BDS 2nd year Pre-Clinics

Exercise Topic
Exercise 4 Introduction to Operative Dentistry
Exercise 5 Dental Caries
Exercise 6 Hand instruments in operative dentistry
Exercise 7 Rotary Instruments in operative dentistry
Exercise 8 Fundamentals of tooth preparation
Exercise 9 Occlusal anatomy and landmarks of mandibular molar tooth
Exercise 10 Occlusal anatomy and landmarks of maxillary molar tooth
Exercise 11 Occlusal anatomy and landmarks of maxillary molar tooth
Exercise 12 Line angles and point angles of Class-I cavity in Pre-molar tooth
Exercise 13 Line angles and point angles of Class-I cavity in molar tooth
Exercise 14 Line angles and point angles of Class-II cavity in molar tooth
Exercise 15 Line angles and point angles of Class-V cavity
 Exercise 4: Introduction to Operative Dentistry

Operative Dentistry (Definition):

Sturdevant- “Operative dentistry is defined as science and art of dentistry which deals with diagnosis,
treatment and prognosis of defects of the teeth which do not require full coverage restorations for
correction. Such treatment should result in the restoration of proper form, function and esthetics
while maintaining the physiologic integrity of the teeth in harmonious relationship with the adjacent
hard and soft tissues, all of which should enhance the general health and welfare of the patient"

Gilmore-"Operative dentistry is that subject which includes diagnosis, prevention, and treatment of
defects of the natural teeth, both vital and nonvital, so as to preserve the natural dentition and
restore it to the best state of health, function and esthetics.

Scope of the Operative Dentistry:

• To know the condition of the affected tooth and other teeth

• To examine not only the affected tooth but also the oral and systemic health of the patient.

• To diagnose the dental problem and the interaction of problem area with other tissues.

• To provide optimal treatment plan to restore the tooth to return to health and function, and
increase the overall wellbeing of the patient.

• Thorough knowledge of dental materials which can be used to restore the affected areas.

• To understand the biological basis and function of the various tooth tissues.

• To maintain the pulp vitality and prevent occurrence of pulpal pathology.

• To have knowledge of dental anatomy and histology.

• To understand the effect of the operative procedures on the treatment of other disciplines.

• An understanding and appreciation for infection control to safeguard both the patient and the
dentist against disease transmission.
 Exercise 5: Dental Caries
Definition:

Dental caries is defined as a multifactorial, transmissible, infectious oral disease caused primarily
by the complex interaction of cariogenic oral flora (biofilm) with fermentable dietary
carbohydrates onthe tooth surface over time.

(Sturdevant) Dental caries is a preventable, chronic, and bioilm-mediated disease modulated by

diet. This multifactorial, oral disease is caused primarily by an imbalance of the oral flora (bioilm)
due to the presence of fermentable dietary carbohydrates on the tooth surface over time.

Etiology: Dental caries is a disease that is dependent on

the complex inter-relationships between thefollowing five
critical parameters:

i. Biofilm
ii. Tooth habitat
iii. Diet
iv. Saliva
v. Oral hygiene.
Modified Keyes-Jordan diagram: Factors influencing
Oral Habitats Responsible for Dental Caries: initiation, transmission and inhibition of dental caries.

• Enamel caries - S. mutans

• Dentin caries - S. mutans & Lactobacillus
• Root caries - Actinomyces

Types of Dental Caries

I) According to location of caries
II) According to extension caries
III) According to rate of caries

Classification

1. According to location of dental caries

a. Primary Caries
• Caries in pit and fissures
• Caries in smooth surface
o Backward caries
o Forward cries
o Residual caries
• Caries on root surface
b. Secondary Caries

2. According to extent of dental caries

a. Incipient / reversible caries
b. Cavitated / irreversible caries

3. According to rate of dental caries

a. Acute or Rampant caries
b. Chronic or Arrested caries
1) According to location of Dental Caries

a) Primary Caries – It is the original carious lesion of the tooth

❖ Pit and Fissure Caries

• This type of lesion occurs in the developmental pits and fissures of the teeth
(especially ifthese areas are deep, narrow and retentive in nature).
• The teeth and their specific areas or surfaces affected by the pit and fissure caries
include occlusal surfaces of molars and premolars, buccal and lingual surfaces of molars
and lingualsurfaces of maxillary incisors.
• The lesions usually appear brown or black, with little softening and opaqueness of the
surface.When the lesion is examined by a fine explorer tip, a “catch point” is often felt,
where the explorer tip catches the area.
• The lesions are smaller in the beginning but become wider as they spread towards the
dentindue to the typical orientation of the enamel rods.
• When the lesions reach the dentin-enamel-junction (DEJ), they spread laterally to
causeundermining of the enamel.
• The enamel directly bordering the pit or fissure may appear opaque and bluish-white
as itbecomes undermined.

