W1D1 - 533 - Operative Dent - Isolation And Class Iii Prep

Front 1

What do we need field isolation?

Back 1

tongue, saliva, cheeks, lips, climate control, gingiva, visibility, accessibility, protection, medicolegal, efficiency - QUALITY

Front 2

How do we isolate the field?

Back 2

cotton rolls and gauze, cheek retractors, saliva ejector, but best of all: RUBBER DAM

Front 3

What is the most complete isolation of the operative field?

Back 3

RUBBER DAM

Front 4

When might we NOT use the rubber dam?

Back 4

partially erupted teeth, some 3rd molars, extremely malposed teeth, some asthma suffers, psychological problems, subgingival margins which preclude retraction.
(b/c we can't or b/c of patient)
- can remove rubber cam for class III prep

Front 5

What are the material necessary for placing a rubber dam?

Back 5

rubber dam material, punch, holder (frame or strap), clamp forceps, clamp, floss, lubricant, scissors

Front 6

There are MANY varieties of rubber dam materials - from really thin to really thick, what is usually recommended?

Back 6

generally, dark, heavy, 6x6 sheets

Front 7

How do you keep the rubber dam in place? what do you use?

Back 7

clamps or retainers -
dental floss or tape (usually better)
rubber dam wedge

Front 8

Is the dull or shiny side faced up when using the rubber dam?

Back 8

dull

Front 9

Which of these is considered "wingless' clamps?
12A, 13A, 14A, 2A, W8, W2A?

Back 9

W8 and W2A

Front 10

What type of clamp is used for a Class V prep?

Back 10

212 Retractor - primarily facial restorations, retract gingiva and rubber dame, stabilize with compound.

Front 11

What is the purpose of the lateral wings on a winged clamp?

Back 11

for holding the lip of the stretched rubber dam hole

Front 12

Why is dental floss tied to the retainer?

Back 12

incase a retainer breaks, you tie both holes and then won't be swallowed by a pt.

Front 13

Before placing a clamp and rubber dam what is done first?

Back 13

check tooth contacts with floss, select a clamp and apply floss ligature, try in clamp, - must be a stable fit
punch holes in rubber dam and place on frame
place clamp on rubber dam (wings or tooth (W)
floss dam through tooth contacts
secure dam evenly over frame

Front 14

What is the difference between a retractor and retainer?

Back 14

retainer is used on the most posterior tooth to keep the rubber dam in place, the retractor is used to retract the gingiva for placement of restoration.

Front 15

What hole do you 'double' punch in a rubber dam and why?

Back 15

the most posterior hole to accommodate the clamp - in this case with a wingless you place the clamp first and then stretch the rubber dam over it it is a retaining clamp not retracting

Front 16

What can be used to anchor the dam in anterior teeth?

Back 16

floss

Front 17

What is first removed upon removal of the isolation/

Back 17

remove clamp first, pull the rubber dam away from the gingiva and clip the interproximal segments and then pull through and check holes to make sure no pieces are missing.

Front 18

What is the lubricant used for and what type of lubricant is used?

Back 18

a water soluble lubricant can be applied to help the material pass through the interprox spaces, can use shaving cream or soap slurry, apply to both sides of dam.

Front 19

General rule for including the teeth is for - _ tooth posterior and _ teeth anterior to the tooth being operated on.

Back 19

one post.
two ant.

Front 20

What is a Class III?

Back 20

Found in The proximal surfaces of anterior teeth and DOES NOT include the incisal edge

Front 21

T/F Anesthesia decreases the salivary flow during the procedure.

Back 21

true

Front 22

When must the shade be picked.

Back 22

before the tooth dhydraes and experiences concomitant lightening.

Front 23

T/F the area must be isolated to permit effective bonding

Back 23

true

Front 24

Class III restorations have been the predominatn sites for the use of ________ restorations in the past because of the typical need for esthetic restorations in anterior teeth.

Back 24

composite

Front 25

Because the bond of composite to enamel and dentin is so strong, most Class II composite restoration are retained only by the ________- bond from acid etching and resin bonding, so no additional preparation retention form is usually necessary.

Back 25

micromechanical

Front 26

What type of stone bur do you use to roughen the surface and increase the surface area?

Back 26

diamond

Front 27

T/F the diamond instruments leave a thickened smear layer. Does this cause a prob?

Back 27

true, yes, self-etching bonding systems can be negatively affected by thick smear alyers because of the mildly aggressive acids they contain.

Front 28

How can you increase the retention forM?

Back 28

groove, or cove that extend onto the root surface or are very large, usually additional needed retention form can be achieved simply by increasing teh surface are witha wider enamel bevel or flare along the margin.

Front 29

When a proximal surface of an anterior tooth is to be restored, should you choose to approach in facially or lingually?

Back 29

lingually, , approach unles such an approach would necessitate excessive cutting of tooth structure.

Front 30

What are the advangtages of the lingual approach?

Back 30

the facial enamel is conserved for enhanced esthetics.
som unsupported, but no friable, enamel may be left on the facial wall of a class II or clas IV prep
color matching of the composite is no as critical
discoloration or deterioration of the restoration is less visible

Front 31

When should you use a facial approach?

