Operative B1: Class Ii Amalgams

Front 1

Back 1

Front 2

What kind of lesions are class II amalgams done on?

Back 2

Posterior interproximal lesions

Front 3

How do you identify where to put a class II amalgam?

Back 3

Visual or touch

Front 4

Proximal box of class II:

1) What degree cavosurface margin?
2) How much clearance should there be from the height of contour of the adjacent tooth?
3) What should you include in the proximal box?

Back 4

1) 90 degree (butte joint margin)
2) 0.5 mm clearance
3) All caries, existing restorations, faults

Front 5

Why should the angle formed at the cavosurface margin between the cavity prep and the external surface be 90 degrees?

Back 5

To follow the enamel rods

Front 6

1) Occlusal table?
2) Proximal box mm depth/cavosurface to dentin floor?
3) Internal angles?
4) mm separation of box?
5) Which burs to use?
6) Facio/lingual convergence or divergence?
7) Axiopulpal line angle?
8) Proximal wall of dovetail area should converge or diverge?

Back 6

1) 1/3-1/2
2) 1.5-2.0
3) Rounded
4) 0.5
5) 330 O, 245 M,D
6) Convergence
7) Beveled
8) Diverge

Front 7

1) How much should contact be broken?
2) What is the depth of the gingival floor?

Back 7

1) 0.5 mm (width of explorer tip)
2) 1.0 mm depth axially

Front 8

What are the five benefits of the matrix/wedge complex?

Back 8

1) Provide rigidity to resist condensation forces
2) Template to re-establish proper anatomic contour
3) Template to re-establish proper proximal contact
4) Prevent gingival excess f restorative material
5) Ease of application/removal

Front 9

Back 9

Front 10

What are the eight steps in restoring an amalgam?

Back 10

1) Condense/overfill occlusally
2) Rudimentary anatomy
3) Marginal ridge
4) Remove band
5) Interproximal margins
6) Carve occlusal anatomy
7) Articulating paper
8) Check interproximal contacts with floss

Front 11

What is the definition of adhesion?

Back 11

State in which two surfaces are held together by interfacial forces which may consist of valence forces or interlocking forces or both

Front 12

What is the definition of an adhesive?

Back 12

Material, frequently a viscous fluid, that joints two substrates together and solidifies and is able to transfer a lod from one surface to another.

Front 13

What are the 8 operative and preventative indications for adhesive dentistry?

Back 13

1) Restore Class 1-6 carious/traumatic defects
2) Seal pits/fissures
3) Change shape/color of anterior teeth
4) Bond all-ceramic restorations
5) Bond indirect resin-based restorations
6) Desensitize exposed root surfaces
7) Seal beneath or bond amalgam to tooth structure
8) Impregnate dentin exposed to oral fluids, make it less susceptible to caries

Front 14

What are the two different types of adhesive dental materials?

Back 14

1) Resin Based Composite (RBC) - chemical (auto cured or self cured) or visible light cured

2) Bonding Agents

Front 15

What is the main component of resin matrix materials?

Back 15

Methacrylates

Front 16

1) What is the job of filler particles in RBCs?
2) What kind of material is the filler?
3) What % filler are RBCs?
4) What is a mixture of different particle sizes called?

Back 16

1) Strength and wear resistance to restoration, b) Reduce shrinkage upon curing and polymerization
2) Quartz, silica, barium, strontium glass
3) 40-70% filler
4) Hybrid

Front 17

What do coupling agents in RBCs do?

Back 17

Improves adherence of resin to filler, silane coats filler surfaces + increases strength by transferring stress to filler particles

Front 18

What are the 4 components of RBCs?

Back 18

Resin matrix (monomers), filler particles, coupling agents, polymerization activators and catalysts

Front 19

What is the function of the catalyst in RBCs? What are the two types?

Back 19

Initiates polymerization reaction. Chemical, visible light cured

Front 20

Visible light cured catalyst:

1) What is activated in the catalyst by the blue light?
2) How many mm do you add resin in and why?

Back 20

1) Camphorquinone
2) Light can only penetrate 2 mm into resin, so add resin in 2 mm increments

Front 21

What are the two primary types of dental adhesion?

Back 21

1) Mechanical - macro level
2) Chemical - atomic level

Front 22

What is the main substrate for adhesion in:

1) Enamel?
2) Dentin?

Back 22

1) 88% mineral, 2% organic, 10% water
2) 50% mineral, 25% organic, 25% water

Front 23

Kerr Dentin/Enamel bonding:

1) What is the purpose of etch? What do you etch with?
2) When you apply the primer/adhesive, what happens?

