NBDE 2 Important Composites Questions with answers-1

question:two things that account for a successful posterior composite restoration?
a. type of resin and size of tooth
b. size of tooth and type of prep
c. type of resin and type of prep
answer-c. type of resin and type of prep

QUESTION: Postoperative MOD composite pain, most likely due to?

QUESTION: what type of bond is composite on tooth structure?
a. chemical bond
b. mechanical bond (micromechanical) ans
c. organic coupling
d. Adhesion

QUESTION: What determine class 1 composite prep?
answer-The depth of decay

QUESTION: What indicates the design of composite class I preparation
Only incorporates pits of lesion – this one
2mm pulpal floor depth
45 degree bevel cavosurface
answer-B i think…
A. It shud conservatively involve only d defective portion/carious portion of d tooth which can
b both d pit or fissureB. its pulpal depth is 1-2mm
C. Cavosurface angle in composites is >90 or obtuse bevel so dat more surface area of rods for
We need an uniform cavity depth in composite like we need in amalgam but there is an ideal
pulpal floor depth for different restorative materials n for composites it’s 1-2 mm

QUESTION: When doing a class 1 with composite what is the requirement?
Answer- contains only pit and fissure.

QUESTION: What determines composite class 2 prep?

QUESTION: prep shape for composite is determined by ?
Answer- extent of caries

QUESTION: When do you replace class 2 composite?
Answer- recurrent decay and marginal break

QUESTION: You are doing a composite slot on mesial and distal of 1st molar, dds decided to
connect by crossing the oblique ridge, why?
answer-when oblique ridge is less than 1.5mm you involve it

QUESTION: Restoration of class 2 for posterior with heavy occlusion ?

Microfilled resin

QUESTION: Class II prep into cementum, how should you restore?
Hybrid ,
Answer-open sandwich technique(The liner is completely covered with the restorative material.
In the open sandwich technique, RMGI is used to replace the dentin and also to fill the cervical
part of the box, which results in a substantial part of the glass ionomer cement being exposed to
the oral environment.)

QUESTION: What is the main problem with class 2 composite?
b) constructions of material
answer-Polymerization shrinkage and also poor interproximal contour

QUESTION: Small occlusal fillings need to be done on posterior, what do you use ?

QUESTION: Large MOD composite, what’s disadvantage?Answer-occlusal wear( low wear resisistance)

QUESTION: What is not a class I cavity preparation?
gingival 1/3 of #19,
Lingual pit of #7,
Lingual pit of #18
Answer-gingival ⅓ of#19

QUESTION: C factor in class 1 composites, which one is correct?
– less walls is lower C factor
–More walls, higher C Factorans

QUESTION: Which part of composite stains the most-?
gingival proximal,
facial proximal,
lingual proximal,
answer-gingivo/facial proximal

QUESTION: 2ndary caries is most likely at ?
Answer- gingival margin

QUESTION: how many mg of fluoride in 1 liter of water at 1 ppm : 1 mg

QUESTION: Patient has 1ppm fluoride in water-what is that equal to in mg/L?- 1mg/L = 1ppm

QUESTION: What ion is replaced to get hydroxyfluoroapatite? —HYDROXYL
Hydroxyapetite + Flouride ——> Flourapetite + Hydroxy The incorporation of fluoride into the
enamel hydroxyapatite crystal: Fluoride ions replace the hydroxyl radicals of the hydroxyapatite
crystals in the enamel, producing fluorapatite. This form of enamel is less soluble in catabolic
acids produced by oral bacteria.

QUESTION: Fluoride becomes fluoroapetite which is insoluable

QUESTION: ***Fluoride works in all these ways except: –Increases strength of collagen**
Fluoride BREAKSDOWN collagen, is bacteriocidal, fluoroapetite is more resistant to acid
attack, decreases solubility of enamel, excreted by kidneys, helps remineralize

QUESTION: Fluoride helps prevent caries in all ways except? I put lower pH of the oral cavity,
since it does not do that! Fluorapetite has a lower critical pH of 4.5

QUESTION: Flouride accumulated most- away from DEJ (surface of tooth)QUESTION: Where does fluoride localize? Outer enamel**

QUESTION: Fluoride spot makes enamel more resistant to future caries

QUESTION Fluoride does all the following, except? – Direct action on plaque

QUESTION What does floride do? Floroapitate that’s acid resistance.

