16. The following are steps in the Cast Restoration Adjusting, Polishing & Finishing Technique.

Transcription

1 16. The following are steps in the Cast Restoration Adjusting, Polishing & Finishing Technique. a. Adjust the occlusion on the patient. b. Mark the patients occlusal contacts with the restoration removed from the tooth. c. Adjust the proximal contact areas on the patient. d. Evaluate the marginal fit of the casting on the patient. e. Check internals of the casting on the patient with PVS impression material. Which of the following sequences the five previously described steps properly? 1. c,d,e,b,a 3. c,b,e,d,a 5. c,e,b,a,d 2. e,d,c,a,b 4. d,e,a,c,b 17. When indicated the occlusal bevel for an inlay should be angled at approximately what degree in relation to the path of insertion of the preparation? degrees degrees degrees 5. none of the above degrees 21. When doing a class II amalgam preparation the direction of the buccal and lingual proximal walls in an occlusal gingival direction is determined by: 1. The direction of the enamel rods. 2. Achieving even access with the adjacent tooth 3. The contour and alignment of the adjacent tooth. 4. The gingival extension of the preparation. 5. Meeting the gingival wall creating a sharp angle. 22. Which of the following is not a clinical criteria for the outline form for a CVC cast restoration? 1. Caries 2. Root sensitivity 3. Terminating margins.65 mm from the crest of the free gingival tissue. 4. Esthetics 5. Final restoration contours 25. Which of the following is not true for the MOD onlay preparation? 1. The outline must include all areas of caries. 45

2 2. All fissured grooves must be eliminated from the occlusal surface. 3. The mesial and distal boxes must have a common path of insertion. 4. The proximal flares should be wider at the occlusal than at the gingival. 5. None of the above. 26. Which of the preparations will have the least retention/resistance assuming the same tooth and all of the preparations have the same length of retentive walls and the same degree of taper of retentive walls. 1. CVC 2. 7/8 crown 3. 3/4 crown 4. MOD onlay 5. All preparation designs would be the same. 27. Quality evaluation criteria for a casting preparation include: 1. Surface, marginal finish, resistance, internal 2. Retention, internal, Debridement/enamel wall finish, outline 3. Debridement/enamel wall finish, taper, outline, reduction 4. Occlusion, retention, internal, marginal finish 28. The proper sequence for a casting preparation is: a. Determine the path of insertion b. Examine the tooth and adjacent teeth c. First plane reduction d. Place bevels e. Visualize the preparation f. Occlusal reduction 1. e,a,c,f,d,b 4. a,c,e,f,d,b 2. b,a,e,c,f,d 5. b,a,f,e,c,d 3. b,e,a,c,f,d 46

3 29. Which of the following are considered primary retention features for a casting preparation? 1. grooves 4. box forms 2. surface area 5. all of the above 3. pins 30. What determines the proper angulation of the occlusal bevel of an inlay preparation? 1. The amount of fissured grooves 2. The amount of occlusal caries 3. All inlays should have a 30 degree occlusal bevel 4. The inclinations of the cusp slopes 5. All of the above 31. You are treating a patient who is missing their lower molars and the maxillary molars have extruded 2.5 mm. You will be restoring the maxillary arch to the correct occlusal and restoring the mandibular arch. How much reduction is need on the buccal cusp of the maxillary molars to do esthetic MOD onlay restorations? 1..5 mm mm mm 5. 3 mm 3. 1 mm 32. In the situation described in the previous question, how much gold should cover the tip of the buccal cusps on the molar restorations? 1..5 mm mm mm 5. 3 mm 3. 1 mm 33. Clinically the gingival extension for a class II amalgam preparation is dictated by which of the following? a. caries b..5 mm separation from the adjacent tooth c. sufficient length for retention d. 2 mm length of axial wall e. minimum of 1 mm axial depth f. decalcification 1. all of the above 4. a,d,e,f 2. a,b,c,e,f 5. a,b,c,d,f 3. a,b,f 47

4 34. The correct axial depth for a minimal CVC preparation at the gingival shoulder should be: 1..3 mm 4. 1 mm mm mm 3. width of the blade of a hoe 1. Suppose you are preparing a mandibular molar for a CVC and you observe that it is aligned in such a manner that the cusps are 1 mm higher (more occlusal) than the cusps of the adjacent teeth. Yo u wish to eventually cement a crown on this tooth that will be in harmony with the height of the cusps of the adjacent teeth. How much occlusal reduction would be optimal for this situation? A. 4 mm B. 3 mm C. 1.5 mm D. 2.5 mm E. None of the above. 2. You are preparing a 3/4 cr. on tooth #12 (it is necessary to cap the buccal cusp) and you want to display as little gold as possible on the buccal cusp tip area. The tooth is extruded by.5 mm compared to the adjacent teeth. The patient has excellent anterior guidance with immediate disclusion of the posterior teeth. You want to restore the tooth into even alignment with the adjacent teeth. How much occlusal reduction should be done at the buccal cusp tip area prior to placement of the occlusal bevel? A. No reduction B..5 mm C. 1 mm D. 1.5 mm E. 2 mm 3. Which of the following statements is/are true? a. Margins of a cast restoration placed within the "biologic width" are more likely to result in gingival inflammation than margins terminating in the area of the junctional epithelium. b. Preparation margins can be extended into the area of the "biologic width" without doing crown lengthening if they require more length for retention. c. Margins terminating 1/2 way into the gingival sulcus are contraindicated as they will result in extreme gingival inflammation and gingival recession. 48

