Podcast
Questions and Answers
What are two ways to detect caries in Class II?
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?
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).
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 (A)
If an occlusal caries lesion is present, what determines whether the lesions should be joined or treated with a separate occlusal restoration?
If an occlusal caries lesion is present, what determines whether the lesions should be joined or treated with a separate occlusal restoration?
It's usually okay to extend the preparation further into a sound occlusal surface to provide retention of the proximal restoration.
It's usually okay to extend the preparation further into a sound occlusal surface to provide retention of the proximal restoration.
What can be done to enhance remineralization after the amalgam restoration has been placed?
What can be done to enhance remineralization after the amalgam restoration has been placed?
What can be done to enhance remineralization before the amalgam restoration is placed?
What can be done to enhance remineralization before the amalgam restoration is placed?
What is the term for a Class II restoration necessitated only because of a proximal caries lesion limited to the marginal ridge area?
What is the term for a Class II restoration necessitated only because of a proximal caries lesion limited to the marginal ridge area?
If the lesion involves the distal surface with access from the occlusal surface, what is it called?
If the lesion involves the distal surface with access from the occlusal surface, what is it called?
Any nicking or scarring of an adjacent tooth should be ___________ before the restoration is placed.
Any nicking or scarring of an adjacent tooth should be ___________ before the restoration is placed.
Carious dentin is removed with which bur?
Carious dentin is removed with which bur?
During preparation, demineralized dentin in the periphery should be:
During preparation, demineralized dentin in the periphery should be:
Which procedure is less likely to result in a pulpal exposure?
Which procedure is less likely to result in a pulpal exposure?
Hand instruments such as a _______ may be used to fracture away the shell of enamel.
Hand instruments such as a _______ may be used to fracture away the shell of enamel.
In the proximal slot preparation, the walls should meet the proximal surface of the tooth at ___ degrees.
In the proximal slot preparation, the walls should meet the proximal surface of the tooth at ___ degrees.
To provide resistance form for the Class II amalgam restoration, the proximal preparation should have a mesiodistal dimension of about ___ mm or more.
To provide resistance form for the Class II amalgam restoration, the proximal preparation should have a mesiodistal dimension of about ___ mm or more.
What determines the location of the gingival floor?
What determines the location of the gingival floor?
If the extension of Class II preparation into the occlusal groove is necessitated, how wide should be the isthmus?
If the extension of Class II preparation into the occlusal groove is necessitated, how wide should be the isthmus?
Retention grooves are placed with a round No.__ or __ bur.
Retention grooves are placed with a round No.__ or __ bur.
For a proximal slot restoration, retentive undercuts should be at least ___ mm deep.
For a proximal slot restoration, retentive undercuts should be at least ___ mm deep.
When is placement of the retention points or grooves unnecessary?
When is placement of the retention points or grooves unnecessary?
Retention points should be cut parallel faciolingually to the DEJ and to the external surface of the tooth.
Retention points should be cut parallel faciolingually to the DEJ and to the external surface of the tooth.
In proximal slot restorations, what is the only feature that will prevent dislodgment of the restoration proximally?
In proximal slot restorations, what is the only feature that will prevent dislodgment of the restoration proximally?
Where is the correct location for the retention grooves for preparation with a deep proximal box?
Where is the correct location for the retention grooves for preparation with a deep proximal box?
What is a keyhole preparation?
What is a keyhole preparation?
When is it recommended to access the Class II lesion from the facial or lingual surface instead?
When is it recommended to access the Class II lesion from the facial or lingual surface instead?
Which of the following is not a feature of all rubber dam clamps?
Which of the following is not a feature of all rubber dam clamps?
What are the clamps recommended for daily use in dentistry?
What are the clamps recommended for daily use in dentistry?
Rubber dam material is:
Rubber dam material is:
What is the advantage of using wingless clamps?
What is the advantage of using wingless clamps?
4 prongs of the retainer should contact the tooth, not beyond the ____________.
4 prongs of the retainer should contact the tooth, not beyond the ____________.
What is the clamp of choice for anterior teeth?
What is the clamp of choice for anterior teeth?
What is the clamp of choice for upper and lower molars?
What is the clamp of choice for upper and lower molars?
The retainer used for Class V lesions is _________.
The retainer used for Class V lesions is _________.
Why is it important for the restoration wall to be at a 90° angle with the enamel surface?
Why is it important for the restoration wall to be at a 90° angle with the enamel surface?
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?
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?
If the amount of intact marginal ridge is more than 1.6 mm for premolars, what should be the correct orientation of the walls?
If the amount of intact marginal ridge is more than 1.6 mm for premolars, what should be the correct orientation of the walls?
The reverse S is placed on which side?
The reverse S is placed on which side?
What is the ideal clearance distance from the adjacent proximal surface F, L, G?
What is the ideal clearance distance from the adjacent proximal surface F, L, G?
What hand instruments can be used to shape and smooth the proximal box?
What hand instruments can be used to shape and smooth the proximal box?
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.
