robbypowell's version from 2016-11-30 04:09


Question Answer
Ideally, where should margins be located relative to the gingival margin?0.5 mm above the free gingival margin if all other requirements are me
When are sub-gingival margins indicated (4 reasons)?
How far below a foundation material should the preparation extend?2mm


Provisional Restorations
Question Answer
What are 2 acceptable techniques for molars?ION metal crown: metal shell lined with resin(PMMA), trimmed, and polished, Integrity Vacuum Matrix:
What are 2 acceptable techniques for anterior teeth?Polycarb and Vacuum Matrix
What material is used for provisional restorations (brand and chemical name)?Jet Acrylic; PMMA , bis-acryl; integrity too
With a direct technique, when should the provisional be pumped on and off the tooth?As it begins to get hot (in the memory stage)
What is the color sequence for the rubber wheels in the provisional block (from coarse to fine)?Green, Black Yellow
What is the primary cement used for provisional restorations (type and brand)? How is it mixed (proportions, time, and mixing surface)? How is it usedTempbond- mix for 30 seconds on a mixing pad, line the inside of crown, seat with finger pressure, then biting pressure
How is a provisional restorations removed at subsequent appointments?With hemostats, applying pressure until the provisional loosens. It may require a slit with a bur, and then pry it open.

Final Impressions

Question Answer
What is the chemical in Hemodent? What is the purpose of Hemodent and how is it used?Buffered aluminum chloride. (It shrinks the tissue resulting in gingival retraction and opening gingival sulcus. Soak cord at least 10 min to fully saturate. )
What is the chemical in Astringedent?15.5% Ferric Sulfate ( Used for hemorrhage control; use a scrubbing technique while expressing solution until bleeding stops/capillaries are plugged. Procedure is done in a wet field to keep the coagulum from sticking to the tooth. Rinse vigorously with air/water spray and evaluate for bleeding spots. If needed, repeat the procedure. Always re-isolate after use of Astringident.)
If there is active hemorrhage, how should this be controlled?Astringident/Viscostat
Why should isolation be maintained from the time the cord is placed until it is removed to make the impression?To keep the hemostatic agents from being diluted. This will result in better hemostasis and retraction.
How long should retraction cord be left in place prior to making an impression?At least 10 minutes.
Following removal of the cord, what is the last thing you should do before injecting the light-bodied impression material?Blow air to dry the sulcus and impression thoroughly and make sure there is no evidence of hemorrhage.
Upon removal of the cord you observe some bleeding in the sulcus. What should you do?Re-scrub with Astringident, rinse and inspect. Re-isolate.
How long must the PVS adhesive be allowed to dry?10 minutes

Quadrant Technique

Question Answer
Why do full arch casts often not fully interdigitate (3 reasons)?Distorted impression, blebs on cast, improperly trimmed IOR
What are four advantages of the quadrant technique for crown fabrication as compared with full arch impressions?Less material (reduced cost), less time, easier on patient, fewer techniques for dentist
When can a quadrant technique be used? Ideal occlusal scheme, properly located MI contacts disocclude in lateral excursions
Question Answer
How can you determine or “test” that the proper occlusion exists that would allow for use of the quadrant technique (4 ways)?Proper contacts exist pre-operatively (determine at initial occlusal exam); Proper contacts are achieved by occlusal adjustmen; Proper contacts are determined by a diagnostic wax-u; Proper contacts are proven by provisional (clinically)
Which side(s) of the IOR is (are) trimmed?The crown preparation side ONLY

Axial Crown Contours

Question Answer
What are the potential negative results (3) of over-contoured PFM crowns?Poor esthetics, caries, periodontal disease
What is meant by the term emergence profile?Portion of axial tooth contour from the base of the gingival sulcus past the free gingival margin into the oral cavity. What type of emergence profile is desirable? Straight
What type of pontic design is best?Modified ridge lap
What are 2 methods to determine if a specific pontic design will be acceptable to the patient?If the patient can properly clean the FPD and if the patient is satisfied with the esthetics.

Restoring endodontically treated teeth

Question Answer
Which posterior teeth require a crown?All endodontically posterior treated teeth
Which anterior teeth require a crown?Badly broken down tooth, need to change tooth contour or color, abutment for FPD or RPD
What is the minimal amount of gutta percha that should be left in the apical part of the tooth?4mm to maintain apical seal
How should gutta percha be removed from the canal?Heat via Gates Glidden (non cutting end) or Pesso Reamer
What is the purpose of a post?to retain the core
What restorative material is unacceptable for a core and why?Glass ionomer, because of low strength and high solubility. Cannot take occlusal load.
What is a ferrule?The encirclement of 1-2mm of vertical axial tooth structure by the crown to protect the tooth from fracture
Why should the Parapost drill not be used to establish the post length?it may cause perforation due to its rigidness and does not conform to the canal accurately

