https://www.spreaker.com/podcast/operative-dentistry--4547561enCoursesCopyright Dr.Mayakha Mariamhttps://d3wo5wojvuv7l.cloudfront.net/t_rss_itunes_square_1400/images.spreaker.com/original/2e2829f9737521f082c089d238323ec2.jpghttps://www.spreaker.com/podcast/operative-dentistry--4547561Fri, 07 Apr 2023 21:10:07 +0000Dr.Mayakha MariamDr.Mayakha Mariamthegulfiedentist@gmail.comThese are lectures of The Gulfie Dentist Online Coachingfalseepisodichttps://www.spreaker.com/episode/1-cons-intro--40398918https://api.spreaker.com/episode/40398918Wed, 19 Aug 2020 04:55:23 +0000Dr.Mayakha Mariam38falsefullhttps://www.spreaker.com/episode/2-amalgam-composition--40398942 Silver, tin, copper, mercury, zinc, palladium, indium

MERCURY
- Spherical cut – 40-45% – requires less mercury, small surfaces are easier to wet
- Lathe cut – 45%-50% - requires more mercury, more difficult to wet

SILVER ― 40-70% or 65% content
- Increases strength
- Increases expansion

TIN – 25-27%
- Opp to silver
- decreases strength
- decreses expansion
- increases setting time


GAMMA PHASES

 Alloy containing mercury
Ag-Sn + Hg ⟶ AgHg + SnHg
Silver Tin + Mercury ⟶ Silver Mercury + Tin Mercury
४ γ1 γ2
(STRONGEST PHASE) (ABUNDANT PHASE) (WEAKEST PHASE)

 γ2 - gamma 2 phase - SnHg - Tin Mercury
➢ Disadvantage - Brittle and Corrodes
➢ Advantage - Self Sealing


COPPER – 6%, 13%
Ag-Sn + Cu + Hg ⟶ AgHg + CuSn
४ γ1 eta η
To get eta phase - need 13% Copper ie. high copper amalgam

Q. The copper ratio that eliminates gamma phase 2 = 13 %.


ZINC – 1%

o In Factory, Silver and Tin, they may form oxide
o ∴ they add Zinc (used as oxide scavenger)
o Provides better clinical performance, less marginal breakdown.
o But, In restoration, zinc if contaminated by moisture, it will cause delayed expansionー seen 3-4 days post restoration ー due to release of hydrogen gas.
o Moisture contamination of Zn can be caused during
aー during trituration.
b ー during restoration.]]>https://api.spreaker.com/episode/40398942Wed, 19 Aug 2020 04:55:10 +0000Dr.Mayakha MariamAMALGAM COMPOSITION Silver, tin, copper, mercury, zinc, palladium, indium MERCURY - Spherical cut – 40-45% – requires less mercury, small surfaces are easier to wet - Lathe cut – 45%-50% - requires more mercury, more difficult to wet... Silver, tin, copper, mercury, zinc, palladium, indium

MERCURY
- Spherical cut – 40-45% – requires less mercury, small surfaces are easier to wet
- Lathe cut – 45%-50% - requires more mercury, more difficult to wet

SILVER ― 40-70% or 65% content
- Increases strength
- Increases expansion

TIN – 25-27%
- Opp to silver
- decreases strength
- decreses expansion
- increases setting time


GAMMA PHASES

 Alloy containing mercury
Ag-Sn + Hg ⟶ AgHg + SnHg
Silver Tin + Mercury ⟶ Silver Mercury + Tin Mercury
४ γ1 γ2
(STRONGEST PHASE) (ABUNDANT PHASE) (WEAKEST PHASE)

 γ2 - gamma 2 phase - SnHg - Tin Mercury
➢ Disadvantage - Brittle and Corrodes
➢ Advantage - Self Sealing


COPPER – 6%, 13%
Ag-Sn + Cu + Hg ⟶ AgHg + CuSn
४ γ1 eta η
To get eta phase - need 13% Copper ie. high copper amalgam

Q. The copper ratio that eliminates gamma phase 2 = 13 %.


ZINC – 1%

o In Factory, Silver and Tin, they may form oxide
o ∴ they add Zinc (used as oxide scavenger)
o Provides better clinical performance, less marginal breakdown.
o But, In restoration, zinc if contaminated by moisture, it will cause delayed expansionー seen 3-4 days post restoration ー due to release of hydrogen gas.
o Moisture contamination of Zn can be caused during
aー during trituration.
b ー during restoration.]]>455falsefullhttps://www.spreaker.com/episode/3-ag-properties--40398933
Trituration
o The longer the trituration the smaller the setting expansion- shiny and wet appearance, strength will be maximal, and will have longer lasting luster after carving
o Inadequate trituration will have poor strength and rough surface, will cause corrosion more
o Trituration Time – 45-60 seconds

P/L ratio
o 1:1 by volume (EamesTechnique)
o 50% by weight

Working/Setting Time ー 3-4 minutes

Q. The maximum time elapsed before condensation of amalgam - 3 min

Condensing Force ー 3-4 lbs

Precarving Burnishing
a) to remove excess mercury
b) to condense and adapt to lateral walls*

Amalgam Cry / Silver Ringing Sound ー Setting Indication

Polishing ー After 24 hours* ー In the presence of water.]]>https://api.spreaker.com/episode/40398933Wed, 19 Aug 2020 04:54:59 +0000Dr.Mayakha MariamPROPERTIES OF AMALGAM RESTORATION Trituration o The longer the trituration the smaller the setting expansion- shiny and wet appearance, strength will be maximal, and will have longer lasting luster after carving o Inadequate trituration will...
Trituration
o The longer the trituration the smaller the setting expansion- shiny and wet appearance, strength will be maximal, and will have longer lasting luster after carving
o Inadequate trituration will have poor strength and rough surface, will cause corrosion more
o Trituration Time – 45-60 seconds

P/L ratio
o 1:1 by volume (EamesTechnique)
o 50% by weight

Working/Setting Time ー 3-4 minutes

Q. The maximum time elapsed before condensation of amalgam - 3 min

Condensing Force ー 3-4 lbs

Precarving Burnishing
a) to remove excess mercury
b) to condense and adapt to lateral walls*

Amalgam Cry / Silver Ringing Sound ー Setting Indication

Polishing ー After 24 hours* ー In the presence of water.]]>257falsefullhttps://www.spreaker.com/episode/4-amalgam-complications--40398935
1. MICROLEAKAGE ー sensitivity
● Prevention ー varnish prior to
● Most common problem.
● Causes
○ Not enough bulk restored
○ Lack of adequate condensation
○ Improper manipulation
○ Overcarving bonded]]>https://api.spreaker.com/episode/40398935Wed, 19 Aug 2020 04:54:48 +0000Dr.Mayakha MariamCOMPLICATIONS IN AMALGAM 1. MICROLEAKAGE ー sensitivity ● Prevention ー varnish prior to ● Most common problem. ● Causes ○ Not enough bulk restored ○ Lack of adequate condensation ○ Improper...
1. MICROLEAKAGE ー sensitivity
● Prevention ー varnish prior to
● Most common problem.
● Causes
○ Not enough bulk restored
○ Lack of adequate condensation
○ Improper manipulation
○ Overcarving bonded]]>100falsefullhttps://www.spreaker.com/episode/5-isthmus-fracture--40398956● Major cause is shallow preparation / inadequate depth of cavity.*
● Other reasons ー too wide cavity preparation, sharp ‘axiopulpal line angle’. So bevel this axiopulpal line angle
● If asked specifically about primary tooth isthmus # - shallow preparation
● If asked specifically about permanent tooth isthmus fracture – sharp axiopulpal line angle .

Q. The most common immediate ttt. Reported for fractured teeth was 25%.

3. AMALGAM BLUEING (TOOTH)
● Seepage of amalgam contents upto DEJ causing blue discolouration.
● Management ー prior application of varnish.

4. AMALGAM TATTOO (MUCOSA)
● Seepage of amalgam into the mucus membrane.
● Restoration, also retrograde amalgam restoration after apicoectomy.
● No treatment required.]]>https://api.spreaker.com/episode/40398956Wed, 19 Aug 2020 04:54:39 +0000Dr.Mayakha Mariam2. ISTHMUS FRACTURE ● Major cause is shallow preparation / inadequate depth of cavity.* ● Other reasons ー too wide cavity preparation, sharp ‘axiopulpal line angle’. So bevel this axiopulpal line angle ● If asked specifically about primary tooth...● Major cause is shallow preparation / inadequate depth of cavity.*
● Other reasons ー too wide cavity preparation, sharp ‘axiopulpal line angle’. So bevel this axiopulpal line angle
● If asked specifically about primary tooth isthmus # - shallow preparation
● If asked specifically about permanent tooth isthmus fracture – sharp axiopulpal line angle .

Q. The most common immediate ttt. Reported for fractured teeth was 25%.

3. AMALGAM BLUEING (TOOTH)
● Seepage of amalgam contents upto DEJ causing blue discolouration.
● Management ー prior application of varnish.

