Lesson 1: FUNDAMENTALS OF CAVITY PREPARATION  4 walls

CAVITY PREPARATION NOMENCLATURE

1. Simple
2. Compound
3. Complex

Walls of Class IV Cavity Preparation

 6 walls

Cavity preparation walls Walls of Class V Cavity Preparation

 Internal walls  5 walls
 not extended to the external tooth surface
1. Axial wall
 an internal wall which is parallel to the
long axis of the tooth
2. Pulpal wall (Pulpal floor)
 an internal wall that is perpendicular to the
long axis of tooth
 occlusal of the pulp
 External wall
 Extends to the external tooth surface
 (Distal, facial, Lingual, Ginigival) CAVITY PREPARATION ANGLES
 Floor Angles
 Horizontal and perpendicular to the occlusal  Junction of two or more prepared surface
forces that are directed occlusogingivally  Almost always softened, slightly rounded
(generally parallel to the long axis of the tooth).
 Enamel wall Line angle
 Prepared external wall that consists enamel  junction of two planar surfaces
 Dentinal wall Point angle
 Prepared external wall consists of dentin  junction of three planal surfaces

Class I
TOOTH PREPARATION WALLS

Walls of Class I Cavity Preparation

 4 walls
 1 pulp (Floor)

Line Angles
1. Mesiofacial line angle
2. Mesiolingual line angle
3. Distofacial line angle
4. Distolingual line angle
3. 5. Faciopulpal line angle
Walls of Class II Cavity Preparation 6. Linguopulpal line angle
7. Mesiopulpal line angle
 7 walls
8. Distopulpal line angle.

Point Angles
1. Mesiofaciopulpal point angle
2. Mesiolinguopulpal point angle
3. Distofaciopulpal point angle
4. Distolinguopulpal point angle.

Walls of Class III Cavity Preparation Class II

 Line Angles
1. Faciogingival
2. Linguogingival
3. Mesiofacial
Occlusal box line angles 4. Mesiolingual
1. buccogingival 5. Mesiopulpal
2. linguogingival 6. Faciopulpal
7. Linguopulpal
3. buccoaxial 8. Axiogingival
4. linguoaxial 9. Axiolingual
5. gingivoaxio 10. Axiofacial
11. Axiopulpal.
Proximal Box line angles Point Angles
1. Axiofaciopulpal point angle
1. buccodistal (mesial) 2. Axiolinguopulpal point angle
2. linguodistal (mesial) 3. Axiofaciogingival point angle
3. distopulpal (mesio) 4. Axiolinguogingival point angle
4. linguopulpal 5. Distofaciopulpal point angle
5. buccopulpal 6. Distolinguopulpal point angle.

Point Angles Class V

1. Distofaciopulpal point angle
2. Axiofaciopulpal point angle
3. Axiofaciogingival point angle
4. Axiolinguogingival point angle
5. Axiolinguopulpal point angle
6. Distolinguopulpal point angle.

Class III

Line Angles
1. Axiogingival
2. Axioincisal
3. Axiomesial
4. Axiodistal
5. Mesioincisal
6. Mesiogingival
7. Distoincisal
8. Distogingival.
Point Angles
1. Axiodistogingival point angle
Line Angles 2. Axiodistoincisal point angle
1. Faciogingival 3. Axiomesiogingival point angle
2. Linguogingival 4. Axiomesioincisal point angle.
3. Axiogingival
4. Axiolingual
5. Axioincisal Cavosurface angle and Cavosurface margin
6. Axiofacial.
Cavosurface angle
Point Angles  is the angle of tooth structure formed by the junction of a
1. Axiofaciogingival point angle
prepared wall and the external surface of the tooth.
2. Axiolinguogingival point angle
3. Axioincisal point angle.
Cavosurface margin
 actual junction

Class IV PRINCIPLES OF CAVITY PREPARATION

INDICATIONS FOR RESTORATIONS
• Caries lesion progression to the point that loss of
tooth structure requires restoration.
• Tooth fracture compromising form and function with
or without associated pain or sensitivity.
• Congenital malformation or improper position in
need of reestablishment of form or function.
• Previous restoration with inadequate occlusal or
proximal contact, defective (open) margins, or poor
esthetics.
• As part of fulfilling other restorative needs
• Preventive (sealants)

CAVITY PREPARATION
• The mechanical alteration of a defective, injured, or
diseased tooth to best receive a restorative material
which will re-establish a healthy state for the tooth
PRINCIPLES OF CAVITY PREPARATION
including aesthetic corrections where indicated,
• G.V. Black suggested that it was necessary to:
along with normal form and function.
• Remove additional tooth structure to gain
access and visibility.
OBJECTIVES OF CAVITY PREPARATION
• Remove all trace of demineralized enamel
• Conserve as much healthy tooth structure as
and dentin from the floor, walls, and margins
possible.
of the cavity.
• Remove all defects while simultaneously providing
• Make room for the insertion of the
protection of the pulp–dentin complex.
restorative material in sufficient bulk to
• Remove unsupported enamel tooth structure.
provide strength.
• Form the tooth preparation so that, under the
• Provide mechanical interlocking retentive
forces of mastication, the tooth, or the restoration
designs.
(or both) will not fracture, and the restoration will
• Extend the cavity to self-cleansing areas to
not be displaced.
avoid recurrent caries.
• Allow for the aesthetic placement of a restorative
material where indicated.
PREPARATION OF CAVITIES
• Each diseased tooth has an individual cavity form
BIOLOGICAL PRINCIPLES
determined by caries involvement, morphology of
• Health and integrity of remaining tooth tissues.
tooth and its location in oral cavity – leading to new
• Protection of the pulp from the following
conservative cavity designs.
irritants:
• Mechanical – avoid overcutting of
enamel (width), dentin (length), use
of small, pointed instrument,
excessive pressure application
during excavation. (prone to
fracture kapag more reduction)
• Thermal – minimize frictional heat,
use coolants
• Chemical
• Bacterial – sterilize instruments,
isolate properly
• Prevention of caries recurrence
• Aseptic procedures