❖ Smooth Surface Caries

• This type of carious lesion occurs in relation to the smooth surfaces of teeth, e.g.
proximalsurfaces or gingival areas of the buccal and lingual aspect of tooth.
• Smooth surface caries most commonly occurs in the proximal surface of the teeth
justbelow the contact point.
• The lesion beings as a well-demarcated, chalky-white opacity of enamel with no loss
ofcontinuity of the surface.
• The white spot lesion becomes pigmented yellow or brown and it often extends
buccallyand lingually.
• The surrounding enamel becomes bluish white as the lesion continues to progress.
• The surface of the affected enamel becomes rough and later on, there is formation
of acavity.

➢ Backward Caries
o These lesions also initially progress from enamel into the dentin, where they spread
▪ laterally and involve a wide area. Later on, these lesions proceed in a
backward directionfrom dentin back to enamel and affect the enamel
once again at a different location.

➢ Forward Caries
o When a carious lesion progresses unidirectionally from enamel into the dentin
and pulp, itis called a forward caries.

➢ Residual Caries
o Caries that remains in completed tooth preparation either by intention or by
accident iscalled residual caries.
 ❖ Caries of root surface
These are carious lesions, which involve the cemental wall of the exposed root surfaces of
teeth.Important features of root caries
• The development of such lesions is preceded by exposure of the roots of the
affectedteeth in the oral environment either due to aging or due to gingival
recession.
• Because of the roughness of the cemental wall, plaque accumulates readily in
the absenceof adequate oral hygiene measures and once the root caries begins it
progresses very fast.
• Cementum is invaded along the direction of ‘Sharpey’s fibers’ and microorganisms
spreadalong the incremental lines.
• Cementum is destroyed beneath the plaque over a wide area.
• The dentin is progressively destroyed by a combination of both
demineralization andproteolysis.
• Involvement of pulp occurs within a few days (mostly because of the softer nature
of thecementum and dentin).
• Clinically, these lesions are extensive, shallow and saucer-shaped, with ill-defined margins.
• The actinomycotic groups of organisms are mostly responsible for the causation of
root caries. However, S. mutans and Lactobacillus acidophilus, etc. may also be
associated withthis disease.
• Microradiograph reveals subsurface demineralization of the root, which extend
to thedentin. Surface remineralization is also seen in some areas.
• The lesions often have soft surfaces with brownish discoloration of the affected area.
• There may be formation of sclerotic dentin as the caries progresses into the
dentin fromcementum.
• Sometimes, the carious lesion may encircle the entire root of the affected tooth.

b) Secondary Caries
• It occurs at the junction of restoration and tooth, may progress under the restoration.
• It is also called recurrent caries

2) According to extent of dental caries

❖ Incipient Caries/ reversible caries

• Initial carious lesion limited to the enamel is called incipient caries and is characterized
by avirtually intact surface but a porous subsurface.
• This type of carious lesions are characterized by the presence of an intact enamel
surface, but there is destruction of the enamel below the surface layer which is called
“subsurface demineralization”.
• Clinically, incipient caries presents a “chalky-white” appearance of the tooth surfaceand it
is only found when the surface of the tooth is dry and the typical chalky-whitecondition
disappears if the surface of the tooth becomes wet.
• The incipient caries is a reversible process and the lesion can be cured due to
remineralization by salivary mineral ions.
• Incipient caries can be prevented by topical fluorides, which help to maintain theintegrity
of enamel undermined by dentinal caries.

