COMPARISON OF CONSERVATIVE CLASS II AMALGAM AND GOLD INLAY PREPARATION

CLASS II GOLD INLAY CLASS II AMALGAM

OCCLUSAL ISTHMUS WIDTH 1/3 Intercuspal (max) 1/3 Intercuspal (max)

BUCCAL & LINGUAL WALLS Diverge occlusally Converge occlusally. 90 degrees in relation to
occlusal cavosurface margin

MESIAL AND DISTAL WALLS Diverge/Parallel occlusally Diverge/Parallel occlusally

DEPTH INTO DENTIN 0.2mm-0.5mm 0.2mm-0.5mmm

INTERNAL LINE ANGLES Sharp Rounded

AXIO-PULPAL LINE ANGLE Beveled or rounded Beveled or rounded

PROXIMAL RETENTION FORM Rectangular box isthmus Retentive grooves

Reverse bevel Isthmus

GINGIVAL WALL Reverse bevel at axiogingival line angle Gingivo-axial line angle slightly rounded

COMPARISON OF THE CAVOSURFACE MARGINS FOR A CONSERVATIVE CLASS II AMALGAM AND GOLD INLAY PREPARATION

CHARACTERISTICS CLASS II GOLD INLAY CLASS II AMALGAM

OCCLUSAL CSM Beveled to result in 40-degree marginal 90 degree angle with the external surface
metal

PROXIMAL CSM Extended up to embrasures to prevent 90 degree angle with the external surface
recurrent caries.

Beveled to result in 40 degree marginal

metal

GINGIVAL CSM Beveled to result in 30 degree marginal Beveled in permanent teeth (to produce
metal 90-degree amalgam marginal angle.

NO BEVEL IN DECIDUOUS !

 CLASS III – Proximal caries in Anterior teeth (not involving incisal angle)

 DISTOLINGUAL surface is BEST RESTORED by GOLD

- COMPOSITES DOES NOT MAINTAIN MESIAL AND DISTAL DIMENSION OF TOOTH

 Questions:

1. What is the best approach in preparing class III caries?

2. When preparing carious tooth adjacent to each other, which one is prepared first and which one is restored first?
 3. Best radiograph to assess proximal caries?

 RETENTIVE FEATURES:

- Gingivoaxial and incisal line angle

CAVITY LINE ANGLE POINT ANGLE

CLASS I 8 4

CLASS II 11 6

MOD 14 8

CLASS III 6 3

CLASS IV 11 6

CLASS V 8 4

 CLASS IV – Proximal in anterior teeth (Involving Incisal Angle)

 CLASS V – Caries in gingival third of facial or lingual surface

o Deformed trapezoidal or kidney shape

o DIVERGING incisal, gingival, mesial, and distal walls
o Axial wall follows contour of the surface of the tooth
o Retention features:
- Placed in gingivoaxial line angle and incisoaxial line angle

 CLASS VI (SIMON) – Incisal edge of anterior teeth or cusp of posterior teeth

CLASSIFICATION OF CAVITIES

SIMPLE ONE SURFACE

COMPOUND TWO SURFACES

COMPLEX MORE THAN 2 SURFACES

TYPES OF CARIES

 SMOOTH SURFACE CARIES

 PROXIMAL CARIES

 INCIPIENT CARIES OR WHITE SPOTS

  ACTIVE CARIES

 INACTIVE CARIES

 RESIDUAL CARIES

 RECURRENT CARIES (SECONDARY CARIES)

 RAMPANT CARIES FRANK CARIES

 ROOT SURFACE CARIES

REMEMBER:

What is the radiolucency found just below the CEJ on the root due to ANATOMICAL VARIATION or a gap between the enamel and the bone
covering the root?

What is the treatment for cervical burnout?

ZONE OF CARIOUS ENAMEL

 Translucent Zone - Deepest zone

 Dark Zone - Zone of remineralization
 Body Zone - Largest zone; demineralized zone
 Surface Zone - Outermost zone; unaffected by carious lesion

ZONE OF CARIOUS DENTIN:

 Normal Dentin

 Subtransparent Dentin

 Transparent Dentin

 Turbid Dentin

 Infected Dentin

COMPOSITION OF TOOTH STRUCTURE

  ENAMEL (substantia adamantina) 96-98% inorganic; 2-4% organic
 DENTIN ( substantia ebornea) 70% inorganic; 30% organic
 CEMENTUM (substantia ossea) 50% inorganic, 50% organic

REMEMBER:
A. Caries progress after in enamel or dentin? DENTIN
B. Dead odontoblasts with EMPTY TUBULES are known as? DEAD TRACK
C. Bleaching affects enamel only, dentin only or both? BOTH

AMALGAM COMPOSITION

TYPES OF AMALGAM ALLOY PARTICLES

 Spherical - less condensation force needed; faster working time

 Admixed - more condensation force needed; easier to carve

 Irregular - irregular shape particles (lathe-cut particles)

REMEMBER:

A. Which amalgam alloy needs the most amount of mercury? IRREGULAR

B. Which amalgam alloy needs the least amount of mercury? SPHERICAL

PHASES OF AMALGAM REACTION

 Gamma Phase
o Silver + Tin alloy
o Strongest and Corrodes least
o 30% of amalgam
 Gamma-One Phase
o Silver + Mercury
o Second Strongest phase
o 60% of amalgam - most numerous
 Gamma-Two Phase
o Tin + Mercury
o Weakest and softest; Corrodes most
o Prone to mircoporosities
REMEMBER:

• Low Copper Amalgam

• <6% Copper

• <10% Copper (other source)

• High Copper Amalgam

• >9%-30% Copper

• 10%-30% (other source)