Class III Restoration: Anterior Teeth

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Questions and Answers

What is the primary location of Class III restorations?

  • Lingual surfaces of premolars
  • Buccal surfaces of molars
  • Anterior approximal surfaces (correct)
  • Posterior occlusal surfaces

Class III restorations are primarily needed due to trauma, not caries.

False (B)

Name three important aspects to consider when completing class III restorations.

Accurate diagnosis, durable restoration, aesthetics

Before initiating a Class III composite restoration, it is essential to check the tooth for signs of ______ health.

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

Match the following pulp health signs with their respective assessment methods:

<p>Vitality = Testing the tooth's response to stimuli Percussion = Tapping on the tooth to check for sensitivity Mobility = Assessing the degree of tooth movement Color = Visually inspecting the tooth's shade and translucency</p> Signup and view all the answers

Which of the following restorative materials offers the best combination of aesthetics, strength, and bond strength for Class III restorations?

<p>Composite (C)</p> Signup and view all the answers

Glass ionomer cements (GICs) offer superior aesthetics compared to composites for Class III restorations.

<p>False (B)</p> Signup and view all the answers

Other than composite name one alternative material for a class III restoration.

<p>Gold, RMGIC, GIC</p> Signup and view all the answers

In the steps for Class III composite restorations, after cavity preparation, a ______ matrix is placed to help with the contouring and isolation of the restoration.

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

Match the steps in Class III composite restorations with their descriptions:

<p>Etching = Applying acid to create micro-retentions on the enamel Priming and Bonding = Applying adhesive agents to enhance the bond between the tooth and composite Composite Placement = Incremental addition of composite material to the cavity Polishing = Smoothing and refining the restoration for aesthetics and function</p> Signup and view all the answers

Why is local anesthesia typically administered during a Class III composite restoration procedure?

<p>To eliminate patient discomfort (B)</p> Signup and view all the answers

Rubber dam isolation is optional and not necessary in Class III composite restorations.

<p>False (B)</p> Signup and view all the answers

What is the main goal when considering enamel during cavity design?

<p>Keep as much enamel as possible.</p> Signup and view all the answers

In Class III cavity design, a ______ approach is generally preferred to minimize visibility of the restoration.

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

Match the following terms with their meaning:

<p>Palatal approach = Accessing the cavity from the lingual or palatal side of the tooth Enamel flaking = Jagged enamel edges that require removal Incisal edge = Cutting edge of anterior teeth.</p> Signup and view all the answers

If a Class III restoration extends to include the incisal angle of an anterior tooth, it should be classified as what?

<p>Class IV (D)</p> Signup and view all the answers

Desiccating the prepared cavity is essential for optimal bonding of composite material.

<p>False (B)</p> Signup and view all the answers

What type of matrix band is needed when restoring the cavity?

<p>Straight or curved transparent strip</p> Signup and view all the answers

A ______ strip is placed proximally and secured with a wooden wedge to aid in restoring the cavity.

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

Match the following:

<p>Matrix band = Used to create a temporary wall for the restoration Wooden wedge = Stabilizes the matrix and provides separation Celluloid Strip = Thin, transparent material placed proximally</p> Signup and view all the answers

What material is recommended for direct pulp capping when the pulp is exposed during cavity preparation?

<p>Calcium hydroxide (Life/Dycal) (C)</p> Signup and view all the answers

If the prepared cavity is deep but not close to the pulp, no lining is needed before placing composite.

<p>False (B)</p> Signup and view all the answers

What material is used to seal calcium hydroxide when used for direct pulp capping?

<p>RMGIC liner</p> Signup and view all the answers

Placing filled composite should be completed in ______.

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

Match the lining material with its use:

<p>Calcium Hydroxide (Life/Dycal) = Direct pulp capping Ca hydroxide &amp; RMGIC liner = When close to pulp (not exposed) RMGIC liner only = If deep but not close to the pulp. No lining = Not close to the pulp</p> Signup and view all the answers

During the etching step of a Class III composite restoration, what is the purpose of applying acid to the enamel?

<p>To create micro-retentions for bonding (B)</p> Signup and view all the answers

After etching, the tooth surface should be completely dried to maximize bond strength.

<p>False (B)</p> Signup and view all the answers

What are two steps that follow etching of the tooth?

<p>Washing and Drying</p> Signup and view all the answers

During composite placement, the tooth is slightly ______ before applying the a celluloid strip.

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

Match the process to the step in restoring the cavity:

<p>Etching = Increases bond strength Prime and Bond = Applying a layer to enhance adhesion of composite material Placement of composite = Packing material into cavity</p> Signup and view all the answers

After placing and light-curing each increment of composite, what is the next step?

<p>Place another increment of composite (B)</p> Signup and view all the answers

Finishing and polishing of the restoration must be delayed until the next appointment.

<p>False (B)</p> Signup and view all the answers

What does the dentist check for after removing wedge and strip?

<p>overhangs and contour</p> Signup and view all the answers

Contouring the resin is completed using finishing ______.

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

Match the tool to its use during finishing and polishing:

<p>Finishing diamonds = Used to contour the restoration Mandrel and Discs = Smoothing surfaces Polishing Strips = Used below the interproximal contact area</p> Signup and view all the answers

What is the benefit of having a less plaque retentive surface?

<p>Both B and C (B)</p> Signup and view all the answers

Occlusion does not need to be adjusted upon completion of a class III restoration.

<p>False (B)</p> Signup and view all the answers

According to Sturdevant's Art and Science of Operative Dentistry, what section should you reference for clinical technique for class III direct composite restorations?

