Questions and Answers
What is preparation?
Preparation
Why do Class II composite restorations often have to be replaced? (Select all that apply)
What is essential for diagnosing Class II caries?
Bitewing radiographs showing cavitation to the dentin.
What are the treatment options for Class II?
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What does the ideal conventional Class II prep assume?
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What does the ideal conservative Class II prep include?
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What type of prep do you use for a Class II that includes pit and fissure caries that is not into dentin?
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When is composite more indicated than amalgam?
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What are the disadvantages of composite restoration?
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What burs can be used for a Class II restoration?
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What hand instruments do you use to smooth the walls?
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What is the clinical technique for Class II tooth preparation?
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What are the purposes for pre-wedging in Class II preparations?
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What are the general steps for a conventional prep?
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What is the purpose of the gingival marginal trimmer?
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What is the minimum requirement for a Class II prep?
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Why do we break contact?
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What is restoration?
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What is the first choice for matrix systems?
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What other sectional matrix system does UCD use that provides better contouring?
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Can sectional matrix be used for amalgam?
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What is the second choice for a matrix system?
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If you have to place two rings for a MOD restoration, do you place the long or short ring first?
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What are the advantages of sectional matrix?
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What are the steps for setting up a sectional matrix for restoration?
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How do you place a sectional matrix?
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How far should the matrix go beyond the marginal ridge and why?
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How do you place the retainer/ring?
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Do you etch and bond before or after placing a matrix system?
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How do you place the first increment of composite?
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Study Notes
Class II Preparation and Restoration Overview
- Class II composite restorations often need replacement due to isolation difficulties and challenges in sealing margins.
- Essential for diagnosing Class II caries are bitewing radiographs that show dentin cavitation.
Treatment Options
- Class II treatment includes prevention and reversal, conservative restoration, and conventional restoration approaches.
- An ideal conventional Class II preparation assumes that pits and fissures have cavitation into dentin, while conservative preparations focus on removing only decay without affecting non-cavitated pits and fissures.
Restoration Types
- Slot preparations with sealants or preventative restorations are used for Class II cases with pit and fissure caries not extending into dentin.
- Composite is preferred over amalgam for minimal surgical intervention, bonding advantages, good isolation, and aesthetic necessities.
Disadvantages of Composite Restoration
- Concerns include shrinkage effects, increased technique sensitivity, greater localized occlusal wear, lower fracture toughness, and unknown biocompatibility of some components.
Instruments for Class II Restoration
- Common burs for Class II restoration: Round No. 1, No. 2, No. 329, No. 330, and Straight Fissure No. 56.
- Hand instruments for smoothing walls include hatchets and gingival marginal trimmers.
Clinical Technique
- Key steps in Class II preparation: create access to the faulty structure, remove the faulty structure, and establish a convenient form for restoration.
- Pre-wedging assists with additional separation, tight contact, and rubber dam protection.
Conventional Preparation Steps
- The process involves pre-wedging, completing occlusal prep, and cutting along the DEJ to the lesion's depth for proximal preparations.
- The gingival marginal trimmer's purpose is to round the pulpal-axial line angle.
Requirements and Rationale
- A minimum requirement for Class II prep is breaking all proximal contacts to remove caries and enable matrix placement for restoration.
Matrix Systems
- The first choice for matrix systems is sectional matrices, specifically the Composit-tight brand used by UCD.
- Triodent system, Palodent plus, and Garrision Composit-Tight 3D are alternate sectional matrix systems that offer better contouring.
- Sectional matrices are exclusively for composites, while Tofflemire matrices are primarily used for amalgam restorations.
Ring Placement
- For MOD restorations requiring two rings, place the short ring first for proper alignment.
Sectional Matrix Advantages
- Benefits of sectional matrices include contouring bands, added tooth separation through rings, and easier proximal contour and contact creation.
- Steps for setting up a sectional matrix involve placing the band, wedge, retainer/ring, and burnishing contact with the convex side of a spoon.
Matrix Placement Techniques
- Sectional matrices are placed from the buccal or lingual side, ensuring the concave portion faces the occlusal (smile up).
- The matrix should extend 0.5 - 1 mm beyond the marginal ridge to prevent bonding to adjacent teeth.
- Retainers/rings are positioned between the wedge and the matrix with the prong gingivally oriented.
Composite Placement Guidelines
- Etching and bonding should be performed after placing the matrix system.
- The first increment of composite is applied to the gingival floor within the proximal box, using a condenser to push the composite towards the wall.
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Description
Explore the essential aspects of Class II composite restorations, their treatment options, and the various restoration types. This quiz emphasizes the challenges in sealing margins and the importance of using bitewing radiographs for diagnosis. Gain insights into conservative versus conventional approaches for effective dental restoration.