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158 Cards in this Set
- Front
- Back
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What is the primary purpose of marginating, finishing and polishing a dental amalgam?
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Produce a smooth surface
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What do smooth surfaces of an amalgam restoration provide
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- less retention of plaque
-easy to keep clean by patient -contribute to localized periodontal health -less prone to recurrent decay |
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Finishing procedures for dental amalgam restoration should be done usually how long after placement?
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24 hours
** should be done after amalgam has completely set |
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The use of finishing burs and stones to REMOVE access margin and gross surface irregularities; and helps to prevent recurrent decay
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Margination
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The use of pumice, glycerin; prophy cups and brushes to produce overall smoothness of amalgam surface
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polishing
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what are indications of Margination
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-Excess interproximal material
(Overhang ex. Class II amalgam restoration) - Overcontour amalgam surface (ex. Class V restoration) |
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What is the Armamentarium for Margination?
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-Finishing Knifes: amalgam or gold knife,cleoid-discoid knife,finishing strips
-Files: remember to use coarse files first then work way to finer files -Scalers/ curettes, spoon excavators -ultrasonic scalers: chisel, straigth, straight triple bend - Finishing discs on Mandrels |
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How do you prevent ditching during a marginatinon procedure?
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Adapt finishing disc using short, overlapping strokes from amalgam to tooth surface of the cavo-surface margin
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These description are of what:
- thin flexible strip of metal -linen abrasive strip -plastic impregnated with abrasive on one side |
Finishing/polishing strips
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Abrasive are alwasy used in succession from _____ coarse to ____coarse
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most coarse to least coarse
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another word for "finer abrasive"
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cuttle
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What is a "FLASH"
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excessive amalgam on margins
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What are the benefits of finishing and polishing amalgams?
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-removes flash
-improves overall smooth of surface -reduces tarnish and corrosion -facilitate plaque control -improves esthetics of restoration |
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What is used to reduce high spots on amalgam surface?
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Green stones: a coarse abrasive stone
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when using a slow-speed hand piece & contra-angle bur or stone it is important to maintain a ____field to reduce the risk of thermal injury to the pulp
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wet field
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When finishing an amalgam restoration at what speed should the handpiece be operating at?
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20,000 rpm
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When polishing an amalgam restoration at what speed shoud the handpiece be operating at?
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5,000 rpm
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To avoid fracturing of the amalgam restoration move bur from?
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amalgam to the tooth
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white stones are used on ?
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Tarnished or pitted areas
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To avoid ditching of the amalgam restoration move bur from?
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Tooth to amalgam
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Finishing burs contain more of what ? than cutting burs
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Flutes
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What is a Round Bur used for?
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- removing caries during tooth prep
-Opening pulp chamber for Endodontic Treatment |
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What is an Inverted Cone Bur used for?
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- Remove caries
- place retention grooves during tooth prep |
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What is a Fissure Bur used for?
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-modify the walls of cavity prep
- place retention grooves -for hard to reach areas of prep |
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What is a Finishing Bur used for?
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- to refine and smooth surface of restoration
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Finishing of Amalgams aids in preventing?
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Tarnish( amalgam to discolor)
Corrosion (amalgam to deteriorate over time do to chemical rxn) Expansion (amalgam to expand beyond cavity margins and chip over time) |
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Margination of Amalgams requires what type of supervision?
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Indirect
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Polishing of amalgams requires what type of supervision?
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General
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Placing?removing a temporary restoration requires what type of supervision?
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General
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Polishing can be achieved in one of two ways?
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- using an abrasive slurry
-using an abrasive cup and mini-points |
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Silicone polisher impregnated with polishing abrasives are used to create?
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brilliant, reflective surfaces
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Name the polishing stones from the most coarse or abrasive to the finiest abrasive
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Brownies,
greenie super greenie |
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Brownies create a
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smooth, dull luster surface
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greenie create a
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lustrous sheen
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Super greenies create a
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super polish shine
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What must be done in between each use of polishing stones?
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area washed out with water
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what is the purpose of placing temporary crowns?
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-prevent sensitivity in prep tooth
-maintain occlusion -prevent fracturing or breakdown of preped tooth -provide for lost fxn -maintain esthetics |
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what are the types of crowns
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- anatomical metal crowns
- anodized Aluminum Crowns - Preformed Plastic Crowns - Custom Resin Crowns |
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This type of crown forms whose exteriors approximate natural teeth in facial, lingual, mesial, distal contours, as well as in the contours of the occlusal surfaces
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anatomical
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What are the two types of Anatomical Metal Crowns
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Anatomical
Stainless steel |
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Stainless crown is often used in restoring what teeth
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Primary.
