Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
412 Cards in this Set
- Front
- Back
|
Under FDA |
Class 1 least regulated( prophy paste) Class 2 requires standards( amalgam, composites) Class 3 most regulated (implants, bone grafting. |
|
|
Classification by use |
Restorations Crowns Bridges complete and partial dentures Impressions caste ect. |
|
|
Restorations |
Held in place by mechanical lock(undercuts) or adhesion or both. Inlays-made in a lab-cemented into mouth. |
|
|
Crowns |
Used when large amount of tooth structure is missing. |
|
|
Bridges |
Replace a missing tooth Abutment Pontic Retainers, a crown the covers the abutment |
|
|
Luting |
Gluing two things together |
|
|
Bases and liners |
Cements can be used to protect the pulp chamber used as an insulator |
|
|
Base |
Provides thermal insulation |
|
|
Liner |
A thin layer to protect the dentin from chemical irritation |
|
|
Temp restoration |
Placed after decay is removed to give time for healing |
|
|
Pit and fissure sealant |
Prevent decay |
|
|
Sports gaurd |
Bruxism/sports |
|
|
Class 1 restoration |
Pit and fissure |
|
|
Class 2 restoration |
Posterior proximal |
|
|
Class 3 restoration |
Anterior proximal |
|
|
Class 4 restoration |
Anterior incisal |
|
|
Class 5 restoration |
Cervical 1/3 anywhere |
|
|
Class 6 |
Cusp tip incisal edge |
|
|
Perio dressings |
Non therapeutic do not aid in healing. Physical barrier Protect tissue |
|
|
Visible light activated surgical packs |
Urethane dimetharylate resin-based materials. Barricaid is a brand name. Syringe Carrier for direct placement No mixing Tasteless useful in anterior |
|
|
Cyanoacrylate dressing |
Liquid that polymerizes after tissue contact. Single dose applicator used in post biopsy site and placement of intramuscular antibiotics. Clear dressing, hemostatic, bacteriostatic |
|
|
Co-pak |
Base larger tube Catalyst= the smaller tube Mix imidiatlen before placing Equal length Approximately the length of the surgical site |
|
|
Mix |
Base into catalyst in small area using tongue blade. 30-45 second gather in mass Let rest 2-3 min dipping in water speeds set time. Luberacate fingers and roll. |
|
|
Placement |
Blot dry with sterile gauze, hemostasis should be achieved. Dry site=better retention Place anterior to posterior. Adapt with plastic instrument Working time 5-8 min. |
|
|
Post OP instruction noneugonal- zinc oxide dressing. |
For 2 hours no excessive talking Eating or drinking warm things Rubbing or applying pressure Pushing on dressing with toungue. If a peice breaks that creates a sharp.edge or sensitive area call detist |
|
|
Co-pak allergens |
Pine tar and peanuts Always wear ppe |
|
|
Removal of co pak |
After one week Cleanse with antimicrobial rinse after removing and assess for new dressing. |
|
|
After removing each suture |
Place a gauze square. |
|
|
Suture abscess |
Can be cause by sutures left behind. |
|
|
Calcium hydoxide |
Dispense in small equal amounts on paper pad. Mix 10 sec Uniformed color Apply material with clean instrument. Use in small increments |
|
|
Zinc phosphate cement |
Use liquid and powder Mix using a large portion of the slab Add powder in small increments mix in figure 8 Mix oil and time 1.5-2 min Luting consistancy is 1 inch string between slab and spatula Base consistency, thick putty like will roll into a ball Setting time 5-9 min |
|
|
Glass ionomer |
Measure powder by fluffing then sliding scoop against lip of bottle Measure liquid by holding bottle vertically to get uniformed drops Powder is added to liquid in one or two portions mixing time 30-45 seconds Luting material should form a .5 inch string between slab and spatula Use material when its glossy |
|
|
Glass ionomer systems |
Disposable capsules Paste/paste system |
|
|
Zinc oxide eugenol cement |
Measure according to manufacturer's direction Draw half the powder into the liquid Spatulate using flat side of spatula and small position of slab Press powder into mix in small amounts Mixing time app. 1.5 min Should be thick and crumbly |
|
|
Temp cement |
Squeeze equal length from each tube onto paper pad Mix to homogeneous color Should form string Apply material to whole surface |
|
|
Attenuation |
Process of reducing energy of primary beam as it passes through differing object/ materials |
|
|
Radiopaque |
Amalgam Gold Metal Stainless steel |
|
|
Radiopaque/radiolucent |
Composte, sealant, cement, bases, porcelain |
|
|
Radiolucent |
Composites without fillers, acrylic, temporaries. |
|
|
Indirect fixed restorations |
Cannot be removed Cemented in place Classified by the tooth stutter they restore And material from which they are made |
|
|
Inlay |
Intracoronal Replaces small to medium percent of the structure Class 1 and 2 Retained by luting Does not replace cusp |
|
|
Onlay |
Also called overlay Involves one or more cusp to entire surface Retained with luting cement Used for cusp fractures |
|
|
Pontics |
Teeth that are replaced |
|
|
Veneers |
Restorations placed on the facial surface of anterior teeth. General esthetic problems Direct veneers-bonded composites If tooth structures not removed, considered reversible. Indirect veneers- porcelain-lab made Tooth structure removed when tooth is prepared Not reversible |
|
|
Retainer |
Crown at each end of bridge |
|
|
Abutments |
Conventional bridges Maryland bridges |
|
|
Metals |
Most are made by a casting prodcedure. Allows custom, complex shapes Withstand high stress |
