Class 5 Amalgam Preparation Quiz

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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)

<ol> <li>Due to plaque accumulation 2. The destruction of normal tooth contour by the carious lesion</li> </ol> Signup and view all the answers

Class 5 restorations are indicated to restore what portion of a tooth?

Facial or lingual cervical 1/3 of any tooth Signup and view all the answers

Class 5 restorations can be especially technique sensitive because of (List 3 reasons)

<ol> <li>Location 2. Extent of Caries 3. Limited access and visibility</li> </ol> Signup and view all the answers

Cervical caries usually develop because of

the chronic presence of acidogenic plaque located in the non-self cleansing area just beneath the height of contour Signup and view all the answers

Name 2 characteristics that predispose patients to cervical caries

<ol> <li>Patients with gingival recession with exposed root surface 2. Patients with reduced salivary flow due to certain medications or head and neck therapy</li> </ol> Signup and view all the answers

Class V restorations may be used to treat both:

cervical and root caries Signup and view all the answers

Carries Progression Class 5 results from smooth surface caries which have what relationship at the DEJ?

Cones of decay have apex to base relationship at DEJ Signup and view all the answers

Incipient smooth caries enamel appear how?

white and chalky (occlusal or incisal to the crest of the MG) Signup and view all the answers

Class 5 caries are overlooked in examination unless teeth are

<ol> <li>free of debris 2. isolated with cotton rolls 3. dried gently with the air syringe</li> </ol> Signup and view all the answers

When may class 5 lesions be remineralized by appropriate techniques?

when incipient cervical caries has not been decalcified the enamel sufficiently to result in cavitation Signup and view all the answers

High caries index is obvious when...

numerous cervical lesions are present Signup and view all the answers

Material qualities and properties important for class 5 amalgam restorations include:

<ol> <li>Strength 2. Longevity 3. Ease of Use 4. Past success</li> </ol> Signup and view all the answers

Which areas usually get class 5 amalgam?

<ol> <li>Non-esthetic areas 2. For areas where access and visibility are limited 3. Where moisture control is difficult 4. For areas significantly deep gingivally</li> </ol> Signup and view all the answers

Many Class 5 restorations are difficult and present special problems because of:

<ul> <li>limited visibility - limited access</li> </ul> Signup and view all the answers

What will contribute to early failure in restorations?

<ul> <li>Inattention to tooth prep materials - Improper manipulation of restorative material - Moisture contamination</li> </ul> Signup and view all the answers

Extended service of the restoration depends on:

<ul> <li>The operator's care in following accepted treatment techniques - Proper care by the patient</li> </ul> Signup and view all the answers

Contraindication in class 5 restorations.

usually contraindicated in esthetically important areas Signup and view all the answers

Advantages of Class V Amalgam Restoration include:

<ol> <li>Stronger 2. Easier to place and less expensive 3. Easily distinguished from tooth structure 4. Usually easier to finish and polish</li> </ol> Signup and view all the answers

Disadvantages of Class V Amalgam Restoration include:

<ul> <li>Metallic and unaesthetic - Requires 90 degree cavosurface margins specific axial depths that need retentive grooves</li> </ul> Signup and view all the answers

Outline form of a Class V is determined mainly by the

the location and extent of the caries Signup and view all the answers

Proper outline form results in extending the cavosurface margins to ____ tooth structure while maintaining a limited axial depth of inside the DEJ

sound;0.5mm Signup and view all the answers

Why is the outline form often widest in the horizontal dimension?

Because the lesion has a tendency to spread laterally toward the line angles, rather than occlusally or cervically. Signup and view all the answers

determines final prep outline, especially when the cavosurface margins approach or extend into areas of enamel decalcification.

Clinical judgment Signup and view all the answers

Inserting amalgam involves which steps?

<ol> <li>Place amalgam into preparation in small increments 2. Condense first into retention grooves with small condenser 3. Condense against mesial and distal wall 4. Overfill and provide sufficient bulk for carving</li> </ol> Signup and view all the answers

The operator must observe the prepared enamel to evaluate the _, and to determine if exists peripheral to the wall.

depth of the decalcified enamel; cavitation Signup and view all the answers

When no cavitation has occurred, and when the decalcification does not extend into the enamel, extension of the outline form often should _______

cease Signup and view all the answers

A _ _____ should be considered for teeth with extensive cervical decalcification.

full-coverage restoration Signup and view all the answers

Initial procedures include:

local anesthesia; rubber dam isolation Signup and view all the answers

The outline can be prepared with which bur?

#56 fissure bur Signup and view all the answers

Other burs that can be used in this prep include:

#329 or 330 pear bur, #34 inverted cone bur (for refining walls) Signup and view all the answers

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.

#330; rounded Signup and view all the answers

Mesial and distal walls are noticeably ___, so that they parallel enamel rods and create a _ degree cavosurface angle.

divergent; 90 Signup and view all the answers

Depth of occlusal wall

1.0-1.25 mm Signup and view all the answers

Depth of cervical/gingival wall

0.75-1.0mm Signup and view all the answers

All preparations should have their cervical cavosurface outline parallel to, and ____mm from the CEJ.

1.0mm Signup and view all the answers

The axial wall is ______ mesiodistally so as to parallel the external contour of the tooth and DEJ.

convex Signup and view all the answers

The primary retention form for the amalgam is ______.

macromechanical Signup and view all the answers

Amalgam can be condensed into areas better than into _ areas, resulting in better adaptation of amalgam onto the retention grooves.

rounded; sharp Signup and view all the answers

The enamel walls may be smoothed using the __ in the slow-speed handpiece. Further finishing may be accomplished with the _ chisel.

#56 bur/fissure; Wedelstaedt Signup and view all the answers

Any old restorative material remaining may be left in place if (List 3 conditions):

<ol> <li>there is no clinical or radiographic evidence of recurrent caries 2. the periphery of the base and liner is intact 3. tooth is asymptomatic</li> </ol> Signup and view all the answers

To check for external contour and correct anatomic form, look at the axial contour from the _____ with a _

proximal; mirror Signup and view all the answers

Height of prep occlusal-cervically

2mm Signup and view all the answers

Width of prep mesio-distally

4mm Signup and view all the answers

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.