G.V.

G.V. BLACKS
BLACKS
CLASSIFICATION
CLASSIFICATION
AND
AND CLASS
CLASS II CAVITY
CAVITY
PREPARATION
PREPARATION
Presented By:
Prakash Subedi

DEFINITION OF CAVITY PREPARATION

Cavity preparation is the mechanical alternation of

defective, injured or diseased tooth in order to best
receive a restorative material that will reestablish a
healthy state for the tooth including esthetic
correction when indicated, along with normal form
and function.
The procedure of the preparing the tooth is the
removal of the defective tooth structure.
Any remaining infected tooth structure may result
of further carious progression, sensitivity or pain or
fracture of the tooth and / restoration.

OBJECTIVES OF CAVITY PREPARATION

To remove all defects and provide necessary

protection to the pulp,
To extend the restoration as conservatively
as possible,
To 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, and
To allow for the esthetic and functional
placement of a restorative material.

PRINCIPLES OF CAVITY PREPARATION

Gain access to caries.

Removal of all carious lesions.
Cut away all significantly unsupported
enamel.
Extended margins so that they are
accessible for instrumentation and
cleaning.

G.V. BLACKS
CLASSIFICATION OF
CAVITY PREPARATION

Greene

The man of the centuries

Father of Modern Dentistry
Raised dentistry froma
trade to a professionand
made it what it is today

Class I: All pit and fissure cavity preparation

are class I and they are assigned to the
three groups as follows
Cavity preparation on occlusal surface of
premolars and molars.

Cavity preparation on occlusal two thirds of

facial and lingual surfaces of molars.

Cavity preparation on palatal surface of

maxillary incisors

Class II : Cavity preparation on the

proximal surface of posteriors involving 2 or
more surfaces (i.e. MO, DO, MOD)

Class III : Cavity preparation on the

proximal surfaces of anterior teeth that do
not involve the incisal angle (i.e. MB, ML,
DB, DL)

Class IV : Cavity preparation on the

proximal surfaces of anterior teeth that do
involve the incisal angle (i.e. MIB, DIB,MIBL)

Class V : Cavity preparation on the gingival

third of the facial or lingual surfaces of all
teeth (except pit-and-fissure lesions).

Class VI : Cavity preparation on the incisal

edge of anterior teeth or the occlusal cusp
heights of posterior teeth.

Class VII : Cavity preparation on the labial

surface of the anterior teeth

CLASS I CAVITY
PREPARATION

STEPS IN THE CAVITY

Initial tooth preparation:
PREPARATION
Obtaining Outline Form & initial depth
Obtaining Primary Resistance Form
Obtaining Primary Retention Form
Obtaining Convenience Form
Final tooth preparation
Removal of any remaining enamel pit or
fissure, infected dentin, and/or old
restorative material, if indicated
Pulp protection, if indicated
Secondary Resistance & Retention forms
Procedures for finishing the external walls
of the tooth preparation
Final procedures: cleaning, inspecting &
sealing

CLASS I CAVITY could be

Simple Occlusal cavity
Compound class I cavity (2 surfaces):
Occluso-buccal cavity
Occluso-lingual or palatal cavity
Complex class I cavity (more than 2
surfaces):
Occluso-bucco-lingual cavity
Buccal or lingual pit
Palatal pit in maxillary incisor

BASIC PRINCIPLES OF
CAVITY PREPARATION

Class

Outline form:

The outline form of a class I cavity should

describe a symmetrical design running
along all pits, fissures, and angular
grooves between the cusps and with a
minimum width.

OUTLINE FORM
Smooth flowing,
regular curves.
No Sharp angles

Angular irregularities in
the outline are
susceptible to fracture
during condensation a
smooth flowing outline is
easier to visualize and
carve following
condensation.

In case of initial carious lesions, access is obtained

by employing a small round bur (by giving a punch
cut).
In big carious lesions, access is obtained easily by
breaking down the undermined enamel overlying the
carious dentin, using a suitable size chisel.
In either case, access is started at the most
defective area of enamel, i.e., a carious pit or
fissure.