|
|
Ceramic |
Used for esthetics are important Simulates natural tooth color and translucency Lack toughness |
|
|
Pfm |
Developed in 1950 Combines strength and esthetics |
|
|
Wax and waxing |
Easy to mold and shape Used to fabricate crowns, restorations, and dentures Creating the shape of the restoration in wax. |
|
|
Inlay casting wax |
For inlays and crowns |
|
|
Sticky wax |
Sticks well melts high temperature |
|
|
Base plate wax |
Fabrication of dentures. |
|
|
Utility wax |
Impressions |
|
|
Sprue |
Plastic or metal tube that will form a opening for the mold- attached to the wax pattern |
|
|
Burnout |
Temperature controlled oven is used to burn out the wax pattern invested in the casting ring Proper burnout results=well-fitting cast. |
|
|
Casting |
Process of melting the cast alloy and forcing it into a mold |
|
|
Gold cast |
Uses blow torch |
|
|
Crucible |
Refactory ceramic divice Alloy help in this for melting. |
|
|
Centrifugal Casting machine |
Most common casting machine Has coiled spring that is wound up Molten alloy is forced into the mold as spring unwinds. |
|
|
Divesting |
Casting is retrieved from the ring by carving away the investing and exposing the casting |
|
|
Alloy |
Metals that are combined |
|
|
Elongation |
Measure the ability of a material to be stretched before it breaks.used to predict alloys ability to burnish. |
|
|
Burnishing |
Pushes the metal against the tooth to close and gaps between the tooth and casting Advantage of soft malleable gold restoration. |
|
|
ADA CLASS I CASTING ALLOY |
Is the weakest; greatest elongation Inlays |
|
|
ADA Class IV casting alloy |
Strongest least elongation Bridges partial denture framework. |
|
|
Gold classification |
Percentage per 100 Carat is parts per 24 Fineness is parts per 1000 75%=18 carat=750 fine |
|
|
High noble |
60% or more. |
|
|
Low noble |
At least 25% |
|
|
Silver palladium |
70% silver 25% palladium |
|
|
Less the 25% |
Predominantly base metals cost is less. |
|
|
Non precious |
No noble elements. |
|
|
Types of ceramic alloys |
Novel alloys Non-precious alloys- less expensive |
|
|
Noble alloys |
Gold-platinum-palladium Gold-palladium-preferred for mechanical properties Palladium silver High palladium |
|
|
Non precious alloy |
Nickle-chromium Chromium-cobalt. |
|
|
Titanium |
Most biocompatible Best choice but most expensive up front Used for implants Osseoinegrate with bone |
|
|
Partial denture framework |
Nickle-chromium |
|
|
Ceramic |
Matches clients teeth best. Very brittle-inadequate for restoring most areas of the mouth. |
|
|
Techniques for strengthening porcelian |
Ceramometal Bonded to porcelain Durable has precise fit |
|
|
Bonding porcelain to metal |
Heat metal to a high temp Adherent oxides form Chemically bond porcelian to metal Porcelain layers Opaque, layer covers metal Dentin/body shade layer Enamel or translucent layer |
|
|
Sintering |
Changing porcelain powder to a solid |
|
|
Fracture most likely |
With ceramic |
|
|
Margin-casting process for metals |
Results in more accuracy then all ceramic restoration |
|
|
Wear materials |
Will wear enamel faster then enamel on enamel |
|
|
The only material translucent to visible light |
Enamel |
|
|
Yello color and opaque |
Dentin |
|
|
Homogeneous in appearance |
Restorations |
|
|
Surface smoothness |
Enamel and dentin are smooth but cementum is rough Polished restoration should smooth Composites and porcelain are smooth but glass ionomer is rough Some cements are rough. |
|
|
Cavosurface margin |
Junction of restoration with external tooth surface. |
|
|
Temps over 140° |
Alter tooth surface characteristics of amalgam=accelerated corrosion and marginal breakdown |
|
|
Excessive use of abrasion |
Trauma, fine scratches, smallest abrasive particles, |
|
|
Abrasiveness depends on |
Particle size Number of particles Speed of application Applied pressure. |
|
|
Around restoration |
Keep working stroked below margin, Use oblique strokes Scaling can damage |
|
|
Air polishing |
Can damage composite, nonmetallic materials and cements Use compatible polishing powder |
|
|
Ultrasonic |
Improper use may harm composite, veneers, crowns, and implants Use lateral surfaces of insert tip Cavitron: use implant insert. |
|
|
Stannous flouride |
May discolor tooth colored restorations. |
|
|
Acidulates phosphate flouride |
May damage porcelian and glass ionomer. |
|
|
Recently placed amalgam |
Finishing burs-low speed up Rubber cup/brush soles followed by tin oxide. |
|
|
Other options for amalgam polishing |
Finishing burs Brown and green rubber polishing points(these have polishing agents embedded in them eliminates use of liquid and powder to polish.) |
|
|
Polishing composites |
Sequence of aluminum oxide-coated disc Egg shapes burs lingual Polishing paste sparkle. |
|
|
Polishing gold |
Same regimen as amalgam Tin oxide is good for finish |
|
|
Ceramics and pocelain |
Paste similar to sparkle. |
|
|
Acrylic resin |
Hard, brittle, glassy, polymers. Clear and colorless |
|
|
Reactions can be |
Chemically activated Heat activated Light activates Dual cure |
|
|
Most common acrylic monomer |
Methylmethacrylate |
|
|
Teeth in a denture |
Acrylic resin Porcelian Composite |
|
|
Denture base |
Pink gingiva Always acrylic |
|
|
Constructing complete denture |
Impression and cast Preliminary impression Preliminary cast Custom tray Final impression Master cast |
