (this is what we use at Case)

But, still takes 20 sec to allow primer in bottle to grab water and evaporate

Front 46

What are the advantages and disadvantages of Two Steps Self Etch?

Back 46

Has self-etching primer bottle and adhesive bottle

But, collagen is exposed but does not completely remove smear layer

Front 47

What are the advantages and disadvantages of One Step Self-Etch (all in one)?

Back 47

Incompatible with self-cure resin
Poor enamel etch and poor bond

Front 48

What is the composition of composite?

Back 48

1. Resin Matrix
2. Inorganic filler particles
3. Coupling agents
4. Activator-initiator system
5. Optical modifiers

Front 49

What makes up the resin matrix?

Back 49

Bis-GMA & TEGDMA

Front 50

What is a coupling agent and what is its function?

Back 50

Provides bonding of the inorganic filler particles to the resin matrix. usually an organosilane

Front 51

How do filler particles affect the material?

Back 51

...

Front 52

How are composite resins classified?

Back 52

Method of polymerization & Particle size

Front 53

What size are the microfil resins?

Back 53

0.04 micron colloidal silica microfill

Front 54

In what situation would you use Microfill over Hybrid resin?

Back 54

Microfill - Preferred for smooth surface caries lesions or veneers

Front 55

When would you use a Hybrid over microfill resin?

Back 55

Hybrid - Anterior restorations including class IV and stress bearing restorations

Front 56

How do you control shrinkage? Can you eliminate it?

Back 56

Layer
No. The only way you can eliminate shrinkage is if you cure composite 100% outside (i.e. in the lab) then cement in the mouth.

Front 57

What is rebonding?

Back 57

If you need to add more composite and there is no air inhibited layer then you need to etch and rebond. This is also true if you need to seal an area off.

Front 58

What are the advantages of posterior composite restorations?

Back 58

1. Aesthetics
2. Conservation of tooth structure
3. Adhesion to tooth
4. Low thermal conductivity
5. Elimination of galvanic current
6. Radiopacity

Front 59

What are the disadvantages of posterior composite restorations?

Back 59

1. Polymerization shrinkage
2. Postoperative sensitivity
3. Marginal leakage
4. Technique sensitive
5. Isolation
6. Time consuming
7. Discoloration

Front 60

What are the indications for posterior composites?

Back 60

Indications
1. Aesthetics
2. Class V
3. Small to moderate class I and class II if amenable to isolation
4. Repair

Front 61

What are the contraindications for posterior composites?

Back 61

Contraindications
1. Adequate isolation not possible
2. Loss of excessive tooth structure
3. Subgingival margins
4. All contacts on restoration

Front 62

When do you use calcium hydroxide prior to etching?

Back 62

only in areas close to the pulp

Front 63

How do you deal with subgingival margin if restoring with composite?

Back 63

If you cannot isolate, don't do the composite! Take impression and make composite onlay or inlay, then cement in place. Otherwise it may break or debond. Also it can leak, have open margin, leading to decay underneath.