4. AMALGAM TATTOO (MUCOSA)
● Seepage of amalgam into the mucus membrane.
● Restoration, also retrograde amalgam restoration after apicoectomy.
● No treatment required.]]>165falsefullhttps://www.spreaker.com/episode/6-isthmus-fracture-2--40398960https://api.spreaker.com/episode/40398960Wed, 19 Aug 2020 04:54:29 +0000Dr.Mayakha Mariam80falsefullhttps://www.spreaker.com/episode/7-ag-complications-contd--40398963 A. Bismuth in blood - Blue-black colour
B. Mercury in blood - black
C. Lead in blood – red / reddish blue.

5. PAIN
● Within 48 hours
➔ Deep cavity ー patients come with sensitivity to hot and cold food.
➔ Pulp exposed.
➔ Class 2 cases ー pulpal horns exposure.
● Supra occlusion / High point / Defective Occlusion
➔ Within 1 week.
➔ TOP +ve
➔ Sensitivity to hot and cold food ーdue to detachment of CEJ from gums ー thus exposing
dentin ∴ Sensitivity.
● If only sensitivity
➔ Dentine cause and not high point]]>https://api.spreaker.com/episode/40398963Wed, 19 Aug 2020 04:54:02 +0000Dr.Mayakha MariamGingival discolouration A. Bismuth in blood - Blue-black colour B. Mercury in blood - black C. Lead in blood – red / reddish blue. 5. PAIN ● Within 48 hours ➔ Deep cavity ー patients come with sensitivity to hot and cold... A. Bismuth in blood - Blue-black colour
B. Mercury in blood - black
C. Lead in blood – red / reddish blue.

5. PAIN
● Within 48 hours
➔ Deep cavity ー patients come with sensitivity to hot and cold food.
➔ Pulp exposed.
➔ Class 2 cases ー pulpal horns exposure.
● Supra occlusion / High point / Defective Occlusion
➔ Within 1 week.
➔ TOP +ve
➔ Sensitivity to hot and cold food ーdue to detachment of CEJ from gums ー thus exposing
dentin ∴ Sensitivity.
● If only sensitivity
➔ Dentine cause and not high point]]>203falsefullhttps://www.spreaker.com/episode/8-ag-compli-overhang--40398961
➔ Symptoms ー irritation/ bleeding to interdental papilla.
➔ Happens due to improper or lack of matrix usage
➔ Instrument used to remove.- hoe
➔ It tears the gingiva leading to attachment loss
➔ It can stimulate inflammatory reaction directly
➔ It provides ideal location for plaque accumulation


7. Galvanic shock

➔ Patient shows pain.
➔ Dissimilar metal.
➔ Amalgam vs Gold, ceramic
➔ RX Plan ー no RX required if no galvanic shock.
➔ Change restoration if pain is seen in the one]]>https://api.spreaker.com/episode/40398961Wed, 19 Aug 2020 04:53:32 +0000Dr.Mayakha Mariam6. Overhanging Restoration ➔ Symptoms ー irritation/ bleeding to interdental papilla. ➔ Happens due to improper or lack of matrix usage ➔ Instrument used to remove.- hoe ➔ It tears the gingiva leading to attachment loss ➔ It can stimulate inflammatory...
➔ Symptoms ー irritation/ bleeding to interdental papilla.
➔ Happens due to improper or lack of matrix usage
➔ Instrument used to remove.- hoe
➔ It tears the gingiva leading to attachment loss
➔ It can stimulate inflammatory reaction directly
➔ It provides ideal location for plaque accumulation


7. Galvanic shock

➔ Patient shows pain.
➔ Dissimilar metal.
➔ Amalgam vs Gold, ceramic
➔ RX Plan ー no RX required if no galvanic shock.
➔ Change restoration if pain is seen in the one]]>176falsefullhttps://www.spreaker.com/episode/9-ag-compli-galvinisnm--40398964
➔ Patient shows pain.
➔ Dissimilar metal.
➔ Amalgam vs Gold, ceramic
➔ RX Plan ー no RX required if no galvanic shock.
➔ Change restoration if pain is seen in the one done recently or varnish over restoration.


8. Delayed Expansion

➔ Caused due to insufficient trituration & condensation
➔ Also moisture contamination during either trituration / condensation – it’s the principle cause of amalgam failure.
➔ Careful of moisture contamination.
➔ Zn + H2O = release of hydrogen gas
➔ No particular time period.
➔ Cracks can be seen.
➔ RX ー change restoration.]]>https://api.spreaker.com/episode/40398964Wed, 19 Aug 2020 04:53:22 +0000Dr.Mayakha Mariam7. Galvanic shock ➔ Patient shows pain. ➔ Dissimilar metal. ➔ Amalgam vs Gold, ceramic ➔ RX Plan ー no RX required if no galvanic shock. ➔ Change restoration if pain is seen in the one done recently or varnish over restoration. 8. Delayed Expansion...
➔ Patient shows pain.
➔ Dissimilar metal.
➔ Amalgam vs Gold, ceramic
➔ RX Plan ー no RX required if no galvanic shock.
➔ Change restoration if pain is seen in the one done recently or varnish over restoration.


8. Delayed Expansion

➔ Caused due to insufficient trituration & condensation
➔ Also moisture contamination during either trituration / condensation – it’s the principle cause of amalgam failure.
➔ Careful of moisture contamination.
➔ Zn + H2O = release of hydrogen gas
➔ No particular time period.
➔ Cracks can be seen.
➔ RX ー change restoration.]]>92falsefullhttps://www.spreaker.com/episode/10-ag-compli-toxicity--40398955
➔ Daily wear of amalgam seen : 1-3 μgs* (microgram)
➔ Mercury threshold ー 50 μgs or 0.5 mg.
➔ Amalgam waste in special container* with fixer solution or sulphide solution - even for extracted tooth containing amalgam.]]>https://api.spreaker.com/episode/40398955Wed, 19 Aug 2020 04:53:09 +0000Dr.Mayakha Mariam9. Mercury Toxicity ➔ Daily wear of amalgam seen : 1-3 μgs* (microgram) ➔ Mercury threshold ー 50 μgs or 0.5 mg. ➔ Amalgam waste in special container* with fixer solution or sulphide solution - even for extracted tooth containing amalgam.
➔ Daily wear of amalgam seen : 1-3 μgs* (microgram)
➔ Mercury threshold ー 50 μgs or 0.5 mg.
➔ Amalgam waste in special container* with fixer solution or sulphide solution - even for extracted tooth containing amalgam.]]>92falsefullhttps://www.spreaker.com/episode/11-ag-restoration--40398958
 Ideal amount of dentine between amalgam & pulp – 2mm
 Amalgam average life span (when pt asks) ー15- 20 years or 2 decades
 For amalgam Restoration of weakened cusp you should reduce cusp by 2mm on a flat base for more resistance.
 Amalgam shows decreased microleakage with age
 It is least technique sensitive of all the current cases
 The base cement for amalgam should have – high modulus of elasticity
 Scale to measure marginal detoriation / leakage / fracture in amalgam – Mahler scale]]>https://api.spreaker.com/episode/40398958Wed, 19 Aug 2020 04:52:54 +0000Dr.Mayakha MariamRESTORATION FEATURES  Ideal amount of dentine between amalgam & pulp – 2mm  Amalgam average life span (when pt asks) ー15- 20 years or 2 decades  For amalgam Restoration of weakened cusp you should reduce cusp by 2mm on a flat base for more...
 Ideal amount of dentine between amalgam & pulp – 2mm
 Amalgam average life span (when pt asks) ー15- 20 years or 2 decades
 For amalgam Restoration of weakened cusp you should reduce cusp by 2mm on a flat base for more resistance.
 Amalgam shows decreased microleakage with age
 It is least technique sensitive of all the current cases
 The base cement for amalgam should have – high modulus of elasticity
 Scale to measure marginal detoriation / leakage / fracture in amalgam – Mahler scale]]>178falsefullhttps://www.spreaker.com/episode/12-cavity-prep--40398957https://api.spreaker.com/episode/40398957Wed, 19 Aug 2020 04:52:36 +0000Dr.Mayakha Mariam125falsefullhttps://www.spreaker.com/episode/13-outline-form--40398962

OUTLINE FORM

Definition – Extension to sound tooth structure at initial depth

1) Include all caries part
2) Place margins on sound tooth structure
3) Remove any caries undermined enamel
4) ideal cavity depth is 0.2-0.75 mm below DEJ / into dentin – floor should end in dentin.
5) Amalgam depth should be 1.5 – 2mm]]>https://api.spreaker.com/episode/40398962Wed, 19 Aug 2020 04:51:44 +0000Dr.Mayakha MariamINITIAL TOOTH PREPARATION: OUTLINE FORM Definition – Extension to sound tooth structure at initial depth 1) Include all caries part 2) Place margins on sound tooth structure 3) Remove any caries undermined enamel 4) ideal cavity depth is 0.2-0.75...