|
|
Arranging teeth in denture |
Casts are mounted in articulate using plaster Teeth are set in wax Wax try in |
|
|
Processing denture |
Wax is removed and acrylic resin replaces it and forms base. |
|
|
Framework of partiel |
Clasp, connectors, mesh area that acrylic flows into around partial Denture base Teeth |
|
|
Immiadiate dentures |
Placed the same day Teeth are not extracted prior to impression. Often need refiting. |
|
|
Obtundent |
Reduces irritants |
|
|
Ethoxybenzoic acid |
An organic liquid added to eugenol |
|
|
Intermediate restorative material |
Zinc oxide eugenol cement |
|
|
Rational for irm |
Covers exposed dentin to prevent sensitivity, biofilm, accumulation, caries, pulpal involvement. Allow patient to eat and speak normally Maintains gingival health Zinc oxide: insulating properties Eugenol: obtundent. |
|
|
Matrix or tofflemire retainer |
Holds band in a loop and tightens band around tooth |
|
|
Tofflemire |
Open head placed toward gingiva |
|
|
Band |
Variety of shapes and sizes, universal , premolar and molar. Smaller side toward gingiva Band to the left for even quads and to the right for odd quads. |
|
|
Tofflemire |
|
|
Dispense |
powder and drops 2 of each |
|
|
Mix the ZOE |
According to manufacturer's instruction, putty like consistancy |
|
|
Zoe (zinc oxide and eugonal) |
Carefully and slowly shake the IRM bottle to distribute.(zinc oxide powder. Place 2 scoops with extra in corner Then two drops of liquid eugenol |
|
|
Mixing ZOE |
Use a firm pressure until material is thick and claylike. Quickly mix 50% of powder into all liquid. Bring in the remaining powder in 2-3 increments. Mix should be complete in 1 minute Roll material into cylinder Increments are pinched off and placed an instrument into preparation. |
|
|
Cavity varnish |
Resin dissolved in solvent Painted over entire inside of cavity preparation. Solvent evaporates and resin remains. Often used under amalgams Decreases initial microleakage until corrosion begins to fill in. Not used for thermal sensitivity Never under composites interferes with adhesion |
|
|
Dentinal bonding agent |
Some dentists are substituting dental bonding agent for varnish Not always necessary Will bond amalgam to tooth Gluma primer. |
|
|
Chemistry of dental |
Dental cements are brittle, ceramic materials Many cements are simple acid base reaction Resulting products are insoluble in water and oral fluid. |
|
|
Formulation |
Powder/liquid system Liquid-acid Powder-base Insoluble in oral fluids Reactive with acid. |
|
|
Acid+excess base |
Residual base + insoluble salt |
|
|
Liquid + excess powder |
Residual powder +matrix |
|
|
Residual powder and matrix |
must be insoluble in oral fluid |
|
|
Composite cement |
The chemistry of composite cement is the same as that of acrylics and composites. |
|
|
Powders used in dental cements |
Zinc oxide Powdered glass. Size of the particles determines thickness of resulting mixing cement Large particles result in high thickness open margins and recurrent decay. |
|
|
Zinc oxide |
Only insoluble nontoxic, reactive oxide that is available to react with an acid. Antibacterial effects |
|
|
Zinc oxide additives |
alumina oxide- stengthens. Magnesium oxide-controls set rate |
|
|
Powdered glass silicon oxide |
Unreactive in itself If oxides reduced-sodium, calcium, and potassium. Increases reactivity. |
|
|
Flouride added to powdered glass |
Reduces melting temp and improves flow of glass. |
|
|
Reactivity of powder |
Controlled by manufacturer Matched to reactivity of the liquid |
|
|
Liquid used in cements |
The composition or strength of the acid determines the reactivity of the liquid. Controlled by the manufacturer |
|
|
Eugonol |
Organic liquid weak acid Major component of oil of cloves Phenol derivative Obtundent to pulp Inhibits free radical polymerization-limits use will inhibit setting of composite resin material. |
|
|
Phosphoric acid |
66%acid 33% water Do not dispense early or use if its cloudy. |
|
|
Polyacrylic acid |
30-50%acid by weight Very viscous Do not store in fridge Do not dispense early High low humidity. Affects water content, ph, reactivity. |
|
|
Coated paper pad |
Common for glass ionomer and polycarboxlate cement |
|
|
Glass slab |
Zinc phosphate cement |
|
|
Reinforced ZOE |
Temp restoration and intermediate bases Not strong enough to be permanent Insulating properties Claylike when its mixed |
|
|
Temp restoration |
IRM( zinc oxide, eugenol, alumina, resin, polymath metgacryliate resin) Cavit(premixed material) |
|
|
Irm is the |
Brand name for ZOE temporary restorative that comes as a liquid(eugenol) and powder (zinc oxide) |
|
|
Zinc phosphate cement |
Zinc oxide and phosphoric acid Stong, low solubility Base, luting Mix powder in slow increments Over glass slab to dissipate heat. |
|
|
Glass Ionomer Cements |
Uses=bases and liners Handling = coated paper pad, mix 30 sec or less, mix in two increments Packaging (powder/liquid, capsule, paste/paste Clean up with water asap |
|
|
Polycarboxylate cement |
Zinc oxide powder mixed with polyacrylic acid Used as luting agent and intermediate base Weak and soluble Similar to glass ionomer same adhesive properties weaker |
|
|
Composite cements |
Highest percentage of rain top reduce viscosity Used with dentinal bonding system for luting ceramic restorations. Can be complex Can be chemically activated, light activated or dual cure |
|