**it can provide temporary coverage for months or years |
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Anodized Aluminun crowns are most commonly used on what teeth?
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premolars and molars
advantage is: resistance to wear and malleable disadvantage: softness |
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what are the two types of Preformed Plastic Crowns
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Polycarbonate
Cellulose |
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These preformed plastic crowns are hollow, tooth shaped, w/walls about 0.3mm thick
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polycarbonate
**usually only available in 2 shades |
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This type of performed plastic crown is clear and hollow and comes in variety of shades and colors
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cellulose
**resin material is mixed additionally |
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Resin Materials are used to line what types of crowns
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polycarbonate
cellulose aluminum custom |
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What are the types of Resin Material
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Methyl Methacrylates
Ethyl Methacrylates Vinyl Ethyl methacrylates Composites |
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Advantages/ Disadvantage of Methyl Methacrylate
Brand Name: JET |
excellent color
stability and wear resistant generates heat, and extensive shrinkage |
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Ethyl Met/ Vinyl Ethyl Met (SNAP)
Advantage/ Disadv: |
less heat generated
decrease shrinkage as it sets Decrease color stability |
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Composite: Bis-acryl (Protemp)
advantage/disadvan: |
high strength
low heat generation low shrinkage *do not have putty stage and Expensive |
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Aluminum Crowns are mainly place on what teeth?
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Posteriors
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Preformed polycarbonate crowns are mainly placed on what teeth?
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Anteriors
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Custom-formed provisional coverage crowns are mainly place on what teeth?
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several teeth that have been prepared for a bridge
**but it can be used for a single crown |
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Laboratory-frabricated crowns are placed on what teeth?
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several teeth that have been prepared for a LONG-SPAN Bridge
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What can be used for a provisional coverage for an inlay or onlay?
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light-cured nonstick composite
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Mechanical retention is usually suffificient to hold a provisional onlay or inlay, but if cement is necessary, what type of cement should be used?
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Noneugenol provisional cement
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What can be used to line a provisional aluminum crown?
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Methylmethacrylate ( self-curing acrylic) for better internal fitting to the prep
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What type of scissors are used to cut a temporary crown?
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Curved and used to in cut in a continous cut action.
**snipping causes uneven edges |
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What can be used to cement an aluminum provisional crown?
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-IRM mixed with petroleum jelly
- Z.O.E **the cement is permitted to set for approximately 8 to 10 minutes |
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the purpose of a suture is?
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-maintain healing tissue in position
-maintain clot during initial healing period -reduce size of wound -lessen time required for healing -protect area from foreign debris |
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There are 2 types of sutures?
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Absorbable
Nonabsorable |
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This type of suture is broken down by proteolysis action by the body tissue fluid and enzymes
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Absorable
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What are examples of absorbable sutures?
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Surgical gut
Polyglycolic acid |
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Tensile strength is lost with this type of suture but is used for short wound healing time
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absorbable
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Example of Nonabsorbable suture
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surgical silk
cotton synthetic fibers |
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this type of suture has great tensile strength but can become encased in the CT and patient must come back to have it removed
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Nonabsorbable
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what is the range of size of suture
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0--12-0
where 4-0 is the most commonly used in dentistry |
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suturing needles are typically made of?
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stainless steel
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Reverse cut needle has the 3rd cutting edge on the _____
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outer convex curve
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the use of specific chemical or pharmaceutial agents for the control of destruction of microoganism, either systemically or at specific sites
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antimicrobial therapy
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tubular instrument placed in a cavity to introduce or withdraw fluid
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cannula
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local delivery of chemotherapeutic agent to a site-specific area; may be a patch to be warn on the skin or a polmeric fiber, such as that used to deliver and agent to a periodontal pocket
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controlled release
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a form of antimicrobial agent produced by or obtained from microorganisms that kill other microorganisms or inhibit their growth; may be specific for certain organisms or may cover a broad spectrum
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antibiotic
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In respect to Local delivery of antibiotics there are two ways to delivery:
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1. irrigation
2. controlled release |
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what is the pathway of systemic antibiotic to the area of treatment
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1. antibiotic absorb into the circulation from the intestine.