❖ Cavitated or irreversible caries

• Here enamel surface is not intact but is cavitated and remineralization is not possible.
3) According to rate of dental caries
a) Acute Caries or Rampant
• This is an acute fulminating type of carious process, which is characterized by
simultaneous involvement of multiple number of teeth (may be all teeth) in multiple
surfaces.
• Rapid coronal destruction occurs within a short span of time, causing early involvement
of the pulp.
• The common age of occurrence of rampant caries is about 4 to 8 years for the
deciduous teeth and 11 to 19 years for the permanent teeth.
• Interestingly, the rampant caries can occur in persons with no previous history of dental
caries and in those persons who maintain a good level of oral hygiene regularly.
• Moreover, rampant caries attacks those surfaces of teeth, which are otherwise
considered immune to the disease.

b) Chronic or arrested caries

• It is a slow process and may or may not become progressive in nature or at times get
arrested.
 Exercise 6: Hand Instruments in Operative Dentistry

• Definition : It is hand-powered dental instruments.

• Most tooth preparation today is accomplished with rotary instruments, but hand cutting
instruments are still important for finishing many tooth preparations.
• Few preparations involving a proximal surface can be completed properly without the use of hand
cutting instruments.
• It is crucial that hand instruments used for cutting tooth structure or carving restorative materials
be sharp.

Materials Used for Manufacturing Cutting Instruments

Carbon Steel
• Carbon steel alloy contains 0.5 to 1.5 % carbon in iron.
• Instruments made from carbon steel are known for their hardness and sharpness.
• Disadvantages with these instruments are their susceptibility to corrosion and fracture.
• They are of two types:
1. Soft steel: It contains <0.5% carbon
2. Hard steel: It contains 0.5 - 1.5% carbon

Stainless Steel
• Stainless steel alloy contains 72 – 85 % iron, 15 – 25 % chromium and 1 - 2 % carbon.
• Instruments made from stainless steel remain shiny bright because of deposition of chromium
oxide layer on the surface of the metal which reduces the tendency to tarnish and corrosion.
• Disadvantages: They tend to lose their sharpness with repeated use, so they need to be
sharpened again and again.

Carbide Inserts
• To increase the durability of cutting edges, some instruments are made with carbide inserts.

Heat Treatments of Materials

Hardening Heat Treatment
• In this:
• Instrument is heated to 815°C in oxygen-free environment and then quenched in a
solution of oil.
• By hardening treatment, the alloy becomes brittle.
Tempering Heat Treatment
• In this:
• Instrument is heated at 176°C and then quenched in solutions of oil, acid or mercury.
• Tempering heat treatment is done to relieve the strain and increase the toughness of
alloy.
Design:
• Hand cutting instruments are composed of three parts: handle (or shaft), shank, and blade.
• Blade:
o The primary cutting edge of a cutting instrument is at the end of the blade (called the
working end, but the sides of the blade are usually beveled and also may be used for
cutting tooth structure
• Shank:
o The shank joins the blade to the handle of the instrument and is angled to keep the
working end of the blade within 2 to 3 mm of the axis of the handle.
 o This angulation is intended to provide balance, so that when force is exerted on the
instrument it is not as likely to rotate, which would decrease the effectiveness of the
blade and could possibly cause damage to the tooth or soft tissue.
• Handle:
o A variety of handle configurations are available.
o Padded handles are said to increase operator comfort and grip during use.
o Most metal handles today are round and have knurled areas for improved grip.
o The standard metal handle has a diameter of approximately ¼ inch (6.4 mm).
o Although little research support can be found, handles with larger diameters, such as the
¾-inch (U.5-mm) diameter handle are said to be more ergonomic and less likely to
contribute to the development of carpal tunnel syndrome.
o A handle with an intermediate diameter (⅝ inch or 7.U mm) is also available.
o The larger diameters are encouraged primarily for dental hygienists, who spend a large
part of their day using hand instruments.
o A drawback to the use of larger handles in operative dentistry is the space they consume
in an instrument tray.

Nomenclature:
• Most names Black assigned to cutting instruments were based on the appearance of the
instrument, such as hatchet, hoe, spoon, and chisel.
• For an instrument that did not have the appearance of a commonly used item, Black based the
name on the intended use (eg, gingival margin trimmer- GMT).

Chisel:
• A chisel has a blade that is either aligned with the handle, slightly angled or curved from the
long axis of the handle, with the working end at a right angle to the handle.