OUTLINE FORM

Definition – Extension to sound tooth structure at initial depth

1) Include all caries part
2) Place margins on sound tooth structure
3) Remove any caries undermined enamel
4) ideal cavity depth is 0.2-0.75 mm below DEJ / into dentin – floor should end in dentin.
5) Amalgam depth should be 1.5 – 2mm]]>155falsefullhttps://www.spreaker.com/episode/14-primary-resistance-form--40398959
Definition – Prevention of tooth or restoration fracture from occlusal forces.

1) Cavosurface angle ー butt joint ー 90 degree - Must be supported by sound dentine - must be located in an area free of occlusal stress
2) Flat Pulpal Floor
3) Internsl line angles ー rounded off

CLASS II
- Gingival beveling ーuse GMTー to give roll resistance
- Unsupported enamel rods(directed towards gingiva) are cut
- Gives strong filling

PRIMARY TOOTH
- enamel rods are occlusally directed
- ∴ no need gingival bevel for class II in primary]]>https://api.spreaker.com/episode/40398959Wed, 19 Aug 2020 04:51:34 +0000Dr.Mayakha MariamPRIMARY RESISTANCE FORM Definition – Prevention of tooth or restoration fracture from occlusal forces. 1) Cavosurface angle ー butt joint ー 90 degree - Must be supported by sound dentine - must be located in an area free of occlusal stress 2) Flat...
Definition – Prevention of tooth or restoration fracture from occlusal forces.

1) Cavosurface angle ー butt joint ー 90 degree - Must be supported by sound dentine - must be located in an area free of occlusal stress
2) Flat Pulpal Floor
3) Internsl line angles ー rounded off

CLASS II
- Gingival beveling ーuse GMTー to give roll resistance
- Unsupported enamel rods(directed towards gingiva) are cut
- Gives strong filling

PRIMARY TOOTH
- enamel rods are occlusally directed
- ∴ no need gingival bevel for class II in primary]]>292falsefullhttps://www.spreaker.com/episode/15-primary-retention-form--40398966
Definition – Prevention of dislodgement of the restoration.
Prepare wall configurations- shape, height & form

● Class I
- buccal and lingual wallsー converge occlusallyー or parallel
- mesial and distal walls has to be divergent because dentine will be removed otherwise as dentine is the major supporter / retentive component.
● Onlay ー entire cavity prep will be divergent
● Class II ー create dovetail.


● Q. If a caries at the Marginal ridge? How would you manage?

- Prepare a conservative cavity where wall closer to the marginal ridge is divergent in order to include the caries & Other side parallel.
- No need to make it as a class II preparation.
- Because we always follow preservation method.

Please go to Lecture 21.CONVENIENCE FORM.]]>https://api.spreaker.com/episode/40398966Wed, 19 Aug 2020 04:51:23 +0000Dr.Mayakha MariamPRIMARY RETENTION FORM Definition – Prevention of dislodgement of the restoration. Prepare wall configurations- shape, height & form ● Class I - buccal and lingual wallsー converge occlusallyー or parallel - mesial and distal walls has to be divergent...
Definition – Prevention of dislodgement of the restoration.
Prepare wall configurations- shape, height & form

● Class I
- buccal and lingual wallsー converge occlusallyー or parallel
- mesial and distal walls has to be divergent because dentine will be removed otherwise as dentine is the major supporter / retentive component.
● Onlay ー entire cavity prep will be divergent
● Class II ー create dovetail.


● Q. If a caries at the Marginal ridge? How would you manage?

- Prepare a conservative cavity where wall closer to the marginal ridge is divergent in order to include the caries & Other side parallel.
- No need to make it as a class II preparation.
- Because we always follow preservation method.

Please go to Lecture 21.CONVENIENCE FORM.]]>199falsefullhttps://www.spreaker.com/episode/16-secondary-retention-resistance-form--40398965
May be performed after placing liners and bases.

1. Amalgams pins
2. Slots - No.35 inverted cone bur
3. Boxes
4. Coves
5. Skirls
6. Bevels- Reverse bevels in inlay prep


AMALGAM PINS

➢ For 2 degree retention and resistance form.
➢ Should be placed parallel to line angles.
➢ 2 mm into the dentine & 2mm in the amalgam
➢ Distance between 2 pins ー 3-5 mm
➢ Place minimum/less material and condense (if more - cracks may form)
➢ Pins need not be parallel to each other
➢ Use one pin per missing line angle, cusp or marginal ridge.
➢ Use large diameter pin whenever possible
➢ Use min no. of pins compatible with adequate retention
➢ Complication :- pulp exposure ⇒ DPC + place pin on same day.]]>https://api.spreaker.com/episode/40398965Wed, 19 Aug 2020 04:51:14 +0000Dr.Mayakha MariamSECONDARY RETENTION AND RESISTANCE FORM May be performed after placing liners and bases. 1. Amalgams pins 2. Slots - No.35 inverted cone bur 3. Boxes 4. Coves 5. Skirls 6. Bevels- Reverse bevels in inlay prep AMALGAM PINS ➢ For 2 degree retention...
May be performed after placing liners and bases.

1. Amalgams pins
2. Slots - No.35 inverted cone bur
3. Boxes
4. Coves
5. Skirls
6. Bevels- Reverse bevels in inlay prep


AMALGAM PINS

➢ For 2 degree retention and resistance form.
➢ Should be placed parallel to line angles.
➢ 2 mm into the dentine & 2mm in the amalgam
➢ Distance between 2 pins ー 3-5 mm
➢ Place minimum/less material and condense (if more - cracks may form)
➢ Pins need not be parallel to each other
➢ Use one pin per missing line angle, cusp or marginal ridge.
➢ Use large diameter pin whenever possible
➢ Use min no. of pins compatible with adequate retention
➢ Complication :- pulp exposure ⇒ DPC + place pin on same day.]]>213falsefullhttps://www.spreaker.com/episode/17-ag-pins--40398954

➢ Types of pins :-

○ Cemented Pin
■ Poor retention
■ Least stress on dentine

○ Friction Lock Pin
■ Better retention
■ More stress on dentine

○ Self Threaded Pin
■ Most retention
■ Most stress on dentine.
■ Yet most preferred
■ Eg : Minikin – 3mm interpin distance
■ Minim – 5mm 8interpin distance]]>https://api.spreaker.com/episode/40398954Wed, 19 Aug 2020 04:51:01 +0000Dr.Mayakha Mariam➢ Stainless steel pins are used for increased retention & increased resistance. ➢ Types of pins :- ○ Cemented Pin ■ Poor retention ■ Least stress on dentine ○ Friction Lock Pin ■ Better retention ■ More stress on dentine ○ Self Threaded Pin ■...

➢ Types of pins :-

○ Cemented Pin
■ Poor retention
■ Least stress on dentine

○ Friction Lock Pin
■ Better retention
■ More stress on dentine

○ Self Threaded Pin
■ Most retention
■ Most stress on dentine.
■ Yet most preferred
■ Eg : Minikin – 3mm interpin distance
■ Minim – 5mm 8interpin distance]]>184falsefullhttps://www.spreaker.com/episode/18-finishing-external-walls--40398949
★ Gingival bevelling ー GMT
★ To make internal line angles , retentive grooves & preparation of cavity wallsー


ANGLE FORMER

★ Remove unsupported / undermined enamel* rods
○ On floor ー CHISEL (primarily for cutting enamel ok)
○ Proximal wall ー ENAMEL HATCHET]]>https://api.spreaker.com/episode/40398949Wed, 19 Aug 2020 04:50:51 +0000Dr.Mayakha MariamFINISHING EXTERNAL WALLS ★ Gingival bevelling ー GMT ★ To make internal line angles , retentive grooves & preparation of cavity wallsー ANGLE FORMER ★ Remove unsupported / undermined enamel* rods ○ On floor ー CHISEL (primarily for cutting enamel...
★ Gingival bevelling ー GMT
★ To make internal line angles , retentive grooves & preparation of cavity wallsー


ANGLE FORMER

★ Remove unsupported / undermined enamel* rods
○ On floor ー CHISEL (primarily for cutting enamel ok)
○ Proximal wall ー ENAMEL HATCHET]]>154falsefullhttps://www.spreaker.com/episode/19-inlay--40398939
○ Retention factor ー cavity depth
○ Most important bevel ー gingival bevel only
○ Reverse bevel* ー 2 degree retention form
○ Indirect composite inlay will have efficient polymerisation than direct composite inlay
○ 65% Paraffin wax is used to cast inlay
○ Indirect composite inlay overcome direct one by insufficient polymerisation, good contact point, gingival seal

