Operative Dentistry Viva questions. To help you revise your syllabus for examination.
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Dr. Muaaz Amjad
4. • In the crown:
o Temporary enamel restoration
o Permanent dentin restoration
o Deep or large carious lesions
o Deep cervical or radicular lesions
o Pulp capping
o Pulpotomy…..
• In the root:
o root and furcation perforations
o internal/external resorptions
o Apexification
o Retrograde surgical filling.
5. ZnO 75%
Gutta percha 25%
Types:
• Standardized type: follows same ISO
classification as endodontic files
• Non-standardized: have a greater taper than
the standard ISO type
6. Use:
Root canal Irrigant
Root canal Medicament
Advantages:
broad spectrum antimicrobial properties 2% equals to 5%
NAOCL in sense of antibacterial action
synergic affect when used with NAOCL
Disadvantage:
can’t dissolve orgainc and inorganic components of pulp
12. • K FILE:
• triangular or square cross section
•Advantages:
• More flexible and don’t fracture
•Disadvantages:
1- Less cutting efficiency
2- Extrusion of debris periapically
• H FILE:
• has flutes that resemble successive triangles..
• Advantage: They have superior cutting efficiency
• Disadvantage is they are not flexible and fracture
easily
13. • Used to extirpate PULP
• Removal of cotton and paper points
14. • Small flame shaped
• Used in conventional hand piece
• Used for :
1- enlarging canal orifice (/coronal 3rd)
2- to remove lingual shoulder in Anteriors
15. • To remove GP during post preparation
• Small flame-shaped cutting instrument
• used in the conventional handpiece
16. • Small flexible instrument
• Placement of material into the canal
• Fits into the conventional slow handpiece
17.
18. • Loss of working length
• Ledging and stripping
• Perforations
19. • ZIP: Apical portion transportation of a canal
• ELBOW: Rotating the instrument in curved
canal can produce a biomechanical defect.
How to avoid these
1- never rotate instrument in curved canal
2- Always pre curve the small size instruments
26. • Tofflemire Universal
• Ivory Bands
• Pilodent – for composites
• Automatrix – difficuilt to contour
27. • When the tooth structure is prepared with a
bur or instruments, residual organic and
inorganic components form a smear layer that
is composed of hydroxyapatite and denatured
collagen.
• When primer and bonding agent are applied
on the etched dentin they form resin-dentin
interdiffusion zone called hybrid layer.
36. • Should have a continuous tapering, conical shape,
with the narrowest cross-sectional diameter apically
and the widest diameter coronally.
• The walls should taper evenly towards the apex and
should be confluent with the access cavity.
• To give the prepared root canal the "quality of flow;'
i.e, a shape that permits plasticized gutta-percha to
flow against the walls without impedance.
• Should keep the apical foramen as small as
practical.
• Should clean and shape the canal without
transporting the apical foramen.
37. • Iodoform paste
– (zinc oxide and iodoform mixture)
– bactericidal and nonirritant
• ZnO Eugenol paste (without catalyst)
why catalyst not used… > to increase working
time……..
• Material should be resorbable, nonirritant and
radioopaque.
• Why GP not used? – Not degraded
38. • Abutment for space maintainer
• Bruxism
• Caries involving 3 or more surfaces
• Developmental defects like Dentinogenesis
imperfecta and enamel hypoplasia
• Extensive caries in class 2 involving cusps
• Following pulp therapy to avoid fracture of
weekend tooth
• Handicapped children
39. • Stain less steel crowns
• Nickel based crowns (ni-chromium 3M)
40. • The process of inducing the development of
root and apex closure in an immature
permanent tooth with open apex.
• Calcific Root-End closure.
• Types:
1. Multiple Step(CaOH)
2. Single Step (MTA)
41. • Physiological process
• Formation of apex in vital young permanent
tooth with appropriate vital pulp therapy
• MAINTAIN PULP VITALITY
• Includes :
1- Direct pulp capping
2- Indirect pulp capping
3- Pulpotomy/Partial Pulpotomy
42. • Since gallium amalgam expands after trituration, it
provides better marginal seal than silver amalgam….
