Cementation of Esthetic Inlays/Onlays
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Questions and Answers

During the re-insertion of an onlay with a rubber dam, which of the following should be ensured to prevent hindrance?

  • The onlay is completely dry before insertion.
  • The operator uses magnification for better visibility.
  • The rubber dam, polyester strips, wedges, or Teflon do not obstruct the placement. (correct)
  • Sufficient pressure is applied during the seating of the onlay.

    • What concentration of hydrofluoric acid is recommended for pre-treating the inner surface of a press-ceramic onlay, such as Ivoclar e.max?

  • 5% hydrofluoric acid (correct)
  • 20% hydrofluoric acid
  • 2% hydrofluoric acid
  • 10% hydrofluoric acid

    • According to the provided guidelines, what is the recommended particle size for sandblasting the inner surface of a composite onlay?

  • 10-20 microns
  • 25-50 microns
  • 50-200 microns
  • 25-100 microns (correct)

    • Following the sandblasting of a composite onlay's inner surface, which of the following is the next recommended pre-treatment step?

    <p>Application of silane (B)</p> Signup and view all the answers

    The pre-treatment protocol for a prepared cavity, prior to onlay cementation, is primarily determined by which factor?

    <p>The type of adhesive cement being used (C)</p> Signup and view all the answers

    Which cement type is specifically mentioned as suitable for student practice in the provided instructions?

    <p>Nexus 3 adhesive cement (B)</p> Signup and view all the answers

    During onlay insertion, what level of pressure is recommended to ensure proper placement in the prepared cavity?

    <p>Ensure firm placement without excessive pressure to avoid damage. (D)</p> Signup and view all the answers

    For optimal removal of excess cement, at which stage should the procedure be initiated?

    <p>When the cement enters the gel phase (1-2 minutes). (D)</p> Signup and view all the answers

    When using polyester strips for proximal excess cement removal, which alternative material is suggested for use with Teflon tape?

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

    At what point in the onlay cementation process should light polymerization be performed?

    <p>Only after excess cement has been removed. (C)</p> Signup and view all the answers

    What is the minimum recommended light curing duration from each direction during the polymerization step?

    <p>40 seconds (A)</p> Signup and view all the answers

    For vital teeth, what precaution is advised during the light curing process to protect the pulp from overheating?

    <p>Apply continuous air coolant and take breaks during light curing. (B)</p> Signup and view all the answers

    Which of the following tools is NOT mentioned for finishing and polishing ceramic onlays after cementation?

    <p>Steel burs (A)</p> Signup and view all the answers

    What should be checked on the articulator before cementation, specifically for non-CAD/CAM restorations?

    <p>Marginal seal, occlusion, contact points, and anatomical shape (D)</p> Signup and view all the answers

    How should the temporary filling be removed prior to cementation?

    <p>With a probe (B)</p> Signup and view all the answers

    Which cleaning agent is recommended for the prepared cavity before cementation?

    <p>Benzine or fluoride-free polishing paste (C)</p> Signup and view all the answers

    What technique can be used to check the marginal seal and integrity of the onlay in the prepared cavity?

    <p>Using an explorer or probe (A)</p> Signup and view all the answers

    What type of isolation is recommended before cementation?

    <p>Absolute isolation with a rubber dam (A)</p> Signup and view all the answers

    What should be done if the onlay does not fit due to tight contact points?

    <p>Adjust the contact points with a polishing disk or diamond bur (B)</p> Signup and view all the answers

    What can be used for matrix and wedging during cementation?

    <p>Polyester strips and plastic wedges, or Teflon tape (B)</p> Signup and view all the answers

    If Teflon tape is used instead of wedges, what additional step is required before light curing?

    <p>Clean adhesive cement excess with superfloss (D)</p> Signup and view all the answers

    When using acetone as a solvent, what bonding technique is employed and why?

    <p>Wet-bond technique, because completely drying dentin compromises the quality of the adhesive bond. (C)</p> Signup and view all the answers

    In the etch-and-rinse technique, what is the purpose of applying phosphoric acid?

    <p>To selectively etch the tooth surface, promoting better adhesion. (C)</p> Signup and view all the answers

    What is a key difference between dual-curing resin cement and self-adhesive dual-curing resin cement?

    <p>Self-adhesive cement does not require separate etching or bonding steps, while dual-curing cement may require them. (A)</p> Signup and view all the answers

    Which cement type might necessitate the use of a bond activator, and under what circumstances?

    <p>Dual-curing resin cement, when used with an etch-and-rinse adhesive system that doesn't require light curing. (D)</p> Signup and view all the answers

    When using a self-adhesive dual-curing resin cement, what practice is strictly prohibited?

    <p>Applying a separate bonding material. (C)</p> Signup and view all the answers

    Why should dentin not be completely dried when using the wet-bond technique?

    <p>It prevents the collapse of the collagen network and ensures optimal adhesion. (D)</p> Signup and view all the answers

    In etch-and-rinse technique, what is applied after the phosphoric acid and before dual-curing resin cement?

    <p>Primer and bond. (B)</p> Signup and view all the answers

    What is the recommended etching time for enamel when performing selective enamel etching in conjunction with self-adhesive dual-curing resin cement?

    <p>30-40 seconds (B)</p> Signup and view all the answers

    Flashcards

    Onlay Insertion

    Re-inserting an onlay while ensuring materials do not interfere.

    Pre-treatment of Inner Surface

    Preparation of the onlay's inner surface following material instructions.