QUESTION How do you determine the severity of fluorosis? Look at the two worst teeth?
Higher the fluoride level, greater degree of enamel change

QUESTION What conc of acidulated phosp fluoride is used in the dental office? 1.23%

QUESTION How many minutes do you place Neutral sodium fluoride tray on teeth? 4 minutes

QUESTION: Floride supplementation is effective in:
only kids,
anyone but most beneficial to children-answer

QUESTION: what age should fluoride supplements be started? 6 months

QUESTION:At what age does florousis of teeth anterior permanent teeth occur?- answer 4-6mo
(others 0-4mo, 1year, 2years and 6 years)

QUESTION: Fluoride – toxic dose 5-10 mg/kg

QUESTION: Usual water flouridation- 1.0 ppm

QUESTION: 1ppm for average fluoride in water (FYI in January of 2011 this statement was issued: “The Department of Health and Human Services today announced that it will revise the recommended levels for optimally fluoridating community water systems. Historically, the recommended optimal level for community water fluoridation has been 0.7 to 1.2 parts per million. The new recommended level is 0.7 ppm.”)

QUESTION: What is the EPA highest conc of natural fluoride in drinking water? 4 ppm

QUESTION: Maximum allowed fluoride in the water by EPA (environmental protection
agency)? 4.0mg/liter

QUESTION: Community fluoride: 0.2% / week in underprivelaged areas

QUESTION: How do they administer Fluoride in schools? 0.2% fluoride rinse 1X week.

QUESTION: What happens when a kid with primary teeth ingests fluoride?–It affects theirpermanent teeth.

QUESTION: Fluoride table, 5yrs old with .75ppm intake – Floridation supplement -0ppm

QUESTION: 4 yr old lives in community with .28 ppm: systemic fluoride supplement /
prescription / fluoride rinse
Ans- systemic fluoride supplement 0.50mg/day

QUESTION: 4 yo with .4ppm fluoride. Supplement? 0.25PPM or 0.25mg/L

QUESTION: 2 yr takes 20mg fluoride pill – coma, nausea, renal failure, cardiac arrest AnsNausea
Early symptoms of fluoride poisoning include gastrointestinal pain, nausea, vomiting, and headaches. The minimum dose that can produce these symptoms is estimated to be 0.1 to 0.3 mg/ kg of fluoride (i.e., 0.1 to 0.3 milligrams of fluoride for every kilogram of bodyweight). A child
weighing 10 kilograms, therefore, can suffer symptoms of acute toxicity by ingesting just 1 to 3 milligrams of fluoride in a single sitting.

QUESTION: 7 year old patient has no fluoride in drinking water. What do you give them systemically… 5 mg, 1 mg, .25 mg ans:1mg
6 months-3 year = 0.25mg 3 -6 years = 0.5mg 7–16y.o. = 1mg

doubtful QUESTION: IF PATIENT GETS 0.3-0.6mg from water then half supplement from

QUESTION: 4.5 years old child with .75ppm fluoride in their water req. how much fluoride
supplement? 0 mg.

QUESTION: The appropriate amount of fluoride in the community water/optimal range of
fluoride in water lies between

QUESTION: Supplementation for 10 year old with no other fluoride source? or 1 mg/day

QUESTION: 2.5 year old with 0.4 ppm fluoride in water… normally I would say rx nothing but
that wasn’t a choice – I put 0.25 mg supplement

QUESTION: The drinking water supply of a community has a natural F level of .6ppm. The F
level is raised by .4ppm. Tooth decay is expected to decrease by what % after 7 years?–
0.4/1 becoz 0.4+0.6=1 so 0.4/1 *100= 40%-explanationQUESTION: 3 year old patient lives in area with 0.4ppm fluoride. How much do you
supplement? 0.25 mg

QUESTION: 7 year old child living in area with .2 ppm fluoridated water-supplement 1.0 mg

QUESTION: what type of Fl in water: include fluorosilicic acid (hydrofluorosilicate) – most
commonly used, sodium fluorosilicate, and sodium fluoride

QUESTION: Types of Fluoride used in toothpaste:— sodium fluoride, Stannous fluoride (most
effective ), Sodium monofluorophosphate
Stannous fluoride has been shown to be more effective than sodium fluoride in reducing the
incidences of dental caries and controlling gingivitis. sodium monoflorophosphate and stanous
flouride is also used in tooth paste.. source=wikki

QUESTION: Which fluoride is not found in toothpaste? Acidulated fluoride

QUESTION: what toothpaste should not be used in a patient with multiple porcelain crowns?

QUESTION: What mouthwash is good for children with caries? NaF

QUESTION: What rinse is used at home for developmental disabled child to reduce of plaque:
2:stannous fluoride,
3: chlorhexidine ans-3

QUESTION: the usual metabolic path of ingested fluoride primarly involves urinary excretion
with remaining portion in skeletal tissue

QUESTION: where is the biggest store of fluoride in tissues? Skeletal tissues

QUESTION: Where does fluoride work the best?
A. interproximal**
B. Pit and fissure prr/sealant)** Ans-A

QUESTION: What is least likely to cause baby bottle caries?
a. Breast milk at night
b.Formula made with fluoridated water
c. water with no fluoride
d. juiceans-c

QUESTION: ECC which location?
a. Max incisors and molars?
b.Max incisor and molars?
c. Max canine
d.Man canine and molars?
Primary max incisors (B&L), then primary molars, mandibular unaffected becoz tongue blocks

QUESTION: Question about what determines fluoride supplementation for a city – temperature

QUESTION: percentage of fluoride water in US – 85% (should be about 65-70%)**ADA site
talks about percentage of people receiving fluoridated water.. couldn’t find percentage of
fluoridated water itself. Percentage went up from about 65% to 74%.