Back 23

1) Creates micromechanical retention in enamel, removes smear layer and opens dentin tubules. 35% phosphoric acid

2) Deposits monomers in tubules, creates hybrid layer in dentin and enamel bond

Front 24

What does etched dentin display?

Back 24

Demineralized surface and exposed collagen fibers

Front 25

What is a hybrid layer?

Back 25

5 micron layer of resin-infused collagen

Front 26

Visible light cured catalyst:

1) What is activated in the catalyst by the blue light?
2) How many mm do you add resin in and why?

Back 26

1) Camphorquinone
2) Light can only penetrate 2 mm into resin, so add resin in 2 mm increments

Front 27

What are the two primary types of dental adhesion?

Back 27

1) Mechanical - macro level
2) Chemical - atomic level

Front 28

What is the main substrate for adhesion in:

1) Enamel?
2) Dentin?

Back 28

1) 88% mineral, 2% organic, 10% water
2) 50% mineral, 25% organic, 25% water

Front 29

Kerr Dentin/Enamel bonding:

1) What is the purpose of etch? What do you etch with?
2) When you apply the primer/adhesive, what happens?

Back 29

1) Creates micromechanical retention in enamel, removes smear layer and opens dentin tubules. 35% phosphoric acid

2) Deposits monomers in tubules, creates hybrid layer in dentin and enamel bond

Front 30

What does etched dentin display?

Back 30

Demineralized surface and exposed collagen fibers

Front 31

What is a hybrid layer?

Back 31

5 micron layer of resin-infused collagen

Front 32

1) How much shrinkage is usually seen with polymerization?
2) What are the 6 main problems associated with shrinkage?

Back 32

1) 1.5-3.0%
2) Adaptation, marginal staining, microleakage, secondary caries, enamel micro-cracks, post-op sensitivity

Front 33

1) What is microleakage and when does it occur?
2) What is the pathological effect of microleakage?

Back 33

1) Leakage of ions, fluids, bacteria, bacterial byproducts through tooth-restoration interface. Occurs w/ poor seal and lack of effective contact between tooth cavity and restorative material
2) Bacterial infection of dentin and pulp resulting in secondary caries and pulp pathology

Front 34

What is a common source of post-op sensitivity from RBC based composite restorations?

Back 34

Microleakage

Front 35

What are the four layers in dentin bonding formation of a hybrid layer

Back 35

Composite, adhesive (all resin), hybrid layer (resin and dentin), dentin

Front 36

How do you minimize shrinkage problems?

Back 36

2 coats of bonding agent cured properly - thick adhesive layer reduces stress of polymerization shrinkage on tooth/adhesive interface

Front 37

What are the 7 main indications for composite restoration?

Back 37

1) Small-moderate restoration, preferably w/ enamel margins
2) Premolar/first molar, aesthetics
3) Doesn't have all occlusal contacts
4) Doesn't have heavy occlusal contacts
5) Can be appropriately isolated
6) Some that serve as foundations for crowns
7) Some very large restorations to strengthen weakened tooth structure (interim, economics)

Front 38

What are the 4 contraindications for composite restoration?

Back 38

1) Can't appropriately isolate operating site
2) Restoration with heavy occlusal stresses
3) Have occlusal contacts only on composite
4) Restorations that extend onto root surface

Front 39

What are the 4 advantages of composite over amalgam?

Back 39

1) More esthetic
2) More conservative
3) Adhesive
4) May actually strengthen tooth

Front 40

What are the 4 disadvantages of composite vs. amalgam?

Back 40

1) polymerization shrinkage
2) more susceptible to recurrent caries
3) post-op sensitivity
4) more technique sensitive - rubber dam necessary, must not dessicate tooth

Front 41

What are the 3 main ways in which composite differs from amalgam?

Back 41

1) Extent of prep dictated by caries
2) May retain unsupported enamel, especially for aesthetics
3) Not necessary to penetrate DEJ

Front 42

How does the occlusal depth of a composite differ from amalgam?

Back 42

Minimum 1 mm occlusal depth on composite, 1.5 on amalgam

Front 43

What are the steps for applying composite?

Back 43

1) Etch prep for 15 sec
2) Rinse well lots of water
3) Dry lightly
4) 2 layers of optibond with light air drying in between
5) Light cure 20 sec
6) Composite in 2 mm increments
7) Light cure each layer 20 sec
8) Finish/polish

Front 44

What is PRR?

Back 44

Preventative resin restoration