    Hydrofluoric Acid Usage

    Applying 5% hydrofluoric acid for 20 seconds on ceramics before bonding.

    Sandblasting Composite

    Using 25-100 micron particles to prepare the composite onlay surface.

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    Cavity Pre-treatment

    Preparation of the cavity based on adhesive cement type.

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    Articulator Check

    Ensure the onlay fits properly and checks occlusion and contact points.

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    Temporary Filling Removal

    Carefully remove the temporary filling without damaging the cavity.

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    Cavity Cleaning

    Clean cavity with benzine or fluoride-free polishing paste to enhance bonding.

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    Onlay Fit Check

    Verify the fit of the onlay in the cavity before final placement.

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    Isolation Technique

    Use a rubber dam to isolate the area and avoid contamination during treatment.

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    Matrix and Wedge Use

    Use polyester strips and plastic wedges for securing the onlay during cementation.

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    Checking for Excess Cement

    Clean out excess adhesive cement from interproximal areas before light curing.

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    Contact Point Assessment

    Evaluate and adjust contact points between the onlay and neighboring teeth.

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    Wet-bond technique

    A bonding method using acetone as a solvent where dentin should not be completely dried.

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    Selective etching

    A technique that etches enamel selectively to improve bonding without affecting dentin.

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    Dual curing resin cement

    A resin cement that can be cured using both light and chemical activations.

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    Self-adhesive dual curing resin cement

    A resin cement that bonds on its own without the need for a separate bonding agent.

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    Etch and rinse technique

    A bonding method involving use of phosphoric acid followed by rinsing before applying a primer and bond.

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    Phosphoric acid concentration

    A common concentration used in dental etching, typically between 35-37% for enamel.

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    Bond activator

    A substance added to the bonding process that enhances the effectiveness of the bond, sometimes requiring no light curing.

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    Nexus 3 adhesive resin cement

    A specific type of dual-curing adhesive resin cement designed for wet bonding.

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    OptiBond Solo (LC)+

    An adhesive used for wet bonding in dental procedures.

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    Nexus 3 adhesive cement

    Cement commonly used in dental restorations for securing onlays.

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    Cement Gel Phase

    The stage when cement is transitioning to a solid state, typically 1-2 minutes after application.

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    Removing Excess Cement

    The process of cleaning away extra cement after it has begun to set.

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    Light Curing

    A method of hardening dental materials using a specific light source, typically for 40 seconds.

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    Oxygen Inhibition

    A condition where oxygen prevents the proper curing of dental materials at exposed surfaces.

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    Rubberdam Removal

    The technique of removing the rubberdam after completing the bonding procedure.

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    Finishing and Polishing

    Final steps using specific tools to smooth and shine the dental restoration.

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    Study Notes

    Cementation of Esthetic Inlays/Onlays

    • Steps for cementation of composite/ceramic materials:
      • Check onlay on articulator (if not CAD/CAM restoration).
      • Remove temporary filling.
      • Clean the cavity.
      • Check onlay in prepared cavity without rubber dam, adjust as needed.
      • Absolute isolation (rubber dam) if gaps exist.
      • Insert onlay with rubber dam.
      • Pre-treat inner surface of onlay.
      • Pre-treat prepared cavity.
    • Additional information:
      • Check marginal seal, occlusion, contact points, and anatomical shape.
      • Avoid damaging prepared cavity (no drilling).
      • Use fluoride-free polishing paste (fluoride inhibits adhesive).
      • Check marginal seal and integrity with probe.

      • Manage contact points (adjust with polishing disks or diamond burs if needed).
      • Neighboring teeth should be included (avoid clamping prepared tooth).
      • Use polyester strips & plastic wedges/teflon tape for matrix.
      • Clean adhesive cement excess (superfloss).
      • Follow manufacturer's instructions for material (e.g., acid concentration, time).
      • Wear goggles when using hydrofluoric acid.
      • Composite: sandblast before applying silane.

    Types of Cements

    • Dual curing resin cement: Utilizes 35-37% phosphoric acid (dentin:15-20 sec, enamel:30-40 sec etch). Primer and bond added according to system used. Then, dual curing resin cement is applied.
    • Self-adhesive dual curing resin cement: Etching step is optional. Primer and bond are applied, followed by the self-adhesive cement application.
    • Etching technique: Selective enamel etching (15 seconds).
    • Self-etching technique: No need for enamel etching.

    Procedure

    • Etch and rinse: Etch dentin (15-20 sec) and enamel (30-40 sec) with phosphoric acid. Apply primer and bond.
    • Self-etch: Apply primer and bond. Application of dual curing resin cement.
    • Apply cement: Apply the dual-curing or self-adhesive dual curing resin cement, according to type.
    • Insert the onlay: Carefully place onlay into cavity.
    • Remove Excess Cement: Remove excess cement with a probe and superfloss.
    • Polymerization: Light cure from several directions for 40 sec.
    • Check and Adjust: Verify occlusion, and make corrections if needed.
    • Finishing and Polishing: Use yellow/red diamond burs, Arkansas stones, Soflex discs for finishing, and rubber finishing instruments.

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    Cementation of Esthetic Inlays/Onlays - PDF

    Description

    This quiz covers the essential steps and techniques for cementing composite and ceramic materials in dental practice. It includes preparation, isolation, treatment, and checks for marginal seal, occlusion, and anatomical integrity. Perfect for dental students and practitioners looking to enhance their skills in esthetic restorations.

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