Operative Lecture 7: Posterior Restorations

What are the three clinical advantages of posterior composites?

1. Structural integrity

2. Superior esthetics

3. Thermal expansion

What are the four patient benefits of posterior composites?

1. Mercury free

2. Tooth-colored

3. Immediate function

4. Less sensitivity

What are the key pits and fissures on posterior teeth?

1. Central pit

2. Buccal pit

3. Lingual pit

What are the ridge systems on posterior teeth?

1. Triangular ridges

2. Marginal ridges

Can sharp explorers accurately detect lesions?

No

What are the two types of fissure shapes?

1. Narrow I

2. Shallow V

What is the low-viscosity fluid resin applied after acid etching used to seal pits and fissures?

Pit-and-Fissure Sealant

What method is used to diagnose Class I lesions?

Visual and tactile assessment

Is color and shade a main focus in posterior restorations?

No

What are the three critical guidelines for Class I tooth preparations?

1. Remove all defective tissue

2. Maintain minimal thickness of 1.5mm

3. Assess ridge strength

What should be placed first in deep Class I cavities?

Base material

What are the three occasional verifications for Class I restorations

1. Maximum intercuspation

2. Excursive movements

3. Selective adjustment

What is the conservative approach for preventive resin restorations?

Remove only minimally cavitated area

What are the two benefits of protective resin restorations?

1. Prevention integration

2. Long-term protection

What are the radiographic evaluations used to diagnose Class II lesions?

1. Bitewing

2. Cavitation confirmation

What are the pre-operative questions you should ask for Class II lesions?

1. Is cavitation confirmed?

2. Where is the shortest access route?

What are the two temporary separation techniques for Class II preparations?

1. Orthodontic separators

2. Wedges

What are the three clinical indications for Class II direct access preparations?

1. No adjacent tooth

2. Rotated tooth positioning

3. Wide spaces between teeth

What are the three clinical indications for facial (horizontal) slots?

1. Lesion on gingival third of proximal surface

2. Sound ridge

3. Gingival recession

When should you use proximal boxes? (2)

1. Undermined marginal ridge

2. No caries on occlusion surface

What are the four clinical requirements for tunnel preparations?

1. Sound marginal ridge

2. Minimal occlusal extension

3. Only suitable for adhesive materials

4. Excellent visibility/access

What are the two clinical indications for occluso-proximal preparations?

1. Weakened ridge

2. Connected lesions

What is the initial bur entry determined by?

Where cavitation is most extensive

What are the pre-preparation protocols for Class II?

1. Apply rubber dam

2. Pre-wedging

What are the four benefits of pre-wedging?

1. Adjacent tooth protection

2. Gingival tissue safety

3. Rubber dam integrity

4. Tooth separation

What are the three preparation outline determinants for Class II restorations?

1. Extension of cavitation

2. Undermined enamel

3. Defective restoration

What are the three critical design principles for occlusal margin design for Class II restorations?

1. 90 degree cavosurface angle

2. Bevels contraindicated

3. Reduced wear

Are specific angulations needed for internal walls in Class II restorations?

No

Are flat floors needed in Class II restorations?

No

Should you bevel close to or below the CEJ in Class II preparations?

No

What are the three challenges for achieving optimal isolation in Class II restorations?

1. Salivary contamination

2. Gingival fluid

3. Inflammation

What is the open sandwich technique used to control in Class II restorations?

Gingival fluid from deep margins

What is the material of choice with the open sandwich technique?

Resin-Modified Glass Ionomer

What are the four benefits of the open sandwich technique?

1. Adhesion properties

2. Moisture tolerance

3. Dual cure system

4. Fluoride release

What are the three essential components of the matrix system to make a contact?

1. Band

2. Wedge

3. Band holder

What is the traditional approach for circumferential matrix systems?

Tofflemire

What are the four advantages of pre-contoured matrix bands?

1. Better proximal contour

2. Thin metal (tighter contacts)

3. Pre-attached to retainer

4. Slight curve

What are the three limitations of pre-contoured matrix bands?

1. Inadequate separation force

2. Inconsistant contacts

3. Cannot replicate natural proximal anatomy

What are the three benefits for sectional matrix systems?

1. Ring separation

2. Wedge

3. Vertical adaptation

What kind of preparations require two sectional matrices?

MOD preparations

What are the five proper wedge placement considerations?

1. Wedge selection

2. Insertion angle

3. Seating position

4. Band contact

5. Separation effect

What technique is needed for Class II composite placement?

Systematic incremental technique

What are the five objectives for marginal ridge contouring in Class II restorations?

1. Remove composite contacting the band

2. Eliminate excess material

3. Shape proper marginal ridge

4. Create smooth transitions

5. Ensure band can be removed

What is the order of matrix removal in Class II restorations? (5)

1. Remove ring

2. Remove wedge

3. Remove band

4. Remove proximal flash

5. Remove rubber dam

What are the three occlusal adjustment protocols for Class II restorations?

1. Mark occlusal contacts

2. Identify premature contacts

3. Selective reduction

Is finishing optional without opposing teeth?

No

What are the four reasons why finishing is not optional even without opposing teeth?

1. Plaque accumulation

2. Surface integrity

3. Future opposition

4. Stain resistance