Read from Dental Decks:
✱Amalgam vs Inlay preparation from DD pg4
✱Amalgam vs Composite pg53
✱Reverse Bevel ー Inlays - retention form pg4 DD]]>https://api.spreaker.com/episode/40398939Wed, 19 Aug 2020 04:34:32 +0000Dr.Mayakha MariamINLAYS ○ Retention factor ー cavity depth ○ Most important bevel ー gingival bevel only ○ Reverse bevel* ー 2 degree retention form ○ Indirect composite inlay will have efficient polymerisation than direct composite inlay ○ 65% Paraffin wax is used to...
○ Retention factor ー cavity depth
○ Most important bevel ー gingival bevel only
○ Reverse bevel* ー 2 degree retention form
○ Indirect composite inlay will have efficient polymerisation than direct composite inlay
○ 65% Paraffin wax is used to cast inlay
○ Indirect composite inlay overcome direct one by insufficient polymerisation, good contact point, gingival seal

Read from Dental Decks:
✱Amalgam vs Inlay preparation from DD pg4
✱Amalgam vs Composite pg53
✱Reverse Bevel ー Inlays - retention form pg4 DD]]>156falsefullhttps://www.spreaker.com/episode/20-shoeing-capping--40398950

Capping – Complete coverage of functional cusp the cusp with amalgam. Reduction needed is 1.5-2mm]]>https://api.spreaker.com/episode/40398950Wed, 19 Aug 2020 04:34:17 +0000Dr.Mayakha MariamAmalgam Shoeing – veneering of non-functional cusp by means of slight finishing bevel. Redection to be done is 1-1.5 mm Capping – Complete coverage of functional cusp the cusp with amalgam. Reduction needed is 1.5-2mm

Capping – Complete coverage of functional cusp the cusp with amalgam. Reduction needed is 1.5-2mm]]>89falsefullhttps://www.spreaker.com/episode/21-convenience-form--40398931
Definition – Alterations to improve access & visibility

Q. The width of cavity preparation = ⅓ inter-cuspal distance.


B. FINAL TOOTH PREPARATION REMOVING REMAINING CARIES + PULP PROTECTION

● If pinpoint caries seen – 1 Point ditching / excavation ⟶ Ca(OH)2 ⟶ base ⟶ Restoration. Check with radiograph


● How to determine Pulp Exposure?

➢ More than 2mm RDT⟶ no need of cavity liner CaOH
➢ If b/w 1-2 mm RDT⟶ RMGI base (may or may not use CaOH liner)
➢ Below 1 mm Or pulp exposure ⟶ Ca(OH)2 (capping) as cavity liner not base or varnish OK ! Then RMGI base.]]>https://api.spreaker.com/episode/40398931Wed, 19 Aug 2020 04:32:50 +0000Dr.Mayakha MariamCONVENIENCE FORM (comes after primary retention form) Definition – Alterations to improve access & visibility Q. The width of cavity preparation = ⅓ inter-cuspal distance. B. FINAL TOOTH PREPARATION REMOVING REMAINING CARIES + PULP PROTECTION ●...
Definition – Alterations to improve access & visibility

Q. The width of cavity preparation = ⅓ inter-cuspal distance.


B. FINAL TOOTH PREPARATION REMOVING REMAINING CARIES + PULP PROTECTION

● If pinpoint caries seen – 1 Point ditching / excavation ⟶ Ca(OH)2 ⟶ base ⟶ Restoration. Check with radiograph


● How to determine Pulp Exposure?

➢ More than 2mm RDT⟶ no need of cavity liner CaOH
➢ If b/w 1-2 mm RDT⟶ RMGI base (may or may not use CaOH liner)
➢ Below 1 mm Or pulp exposure ⟶ Ca(OH)2 (capping) as cavity liner not base or varnish OK ! Then RMGI base.]]>178falsefullhttps://www.spreaker.com/episode/22-instrument-formula--40398941
○ 3 DIGIT
WIDTH OF BLADE ー LENGTH OF BLADE ー ANGLE OF THE BLADE

○ 4 No formula ー 2nd no. is added

○ Angle former, Gingival Marginal Trimmer

WIDTH OF BLADE ー ANGLE OF CUTTING EDGE ー LENGTH OF BLADE ー ANGLE OF THE BLADE


GRASPS

○ Modified pen grasps ー most commonly used clinically
○ Inverted pen grasp
○ Palm and thumb grasp ー least preferred clinically [70-110 degree] ー most used in sharpening Instrument
○ Modified palm and thumb grasp]]>https://api.spreaker.com/episode/40398941Wed, 19 Aug 2020 04:32:39 +0000Dr.Mayakha MariamINSTRUMENT FORMULA ○ 3 DIGIT WIDTH OF BLADE ー LENGTH OF BLADE ー ANGLE OF THE BLADE ○ 4 No formula ー 2nd no. is added ○ Angle former, Gingival Marginal Trimmer WIDTH OF BLADE ー ANGLE OF CUTTING EDGE ー LENGTH OF BLADE ー ANGLE OF THE BLADE GRASPS...
○ 3 DIGIT
WIDTH OF BLADE ー LENGTH OF BLADE ー ANGLE OF THE BLADE

○ 4 No formula ー 2nd no. is added

○ Angle former, Gingival Marginal Trimmer

WIDTH OF BLADE ー ANGLE OF CUTTING EDGE ー LENGTH OF BLADE ー ANGLE OF THE BLADE


GRASPS

○ Modified pen grasps ー most commonly used clinically
○ Inverted pen grasp
○ Palm and thumb grasp ー least preferred clinically [70-110 degree] ー most used in sharpening Instrument
○ Modified palm and thumb grasp]]>158falsefullhttps://www.spreaker.com/episode/23-sharpening-instruments--40398940
○ Hand scaling instruments
○ Chisel and all
○ Palm and thumb grasp- Best grasp for sharpening instruments
○ If mounted instrument
■ Fine grains removed
■ Large amounts of material lost
○ If free hand sharpening
■ Large grains removed
■ Less amount
○ Angle ー 70 (Or 110 Degrees)]]>https://api.spreaker.com/episode/40398940Wed, 19 Aug 2020 04:32:30 +0000Dr.Mayakha MariamSHARPENING INSTRUMENTS ○ Hand scaling instruments ○ Chisel and all ○ Palm and thumb grasp- Best grasp for sharpening instruments ○ If mounted instrument ■ Fine grains removed ■ Large amounts of material lost ○ If free hand sharpening ■ Large grains...
○ Hand scaling instruments
○ Chisel and all
○ Palm and thumb grasp- Best grasp for sharpening instruments
○ If mounted instrument
■ Fine grains removed
■ Large amounts of material lost
○ If free hand sharpening
■ Large grains removed
■ Less amount
○ Angle ー 70 (Or 110 Degrees)]]>118falsefullhttps://www.spreaker.com/episode/24-liners--40398952CaOH is used as liner when there is pulp exposure- like direct capping – or 0.5mm RDT
Liners should have final film thickness as 5microns.

VARNISH
○ Chemical insulation
○ Prevents microleakage
○ Prevents discolouration from amalgam
○ Most used in 1o tooth for amalgam
○ Contra-indicated in composite - inhibits polymerisation *
○ Minimum no. of coats - 2
■ Walls of cavity
■ Floor of cavity
■ Over the amalgam for sensitivity microleakage*
■ Over GIC for sensitivity also*]]>https://api.spreaker.com/episode/40398952Wed, 19 Aug 2020 04:32:22 +0000Dr.Mayakha MariamLINER CaOH is used as liner when there is pulp exposure- like direct capping – or 0.5mm RDT Liners should have final film thickness as 5microns. VARNISH ○ Chemical insulation ○ Prevents microleakage ○ Prevents discolouration from amalgam ○ Most used...CaOH is used as liner when there is pulp exposure- like direct capping – or 0.5mm RDT
Liners should have final film thickness as 5microns.

