CLASS II CAST METAL

RESTORATIONS
INTRODUCTION
■ Cast restorations are versatile that
require meticulous care in both
clinical and lab procedures. Its
applications have become basic
treatment modalities in dentistry
both for strengthening and
maintaining the functional value of
the tooth structure.
 DEFINITIONS
■ The class II inlay is an intracoronal cast
metal restoration that involves the
occlusal and proximal surfaces of a
■ posterior tooth.
The partial onlay is a cast metal
restoration that involves the occlusal and
proximal surfaces of a posterior and
covers and restores at least one but not
all of the cusp tips of a posterior tooth.
■ The class II onlay is a cast metal
restoration that involves the occlusal
and proximal surfaces of a posterior tooth
Cast Metal Alloys
■ Cast metal restorations can be made from a
variety of casting alloys. Their high
compressive and tensile strengths are
especially valuable in restorations that rebuild
most or all of the occlusal surface. At present,
four distinct groups of alloys are in use for cast
■ restorations:
■ Traditional high-gold alloys (ADA specifi cation
■ No. 5) Low-gold alloy
■ Palladium–silver alloys.
Base metal alloys (most commonly used).
Indications
■ Large restoration
■ Endodontically treated teeth
■ Teeth at risk of fracture
■ Dental rehabilitation with cast metal
alloys
■ Diastema closure
■ Occlusal plane correction
■ RPD abutment
Contraindications
■ High caries rate
■ Young patients
■ Esthetics
■ Small
restorations
Advantages
■ Strength
■ Biocompatible
■ Low wear
■ Control of contours &
contacts
Disadvantages
■ Higher number of
appointments
■ Temporary
■ Cost
■ Technique sensitive
■ Splitting forces
Clinical steps in tooth preparation
of a class II inlay
I. Initial preparation
a. Occlusal step
■ Step 1 Orienting the bur
■ Step 2 Occlusal punch
cut
■ Step 3 Occlusal
extension
■ Step 4 Dovetail retention
■ Step 5 Occlusal outline
b. Proximal box
Step 1 Proximal ditch
preparation Step 2 Proximal
box preparation Step 3
Planing of the walls
Step 4 Placement of
retention grooves
Final preparation
a. Removal of infected carious
dentin and pulp protection
■ Step 1 Inspection
■ Step 2 Removal of infected caries
■ Step 3 Removal of old restorative
material
■ Step 4 Pulp protection with light
cure GIC
■ Step 5 Lining with calcium
b. Preparation of bevels and
flares Step 1 Preparation of
occlusal bevel
Step 2 Beveling the axio-pulpal line
angle Step 3 Preparing the secondary
lingual flare Step 4 Beveling the
gingival margin
Step 5 Preparing the secondary facial
flare
 BEVELS are the flexible extensions of a cavity
preparation, allowing the inclusions of the surface
defects, supplementary grooves & other areas on the
tooth surface.

Partial bevel Short bevel Long

bevel

Trim weak enamel With class I Preserves the

rods. alloys. internal boxed up
resistance &
Retention form.
 Full Counter Hollow ground
bevel bevel bevel
(concave)

Well reproduced by all Used for capping Allows more space for
Classes of cast cusps On the facial the Casting, better
materials. Deprives & lingual Walls. resistance to stresses.
the preparation’s Ideal for class IV, V.
Resistance &
retention form.
A diamond point(8862) or a finishing bur can
be used
 FUNCTIONS
■ They create obtuse angle (cavosurface margin), which is the
bulkiest and strongest configuration of any marginal tooth
anatomy – acute angled casting.
■ Marginal bevels reduce the error facts.
■ Hollow ground occlusal and counter bevel are used for the
resistance form of the tooth restoration complex at the
■ cuspal region.
■ Gingival bevel bring the gingival margin to
■ cleansable area. Are the major retention form for a
restoration.
Require only minimum tooth involvement & they do not
sacrifice the resistance & retention form of the restoration.
FLARES are bevels given on the facial and lingual &
proximal walls.