|
Silicate cement |
Glass powder mixed with phosphoric acid. Not commonly used |
|
|
Calcium hydroxide liner and base |
Promote secondary dentin formation Direct pulp cap placed on vital pulp Use had diminished |
|
|
Temporary cement |
Used to retain a temporary restoration during time of fabrication of permanent restoration Many are paste/paste ZOE formulation obtundent. |
|
|
Surgic periodontal packs |
Similar to ZOE temporary cement Placed on site to protect underlying tissue. |
|
|
Iatrogenic overhangs |
Failure to adapt matrix band Matrix band slips Wedge wrong Mishandling of material |
|
|
Natural progression |
Different expansion and contraction reate leads to expansion beyond the outline of the prep. |
|
|
How to find overhangs |
Radiographs Tactile sensitivity Subjective information from patient Shredding of floss |
|
|
Remove overhang with |
Lightening strips/finishing strips Amalgam knives/gold knives Amalgam files Diamonds Profin system |
|
|
Strips |
Diamond impregnated Downside Trauma evident to the gingiva Difficult to adapt May open contact |
|
|
Amalgam knife |
Downside Requires pressure Works best for small overhang Shaves metal down Difficult to maintain contour |
|
|
Amalgam file |
Single direction pull stroke only Reduces overhang to manageable level. |
|
|
Diamonds |
Upside=quick Downside=not conducive to flat surface, risk in nicking adjacent tooth, gingiva trauma, used on high speed. Not for auxiliary |
|
|
Profin system |
Still requires thoughtful adaption works on conventional handpeice, minimal trauma to the gingiva, great client acceptance adaptable to amalgams or composites. |
|
|
Handpeice set up |
Motor Straight cone Profin hand peice. |
|
|
Abrasive inserts |
Insert sequence start with most abrasive Red, green, yellow, black Black-wolfram for polishing. |
|
|
Red |
Corse removes restorative material and tooth surface |
|
|
Green |
Medium removes restorative and tooth surface |
|
|
Yellow |
Fine removes scratches cause by abrasive inserts and only restorative material not tooth surface |
|
|
Black-wolfram |
Polishes restorative material no tooth surface |
|
|
Margination |
Must be approved and written in treatment record. Must be appropriately selected based on access and ability |
|
|
When using profin |
Round toward tooth Continue with most abrasive needed until it feels smooth. |
|
|
Amalgam |
Metal alloy consists of silver, tin, copper, zinc, and minimally gold, palladium, indium, and mercury. |
|
|
Dental amalgam equal parts |
Powdered metal amalgam alloy and liquid mercury |
|
|
Trituration or amagamation- |
process of mixing |
|
|
Reaction begins |
As soon as mercury contacts the amalgam alloy |
|
|
Working time |
Time needed to condense and carve Not controlled by the operator |
|
|
Almagam held in place by |
Mechanical retention Undercuts and grooves |
|
|
Lathe cut |
Easier to restore proximal Requires more force during condensation of amalgam |
|
|
Advantages of spherical |
Less mercury Less resistant to condensation force requires less condensation force |
|
|
Advantages yo admixed |
Adapt better Produces better contrast |
|
|
Amalgsm life span |
Class I 15-18 years Class II 12-15 yr |
|
|
High copper amalgam |
What is used now, 40-60% silver 27-30% tin, Copper 13-30% stronger, less corrosion, less breakdown, lower creep, silver increases strength. |
|
|
Strength |
High compression strength Low tensile and shear strength. Must be supported by tooth structure. |
|
|
Creep |
Slow change in shape caused by compression Dimensional change occurring under load. Distorted cusps Marginal fracture |
|
|
Corrosion |
Loss of surface Pitting from chemical attack |
|
|
Galvanism |
Two dissimilar metals exist in a wet environment |
|
|
Internal corosion |
Cannot be seen by the clinician Leads to marginal breakdown. |
|
|
Tarnish |
Discoloration of the restoration on the surface Deposit of film from sulfides calculus and plaque, Can be polished. |
|
|
Cavity varnish |
Resin dissolved into a solvent Most common copal varnish Paint on cavity prep. Reduces initial leakage by sealing margins Cavity varnish is being replaced by systems that are being developed to bond amagam to tooth structure. |
|
|
Effect of moisture |
Contamination if prepped or placed in wet environment Delayed expansion Decreased longevity and increase in corrosion |
|
|
Direct gold restoration |
Gold foil Adhesive gold For small restoration Long lasting Cold welds itself |
|
|
Burnisher |
|
|
Condenser |
|
|
Amagam placement |
Condense to bottom with condenser Carve proximal surface Carve occlusal anatomy with Carver Contine to carve with explorer Check occlusion Readjust Examine restoration Postoperative instructions |
|
|
Perception of color |
Varies among individuals |
|
|
Munsell color system |
Matching test color to color tabs Each tab has a hur, chroma and value In dentistry we use shade guides |
|
|
Spectrophotometry |
The quantitative measurement of the reflection or transmission properties of a material as a function of wavelength. Measures intensity of light that is reflected by an object at numerous wavelengths of visible light |
|
|
Hue |
A fundamental color of an object, a pure color, one without light or black, different reflected wavelength of light. Outside of wheel Red, orange, yellow, green,blue, indigo, violet White light all light reflects back Black light no light is reflected back |
|
|
Value |
