10. Class V Amalgam Preparation/ Restoration Flashcards Preview

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Flashcards in 10. Class V Amalgam Preparation/ Restoration Deck (22)
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1
Q

• class 5 is called the cervical lesion-in cervical 1⁄3
• not prepping in GRD she’s giving us the tooth
• why amalgam?–b.c,esp if high risk,only gets better as it ____ • can’t do if ____ + ____ won’t work
◦ if partial denture w/ ____ hooks it may have a hook here so you want
◦ metal and not plastic

A

erodes
bloody
wet
metal

2
Q
“Class V” Carious Lesions: Smooth Surface Cervical Lesions
 !  Originates in the \_\_\_\_ of the tooth
!  Occurs on \_\_\_\_ surfaces of tooth
!  \_\_\_\_ or \_\_\_\_
!  \_\_\_\_ surfaces most common

! Normally found ____ rather than radiographically
! Most often found in patients with poor oral hygiene

• if present MD then it's a class 2-just a lass 2 that extend s down to cervical 1⁄3 
◦ class 5 therefore has to be \_\_\_\_ or \_\_\_\_
• can be anterior or posterior(just don't use \_\_\_\_ on anterior) 
• most common is \_\_\_\_-found in ppl w/ poor oral hygiene
A
cervical third
smooth
anterior
posterior
facial/buccal

clinically

B
L
amalgam
facial

3
Q

“Class V” Carious Lesions: Smooth Surface Cervical Lesions

! Sometimes ____ inflammation is present

!  Carious lesion can occur below the \_\_\_\_ also
---!  gingival \_\_\_\_ present 
---!  Called  Root
Caries  ( \_\_\_\_ caries ) 
!  Not \_\_\_\_ caries
---!  cementum
A
gingival
CEJ
recession
senile
enamel
4
Q

“Class V” Carious Lesions: Smooth Surface Cervical Lesions

! Smooth surface lesion:
! Cones of decay have ____ relationship at the DEJ

! Caries begins as a ____ line around the gingival part of the tooth
! Area of ____
(demineralization, hypocalcification)

A

apex to base
white
decalcification

5
Q

“Class V” NON Carious Lesions: Cervical NON Carious Lesions

Three types of non carious Class V lesions:
1. ____
2. ____
3. ____
! Ditched cervical areas usually on ____ surfaces
! A restoration is placed to prevent further loss of tooth structure and reduce sensitivity of teeth

  1. Abrasion – ____ Shaped Defect
    Example: ____ Abrasion

◦ don’t restore unless you feel the crown will ____ or Pt is ____

A
abrasion
erosion
abfraction
facial
wedge/"V"
tooth brush
crumble
sensitive
6
Q

“Class V” NON Carious Lesions:
Cervical NON Carious Lesions

  1. Chemical Erosion – ____ Shaped Defect
    Example: ____ fruit juices and other ____ agents wash over the surface and dissolve the enamel away
  2. Abfraction – ____ Shaped Defect over ____
    Fracture of enamel at the ____ due to stress/flexure of the teeth buccolingually
    Example: ____
A
irregular cup
citrus
acidic
wedge/"V"
time
CEJ
bruxism/grinding
7
Q

“Class V” Preparation: Outline Form

! No ____ to direct
the outline form
! Outline form is determined ____, but not entirely, by the extent of the ____
! Lesion has a tendency to spread laterally toward ____ angles
! Usually widest ____
! The ____ and chalky areas of ____ (hypocalcification) should be included in the outline.
! The outline should be free flowing, with no ____ cavosurface angles

• no outline to follow - no anatomy
• bonding-clean it all up, no ____ enamel
◦ amalgam: follow ____ form
• class 5 spreads MD towards transitional lines
◦ try to envision transitional lines then center prep around lesion
◦ no sharp corners - amalgam hates those!

A
pits and fissures
mainly
caries
transitional line
horizontally
carious lesion
decalcification
sharp

unsupporting
resistance

8
Q

“Class V” Preparation: Outline Form

! The ____ extensions are difficult to define since the lesions vary so greatly
! The Mesial and Distal borders are usually defined by the ____

A

ideal

transitional lines

9
Q

“Class V” Preparation: Outline Form

! The ____ is centered in the outline
! The mesial and distal walls follow the mesial and distal ____ angles
! The gingival wall is ____ to, and ____mm above the gingival margin
! The occlusal wall is ____ mm above the gingival wall and is ____ to the gingival wall

A
lesion
transitional line
parallel
1
1.5
parallel
10
Q

“Class V” Preparation: Convenience Form
! You need to see and access the carious lesion for removal and restoration
! Many times gingival tissue displacement with a ____ clamp is necessary