PRIMARY SECONDARY
 PRIMARY FLARE similar to long bevel placed
on the isthmus of facial or lingual walls of the
■ preparation.
■ They
May bealways have
a hollow 45o to bevel
ground the inner wall
if the proper.
preparation
is a non noble metal alloy.
■ They bring the facial and lingual wall in self
cleansable areas, if not a secondary flare must
be placed.
 SECONDARY FLARE is almost a flat
plane superimposed peripherally to a
primary flare.
■ It may be either prepared only in enamel or
with dentin (hollow ground).
■ A 2o superimposed flare placed at the correct
angulation can create the needed obtuse angle of
the marginal tooth
structur
e.

1o
2
o
■ This is done without any change in
resistance and retention form.
■ 2o flare placed on the 1o flare eliminate the
undercuts with minimal sacrifice to tooth
■ structure.
Also eliminate the surface defects or
decalcifications, facial or lingual to the
primary flare.
CIRCUMFERENTIAL TIE CONSTITUENTS
FOR ONLAYS - FINISH LINES
 CHAMFER

■ forclass I, II III cast materials

■ Bulk & definite termination of the
prep. with minimal tooth
involvement (0.5mm)
■ Can be placed gingivally &
subgingivally.
FEATHER EDGE
■ Margins are entirely in enamel.
■ Used only to accommodate a very castable –
burnishable type of alloy.
■ Located in accessible areas of tooth surface for
proper finishing.
■ Disadvantage of feather edge is the indefinite
termination of the casting.
 BEVELLED SHOULDER

■ Indicated when maximum bulk of cast is

needed in the margins.
■ When a definite gingival floor with all its
components is needed for retention &
■ resistance.
■ It blends easily with the beveled
subgingivall
constituents. Reduces maximum marginal
y.
defects, can be placed Can be used
with any type
of metal
 HOLLOW GROUND BEVEL

■ An exaggerated chamfer or a concave beveled

■ shoulder. Its termination is not as predictable to a
beveled shoulder, but it is superior to chamfer.
■ This bevel helps the casting to seat preferentially,
aids in stabilising the casting – ideal for class IV, V
cast materials.
 AUXILLARY RETENTION

■ Groove ■ Collar ■ Reciprocal

■ s
Reverse s ■ retention
■ bevel
Internal
■ ■ Skirts of cusps, ■
Capping Electrolytic
■ box marginal ridge etching Luting
■ External ■ Posts cements.
■ box Slot ■ Multiple levelling
Pins
■ Are contraindicated in case of the restoration
Impinging on the pulp chamber.
■ Prevent lateral displacement of the
restoration.

169L or
699
 REVERSE BEVEL

■ Placed at the expense of the gingival floor

creating an internal dentinal plane gingivally –
axially, locking the restoration & preventing
■ proximal displacement.
Prepared by using GMT if the gingival floor has
sufficient dimension to accommodate.

Indicated for class I,

II, III
 INTERNAL BOXES & SLOTS
■ Internal boxes are prepared in dentin with four
vertical walls joining a floor at definite line and
■ point angles.
Indicated in shallow cavities when occlusal
■ dovetail cannot be prepared.
Slots are internal boxes without any definite
wall or floor.

Placed at the periphery of the

margin closer to the marginal
slot
I. box ridge Contraindicated for class
IV, V
 EXTERNAL BOX

■ These are box shaped preparations opening to

axial tooth surface. They can be proximal,
■ facial or lingual. They can be either stepped
occlusally or gingivally.
 INLAY - CAVITY PREPARATION
■ Are the cast restorations that involve the
occlusal, proximal surfaces that may cap 1 or
more cusps but not all the cusps which
derive their support from the internal walls.
INLAY
INLAY
INLAY
 INDICATIONS
■ The cavity width does not exceed one third
the intercuspal distance.
■ Strong, self resistant cusps remain.
■ The tooth is an abutment for removable
■ prosthesis. Diastema closure and occlusal plane
■ correction.
Restoring endodontically treated tooth
 CAVITY DESIGNS
OUTLINE
1 – 1.5mm
From DEJ

1.5mm

Occlusa Proxim
l al

886 27 169
2 1 L
Location of
margins
PROXIMAL

■ In the self cleansable

■ areas. 1o flare ,if
necessary 2o flare
can be
superimposed to
with in the limits.
 Bevel
s
OCCLUSAL

■ Long bevel – 30o – 45o to the long axis of the crown.

