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50 Cards in this Set

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describe the factors that affect the decision on the selection of amalgam or resin composite for a posterior restoration
1.esthetic concerns

2.extent of caries

3.ability to isolate the tooth

4.resistance to recur. caries

5.longevity/wear reisistance
what clinical situations would indicate the use of a slot type Class II cavity preparation design?
carious lesions on proximal side of tooth but pits and fissures are not cariously involved

pt has lo caries risk
explain what a preventive amalgam restoration is and when it would be indecated for use
when the slot prep considers forms of prevention for occlusal pits and fissures like sealants. selants, small conservateve resin restorations, and small conservative amalgum restorations can be used in isolated areas of occlusal pits and fissures in combination w/amalgam slot restoraions
2 main types of direct restorative materials that are used to restore posterior Class II caries
silver amalgum alloy and resin composite
how does amalgum aid in pts who are susceptible to recurrent
somewhat antimicrobial and the metal ions can actually inhibit the growth of bacteria to a slight extent
lifespan for Class II resin composite vs amalgum
7 yrs for resin composite

12 yrs for amalgum
explain why it is important to remove all of the old amalgum and the basing media when removing an existing amalgam restoration exhibiting recurrent caries
since it is likely that you did not place the original restoration you do not know the condition of the tooth under the restoration
indications for use of slot type Class II cavity prep for amalgum
carious lesion in proximal surface of posterior tooth

low caries risk pt

no caries in occlusal pits and fissures
contraindications for use of slot type class II cavity prep
caries in occlusal pits and fissures of tooth

hi caries risk pt

cavity prep in which the facial and lingual walls must be overextended

surfaces that are to receive a removable partial denture rest prep

teeth that have an extisting resotration in the occlusal pits and fissures
describe the criteria that should be used in deciding whether a defect at a margin of an existing amalgam restoration indicates the need to replace/repair restoration
overhang
tooth/amalgum fx
open contace
cores for fixed pros


-usually rough margins can be corrected w/enameloplasty and finishing/polishing inseatd of replacement.
are open or rough margins on amalgum restorations a reason for replacing the amalgum?
NO

the defect at the margin must be at least 0.5 mm deep or show signs of decalcification or caries to justify removal and replacement
what general criteria should be used to eval the serviceabiity/need for replacement of existing restorations?
1.strurctural integrity

2.marginal opening

3.anatomic form

4.restoration related periodontal health

5.occlusal and interproximal contacts

6. caries lesions

7. esthetics
how does presence of cracks/voids affect the serviceability of an existing restoration?
the presence of fx line dictates replacement of restoration. If voids are present the denttist must exercise judgement in determing whether their size and location will weaken the restoration and predispose it to further deterioration or recurrent carious involvement
why does existence of an oopen gap at margin of existing restoration not always need the replacement of the restoration/
bc margins of amlagum restorations become sealed by corrosion products uless signs of recurrent caries lesions are present the restoration does not need to be replaced
what three problems commonly seein in existing retoration my cause inflam of periodontal health?
suface roghness of restoration


interproximal overhangs

impingemnt of restoration margin on dentogingival junction
what criteria are used to deterine if a restoration should be replaced due to rough, light, or oopen interproximal contact?
with roughness that does not allow passage of floss, the restoration must be altered or replaced to permit use of floss. an interpoximal contact smoothing device is often used

contacts that are open or very light should be evaluated to determine whether pathosis, food impaction, or annoyance to pt has occured. with any of these problems take steps to alivate problem. usually repalcement of restoration is needed to have adequate proximal contact
how might occlusal contace affect the staus of the proximal contacts of an exising restoraiton?
if hyperocclusion can cause primary occlusal trauma
what effects might occur if an exisitn restoration is in hyper occlustion or infraocclusion?
if hyperocclusion can get significant attachment deficits

restorations that are infra oclusion may permit the supraeruption of teeth and should be considered for replacment
does the apperance of stain arould existing restoration necessarily indicate that it needs to be replaced?
not necessarily bc corrosion products of amalgum can discolor the tooth when little dentin is present. When there is not communication between cavosurface margin and stained area and when the color is mainly gray and metal show through is sucpected just observe.

when the discoloration is yellow or brown and appears to communicate w/cavosurface margin replacement of resotration is indicated
what should a dentist explain to the pt prior to replacing a restoration for esthetic reasons?
explain risks of replacement
2 most useful tests for diagnosing cracked tooth syndrome
tranillumination - light transmission is interupted at pt of crack

biting test-pt bite on stick see if pt has pain
list 4 alternative matrices besides the Toffelmire matrix assemblem
Welded band matrix
copper band matrix
anatomic matrix
automatrix
BiTine Ring/Sectional matrix
when should you use a welded band matrix?
extensive loss of tooth structure