VARNISH
○ Chemical insulation
○ Prevents microleakage
○ Prevents discolouration from amalgam
○ Most used in 1o tooth for amalgam
○ Contra-indicated in composite - inhibits polymerisation *
○ Minimum no. of coats - 2
■ Walls of cavity
■ Floor of cavity
■ Over the amalgam for sensitivity microleakage*
■ Over GIC for sensitivity also*]]>189falsefullhttps://www.spreaker.com/episode/25-bases--40398938
○ Mechanical and thermal insulation*
○ Replaces the lost dentin
○ Thickness = (0.75 mm) 1-2 mm
○ High modulus of elasticity


Order:-
(OLD CONCEPT)
LINER
VARNISH
BASE
AMALGAM

Now a days bases are more dentine n pulp friendly like GIC, so you don't need varnish below GIC. So answer the question acc to what base is used.
LINER
BASE
VARNISH
AMALGAM]]>https://api.spreaker.com/episode/40398938Wed, 19 Aug 2020 04:32:13 +0000Dr.Mayakha MariamBASE ○ Mechanical and thermal insulation* ○ Replaces the lost dentin ○ Thickness = (0.75 mm) 1-2 mm ○ High modulus of elasticity Order:- (OLD CONCEPT) LINER VARNISH BASE AMALGAM Now a days bases are more dentine n pulp friendly like GIC, so you...
○ Mechanical and thermal insulation*
○ Replaces the lost dentin
○ Thickness = (0.75 mm) 1-2 mm
○ High modulus of elasticity


Order:-
(OLD CONCEPT)
LINER
VARNISH
BASE
AMALGAM

Now a days bases are more dentine n pulp friendly like GIC, so you don't need varnish below GIC. So answer the question acc to what base is used.
LINER
BASE
VARNISH
AMALGAM]]>70falsefullhttps://www.spreaker.com/episode/26-cements-1--40398932
a. Formed when Zn oxide reacts with phosphoric acid.
b. Micromechanical bond with tooth structure.
c. 1st 24 hours ー irritant to pulp ∵ pH 2
d. After that ー non irritant, pH - 5.9 (24 hours) pH - 7 (48 hours )
e. Mix in maximum increments.
f. Best agent to lute metal ceramic crowns*
g. Apply varnish before ZnPh

Q. Best Luting for ceramic restorations?
Resin luting cement (HEMA+4META+organophosphates)]]>https://api.spreaker.com/episode/40398932Wed, 19 Aug 2020 04:32:04 +0000Dr.Mayakha MariamZINC PHOSPHATE a. Formed when Zn oxide reacts with phosphoric acid. b. Micromechanical bond with tooth structure. c. 1st 24 hours ー irritant to pulp ∵ pH 2 d. After that ー non irritant, pH - 5.9 (24 hours) pH - 7 (48 hours ) e. Mix in maximum...
a. Formed when Zn oxide reacts with phosphoric acid.
b. Micromechanical bond with tooth structure.
c. 1st 24 hours ー irritant to pulp ∵ pH 2
d. After that ー non irritant, pH - 5.9 (24 hours) pH - 7 (48 hours )
e. Mix in maximum increments.
f. Best agent to lute metal ceramic crowns*
g. Apply varnish before ZnPh

Q. Best Luting for ceramic restorations?
Resin luting cement (HEMA+4META+organophosphates)]]>188falsefullhttps://www.spreaker.com/episode/27-cements-2--40398930
 Both Zn phosphate & polycarboxylate has ZnO particles
 Formed when Zn oxide reacts with polyacrylic acid*
 1st material to chemically bond to tooth structure
 Bonding with enamel ↑,dentine ↓
 Tin / Stannous fluoride is added
 Tin increases
a. Working time
b. Strength }1st option
c. Not for fluoride releases (don’t tick such options for exam) OK !]]>https://api.spreaker.com/episode/40398930Wed, 19 Aug 2020 04:31:56 +0000Dr.Mayakha MariamZINC POLYCARBOXYLATE/ POLYACRYLATE  Both Zn phosphate & polycarboxylate has ZnO particles  Formed when Zn oxide reacts with polyacrylic acid*  1st material to chemically bond to tooth structure  Bonding with enamel ↑,dentine ↓  Tin / Stannous...
 Both Zn phosphate & polycarboxylate has ZnO particles
 Formed when Zn oxide reacts with polyacrylic acid*
 1st material to chemically bond to tooth structure
 Bonding with enamel ↑,dentine ↓
 Tin / Stannous fluoride is added
 Tin increases
a. Working time
b. Strength }1st option
c. Not for fluoride releases (don’t tick such options for exam) OK !]]>134falsefullhttps://www.spreaker.com/episode/28-cements-3--40398953
a. Used as temporary, CO2 pH is neutral and its Eugenol content ー provides palliative effect.
b. Type IV ー used as liner.
c. Biocompatibility is highest -- sedative / soothing action to pulp ー type IV
d. Disadvantage ー causes burning sensation.
e. ZnOE Eba ー modified form ー no burning sensation.
f. Retarded of setting reaction ー glycerin.
g. Acceleration of setting reaction ー acetate water

Increase working time of all above materials :
○ Cool glass slab
○ Alter P/L ratio
○ Maximum increments for Zn phosphates]]>https://api.spreaker.com/episode/40398953Wed, 19 Aug 2020 04:31:48 +0000Dr.Mayakha MariamZINC OXIDE EUGENOL a. Used as temporary, CO2 pH is neutral and its Eugenol content ー provides palliative effect. b. Type IV ー used as liner. c. Biocompatibility is highest -- sedative / soothing action to pulp ー type IV d. Disadvantage ー causes...
a. Used as temporary, CO2 pH is neutral and its Eugenol content ー provides palliative effect.
b. Type IV ー used as liner.
c. Biocompatibility is highest -- sedative / soothing action to pulp ー type IV
d. Disadvantage ー causes burning sensation.
e. ZnOE Eba ー modified form ー no burning sensation.
f. Retarded of setting reaction ー glycerin.
g. Acceleration of setting reaction ー acetate water

Increase working time of all above materials :
○ Cool glass slab
○ Alter P/L ratio
○ Maximum increments for Zn phosphates]]>175falsefullhttps://www.spreaker.com/episode/29-cements-4--40398937
1. Formed when glass particles reacts with phosphoric acid
2. Micromechanical bonding
3. Used in anteriors earlier.
4. 1st tooth coloured material.
5. Contains 15% fluoride*
6. Can be used as permanent restoration
7. Least biocompatible.
8. Less chance of plaque growth.
9. Contra-indicated in mouth breathing.]]>https://api.spreaker.com/episode/40398937Wed, 19 Aug 2020 04:31:34 +0000Dr.Mayakha MariamSILICATES 1. Formed when glass particles reacts with phosphoric acid 2. Micromechanical bonding 3. Used in anteriors earlier. 4. 1st tooth coloured material. 5. Contains 15% fluoride* 6. Can be used as permanent restoration 7. Least biocompatible. 8....
1. Formed when glass particles reacts with phosphoric acid
2. Micromechanical bonding
3. Used in anteriors earlier.
4. 1st tooth coloured material.
5. Contains 15% fluoride*
6. Can be used as permanent restoration
7. Least biocompatible.
8. Less chance of plaque growth.
9. Contra-indicated in mouth breathing.]]>73falsefullhttps://www.spreaker.com/episode/30-cements-gic-1--40398927
a. Refractive index ー close to that of enamel.
b. Thermal expansion ＝tooth structures thermal expansion
c. Most pediatric restorative material ー most common.
d. Compared to composite has more polymerisation shrinkage

LIQUID ー polyacrylic acid ✱Polishing:- Aluminium oxide
i. Bond ー chemically
ii. Adhesive
iii. 10 second surface conditioning / etching
iv. Has macromolecules ∴ biocompatible

POWDER ー Al,Ca ,F ー SiO2 , Al2O3, CaFl
i. Fluoride release - anti-cariogenic property
ii. Fluoride helps in - ceramic flux (AlF,CaF all detaches)
iii. Maturation [complete setting of GIC]- 24 HOURS.
iv. After 24 hours GIC needs wetness for its stability
v. Dry oral cavity [xerostomia, mouth breathers, radiation]- contra-indicated.]]>https://api.spreaker.com/episode/40398927Wed, 19 Aug 2020 04:31:23 +0000Dr.Mayakha MariamGLASS IONOMER CEMENT a. Refractive index ー close to that of enamel. b. Thermal expansion ＝tooth structures thermal expansion c. Most pediatric restorative material ー most common. d. Compared to composite has more polymerisation shrinkage LIQUID ー...
a. Refractive index ー close to that of enamel.
b. Thermal expansion ＝tooth structures thermal expansion
c. Most pediatric restorative material ー most common.
d. Compared to composite has more polymerisation shrinkage

LIQUID ー polyacrylic acid ✱Polishing:- Aluminium oxide
i. Bond ー chemically
ii. Adhesive
iii. 10 second surface conditioning / etching
iv. Has macromolecules ∴ biocompatible

POWDER ー Al,Ca ,F ー SiO2 , Al2O3, CaFl
i. Fluoride release - anti-cariogenic property
ii. Fluoride helps in - ceramic flux (AlF,CaF all detaches)
iii. Maturation [complete setting of GIC]- 24 HOURS.
iv. After 24 hours GIC needs wetness for its stability
v. Dry oral cavity [xerostomia, mouth breathers, radiation]- contra-indicated.]]>222falsefullhttps://www.spreaker.com/episode/31-gic-modifications--40398936
Miracle mix
■ Silver alloy powder is mixed with gic.
■ ∴ abrasion resistance is increased.
■ Strength ー same or decreased.

