OSCE

irreversible hydrocolloid

• Alginate

• Used for:

  • Bleach trays

  • Models

  • Pre-op impression ONLY

• Adv: cheap, easy to work w/

• Disadv: loss of accuracy, tissue distortion (synethis, inhibition)

reversible hydrocolloid

• Agar-agar

• Able to go from sol to gel, back to sol

• Used for:

  • Could be: Premil

  • Final imp

• Oldest

• Adv: accuracy

• Disadv: takes a lot of equipment

elastomeric

• Polysulfide

• Used for:

  • Could be: Premil

  • Final imp

• Rubberlike quality, base/catalyst, light & heavy body

• Adv: very stable & accurate

• Disadv: taste, stain, odor

silicone

• Polysiloxane & polyvinal siloxanes

• Used for:

  • Could be: Premil

  • Final imp

• Latex gloves affect set time

• Adv: highly accurate stable, base-catalyst

• Disadv: expensive

polyether

• Used for:

  • Could be: prelim imp

  • Final imp

• accurate, no distortion, quick set time

• adv: highly, accurate, stable

• disadv: expensive

stock tray

• full arch

• quadrant

• anterior

• disposable

• pre-manufactured

triple tray

• take impression of opposing teeth, bite registration & arch of interest

• triple tray as final: only as preliminary needed

custom tray

• made of acrylic or thermoplastic material for most accuracy

• beneficial for taking final imp

tofflemire

• universal retainer

• mechanical device that holds the matrix band

• used anywhere posterior

• utilizes retainer and band system

parts of a tofflemire

outer knob: secures matrix band

inner knob: extends/tightens the band

guide channels: holds matrix band

placement of tofflemire

• diagonal slot ALWAYS positioned toward gingiva

• retainer positioned at buccal/facial of tooth

• guide channel ALWAYS faces gingiva

• handle extends out

• matrix band: small circumference edge faces toward gingiva

matrix band

• thin, flexible stainless steel

• universal band: selected for class II

• Extension band: deeper class II prep requiring gingival extension

ironing band

if matrix band becomes creased or bent, smoothing it out with back end of mirror or acorn banisher

wedge

• holds band securly in place

• adapt band to gingival contour

• used to prevent overhangs

wooden vs plastic wedges

wooden: amalgams

plastic: composite or amalgam

selectional matrix system

• class II composite restorations to restore anatomical contacts

• produce tight anatomical contact

steps selectional matrix

1) matrix band placed interproximal

2) wedge is placed to close the cervical margin

3) prongs of tension ring placed between band and wedge

• create solid closure of cavity preparation

amalgam carrier

packs amalgam

condensor

packs into tooth

• small to large

• used for amalgam

cleoid/discleoid

cleoid: spade

discleoid: circle

• carve any excess material

• used for amalgam

hollemback

• trim/carves away interproximal

• used for amalgam

burnisher

• polishes

• contours, shapes the filling

• used for amalgam

articulating paper

checks for the bite

class II tray set up #1 instrument

Instruments tray 1:

• Basic 3

• Spoon excavator

• Dycal

• PFI

• Acorn Burinisher

• Gold knife

• Articulating paper

instrument tray 2:

• garison forceps

• wedge

• matrix band

• rubberdam frame

• rubberdam napkin

• rubberdam (precup)

• anesthetic

• shade taker

Burs for Class II

Burs

• 330 bur

• Finishing bur

• cup,disc,bullet

• 2/4 round bur

class II tray set up #1 materials

• limelight

• gluma

• etch

• bond

• flowable comp

• condensable comp

for what class is this tray set up?

Class II

for what procedure is this tray set up?

amalgam

for what procedure is this tray set up

Crown prep

limelite

• promotes secondary dentin formation

• protects pulp, sedative

• “medicine”

etch

• improves retention of restoration

• increase surface area of dentin

• remove smear layer

• allows for penetration

what acid is etch

phosphoric acid

gluma

• desensitizer

• prevents tooth sensitivity

• used in class II

• DON’T CURE, light air

Bond

• adhesive bond to collagen fibers in dentin

• mechanically locks in

• hybrid layer

• cure 10 secs

flowable comp

• hybrid with smaller and fewer particles

• first layer of comp

condensable comp

• packable comp

• hybrid with larger and more particles

tempbond

• temporary cement for crowns

• ZOE

hemodent

• used to control bleeding

• shrinks tissue (ischemia)

glass ionomer

• used liner, luting cement and restoration

• releases fluoride

part of clamp for rubberdam

8: maxillary

7: mandibular

W: wingless

No W: winged

Jaws: goes onto gingival

Bow: goes around, faces distal

Bass method

• brush 45 degree to gumline

• gentle, vibrating strokes

modified bass method

after done w/ vibration, sweep bristles over crown of tooth

fones method

• for children

• use circles

• posterior to anterior

charters method

• opposite of bass

• 45 degree toward occlusal

• more for ortho

floss method

• wrap in C shape

PHP plaque index

• assess extent of biofilm and debris present over tooth surface

• disclosing agent: applied to teeth to stain the biofilm present

scoring PHP

vertically:

