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127 Cards in this Set

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Class III

don't use composite on distal-lingual of canine (amalgam or gold)

prepare larger filling first, fill smaller one first

Ideal b/w prep and pulp

2 mm: thermal insulator, place caoh or zoe under amalgam to be a thermal insulator since amalgam is bad at that


used to initiate reaction with alloy

Class II inlay vs amalgam

inlay: divergent walls, sharp internal line angles, reverse bevel

amalgam: convergent walls, rounded internal line angles, retentive grooves


still has optimal strength

longer trituration time smaller setting expansion

want it shiny and wet

Class V amalgam

retentive grooves

deformed trapezoid (kidney shaped)

delayed expansion of amalgam

insufficient trituration/condesation and contamination of amalgam by moisture during condensation (main cause of failure)

-compressive strength reduced with combined with moisture

tooth and amalgam have different coeficcients of thermal expansion

high thermal conductor

poor thermal insulator

amalgam strength

has to do with mercury content

>55% mercury dramatic loss in strength


unreacted alloy (30% amalgam)

Gamma one

matrix for unreacted alloy 60%, second strongerst

Gamma two

weakest, most susceptible to corrosion

low copper amalgams have gamma two phase while high copper amalgams do not

Class II amalgam

butt joint, occlusal dovetail, walls converge occlusally, bevel axiopulpal line angle bevel

2 mm amalgam functional cusps

1.5 mm amalgam for non functional cusps

Gingival cavosurface margin bevel

only if in enamel to remove unsupported

ging margin trimmer

Mandibular first bicuspid

tilt bur lingually to prevent encroachment on facial pulp horm

Divergent walls

Only mesial and distal

not buccal lingual they converge

for class I inlays also

PM from marginal ride>proximal at least 1.6 mm. 2 mm for molars


to compensate for thickness of the matrix band

Polishing amalgam

reduces marginal discrepancy, prevents tarnishing, improves appearance

avoid generating heat

Dimensional change

Setting expansion: more mercury, less trituration time, less pressure in condensation, greater particle size

Strength of amalgam

higher condensation, smaller particle, longer trituration, fewer voids

cavosurface margin

obtuse, 90 degrees (butt joint)

amalgam is brittle

Constituents in amalgam

most to least





high copper: less marginal breakdown less likely to corrode


process that happens over time, deformation with time in response to constant stress: main cause of marginal fracture

increase condensation decreases the creep rate

Free mercury

no free mercury in triturated amalgam because trituration coats alloy particles with mercury

Pulp protection

thickness of remaining dentin most important

diff b/w a base, cement, and liner is their thickness


15-25 micron thick

Cavity liners

thin coating (5 microns) barrier to chemical irritants


1 mm to 2mm

substitutes for dentin

barrier chemical irritants, thermal insulation, resist condensation forces

Glass ionomer cements

release f, chem adhesion, therm insul, therm expan like tooth, low solubility

fluoro-alumino-silicate glass that reacts with polyacrylic acid

Zinc phosphate cement

oldest, standard

low ph-sensitivity, no anticariogenic

superior strength: mechanical interlocking

mix very slowly: cool mixing slab, add small amounts every 20 seconds

need to apply varnish before han

zinc polycarboxylate cement

chemically adjesive-mainly to enamel, chelation

good to pulp

high tensile strength, lower compressive strength

disadvantage: thick, short working time

rmgi luting agents

higher strength and lower solubility and good characteristics of glass ionomers

don't use with all ceramic-fracture

resin luting agents

bond to dentin, high strength low solubility

irritate pulp

use for ceramic restorations

zoe sedative restoration

neutral ph

palliative on pulp

don't use on a pulp calp

low strength base under non resin restorations

interferes with subsequent placement of a resin filling

glass ionomer restorations

root caries in high risk, adheres to mineralized tooth

light cured is preferred

low stress areas

lower compressive strength, tensile strength, and hardness compared to composite

technique sensitive: high solubility

only material used as a cement and permanent restorative material


Primary: placed on dentin near pulp: calcium hydroxide under comp/amal, use zinc polycarboxylate/phosphate under gold

Secondary: zinc phosphate cement over caoh base

Cavity liner

not under composite: inhibits polymerization

thin coatings over exposed dentin to protect pulp

Solution liner

Varnish, water insolubel

copalite, hydroxyline

You don't need these as much anymore because of dentin bonding

Suspension liner

water soluble

pulpdent and hypo-cal

Calcium hydroxide

released from liner or cement or base

very basic

react by drying

Carious dentin zones

Zone 1: normal dentin

Zone 2: subtransparent dentin: cpable to remineralize

Zone 3: transparent dentin: capable to remineralize

Zone 4: turbid dentin: bacterial invasion, not capable of remin

Zone 5: infected dentin outermost, totally removed

Chronic caries

shallow lesion, wide entrance, no pain

Acute caries

rampant caries

entrance small, lesion deep/narrow, pain, no staining, children


enzyme that strep mutans uses


pH 5.5 or below

remin above

Step mutals

produces lactic acid, stimulated by sucrose,

Light curing

don't use UV anymore

use visible light cure now


polymerization shrinkage: causes internal stresses and gap formations at butt joints

C factor: ratio of bonded and unbonded surfaces: increase in c factor is increase in polymerization shrinkage

Composite features

low wear resistance

Microfill composite



70-77% filled by volume




marginal adaptation of posterior composites

Composite filler particles

reduces shrinkage on curing


greater than one micron filler

microfills: less

Filler content

all properties of composite improved using higher filler levels: decreases fluidity though

