Amalgam Restoration Techniques
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Questions and Answers

What is a primary reason for repairing amalgam restorations?

  • To address secondary caries. (correct)
  • To prevent any future discoloration.
  • To replace the restoration with composite.
  • To improve the esthetics of the restoration.
  • Which of the following is a benefit of repairing an amalgam restoration compared to replacing it?

  • Increased longevity of the restoration
  • Enhanced ability to remove deep caries
  • Higher initial cost, but lower long-term cost
  • More conservative of tooth tissue (correct)
  • In which location is a dentist most likely to repair an amalgam restoration?

  • Incisor with significant discoloration.
  • Cuspid with extensive cracking
  • Premolar with multiple surfaces needing restoration
  • Molar with a single surface needing restoration (correct)
  • What factor is most important factor related to the quality of an amalgam repair according to the content above?

    <p>The interfacial bond between the new and existing amalgam. (D)</p> Signup and view all the answers

    What percentage of flexural strength can a repaired amalgam reach when a freshly triturated amalgam is condensed directly onto a roughened existing amalgam surface?

    <p>50% (B)</p> Signup and view all the answers

    What is the primary goal of condensation in amalgam placement?

    <p>To adapt amalgam to the cavity walls and increase the restoration's density. (D)</p> Signup and view all the answers

    Which of the following best describes the appearance of a properly triturated amalgam?

    <p>Shiny and separates in a single mass from the capsule. (C)</p> Signup and view all the answers

    What is a key difference between spherical and lathe-cut amalgams regarding condensation?

    <p>Spherical amalgams require less condensation force, while lathe-cut amalgams need more. (B)</p> Signup and view all the answers

    What is the effect of over-trituration on amalgam?

    <p>It produces a wet, soft mix that is difficult to remove and sets quickly. (B)</p> Signup and view all the answers

    During amalgam condensation, what is the recommended force to apply for condensable amalgam?

    <p>2 to 5 kg (D)</p> Signup and view all the answers

    Why is it important to maintain a dry field of operation during amalgam condensation?

    <p>To prevent contamination and ensure optimal properties of the restoration. (D)</p> Signup and view all the answers

    What is the purpose of trituration in amalgam preparation?

    <p>To mix the liquid mercury with the dry amalgam alloy powder to form a plastic mass. (A)</p> Signup and view all the answers

    Which of the following is a characteristic of spherical amalgam alloys?

    <p>They generally have a shorter working time and demonstrate a faster set than admixtures. (C)</p> Signup and view all the answers

    Why is less condensation force required for spherical amalgams compared to other types?

    <p>Heavy forces tend to push spherical particles to the side, potentially punching through the amalgam mass. (A)</p> Signup and view all the answers

    In what directions should amalgam be condensed within a preparation?

    <p>Vertically and horizontally (laterally toward walls of the preparation). (A)</p> Signup and view all the answers

    What is a primary advantage of mechanical condensation over hand condensation?

    <p>Mechanical condensation requires less energy, reducing dentist fatigue. (D)</p> Signup and view all the answers

    What is the purpose of precarve burnishing of an amalgam restoration?

    <p>To further shape the amalgam occlusally and adapt the amalgam to the cavo surface anatomy. (B)</p> Signup and view all the answers

    When using a round-end burnisher during amalgam placement, in which direction should it be pulled?

    <p>Parallel to the amalgam margin, positioning burnisher on the unprepared enamel. (D)</p> Signup and view all the answers

    What is the objective of carving amalgam?

    <p>To simulate the anatomy of the tooth. (A)</p> Signup and view all the answers

    What is the ideal angle for the amalgam margin at the occlusal surface?

    <p>90 degrees (C)</p> Signup and view all the answers

    What is/are the objectives of burnishing amalgam?

    <p>To further decrease the size and number of voids, express excess Hg on the surface of the amalgam restoration and adapt amalgam to the cavo surface. (C)</p> Signup and view all the answers

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    Flashcards

    Amalgam Placement Technique

    The technique for placing amalgam is similar across different preparations, involving mixing, carrying, and condensing.

    Amalgam Trituration

    The process of mixing liquid mercury with dry amalgam alloy powder to form a plastic mix.

    Types of Trituration

    Includes hand trituration and mechanical trituration using electric amalgam mixers.

    Proper Trituration Appearance

    Properly triturated amalgam appears shiny and separates as a single mass from the capsule.

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    Amalgam Condensation

    The process of compressing amalgam into the cavity preparation until it is filled and overfilled.

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    Objectives of Condensation

    To adapt amalgam to cavity walls, remove excess mercury, and increase restoration density.

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    Types of Condensation

    Hand condensation and mechanical condensation are two methods of compacting amalgam.

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    Condensation Force

    Adequate force for condensation should be 2 to 5 kg for effective amalgam placement.

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    Reasons for Amalgam Repair

    Primary reasons include secondary caries, marginal defect, and cusp fracture.

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    Conservative Repair Benefits

    Repairing restorations conserves tissue, reduces iatrogenic damage, minimizes anesthesia use, enhances experience, and saves time.

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    Factors in Amalgam Repair

    Quality of repair relates to interfacial bond; old amalgam surface must be roughened to remove contaminants.

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    Amalgam Flexural Strength

    A fresh amalgam condensed on roughened old amalgam can achieve up to 50% of the original strength.

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    Selective Replacement Strategy

    Sometimes, it's simplest to replace only the damaged portion of a restoration to minimize overall impact.