■ Angulation as width
In steeper cusps, .
bevels are not
■ needed. For direct wax pattern – as more
bevel angulation bulk is needed. marginal
 GINGIVAL

■ Adds marginal bulk to the cast

restoration.
 INTERNAL
ANATOMY

■ Pulpal floor must be flat but in

1 -1.5mm cases it may have multiple
from DEJ
o –
o
4 ■ levelling.
2
All line angles of pulpal floor must
■ be definite except the axial wall –
rounded.
The axial wall my be flat or 5o to 10o
taper towards the pulpal wall.
CAVITY PREPARATION FOR CLASS II
INLAYS

■ The burs used for the cavity

preparation are carbide burs no.271
and no.l69L.
■ For preparing the cavosurface
bevels, the no.8862 flame-
shaped, finishing diamond point is
used.
Occlusal step
■

■ Startingthe occlusal step preparation with

no.271 bur.
■ Extend the preparation mesially and
provide adequate width for the
preparation.
■ Circumvent the cusps by gracefully
curving the facial and lingual walls of
the preparation around the cusps.
■ The facial and lingual extension in
the mesial pit region should provide
dovetail retention form to resist
distal displacement of the final
restoration.
Section of the tooth showingthe caries and
occlusal step preparation.Note that the bur is
held parallelto the long axis of the tooth
Establishing the initial depth of the
pulpal floor
■ The mesial marginal ridge should be
conserved.
Any shallow fissure on the mesial marginal
ridge should be included in the outline by
means of a cavosurface bevel
Extending the occlusal step distally
into the distal marginal ridge
Proximal box preparation

Proximal ditch cut using the no. 271 bur

The mesiodistal width of the ditch should be
0.8mm with approximately 2/3rds at the expense
of dentin (0.5mm) and l/3rd at the expense of
enamel (0.3mm).

Sectional view of proximal ditch cut. Note the gingival extension of the
proximal ditch cut is 0.5 mm beyond the gingival limit of contact and
caries
Extending the proximal ditch cut facially and
lingually beyond the caries
Bur emerging through the gingival limit of
contact

■ The ragged enamel edges at the proximal

surface may then be planed using an enamel
hatchet or a binangle chisel. The flame-shape
finishing diamond may also be used to
smoothen the enamel walls.
Removing remaining carious dentin and
pulp protection
■ A round bur at slow speed or a spoon
excavator may be used to remove the
remaining carious dentin.

Infected dentin present on axial wall after initial cavity preparation

 Calcium hydroxide liner and
glass ionomer base placed on the axial
wall after removal of remaining
infected dentin

Calcium
hydroxid
e Liner

Glass ionomer
cement
base
Placement of retention grooves

Facioaxial
groove

Linguoaxi
al groove
 Cross section of the tooth
showing the direction of translation
of the bur for placement of
retention grooves
 Preparation of bevels and flares
Placement of bevels using the flame-shaped diamond

■ Bevels are placed at the occlusal and gingival

cavosurface margin while the secondary flares are
placed on the distofacial and the distolingual walls.
■ They create a cavosurface angle of 140° -
150°
which produces strong enamel margins
and helps to seal and protect the
margins.
■ They also create a 30° - 40° marginal
metal which is most amenable to
burnishing.
■ There should be uninterrupted blending
of the occlusal bevels, secondary flares
and the gingivai bevel so as to prevent
open margins and leakage in the final
restoration.
■ The diamond instrument is also used to
slightly
bevel the axiopulpal line angle so as to
create a thicker and stronger wax
pattern at this critical area.