2. from the bloodsstream the drug is passed into the body tissue 3. enters the periodontal tissue asn passes into the pocket by way of the gingival sulcus fluid |
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the system drug (antibiotic) is in a_______form by the time is reaches the pathogenic microorganism where the destruction is taking place
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diluted form
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Indications for systemic ABX
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NUG
NUP Periodontal abscess formation Percoronal abscess formation |
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What are the types of cannula tips
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side port delivery
twin side port delivery end delivery |
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Irrigation delivery method procedure includes:
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1. prepare cannula by bending it slightly
2. insert cannula subgingivally 3. allow the irrigant to fill the pocket 4. apply cirucumferentially, releasing soln. at 3 points on facial and 3 points on lingual surfaces |
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Subgingival irrigation can produce ______
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bacteremia
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For local delivery to be successful it must:
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1. be of a conc. that will act on the microbes causing the infection
2. reach all areas including furcations and bottom of pocket 3. stay in contact long enough at the effective conc. for abx action to take place |
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what are the types of local delivery agents?
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1. tetracycline fibers
2. minocycline 3.doxycycline 4. CHX chip |
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Tetracycline Fiber: controlled-released delivery for TX of periodontal pathogens developed by __________ (person's name)
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Goodson and co-workers
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The use of the fiber has show significant clinical improvement in:
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probing depth
CAL (clinical attachment levels) BOP |
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Tetracycline Fiber characteristics
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1. Monolithic fiber
2. 12.7 mg tetracyline HCL mixed with polymer 3. Controlled delivery maintains High conc. over full 10 day period of application |
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What probing depth is best for the tetracycline fiber?
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5mm or more
**the deeper the probing depth--the longer the fiber has has to be |
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Steps in placing the fiber?
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1. first placed around the tooth to provide retention
2. start at the bottom of pocket, the fiber is layered on itself until the pocket is filled 3. pack fiber down with dull instrument 4. place adhesive dressing |
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Doxycyline initially is in this form before it solidifies when it comes into contact with sulcus fluid
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liquid
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this Rx is synthetically derived from oxytetracycline
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Doxycycline (Atridox)
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This Rx is a 1st generation agent that is capable of reducing broad spectrum microbes
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CHX
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This RX reacts with microbial cell surface and destroys the integrity of cell membranes
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CHX
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This RX penetrates the cell and precipitates the cytoplasm of microbes
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CHX
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This RX has 2.5 mg dosage mixed with hydrolyzed matrix and gluteraldehyde; has low toxicity there for good for soft tissue managment; biodegrades in 7-10 days and is best used in pockets that are greater than 5mm
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CHX Chip
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what are some adverse rxn to the CHX
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staining
altered taste ( not really seen when just using 2 or 3... seen more when more than 3 are used) may cause dental sensitivity |
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this Rx is second generation agent; is a broad spectrum ABX; it has bacteriostatic properties
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Doxycycline
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This RX is a little more labor intensive, need to mix ahead of time because it takes time to prepare
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Doxycycline
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This RX is a two syringe mixing system: Syringe A contains: Bioabsorbable polymer--helps keep active ingredient in place and Syringe B contains 10% liquid (42.5mg) of the drug
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Doxycycline
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This drug solidief on contact with crevicular fluid
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Doxycycline
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When being treated with this RX patient must avoid excessive sunlight or artifical UV light
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Doxycycline and minocycline
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This Rx may decrease the effectiveness of birth control pills
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Doxycycline
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When being treated with this Rx patient must avoid brushing and flossing in the treated area for 7 days
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Doxycycline
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What are some adverse effects of DOXY
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gingival discomfort
Toothache, pressure sensitivity Thermal sensitivity |
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This Rx is 3rd generation agent
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MINOcycline
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this Rx is a tetracycline class broad spectrum antibiotic
bacteriostatic and inhibits protein synthesis of microbe |
MINO
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Minocycline comes in the form of little _______
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microspheres
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This RX is 1mg and sustain release for 14 days
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Minocycline
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This Rx is the second easiest to use but most expensive
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MInocycline
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Pt instruction of this RX is:
1. avoid hard crunch foods X 7 days 2. Postpone brushing for 12hrs 3. Postpone interproximal cleaning device x10 days 4. avoid excessive sunlight for UV light X 14days |
Minocycline
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Adverse effects of MInocycline:
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Headache
Soreness Flu symptoms |
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what is the pocket depth reduction for CHX (periochip)
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1.0mm
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What is the pocket depth reduction for Atridox ( doxy)
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1.4mm
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What is the pocket depth reduction for Arestin (minocycline)
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1.42mm
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what is the size and shape of the of the CHX chip
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4 x 5 x 0.35mm thick
rectangular, rounded on one end |
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CHX chip must be stored in
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controlled room temp at 15-25 degrees Celcius or 59-77 degrees farenheit
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Which side of the CHX chip is inserted into the pocket
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the rounded end
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Approxiamately what % if CHX chip is release in 24 hours
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40%
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Pt instruction for having CHX chip:
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avoid disturbing area for 10 days
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what are the contraindications for for AIr polishing?