• mesial

• middle

• distal

Horizontally

• gingival

• middle

• occlusal or incisal

what is the score for 8 F

2

score for #8 F and #24 F

#8 F: 4

#24 F: 5

what do we use for OH for crowns and bridge

floss threader

PHP score

total debris score / number of teeth scored

ex. 24/6= 4

ranges of scores PHP

Excellent 0 - no debris

Good 0.1 - 1.7

Fair 1.8 - 3.4

Poor 3.5 – 5.0

what would a pt with a 3.1 PHP score be considered?

fair

interproximal aids

• help clean interproximals

• ex) rubbertip stimulator, toothpicks, proxabrush

orthodontic care

• electric toothbrush

• waterpik

• floss threaders

• interdental cleaners

• end tuft brushes

• fluoride rinse or gel

prosethetic care

• brush appliance, toothpaste or a mild soap

• immerse in solvent (tablets) or detergent solution

• take them out overnight, leave them to breathe

implant care

• soft bristle brushes

• interdental brushes with nylon

• end-tuft brushes

• dental floss

• rubbertip stimulator

strategies for caries prevention

1) chemical strategies

• minerals (ex. fluoride)

2) physical strategies

• sealants

• oral hygiene practices to remove biofilm (brushing)

3) nutritional strategies

• limiting snacking/sugar

clinical note for Class II

Rev med hx; BP: 120/80mmhg, HR: 72bpm, Resp: 20rpm; Benzo applied; R-PSA; 30-short; Carbocaine plain; 1.mL; #3 MO comp; RD w/ clamp at #2; section matrix placed; applied limelight, etch, gluma, bond, flow and condensable comp; Shade A2; adj and polished; pt had no adverse rxn; post-op instr; NV: prophy/exam 6mos; L.T

clinical note for Class III

Rev med hx; BP: 120/80mmhg; HR: 72bpm: Resp: 20 rpm: Benzo applied; #9 infilt; 30-short; Carbocaine plain; 1.mL; #9 ML comp; RD Ants/wedgets; mylar strip; applied limelite, etch, bond, comp; Shade A-2; adj and polish; Pt had no adv rxn to tx or anesth; post-op instr; NV:prophy/exam 6mos; L.T

clinical notes for anesthesia

Rev med hx; BP: 120/80mmhg; HR: 72bpm: Resp: 20 rpm: Benzo applied; R-PSA; 30-short; Carbocaine plain; 1.mL; no adv rxn; POI; L.T

clinical notes for crown prep

Rev med hx; BP: 120/80mmhg; HR: 72bpm: Resp: 20 rpm: Benzo applied; R-IA; 27-Long; Carbocaine plain; 1.mL; #30 crn prep; PFM- highnoble; Shade A-2; prelim imp; VPS putty temp; 1 cord; sz 2 w/ hemodent; final imp-vps triple tray; maxitemp crn w/tempbond; no adv rxn; POI; Dani Dental Lab- order completed; NV: PFM seat-2wks; L.T

what does temp crn need?

1) mechanical

• biting, force

• no voids/cracks

2) biological

• margins, contours

• acting like a tooth

3) esthetics

• looks like a natural tooth

temp crown fabrication

1) notify op

2) anesthesia

3) preliminary op

4) prep tooth

5) pack cord

6) final imp

7) fabricate temp

8) cementation of temp

9) post op

what does a ideal temp crn need to have?

• contour

  • act and look like an actual tooth so it can function the same

• margin

  • flushed, no gaps so bacteria/food wont enter

• contacts

  • helps with food impaction and bacteria

• occlusal

  • too high= breaks, uncomfortable

types of final imp

• conventional

  • light/heavy body

• digital

  • scans final imp

final imp material

• elastomeric

  • light/heavy body

permanent crown methods

• uses a scaler instead of explorer

• permanent cement

polymerization methods

• auto-polymerization

  • self- or chemical- cure

• photo-polymerization

  • light cure by uv light

• dual-polymerization

  • combo of auto- & photo-

polymerization

• creating a polymer through chemical reaction

straight handpiece

• used for acrylic burs

contra-angle

• more for smoothing (polishers)

high speed

mainly for cutting burs

• cutting: 6-12

• finishing: more than 12

zinc phosphate

§  Permanent and temporary

§  Restorative material & base

§  Mixed on glass, oldest cement, very acidic, incremental mixing. mix slowly

§  Brand name: hy-bond

zinc oxide-eugenol

§  Temporary

§  Restorative material & liner/base

§  Sedative

§  Cannot be used with porcelain/ceramic

burs for crown prep

• high speed

  • diamond flame bur

• low speed

  • acrylic bur

  • mandrel

burs for class III