Restorative tutorial

Question 1

Why do we use GI luting cement?

Answer 1

• Cheap
• Fluoride release
• Self adhesive to the tooth

Question 2

How does GI set?

Answer 2

Self-cured

Question 3

When would you use a GI cement?

Answer 3

• Metal ceramic crowns and bridges
• Metal posts

Question 4

How does RMGIC compare to GIC ?

Answer 4

• RMGIC has a shorter setting time
• RMGIC has a longer working time
• RMGIC has a higher compressive and tensile strength
• RMGIC has decreased solubility
• RMGIC has a better bond strength to tooth

Question 5

How does it set RMGIC set?

Answer 5

Self cure or dual cure

Question 6

When would you use RMGIC?

Answer 6

MCC
metal posts

Question 7

Describe the properties of composite luting cements

Answer 7

• technique sensitive
• need good moisture control
• need to be used with a dentine bonding agent

Question 8

What would you use with a composite luting cement when cementing a ceramic restoration?

Answer 8

Silane coupling agent

Question 9

With what do etch a porcelain?

Answer 9

Hydrofluoric Acid

Question 10

What does composite luting cement need to be cement to cement non precious metal ?

Answer 10

MDP or 4-Meta + need to sandblast metal surface

Question 11

Describe the different curing systems for composite luting cements?

Answer 11

• Self-cured
• Light-cured
• Dual-cured

Question 12

When would you use a dual cure composite luting cement?

Answer 12

• Ceramic crowns and onlays
• Composite Onlays
• Fibre posts

Question 13

When would you use a light cured composite resin luting cement?

Answer 13

• Veneers as it sets on demand and allow for longer working time
• good for cementing multiple units

Question 14

When would you use a self-adhesive composite resin?

Answer 14

In resin retained bridges

Question 15

What do we mean by anaerobic self cure ?

Answer 15

• Only sets when oxygen is not in contact with the cement
• It starts setting when there is close contact between two surfaced
• Contains MDP

Question 16

When would you use a self-etching composite resin cement?

Answer 16

Fibre posts
ceramic ,composite and porcelain indirect restorations

Question 17

When do you place a post?

Answer 17

When there is not enough coronal tooth structure to support a core in order to retain the crown ( in an endodontically treated tooth)

Question 18

Why is placing a post in posterior teeth not advised?

Answer 18

• Posts work better in straight canals , posteriors have curved ones which can lead to perforations

Question 19

What would you place in posterior teeth instead of a post?

Answer 19

• Nayyar core which is an amalgam core
• Onlay

Question 20

What is the ideal dimensions of post length?

Answer 20

• It needs to extend beyond the level of the alveolar bone
• At least 1:1 height ratio to crown
• 3-5mm of GP must be in the canal apically

Question 21

What are the ideal dimensions of post width?

Answer 21

• Less than 1/3d of the diameter of the root

Question 22

ferrule ideal dimensions?

Answer 22

1-1.5mm circumferential dentine

Question 23

3 post materials?

Answer 23

• Metal - gold , SS , brass and titanium
• Ceramics - alumina and zirconia
• Fibre - glass, quartz and carbon

Question 24

4 disadvantages of metal posts?

Answer 24

• Poor aesthetics
• root fracture
• corrosion
• nickel sensitivity

Question 25

1 advantages of metal posts?

Answer 25

radiopaque on radiographs

Question 26

3 advantages of ceramic posts?

Answer 26

* high flexural strength * high fracture toughness * good aesthetics

Question 27

2 disadvantages of ceramic posts?

Answer 27

* difficult retrievability * root fracture is common

Question 28

4 advantages of fibre posts?

Answer 28

* Flexible * Similar properties to dentine * good aesthetics * retrievable * bonds to dentine by DBA

Question 29

1 disadvantage of fibre posts?

Answer 29

Radiolucent on radiographs

Question 30

2 advatages of parallel posts?

Answer 30

* High strength * good retention

Question 31

2 disadvantages of parallel posts?

Answer 31

* Corrosion of SS * less conservative to the tooth and may cause perforations during preparation

Question 32

What is the advantage of threaded posts?

Answer 32

* high retention

Question 33

disadvantage of threaded post?

Answer 33

High stress generated in the canal causing fracture

Question 34

How do explain why you are placing a post?

Answer 34

* It is the last thing that can be done to the tooth other than extraction to keep it in place as we are placing the post to make the tooth stronger to withstand the crown on top of it

Question 35

What are the associated risks with placing posts? (6)

Answer 35

* Restoration failure * Root fracture - occlusal load can be the issue * Post fracture * Risk of debonding * Perforation * limited future treatment -

Question 36

If a patient has a history of deep pocketing or swelling and the tooth has been RCT , what other might cause this other than pariapical pathology?

Answer 36

* Root fracture * Lateral perforation

Question 37

What other clinical tests would you do beyond SOCRATES?

Answer 37

* Tender to percussion * Sinus * Pocket depth * Mobility * Sensibility test - ECT and EPT * Tooth slooth and transillumination (for fracture)

Question 38

Would you take sensibility testing for root treated teeth?

Answer 38

NO

Question 39

When would you use a bitewings radiograph?

Answer 39

* Caries * Endodontic status * Periodontal bone loss (not advanced) * Restorations overhangs

Question 40

When would you use a periapical radiograph?

Answer 40

* Caries * Periodontal bone loss * Restoration overhangs * Endodontic status * PA pathology

Question 41

When would you use OPT (full or half)

Answer 41

* Periodontal bone loss * Endodontic status * PA pathology * Wisdom tooth * assessment * TMJ