“Class V” Preparation: Depth
! Ideal depth is just into ____
! The occlusal wall needs to penetrate more enamel so it will be slightly deeper, ____ mm
! The gingival wall will be less deep due to thinning enamel near the CEJ, ____ mm

  • convenience form: might need to wrap around transitional line, may need to use clamp to push skin away, or surgically remove tissue
  • stop 0.5 mm into dentin b.c this is only class ____ lesion
  • enamel gets thinner towards CEJ-don’t ____ axial wall cuz tooth naturally tapers itself
A

gingival retraction
dentin
1.5
1

1
slant

11
Q

“Class V” Preparation: Resistance Form

The Mesial and Distal Walls ____ towards the transitional line angles
! the external surface is ____
! The walls ____ the enamel rods
! Walls create a 90 degree cavosurface angle – “____”
!The Occlusal and Gingival walls are ____ to the external surface

A
diverge
convex
parallel
butt joint
parallel
12
Q

“Class V” Preparation: Resistance Form

! Preparations have to be ____ to enamel rods
! Enamel rods have to be supported by ____
! All preparations must end in ____ to give
bulk to amalgam
! Preparation needs to have ____ butt joint

“Class V” Preparation: Retention Form
! Grooves are placed all along the ____ and ____ walls at their ____ wall line angles

A

parallel
dentin
dentin
90o

incisal
gingival
axial

13
Q

“Class V” Preparation: Steps

! Rough out cavity preparation using a 330 pear bur
! Place 2 or 3 depth holes
! Then use a sweeping motion from the mesial to distal

! End of the bur will form the axial wall in a curve which will parallel external surface of tooth
! ____ wall should be just in dentin
! Mesial wall depth: ____ mm ! Distal wall depth: ____ mm

A

axial

  1. 5
  2. 5
14
Q

“Class V” Preparation: Steps
! Continue to refine outline form with 330 bur
! Extend cavity preparation almost to designed
outline of gingival and proximal walls
! Establish ____ depth
! With 330 bur, prepare divergent mesial and distal walls – tilt the bur
! Can use 171 carefully

A

uniform

15
Q

“Class V” Preparation: Steps
! Extend the preparation into proximo-incisal corners
! All four corners are gently and smoothly rounded

! Retention Grooves
! Placed in the incisal and gingival walls at the ____ angle intersections – LOW SPEED
! CANNOT be placed in the ____ wall

“put burr ____ to surface you’re cutting” - said this multiple times
• draw line that’s 1mm thick then take burr + make it wider-want ____mm
occlusal-gingivally
• grooves: NOT perpendicular! - ____

A

axial
perpendicular
2.5-3
angled

16
Q

“Class V” Preparation: Steps
! Refine ____, ____, ____, and ____ Walls:
! Plane and finish with gingival margin trimmers

A

mesial
distal
gingival
incisal

17
Q

Tooth that is being worked on has a ____ punch and a ____ or ____ clamp with floss

Tooth behind it gets the ____ tooh clamp

No ____ will be used - just floss

A
special double
212
90N
terminal
compound
18
Q
Amalgam – Use Dispersalloy
!  Usually - Tytin Single Spill
!  400mg alloy + 330mg mercury 
!  Small \_\_\_\_ surface restorations
!  Use Dispersalloy
!  More of this material
A

single

19
Q

Placing the Amalgam
First Increment Placement: Keeping nozzle in contact with the tooth, a small increment is squeezed out against the ____ wall by depressing lever
! ____mm – ____mm thickness

First Increment Condensation: Amalgam is thoroughly condensed into retentive areas ____ and ____ first
(____ condensation))

Another increment from the original mix is added and condensed within the cavity – against the ____, ____ and ____ walls

A

axial
1 1/2
2

occlusally
gingivally
lateral

axial
buccal
gingival

20
Q

Carving and Contouring
! Always carve amalgam from ____ toward ____
! Carve ____ to cavosurface margin, using natural tooth as a rest for the instrument and guide
! Will prevent gouging and ditching
! Restore natural contour of tooth
! Remove excess amalgam beyond cavosurface margin
! Follow with Burnishing

A

tooth
amalgam
parallel

21
Q

Burnishing
! Smoothes the carved surface by rubbing restoration with a burnisher instrument
! Improves ____
! If burnished well, there is less need ____ needed when finishing and polishing once the material has set
! Smoothes Improves marginal adaptation
! If burnished well, amalgam polishing (done at a following visit) is less involved

• use ____ burnisher more than round end or football

A

marginal adaptation
refinement
flat

22
Q

Restoration is convex in a ____ direction and in an ____ direction

A

BL

OG