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PREPARATION
Restoration replacement
Factors affecting tooth preparation
1. General Factors
Pulpal & periodontal status
Occlusal relationship
2.Dental anatomy
Direction of enamel rods
Thichness of enamel /dentin
Size and positionof pulp
Relationship of tooth to its supporting tissues
3.Patient factors
Age
Esthetic consideration
Economic status
Patients with high risk caries
Cavity preparation
Matrix application
Preparation of materials
Insertion and carving of materials
Finishing and Polishing
Cavity Preparation
walls
angles
Floor
Classification of cavity
Class I
Class II
Class III
Class IV
Class V
Class VI
—G.V.Black in 1908
Cavity
Class 6
Class 1 Class 4
Class 2 Class 3
Class 2 Class 5
Stages and Steps in Cavity
preparation
Definition:
placing the cavity margins in the positions
they will occupy in the final preparation.
Principles:
all friable and/or weakened enamel should be
removed
all faults should be included
all margins should be placed in a position to
afford good finishing of
the margins of the restoration.
Margins of the preparation will be located on
finishable, self –cleansing area.
Outline Form and Initial Depth
Features:
preserving cuspal strength
preserving marginal ridge strength
minimizing facio-lingual extension
using enameloplasty
connecting two close faults or cavities
restricting the depth of the preparation into
dentin.
Auxillary Factors
Conservation
Adjacent enamel cracks or decalcification could
be involved in the preparation.
Type of restorative material.
Extension for access.
anatomy and alignment.
If possible, no margins will be in occlusion with
opposing teeth.
Esthetics
Outline Form and Initial Depth for pit and fissure
cavities
Extension of cavity.
Sufficient access.
Depth.
Sufficient clearance with adjacent tooth.
Initial cavity preparation stage
Principles:
To utilize the box shape with a relatively flat floor to
resist occlusal loading by virtue of being at right angles
to mastication force.
To restrict the extension of the external walls (keep as
small as possible) to allow strong cusp and ridge areas
to remain with sufficient dentin support.
Primary Resistance Form
Principles:
To have a slight rounding of internal line angles to
reduce stress concentration in tooth structure;
The presence of sharp internal line angles in
GOLD FOIL resist the movement of the
restoration
Sharp internal line and point angles in dentin
serve as convenient “starting” points for
compacting of direct gold.
To provide enough thickness of restorative
material to prevent its fracture under load.
Primary Resistance Form
Feature:
Box shape
Relatively flat floors
Inclusion of weakened tooth structure
Preservation of cusps and marginal ridges
Rounded internal line angles
Adequate thickness of restorative materials
Reduction of cusps for capping if indicated
Primary Resistance cont….
Definition:
The shape or form of the prepared cavity
that resists displacement or removal of the
restoration from tipping or lifting forces.
Primary Retention Form
Conception:
The shape or form of the cavity that
provides for adequate observation,
accessibility, and ease of operation in
preparing and restoring the cavity.
Convenience Form
Principles:
Definition:
The elimination of any infected carious tooth
structure or faulty restorative material left in the
tooth after initial cavity preparation.
Removal of dentinal caries using round burs and spoon excavators
Pulp protection
Mechanical forms
Proximal locks
Proximal slots
Proximal locks
Slot on gingival wall
Final cavity preparation stage….
Objectives:
To create the best marginal seal possible
between the restorative material and tooth
structure;
To afford a smooth marginal junction;
To provide maximum strength of both the
tooth and the restorative material at and
near the margin.
The strongest enamel margin is that margin which is
composed of full-length enamel rods that are supported
on the cavity side by shorter enamel rods, all of which
extend to sound dentin.
Finishing the external walls
Amalgam: 90°
cleaning
inspecting
varnishing
conditioning
Multiple Choice Questions
Q.1. In cavity prepartion cavo-surface margin will be
a junction between :
a) Cavity wall/floor and adjacent tooth surface.
b) Cavity wall and floor.
c) Floor of the occlusal box and aproximal box
d) Axial wall and occlusal floor.
Q.2 Toilet of the cavity is:
a) Removal of debris by washing with water
b) Removal of debris by cold air
c) Removal of debris by hot air
d) Washing the cavity with water.
Q.3 Most common fracture seen in amalgam
restoration at:
a) Cavosurface margin.
b) Contact area
c) Isthmus area
d) Proximal box
Q 4 G. V Black concluded that following area of
tooth surface are relatively non-selfcleansing:
A) Pit and fissures
B) Tips and cusps
C) Fossa
D) Marginal ridge
Q.5 Class III amalgam restorations areusualy
prepared on:
a) Distal surface of anterior teeth
b) Mesial surface of canine
c) Distal surface of canine
c) Mesial and distal surface of all teeth.