Questions and Answers
A Class 5 lesion is normally a _____________________ finding (clinical or radiographic)
clinical
Is the patient usually aware of the caries? Why or why not?
Yes, because of sensitivity to thermal or mechanical stimuli
Class V caries are often found in patients with ___________ ___________ ______________________.
poor oral hygiene
Why is the gingival tissue in the area of a cervical lesion sometimes inflamed? (List 2 reasons)
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Class 5 restorations are indicated to restore what portion of a tooth?
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Class 5 restorations can be especially technique sensitive because of (List 3 reasons)
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Cervical caries usually develop because of
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Name 2 characteristics that predispose patients to cervical caries
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Class V restorations may be used to treat both:
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Carries Progression Class 5 results from smooth surface caries which have what relationship at the DEJ?
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Incipient smooth caries enamel appear how?
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Class 5 caries are overlooked in examination unless teeth are
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When may class 5 lesions be remineralized by appropriate techniques?
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High caries index is obvious when...
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Material qualities and properties important for class 5 amalgam restorations include:
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Which areas usually get class 5 amalgam?
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Many Class 5 restorations are difficult and present special problems because of:
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What will contribute to early failure in restorations?
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Extended service of the restoration depends on:
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Contraindication in class 5 restorations.
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Advantages of Class V Amalgam Restoration include:
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Disadvantages of Class V Amalgam Restoration include:
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Outline form of a Class V is determined mainly by the
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Proper outline form results in extending the cavosurface margins to ________________ tooth structure while maintaining a limited axial depth of ____________ inside the DEJ
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Why is the outline form often widest in the horizontal dimension?
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______________________ ______________________ determines final prep outline, especially when the cavosurface margins approach or extend into areas of enamel decalcification.
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Inserting amalgam involves which steps?
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The operator must observe the prepared enamel to evaluate the _________________, and to determine if ________________ exists peripheral to the wall.
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When no cavitation has occurred, and when the decalcification does not extend into the enamel, extension of the outline form often should _______
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A ___________ _______________ should be considered for teeth with extensive cervical decalcification.
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Initial procedures include:
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The outline can be prepared with which bur?
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Other burs that can be used in this prep include:
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If you begin with a #56, 271 or other similar bur and sharp internal line angles remain, use a _____ bur to ensure defined but ____ internal line angles.
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Mesial and distal walls are noticeably _____, so that they parallel enamel rods and create a ___ degree cavosurface angle.
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Depth of occlusal wall
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Depth of cervical/gingival wall
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All preparations should have their cervical cavosurface outline parallel to, and ____mm from the CEJ.
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The axial wall is ______ mesiodistally so as to parallel the external contour of the tooth and DEJ.
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The primary retention form for the amalgam is ______.
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Amalgam can be condensed into ______ areas better than into _______ areas, resulting in better adaptation of amalgam onto the retention grooves.
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The enamel walls may be smoothed using the __________ in the slow-speed handpiece. Further finishing may be accomplished with the _________ chisel.
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Any old restorative material remaining may be left in place if (List 3 conditions):
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To check for external contour and correct anatomic form, look at the axial contour from the _________ with a _____
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Height of prep occlusal-cervically
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Width of prep mesio-distally
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Study Notes
Class 5 Amalgam Preparation and Restoration
- Class 5 lesions are primarily a clinical finding; large lesions may be visible radiographically.
- Patients typically notice caries due to sensitivity to temperature or mechanical stimuli.
- Class V caries commonly occur in individuals with poor oral hygiene.
- Inflammation of gingival tissue around cervical lesions can result from plaque build-up or the carious lesion disrupting tooth contour.
- Class 5 restorations aim to restore the facial or lingual cervical third of any tooth.
- These restorations require careful technique due to their location, extent of caries, and limited access or visibility.
- Cervical caries often arise from persistent acidogenic plaque located beneath the tooth's height of contour.
- Factors predisposing to cervical caries include gingival recession exposing root surfaces and reduced salivary flow from medications or therapies.
- Class V restorations can treat both cervical and root caries.
- Smooth surface caries progress by forming cones of decay with an apex-to-base relationship at the dentin-enamel junction (DEJ).
- Incipient smooth caries in enamel often appear white and chalky, clearing at the crest of the marginal gingiva.
- Class 5 caries may go unnoticed unless teeth are free of debris, isolated, and dried properly.
- Remineralization of class 5 lesions can be achieved if decay has not progressed to cavitation.
- A high caries index is indicated by the presence of many cervical lesions.
- Key qualities for Class 5 amalgam restorations include strength, longevity, ease of use, and a history of success.
- Class 5 amalgam is typically used in non-esthetic areas where visibility, access, and moisture control are challenging, especially when deep gingivally.
- Many Class 5 restorations present unique challenges due to limited visibility and access.
- Early failures in restorations can result from poor preparation of tooth materials, improper manipulation, and moisture contamination.
- Successful restoration longevity is influenced by proper treatment techniques and patient care.
- Class 5 restorations are usually not recommended for esthetically important areas due to visibility concerns.
- Advantages of Class V amalgam restorations include strength, affordability, visibility distinction from teeth, and easier polishing.
- Disadvantages include a metallic appearance and requirements for specific preparation angles that may reduce conservativeness.
- The outline form for Class V restorations is determined by the caries extent and location.
- Proper outline preparation should extend cavosurface margins to sound tooth structure, maintaining limited axial depth.
- The horizontal dimension of the outline is typically broader due to the lateral spread of lesions toward line angles.
- Clinical judgment is critical when defining the final preparation outline, particularly if margins extend into decalcified enamel areas.
- Amalgam insertion requires placing material in increments, condensing into retention grooves, and overfilling for sufficient bulk.
- Prepared enamel must be evaluated for decalcification depth and potential cavitation.
- If no cavitation and decalcification are present, extending the outline form should stop.
- Full-coverage restorations may be necessary for teeth with significant cervical decalcification.
- Initial procedures include administering local anesthesia and rubber dam isolation.
- The outline can be created using a #56 fissure bur; others such as #329, #330, or #34 inverted cone burs can refine preparation.
- If sharp internal angles remain after using certain burs, switch to a #330 for rounded angles.
- Mesial and distal walls should diverge to parallel enamel rods, forming a 90-degree cavosurface angle.
- The required depth for the occlusal wall is 1.0-1.25 mm, while the cervical wall ranges from 0.75-1.0 mm.
- The cervical cavosurface outline must be parallel to and 1.0 mm from the cemento-enamel junction (CEJ).
- The axial wall should be convex to align with the tooth’s external contour and DEJ.
- The primary retention form for amalgam is macromechanical.
- Amalgam adapts better in rounded areas than sharp areas for optimal retention.
- Enamel walls can be smoothed with a #56 fissure bur, further refining with a Wedelstaedt chisel.
- Old restorative materials may remain if no recurrent caries are evident, the periphery is intact, and the tooth is asymptomatic.
- To check for external contour and anatomical form, assess axial contours from the proximal perspective using a mirror.
- The height of the preparation should measure 2 mm, while the width should be 4 mm.
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Description
Test your knowledge on Class 5 amalgam preparation and restoration. This quiz includes questions about clinical findings, patient awareness, and characteristics of Class V caries. Perfect for Class 5 dental students looking to improve their understanding of this specific dental issue.