• Setting time is less than silver mercury amalgam,
therefore can be finished and polished after one hour..
• Most of the physical and mechanical properties of
gallium alloy are similar to high copper mercury
amalgam.
So better marginal seal, less setting time and same
mechanical properties………
43. • A ferrule, is defined as a circumferential area
of axial dentin superior to preparation bevel
should have a height of 1.5mm to 2.5mm
45. • Leave the tooth in place
• Clean with saline and chlorohexidiene
• Suture the lacerated gingiva
• Determine position of the tooth both clinically and
radiographically.
• Apply a flexible splint for 2 weeks
• Antibiotics adminstration for 7 days
• Initiate root canal in transplanted tooth after 10 days with
closed apex
• Open apex in growing children can be waited for pulp
revasculrization and in adult cases open apex closed with
MTA
46. • Apply local anesthesia
• Rinse the area with saline or chlorohexidine
• Reposition the tooth using digital pressure or
forcep.
• Reposition the displaced bone both facially
and lingually
• Suture the gingiva if lacerated
• Splint with wire or acrylic for 4 months.
47. • BV Rupture → Blood into Dentin →
Breakdown of blood (Hemin, Hematin,
Hemosiderin) → Pinkish brown discoloration
49. • Radiographic Apex : Apex of tooth determined
radiographically
• Anatomic Apex: apex of tooth determined
morphologically. At the CDJ.
• Difference can be 1.5 – 3 mm because of
cementum deposition with age.
50. • From a Coronal refrence point to the point
where cleaning and shaping or obturation
ends
• Refrence point:
– Anteriors → Incisal Edge
– Anteriors with broken edges → Smoothen the edge
– Posteriors → Cusp Tip
51. Pulp sensibility Test
MOA:
Ionic shift in the dentinal tubules Local depolariztion in
Delta A fibers
Tells if the tooth is Vital or Non-Vital
52. • False Positive
➢ Gangrenous necrotic pulp
➢ Partially necortic pulp in multi-rooted
• False Negative
➢ Recent Trauma
➢ Extensive pulpal calcification
➢ Fibrotic pulp
➢ Extensive restorations with base
➢ Pt on sedatives
54. Based on Shape (Parallel, Tapered, Parallel and
Tapered)
Based on surface characteristic ( Active, Passive)
Based on Method of fabrication:
• Custom
• PreFabricated (Metal, Zirconia, Fiber-post)
Which one causes most internal stresses..+ Fracture :
Metal, Active, Tapered
55. Tooth has incompletely cracked but no part of
the tooth has yet broken off.
Diagnosed with:
Bite Test
Biting on Tooth Sloth
(Pain on releasing of biting force)
Pain on biting Symptomatic apical periodontitis
56. Conventional tooth prep:
• Specific walls, floor, angulation.
• Amalgum
Modified:
• Does not require specific wall forms, angulation, Walls and floor
• Composite
57. Shape and form of cavity is such that it prevents the
displacement or removal of restoration by tipping and
lifting forces
Occlusal covergence
Adhesive systems
Beveling/flaring cavity margin for composite
58. “Shape and placement of preparation walls and cavity is
such that it enables to tooth structure AND THE
RESTORATION to withstand the forces of mastication
without getting fractured”
Box like cavity
Flat floor
Rounded line angles
Adequate thickness of material
Preservation of cusps and marginal ridges
Reduction of cusp for capping
67. 1.Bisecting Angle - Used in Endo
a.Xray beam is at right angle to long axis of tooth
2.Parallex
a.For curved roots in upper anteriors
b.Not recomended for Endo though
c.Superimposition of zygomatic process
68. • Right angle to the dentin surface
• Vertical in the cuspal region
• Deciduous Horizontal cervically
• Permenant Oblique cervically