Enameloplasty done on terminal ends of shallow

fissures to conserve tooth structure.
procedure of reshaping the enamel surface with suitable rotary
cutting instruments is termed enameloplasty.
If one-third or less of the enamel depth is involved, the fissure
may be removed by enameloplasty without preparing or extending
the tooth preparation

Resistance form:
provided by:
Sufficient area or areas of relatively flat pulpal
floor in sound tooth structure to resist forces
directed in the long axis of the tooth and
provide a strong, stable seat for the restoration
Minimal extension of external walls, which
reduces weakening the tooth
Strong, ideal enamel margins
Sufficient depth (i.e., 1.5 mm) to result in
adequate thickness of the restoration, providing
resistance to fracture and wear

EXTENSIONS (Extension for Prevention)

Conservation of tooth structure is the basis for
all cavity preparations in order to preserve the
strength of the tooth.
However, sufficient extension of cavity
preparations is necessary to ensure access
(convenience form) for instrumentation, removal
of defective tooth structure, insertion and
finish of the restorative material, and
maintenance of the restoration (prevention).

The bur is held at a right angle to

the involved surface of the tooth
with light pressure and in-and-out
direction is exerted. Cutting is
continued until the Dentinoenamel
Junction is reached.

Long axis of
the tooth

WRONG!

Long axis of
the crown

CORRECT!

Extensions consist of:

a.

Caries and
decalcifications

b. Enamel unsupported by
sound dentin
c. Pits
d. Major fissures and
grooves
e. Existing restorations
f. Joining two outlines that
come close together (i.e.,
less than 0.5 mm apart)

eliminates defective
tooth structure and
eliminates areas (pits,
fissures, etc.) which are
susceptible to recurrent
caries and facilities oral
hygiene procedures.

Bucco lingual extension

1. Extend fully in areas of
buccal and lingual grooves
to terminate on smooth
surfaces.

to allow a smooth
tooth-restoration
margin to be created
(easier to finish and
keep clean).

2. Extend minimally in
areas of triangular
ridges (optimal isthmus
width is intercuspal
distance or less)
terminating on smooth
surfaces.

to preserve the
strength and function
of the cusps while
eliminating susceptible
grooves or defective
tooth structure (must
be wide enough to allow
condensation).

Isthmus just wide enough to accept

instrumentation (Diameter of bur
should be considered)
1/4 th intercuspal
distance

Not more than 1 1.5 mm

In a bucco-lingual direction, the cavity is

extended just sufficient to eliminate the
defective and susceptible tissues.
The lingual and the buccal wall should be
parallel to the respective tooth surface.

Mesio-distal extension
1. Marginal ridge walls
should be 1/2 distance
from mesial and distal
pit to the crest of each
marginal.

to preserve strength of
marginal ridges.

3. Parallel to the contour

of the marginal ridge

to preserve a uniform
bulk (strength) to the
mariginal ridges.

2. Groove extensions are

kept narrow (mesiodistally) where possible
terminating on smooth
tooth structure.

to preserve strength of
cusps while eliminating
susceptible grooves
and/or defective tooth
structure (must be at
least as wide as the
narrowest condenser).

4. If marginal ridge is
unsupported or very
thin (less than 1.6mm)
it should be included,
resulting in a Class II
preparation.

If not included the

marginal ridge may
fracture. (amalgam will
be stronger than the
unsupported enamel)

RESISTANCE AND RETENTION FORM

A. Depth = 0.1-0.2mm
into dentin.
Depth of prepared
external walls is 1.5 2
mm.

Minimum depth is
required to provide
sufficient bulk to
prevent fracture and
retain the amalgam.

B. Pulpal floor
1. Smooth and flat

Uniform thickness of
restorative material.

2. Parallel to the
occlusal plane

resists occlusal stress

and forces of
condensation.

Pulpal floor mesio-distally is flat and

perpendicular to the long axis

C. Buccal and lingual walls

1. Smooth and curved
mesio-distally.
2. Smooth and straight
pulpo-occlusally.

Facilitates adaptation
of amalgam and
elimination of weak
tooth structure.

3. Converge slightly
pulpo-occlusally.

4.Diverge slightly
pulpo-occlusally in
buccal and lingual
groove extensions
(60).