Cermet
■ Silver alloy sintered with GIC
■ Strength is increased

Resin modified GIC
○ Resin added to gic
○ Setting reaction 2 types ー cold cure & light cure ∴ called dual cure
○ Never used for crown fixation - luting
○ Because it has a tendency to absorb water and this dislodges crown / fracture all-ceramic crowns.
○ Less fluoride* release than usual GIC
○ Used only for cementing post inside canal
○ Better aesthetics, bonding manipulation ease.]]>https://api.spreaker.com/episode/40398936Wed, 19 Aug 2020 04:31:14 +0000Dr.Mayakha MariamMetal - modified GIC Miracle mix ■ Silver alloy powder is mixed with gic. ■ ∴ abrasion resistance is increased. ■ Strength ー same or decreased. Cermet ■ Silver alloy sintered with GIC ■ Strength is increased Resin modified GIC ○ Resin added to gic...
Miracle mix
■ Silver alloy powder is mixed with gic.
■ ∴ abrasion resistance is increased.
■ Strength ー same or decreased.

Cermet
■ Silver alloy sintered with GIC
■ Strength is increased

Resin modified GIC
○ Resin added to gic
○ Setting reaction 2 types ー cold cure & light cure ∴ called dual cure
○ Never used for crown fixation - luting
○ Because it has a tendency to absorb water and this dislodges crown / fracture all-ceramic crowns.
○ Less fluoride* release than usual GIC
○ Used only for cementing post inside canal
○ Better aesthetics, bonding manipulation ease.]]>191falsefullhttps://www.spreaker.com/episode/32-gic-modifications-2--40398929
○ Modification in liquid ie; polyacid modification
● Whereas; GIC ー polyacrylic
● Zn Phospate ー phosphoric
○ GIC modification , liquid polyacid modification
○ Least fluoride release*
○ Resin with fluoride releasing glass.]]>https://api.spreaker.com/episode/40398929Wed, 19 Aug 2020 04:31:04 +0000Dr.Mayakha MariamCompomer ○ Modification in liquid ie; polyacid modification ● Whereas; GIC ー polyacrylic ● Zn Phospate ー phosphoric ○ GIC modification , liquid polyacid modification ○ Least fluoride release* ○ Resin with fluoride releasing glass.
○ Modification in liquid ie; polyacid modification
● Whereas; GIC ー polyacrylic
● Zn Phospate ー phosphoric
○ GIC modification , liquid polyacid modification
○ Least fluoride release*
○ Resin with fluoride releasing glass.]]>70falsefullhttps://www.spreaker.com/episode/33-composite--40398943
COMPOSITION
● Resin ー chemical name = methyl acrylate* (Denture base resin → PMMA)
● Filler ー glass fillers*
● Coupling agent ー silane / organosilane*
● Packable and flowable composite difference
○ Viscosityーresistance to flow
● TEGMA is added to increase flow, ie becomes flowable composite
○ Eg: pit and fissure sealants.

FEATURES
● Micromechanical bonding
● Resin tags - penetrate into tooth structure -7 to 25 mm (tag length)
● Ratio of bonded : unbonded Molecules /components→ C factor
● Class I,II,III,IV → hybrid composite
● Class V ー microfilled composite
¤ High polishability
¤ ∴ maximum cleaning efficiency
¤ Or else rough surface → stains, calculus, perio problems etc.

TYPES OF COMPOSITES

MACROFILLED COMPOSITE
a. Average particle size ー 10 μm
b. 1st generation restoration composites.
c. Paste - paste , chemical cure
d. Limited shade matching capabilities
e. Poor physical and mechanical properties
f. Poor esthetics.

MICROFILLED COMPOSITE
g. Average particle size ー 0.04μm
h. Light cured
i. Suboptimal #toughness ー not strong for occlusal bearing area
j. Excellent esthetics and polishability
k. Lower elastic modulus ー better in class V
l. Use primarily in anterior restoration.

HYBRID (MINIFILL) COMPOSITE
m. Average particle size ー 1 μm
n. Light-cured
o. Good properties.
p. Good esthetics but not as polishable as microfilled.
q. Universal use ー anterior and posterior restoration.

MICROHYBRID COMPOSITES
r. Average particle size ー 0.4 to 0.8 μm
s. Light cured
t. Retain good properties of hybrid (strength) with improved handling.
u. Polishability almost equal to microfills
v. Universal use ー anterior and posterior.

NANOFILLED / NANOHYBRID COMPOSITES
w. Filler - 20 nm nanomers 0.6 to 1.5 μm nanoclusters
x. Light cured
y. Excellent handling
z. High polishability
aa. Low shrinkage
bb. Universal use ー anterior and posterior.

FLOWABLE COMPOSITES
cc. High matrix/filler ratio content
dd. Higher polymerization shrinkage

PACKABLE COMPOSITES
ee. Increased viscosity
ff. No documented benefits]]>https://api.spreaker.com/episode/40398943Wed, 19 Aug 2020 04:30:47 +0000Dr.Mayakha MariamCOMPOSITE COMPOSITION ● Resin ー chemical name = methyl acrylate* (Denture base resin → PMMA) ● Filler ー glass fillers* ● Coupling agent ー silane / organosilane* ● Packable and flowable composite difference ○ Viscosityーresistance to flow ● TEGMA is...
COMPOSITION
● Resin ー chemical name = methyl acrylate* (Denture base resin → PMMA)
● Filler ー glass fillers*
● Coupling agent ー silane / organosilane*
● Packable and flowable composite difference
○ Viscosityーresistance to flow
● TEGMA is added to increase flow, ie becomes flowable composite
○ Eg: pit and fissure sealants.

FEATURES
● Micromechanical bonding
● Resin tags - penetrate into tooth structure -7 to 25 mm (tag length)
● Ratio of bonded : unbonded Molecules /components→ C factor
● Class I,II,III,IV → hybrid composite
● Class V ー microfilled composite
¤ High polishability
¤ ∴ maximum cleaning efficiency
¤ Or else rough surface → stains, calculus, perio problems etc.

TYPES OF COMPOSITES

MACROFILLED COMPOSITE
a. Average particle size ー 10 μm
b. 1st generation restoration composites.
c. Paste - paste , chemical cure
d. Limited shade matching capabilities
e. Poor physical and mechanical properties
f. Poor esthetics.

MICROFILLED COMPOSITE
g. Average particle size ー 0.04μm
h. Light cured
i. Suboptimal #toughness ー not strong for occlusal bearing area
j. Excellent esthetics and polishability
k. Lower elastic modulus ー better in class V
l. Use primarily in anterior restoration.

HYBRID (MINIFILL) COMPOSITE
m. Average particle size ー 1 μm
n. Light-cured
o. Good properties.
p. Good esthetics but not as polishable as microfilled.
q. Universal use ー anterior and posterior restoration.

MICROHYBRID COMPOSITES
r. Average particle size ー 0.4 to 0.8 μm
s. Light cured
t. Retain good properties of hybrid (strength) with improved handling.
u. Polishability almost equal to microfills
v. Universal use ー anterior and posterior.

NANOFILLED / NANOHYBRID COMPOSITES
w. Filler - 20 nm nanomers 0.6 to 1.5 μm nanoclusters
x. Light cured
y. Excellent handling
z. High polishability
aa. Low shrinkage
bb. Universal use ー anterior and posterior.

FLOWABLE COMPOSITES
cc. High matrix/filler ratio content
dd. Higher polymerization shrinkage

PACKABLE COMPOSITES
ee. Increased viscosity
ff. No documented benefits]]>256falsefullhttps://www.spreaker.com/episode/34-acid-etching--40398928
● 37% phosphoric / orthophosphoric acid
● 10-15 second
● Also known as conditioning of dentin.
● While GIC by 10% polyacrylic Acid for 10 seconds.
● White frosted appearance
● Objective ー to increase the surface area and remove smear layer*
● Alterations in time
1. Primary tooth(inorganic content is less)ー 30 Secs
2. Fluorosed tooth ー30 seconds
3. Contaminated tooth, when doing re-etching ー etch for lesser time only ー 10 seconds
● What happens during improper / inadequate acid-etching -- bond of composite weakness ー in turn results in microleakage
● If over dried with air after etch ー causes nano leakage
● The time duration for complete remineralization of accidentally etched tooth- 24hrs
● Read generations for DHA, recent gen etc


Dentine bonding

● 10-15second
● 5th generation – 25 Megapascal
● The strength of bonding enamel 25 MP
● While bonding dentin 35 MP.]]>https://api.spreaker.com/episode/40398928Wed, 19 Aug 2020 04:30:36 +0000Dr.Mayakha MariamACID ETCHING ● 37% phosphoric / orthophosphoric acid ● 10-15 second ● Also known as conditioning of dentin. ● While GIC by 10% polyacrylic Acid for 10 seconds. ● White frosted appearance ● Objective ー to increase the surface area and remove smear...
● 37% phosphoric / orthophosphoric acid
● 10-15 second
● Also known as conditioning of dentin.
● While GIC by 10% polyacrylic Acid for 10 seconds.
● White frosted appearance
● Objective ー to increase the surface area and remove smear layer*
● Alterations in time
1. Primary tooth(inorganic content is less)ー 30 Secs
2. Fluorosed tooth ー30 seconds
3. Contaminated tooth, when doing re-etching ー etch for lesser time only ー 10 seconds
● What happens during improper / inadequate acid-etching -- bond of composite weakness ー in turn results in microleakage
● If over dried with air after etch ー causes nano leakage
● The time duration for complete remineralization of accidentally etched tooth- 24hrs
● Read generations for DHA, recent gen etc