5 d. Richter's research indicated that there was no difference in gingival response to margins placed subgingival or supra gingival if the margins fit accurately and were finished properly. A. a B. b,c C. c D. d E. none of the above 4. Which of the following statements is/are true concerning the outline of a cast restoration? a. Margins must terminate on smooth finishable tooth structure. b. Margins must never terminate in cementum. c. Clinically, margins should terminate.65 mm occlusal to the gingival tissue. d. When doing an MOD onlay a fissured groove on the buccal surface of the tooth might influence the outline of the preparation. A. a B. a,c,d C. b,c D. a,d E. a,b,c,d 5. If in preparing the bevel on a tooth for a CVC you eliminate the shoulder, that was previously established at the ideal depth, it is best to: A. re-establish a shoulder at the end of the bevel and reprepare the bevel. B. maintain the bevel, but prepare the shoulder deeper with the diamond. C. use a hand instrument such as a hoe to re-establish the shoulder. D. leave the preparation as is. E. extract the tooth. 6. You are preparing a tooth for an MOD onlay on tooth # 21 that has mesial caries which extends 2.5 mm axial to the DEJ at its deepest point. How deep axially should the buccal and lingual axial line angles be extended after caries removal, but prior to placement of a base? A..5 mm into dentin B. 1 mm C. 1.5 mm D. 2 mm E. 2.5 mm 7. Which of the following statements is correct for the proper placement of the mesial lingual flare for an MOD onlay on tooth #3? a. It should be wider at the occlusal then at the gingival. b. It should be wider at the gingival then at the occlusal. c. It should be directed toward the mid-point of the lingual axial surface of the tooth. d. It should create an angle of approximately 90 o with the external surface of the tooth. 49

6 e. It should create an angle of approximately 45 o with the external surface of the tooth. A. a B. a,e C. b,e D. a,d E. b,d 8. Which of the following are indicators of dentinal caries? a. leathery appearance of the dentin. b. discoloration of the dentin. c. softness of the dentin. d. discoloration at the DEJ. A. a,b,d B. a,c C. a,c,d D. b,d,d E. a,b,c,d 9. A patient comes into your office with a crown that has fallen off. There is caries at the mesial gingival margin that extends 1.5 mm apical to the margin of the existing restoration. The mesial and buccal first plane walls are 3 mm long. The lingual and distal first plane walls are 1.5 mm long. All of the margins terminate 1 mm into a 2 mm gingival sulcus. Based on the information given which of the following modifications should be made? a. Lengthen the distal and lingual walls by 1.5 mm. b. Place a box on the mesial. c. Lengthen the mesial wall 1.5 mm. d. Place a groove on the buccal. A. a,d B. a,c C. b,d D. b,c,d E. a,b,c,d 10. A patient needs a CVC restoration on tooth #30. They have an existing MOD amalgam. After the preparation is completed you recognize that the buccal and lingual first plane walls of the preparation are 1.5 mm long. Your bevel terminates.65 mm occlusal to the gingival tissues. The buccal and lingual sulcular depth is 1 mm. How should the preparation be modified? A. Lengthen the buccal and lingual first plane walls by approximately 1 mm. B. Place a groove on the mesial axial. C. Place a box on the mesial and distal. D. A & B E. A & C 11. You are treating a maxillary first molar (#3) with a 7/8 crown. The tooth is in cross-bite, the lingual cusp of the lower molar (#30) occludes with the central fossa of #3. What is the correct margin design for the lingual cusps of #3? A. Shoulder bevel B. 1 mm reverse bevel 50

7 C..5 mm bevel at right angles to the long axis of the tooth. D. Chamfer finish line E. none of the above 12. When preparing a maxillary MOD onlay it is determined that the mesial buccal extension can be kept minimal. When evaluating the mesial buccal extension of the preparation you find that the width of the blade of a 6 1/2-2 1/2-9 instrument will fit between the margin and the adjacent tooth with approximately.1 mm of clearance. The rest of the outline is perfect. How should you evaluate the outline of this preparation? A. R B. S C. M D. T E. V 13. When trying in the acrylic provisional you made for your patient you see that the margins are uniformly open. Which of the following might have caused the problem? A. An internal nodule B. A void in the alginate impression in the area of the cusp tip of the preparation. C. A nodule on the occlusal surface of the tooth adjacent to the prepared tooth in the plaster cast. D. A & C E. A,B & C 14. Which of the following might result in the occlusion on your provisional being in hyper-occlusion? A. The plaster cast had a nodule on the occlusal surface of the tooth adjacent to the prepared tooth. B. The diagnostic cast used to make the Ellman form had a void on the occlusal surface of the tooth adjacent to the tooth to be prepared. C. The plaster cast had a void on the occlusal surface of the prepared tooth. D. none of the above E. A,B & C 15. What material is recommend to be used on the surface of the acrylic provisional to help prevent the temporary cement from adhering to the surface of the provisional? A. Copalite B. Vaseline C. Alcote D. Die lubricant E. Polyacrylic acid 51

8 16. The following are steps from the handout "Cast Restorations - Adjusting, Polishing & Finishing Techniques". What is the correct sequence for finishing the gold restoration? a. Evaluate the margins on the patient's tooth. b. Adjust the occlusion on the articulator. c. Remove internal nodules d. Adjust the proximal contact areas in the patient's mouth. e. Adjust the occlusion in the patient's mouth. f. Do the initial polish of the occlusal and axial surfaces. A) c,f,b,d,a,e B) c,b,f,d,a,e C) c,f,b,a,d,e D) f,b,c,a,d,e E) f,c,b,d,e,a 19. When testing a cemented CVC for retention the forces the cement is subjected to on the axial first plane walls is: Assume the first plane walls are parallel to the path of insertion? A. tensile B. shear C. compressive D. A & B E. B & C 20. Which of the following statements are true about the occlusal bevel for an inlay with proper direction of occlusal walls? a. The bevel angulation is determined by the length of the occlusal walls. b. The bevel angulation is determined by the width of the occlusal isthmus. c. The bevel should be 15 o to the external surface of the tooth. d. The bevel should be approximately 1/3 the length of the walls. e. The bevel angulation is determined by the cusp slope angulation. A. a,c,d B. d,e C. a,c,e D. c,d,e E. b,c,d,e 21. Assume that all of the preparation criteria will allow you to do a minimal MOD onlay on tooth #12. What is the range of acceptability for the mesial buccal proximal extension. A..25 mm to.5 mm B..25 mm to.65 mm C..5 mm to.75 mm D..25 mm to.75 mm E..65 mm to 1 mm 22. When viewing your preparation with one eye closed and parallel with the path of insertion you observe that you can not see the gingival portion of the mesial buccal flare. When viewing the preparation from the mesial 52