To provide mechanical
lock or retention to the
occlusal portion and
create bulk at the
margins.
protects buccal and
lingual surfaces from
being undermined
(RESISTANCE FORM).

Cavosurface angle of 90
100are ideal.
Marginal
amalgam
angle

If less than 90 , unsupported

ennalmel rods may remain
which are liable to fracture
If more, creates an acute
amalgam margin that has
tendency to fracture

D. Mesial and distal wall

1. Smooth and straight

facilitates adaptation
of amalgam and
elimination of weak
tooth structure.

2. Diverges slightly
pulpo-occlusally
(forms an obtuse
angle with pulpal
floor; not more than
10).

protects marginal ridge

from being undermined or
weakened (enamel must
be supported by dentin)

Removal of remaining
Carious Dentin

In small size cavities, the carious dentin should

have been removed during making the cavity

extensions.
In moderately deep and deep cavities, the
carious dentin is peeled off carefully at the
sides using large spoon excavators.
Only light pressure in a direction parallel to
that of the pulp is utilized. This is continued
until a sound dentin floor is reached.
Only defective areas are removed leaving round
depressed areas in the wall.
The level or position of entire wall shouldnt be
altered

Planning of Enamel
Walls
The enamel walls of the cavity should be

finished free from any loose, short, or

undermined enamel, and trimmed to meet the
tooth surface at a right cavo-surface angle.
This may be done by sharp and regular edged
chisels and hatchets, plane fissure burs, stones,
or sand-paper discs.
All sharp corners in enamel must be rounded, as
they may contain short enamel rods.

CAVITY FINISH
A. Pulpo-occlusal line
angle is well defined
(no point angles are
present) and follows
general
configuration of
cavosurface outline.

increases retention of the

amalgam restoration and
preparation is more easily
visualized.

B. Cavosurface margins
1. Sharp (well defined)

easier to visualize and

carve.

2. Sound (well supported)

provides marginal
integrity.

C. Cleanliness cavity
is free of debris
and moisture.

facilitates adaptation of
amalgam to the cavity and
improves the physical
properties of the
restoration by elimination of
void or foreign material.

A sharp explorer
is then used to
check the details
of the prepared
cavity
and
to
loosen the tooth
debris which are
then blasted out
with warm air.

Buccal and Lingual

Extensions
In case of occluso-buccal

and occluso-lingual cavities

extensions are made through
the fissures and towards the
respective surfaces.
The cutting is done in dentin
at
the
dentinoenamel
junction using a bur until the
occlusal ridge is undermined
and removed.

After preparing occlusal cavity:

Bur is held perpendicular to the pulpal
floor & parallel to the long axis of the tooth
crown.
Moved towards the buccal/lingual direction
along the fissure maintaining uniform depth
until the bur reaches the buccal / lingual
surface

Resistance form:
Keep

the bur parallel to the

buccal/ lingual surface of the
corresponding groove so that
the axial wall will follow the
contour of the buccal / lingual
surface at a uniform depth of
0.5mm inside the DEJ (0.2mm
is permissible)

Resistance form:
Extend the lingual box gingivally
to
terminate
at
the
buccal/lingual groove creating a
flat gingival seat for resistance.
Gingival wall meets the tooth
surface at 90 & the axial wall
makes an obtuse angle with the
pulpal floor
Axiopulpal line angle is rounded

Retention form:
Mesial

& distal walls of the B/L

BOX are made parallel to each
other with slight occlusal
convergence.
Retentive grooves are then made
in dentin along the axio-mesial
and axio-distal line angles.
The cavity walls and margins are finished as previously
described.

Buccal Pit/ Palatal pit

Cavities

The outline of these cavities usually

describes a triangle with its base facing
the gingival wall and its sides forming the
mesial and distal walls.

All walls are extended just enough to

eliminate defective enamel and dentin.

The enamel walls are planed in the

direction
of
enamel
rods
perpendicular to the axial wall.

and

Axial wall follows the contour of the

buccal / lingual surface.

Hoe excavators are used to smooth the axial wall and

make it parallel with the external surface of the

tooth.

It should be re-emphasize that the shape of the

cavity will be governed by the extension of caries,

accordingly the outline of these cavities may be a
rounded or oval in shape.