Straight chisel: with bevels on the Angled chisels:

sides of the blade, to give (A) Monoangle chisel;
secondary cutting edges, as well as (B) Binangled chisel;
on the end (primary cutting edge) (C) Wedelstaedt chisel
Hatchet:
• In a hatchet (also called an enamel hatchet), the blade and cutting edge are on a plane with the
long axis of the handle; the shank has one or more angles
• The face of the blade of the hatchet will be directed either to the left or the right in relation to
the handle, and the instrument is usually supplied in a double-ended form.
• Therefore, there are left-cutting and right-cutting ends of the double-ended hatchet.

Right Left
cutting cutting
hatchet hatchet

Enamel Hatchet

Hoe:
• A hoe has a cutting edge that is at a right angle to the handle, like that of a chisel. However, its
blade has a greater angle from the long axis of the handle than does the chisel; its shank also
has one or more angles.
• A general guideline for distinguishing between a hoe and a chisel will be given later in the
chapter.
• By definition, chisel is an instrument where the blade makes up to 12.5° angle with the plane of
the instrument, whereas in hoe, the blade is angled more than a 12.5° with the plane of the
instrument.

Monoangle hoe

Schematic representation of dental hoe Binangle hoe

Spoon Excavators:
• Spoon excavator is a modified hatchet.
• Like the hatchet, the spoon has a cutting edge at the end of its blade that is parallel to the
handle of the instrument; therefore, there are left-cutting and right-cutting spoons.
• It is a double-ended instrument with a spoon, claw, or disk-shaped blade.
• The blade of a spoon is curved, and the cutting edge at the end of the blade is in the form of a
semicircle, this gives the instrument an outer convexity and an inner concavity that make it look
somewhat like a spoon.
• The shank of some spoons holds a small circular, or disk-shaped, blade at its end, and the
cutting edge extends around the disk except for its junction with the shank; these are called
discoid spoons.
• Spoon excavator is used to:
• Remove caries and debris in the scooping motion from carious teeth.
• For carving amalgam restorations and wax patterns.

Spoon excavators:
(i) Regular spoon
shaped;
Spoon Excavators
(ii) Discoid spoon
shaped

Cleoid End

Discoid End
Gingival Marginal Trimmers (GMTs):
• A gingival margin trimmer is similar to an enamel hatchet, except that the blade is curved and
the bevel for the cutting edge at the end of the blade is always on the outside of the curve; the
face of the instrument is on the inside of the curve
• Gingival margin trimmers, like hatchets and spoons, come in pairs (left cutting and right
cutting), but there are also mesial gingival margin trimmers and distal gingival margin trimmers
• Thus, a set of gingival margin trimmers is composed of four instruments: left-cutting and right-
cutting mesial gingival margin trimmers and left-cutting and right-cutting distal gingival margin
trimmers. Because these are usually double-ended instruments, one instrument is a mesial
gingival margin trimmer (with left- and right-cutting ends), and the other is a distal gingival
margin trimmer (with left- and right-cutting ends).

Right cutting Left cutting

GMT GMT

Right & Left Side GMT (In pair) Use of GMT in Proximal Box wall
refinement
 Exercise 7: Rotary Instruments in Operative Dentistry

Micromotor handpiece Straight handpiece:

• In straight handpiece, long axis of bur lies in same plane as long axis of handpiece.
• This handpiece is commonly used in oral surgical and laboratory procedures
Contra-angle hand piece:
• Head of handpiece is first angled away from and then back towards the long axis of the
handle.
• Bur head lies close to long axis of the handle of handpiece which improve accessibility,
visibility and stability of handpiece while working.
Air-rotor contra-angle handpiece

Dental Burs
The word bur is useful for all the rotary cutting instruments having the bladed cutting heads used for
removing tooth structure either by the cutting action or by abrading. Dental burs are responsible for
revolutionizing dentistry, being used to cut hard tissues like bone, tooth. In the field of conservative
dentistry, there is the availability of a wide range of rotary instruments from the stainless-steel burs to
the tungsten carbide burs to the diamond abrasives, which are used on a dental drill having an air
turbine.
Classification:
1. Based on its mode for attachment in the handpiece:
a. The Latch types.
b. The friction grip types.

2. Based on its composition:

a. Stainless steel bur.
b. Tungsten carbide burs or
c. Combination of both.

3. Based on the motion of rotation:

a. Right Bur - one which will cut, on clockwise revolution.
b. Left Bur - one which will cut on anticlockwise revolution.

4. Based on the length of the bur head

a. Long
b. Short
c. Regular.