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Sodium restrictive diet,Chronic Respiratory illness
Contact lenses,Non-karatanized tissue trauma Comm. Dz ( herpes, TB,Damaged root surface Spongy gingiva ,Non-metal restoration,Hypokalemia Use of diuretics |
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Who developed sealants?
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M. Buonocore in Rochester NY
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There are three types of Sealants
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fillled
unfilled fluoride releasing |
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Indication for sealants
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pit/fissure
risk for dental caries newly errupted teeth |
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types of Etchant:
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phosphoric acid 15-50%
low viscosity- liquid (harder to control) Gel-( tinted harder to rinse off) Semi-gel ( easy to control, and rinse off) |
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Clamp sizes:
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9-Anteriors
8-Max. molars 7-Mand molars 3- small molars 2- premolars 0 & W00- primary |
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Jaws of clamp fit on the cervical:
_____height of contour ____or ____ CEJ |
Below Height of contour
at or slight Below CEJ |
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the clamp only touches tooth at ___points
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4 points of the tooth
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The seat the clamp, do the ____side first then the buccal
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Lingual
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to open the forceps you much
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squeeze to open
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The rubber dam holes
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5- anchor tooth
4- molars 3- premolars/canine 2-Maxillary Anteriors 1- mandibular anteriors |
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when you have a lingual or labial rotation of teeth, punch hole ____ beyond marking
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1 mm
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the stainless metal frame goes on the ___ of the rubber dam
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outside
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the plastic frames goes on the ___or (face) of the rubber dam
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inside
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optimum stability of the dam is acquired when placing it over ____teeth
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6-8
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when lubricating the rubber dam it must be ___
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water soluble
** Do NOT use petroleum jelly if rubber dam in Latex |
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for anterior teeth the max. stability is to place the dam from___ to ____
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canine to canine
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if the patient has trouble breathing with the rubber dam; you can place a hole in the ____area
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palatal
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the rubber dam holes punched: the number , size, and location of holes are determined by?
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1Location and size of teeth to be treated
2. shape and size of arch 3. position and spacing of teeth 4. type of preparation |
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in the anterior teeth there should be ____mm of space b/t each hole punched for the rubber dam
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4mm
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for the posterior teeth there should be ___mm of space b/t each hole punched for the rubber dam
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5mm
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what are the criteria for the ideal sealant
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prolonged bonding
biocompatible simple application low viscosity low solubility in oral environment |
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what is the purpose of the fillers in the filled sealant?
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increase bond strength and increase resistant to abrasion and wear
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Garmer holder is a
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cotton holder
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bibulous pad is a
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triangular pad to cover the parotid duct when placing a sealant
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Phosphoric acid is what %
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30-50 % ( mrs. Mack's notes)
15-50% in book |
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Sealant materials should not be placed near what types of products?
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eugenol containing products
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In what direction should the toffleimer be removed when finished with the restoration
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occlusal direction
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the top of matrix band should be ____ from the occlusal surface to the marginal ridge
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1.0 to 1.5 mm
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the gingival extension of the band should be extended about _____ beyond the gingivalcavo-surface to prevent ____
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1.0mm to prevent overhang
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the Universal Matrix Band (#1) is used for
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premolars and molars
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The #2 Matrix band is used for
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deep proximal preparations
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the matrix band and should not be used on what type of restoration
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Composites--b/c the curing light does not go through the band, there it is not recommend to use them on composite
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what are the desirable qualities of the IRM
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easy to mix
non-irritating to the teeth thermal insulating strong |
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Liners cause what?
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stimulate reparative dentin/ secondary dentin
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Varnishes do what
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occlude dentinal tubules
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what types of burs should not be used in finishing?
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carbide burs with few flutes (3 to 5).
these burs are used for cutting cavity preparations--it would cause significant destruction and removal of restoration |
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what are the desirable qualities of the IRM
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easy to mix
non-irritating to the teeth thermal insulating strong |
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Liners cause what?
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stimulate reparative dentin/ secondary dentin
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Varnishes do what
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occlude dentinal tubules
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what types of burs should not be used in finishing?
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carbide burs with few flutes (3 to 5).
these burs are used for cutting cavity preparations--it would cause significant destruction and removal of restoration |