Dentine bonding

● 10-15second
● 5th generation – 25 Megapascal
● The strength of bonding enamel 25 MP
● While bonding dentin 35 MP.]]>388falsefullhttps://www.spreaker.com/episode/35-composite-curing--40398948● Maximum thickness is 2 mm
● Curing tip ー should almost touch ー or at least 1 mm distance*
● Blue colour ー 475 nm
● If laser ー argon laser
● Light ー complication ー can cause retinal damage
● Must give eye protective glasses for cataract patients, eye treated patients

Shade Selection
● Done before starting, before rubber dam
● Dental chair light should be off
● Cure with selected shade first
● If patient comes back after 2 days with complaint of :
○ Darker shade ー due to improper polishing, rough surface takes up stains
○ Lighter shade ー improper curing / polymerisation]]>https://api.spreaker.com/episode/40398948Wed, 19 Aug 2020 04:30:28 +0000Dr.Mayakha MariamComposite Curing:- ● Maximum thickness is 2 mm ● Curing tip ー should almost touch ー or at least 1 mm distance* ● Blue colour ー 475 nm ● If laser ー argon laser ● Light ー complication ー can cause retinal damage ● Must give eye protective glasses for...● Maximum thickness is 2 mm
● Curing tip ー should almost touch ー or at least 1 mm distance*
● Blue colour ー 475 nm
● If laser ー argon laser
● Light ー complication ー can cause retinal damage
● Must give eye protective glasses for cataract patients, eye treated patients

Shade Selection
● Done before starting, before rubber dam
● Dental chair light should be off
● Cure with selected shade first
● If patient comes back after 2 days with complaint of :
○ Darker shade ー due to improper polishing, rough surface takes up stains
○ Lighter shade ー improper curing / polymerisation]]>234falsefullhttps://www.spreaker.com/episode/36-composite-cavity-prep--40398925● No cavity outline, no particular shape
● Outline is determined by caries margin
● Anterior prep ー give beveling is must; retention
● Posterior prepー no beveling at cavo surface angle, 90 degree is okay – Because it can't take masticatory load – might fracture ∴ causes microleakage would happen

BASE UNDER COMPOSITE

Preferred
 Ca(OH)2 or GIC or any modifications – RMGI – best
 Zn Phosphate
 Zn polycarboxylate

Contra indicated
● ZnOE
● Varnish
● Hydrogen peroxide [that's why wait 1 week after intra-coronal bleach (bleaching agents)

Q. Dentist provided bleaching which also known as (home bleaching) (night guard Vita Bleaching) contain : 5 - 22 % carbamide peroxide.

Q. After bleaching a tooth, we want to restore the tooth with composite resin, we don’t want to compromise the bonding, and we wait for: 1-2 Weeks.]]>https://api.spreaker.com/episode/40398925Wed, 19 Aug 2020 04:30:17 +0000Dr.Mayakha MariamCavity Preparation :- ● No cavity outline, no particular shape ● Outline is determined by caries margin ● Anterior prep ー give beveling is must; retention ● Posterior prepー no beveling at cavo surface angle, 90 degree is okay – Because it can't take...● No cavity outline, no particular shape
● Outline is determined by caries margin
● Anterior prep ー give beveling is must; retention
● Posterior prepー no beveling at cavo surface angle, 90 degree is okay – Because it can't take masticatory load – might fracture ∴ causes microleakage would happen

BASE UNDER COMPOSITE

Preferred
 Ca(OH)2 or GIC or any modifications – RMGI – best
 Zn Phosphate
 Zn polycarboxylate

Contra indicated
● ZnOE
● Varnish
● Hydrogen peroxide [that's why wait 1 week after intra-coronal bleach (bleaching agents)

Q. Dentist provided bleaching which also known as (home bleaching) (night guard Vita Bleaching) contain : 5 - 22 % carbamide peroxide.

Q. After bleaching a tooth, we want to restore the tooth with composite resin, we don’t want to compromise the bonding, and we wait for: 1-2 Weeks.]]>251falsefullhttps://www.spreaker.com/episode/37-composite-finishing--40398934
 Best finished surface is achieved by – 12 fluted bur
 Finishing → 12 fluted carbide bur (because high abrasion resistance)
 Bur with more number of flutes
 Less cutting efficiency & more smooth surface]]>https://api.spreaker.com/episode/40398934Wed, 19 Aug 2020 04:30:07 +0000Dr.Mayakha MariamFINISHING  Best finished surface is achieved by – 12 fluted bur  Finishing → 12 fluted carbide bur (because high abrasion resistance)  Bur with more number of flutes  Less cutting efficiency & more smooth surface
 Best finished surface is achieved by – 12 fluted bur
 Finishing → 12 fluted carbide bur (because high abrasion resistance)
 Bur with more number of flutes
 Less cutting efficiency & more smooth surface]]>34falsefullhttps://www.spreaker.com/episode/38-pit-fissure-sealants-1--40398951● Deep pits and fissures
● Preventive treatment procedure - prophylactic
● To prevent food lodgement into pit and fissure
● No preparation required
● Composite ー micromechanical ー pit and fissure
● RATIONALE – Act as barrier between the sealed site & the oral environment ー micromechanical
● Etch+bond+flowable sealant + cure
● Use diagnodent ー laser fluorescence ー digital
● Preferred ー recently erupted molars
(ORDER)
¤ Permanent 1st molars(1st preference)
¤ Rest primary molars
¤ Then PREMOLARS
¤ Then ANTERIORS (LINGUAL PITS)
● Retention of sealant ー is the success determination criteria.]]>https://api.spreaker.com/episode/40398951Wed, 19 Aug 2020 04:29:56 +0000Dr.Mayakha MariamPIT AND FISSURE SEALANTS ● Deep pits and fissures ● Preventive treatment procedure - prophylactic ● To prevent food lodgement into pit and fissure ● No preparation required ● Composite ー micromechanical ー pit and fissure ● RATIONALE – Act as barrier...● Deep pits and fissures
● Preventive treatment procedure - prophylactic
● To prevent food lodgement into pit and fissure
● No preparation required
● Composite ー micromechanical ー pit and fissure
● RATIONALE – Act as barrier between the sealed site & the oral environment ー micromechanical
● Etch+bond+flowable sealant + cure
● Use diagnodent ー laser fluorescence ー digital
● Preferred ー recently erupted molars
(ORDER)
¤ Permanent 1st molars(1st preference)
¤ Rest primary molars
¤ Then PREMOLARS
¤ Then ANTERIORS (LINGUAL PITS)
● Retention of sealant ー is the success determination criteria.]]>182falsefullhttps://www.spreaker.com/episode/39-pit-fissure-sealants-2--40398946○ 3 – 4 y for 1st molars
○ 6 – 7 y for 1st permenant molar
○ 11 – 13 y for 2nd permenant molars & premolars.

Bonding nature of Cements
● Zn polycarboxylate ー chemical
● GIC ー chemical }acrylic liquid
● Composite ー micromechanical
● Pit and fissure ー micromechanical } phosphoric
● Zn phosphoric ー micromechanical
● InLay ー retention
● OnLay ー retention

Prophylactic Rx
● Occlusal only ー pit and fissure
● Others ー fluoride application (not enough for pits – no retention)
● Full mouth ー pit and fissure 1st followed by topical fluoride]]>https://api.spreaker.com/episode/40398946Wed, 19 Aug 2020 04:29:47 +0000Dr.Mayakha Mariam● Age of pits & fissures sealant: ○ 3 – 4 y for 1st molars ○ 6 – 7 y for 1st permenant molar ○ 11 – 13 y for 2nd permenant molars & premolars. Bonding nature of Cements ● Zn polycarboxylate ー chemical ● GIC ー chemical }acrylic liquid ● Composite ー...○ 3 – 4 y for 1st molars
○ 6 – 7 y for 1st permenant molar
○ 11 – 13 y for 2nd permenant molars & premolars.