pin retained amalgum restoration

quadrant operative dentistry in pedo
when should dr use copper band matrix
restore mutilated teeth
when should Dr use anatomic (custom) matrix?
best matrix bc it is custom made for tooth and bc restoration contor is best controlled in this matrix.
when should Dr use Bi Tine ring?
posterior composites
list advantages of welded band matrix
goo when there is extensive loss of tooth structure when you are using pin retained amalgum restorations or for quad operataive in pedo
list disadvantages of welded band matrix
inadequate contour especially when buccal or lingual surfaces are involved in cavity prep
Copper band matrix advantages
only way to restore mutilated teeth
copper band matrix disadvantages
requires additional time and skill compared to other matrix techniques

band must be contoured and festtoned

higher probability of weak or absent contacts w/adjacent teeth

poor ginigal adaptation

hi potential for damaging freshly placed restorations when band is removed

inability to achieve close gingival adaptation since band cant be tightened

need to try on series of bands before finding acceptable one
anatomic matrix advantages
regarded as best bc custom made

restoration contour is best controlled w/application
anatomic matrix disadvantages
difficult to manipulate especially for complex prep
automatrix advantages
allows placement of SS matrix band around tooth without cumbersome weight of Toffelmire matrix
Disadvantage of Automatrix
require two special devices which are sold as part of kit along with bands (wrench and nipping shears)
Bi Tine ring advantages
considered to be ideal matrix system for Class II posterior resin composite retoration
advantages of resin composite when used to restore posterior proximal
compositeesthetically pleasing tooth colored shades

no mercury

not thermally conductive

bonds to tooth structure in conjunction w/dentin bonding adhesives

conservtive preps
disadvantages of resin composite when used to restore posterior proximal
polymerization shrinkage during setting

less than ideal fx and wear resistance

increased incidence of post op sensitivity

increased chance of recurrent caries
list criteria for decision to use resin composite to restore a posterior proximal cavity
cavity prep that cant be isolated w/rubber dam are not good candidates for resin composite placement

lesion should be small

preps should be conservative

pts should not exhibit any abnormal occlusal functions like bruxism or clenching

pts should not exhibit rampant caries or hi caries risk

preps in areas of hvy occlusal areas should get amalgum
describe guidelines for compoite cavity prep for a posterior proximal carious lesion
conservative outline

proximal contact box should be extended to just minimally break contact w/adjacent tooth; a small bevel should be placed on facialand lingual proximal walls

gingival wall should not extend beyond pt that allos adequate amount of enamel for effective ethciing and bonding at cavosurface margin

internal form of prep will differ from amalgum bc it will have rounded internal line angels, no retentive grooves, and buccolingual width will be conservative

an interproximal wedge should be placed before begininng the prep of the tooth to help establish an adequate proximal contact
when is class II slot type prep preferred over more conventinal class II cavity prep that includes occlusal pits and fissures
slot prep is preferred if caries is not present in the occlusal pits and fissures; the slot prep can be used in conjunction w/sealant or preventative type of restoration at occlusal surface

the conventional prep is used when there are extensive caries that requre the bulk and strength of the bybrid composite restorative material for resistance to wider more extensive prep. it will be used when prep will need to be used to replace an existing conventional type restoration
what criteris is used to determine the depth of conservative Class II resin composite cavity prep
depth depends on depth of careis in pits and fissure

should be as shallow as possibel
what is purpose of placing cavosurface bevels on facial and lingual proximal walls of class II cavity prep composites?
bevels create more cut enamel surface that will allow better adhesive bond to the walls. a bevel may be created at givinal wall if adequate enamel remains
How is retention form for class II cavity prep for composite established?
the retention form for Class II resin composites is provided mainly be adhesive bond formed between resin bonding agent and etched dentin and enamel surfaces. This bond provides majority of retention for retoration and protects against leakage at interface
what type of resin composite restorative material is currently considered best suited for posterior composit restorations?
autocured resin composite
when should shade selection of compoite material be made?
for posterior resin shade is not critical so it does not matter

when shade is important selection should be performed before isolation of tooth
what is authors opinion of importance of use of rubber dam isolation during posterior compooite restorative procedure?
it is the most reliabel method t oaccomplish field isolation bc it prevent moisture contamination and protects tissue from laceration
purpose of prewedgining and how it is important in restoration procedures for Class II resin composites
to open contact w/adjacent tooth and to comensate for thickness of matrix band
describe bevel utilization on facial and lingual proximal walls of class II cavity prep for composite
bevel is designed to expose enamel rods transversely to achieve a more effective etching pattern
what criteria are used to decide whether or not to place a bevel on cavosurface of gingival wall in class II cavity prep for composite?
only if margin is in enamel well away from CEJ and an adequate band of enamel remains
Why are bevels on cavosurface margins at occlusal surface contraindicated in posterior resin composite restoration
avoidance of bels prevents loss of tooth structure so..
decreases surface area of final resotration

lessens chance of occlusal contact on restoration

eleimated thin area of resin compoite that would be mroe susceptible to fx and wear

present a well demarcated marginal periphery to which resin compoite can be finished more precisely