Relative lightness or darkness even brightness. Linear axis through the middle of the wheel shades of gray |
|
|
Saturation/chroma |
Dominance of hue is color or strength of color Higher chroma more vivid color Desaturated color grayscale |
|
|
Color value |
Refers to the lightness or darkness of the hue High value color by adding white often called a tint Low value by adding black low value color or shade Intensity or chroma= refers to brightness of a color |
|
|
Metamerism |
When two colors that are not actually the same but appear the same under certain lighting conditions |
|
|
Metamers |
Colors that match under some lights but not others. Represent an effect of a color-looking good under one light and different under another. |
|
|
Vital shade guide |
Is the standard color no matter what brand material is used always use two types of light to select shade One light must be natural. |
|
|
Only translucent structure is |
Enamel |
|
|
Dentin |
More opaque |
|
|
Cervical |
More reddish gingiva |
|
|
Natural teeth |
Hue=yellow to yellow-red Value=1-10 natural teeth usually 6-8 Chroma(saturation) 1-10 natural teeth usually 1-3 |
|
|
Stains that can be bleached |
Yellowish teeth bleach best Brownish teeth moderately well Grayish teeth=not at all(tetracycline stain) |
|
|
Extrinsic stain |
On the surface Food drink, tobacco, Whitening is most effective |
|
|
Intrinsic stain |
Occurs in tooth structure Post eruptive Amal gdx am restoration, caries, endo Pre-eruptive Tetracycline, minocycline Fluorosis, dentinogenesis imperfect, amelogenisis imperfecta. |
|
|
Whitening agent |
Hydrogen peroxide Carbamide peroxide Sodium perborate. |
|
|
Hydrogen peroxide |
Strong oxidizing agent Readily decomposes into water and o2 Releases free radical Penetrates enamel and dentin 5%-35% strength Quicker 30-60minute wear time Must protect eyes, face, intraoral tissue, clothing. |
|
|
Carbamide peroxide |
Weaker oxidizing agent More stable Liquid or gel 10%-20% strength Complex breaks down into urea and hydrogen peroxide Slow act iij ng releases 50% in 2-4 hrs the rest in next 2-6 |
|
|
Sodium perborate |
Weaker oxidizing agent Used with hydrogen peroxide to whiten non vital teeth |
|
|
Nonvital whitening |
Not done by auxiliary two methods Power Walking bleach |
|
|
Power(heat or light activated) |
Canal sealed tooth isolated In office heat or light activated bleaching material is applied Esthetic restoration placed at least 7 days later. |
|
|
Walking bleach |
35% sodium perborate placed in canal- canal packed with cotton pellet and temporary sealed. Return in 7 days if satisfied permanently filled. |
|
|
Gingiva needs to be healthy |
Before bleaching |
|
|
Professionally in-office whitening |
Higher concentration of hydrogen peroxide 15-35% Teeth are being whitened isolated paint on dam Gingiva must be protected Hydrogen peroxide is activated by heat. |
|
|
In-office |
30-1hr Rubber dam use Gel applied to tissue Special light Bleaching agent(15-35% hydrogen peroxide) Use of laser Patient will use in home whitening trays |
|
|
At home whitening |
Hydrogen peroxide Carbamide peroxide Power swab |
|
|
Hydrogen peroxide |
2-10% hydrogen peroxide gels(custom trays, 30 min sessions at home) White strips 14%hydrogen peroxide 30 min 2x a day. Opalescence product called go (6,10,15% concentration tray infused strength dependent of length. |
|
|
Carbamide peroxide |
10-22% carbamide peroxide gel custom made tray, treatment sessions 2 hours at home or overnight. |
|
|
OTC product |
White strips 3-7% hydrogen peroxide Professional strength of 14% available only at office. |
|
|
Side effect of whitening |
Enamel breakdown( usually from unreliable sources.) Tooth sensitivity Gingival irritation Free radical may be produced. |
|
|
When whitning |
Avoid foods that stain for 24-48 hours Use neutral flouride for 30 min in whitening tray or potassium nitrate tooth paste twice daily Additional night gaurd bleaching can also be used to maintain whitening. Dentist must be notified is sensitivity lasts more then 2 days. |
|
|
True adhesion |
Involves chemical bonds-but not all bonding to tooth structure is truly adhesive. |
|
|
Micromechanical |
Bonding using surface irregularities Enamel tags Force is evenly distributed and strong. |
|
|
Macromechanical |
Surface roughness is visible easily detectable Think screw nail bolt Stress/force is more localized. |
|
|
Adhesive |
Retention not requiring undercuts and other retention grooves. Veneers Orthodontics brackets Space maintainers Perio splints |
|
|
Ise of adhesions |
Reduces it eliminates microleakage |
|
|
Adhesive use |
Reduces post-OP sensitivity by reducing perculation. Reduces straining at margins Reduces recurrent decay |
|
|
Acid-etching |
First used to retain pit and fissure sealent. Can reduce with composite restoration to reduce leakage and staining. Acid etching is micromechanical bonding technique Rough surface allows adhesive to flow into irregularities |
|
|
Acid etching is considered |
Gold standard |
|
|
Chemical adhesion. |
Glass ionomer used on class 5 to due to high recurrent decay. |
|
|
Adhesive failure |
If adhesive came off cleanly |
|
|
Cohesive failure |
If failure occurs inside the bonding material. If adhesive breaks tooth Measure of bonding material strength on the bond itself. |
|
|
Acid etching |
Creates enamel tags or micropores Bonds material to enamel Etch 15-30 sec Chaly white Deciduous teeth need to be etched longer |