Light curing methods

hold within 2 mm, cure in increments 1.5-2 mm, cure longer for darker shades

Tooth prep composite

rough walls, diamond burs, no resistance form or retention form, no base

Monomers for composite




these are part of organic resin matrix

questionable color stability and high viscosity

Methyl methacrylate

most common acrylic used for temps

cemented with zoe cement

lowest thermal conductivity and diffusivity

unfilled resin

high coefficient of thermal expansion

Acid etch

increases surface energy, chemical cleans tooth, creates micropores for micromechanical retention

37% phosphoric acid

Class V outline form

with composite you can make them more rounded

use a bevel with composite to stop microleakage done when the cavosurface margin is on enamel

Dentin bonding

5th gen: two step etch and rinse

6th gen: type 2: one step self etch

7th gen: one step no mixing


veneering non functional cusp with a finishing bevel


complete coverage of functional cusp with 1.5 mm gold

Onlay preps

1.0 mm gold non func 1.5 mm gold func

taper lingual/buc walls


increases resistance to tarnish and corrosion


increases hardness


modifies orange color of copper

Gold alloys

I: highest gold, small inlays

II: larger inlays/onlays

III: onlays and crowns

IV: bridges, rpds, hardest

Onlay prep

all walls must converge

0.5 mm bevel on cavosurface margin: 40 degrees

gingival bevel

Class V gold

trapezoid or kidney

outline form determined by caries

Sprue pin

molten alloy reaches the mold

Gypsum bonded investments

refractory filler (quartz) gives thermal expansion

binder: adds strength


Class II gold inlay

history of perio problems

Gypsum bonded gold

used with types 1-3 gold alloys


hollow ground bevel

use bevel with gold

Class II onlay prep

occlusal lock (dovetail)

rounded marginal edges


main reason why crowns fail

3 mm is minimal height of crown prep

retention: area and parallel of axial wall

Retention form

Length of walls: 3 mm minimum

Taper of walls: 2-5 degrees

more parallel

Base metal alloy

corrosion resistant

strength and low density

Noble metals

very resistant to corrosion

Onlay bevel

30-40 degree bevel

Ferrule effect

if a tooth can't have a crown it can't have an onlay

envelopment of tooth structure by a crown. 1.5 mm of bucall and lingual subgingival tooth structure is sufficient

1 mm tooth thickness after prep

4 mm suprabony tooth

Retention of an onlay

parallel axial walls

sharp point and line angles

box/groove: box gives more retention


check occlusion of gold crown

Air bubbles on gold castings

vacuum invest them to get rid of em

Minimum occlusal reductions

amalgam: 2.5/2

Cast gold: 1.5/1

PFM: 2/1.5

Rake angle

ange b/w line connecting edge of blade to axis of bur and rake face (pos or neg)

soft materials (acrylic): positive rake angle

hard (amalgam): negative rake angle

carbide: negative rake angles

Rake face

surface of blade that hits the tooth

Clearance face

surface of blade away from direction of bur rotation

Edge angle

angle b/w rake face and clearance face

Clearance angle

angle b/w clearance face and tangent to path of rotation

Cutting instrument formular


10 mm width of blade

85 degree primary cutting edge angle

8 mm blade length

14 degree blade angle


cut enamel



Angle former


Spoon excavator


class III and V gold preps

Angle former

sharpen line angles


Anterior teeth for retention

Spoon excavator

removes carious dentin and carves amalgam


pointed side of soon

Speed of burs

slow under 12,000 rpm

intermediate 12,000 to 200,000

high above 200,00

In office bleaching

35% hydrogen peroxide

At home bleeching

carbamide peroxide 10%: ADA sealed




spillway for food

teeth self-cleansing

protect gingival tissue from friction

Why proper embrasures

prevent food impaction

stabilize dental arches

protects periodontium

Premolar contacts

Jxn occlusal and middle third

Molar contacts

middle third

Indirect pulp cap

CaOH base on thin layer of questionable dentin over pulp, wait 3-4 months to remove remaining decay

Reversible pulpitis

pain not longer than 10 seconds

short duration and low intensity

tx: remove high restoration, sedative restoration, indirect pulp cap

Irreversible pulpitis

pain longer than 15 seconds

Pin amaglams

one pin per missing line angle

choose largest pin possible

improves retention of large restoration, weakens the restorative material

best is 2 mm into dentin, 2 mm in amalgam, 1 mm from dej


more like unfilled direct resins

low viscosity


reduces rate of enamel solubility

precipitates fluorapatite

remineralizes carious lesions


optimal fluoride conc in water

around 1 ppm (0.7-1.2)

Hydrodynamic theory

explains sensitivity of exposed roots to stimuli: dentinal fluid movement in tubules

Fluoride gel in custom trays

rample caries


h/n radiation

abutment tooh overdenture

hypersensitive roots

Sodium fluoride

most common otc fluoride

phosphate fluoride

in office fluoride

very acidic

don't give on porcelain and composite

Toxic fluoride

5 mg/kg body weight


ability of metal to be worked into desired shapes


metal hammered without rupture

gold most ductile and malleable then silver

Extension for prevention

place margins in areas of lessened caries susceptibility

Galvanic shock

brief sharp electrical sensation when two similar metals touch in mouth, ends in a few days

Coefficient thermal expansion

tendency of material to change shape under temperature change.

gold best: close to teeth

unfilled resins worst, then comp