9 buccal you observe that the flare extends to the gingival bevel. Which of the following statements is/are true. a. The preparation has an internal undercut b. The preparation has an external undercut c. The preparation is acceptable if the undercut can be blocked out with die spacer. d. The preparation is unacceptable in the category of internal. e. The preparation should be evaluated as acceptable in the category of marginal finish A. a,c,e B. b,d, C. a,d D. b E. a,e 23. How should the following CVC preparation be modified. The first plane buccal and lingual walls are 2.5 mm. The mesial and distal walls are 2.5 mm. The margins terminate at the crest of the free gingival tissue. The gingival bevel is.4 mm wide on the mesial. The buccal axial depth is 1 mm. There is a 2 mm wide area of caries on the mesial axial wall. a. Place a distal groove, remove the mesial caries and place a base. b. Place a mesial box c. Place a buccal groove d. Increase the width of the mesial bevel to.65 mm e. Do not increase the mesial bevel as this will terminate the margin subgingivally. A. a,c,d B. b,c,e C. b,c,d D. a,d E. b,d 24. Which of the following is not a factor that determines the outline for a cast restoration? A. Esthetics B. Periodontal considerations C. Crown contours D. Access E. None of the above 25. A patient presents in your office with a problem that their CVC on tooth #2 has fallen out. You examine the tooth and determine that the first plane walls on the buccal and lingual of the preparation are convergent by about 20 o to the long axis of the tooth. The length of the first plane axial walls on the buccal and lingual are about 3.5 mm. The length of the mesial wall is 1.5 mm and the length of the distal axial wall is 3 mm. The buccal and lingual gingival margins terminate exactly at the crest of the gingival tissues. The mesial wall terminate 1 mm into the gingival sulcus. The marginal configuration of the preparation is a shoulder bevel circumferentially around the tooth. You measure the sulcular depth with a periodontal probe and find it to be uniformly 3 mm in depth. How would you modify the preparation to obtain adequate retention? (1 pt) 53

10 a. lengthen the buccal and lingual first plane walls by 1.5 to 2 mm b. create a chamfer finish line on the buccal and lingual c. place a distal groove d. lengthen the mesial wall by 2 mm e. place a buccal groove A) b,d B) a,c,e C) c,e D) c,d E) a,b,c,e 27. Which of the following describe an unacceptable margin on an acrylic provisional restoration? A. The margin is.25 mm submarginal B. The margin is greater than.5 mm submarginal C. The margin is.5 mm beyond the margin (excess) D. A & C E. B & C 54

11 28. Which of the following might result in an unacceptable contact area when making and adjusting the acrylic provisional restoration? A. The diagnostic cast not properly waxed. B. Not abrading the plaster cast in the contact areas on the teeth adjacent to the prepared tooth. C. Removing the contacting area when trimming the provisional. D. B & C E. A,B & C 29. When first trying the provisional on the patient's tooth you observe the margins are open. Which of the following are possibly the cause for the margins being open? a. Excessive thickness of Alcote on the plaster cast. b. Nodules on the surface of the plaster cast in the area of the teeth adjacent to the prepared tooth. c. Nodules on the surface of the plaster cast in the area of occlusal surface of the prepared tooth. d. Excessive abrasion of the plaster cast in the contact areas adjacent to the prepared tooth. e. Poor adaptation of the Ellman to the patient's diagnostic casts in the gingival areas. A. a,d B. b,c C. a,b,d,e D. d,e E. a,d,e 30. A CVC casting is made for a maxillary second molar. When tried in the patient's mouth it does not seat onto the tooth completely, appears to rock, and all the margins are open. Which of the following could cause this problem? a. Prepared tooth hitting the custom tray b. Failure to use tray adhesive. c. An internal nodule. d. Excessive thickness of die spacer e. Tight interproximal contacts. A) c,e B) a,b,c,e C) b,c,e D) b,c,d,e E) all of the above 31. Finishing the margins of a cast restoration on the tooth can result in an improvement of the marginal fit of the restoration. Which of the following is true about finishing the margins on the patient's tooth prior to cementing? A. All accessible margins should be finished with a stone and disc. B. The stone should be rotated from the gold toward the tooth. C. The casting must be held firmly in place during the finishing procedure. D. B & C E. A,B, & C 55

12 33. You are preparing a patient's tooth for a CVC. All of the criteria for proper outline have been fulfilled and the gingival margins terminate 2 mm occlusal to the crest of the gingival tissue. The preparation should be modified as follows: A. Extend the preparation further gingivally to terminate the margins.65 mm occlusal to the crest of the gingival tissues. B. Place a groove on the buccal surface to increase the retention. C. Extend the buccal gingival margin.5 mm apical to the crest of the gingival tissue for a better esthetic result. D. Extend approximately 2.5 mm further gingivally to increase the preparation's retention and resistance. E. Do not alter the preparation. 35. Clinically, decalcification of the enamel is determined by: A. White spots or lines on the surface of the tooth. B. Soft enamel which can be removed with an explorer. C. Brown spots on the surface of the tooth. D. A & B E. B & C 36. Which of the following could cause the margins of a cast restoration not to fit accurately on the trimmed and untouched stone die made from the same impression as the die the wax pattern was fabricated on? a. An internal void in the casting. b. An internal nodule on the casting. c. Excessive thickness of die spacer. d. Distorted or inaccurate impression. e. Abrasion of the marginal area of the stone die the wax pattern was fabricated on. A. b,c,d,e B. a,e C. b D. b,d,e E. b,e 37. What is the correct axial depth for the mesial and distal box of an MOD onlay after placement of the bevel? A. 2 mm B. 3-4 mm C..65 mm D mm E..5 mm 39. According to the majority of scientific studies, which of the following margin placements will result in the least amount of gingival inflammation (assuming all other factors are the same)? A. Supra-gingival 56