Bonding nature of Cements
● Zn polycarboxylate ー chemical
● GIC ー chemical }acrylic liquid
● Composite ー micromechanical
● Pit and fissure ー micromechanical } phosphoric
● Zn phosphoric ー micromechanical
● InLay ー retention
● OnLay ー retention

Prophylactic Rx
● Occlusal only ー pit and fissure
● Others ー fluoride application (not enough for pits – no retention)
● Full mouth ー pit and fissure 1st followed by topical fluoride]]>200falsefullhttps://www.spreaker.com/episode/40-gv-black-classification-1--40398944
CLASS I
○ Pit and fissure
○ Lingual pits in anteriors
○ Most commonly seen in mandibular 1st molars Because 1st erupting tooth ー highest time of exposure

CLASS 2 PROXIMAL OF PMS AND MOLARS
○ Commonly seen below the contact area

CLASS 3 Proximal of anterior tooth
○ Restorative preference ー composite
○ Exception in Distal aspect of canine ー amalgam
○ Reason ー mesial migration of posterior tooth

CLASS 4 PROXIMAL + INCISAL OF ANTERIOR

CLASS 5 CERVICAL ASPECT

CLASS 6 INCISAL EDGE + CUSP TIP
○ Amalgam shoeing / cusp capping
○ Thickness of amalgam in complex amalgam restoration in cusp tip area 2 - 3 mm.
○ The thickness of amalgam 1.5 – 2 mm.]]>https://api.spreaker.com/episode/40398944Wed, 19 Aug 2020 04:29:34 +0000Dr.Mayakha MariamGV BLACK CLASSIFICATION CLASS I ○ Pit and fissure ○ Lingual pits in anteriors ○ Most commonly seen in mandibular 1st molars Because 1st erupting tooth ー highest time of exposure CLASS 2 PROXIMAL OF PMS AND MOLARS ○ Commonly seen below the contact...
CLASS I
○ Pit and fissure
○ Lingual pits in anteriors
○ Most commonly seen in mandibular 1st molars Because 1st erupting tooth ー highest time of exposure

CLASS 2 PROXIMAL OF PMS AND MOLARS
○ Commonly seen below the contact area

CLASS 3 Proximal of anterior tooth
○ Restorative preference ー composite
○ Exception in Distal aspect of canine ー amalgam
○ Reason ー mesial migration of posterior tooth

CLASS 4 PROXIMAL + INCISAL OF ANTERIOR

CLASS 5 CERVICAL ASPECT

CLASS 6 INCISAL EDGE + CUSP TIP
○ Amalgam shoeing / cusp capping
○ Thickness of amalgam in complex amalgam restoration in cusp tip area 2 - 3 mm.
○ The thickness of amalgam 1.5 – 2 mm.]]>228falsefullhttps://www.spreaker.com/episode/41-gv-black-classification-2--40398947
Cavity prep:-
¤ Extension determined by Caries extension, follow gingival contour.
¤ Occlusal and gingival walls ー arc shaped - Both parallel to each other
¤ Occlusal arc will be longer than gingival arc
¤ Pulpal floor ー convex shape ( to preserve the center of the tooth which is having close proximity to the pulp)
¤ 2 line angles names :- Occlusoーaxial line angle & Gingivoーaxial line angle- retentive grooves [Not Rounded]
¤ Best restorative ー Direct filling Gold - due to its high biocompatibility
¤ Composite ー microfilled – able to get high polishability
¤ After GIC restoration, thin flush is removed by scaler or knife immediately or finishing stone later

Q. The Carat of gold foil used for direct filling restorations is 24.

ROOT CARIES
○ Actinomyces
○ No shape ー caries extension determines the margin of cavity preparation
○ Gingival recession will promote senile caries.
○ Best material ー GIC
○ Old ppl ー RMGIー aesthetic area]]>https://api.spreaker.com/episode/40398947Wed, 19 Aug 2020 04:29:21 +0000Dr.Mayakha MariamCLASS V Cavity prep:- ¤ Extension determined by Caries extension, follow gingival contour. ¤ Occlusal and gingival walls ー arc shaped - Both parallel to each other ¤ Occlusal arc will be longer than gingival arc ¤ Pulpal floor ー convex shape ( to...
Cavity prep:-
¤ Extension determined by Caries extension, follow gingival contour.
¤ Occlusal and gingival walls ー arc shaped - Both parallel to each other
¤ Occlusal arc will be longer than gingival arc
¤ Pulpal floor ー convex shape ( to preserve the center of the tooth which is having close proximity to the pulp)
¤ 2 line angles names :- Occlusoーaxial line angle & Gingivoーaxial line angle- retentive grooves [Not Rounded]
¤ Best restorative ー Direct filling Gold - due to its high biocompatibility
¤ Composite ー microfilled – able to get high polishability
¤ After GIC restoration, thin flush is removed by scaler or knife immediately or finishing stone later

Q. The Carat of gold foil used for direct filling restorations is 24.

ROOT CARIES
○ Actinomyces
○ No shape ー caries extension determines the margin of cavity preparation
○ Gingival recession will promote senile caries.
○ Best material ー GIC
○ Old ppl ー RMGIー aesthetic area]]>290falsefullhttps://www.spreaker.com/episode/42-zones-of-caries--40398926
 HUNTER SCHRUGER BANDS- white & dark lines in enamel appearing in longitudinal section- enamal rods change their direction.
 ENAMEL SPINDLES- Extension of odontoblasts that cross DEJ, extend into the enamel
 Specific gravity of enamel is – 2.8
 Density of enamel crystal is the lowest at – Edge of enamel prisms
 Dentine permeability –decreased by smear layer, increases towards the DEJ
 Critical PH at which enamel start to demineralization is: 5.
 The pH the enamel make complete remineralization: 5.5 or above.
 Complete remineralization occur after 24 hours
 ph of saliva 6.5


ZONES OF ENAMEL CARIES

SURFACE ZONE
BODY OF THE LESION
DARK ZONE
TRANSLUCENT ZONE


ZONES OF DENTINAL CARIES

NORMAL DENTIN
SUBTRANSPARENT DENTIN (AFFECTED)
TRANSPARENT DENTIN
TURBID DENTIN (INFECTED)
INFECTED / NECROTIC DENTIN]]>https://api.spreaker.com/episode/40398926Wed, 19 Aug 2020 04:29:05 +0000Dr.Mayakha MariamDENTAL ANATOMY  HUNTER SCHRUGER BANDS- white & dark lines in enamel appearing in longitudinal section- enamal rods change their direction.  ENAMEL SPINDLES- Extension of odontoblasts that cross DEJ, extend into the enamel  Specific gravity of...
 HUNTER SCHRUGER BANDS- white & dark lines in enamel appearing in longitudinal section- enamal rods change their direction.
 ENAMEL SPINDLES- Extension of odontoblasts that cross DEJ, extend into the enamel
 Specific gravity of enamel is – 2.8
 Density of enamel crystal is the lowest at – Edge of enamel prisms
 Dentine permeability –decreased by smear layer, increases towards the DEJ
 Critical PH at which enamel start to demineralization is: 5.
 The pH the enamel make complete remineralization: 5.5 or above.
 Complete remineralization occur after 24 hours
 ph of saliva 6.5


ZONES OF ENAMEL CARIES

SURFACE ZONE
BODY OF THE LESION
DARK ZONE
TRANSLUCENT ZONE


ZONES OF DENTINAL CARIES

NORMAL DENTIN
SUBTRANSPARENT DENTIN (AFFECTED)
TRANSPARENT DENTIN
TURBID DENTIN (INFECTED)
INFECTED / NECROTIC DENTIN]]>116falsefullhttps://www.spreaker.com/episode/43-caries-general-info--40398945
 Initiation of caries require 4 entities- Host, bacteria, time, crabohydrates
 Proximal caries confined within enamel – no fillimg neede only prevention
 Only enamel caries and not extending DEJ then :-No Rx required in surface caries. - Only preventive Rx - oral hygiene,wait and watch
- Because enamel can remineralize
 Most important factor in increased caries rate in old ppl – Xerostomia
 V-shaped cervical liesion – doesn’t require any preparation for gic filling
 Incipient careies detected by – fibroptic light
 The percentage of simple caries located in the outer wall of the dentin (proximal sides of the tooth) which left without cavitations is around - 60%.
 Ultra-Sonic. Devices:magnet. : 25000-40000 RPM, but piezo speed is: 60000 – 80000 RPM.
 CMCP contains phenol in concentration: Chlorophenol 35%, Camphor 65%.]]>https://api.spreaker.com/episode/40398945Wed, 19 Aug 2020 04:28:54 +0000Dr.Mayakha MariamCARIES  Initiation of caries require 4 entities- Host, bacteria, time, crabohydrates  Proximal caries confined within enamel – no fillimg neede only prevention  Only enamel caries and not extending DEJ then :-No Rx required in surface caries. -...
 Initiation of caries require 4 entities- Host, bacteria, time, crabohydrates
 Proximal caries confined within enamel – no fillimg neede only prevention
 Only enamel caries and not extending DEJ then :-No Rx required in surface caries. - Only preventive Rx - oral hygiene,wait and watch
- Because enamel can remineralize
 Most important factor in increased caries rate in old ppl – Xerostomia
 V-shaped cervical liesion – doesn’t require any preparation for gic filling
 Incipient careies detected by – fibroptic light
 The percentage of simple caries located in the outer wall of the dentin (proximal sides of the tooth) which left without cavitations is around - 60%.
 Ultra-Sonic. Devices:magnet. : 25000-40000 RPM, but piezo speed is: 60000 – 80000 RPM.
 CMCP contains phenol in concentration: Chlorophenol 35%, Camphor 65%.]]>132falsefull