Podcast
Questions and Answers
What is the primary reason for using a high filler loading in resin composite restorations in posterior teeth?
What is the primary reason for using a high filler loading in resin composite restorations in posterior teeth?
- To increase flexibility and adapt to tooth stresses
- To reduce polymerization shrinkage
- To provide a lasting smooth finish
- To withstand direct occlusal forces (correct)
What is the main purpose of evaluating the shade of the tooth under different light sources?
What is the main purpose of evaluating the shade of the tooth under different light sources?
- To account for the color changes that occur after light curing (correct)
- To make the shade selection process more efficient
- To reduce eye fatigue during the shade selection process
- To ensure a perfect match with the surrounding teeth
What is the primary benefit of using a rubber dam in isolating the operating field?
What is the primary benefit of using a rubber dam in isolating the operating field?
- To reduce the risk of moisture contamination during resin composite insertion (correct)
- To increase the curing speed of the resin composite
- To improve the bonding of the adhesive system
- To prevent contamination of the enamel and dentin during application
What is the purpose of applying a flowable composite layer under packable or highly filled composites?
What is the purpose of applying a flowable composite layer under packable or highly filled composites?
What is the main advantage of using a shade guide in shade selection?
What is the main advantage of using a shade guide in shade selection?
Why is it important to remove bright colors from the field of view during shade selection?
Why is it important to remove bright colors from the field of view during shade selection?
What is the primary reason for making a mock-up during shade selection?
What is the primary reason for making a mock-up during shade selection?
What is the primary consequence of moisture contamination during resin composite insertion?
What is the primary consequence of moisture contamination during resin composite insertion?
Why is it important to view the patient at eye level during shade selection?
Why is it important to view the patient at eye level during shade selection?
What is the primary benefit of using a low filler loading in resin composite restorations?
What is the primary benefit of using a low filler loading in resin composite restorations?
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Study Notes
Universal Adhesives
- Can be used as self-etch, etch-and-rinse, or enamel selective-etch agents for bonding direct and indirect restorations to enamel and dentin
- Maintains the "all-in-one" philosophy
Selective Etching
- Etchant gel is applied only on enamel
- Spreading of the adhesive layer should be done with brush-thinning rather than air-thinning to provide a sufficiently thick layer of adhesive
- The adhesive layer should be cured before applying resin composite
Bonding to Enamel
- Acid etching transforms the smooth enamel surface into an irregular/rough surface
- The resin bond infiltrates into the micro-porosities produced in the etched enamel to provide micro-mechanical retention
- Resin macro-tags and micro-tags are formed
Dentin Etching
- Goal: total removal of the smear layer and smear plugs, de-mineralize the superficial dentin surface, and expose a micro-porous layer of organic collagen fibers network
- The smear layer is removed with acid etching, leaving the dentinal tubules opened
Bonding to Dentin
- The bonding agent penetrates the opened dentinal tubules and the micro-porous collagen fibrils network
- Resin tags are formed within the dentinal tubules upon polymerization of the adhesive layer
- Etch and rinse adhesives can result in nanoleakage and collapse of collagen fibrils, leading to weaker bond strengths and a poorer-quality hybrid layer
Resin Composites
- High filler loading results in high modulus of elasticity, making them stiff and suitable for posterior restorations
- Low filler loading results in low modulus of elasticity, making them flexible and suitable for anterior restorations
Shade Selection
- Shade to be matched must be clean and wet
- Remove bright colors from the field of view and evaluate shade under different light sources
- Shade selection should be made quickly to avoid eye fatigue
- A mock-up can be made to assure an accurate assessment of the selected shade
Isolation of the Operating Field
- Isolation from moisture is essential to avoid contamination of enamel or dentin during application of adhesive system
- Application of a Rubber Dam is the most accurate method to properly isolate the cavity during bonding and application of composite
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