5. According to its application:

a. Cutting burs
b. Finishing burs
c. Polish burs.
 6. According to the shape of the bur:
a. Round,
b. Pear-shaped,
c. Inverted cone,
d. Wheel-shaped,
e. Tapering fissure
f. End cutting,
g. Straight fissure etc.

The dental bur has three parts: the head, the neck, and the shank.

Shank:
The shank is that part of the bur that fits into the handpiece, accepts the rotary movement from the
handpiece and controls the alignment and concentricity of the instrument.
The three commonly seen instrument shanks are:
1. Straight handpiece shank:
It is like a cylinder into which bur is held with a metal chuck which has different sizes
of shank diameter.

2. Latch type handpiece shank:

In this handpiece posterior portion of shank is made flat on one side so that end of bur
fits into D-shaped socket at bottom of bur tube.
In this, instrument is not retained in handpiece with chuck but with a latch which fits
into the grooves made in shank of bur.
These instruments are commonly used in contra-angle handpiece for finishing and
polishing procedures.
3. Friction grip handpiece shank.
This was introduced for high speed handpiece.
Here the shank is simple cylinder which is held in the handpiece by friction between
shank and metal chuck.
This design of shank is much smaller than latch type instruments.
 Straight Handpiece Type

Latch Type

Friction Grip Type

Neck:
The neck connects the shank to the hand
Main function of neck is to transmit rotational and translational forces to the head.
Neck connects head and shank.
It is tapered from shank to the head.
For optical visibility and efficiency of bur, dimensions of neck should be small but at the same
time it should not compromise the strength.

Head:
It is working part of the instrument.
Based upon their head characteristics, the instruments can be bladed or abrasive.
They can be made of steel and then coated with a hard coating, such as tungsten carbide
coating, or they can be entirely tungsten carbide or diamond coated.
Numerous shapes of burs are manufactured for various applications, cutting, and drilling
abilities.
Dental burs come in many shapes (round, inverted cone, pear shaped, straight fissure, tapered
fissure, etc.) and sizes designed for specific applications and can rotate at speeds of up to
500,000 revolutions per minute (rpm).
Bur head:
According to the shape of the bur:
a. Round,
b. Pear-shaped,
c. Inverted cone,
d. Wheel-shaped,
e. Tapering fissure
f. End cutting,
g. Straight fissure etc.

Round bur: Spherical in shape,

used for removal of caries, extension of the preparation and for the placement of retentive grooves.
Inverted cone bur: It has flat base and sides tapered towards shank. It is used for establishing
wall angulations and providing undercuts in tooth preparations.
Pear shaped bur: Here head is shaped like tapered cone with small end of cone directed
towards shank. It is used in class I tooth preparation for gold foil. A long length pear bur is used
for tooth preparation for amalgam.
Straight fissure bur: It is parallel sided cylindrical bur of different lengths and is used for
amalgam tooth preparations.
Tapering fissure bur: It is tapered sided cylindrical but sides tapering towards tip and is used
for inlay and crown preparations.
End cutting bur: It is used for carrying the preparation apically without axial reduction.
Bur head consists of uniformly spaced blades with concave areas in between them.
These concave depressed areas are called chip or flute spaces.
Bladed Burs:
The head contains the blades, which produce cutting action by rotary motion. The blades are
positioned at various degree angles in order to change the property of the bur.
Normally, a bur has 6, 8, or 10 numbers of blades

(The basic design of a six blades fissure bur)

Blade is a projection on the bur head which forms a cutting edge.

Blade has two surfaces:
• Blade face/Rake face: It is the surface of bur blade on the leading edge
• Clearance face: It is the surface of bur blade on the trailing edge.
Rake Angle:
➢ This is angle between the rake face and the radial line.
➢ Positive rake angle:
o When rake face trails the radial line
o Positive rake angle increases the cutting efficiency but since it reduces the
bulk of bur blade, it becomes prone to fracture.
o Positive rake angle also causes clogging of debris in the chip space
➢ Negative rake angle:
o When rake face is ahead of radial line
o Negative rake angle increases the life of bur by reducing fracture of cutting
edges.
➢ Zero rake angle: When rake face and radial line coincide each other.
Radial line: It is the line connecting center of the bur and the blade
Land: It is the plane surface immediately following the cutting edge
 Clearance angle: This is the angle between the clearance face and the work
o Significance: Clearance angle provides a stop to prevent the bur edge from digging into the tooth and
provides adequate chip space for clearing debris.
Blade angle: It is the angle between the rake face and the clearance face.
o Significance: Among these, rake angle is one of the most important feature of bur blade design.
The carbide burs have negative rake angles and 90° of blade angle so as to reduce their
chances of fracture.
For better clearance of debris, the clearance faces of carbide burs are made curved to provide
adequate flute space.

