RESTO 082018
molars have flat surface so it’s not critical to
2 BASIC DESIGNS FOR OUTLINE FOR CLASS V
AMALGAM
1. Follow cervical line
- like a v-shape outline
2. Trapezoid outline
- Usually used in direct filling gold (24 karat
gold)
- Also called the Ferrier class V
- Gingival wall - the incisal in anterior
(occlusal in posterior), they are parallel to
the incisal or occlusal surface
- Modified Ferrier Class V
o you can modify gingival or cervical
wall for a more conservative
preparation unless the lesion is up
to the root area and to follow the
cervical line
- Walls:
o Gingival
o Distal
o Mesial
o Axial – do not communicate with the
external surface that’s why it’s an
internal wall
o Incisal or occlusal
 Internal wall not existing on class V: Pulpal wall
 Class III there’s a special nomenclature for line
and point angle
TECHNIQUE USED TO THE CONVEX AXIAL WALL
OF MANDIBULAR 1ST AND 2ND PREMOLAR:
 Using the edge of the 245 bur
- Hard to form a convex axial wall, you have
to parallel the axial wall to the external tooth
surface
- Ideally nakaparallel sa DEJ wall
- Same preparation depth with other class
0.5mm from the DEJ if you will be placing
undercut. If not, it’s on 0.2mm from the DEJ
- But usually u make undercuts in amalgam
tooth preparations. Unlike in composite, you
don’t need the mechanical retention form
because you’re using bonding system, you
etch or you prime.
Characteristic you can see:
- If you are using the 245 bur, you introduce
the edge of the bur or the flat end of the bur
because there’s a tendency for the bur to
crawl on the surface. That’s why they’re
using the sharp edge to prevent the crawling
of the bur.
- Unlike in mandibular premolars, maxilarry
make
- Critical to make a convex axial wall
compared to a flat tooth surface
Retention groove
- Gingivoaxial line angle
- Axioincisal or axioocclusal line angle
 Typically, the walls (mesial, distal. evenly
gingival), the incisal walls are diverging outwards
because they follow enamel rod direction
 The same depth for resistance
- s-curve
o To make a 90 degree angulation
with the external wall
o Purpose of 90 degree – Adequate
resistance
 When you deepen pulpal floor for adequate
depth, you want to have an adequate retention
 Retention- You don’t want the restorative
material to be dislodged
 Resistance – You don’t want the tooth and the
restorative material to be fractured
 You do not place undercuts on the mesial and
the distal wall because it will undermine the
mesial and distal wall just like in class I occlusal
prep
Minimum Depth at the root caries (range)
- 0.75-0.8mm
Alternatively, aside from retention groove (if you don’t
want to use retention groove) you can use retention
coves:
- Distoincisoaxial point angle
- Mesioincisoaxial point angle
- Mesiogingivoaxial point angle
- Distogingivoaxial point angle
 Slight convexity of axial wall paralleling the
external tooth surface for class V
 Try preparing a class V on a very curved
mandibular 1st premolar, you have the tendency
to make a very flat axial wall
- When you make a flat axial wall you don’t
have a uniform depth. Typically, very deep
at the center of prep but you don’t have
depth mesially and distally
 You can use hand cutting instrument to finish the
walls, line angles of the tooth prep for amalgam.
What specific hand cutting instrument?
 - Gingival margin trimmer o wet – if the tooth is dry, the shade of the
 What hand cutting instrument to bevel tooth will be darker(?)
gingival cavosurface margin?
- Gingival margin trimmer Class III tooth prep may also be:
- Simple
 When you are restoring a class II and a class V, - Compound
what you need to do first prepare and restore - Complex
first is the class II, why?