|
|
Dentinal bonding |
Micro mechanical and secondary atomic. Both enamel and dentin |
|
|
Primary dentin |
Formed prior to root completion |
|
|
Secondary dentin |
Formed after root completion |
|
|
Reparative dentin |
Formed after trauma |
|
|
Sclerotic dentin |
Fills dead tract. |
|
|
Dentin type |
Intratubular dentin(within tubules) Also between tubules |
|
|
Dentinal tubules |
Mostly water Filled with odontoblasitic processes. |
|
|
Smear layer |
Layer of debris caused by preping tooth Like sawing green wood, saw dust and sap.stick Enamel cuts cleaner |
|
|
Dentinal bonding step1 |
Watching 37% orthophospheric acid Etch enamel and dentin Removed smear layer Reduces fluid that oozes from tubules Decalcifies dentin Opens tubules. Dry slightly, don't over dry |
|
|
Step 2 |
Primer flows into surface irregularities of etched enamel and into open tubules of etched dentin-flows around exposed collagen fiber Hydrophilic, wetting agent Solvent, acetone thins and improves flow More tolerant if a moist surf as ce |
|
|
Step 3 |
Adhesive low viscosity Contains hydrophilic chemicals but less then primer Two adhesive mechanisms Micromechanical-enamel tag Hydrid layer-resin and decalcified dentin Both occur at same time. |
|
|
Composite material |
Bonds to dentinal bonding system Result is retention of the restoration and reduced microleakage |
|
|
Glass ionomer bonding |
Simpler No separate adhesive Adhesive and restoration Used on exposed root surfaces High caries risk patients. |
|
|
White swabs |
Prepare teeth for whitening |
|
|
No whitening for |
Pregnant or lactating Minors under 14 Heavy smokers Anterior restorations. |
|
|
Bleaching trays |
Clear vinyl .040 Stone model made from algenate. |
|
|
Vaccum seal |
Bleaching tray over stone model |
|
|
Trim whitening tray |
Trim with scissor and create scalloped borders to follow gingival margins Heat cut edges with micro torch and return to tray. Wet fingers and read apt edges keep tray on model until delivered. |
|
|
Application and activation |
Light is placed for 15-20 min Check patient comfort Repeat 2-3 times total of 3 application Remove dam And take final picture. |
|
|
Cast model |
Should be 2 3/4 inches total. Mark canine eminence and modine with a pencil Angles should be equal. Fill in any wholes and let sit 12 hours. |
|
|
Finishing cast |
Use sandpaper Before glossing add your name/clients name/and date on back of both Place in gloss for 30 min Allow to completely dry Polish with damp cloth Store wrapped in a damp towel |
|
|
Plastic impression trays |
Aspectic Inexpensive Convenient Lack support for material |
|
|
Rimlock trays |
Metal must be sterilized. Locking mechanism Less likely to distort |
|
|
Perforated impression trays |
Locking mechanism May be metal or plastic |
|
|
Alginate |
Irresible hydrocolloid Sets by chemical change SOL viscous liquid that reacts and becomes a gel |
|
|
Sol |
One material dissolved into another |
|
|
Two phases |
A solid surrounding channels of water (water will evaporate and distort the impression. |
|
|
Syneresis |
Slight contraction after setting |
|
|
Imbibtion |
Absorbs water, swells, and distorts if stored in disinfecting solution. |
|
|
Advantages of alginate |
Easy to mix Hydrophilic Absorbs limited amount of oral fluid Fewer air bubbles Pours are easier because of water level |
|
|
Disadvantage of alginate |
Evaporation of water causes shrinkage Syneresis Imbibtion |
|
|
Calcium sulfate |
Reactor causes reaction to begin |
|
|
Sodium phosphate |
Retarder |
|
|
Handling alginate |
Bulk must be fluffed filler-silica mask is critical |
|
|
Alginate set time |
Fast set-1-2 min Regular set 3-4 min Gently stir until powder is absorbed 1 min until smooth and creamy Scoop all and load tray. |
|
|
Boxing wax |
Used to trim edges of model. Aids retention Extends model Protects tissue |
|
|
Mandibular impression |
Always first taken standing in front of patient. |
|
|
Pop |
The impression out Do not rock impression |
|
|
Never store impression |
Longer then 30 minutes before pouring model |
|
|
Rinse with birex |
Impression after taking them |
|
|
Study model |
Used to treatment plan Observe progress Counter model Attaching cast to articulator. |
|
|
Cast |
Replica in which restoration is fabricated. |
|
|
Die |
Working replica or a single tooth Able to remove |
|
|
Gypsum products |
Natural rock that is mined can also be produced synthetically Ground into a powder Calcium sulfate dehydrate Calcination is the term for the process vg which gypsum is produced |
|
|
Calcination |
A result of heating and driving off part of the water of crystallization. |
|
|
Types of gypsum |
Plaster- heated in open kettle Stone- hosted under steam pressure in a closed container Improved stone-heated under pressure with calcium chloride solution. |
|
|
Plaster |
First gypsum product used in dentistry Crystal's are porous Requires most water Weakest Usually white Beta-hemihydrate type 2 |
|
|
Stone |
More regular shape Crystal's Less porous Stronger Harder More expensive Yellow Alpha-hemihydrate type 3 |
|
|
High strength/improved stone |
Very dense Least water Strongest Most expensive Type 4 stone modified alpha-hemihydrate. |
|
|
When calcium sulfate dehydrate mixed with water |
Hemihydrate is changed back to dehydrate by process of hydration exothermic reaction. |
|
|
Consistancy |