IOR and Occlusion for Dentate Patients

Question Answer
Why is a semi-adjustable articulator more accurate than a hinge articulator?Because it represents anatomical movement of the patient, allowing for more accurate representation of condylar positioning and excursive movements
What occlusal problems, if any, would you anticipate with a restoration made on a hinge articulator?In choosing a hinge articular, the tooth should not be involved in any excursive movement or hit first in CR. Therefore the only problem you should encounter is if the occlusion is high. IN doing a hinge without checking for excursive movements, one could encounter nonworking interferences or no guidance from the tooth at all even though there is in the patient.
When is a hinge articulator as accurate as a semi-adjustable articulator? Why?A hinge articulator is as accurate as a semi-adjustable articulator if the tooth that is being prepared is a posterior tooth that has no excursive contact from it’s original MI position. Also, the tooth must not be the first contact in CO if CO does not equal MI.
What jaw position is used for restoration with crowns or FPDs?Maximum Intercuspation is almost exclusively used in the restoration of crowns and FPDs
When is a semi-adjustable articulator required?More than 2 units, guidance to be developed, anterior restorations, opposing quadrants
What material is most often used for interocclusal records (type, brand)?PVS /Regisil

Lab Procedures

Question Answer
What gypsum (type and brand name) is used for diagnostic casts? Working casts? Articulation of casts?Diagnostic-Microstone; Working-Jade Stone; Articulation-Mounting Stone
How is the margin on a working die identified for the technician?Dies must have margins marked with non-indelible colored pencil. It should be a fine continuous line
When is a custom incisal guide table required and how is it made?A custom incisal guide table is indicated when the teeth/tooth to be restored participate significantly in excursive guidance of the mandible
How is a solid cast prepared and what is its purpose (3)?The solid cast is poured from the impression after the working cast is poured. It’s purpose is to evaluate the proximal contacts, gingival contours, and to see if the crown seats. It can also serve as a back up in case the working cast breaks.
When making anterior indirect restorations, what is the best guide to provide the laboratory technician?Working cast articulated, Full arch cast with wax up of provisional made with the CIGT. . A CUSTOM INCISAL GUIDE TABLE (CIGT) IS REQUIRED ON EACH PATIENT WHERE THE TOOTH OR TEETH BEING RESTORED WILL PARTICIPATE IN PROTRUSIVE OR LATERAL GUIDANCE.

Clinical Try-in / Delivery

Question Answer
When should anesthesia be used for try-in?Anesthesia is rarely used for the clinical try-in appointment. If the patient has extreme sensitivity and the preparation needs to be adjusted, local anesthesia may be administered.
If the provisional crown was lost by the patient, what problems (3) should be anticipated at try-in?-Adjacent tooth position may have been compromised, leading to tight proximal contacts, or crown no longer being able to be place; -Supraeruption of opposing tooth, leading to high occlusion; -Compromised tissue, leading to tissue impingement when placing the crown
List the sequence of clinical steps (5) for try-in and adjustment of a crown.Proximal contacts; b. Internal adaptation; c.Margins; d. Occlusion; e. Contour
Where is the crown adjustment kit obtained? What does it contain?Dispensary
What is the first aspect of a restoration that should be evaluated and adjusted?The first aspect of a restoration that should be evaluated and adjusted are the PROXIMAL CONTACTS. You should use the following criteria to determine if the proximal contacts are accurate:
How do you know that a restoration is completely seated?Using fit-checker you can make sure the crown is fully seated and there are no impinging areas of the preparation on the internal aspect of the crown. You should see a bond of fitchecker around the margin, and a thin, even layer of fitchecker throughout the internal adaptation of the crown.
How is seating force applied when using Fit Checker for a posterior crown?Seat with firm finger pressure followed by heavy biting force on cotton rolls positioned in the B-L position (location of cotton roll is critical (For a posterior FPD? Same as above, but the cotton roll should be placed in the B-L position on the pontic. For an anterior restoration? Firm finger pressure on long axis of tooth (do not let patient bite, this may dislodge restoration due to direction of biting force)
How are corrections made for internal discrepancies that interfere with complete seating?If the discrepancy is on the occlusal ⅓, adjustments should be made on the tooth. If the discrepancy is near the gingiva, the adjustment should be made on the casting.
What instruments are used for occlusal adjustment on porcelain surfaces (2)?Fine diamond and/or a rubber wheel Metal surfaces (2)? Carbide and/or rubber wheel

Final Cementation

Question Answer
What cement is primarily used (type, brand)? Resin Ionomer (RMGI or resin modified glass ionomer), RelyX. How is it mixed (proportions, mixing surface, technique, time)? For the paste version, use equal lengths of base and catalyst. For powder/liquid version, use an equal number of powder scoops and liquid drops. Mix on paper pad with a cement spatula until uniform, about 30 seconds.
When and how is the cement removed?Remove excess cement only after it has set completely hard (3-5 minutes for resin-modified glass ionomer). Clinician can use an explorer and a floss with knot in it to remove excess cement.

Implant Prosthodontics

Question Answer
Describe the anatomic criteria required for implant placement as listed in the implant protocol.There must be adequate bone height to accept a 10 mm or longer implant as measured from the osseous ridge crest to the limiting anatomic landmark (e.g. inferior alveolar canal, maxillary sinus, mental foramen, nasal floor etc.; There must be a minimum of 7 mm mesio-distal width between the proximal surfaces of adjacent teeth (4 mm for the implant, 1.5 mm space on either side). The edentulous ridge must have sufficient facial-lingual, facial –palatal width to allow for peri-implant circumferential bone; Patient must have an acceptable occlusal plane and adequate interarch space (minimum of 4 mm measured from soft tissue to marginal ridge of adjacent tooth).
What are the advantages (3) of implant replacement as compared to other options?No caries; No endodontic problems ; No retention failur; No periodontal breakdow; Easier to clean
What is the usual timeline for treatment with an implant?Typical time for bone integration of a dental implant is 4-6 months, depending on the bone quality.

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