Class II Amalgam Restoration Flashcards
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Questions and Answers

What are two ways to detect caries in Class II?

  • X-ray (correct)
  • CT scan
  • Blood test
  • Visually during examination (correct)
  • What is an important thing to keep in mind when looking at Class II lesions in X-rays?

    The depth of the penetration of demineralization in enamel and dentin is actually greater than it appears in a bite-wing radiograph.

    A caries lesion that appears radiographically to have penetrated about two thirds of the way through the proximal enamel has actually penetrated the dentinoenamel junction (DEJ).

    True

    If an occlusal caries lesion is present, what determines whether the lesions should be joined or treated with a separate occlusal restoration?

    <p>Depends on the distance between the two lesions.</p> Signup and view all the answers

    It's usually okay to extend the preparation further into a sound occlusal surface to provide retention of the proximal restoration.

    <p>False</p> Signup and view all the answers

    What can be done to enhance remineralization after the amalgam restoration has been placed?

    <p>Treated with fluoride and acid etched and coated with light-cured resin.</p> Signup and view all the answers

    What can be done to enhance remineralization before the amalgam restoration is placed?

    <p>Remove demineralized enamel and etch the sound enamel walls.</p> Signup and view all the answers

    What is the term for a Class II restoration necessitated only because of a proximal caries lesion limited to the marginal ridge area?

    <p>Slot restoration</p> Signup and view all the answers

    If the lesion involves the distal surface with access from the occlusal surface, what is it called?

    <p>A disto-occlusal slot restoration</p> Signup and view all the answers

    Any nicking or scarring of an adjacent tooth should be ___________ before the restoration is placed.

    <p>polished away</p> Signup and view all the answers

    Carious dentin is removed with which bur?

    <p>The largest round bur that will fit into the area.</p> Signup and view all the answers

    During preparation, demineralized dentin in the periphery should be:

    <p>Completely removed</p> Signup and view all the answers

    Which procedure is less likely to result in a pulpal exposure?

    <p>Using a slow rotating round bur</p> Signup and view all the answers

    Hand instruments such as a _______ may be used to fracture away the shell of enamel.

    <p>gingival margin trimmer</p> Signup and view all the answers

    In the proximal slot preparation, the walls should meet the proximal surface of the tooth at ___ degrees.

    <p>90</p> Signup and view all the answers

    To provide resistance form for the Class II amalgam restoration, the proximal preparation should have a mesiodistal dimension of about ___ mm or more.

    <p>1.5 mm</p> Signup and view all the answers

    What determines the location of the gingival floor?

    <p>Sited by the gingival extent of the carious lesion.</p> Signup and view all the answers

    If the extension of Class II preparation into the occlusal groove is necessitated, how wide should be the isthmus?

    <p>1/4th of the intercuspal distance</p> Signup and view all the answers

    Retention grooves are placed with a round No.__ or __ bur.

    <p>1/8 or 1/4</p> Signup and view all the answers

    For a proximal slot restoration, retentive undercuts should be at least ___ mm deep.

    <p>0.5 mm</p> Signup and view all the answers

    When is placement of the retention points or grooves unnecessary?

    <p>When the occlusal extension is wide and has parallel walls.</p> Signup and view all the answers

    Retention points should be cut parallel faciolingually to the DEJ and to the external surface of the tooth.

    <p>True</p> Signup and view all the answers

    In proximal slot restorations, what is the only feature that will prevent dislodgment of the restoration proximally?

    <p>Retention spots and undercuts</p> Signup and view all the answers

    Where is the correct location for the retention grooves for preparation with a deep proximal box?

    <p>Just inside the DEJ and NOT in the corners of the box.</p> Signup and view all the answers

    What is a keyhole preparation?

    <p>Class II amalgam restoration with facial or lingual access instead of occlusal.</p> Signup and view all the answers

    When is it recommended to access the Class II lesion from the facial or lingual surface instead?

    <p>If a proximal caries lesion is at or apical to the cementoenamel junction.</p> Signup and view all the answers

    Which of the following is not a feature of all rubber dam clamps?

    <p>Wing</p> Signup and view all the answers

    What are the clamps recommended for daily use in dentistry?

    <p>W8A, B1, 27, No.W2A, No. 212SA retractor.</p> Signup and view all the answers

    Rubber dam material is:

    <p>Both A and B</p> Signup and view all the answers

    What is the advantage of using wingless clamps?

    <p>Less likely to interfere with matrix bands and wedges.</p> Signup and view all the answers

    4 prongs of the retainer should contact the tooth, not beyond the ____________.