Plaster-resembles ansmoothie consistancy Stone- intermediate consistancy Improved stone- cake batter consistancy. |
|
|
Setting |
Initial set=start if mix until semi hard. Loss of gloss, typically 5-7 min Final setting time= start of mix until rigid, separation from impression is possible, one hour after start of mix. |
|
|
Retarder |
Borax increases set time |
|
|
Accelerator |
Potassium sulfate, faster set |
|
|
Hygroscopic expansion |
Contact with water during setting |
|
|
More expansion |
Thicker mix and or increased spatulation |
|
|
Less expansion |
Thinner mix and or decreases spatulation |
|
|
Strength develops most in first |
45 min |
|
|
Wet strength |
Model is still wet some excess water present |
|
|
Dry strength |
2x wet strength occurs 24 hours later if not stored in moist enviroment. |
|
|
Thicker mix |
Increases strength |
|
|
Thinner mix |
Decreases strength |
|
|
Stability |
Never soak in water Saturated in calcium sulfate is best |
|
|
Sports gaurds |
Decrease injury tooth avulsion, fractured teeth, neck injury, gingival/mucosal injury, concussion. |
|
|
Types of sports gaurds |
Stock Mouth formed boil and bite Custom made |
|
|
Flouride custom tray |
High caries risk Chemotherapy Hypersensitivity Radio therapy Gels Neutral sodium 1.1 Stannous flouride 0.4 |
|
|
Thermoplastic materials |
Polyethylene Polyvinyl Polypropylene Polystrenes Polycarbonate |
|
|
Cast must show |
Gingival margin Frenula Tooth anatomy Maxillary tuberosity Retromolar region |
|
|
Mouthguard |
Remove palatial area so vacuum is more effective |
|
|
Block put us applied to |
Bleaching trays. |
|
|
Thickeness |
Mouthguard. 08 thickness Bleaching and flourode .06 or .04 |
|
|
Impression |
Is a negative reproduction |
|
|
Cast |
Is a positive reproduction |
|
|
Study model |
Replica used for studies of oral tissue, treatment planning, and diagnosis |
|
|
Cast |
Replica used for making appliances. Accuracy must be almost perfect |
|
|
Die |
Replica of a single tooth |
|
|
Bite registration |
Is taken before every alginate impression. |
|
|
Thermoset |
Chemical reaction |
|
|
Thermoplastic |
Physical change |
|
|
Gelatin |
Liquid to semi solid |
|
|
Thermoset |
More stable the. Thermoplastic |
|
|
Retraction cord |
Pushes gingiva away from the tooth to allow material flow |
|
|
Inelastic impression material |
Plaster, wax, ZOE |
|
|
Aqueous elastomeric impression material |
Alginate(irreversible hydrocolloid) Agar(reversible hydrocolloid) |
|
|
Non aqueous elastomeric impression material |
Polysulfide Condensation silicones Polyethers Additional silicone |
|
|
Hydrocolloids |
Major component is water Irreversible are set by chemical reaction. Reversible are set by physical change Sol=viscous liquid state, one material dissolved into another Gel= semisolid, rubbery state. 2 phases occur |
|
|
Alginate |
Irreversible hydrocolloid Powder water system Placed intra oral as sol converts to gel in chemical reaction. |
|
|
Alginate advantages |
Predominantly water Few air bubbles Easier to pour. |
|
|
Disadvantage of alginate |
Water evaporates and impression can shrink |
|
|
Syneresis |
When impression contact and exudes water. |
|
|
Imbibtion |
When impression absorbs water and swells. |
|
|
Agar |
Reversible hydrocolloid Indications, crown and bridge due to high accuracy. Requires special equipment |
|
|
Agar is |
Premixed by the manufacturer and supplied as semi solid materials in tubes. Predominantly water with added sugar. |
|
|
Hystersis |
Characteristic of melting and gelling at different temperatures. Melts at a high temp then it gels. |
|
|
Hydrocolloid |
Works well in a wet environment, very accurate impression Bad requires special equipment has poor tear strength |
|
|
For study model |
Alginate is the most widely used Inexpensive Diplseces moisture Lowers detail reproduction Dimensionally unstable |
|
|
For prosthosdontics |
Additional silicones most popular Accurate Dimensionally stable User friendly Expensive |
|
|
Polysulfides |
Undergo cross linking and chain lengthening. Polymerization reaction. Used for dentures. Teo pastes one white and one brown More accurate May stain clothe Longer working time. |
|
|
Additional silicone |
Final impression material for crowns and bridges Used in two viscosities thick is used in tray. Thin used in a syringe on and around tissue |
|
|
Tray prep for silicone |
Coat with adhesive air dry for 10 min |
|
|
Causes for loss of tooth vitality |
Bacterial invasion of pulp. Trauma Cavity preparation Rapid orthodontic movement |
|
|
Criteria for tooth testing |
Discoloration Fracture Large carious lesion Fistula |
|
|
Additional testing |
Hot/cold test Tooth slooth |
|
|
Responses to pulp vitality tester |
No response= necrotic pulse Lingering pain after stimulus removal= irreversible pulpits Pain subside promptly = reversible pulpitis. |
|
|
Polymers |
Made of a longer larger molecule formed by chemically reacting building blocks. |
|
|
Polymerization |
Chemical reaction that links monomers to produce polymer |
|
|
Thermoplastic polymer |
Easily recycled polymers that can be re-melted |
|
|
Thermoset polymers |
Cross linked not linear cannot be reshaped stronger then thermoplastic |
|
|
Acrylic resin |
Used to make gingival part of dentures |
|
|
Functional group |
Monomers with a reactive group that participates in the polymerization reaction. |
|
|
Heat activated |
Heat is activator-powder/liquid system |
|
|
