Class IV

Question 1

Indications
(2)

Answer 1

• Carious lesion involving the incisal edge or undermines the enamel
  of the incisal edge an anterior tooth.
• Trauma- Fracture involving one or both incisal angles of an
  anterior tooth.

Question 2

Assessment (carious)
* Determine —.
* Evaluate extent of — and presence of other — or — on the tooth.
* Examine radiographs for —.
* Determine size of the —.
* Determine — of tooth and adjacent teeth using —.

Answer 2

vitality
caries, lesions, defective restorations
periapical lesions
pulp chamber
shade, Vita shade guide

Question 3

Assessment (trauma)
* Determine cause of — and — of occurrence.
* Determine —.
* Evaluate — of fracture and — of the tooth as well as
—.
* Determine presence of — or — on the tooth.
* Examine tooth/radiographs for (3).

Answer 3

fracture, time (history)
vitality
extent, integrity, discoloration
carious lesions, defective restorations
root fractures, buccal/lingual plate fractures, and integrity of adjacent teeth

Question 4

Preparation (carious)
(4)

Answer 4

• Anesthetize tooth
• Isolate tooth- Rubber Dam, Isovac, Cheek Retractor.
• Remove unsupported enamel with carbide/diamond bur.
• Remove all caries with largest round bur that will fit in the space.

Question 5

Preparation (carious)
(3)

Answer 5

• Place a liner (RMGI/CaOH) if preparation is within 0.5 mm of the
  pulp.
• Place retention points (if necessary).
• Bevel all enamel margins with a medium grit diamond bur:

Question 6

• Bevel all enamel margins with a medium grit diamond bur:
  (2)

Answer 6

• Place 45o bevel on lingual and interproximal margins.
• Place long, shallow bevel on facial surface.

Question 7

Preparation (trauma)
(6)

Answer 7

• Anesthetize tooth
• Isolate tooth- Rubber Dam, Isovac, Cheek Retractor.
• Remove unsupported enamel with carbide/diamond bur.
• Place a liner (RMGI/CaOH) if preparation is within 0.5 mm of the
  pulp.
• Place retention points (if necessary).
• Bevel all enamel margins with a medium grit diamond bur:

Question 8

• Bevel all enamel margins with a medium grit diamond bur:
  (2)

Answer 8

• Place 45o bevel on lingual and interproximal margins.
• Place long, shallow bevel on facial surface.

Question 9

skipped
Restoration
(12)

Answer 9

• Verify shade- Place a small amount of composite on facial surface
  of tooth and light cure.
• Place mylar matrix strip between adjacent teeth and carefully
  wedge in place.
• Etch surface of tooth
• Dry excess water from enamel surface; dentin surface must
  remain moist to ensure maximum bond strength
• Bonding agent applied to all enamel and dentin surfaces
• Air dry for 5 seconds with gentle stream from air/water syringe.
• Second coat of bonding agent applied.
• Air dry for 5 seconds.
• Light cure all areas of tooth for 20 seconds.
• Place first increment of composite to restore most lingual surface of the
  tooth to include incisal edge.
• Cure for 40 seconds.
• Place second increment of composite to restore the labial surface of the
  tooth
• Cure for 40 seconds.

Question 10

• Etch surface of tooth
  (2)

Answer 10

• enamel can be etched for 30 seconds or longer.
• dentin must not be etched for longer than 15 seconds

Question 11

skipped
* Place second increment of composite to restore the labial surface of the
tooth:
(3)

Answer 11

• Include the contact and incisal angle to mirror adjacent tooth
  surface.
• Place developmental grooves on facial surface of tooth.
• Place proper contour of tooth to include all line angles.

Question 12

skipped
Finish
(3)

Answer 12

• Final shaping of facial surface is accomplished with a 7902
  finishing bur.
• Lingual surface is shaped with #4, 6 carbide burs on a slowspeed
  handpiece (< 10,000 rpm) and a 7460 finishing bur (highspeed).
• Occlusion is adjusted with articulating paper and #4, 6 carbide
  burs on a slowspeed handpiece.

Question 13

Polish
* — are used to finish and polish restoration

Answer 13

Soflex Discs

Question 14

skipped
Polish
* Soflex Discs are used to finish and polish restoration
(6)

Answer 14

• a series of four disc (yellow, light orange, orange, dark orange)
• Do not use the dark orange disc! It is too course and will remove
  composite very quickly even on slowspeed.
• break the spine of the discs before use.
• always use the discs wet and at very low rpm, creating a slurry.
• avoid holding the disc flat against the tooth. This will remove
  tooth anatomy, hold at 45o angle.
• polish with the orange and light orange removing all scratches

Question 15

skipped
Polish
(4)

Answer 15

• Polish with Diacomp points.
• Finish polish with yellow Soflex disc
• Remove excess composite from margins and interproximal areas
  with #12 surgical blade.
• Optiguard may be placed and cured to seal restoration

Question 16

• Polish with Diacomp points.
  (2)

Answer 16

• green Diacomp points (wet, slowspeed)
• white Diacomp points (wet, slowspeed)