Questions and Answers
What does tooth preparation for moderate to large Class II direct composite restorations resemble?
More traditional Class II amalgam tooth preparation
How is retention obtained in Class II restorations?
By bonding, eliminating the need for mechanical retention features.
What dictates the extension of the preparation?
Fault or defect
Is it necessary to reduce sound tooth structure to provide 'bulk for strength' in Class II restorations?
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What should be assessed preoperatively?
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Is isolation critical in Class II restorations?
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What is the primary purpose of wedging in Class II restorations?
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What does initial separation by wooden wedges facilitate?
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Why is pre-wedging important?
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What are the aims of cavity preparation? (Select all that apply)
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What are the three steps involved in cavity preparation?
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Where does caries usually develop?
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What two factors dictate the facial, lingual, and gingival extensions of the proximal box of preparation?
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Is it required to extend the proximal box beyond contact with the adjacent tooth?
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How much should the gingival extension be?
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How is the gingival floor prepared?
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How is the gingival floor prepared in a deep Class II?
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Are bevels recommended along the gingival margins of the proximal box?
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In what preparations are margins approaching the cementoenamel junction, and enamel is thin?
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What should be done if the preparation extends onto the root surface?
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What is essential for achieving a preparation with all-enamel margins?
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What should be considered if the preparation extends onto the root surface?
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Study Notes
Class II Resin Composite Preparation and Restoration
- Tooth Preparation: For moderate to large Class II restorations, tooth preparations resemble traditional Class II amalgams; may involve an occlusal step and proximal box based on caries location and depth.
- Retention Method: Retention achieved through bonding, eliminating the need for mechanical retention features.
- Preparation Extension: Determined by the fault or defect present.
- Tooth Structure Reduction: Not necessary to reduce sound tooth structure for strength or conventional retention forms.
- Preoperative Assessment: Evaluate expected preparation extensions and assess for heavy occlusal contacts that may indicate potential wear.
- Isolation Importance: Critical to maintain a dry field; can use rubber dam, cotton rolls, or dry angles.
- Wedging Purpose: Protect adjacent teeth and facilitate interproximal separation; may use wedges with or without stainless steel barriers.
- Initial Separation Method: Wooden wedges help facilitate matrix placement and ensure tighter interproximal contacts.
- Pre-Wedging Benefits: Protects proximal rubber during cavity preparation, pushes gingiva apically, and eases proximal preparation.
- Aim of Cavity Preparation: Access the faulty structure, remove faulty components (caries, defective restoration, base material), and create a convenience form for restoration.
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Cavity Preparation Steps:
- Access creation
- Caries removal
- Finishing the cavity
- Common Tools: Use cylindrical-round bur (0.9 mm) for access; finish with fine bur for better seal using low-speed micromotor.
- Caries Development Location: Typically found on proximal surfaces, gingival to the proximal contact.
- Influencing Factors of Preparation Extensions: The extent of caries lesions and existing restorative material dictate facial, lingual, and gingival box extensions.
- Proximal Box Extension: Not mandatory to extend beyond contact with adjacent tooth, but it simplifies procedures.
- Gingival Extension Guidelines: Should be minimal to maintain enamel margins and just break contact.
- Gingival Floor Preparation: Should be flat with a 90-degree cavosurface margin.
- Deep Class II Preparation: "J" margin may be used to preserve thin enamel margins.
- Gingival Margin Bevels: Not recommended along the gingival margins of the proximal box; however, unsupported enamel rods should be removed.
- Class II Margin Considerations: When margins approach the cementoenamel junction with thin enamel, care is needed to preserve enamel for optimal bonding predictability.
- Root Surface Extension Concerns: If preparation extends onto root surfaces, focus on isolation during bonding without changing preparation techniques (consider using the sandwich technique).
- Management of Enamel Margins: Maintaining enamel to ensure predictable bond strength, as bonding to enamel is more reliable than to dentin.
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Description
This quiz focuses on the preparation and restoration techniques for Class II direct composite restorations. It covers key concepts such as tooth preparation similarities to traditional methods and the bonding process involved in retention. Perfect for dental students and professionals looking to enhance their understanding of composite materials.