Abrasive instruments/ Diamond Burs:

William and Schroeder first made diamond dental bur
Modern diamond bur was introduced in 1932 by W H Drendel by bonding diamond points to
stainless steel shanks.
Diamond particles of < 25 um size are recommended for polishing procedures and > 100 um
are used for cavity preparation.
The head of these instruments consists of small angular particles of a hard substance held in a
matrix of softer material called as the binder.
Different materials used for a binder are ceramic, metal, rubber, shellac, etc.
Abrasive instruments can be divided into:
o Diamond abrasives
o Other abrasives.
They were introduced in 1942.
They have greater resistance to abrasion, lower heat generation and longer life to be preferred
over tungsten carbide
Diamonds have good cutting efficiency in removing enamel (brittle) while carbide burs cut
dentin (elastic material) with maximum efficiency.
Diamond instruments consist of three parts:
1. A metal blank.
2. Powdered diamond abrasive: Abrasive diamond can be natural or synthetic which is crushed
to a powder of desired particles.
3. The bonding agent: It serves the purpose of holding the abrasive particles together and
binding the particles to the metal blank. Most commonly used binding agents for diamond
instruments are ceramic and metal.
Diamond Grit Sizes:
Classification:
• Coarse grit diamonds burs (125-150 u particle size)
• Medium grit diamond burs (88-125 u particle size)
• Fine grit diamond burs (60-74 u particle size)
• Very fine grit diamond burs (38 44 u particle size).

Factors Influencing the Abrasive Efficiency and Effectiveness:

➢ Size of the abrasive particles: Abrasive nature is directly proportional to size of abrasive
particle. Rapid removal of material occurs with coarse grit burs compared to medium or
fine grit burs
➢ Shape of the abrasive particles: The abrasive particles with irregular shape show more
efficiency because they present a sharp edge
➢ Density of the abrasive particles: Coarse grit burs have a low density compared to fine grit
burs.
➢ Hardness of the abrasive particle: The hardness of the abrasive particles should be more
than the hardness of the surface on which it is to be used.
➢ Clogging of the abrasive surface: Clogging of the spaces between the particles by grinding
debris decreases efficiency.
➢ Pressure: Excessive pressure causes the loss of diamonds, thus, decrease their cutting
efficiency.

Finishing burs:
Finishing burs are usually made of stainless steel or tungsten carbide
Bur should be at least 12 fluted
The main function of finishing bur is to remove excess of restorative material rather than
cutting the surface.
These burs also make the surface smoother.
Burs are available in different shapes and sizes, i.e. tapered, inverted cone, rounded and pear-
shaped, etc.
Stainless steel burs:
➢ Stainless steel burs are designed for slow speed< 5000 rpm
➢ Usually a bur has eight blades with positive rake angle for active cutting of dentin.
➢ They are used for cutting soft carious dentin and finishing procedures.
Tungsten carbide burs:
➢ With the development of high speed handpieces, tungsten carbide burs were designed to withstand
heavy stresses and increase shelf life
➢ These burs work best beyond 3,00,000.
➢ These burs have six blades and negative rake angle to provide better support for cutting edge.
 Exercise 8: Fundamentals of Cavity Preparation
Definition: Tooth preparation is the mechanical alteration of a defective, injured or diseased tooth to
receive a restorative material that re-establishes a healthy state for the tooth, including esthetic
corrections where indicated and normal form and function.

Objectives:

1. Remove all defects and provide necessary protection to the pulp.

2. Extend the restoration as conservatively as possible.
3. Form the tooth preparation so that under the force of mastication the tooth or the
restoration or both will not fracture and the restoration will not be displaced.
4. Allow for the esthetic and functional placement of the restorative material.