- di ko maintindihan maingay yung room SIMPLE CLASS III
- When you are condensing the wall……. - Easier to prepare if adjacent tooth is absent
(just like class II) but still you can still prep a
CLASS III TOOTH PREP simple class III if there’s an adjacent tooth
- Found in anterior teeth just like in Class V Walls:
Difference of Class III and Class IV - Labial
- Class III – does not involve the incisal angle - Gingival
- Class IV – it involve the incisal angle - Lingual
- But both are found in anterior teeth - Axial
- Doesn’t have incisal wall (according to
Class III lesion Sturdevant)
- If you have small Class III Lesion: Line angles:
o Lesion usually begins gingival to the - Linguoaxial
interproximal contact area - Labioaxial/Facioaxial
o It is gingival to the contact area - Faciogingival
o Because you seldom clean that area - Gingivoaxial
unless you use a dental floss - Gingivolingual
o Bacteria of your undisturbed plaque - Incisal (labiolingual)
will initiate caries formation just o A line angle that receives a special
gingival to the contact are nomenclature
o Doesn’t follow the general principle
 Due to cosmetic locations of these lesions, tooth in naming a line angle
colored restorative material are indicated. Point angles:
 Typically, amalgam is not the restorative - Linguogingivoaxial
material of choice because you are considering - Gingivofacioaxial
the esthetics - Incisoaxial (labiolinguoaxial)
 And usually, the tooth colored restorative o Special nomenclature
material usually used is composite resin
COMPOUND CLASS III
 Resto deals with type I and II fracture - May have a lingual access or labial access
o you need a radiograph first because - Presence incisal wall
there might be other fracture on the Walls:
other parts of the tooth or it has - Facial
damaged the supporting tissue - Lingual
 Type I - involve only enamel and small dentin o Usually wala
 Type II - considerable amount of dentin but not o But in class III it is acceptable. Even
pulp unsupported but not friable enamel
may stay in tooth prep. You don’t
 You have match the shade of the composite with necessary remove that because of
the tooth the prevention for extension for
 When you select the shade, it should be: minimal intervention dentistry
o before placement of rubber dam sheet - - Gingival
because if there’s rubber dam already - Axial
and it has different colors, it will affect - Incisal
the shade selection Carious lesion more on labial
- You can approach through labial
 - No labial wall but you will have the lingual cases of composite resin particularly when
wall the margins are located into root surfaces
and non-enamel areas
CLASS V COMPOSITE PREP 2. Beveled Conventional Preparation Design
- Same line angles, point angles and walls in - Similar to conventional prep
Class V amalgam - Box-like walls but with beveled cavosurface
- Bean or kidney shape margin
 Class IV - You bevel it because it is not subjected to
- Used in cast metal restoration (time nila doc heavy masticatory forces
Chny) o But in class I it is slightly subjected
o With pin channel with wax pattern to heavy masticatory forces so its
o But because of esthetics cast metal not suggested or advised by
restoration is not used anymore Sturdevant to bevel it but in some
- Have proximal segment and incisal segment journals and textbook, we might.
o Mesioincisal Preparation Walls: - Indicated:
 Distal o to the place existing restorations
 Labial with conventional preparation
 Lingual design where enamel margins are
 Pulpal present
o Proximal  All beveled enamel margins are acid etched to
 Labial facilitate better marginal filling and angle
 Lingual  Cavosurface margin is not a routine procedure
 Gingival to bevel
 Axial  Axiopulpal wall a routine procedure to bevel
o Point angles  Compound class II
 At the junction of incisal - On the cervical 3rd of an adult tooth, gingival
segment and proximal cavosurface margin is beveled
segment
 Labiopulpoaxial Combination conventional and beveled convention
 Linguopulpoaxial preparation design of Class III
 Incisal segment: Lesion
 Distolingoupulpal - Partly on the coronal and partly root area
 Distolabiopulpal - Coronal
 Proximal segment o Because there is enamel you bevel
 Labiogingivoaxial the cavosurface margin
 Linguogingivoaxial - Cervical
o Dentin is covered by cementum
PREPARATION DESIGNS FOR CLASS III, IV AND V there is no enamel to be beveled so
1. Conventional Preparation Design butt joint conventional preparation
- Butt joint 3. Modified Preparation design
- 90 degrees - No specified cavity wall configuration or
- Marginal configuration pulpal depth (no definite pulpal depth)
- You applied conventional in amalgam - No margin and it appears scooped out
 In composite, any of these preparation design - Retention relies on etched enamel
depending whether the composite is subjected - Conserves more tooth structure because
to heavy masticatory forces you do not bevel only areas with caries are removed
cavosurface margin (according to pareng - Indicated:
Sturdevant) o for small, new, cavitated carious
Presence of Retention grooves, coves, and lesion surrounded by enamel
undercuts on dentin o for correcting enamel defect
- No. ¼ round bur for placing the undercut - Preparation not necessary in dentin
Indication:
- It is used for brittle material like silicate
cements, porcelain, amalgam and some
Indications (you do the class III, IV, and V):
1. If restorations are in the esthetic prominent
areas. Areas can be adequately isolated and
the tooth preparation have all enamel
margins
o Ideal if there’s a presence of enamel
margin so you can bevel, after
beveling you acid etch. You
increase the surface area to be
bonded with bonding agent.
 Resin cuts in the form of
retention micromechanical
bonding composite resin
Contraindications:
1. An operating area that cannot be adequately
isolated
o Amalgams are more forgiving than
composite
o If composite is below the non-tissue,
you cannot control the moisture.
You cannot have a successful
composite resin restoration
o One of the major contraindications
in composite restoration
2. Class V restoration that are not esthetically
critical
o Sometimes you do amalgam on
posterior teeth if that is not an area
where esthetic is of concern
3. Restorations that extend up to the root
surface
o Because you produce contraction
gap (Because root surface doesn’t
have enamel (where retention is),
there is no good micromechanical
retention)
o Since composite has polymerization
shrinkage during setting, you
produce a microcontraction gap
o Solution: you place first a glass
ionomer cement because glass
ionomer cement it simply adheres to
the tooth tissue. After placement of
GI, you place your composite on
root area to minimize the
microcontraction gap.

Advantages of composite:
- Esthetics
- Conservative tooth structure removal
- Less complex when preparing the tooth
- No thermal conductivity
-