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    Mechanical Condensation

    Condensation of amalgam performed using an automatic device requiring less energy than hand methods.

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    Precarve Burnishing

    Shaping the amalgam occlusally with a burnishing instrument before carving.

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    Carving

    The process of shaping amalgam to mimic tooth anatomy without removing excess material.

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    Burnishing Objectives

    To reduce voids, express excess mercury, and adapt the amalgam to cavity surfaces.

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    Occlusion Adjustment

    Checking the fitting of the restoration against occlusal surfaces after carving.

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    Articulating Ribbon

    A tool used to mark contact points between teeth and restorations during occlusion checks.

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    Amalgam Margin

    The edge where the amalgam meets the tooth structure, ideally forming a 90-degree angle.

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    Study Notes

    Amalgam Placement

    • Amalgam placement technique is consistent, regardless of the preparation type or classification.
    • Amalgam is mixed, placed in the cavity, and condensed to eliminate voids and fill all areas of the cavity.
    • The amalgam is then shaped (carved) to restore the missing tooth portion.

    Spherical Alloys

    • Spherical alloys create amalgam needing a lower mercury-alloy ratio and less condensation force.
    • The direction of condensation force is critical for spherical amalgam as it does not adapt to cavity walls as well as other amalgam types.
    • Spherical amalgam has a shorter working time and a faster set than admixtures.

    Trituration

    • Trituration involves mixing liquid mercury with dry amalgam alloy powder.
    • This can be done by hand or mechanically.
    • Electric amalgam mixers (amalgamators) are used for trituration.
    • The duration and speed of trituration must be just enough to coat all alloy particles with mercury, forming a plastic amalgam matrix.
    • Under-triturated amalgam is dry and crumbly, setting quickly. Over-triturated amalgam is wet and soft, also setting quickly. Properly triturated amalgam appears shiny and separates into a single mass.

    Condensation

    • Condensation is the process of compressing and directing amalgam into the tooth preparation.
    • Amalgam condensing instruments are used until the cavity is entirely and slightly overfilled with dense amalgam.
    • Objectives of condensation include adapting the amalgam to the cavity walls, removing excess mercury, and increasing the restoration's density.
    • Two types of condensation are hand and mechanical condensation.
    • The field of operation must be kept absolutely dry during condensation.
    • Condensation is performed using sufficient pressure (3-4 pounds) in both vertical and horizontal directions, starting with smaller condensers.
    • Spherical amalgam requires considerably less condensation force, as heavy forces force particles to the side or through the amalgam mass.
    • Amalgam should be condensed vertically and horizontally, or laterally.

    Precarve Burnishing

    • After condensing, the amalgam can be shaped further occlusally using a large egg-shaped or ball burnisher.
    • The round-end burnisher is used on the unprepared enamel adjacent to the amalgam margin to remove excess material parallel to the margin without overcarving the marginal amalgam.

    Carving

    • The objective of carving is simulating the tooth's anatomy instead of precisely recreating fine details.
    • Carving is started only after the amalgam has hardened enough to resist the carving instrument.
    • Carving is performed from the tooth surface to the restoration surface to avoid removing amalgam at the margins.
    • The dentist tries to develop amalgam margins that form 90-degree angles at the occlusal amalgam.

    Burnishing

    • Burnishing aims to further reduce voids, force out excess mercury, and adapt the amalgam to the cavity.
    • Burnishing is done using a burnisher moving from the amalgam to the tooth.
    • Final smoothing may be done with moist cotton.

    Amalgam Placement Problems

    • Overpacked amalgam is a placement problem.
    • Initial grooves, carving to the margins, removing flash, final shape and burnishing are steps to resolve amalgam placement flaws.
    • Class II restoration is crucial for proper procedures to avoid mistakes.
    • Initial condensation, overpacking, marginal ridge condensation, removing wedge, removing band are all parts of the procedure.

    Repair of Amalgam Restorations

    • Main reasons for amalgam restoration repair include secondary caries, marginal defects, and cusp fractures.
    • Reasons for replacing or repairing amalgam include loss of dental tissue, increasing preparation, cost, time-consuming procedures, and potential pulp damage.
    • Benefits of repair are more conservative tissue usage, reducing iatrogenic damage, minimizing anesthesia need, providing a better patient experience, and saving time.
    • Dentists tend to more often repair restorations in molars than premolars, preferring ones with single surfaces over multiple surfaces.
    • Amalgam repair quality relies on the interfacial bond between the new and old amalgam. Roughening the old amalgam surface helps remove corrosion and saliva contaminants.
    • If a mesio-occlusodistal restoration fractures in the mesial box but the remaining portion includes a deep distal margin, conservative replacement of the mesio-occlusal part of the restoration is recommended.

    Adjusting the Occlusion

    • After carving the amalgam, a rubber dam is removed, and the occlusion is checked.
    • This process uses articulating ribbon to mark points of contact between mandibular and maxillary teeth.

    Other Key Concepts

    • Amalgamators assist in creating the amalgam mixture.
    • Properly prepared amalgam results in a satisfactory restoration.
    • Specific procedures like initial groove creation, carving, flash removal, final shaping and burnishing ensures quality.
    • Understanding procedures such as initial condensation, overpacking, and marginal ridge condensation are important.

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    Placement of Amalgam PDF

    Description

    Test your knowledge on the repair and placement of amalgam restorations. This quiz covers benefits, techniques, and factors influencing the quality of the repairs. Ideal for dental students and practitioners looking to enhance their skills.

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