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Cavity Preparation 2

Teeth cavity preparation for dentist

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Najwan Adil
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18 views39 pages

Cavity Preparation 2

Teeth cavity preparation for dentist

Uploaded by

Najwan Adil
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPSX, PDF, TXT or read online on Scribd
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Class III & IV

Cavity Preparation

Dr. Abeer Abdelmoneim


Class III Caries
Class IV Caries
Review of the Steps in
Cavity Preparation
AMALGAM

G.V. Black’s Seven Steps


• Establish Outline Form
• Obtain Resistance Form
• Obtain Retention Form
• Obtain Convenience Form
• Remove Remaining Caries
Conventional
• Finish Walls and Margins
Classification
• Cleansing of cavity
Material Selection For Class III & IV
Amalgam VS Composite
Advantages of Composite Disadvantages of
vs. amalgam Composite Vs amalgam

 Conservation of tooth  Cost


structure - overall a stronger  Extremely technique
restored tooth sensitive
 More esthetic  Durability
• Because Classes III and IV restorations
involve only anterior teeth, an esthetic material
such as composite is indicated almost always
Types of Cavity Preparation For
Composite Resins

1. Conventional.

2. Beveled conventional.

3. Modified.
Clinical Technique for Direct
Class III&IV Composite
Restorations
Initial Clinical Procedures
(1)Anesthesia
(2) Occlusal assessments
(3) The shade must be selected before the tooth
dehydrates and experiences lightening.
Initial Clinical Procedures
(4) The area must be isolated to permit effective
bonding.

(5) If the restoration will be large (including all of


the proximal contact),
prewedging the area will assist
in the reestablishment of the
proximal contact with
composite.
Tooth preparation
• Because the bond of composite to enamel and dentin is so
strong, most Class III & IV composite restorations are
retained only by the micromechanical bond from acid-
etching and resin bonding, so no additional preparation
retention form is usually necessary.

• Using diamond stones for the tooth preparation leaves the


prepared surfaces rougher,
thereby increasing the surface area
and the micromechanical retention.
Tooth preparation
• When a proximal surface of an anterior tooth
is to be restored and there is a choice between
facial or lingual entry into the tooth, the
lingual approach is preferable.
Lingual approach Facial approach

The facial enamel is .1 1. The carious lesion is


conserved for enhanced positioned facially .
.esthetics 2. The teeth are irregularly
Some unsupported, but not .2 aligned, making lingual
friable, enamel may access undesirable.
be left on the facial wall of a 3. An extensive carious lesion
Class III or Class IV extends onto the facial
.preparation surface.
Color matching of the .3 4. A faulty restoration that
.composite is not as critical originally was placed from
Discoloration or deterioration .4 the facial approach needs to be
of the restoration is replaced.
.less visible
Conventional
Typical to amalgam design with: uniform depth,
.flat floors, butt joint and retention grooves

:Indications
Large cavities, which extended to the root
surfaces
Beveled conventional
• Similar to the conventional design but with
beveled enamel margins .
:Indications
When composite resin is used to replace -1
an existing restoration with conventional
.design
.Large class III & IV -2
Beveled conventional
• Unless necessary do not:
(1)Include the proximal contact area
(2) Extend onto the facial surface,
(3) Extend subgingivally.
1.25
0.75
Beveled conventional
• The tooth preparation takes the shape of the
existing restoration along with any extensions
necessary to include recurrent caries, friable tooth
structure, or defects.
• Any extensions required may be prepared with a
modified tooth preparation design
Beveled conventional
• If part of the tooth to be restored is located on
the root surface, a combination of two tooth
preparation designs should be prepared, a
conventional type in the root portion, and a
beveled conventional type in the crown
portion.
Beveled conventional
• The retention form maybe be enhanced by
placing groove (at gingivoaxial) and/or cove
(at incisioaxial) angles in addition to the
bonded tooth structure.
Beveled conventional
• The cavosurface bevel or flare is best prepared with
either a flame shaped or a round diamond
instrument, resulting in an angle approximately 45
degrees to the external tooth surface.

• A bevel width of
0.25 to 0.5 mm is
considered sufficient.
Modified Cavity Preparation
It is a “ scooped out” appearance cavity, i.e.
without definite line angles or retentive features.

Indications:
Indicated for small and
moderate lesions or
faults and is designed
to be as conservative as possible.
Modified Cavity Preparation
Preparation features
• Preparation design is dictated by the extent of
the fault or defect

• No effort is made to produce preparation walls


that have specific shapes or forms
Class V
Composite Restoration
Class V tooth prep. are
located in the gingival 1/3
of the facial & lingual
tooth surfaces
What are the causes for cervical caries
?formation
• Due to ↑ caries inducing diet & the existing
tooth surface is unclean.
• Gingival recesion ( dentine is more suceptibale
to caries than enamel)
• Pt with salivary flow . (medical conditions,
drugs, head &neck radiation therapy)
Class V might be clinically challenging
• This is due to:
1. Location and extension of caries.
2. Limited access and visibility.
3. Might be difficult to isolate.
What is the best type of composite to be
?used in a class V cavity
• Microfilled composites are best used for class
V due to:-
1. Increased restoration smoothness.
2. Restoration flexibility under cervical flexure.
Tooth preparation For class V composite

Conventional Conventional bevelled Modified


Conventional class V tooth prep .1
Indications:
• For defective /carious lesion entirely on the
facial or lingual root surface of the tooth.
Features
1. 90 cavo surface angle
2. Uniform depth of the axial line angles
3. Axial depth 0.75mm
4.Groove retention (incisal, gingival grooves)
Beveled conventional class V .2
• Indication
1.Replacment of an existing Cl V restoration that initially used
a conventional prep
2.Large new carious lesion.
Features:
1. A beveled 90 cavosurface margin.
2. The axial depth into dentine is only 0.2 if there is no need for
grooves, 0.5mm if grooves are nessecary and margins are still
in enamel.
3. Large prep(root)→ beveled conventional &
a conventional
.Modified Class V tooth prep.3
• Indication:
• Small- moderate class
V entirely in enamel
including decalcified/
hypolastic area in
Features:
cervical 1/3
1. No effort to prepare walls
as butt joints
• Objective: To restore 2. No groove retention
as conservative as 3. Walls are usually
possible divergent & axial surface
is not uniform in depth
Thank You

39

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