    <p>transitional line angle</p> Signup and view all the answers

    What is the clamp of choice for anterior teeth?

    <p>No. 212S</p> Signup and view all the answers

    What is the clamp of choice for upper and lower molars?

    <p>14A</p> Signup and view all the answers

    The retainer used for Class V lesions is _________.

    <p>212 retainer</p> Signup and view all the answers

    Why is it important for the restoration wall to be at a 90° angle with the enamel surface?

    <p>To put the bulk of mercury in there.</p> Signup and view all the answers

    If the amount of intact marginal ridge in a Class II amalgam restoration is less than 1.6 mm for premolars, what should be the correct orientation of the walls?

    <p>Slightly divergent occlusally to prevent undermining.</p> Signup and view all the answers

    If the amount of intact marginal ridge is more than 1.6 mm for premolars, what should be the correct orientation of the walls?

    <p>Parallel</p> Signup and view all the answers

    The reverse S is placed on which side?

    <p>Buccal</p> Signup and view all the answers

    What is the ideal clearance distance from the adjacent proximal surface F, L, G?

    <p>0.2 - 0.3 mm</p> Signup and view all the answers

    What hand instruments can be used to shape and smooth the proximal box?

    <p>Margin trimmer and hatchet.</p> Signup and view all the answers

    Study Notes

    Detection of Caries

    • Caries in Class II restorations can be detected visually or via X-ray.
    • X-ray examination may not accurately reflect the depth of demineralization; actual penetration may be more extensive.

    X-ray Interpretation

    • A radiographically visible caries lesion near the dentinoenamel junction (DEJ) may have progressed further than expected.

    Restoration Techniques

    • If occlusal and proximal caries lesions are close, they should typically be joined; if not, treat separately.
    • Avoid extending the preparation into sound occlusal surfaces to maintain tooth strength.

    Enhancing Remineralization

    • After restoration, fluoride treatment can aid remineralization.
    • Before restoration, demineralized enamel can be removed and the area restored with bonded resin composite.

    Types of Restorations

    • A Class II restoration limited to the marginal ridge is termed a slot restoration.
    • If access to a distal lesion is from the occlusal surface, it’s classified as a disto-occlusal slot restoration.

    Preparation Techniques

    • Polishing is needed to remove damage from an adjacent tooth before restoration.
    • Use a large round bur to remove carious dentin thoroughly, ensuring sound dentin supports the enamel margins.

    Efficient Tools

    • Slow rotating round burs reduce the risk of pulpal exposure compared to spoon excavators.
    • After initial preparation, gingival margin trimmers can help refine enamel edges.

    Preparation Angles and Dimensions

    • Proximal box walls should meet at 90 degrees and converge occlusally for proper retention.
    • The mesiodistal dimension for resistance form should be around 1.5 mm.

    Retention Features

    • The gingival floor location depends on carious extent or the need for margin separation.
    • For effective retention, the isthmus width during occlusal extension should be 1/4th of the intercuspal distance.

    Retention Grooves

    • Use round burs of sizes No. 1/8 or 1/4 to create retention grooves.
    • Retentive undercuts in proximal slot restorations should be significant (at least 0.5 mm deep).

    Rubber Dam Clamps

    • Rubber dam clamps lack wings in wingless designs, indicated by a “W” before the number.
    • Recommended clamps for everyday use include W8A, B1, 27, W2A, and 212SA retractors.

    Materials and Instruments

    • Rubber dam material may be latex rubber or vinyl; wingless clamps minimize interference with procedures.
    • Retainers should make contact with the tooth at transitional line angles to avoid injury.

    Specific Restorations

    • For anterior teeth, the preferred clamp is No. 212S; for molars, choose 14A.
    • Class V lesions are treated with a 212 retainer, ensuring holes are punched slightly buccal.

    Surgical Preparation

    • Restoration walls should form a 90° angle with the enamel surface for optimal mercury placement.
    • Orientation of walls in Class II restorations depends on intact marginal ridge thickness; walls should diverge if less than 1.6 mm for premolars.

    Geometry and Clearance

    • A reverse S shape is added on the buccal side to ensure proper extension without undermining enamel.
    • Ideal clearance from adjacent proximal surfaces is 0.2 - 0.3 mm.

    Hand Instruments

    • Use margin trimmers and hatchets for shaping and smoothing the proximal box during preparation.

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    Description

    This quiz covers essential knowledge for detecting caries in Class II amalgam restorations. It explores methods like visual examination and X-ray, and emphasizes the deeper implications of caries appearance in radiographs. Test your understanding of these critical concepts in dental restoration.

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