Teminologies:

• TOOTH PREPARATION WALLS

➢ INTERNAL WALL- An internal wall is a prepared surface that does not extend to the
external tooth surface.
➢ AXIAL WALL- An axial wall is an internal wall parallel with the long axis of the tooth.
➢ PULPAL WALL- A pulpal wall is an internal wall that is perpendicular to the long axis of
the tooth and occlusal of the pulp.
➢ EXTERNAL WALL- An external wall is a prepared surface that extends to the external
tooth surface.
➢ FLOOR (SEAT)- A floor is a prepared wall that is reasonably flat and perpendicular to the
occlusal forces that are directed occluso-gingivally.
➢ ENAMEL WALL- The enamel wall is that portion of a prepared external wall consisting of
enamel.
➢ DENTINAL WALL- The dentinal wall is that portion of a prepared external wall consisting
of dentin, in which mechanical retention features may be located.
• DENTINOENAMEL JUNCTION- The DEJ is the junction of the enamel and dentin.
• CEMENTOENAMEL JUNCTION- The cementoenamel junction is the junction of the enamel
and cementum. It is also referred to as the cervical line.
• TOOTH PREPARATION ANGLES
➢ LINE ANGLE- A line angle is the junction of two planal surfaces of different orientation
along a line.
o An INTERNAL LINE ANGLE is a line angle whose apex points into the tooth.
o An EXTERNAL LINE ANGLE is a line angle whose apex points away from the tooth.
➢ POINT ANGLE- A point angle is the junction of three planal surfaces of different
orientation.
Cavity Design Line angles Point angles
Class-I 8 4
Class-II 11 6
MOD 14 8
Class-III 6 3
Class-IV 11 6
Class-V 8 4

Line angle and point angles for Class-I cavity

Line angles (8) Point angles (4)

MF- Mesio Facial MFP- Mesio Facio Pulpal
ML- Mesio Lingual MLP- Mesio Lingo Pulpal
DF- Disto Facial DFP- Disto Facio Pulpal
DL- Disto Lingual DLP- Disto Lingo Pulpal
FP- Facio Pulpal
FL- Facio Lingual
DP- Disto Pulpal
MP- Mesio Pulpal

Line angle and point angles for Class-II MO cavity

Line angles (11) Point angles (6)

DF- Disto Facial DFP- Disto Facio Pulpal
FP- Facio Pulpal AFP- Axio Facio Pulpal
AF- Axio Facial AFG- Axio Facio Gingival
FG- Facio Gingival ALG- Axio Lingo Gingival
AG- Axio Gingival ALP- Axio Lingo Pulpal
LG- Lingo Gingival DLP- Disto Lingo Pulpal
AL- Axio Lingual
AP- Axio Pulpal
LP- Lingo Pulpal
DL- Disto Lingual
Line angle and point angles for Class-III cavity

Line angles (6) Point angles (3)

I- Incisal AI- Axio Incisal
AL- Axio Lingual AFG- Axio Facio Gingival
LG- Lingo Gingival ALG- Axio Lingo Gingival
FG- Facio Gingival
AF- Axio Facial
AI- Axio Incisal

Line angle and point angles for Class-IV cavity

Line angles (11) Point angles (6)

MP- Mesio Palatal MFP- Mesio Facio Palatal
MF- Mesio Facial AFP- Axio Facio Palatal
FP- Facio Palatal AFG- Axio Facio Gingival
AF- Axio Facial ALG- Axio Lingo Gingival
FG- Facio Gingival ALP- Axio Lingo Gingival
LG- Lingo Gingival MLP- Mesio Linguo Palatal
AL- Axio Lingual
AP- Axio Palatal
LP- Lingo Palatal
ML- Misio Lingual

Line angle and point angles for Class-III cavity

Line angles (8) Point angles (4)

MI- Mesio Incisal AMI- Axio Mesio Incisal
MG- Mesio Gingival MIG- Mesio Inciso Gingival
AM- Axio Mesial ADI- Axio Disto Incisal
AI- Axio Incisal ADG- Axio Disto Gingival
DI- Disto Incisal
AD- Axio Distal
DG- Disto Gingival
AG- Axio Gingival
➢ CAVOSURFACE ANGLE AND CAVOSUFACE MARGIN-

o The cavosurface angle is the angle of tooth surface formed by the junction of a
prepared wall and the external surface of the tooth. The actual junction is
referred to as the cavosurface margin.

The proximal Cavosurface margins

prepeared at a 90° angle also
produces a 90° amalgam margin.
This is called a butt-joint form.
(Thus, in this area, there is an
equal amount of tooth and
amalgam material.