Proximal view of the completed cavity

preparation showing uninterrupted
blending of bevels and flares
 ONLAY - CAVITY DESIGNS

■ Are the cast restorations that involve the

proximal surfaces of the tooth that cap all
the cusps.
INDICATIONS
■ Cuspal protection is to be considered if the
lesion width is1/3 or ½ the intercuspal
■ distance.
Cuspal protection is mandatory, if the
■ width of the lesion exceeds ½ the
intercuspal distance.
In the tooth preparation, if the length :
■ width ratio of the cusps is more than 1:1 but
not exceeding 2:1, cuspal protection to be
considered.
if the length : width ratio is more than
2:1,cuspal protection is mandatory.
 CAVITY DESIGNS

Occlusa Proxim
l al
 Location of margins

■ Functional cusps ( capped side) must be located

far gingivally to be away from contact with the
opposing tooth surface.

1
mm
■ Gingivally , margins should include all facial or
lingual grooves, the retention & resistance of
the restoration.
F
F

NF NF
Prepared sections
 INTERNAL
ANATOMY
■ Wall proper - half of the vertical height of the
total wall, completely in dentin – 2o – 5o taper
with the pulpal floor.
■ Occlusal bevel – 1/3
of total wall height.
 Shoulder preparation
■ Prepared on the external surface of the centric cusp
to provide a band of metal to protect the tooth. The
bur is held parallel to the external surface of the
tooth and a shoulder about 1.0mm in height and
■ 1.0
The mm in axial depth
occlusoaxial is cut. are
line angles
rounded.

Each cusp is prepared

in Four planes.
■ The counter bevel is the extra coronal
feature that makes each cusps in four
planes.
Bucca Palata
l l
 Reverse 2o
flare
Skirt
SURFECE EXTENSIONS - ONLAY
Colla
r
INDICATIONS
■ Required to include facial or lingual defects
beyond the facial or lingual line angle of the
■ tooth.
■ Eradicate peripheral marginal undercuts.
To add to the retentive capability of the
■ restoration proximally.
To encompass an axial angle for
reinforcing and supporting reasons.
Reverse 20 flare – Partial bevel
■ Are added to the tooth due to the extreme
faciolingual width of the tooth or to due to the
■ rotation of the tooth. Ends on the facial or
lingual surface with a knife edge
■ finish line – should not exceed the height of
contour.
2o flare – only open the contact area. Reverse
2o flare provide obtuse angled marginal tooth
structure.
Skirts more extensive surface extensions than reverse
2o flare
■ Required to involve defects more
dimensionally than those that can be involved
■ in 2o flare.
To impart resistance & retention – missing or
■ shortened opposing facial lingual walls.
Allow sufficient casting to accommodate
■ without any sacrifice to facial or lingual walls.
Indicated in tilted teeth.
 Features
■ It includes a part of
the facial and lingual
surfaces near the
axial angle to a depth
of 0.5 to 2mm.it ends
with a chamfer or a
hollow ground bevel.
■ It should be
terminated in the
facial or lingual
groove.
 Most involving extension in
Collar surfacewise & Depth wise
s

Cuspa Toot
l h
Indicatio
ns
■ Help in retention & resistance when an entire
cusp is lost prior to tooth preparation.
■ Help in retention of shortened teeth.
■ Used in situations where pins are
■ contraindicated. Used for materials with
low castability.
■ With axial depth of
1.5mm to 2 mm, collar
surface extend
gingivally in a beveled
shoulder finishing line,
making it most
reproducible
extension.
Collars should have
less taper toward the
cavity
preparations than
skirts. This improves
retention in the
shortened tooth or cusp
preparations.
■ IMPRESSIONS FOR INLAYS AND ONLAYS
■ DIES

■ FABRICATION OF THE WAX PATTERN

Two methods :

■ Direct Method
■ Indirect Method
■ SPRUING THE WAX PATTERN
■ INVESTING THE WAX PATTERN
■ BURNOUT OF THE WAX PATTERN
■ CASTING THE ALLOY
■ CLEANING THE CASTING
■ TRIMMING THE CASTING AND
POLISHING THE RESTORATION
■ TRY-IN AND CEMENTATION OF THE CAST
RESTORATION
THANK
YOU