13 B. Equal-gingival C. Sub-gingival by.5 mm D. At the base of the gingival sulcus E. A & B are the same. 57

14 40. A patient's tooth is prepared for a CVC restoration and the mesial proximal contact of the provisional restoration is open. What is the most probable result this will have on the final restoration prior to modifications? a. The final restoration will have an open mesial contact. b. The mesial contact may be too tight. c. The tooth will be hypersensitive. d. The margins may be open. A. a B. b C. a,c D. b,c E. b,d 44. What is the optimal measurement for the lingual shoulder on an MOD onlay preparation after placement of the lingual bevel? A..25 mm B..65 mm C. 1 mm D. Less than 1 mm E. Greater than 1 mm 45. When evaluating a final PVS impression you observe the following. Which situation would require remaking the impression? a. The tray is contacting the prepared tooth on the reduced portion of the non-functional cusp tip. b. The tray contacts the tooth adjacent to the prepared tooth on the nonfunctional cusp tip. c. The impression terminates at the gingival margin. d. The impression has slightly pulled away from the tray in the area of the preparation. e. The handle on the tray breaks when removing the impression from the mouth. A. a,c,e B. a,c,d C. b,d D. a,d E. all of the above 58

15 46. When trying in a 3/4 crown on the patient's tooth you determine that the margin at the mid- mesial is submarginal by.2 mm. The rest of the margins fit perfectly. Which of the following might explain the reason for the margin being submarginal? a. The mesial contact is too tight. b. The die was abraded. c. The casting has an internal nodule. d. The margin was excessively polished in that area. e. The margination of the wax pattern was inaccurate. A. a,b,d B. b,c,d,e C. a,c D. b,d,e E. a,b,c,d,e 47. The range of acceptability for the axial depth at the distal buccal area of a 7/8 crown when measured at the gingival shoulder is: A mm B mm C mm D mm E. None of the above 48. A patient comes into your office with an existing CVC on tooth #19. The tissue is very inflamed in the mesial interproximal area. What are the possible cause of the inflammation? a. The margin on the mesial terminates in the connective tissue attachment. b. The mesial contact is open. c. There is cement in the mesial gingival sulcus. d. The mesial surface in the gingival embrasure is rough. e. The mesial gingival embrasure is overcontoured. A. a,b,d,e B. b,d,e C. b,c,d D. a,d,e E. a,b,c,d,e 49. The range of acceptability for the distal buccal extension of a 3/4 crown on tooth #5 is: A mm B mm C..5-1 mm D mm E mm 50. Given the following information what design of casting preparation should you do. Tooth #14 has an existing MOD amalgam. The distal lingual cusp has fracture slightly gingival (.5 mm) to the level of the pulpal wall of the amalgam preparation. The distal buccal portion of the tooth has a white spot that is 2 mm occlusal to the gingival tissue that is soft when scraped with an explorer. The mesial and distal extensions of the 59

16 amalgam extend 3 mm apical to the properly extended pulpal wall of the amalgam preparation. All other factors that would effect outline are not a consideration. A. MOD onlay B. MOD onlay with a distal buccal that terminates at the mid-buccal and 1 mm occlusal to the gingivae. C. 7/8 crown D. CVC E. Reverse 3/4 crown 1. The optimal distal buccal extension for a DO inlay on tooth # 5 is. Assume there are no other factors that would require an extension greater than the optimal. a..25 mm b..5 mm c..65 mm d..75 mm e. 1 mm 2. Which of the following would not have any influence on the outline of a cast restoration? a. configuration of the gingival margin (i.e.: chamfer, shoulder-bevel, etc.) b. esthetics c. retention d. restoration contours e. none of the above 3. The optimal mesial buccal extension for an MOD onlay on tooth #18 is. Assume there are no other factors that would require an extension greater than the optimal. a..25 mm b..5 mm c..65 mm d..75 mm e. 1 mm 4. What is the range of acceptability for the mesial gingival extension for a 7/8 preparation? Assume there are no other factors that would require an extension greater than the optimal. a..1 mm - 1 mm b..25 mm -.75 mm c..25 mm - 1 mm d..5 mm mm e..5 mm - 1 mm 60

17 5. What is the range of acceptability for the mesial buccal extension for a 3/4 crown preparation on tooth # 5? Assume there are no other factors that would require an extension greater than the optimal. a..1 mm - 1 mm b..25 mm -.75 mm c..25 mm - 1 mm d..5 mm - 1 mm e. none of the above 6. Which of the following structures define the biologic width? 1. Epithelial attachment 2. Gingival sulcus 3. Alveolar bone 4. Connective tissue attachment 5. Cemental-enamel junction a. 1 & 4 b. 1,3 & 4 c. 2 d. 4 &5 e. 1 & 3 7. Clinically decalcification of the enamel is determined by which of the following? a. White opaque area on the enamel b. Brown discoloration on the enamel c. Softness of the enamel when tested with an explorer. d. Whitish hard material on the surface of the tooth. e. None of the above 8. The optimal axial depth for the mesial box portion of an MOD onlay preparation on tooth #30 is. a. 1.5 mm b. 1.2 mm c..5 mm into dentin d..75 mm e. depends on the depth of the caries. 9. When planning the treatment for your patient you determine that tooth #19 requires a CVC restoration. On the patient s diagnostic casts you determine that tooth #14 has been extracted and tooth #19 has extruded 1.5 mm into the edentulous space. The patient needs an implant to replace tooth #14 and the mandibular occlusal plane needs to be corrected. How much occlusal reduction should optimally be done when preparing tooth #19. a. 1 mm b. 1.5 mm c. 2 mm d. 2.5 mm 61

