Restorative Dentistry

Lecture 13

What is defined as the sealing of exposed denital tubules?

restoration

What is the purpose of restorative dentistry?

to help eliminate or reduce tooth sensitivity in areas of exposed dentin and help prevent pulpitis or pulp necrosis

Shallow defects are restored with the use of what?

dentinal “bonding agent”

Deeper defect may be indications for what restorative methods?

detinal bonding and composite restoration

List indications for restoration.

uncomplicated crown fractures (no pulp exposure)

dental caries lesion wihout pulp exposure on the occlusal surface of maxillary molar 1

restoration of a root canal access (advanced procedure)

enamel defects fom enamel hypoplasia or hypocalcification

List contraindications for restoration.

crown fractures or crown/root fractures with pulp exposure

crown fractures with near pulp exposure

teeth that are affected by endodontic disease (radiograph tooth first)

teeth that are affected by periodontitis (probe gingival sulcus, radiograph first)

cats with tooth resorption

Which bonding agent is typically 35-37% phosphoric acid, and is used to prepare enamel and dentin to receive the primer?

Etchant

Which bonding agent is made up of hydrophilic monomers carried in a water soluble solvent (acetone, ethanol, water) to promote good flow into the hydrophilic enamel and dentin in order to influence bonding strength?

primer

Which bonding agent promoted bonding between enamel or dentin and the resin composite restorative material or cement by acting as a link between hydrophilic resin primer and hydrophobic resin composite?

adhesive

Which bonding agent is made up of sub-micron glass particles and nano fillers in order to control handling and improve strength?

fillers

Which bonding agent includes acetone, ethanol, and water as a means to control evaporation rate?

solvent

Describe the mechanism of bonding to enamel.

primarily through mechanical retention to the etched enamel

Describe the mechanism of bonding to dentin.

results from penetration of the dentin tubules and the formation of resin-collagen hybrid layer

Which generations of bonding agents are currently available on the market, and which is the most commonly used?

5th-7th available

5th most common

Describe the procedure for bonding an uncomplicated crown fracture.

probe gingival sulcus to determine periodontal status

radiograph tooth to determine soundness and endodontic disease status

transilluminate the tooth to ensure vitality

clean tooth

probe for pulp exposure

remove any sharp enamel edges

smoothen fracture surface

polish

isolate tooth with gauze or rubber dam

apply 37% acid etch then rinse

apply bonding agent then air dry and light cure

repeat application 1-2 times

visually evaluate and check smoothness

If you find pulp exposure when probing prior to a bonding procedure on an uncomplicated crown fracture, what should you do?

extract tooth or refer for endodontic therapy

What is the order of the polishing discs from coarsest to finest?

black

purple

green

pink

white

Why do we need to use non-fluoride polish to remove any remaining plaque biofilm and smoothen the tooth surface prior to uncomplicated crown fracture bonding?

fluoride reduces efficacy of acid etch thus reducing bond strength

What should you do for follow up after bonding an uncomplicated crown fracture?

radiographs in 6-12 months of bonded tooth and contralateral tooth to compare width of root canals and ensure vitality

A contra-angle tool operates on which handpiece?

low speed