MECHANICAL PRINCIPLES
• Structural integrity of both tooth and restoration
demanding:
• Provision of correct resistance
• Provision of adequate retention
• Correct cavity design STEPS IN CAVITY PREPARATION (G.V. BLACK)
 INITIAL TOOTH PREPARATION STAGE

Step 1: Initial depth and outline form

• Outline form – shape of the area of the
tooth surface included within the
cavosurface margins of the prepared cavity.
• Initial depth varies from 0.2 – 0.8mm

Step 3: Primary retention form

• Principles of establishing outline form:
• All weakened enamel should be removed.
• All faults should be included.
• All margins should be placed in esthetically
pleasing position.
• Extend all cavity margins into solid
structure
• No marginal caries remain and enamel
walls should be supported by sound dentin
• Extend into the deepest groves, pit and
fissures
• Factors determining the outline form:
• Extent of caries or old restoration.
• Occlusal condition
• Cavo surface marginal configuration
• Adjacent tooth contour
• Esthetic consideration
• Shape given to the preparation that resists
displacement or removal of the restoration
from tipping or lifting forces.
• Establish
 Parallel walls
 Presence of dovetails
Fig. 4.14: Basic primary retention form in Class II tooth
preparations for amalgam (A) with vertical external walls of
proximal and occlusal portions converging occlusally and for
inlay (B) with similar walls slightly diverging occlusally.
PRINCIPAL MEANS OF RETENTION
• Frictional retention
• Undercuts or inverted truncated cones
• Dove-tail retention

AUXILIARY MEANS OF RETENTION

Step 2: Primary resistance form
• Grooves cut in dentin
• Shape given to the preparation that enables
• Internal boxes have definite walls and floors
the restoration and remaining tooth
• Posts
structure to withstand masticatory stresses
• Pins
without fracture.
• Acid conditioning or etching of enamel
• Features:
• Cements or luting agents
• Flat pulpal and gingival wall
• Box shaped cavity
• Inclusion of weakened tooth
structure
• Restricting the extension of external
walls
• Preservation of cusps and marginal
Step 4: Convenience form
ridges
• Rounding internal line angles  Extension of preparation to see it conveniently
• Providing adequate thickness of • Shape given to a tooth preparation to
estorative material facilitate proper instrumentation for the
• Parallelism of the walls preparation of the cavity or insertion of the
restorative material.
• Tooth preparation modification –
flaring of walls, decreasing
roundness of some walls, and
extension of margins.
• Instrument modification – contra-
angling and addition of angles to the
shank of an instrument.
 • Separation – use of wedges
interproximally
FINAL TOOTH PREPARATION STAGE
Step 5: Removal of remaining carious tooth portion and old
restoration
 If the decay is soft, removal should be done with the
broadest spoon excavator.
 If the decay is hard, a large round bur is used in
addition to excavator.
Step 6: Pulp protection
Step 7: Secondary resistance and retention form
• Mechanical preparation features
• Retention Locks
 Place on axiolingual,
axiobuccal line angles of
proximal box of class 2
• Retention Grooves and Coves
 Coves are undercuts place
for incisal retention
• Placement of etchant, primer or adhesive
on prepared walls.
• 1. Enamel wall etching
• 2. Dentin treatment
Step 8: Finishing of external walls
• Ideal enamel wall requirements:
• Enamel wall must rest upon sound
dentin
• Enamel rods must be supported
• Cavosurface angle must be trimmed
or beveled
Step 9: Debridement of the preparation
• Freeing of preparation walls and margins
from objects that may interfere with the
proper adaptability and behavior of the
restorative material.
• Methods:
1. Water, air, or combinations of air-
water jets using air-water syringe.
2. Use of dry cotton pellets.
3. Use of cavity cleaners.
4. Use of hydrogen peroxide
5. Scrapping preparation walls, floors,
and margins with sharp hand
instruments.
6. Use of 10% EDTA
CAVITY DEBRIDEMENT
Water, air, or combinations of
air-water jets
Dry cotton pellets
Cavity cleaners
Scraping walls, floors and
ns
Using preparation
disinfectant
Using 10% EDTA
Solution

Objectives
1. Freeing of all preparation walls, floors and margins
from enamel and dentin chips
2. Drying the preparation walls, floors and margins
3. Sterilization of prepared walls and floors.