18 e. 3 mm 10. How much occlusal reduction should be done on the buccal cusp of tooth #12 prior to placing the occlusal bevel? The buccal cusp is.75 mm longer than the adjacent teeth and you want to have even buccal cusp lengths after restoring the tooth. The patient has no wear of the buccal cusp and has excellent anterior disclusion. a. none, the prep should terminate at the tip of the cusp. b..5 mm c..75 mm d. 1.5 mm e..25 mm 11. How many planes of reduction should there be on the lingual axial surface for a 3/4 crown on tooth #29? Assume the lingual surface of the tooth is intact and will be restored into an optimal class I occlusion. a. 1 b. 2 c. 3 d. 4 e How many planes of reduction should there be on the lingual axial surface of a 7/8 crown preparation on tooth #3? The lingual cusps of the tooth have fractured half way down the lingual surface of the tooth. (drawing shows lingual cusp fracture) a. 1 b. 2 c. 3 d. 4 e. 5 62

19 13. The range of acceptability for the axial reduction of a CVC when measured at the gingival shoulder prior to placement of the gingival bevel is. a mm b mm c mm d mm e mm 14. Your patient has minimal occlusal and proximal caries that extends laterally at the DEJ. The thickness of the occlusal enamel is 2 mm at the occlusal pit areas. Your treatment plan is to do a minimal two surface inlay. What is the correct pulpal depth for this preparation when measured at the pulpal occlusal? a. 1.5 mm at the pits b. 2 mm at the occlusal walls c. At the level of the DEJ d. At a level even with deepest area on the pulpal floor after removal of the caries that extends pulpal to the DEJ. e. a & b 15. When doing an MOD onlay preparation you notice discoloration on the mesial axial wall after establishing the optimal axial depth of the preparation. What should you do? a. Deepen all of the axial wall to remove the discoloration. b. Deepen the axial wall only in the area of discoloration by removing the discoloration with a round bur. c. Leave the area of discoloration d. Convert the preparation to a 3/4 crown to obtain more retention. e. More information is required to make the determination whether to remove discoloration on the axial wall. 16. When evaluating your MOD onlay preparation on tooth #4 you notice discoloration at the DEJ in the area of the mesial buccal proximal wall. The patient had mesial caries on the radiograph. The patient is concerned about showing gold and the preparation is at the optimal extension. What should you do? a. Extend the preparation to remove the area of discoloration b. Remove the discoloration with a small round bur to maintain the minimal extension. c. Do not change the preparation. d. Extract the tooth. e. None of the above. 17. When preparing an MOD onlay you make the pulpal wall 3.5 mm deep. After extending gingivally on the proximal to create the box portion of the preparation you notice that the length of the axial wall is only 1.5 mm. You 63

20 have extended apical enough to include the caries and have satisfactory extension from the adjacent tooth. The gingival margin terminates at the crest of the gingival tissue. All other aspects of the preparation are optimal. What should you do to modify the preparation? a. Extend gingivally another 1 mm. b. Extend gingivally another.5 mm c. Leave the preparation as is. d. Convert the preparation to a CVC e. Do crown lengthening to reposition the gingival tissue more apically. 18. Which of the following statements accurately describes supplemental retentive features for a cast restoration? 1. Placed 90 degrees to the wall being compensated for. 2. Placed parallel to the path of insertion of the preparation. 3. Supplemental groove should be as long as possible. 4. The internal walls of a groove should be near parallel in a buccal to lingual direction if the groove is on the buccal. a. 1 & 3 b. 2 & 4 c. 1, 2 & 3 d. 2 & 3 e. 1, 2, 3 & A minimal internal undercut of the mesial box for an MOD onlay which will not significantly interfere with the fabrication of the final restoration should receive which of the following evaluations? Assume the rest of the preparation is optimal. a. an acceptable evaluation (S or M) in the category of outline b. an unacceptable evaluation (T) in the category of outline c. an acceptable evaluation (S or M) in the category of internal d. an unacceptable evaluation (T) in the category of internal e. an acceptable (S or M) evaluation in the category of marginal finish 20. A minimal undercut at the gingival corner of the distal lingual margin of a DO inlay preparation should receive which of the following evaluations? Assume the rest of the preparation is optimal. a. an acceptable evaluation (S or M) in the category of marginal finish b. an unacceptable evaluation (T) in the category of marginal finish c. an acceptable evaluation (S or M) in the category of internal d. an unacceptable evaluation (T) in the category of internal e. an acceptable evaluation (S or M) in the category of outline 21. The range of acceptability for the width of a gingival bevel should be. a mm b mm c..5-1 mm d mm e mm 64

21 22. Tooth # 13 is extruded 1 mm when compared to the adjacent teeth. When restoring the tooth with an MOD onlay you want to restore the tooth to be at the same occlusal plane as the adjacent teeth. The patient wants an esthetic restoration. The patient has good anterior disclusion. What is the optimal width of the buccal occlusal bevel for this situation? a..2 mm b..5 mm c..65 mm d. 1 mm e. 1.5 mm 23. The range of acceptability for the marginal fit of a provisional restoration is? a. Exactly at the termination of the bevel to.5 mm submarginal. b..25 mm excess to.5 mm submarginal. c. Exactly at the termination of the bevel to.25 mm submarginal. d..5 mm excess to.5 mm submarginal. e. none of the above 24. A provisional restoration would be unacceptably (T or V) in hyper-occlusion in which of the following situations? Assume the teeth adjacent to the prepared tooth are in occlusion. 1. The restoration holds 1 thickness of mylar and the adjacent teeth hold 2 thickness of mylar. 2. The restoration holds 4 thickness of mylar and the adjacent teeth hold 1 thickness of mylar. 3. The restoration holds 2 thickness of mylar and the adjacent teeth hold 1 thickness of mylar. 4. The restoration marks with marking material and the adjacent teeth do not mark. 5. The restoration does not mark with marking material and the adjacent teeth do mark. a. 1 b. 2 & 3 c. 2,3 & 4 d. 1, 3 & 5 e. 1 & 4 65