Chemical activated |
Chemical used to activate acrylics |
|
|
Light activated |
Uses several chemicals and activators absorbs light and activates. |
|
|
Dual cure material |
Have both light and chemical activated capabilities |
|
|
Hard fillers like composite |
Are added to strengthen |
|
|
Silane coupling agents |
Transfer stress. |
|
|
Composite material |
Combination of two materials that are stronger then one by itself |
|
|
Chemically activated |
Two paste system mixed chairside |
|
|
Light activate material |
One paste system mixed by manufacturer |
|
|
Macrofilled |
Quartz material 70-80% by weight Denser then resin Large rough particles. |
|
|
Microfilled composite |
Much smaller ideal for IV and V restorations. |
|
|
Hybrid |
Mix popular Strong and polish well Class I, II, III, IV |
|
|
Improved hybrid |
Maximize the amount of filler by controlling particle size and distribution. Nano sized particles. |
|
|
Composite has the best |
Translucency Hybrids are most used. |
|
|
Glass ionomer material |
Chemical cure set by acid-base chemical reaction Resin modified Tooth colored but opaque Class V restorations Release flouride Popular as luting cement Disadvantage poor wear reisitance. |
|
|
Compomer |
Composite and glass ionomer Not frequently used. |
|
|
Finishing |
Contours are corrected while margins and irregularities are smoothed |
|
|
Polishing |
Produces smooth lustrous finish |
|
|
Purpose of finishing |
To create a smooth and uniform restoration that are easy to clean for patient to increase longevity to decrease caries reoccurance promote health of surrounding tissue. |
|
|
Polishing points are used on |
Occlusal surfaces |
|
|
Density |
Amount or mass of a material in a given volume Depends on type, packing of atoms, voids in material. |
|
|
Boiling or melting points |
Physical.properties breaking down of atomic bonds by thermal energy Melting or boild range vs point. Temperature range vs specific temperature. |
|
|
Vapor pressure |
Liquids tendency to become a gas. Low vapor like cooking oil doesn't evaporate quick High vapor p rubbing alcahol |
|
|
Thermal conductivity |
Rate of heat flow through material |
|
|
Heat capacity |
Measure how much thermal energy a material can hoard. |
|
|
Heat of fusion |
Amount of energy required to melt material |
|
|
Heat of vaporization |
Amount of energy required to boil a material |
|
|
Percolation |
Results in microleakage, tooth sensitivy and recurrent decay. Occurs when the coefficient of thermal.expansion differs between tooth and restorative material. |
|
|
Electrical conductivity |
Good electric sl conductor metal Poor conductors polymers, and ceramics. |
|
|
Snoop hardness # |
Enamel 350 Dentin 70 Porcelain 400-500 Acrylic denture 20 |
|
|
Durometer test |
How far will a steel ball sink |
|
|
Watersorption |
Many polymers absorb small amounts of water over time |
|
|
Force |
Weight load applied to an object |
|
|
Stress |
Force divided by the area on which the force has been applied |
|
|
Relationship of stress and strain |
Stress/strain |
|
|
Elastic deformation |
When the stress is removed and the object returns to it's original length. |
|
|
Plastic or permanent deformation |
When the stress is removed and it does not return to it's original length. |
|
|
Compression |
Pushing or crunching |
|
|
Tension |
Pulling |
|
|
Shear |
Sliding |
|
|
Torsion |
Twisting |
|
|
Bending |
Combination of stresses compression+tension |
|
|
Poissons. Ratio |
The ratio of the strain in the direction of the stress to the strain in a direction perpendicular to the stress. |
|
|
Resilience |
The materials ability to absorb energy and not become deformed |
|
|
Toughness |
Energy absorbed up to the failure point on the stress strain plot. |
|
|
Fracture toughness |
Measure of the energy required to fracture a material when a crack is present. Low glass High metal |
|
|
Fatigue |
Material object failure due to being stressed repeatedly for a long time |
|
|
Creep |
Small changes in shape when an object is under continuous compression |
|
|
Stress relaxation |
Slow decrease in force over time loss of pull over time. |
|
|
Creep and stress relaxation |
Increase when the temperature increases. |
|
|
Stress concentration |
Stress increases around defects. I creased likelyhood of fracture due to cracks. |
|
|
What is a sealant |
Clear or opaque plastic material applied tonthebtooths occlusal surface. Wherever pits and fissures exist. |
|
|
Sealant is held in place |
By mechanical locks in the form of enamel tags created by acid ectching. |
|
|
Sealant placement is both |
Preventative and therapeutic. |
|
|
Diagnodent |
Used to detect dental caries. |
|
|
Gases |
Atomic bond between gas molecules is weak Easily broken No molecular organization Take on the shape of the container. Can condense with to a liquid |
|
|
Liquids |
Stronger bond then gas Attraction results in short range order Takes the shape of the container. Molecular attraction makes longer to boil gut quicker to evaporate |
|
|
Solids |
Strongest attraction between molecules and atoms strongest bond. Maintain shape resist external forces |
|
|
Crystalline |
Tight spatial relationship long range order and short range order due to repeated consistent order. |
|
|
Amorphous |
Same atomic bond short range order only like liquid. |
|
|
Atomic bonds are a result of |
Electromagnetic forces |
|
|
Em forces cause |
Opposites to attract. |