QUESTION: What is percentage of community water fluoridation- 67, 85, 35 ans-67

QUESTION: Fluoridation for water: effectiveness: early studies showed that it prevents 50%-70% of caries in permanent teeth, Howerver currently the effectiveness is 20%-40%

QUESTION: Fluoridation: daily use of tablet cause 30% reduction in new carious lesions

QUESTION: Fluoridation: know the primary/secondary/tertiary prevention differences.
Primary: aims to prevent the disease before it occurs. Health education, community fluoridated
water, sealants.
Secondary: Elimates or reduces disease after they occur. Composite filling
Tertiary prevention: Rehabilitates an individual in later stages to restore tissues after the failure
secondary prevention. Examples include dentures and crown and bridge.

QUESTION: Fluorosis does what – inhibits remineralization (irreversible)
, however fluoride induced enamel hypoplasia or hypocalcification which is characteristic of
fluorosis is caries resistant

QUESTION: Do certain fluorides stain? Stannous fluoride may stain.

QUESTION: Dentist places sodium fluoride on patient with GI fillings rather than acidulated
fluoride because – acid of fluoride will wear away at GI. TRUE

QUESTION: Applying Fluoride (APF) on GI cement what happens? A. dissolves it b. stains c. it
(decks says loos glace) roughens it Ans-c

QUESTION: Pt has veneers from 6-11, which fluoride do you use to not stain? A. Stannous
B. Sodium Flouride**
C. Acid Flouride ans-b

QUESTION: What fluoride tx used in a pt with amalgams, pfm’s , composite restorations,
implants? NaF
àmore profound= acidulated

QUESTION:Pt has fillings and full porc. Crowns, but has decalcification on class V? 1.1 % NaF

QUESTION: Caries in elderly, which one is not useful in managing: use of 1.1% fluoride as a
standard of care

QUESTION: what is her dental age based on xrays à advanced, chronological lags behind dental,
Tx for #D-TE, c. what to do with lesion on distal of #S (look incipient, resorbed)àapply fluoride
varnish every week, do DO comp or amalgam, observe and reassess next visit, disc the distal surface, d. both child and guardian should receive oral health instructions, oral health care should
include daily fluoride rinsesàboth statements are true.(didnt understand clearly)

QUESTION: Sealants- mechanical microretention binding to tooth

QUESTION:Contradiction of sealant: when you have rampant or gross caries

QUESTION: Patient has deep grooves but no decay on permanent molars, what do you suggest?
– Sealants

QUESTION: Ortho pt: has never had a restoration? Wut wud you do?àsealants, do nothing, etc.
Ans— do nothing

QUESTION: High caries risk patient, when is he indicated for sealants? Obvious clinical
cavitation on the occlusal,/deep fissures without caries
Ans: deep fissures without caries

QUESTION: pictures of molars in 16 y/o – does it need sealants, no treatment, Class I. Book
says do sealant age 6-12, so no treatment most likely unless caries visualized.

QUESTION :In home bleaching percentage – 10% carbamide

QUESTION: H2O2 – 35% used in in-office bleaching

QUESTION Material used for mouth guard vital bleaching:10% carbamide peroxide

QUESTION :home bleaching what causes : sensitivity

QUESTION:Most successful teeth for bleaching? Aged yellow staining

QUESTION:What is the most effective way of bleaching teeth? In-home vital bleaching.

QUESTION:Non vital bleaching is with? hydrogen peroxide 35%, carbamide peroxide, and
sodium perborate. Ans– sodium perborate.

QUESTION:Bleach most often used in internal bleaching: sodium perborate

QUESTION:Difference b/t dentist and home bleaching.. strength of peroxide

QUESTION:Bleaching tray at home? Make sure custom fitQUESTION:best way to decrease gingival irritation w/ home bleaching? well fitting trays

QUESTION:Bleach used to dissolve organic tissue

Purpose of bleach except- getting past foramen to treat bone
Vital bleaching Agents–>
(in office)– H2O2 [25-38%]
(At home)– H2O2 [3-7.5%] or Carbamide peroxide [10-30%]
Side effects– tooth sensitivity & gingival irritation
Diadv.– More expensive than non-vital bleaching..
Non-vital bleaching–>
Walking bleach– Sodium perborate mixed with water/H2O2 [3-30%] or
Carbamide peroxide [37%] is also used in non-vital bleaching…
Side effects– External cervical root resorption (more seen in thermocatalytic bleaching with
superoxol) &
Acute apical periodontitis (where endo-treated tooth is not properly obturated prior to bleaching)

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