22 25. A provisional restoration would be unacceptable (T or V) in the category of axial contours in which of the following situations? a. The proximal contact area hold 1 thickness of mylar. The provisional is fully seated and requires minimal force to be inserted and removed. b. When testing the proximal contact area with mylar the mylar tears when you try to remove the mylar. The provisional is fully seated and requires minimal force to be inserted and removed. c. When testing the proximal contact area with mylar the mylar drags when you try to remove the mylar. The provisional is fully seated and requires minimal force to be inserted and removed. d. a & b are both correct. e. none of the above 26. Which of the following is likely to result in the margins of a provisional restoration being open? The provisional restoration was made using the indirect method. a. There is an internal nodule in the provisional. b. The Ellman form was not fully seated on the plaster cast. c. There was a nodule on the occlusal surface of the preparation in the plaster cast. d. a & b e. a, b & c 28. Porosity or voids in an acrylic provisional made indirectly might be caused by which of the following? a. A void at the tip of a cusp on the plaster cast used to make the provisional. b. Insufficient viscosity of the acrylic when placing the acrylic on the plaster cast. c. A nodule on the plaster cast in the area of the occlusal of the tooth adjacent to the prepared tooth. d. a & b e. b & c 29. Which of the following might result in an open proximal contact when making a provisional restoration using the indirect method? a. Excessive trimming of the contact area of the teeth adjacent to the prepared tooth on the plaster cast used to fabricate the provisional. b. Excessive wax applied to the contact area of the patient s diagnostic prior to making the Ellman form. c. Insufficient powder added to the liquid monomer resulting in a fluid mix of acrylic when making the provisional. d. a & c e. none of the above 66

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24 30. When articulating your clinical patient s stone casts you can verify the accuracy of the mounting by doing which of the following? a. Examine the patient s dentition by using thin marking material (articulating paper) and mylar to determine the points of centric contacts and verifying that the casts are mounted in the same relationship. b. Check the mounted stone casts with mylar to verify that the teeth are holding mylar anterior and posterior to the prepared teeth. Assume the patient has teeth anterior and posterior to the prepared teeth. c. Use a thin marking material to mark the articulated stone casts to verify that the teeth anterior and posterior to the prepared tooth are marking as well as the teeth on the opposite side of the mouth. Assume the patient has teeth anterior and posterior to the prepared teeth. d. b & c e. a & b 31. Which of the following might result in a cast restoration not seating properly on the patient s tooth? a. A distorted or inaccurate final impression. b. Abrasion of the preparation die used to fabricate the wax pattern. c. Excessive use of die spacer on the occlusal surface of the die used to fabricate the wax pattern. d. a & b e. a, b, & c 33. Which of the following forms of gingival finish lines (marginal configuration) will result in a preparation with the most retention? Assume all restorations terminate at the same gingival extensions. a. Shoulder bevel b. Chamfer c. Shoulder d. a & b are the same e. a, b & c are the same 34. Which of the following statements is (are) true for the MOD onlay preparation? 1. One of the factors that determines gingival extension is retention. 2. When developing the occlusal isthmus all fissured grooves must be eliminated from the occlusal surface. 3. The axial wall length should not exceed 2 mm. 4. Decalcification that extends to the minimal outline of the preparation must be included in the outline even if this will compromise the esthetics. a. 1 & 4 b. 2 & 3 c. 1, 2 & 4 d. 2, 3 & 4 e. 3 & 4 68

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26 35. You are preparing a tooth for a CVC. All of the criteria for proper outline have been fulfilled and the gingival margins terminate 2 mm occlusal to the crest of the gingival tissue. The preparation should be modified as follows: a. Extend the preparation further gingivally to terminate the margins.65 mm occlusal to the crest of the gingival tissues. b. Place a groove on the buccal surface to increase the retention. c. Extend the buccal gingival margin.5 mm apical to the crest of the gingival tissue for a better esthetic result. d. Extend approximately 1.5 mm further gingivally to increase the preparations retention and resistance. e. Do not alter the preparation. 36. The purpose for a gingival bevel in a casting preparation is? a. The metal at the margin is thin and can be burnished. b. The bevel increases the retention of the restoration. c. A bevel decreases the chance of leaving unsupported enamel at the margin. d. a & c e. a, b, & c 37. A patient comes into your office with a loose CVC restoration. After removal of the restoration you determine the reason it come loose was due to the over tapering of all the axial walls of the preparation. The margins of the preparation are at the crest of the gingival tissue and the sulcular depth is uniformly 1.5 mm. The length of the axial walls are approximately 4-5 mm. The marginal configuration is a chamfer with approximately.5 mm of reduction at the gingival area of the preparation. What is the method of choice to increase the retention/resistance of the preparation? a. Increase the parallelism of the first plane walls by accentuating the depth of the preparation at the gingival. b. Extend the preparation 1.5 mm further apically to increase the length of the walls. c. Place grooves parallel to the proper path of insertion on the mesial and buccal walls. d. a & c e. a, b & c 38. The following are steps in the adjusting and finishing of a cast restoration. 1. Adjust the occlusion on the patient. 2. Mark the patients occlusal contacts with the restoration removed from the tooth. 3. Adjust the proximal contact areas on the patient. 4. Check internals of the casting on the patient with PVS impression material. 70