<p>Sections: General considerations for CompositeRestorations, andRestorationsClinical Technique for Class III Direct Composite</p> Signup and view all the answers

Clinical aspects of ______ covers dental materials.

<p>dental materials</p> Signup and view all the answers

Match the following article authors with their contribution to research:

<p>Ceballos, L et al. = Curing effectiveness of resin composites at different exposure times using LED and halogen units. David, J et al. = Effect of exposure time on curing efficiency of polymerising units equipped with light- emitting diodes. Fan, P. et al = Curing light intensity and depth of cure of resin-based composites tested according to international standards.</p> Signup and view all the answers

Flashcards

Class III Restorations

Class III restorations are anterior approximal restorations, often resulting from caries.

Diagnosis for Class III

Diagnosis involves clinical examination and potentially radiographic analysis to assess caries extent.

Restorative Materials

Composite offers good aesthetics, strength, and bond strength. GICs are less aesthetic/strong. Gold is also an option.

Class 3 Composite Steps

Steps include LA, isolation, cavity prep, conditioner/liner, matrix placement, etch, prime/bond, composite placement, and polish.

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Class 3 Cavity Design Rules

Maintain as much enamel as possible, preserve the incisal edge unless weak, remove jagged edges, and prefer a palatal approach.

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Lining materials

Direct pulp capping uses calcium hydroxide and an RMGIC liner; close to pulp uses Ca hydroxide & RMGIC; deep but OK uses RMGIC only.

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Finishing and Polishing

Finishing involves removing excess material and adjusting occlusion. Polishing lessens plaque retention and staining.

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Cavity Preparation

Process removes decay, shapes the cavity, and can use burs for access and shaping.

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Purpose of Isolation

Using rubber dam or other methods like cotton rolls to maintain a dry field.

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Matrix Strip Use

A celluloid strip is placed proximally and secured with a wooden wedge to shape the restoration.

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Etching and Drying

Etching, washing, and drying prepare the enamel surface for bonding.

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Bonding process

Bonding agents are applied and light-cured to improve adhesion of composite to tooth structure.

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Composite Placement

Composite is placed in layers (increments), each light-cured to minimize shrinkage and ensure full cure.

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Study Notes

  • Class III restorations involve restoring anterior teeth on the approximal surfaces.
  • Lost tooth tissue in Class III restorations usually results from caries.
  • Accurate diagnosis, durable restoration, and aesthetics are important aspects of Class III restorations.

Steps for Class 3 Composite Restoration

  • Local anesthesia is administered.
  • Isolation is a required procedure.
  • Cavity preparation is undertaken.
  • Placement of a conditioner or liner.
  • A celluloid matrix is placed.
  • Etchant application covers the entire cavity.
  • Primer and bond are applied to the entire cavity.
  • A composite is placed in increments.
  • Polishing procedure.

Local Anesthesia

  • Local anesthesia is necessary for Class 3 composite restorations.

Isolation Guidelines

  • Rubber dam isolation is important.

Rules of Class 3 Cavity Design

  • As much enamel should be preserved as possible, even if not well supported.
  • Keep the incisal edge unless it is very weak.
  • Only remove jagged enamel edges, for example, enamel flaking.
  • Palatal approach is preferable.

Accessing the Cavity

  • Access can be gained from a specific surface.

Preparing the Cavity

  • Prepare the cavity
  • Remove any carious or infected dentine, being mindful of the pulp and DEJ (Dentin-Enamel Junction)

Completion of Cavity Preparation

  • Cavity preparation.

Class III vs Class IV

  • When incisal edge is involved in a Class III; that is when Class III becomes a Class IV.

Restoring the Cavity

  • Wash and dry the prepared cavity.
  • Apply a matrix band, either straight or curved and transparent.
  • Lining is done as necessary.
  • Etch the area.
  • Wash and dry, but do not dessicate.
  • Apply prime/bond.
  • Light cure the bond.
  • Apply composite in increments.
  • Light cure after each increment.

Matrix Strip

  • Place the celluloid strip proximally.
  • Secure the matrix with a wooden wedge.

Lining Options

  • With direct pulp capping (exposed pulp), use calcium hydroxide (Life/Dycal) and seal over it with RMGIC liner (Fuji Bond/Vitrebond).
  • If close to the pulp but the pulp is not exposed use Ca hydroxide & RMGIC liner
  • If deep, but not close to the pulp, use RMGIC liner only.
  • No lining is needed if it is not close to the pulp.

Steps after Lining

  • Etching, washing, and drying the cavity.
  • Bonding and light curing.

Placing Composite

  • The first increment of composite is placed and packed well into the cavity base.
  • The cavity should be slightly overfilled. Hold celluloid strip tightly against the labial aspect of the tooth, pulling so that it wraps around the distal surface.

Restoration Assessment

  • Remove wedge and strip, then review the restoration. Check for overhangs and contour.
  • Achieve contour and marginal seal.

Finishing and Polishing

  • Finishing and polishing can be done immediately after placement.
  • This is done to remove excess material and adjust occlusion.
  • Resulting in a less plaque-retentive surface.
  • Results in a better aesthetic and lower risk of marginal or surface staining.
  • Improves reflective properties.

Trimming and Contouring

  • Contour the restoration with a finishing diamond bur, ensuring the bur contour mimics the tooth contour.

Instruments for Finishing and Polishing

  • Mandrel and discs are used.
  • Cups, cones, and discs are used.
  • Finishing and polishing strips are used below the interproximal contact area.

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