Back 31

The carious lesion is positioned facially such that facial access would significantly conseve tooth structure
The teeth are irregularly aligned, making lingual access undesirable
an extensive carious lesion extends onto the facial surface
a faulty restoraiton that originally was placed from the facial approach need to be replaced

Front 32

What types of Class III Preps are there?

Back 32

conventional
beveled
modified

Front 33

What is the primary indicator for a conventional class III tooth prep?

Back 33

is for the restoration of root surfaces, it would be unusual to have an entire class III prep of the conventional type. - more likely, only a portion of a tooth prep - the portion on the root surface that has no enamel margin - would be prepared in this manner

Front 34

When preparing the conventional portion of a preparation (on the root surface), the form of the prep walls is the same as that of an _______ prep.

Back 34

amalgam

Front 35

What does the conventional portion look like?

Back 35

cavosurface margins exhibit a 90 degree cavosurface angle and provide butt joints between the tooth and the composite material
the external walls are prepared perpendicular to the root surface - walls are composed entirely of dentin and cementum - these walls must be prepared to a sufficient depth pulpally to provide for the followoing: adequate removal of caries, old restorative material, or fault and sometimes the placement of retention grooves, if deemed necessary.
Wall depth: usually .75mm into dentin - groove retention in non-enamel, root-surface prep -
could use RMGI liner on the root -surface portion before composite is placed...

Front 36

The crown areas of the prep (where enamel margins are present) are prepared to ahave a beveled or flared marginal configuration. T/F?

Back 36

true

Front 37

How is the pulpal depth dicated?

Back 37

by either the extent of the infected portion of the carious lesion, or restoration being replaced

Front 38

Typically, the retention of the restorative material in the crown portion of the prep would be provided by the bond afforded by the etching the enamel and dentin surfaces, priming the dentinal surfaces, and placing bonding adhesive to ___ (all/some) prepared surfaces.

Back 38

all

Front 39

What bur is used to place a retentive groove?

Back 39

1/4 round bur

Front 40

If a retention groove is to be place, the axial wall should be ______mm, instead of 2 mm, because this will prevent undermining enamel where the retention form is prepared.

Back 40

.5mm

Front 41

If the axial wall extends onto the root surface it should be _mm deep.

Back 41

.75

Front 42

The final tooth prep is accomplsihed by remvoing any remainging infected dentin with a ______ bur at low speed, or a small _ excavator, or both.

Back 42

round, spoon

Front 43

When would you use a CaOH liner with RMGI base?

Back 43

are applied only if indicated for pulp protection (direct or indirect)

Front 44

What are the walls usually beveled with?

Back 44

flame finishing or small round bur

Front 45

In the preclinic what were the requirements for the class III preps?

Back 45

Preplocation: correct position, incisal touches middle of contact
extension facial, axial, gingival: facial: slightly visible from facial
axial: 1.25mm mesiodistally
incisogingival width is 2.0mm
outline shape: rectangular no sharp angles
1.5 mm depth
outline with 330 bur on high speed

Front 46

If the bonding is to enamel only, a separate priming step (necessary or unnecessary)

Back 46

UNnecessary

Front 47

T/F If the bonding system combines the primer and adhesive components, placing this "one-bottle" type of bonding material on etched enamel surfaces does not adversely affect the bond strength.

Back 47

True

Front 48

IF dentin is being bonded then it should be left (moist or dry) after etching and before primer application.

Back 48

moist

Front 49

What is the usual sequence for etch, primer and adhesive?

Back 49

Etch, primer, adhesive!

Front 50

What first occurs:

Back 50

the proximal surface of the adjacent unpreped tooth should be protected from inadvertent etching by placing a polyester strip, gel etchant is applied to ALL of the prepared tooth structure and .5 mm beyond, stay there for 15-20sec. and then rinse off and dry (unless if on dentin)

Front 51

What then is the second step?

Back 51

the primer is applied to all of the prepared tooth structure with a microbrush or other suitable applicator tip. - usually light cured

Front 52

If the bonding system doesn't include the primer and adhesive the bonding adhesive is applied. next.

Back 52

true

Front 53

What is used to apply the adhesive?

Back 53

another microbrush or appliator tip - on all of the tooth structure that has been etched and primed. - dont' let it pool, then lightley dried. then light polymerize again.

Front 54

The bonding and adhesive are resin based, what does this mean?

Back 54

they generally exhibit an oxygen-inhibiting layer on the surface after plymerization - the composite material bonds directly to the cured adhesvie, unless the oxygen-inhib layer is contaminated.

Front 55

What type of bond occurs between the etched enamel and primed dentin?

Back 55

micromechanical strong

Front 56

What type of bond occurs between the bonding adhesive and composite?

Back 56

chemcial bond - strong

Front 57

What two types of composite are present?

Back 57

light cured and self-cured

Front 58

mOst compostie materials used for purposes are the light-cured type.

Back 58

true

Front 59

Is etching or bonding adhesive requried between the layers of composite?

Back 59

no