27 Which of the following sequences the above steps properly? a. 2, 3, 4, 1 b. 3, 2, 1, 4 c. 2, 4, 3, 1 d. 2, 1, 4, 3 e. 3, 4, 1, Clinically gingival extensions for a cast restoration may be determined by: mm. from the base of the gingival sulcus. 2. Desired contours of the final restoration. 3. Root sensitivity mm occlusal to the crest of the free gingival margin. 5. Preparation retention. a. 2, 3, & 5 b. 3 & 5 c. 2, 3, & 4 d. 1, 2, 3, & 5 e. 1, 2, 3, 4 & You are preparing a tooth for a CVC restoration. There is caries at the mid buccal area at the level of the gingival shoulder. The caries extends 1.5 mm axially. What is the optimal width of the shoulder prior to placement of the gingival bevel in the area of the gingival caries? a..5 mm b..65 mm c. 1 mm d. 1.5 mm e mm 42. A patient comes into your office with a loose CVC crown. After removal of the crown you determine the reason for the crown coming loose is the first plane wall on the buccal is 2 mm and lingual first plane wall is 2.5 mm in length. The buccal and lingual margins terminate.5 mm occlusal to the crest of the gingival tissue. The sulcular depth is circumferentially 2 mm. The mesial wall is over tapered and terminates 1 mm gingival to the crest of the gingival tissue. What is the best way to improve the retention of the preparation? 1. Lengthen the buccal and lingual first plane walls by 2 mm. 2. Lengthen the buccal and lingual first plane walls by 1 mm. 3. Place a groove on the buccal wall parallel with the path of insertion. 4. Place a groove on the lingual wall parallel with the mesial wall. 5. Make the mesial axial wall deeper to increase the parallelism of the wall and extend 1 mm farther gingivally to increase the length. a. 1, 3, & 5 b. 2, 3 c. 1, 4, & 5 d. 2 e. 2, 3 & When evaluating the MOD onlay you prepared for your patient you find that the length of the internal walls of the distal box are 3 mm in length and the length of the internal walls of the mesial box are 2 mm in length. The gingival margin on the mesial and distal interproximal areas terminate 1 mm into a 2 mm sulcus. All other aspects of the preparation are optimal. What modifications to the preparation should be done? 71

28 a. No modifications are required. b. Increase the length of the mesial box by.5 mm. c. Increase the length of the mesial box by 1 mm. d. Change the preparation to a 3/4 crown. e. Change the preparation to a 3/4 crown with a lingual groove. 44. A patient comes into your office needing a CVC on tooth #30. The tooth had a previous CVC which fell out 1 year prior. The tooth has extruded and is now in occlusion with the opposing molar. After repreparing the tooth and obtaining the correct amount of occlusal reduction you realize that the first plane walls of the preparation are 2 mm long on the buccal and lingual and the length of the mesial and distal walls are 1.5 mm. All margins terminate 1 mm into a 2 mm gingival sulcus. What is the best way to correct this preparation? a. Do a surgical crown lengthening procedure prior to preparation modifications. b. Place a 2 mm groove on the buccal and lingual walls c. Place grooves on the buccal, lingual, mesial and distal walls. d. Extend all walls 1 mm gingivally and place grooves on the buccal and lingual walls. e. No modifications are required. 3. The optimal mesial buccal extension for an MOD onlay on tooth #4 is. Assume there are no other factors that would require an extension greater than the optimal. a..25 mm b..5 mm c..65 mm d..75 mm e. 1 mm 6. Which of the following structures define the biologic width? 1. Epithelial attachment 2. Gingival sulcus 3. Alveolar bone 4. Connective tissue attachment 5. Cemental-enamel junction a. 1,3 & 4 b. 1& 4 c. 2 d. 4 &5 e. 1 & 3 9. When planning the treatment for your patient you determine that tooth #19 requires a CVC restoration. On the patient s diagnostic casts you determine that tooth #14 has been extracted and tooth #19 has extruded 2.5 mm into the edentulous space. The patient needs an implant to replace tooth #14 and the mandibular occlusal plane needs to be 72

29 corrected. How much occlusal reduction should optimally be done when preparing tooth #19. a. 1 mm b. 1.5 mm c. 2 mm d. 2.5 mm e. 3 mm f. no reduction is required 10. How much occlusal reduction should be done on the buccal cusp of tooth #12 prior to placing the occlusal bevel? The buccal cusp is.75 mm longer than the adjacent teeth and you want to have even buccal cusp lengths after restoring the tooth. The patient has no wear of the buccal cusp and has excellent anterior disclusion. a. none, the prep should terminate at the tip of the cusp. b..5 mm c..75 mm d. 1.5 mm e..25 mm 11. How many planes of reduction should there be on the lingual axial surface for a 3/4 crown on tooth #29? Assume the lingual surface of the tooth is intact and will be restored into an optimal class I occlusion. a. 1 b. 2 c. 3 d. 4 e How many planes of reduction should there be on the lingual axial surface of a 7/8 crown preparation on tooth #3? The lingual cusps of the tooth have fractured half way down the lingual surface of the tooth. (drawing shows lingual cusp fracture) a. 1 b. 2 c. 3 d. 4 e. 5 73

30 13. The range of acceptability for the axial reduction of a CVC when measured at the gingival shoulder prior to placement of the gingival bevel is. a mm b mm c mm d mm e mm 14. Your patient has minimal occlusal and proximal caries that extends laterally at the DEJ. The thickness of the occlusal enamel is 2 mm at the occlusal pit areas. Your treatment plan is to do a minimal two surface inlay. What is the correct pulpal depth for this preparation when measured at the pulpal occlusal? a. 1.5 mm at the pits b. 2 mm at the occlusal walls c. At the level of the DEJ d. At a level even with deepest area on the pulpal floor after removal of the caries that extends pulpal to the DEJ. e. a & b 15. When doing an MOD onlay preparation you notice discoloration on the mesial axial wall after establishing the optimal axial depth of the preparation. What should you do? a. Deepen all of the axial wall to remove the discoloration. b. Deepen the axial wall only in the area of discoloration by removing the discoloration with a round bur. c. Leave the area of discoloration d. Convert the preparation to a 3/4 crown to obtain more retention. e. More information is required to make the determination whether to remove discoloration on the axial wall. 16. When evaluating your MOD onlay preparation on tooth #4 you notice discoloration at the DEJ in the area of the mesial buccal proximal wall. The patient had mesial caries on the radiograph. The patient is concerned about showing gold and the preparation is at the optimal extension. What should you do? a. Extend the preparation to remove the area of discoloration b. Remove the discoloration with a small round bur to maintain the minimal extension. c. Do not change the preparation. d. Extract the tooth. e. None of the above. 17. When preparing an MOD onlay you make the pulpal wall 3.5 mm deep. After extending gingivally on the proximal to create the box portion of the preparation you notice that the length of the axial wall is only 1.5 mm. You 74

31 have extended apical enough to include the caries and have satisfactory extension from the adjacent tooth. The gingival margin terminates at the crest of the gingival tissue. All other aspects of the preparation are optimal. What should you do to modify the preparation? a. Extend gingivally another 1 mm. b. Extend gingivally another.5 mm c. Leave the preparation as is. d. Convert the preparation to a CVC e. Do crown lengthening to reposition the gingival tissue more apically. 18. Which of the following statements accurately describes supplemental retentive features for a cast restoration? 1. Placed 90 degrees to the wall being compensated for. 2. Placed parallel to the path of insertion of the preparation. 3. Supplemental groove should be as long as possible. 4. The internal walls of a groove should be near parallel in a buccal to lingual direction if the groove is on the buccal. a. 1 & 3 b. 2 & 4 c. 1, 2 & 3 d. 2 & 3 e. 1, 2, 3 & A minimal internal undercut of the mesial box for an MOD onlay which will not significantly interfere with the fabrication of the final restoration should receive which of the following evaluations? Assume the rest of the preparation is optimal. a. an acceptable evaluation (S or M) in the category of outline b. an unacceptable evaluation (T) in the category of outline c. an acceptable evaluation (S or M) in the category of internal d. an unacceptable evaluation (T) in the category of internal e. an acceptable (S or M) evaluation in the category of marginal finish 20. A minimal undercut at the gingival corner of the distal lingual margin of a DO inlay preparation should receive which of the following evaluations? Assume the rest of the preparation is optimal. a. an acceptable evaluation (S or M) in the category of marginal finish b. an unacceptable evaluation (T) in the category of marginal finish c. an acceptable evaluation (S or M) in the category of internal d. an unacceptable evaluation (T) in the category of internal e. an acceptable evaluation (S or M) in the category of outline 21. The range of acceptability for the width of a gingival bevel should be. a mm b mm c..5-1 mm d mm e mm 75

32 22. Tooth # 13 is extruded 1 mm when compared to the adjacent teeth. When restoring the tooth with an MOD onlay you want to restore the tooth to be at the same occlusal plane as the adjacent teeth. The patient wants an esthetic restoration. The patient has good anterior disclusion. What is the optimal width of the buccal occlusal bevel for this situation? a..2 mm b..5 mm c..65 mm d. 1 mm e. 1.5 mm 23. The range of acceptability for the marginal fit of a provisional restoration is? a. Exactly at the termination of the bevel to.5 mm submarginal. b..25 mm excess to.5 mm submarginal. c. Exactly at the termination of the bevel to.25 mm submarginal. d..5 mm excess to.5 mm submarginal. e. none of the above 24. A provisional restoration would be unacceptably (T or V) in hyper-occlusion in which of the following situations? Assume the teeth adjacent to the prepared tooth are in occlusion. 1. The restoration holds 1 thickness of mylar and the adjacent teeth hold 2 thickness of mylar. 2. The restoration holds 4 thickness of mylar and the adjacent teeth hold 1 thickness of mylar. 3. The restoration holds 2 thickness of mylar and the adjacent teeth hold 1 thickness of mylar. 4. The restoration marks with marking material and the adjacent teeth do not mark. 5. The restoration does not mark with marking material and the adjacent teeth do mark. a. 1 b. 2 & 3 c. 2,3 & 4 d. 1, 3 & 5 e. 1 & 4 76

33 25. A provisional restoration would be unacceptable (T or V) in the category of axial contours in which of the following situations? a. The proximal contact area hold 1 thickness of mylar. The provisional is fully seated and requires minimal force to be inserted and removed. b. When testing the proximal contact area with mylar the mylar tears when you try to remove the mylar. The provisional is fully seated and requires minimal force to be inserted and removed. c. When testing the proximal contact area with mylar the mylar drags when you try to remove the mylar. The provisional is fully seated and requires minimal force to be inserted and removed. d. a & b are both correct. e. none of the above 26. Which of the following is likely to result in the margins of a provisional restoration being open? The provisional restoration was made using the indirect method. a. There is an internal nodule in the provisional. b. The Ellman form was not fully seated on the plaster cast. c. There was a nodule on the occlusal surface of the preparation in the plaster cast. d. a & b e. a, b & c 27. Which of the following might result in a provisional restoration being in hyperocclusion? The provisional restoration was made using the indirect method. a. Excessive thickness of Alcote b. The cusp tip of the patient s diagnostic cast chipping on the tooth adjacent to the tooth to be prepared prior to making the Ellman form. c. A nodule on the plaster cast in the area of the central groove on the tooth adjacent to the prepared tooth. d. b & c e. a, b, & c 28. Porosity or voids in an acrylic provisional made indirectly might be caused by which of the following? a. A void at the tip of a cusp on the plaster cast used to make the provisional. b. Insufficient viscosity of the acrylic when placing the acrylic on the plaster cast. c. A nodule on the plaster cast in the area of the occlusal of the tooth adjacent to the prepared tooth. d. a & b e. b & c 77