GV BLACKS CLASSIFICATION

CLASS I

PIT AND FISSURE CARIES IN

a. OCCLUSAL SURFACE OF MOLARS AND PREMOLARS

b. OCCLUSAL 3RD OF BUCCO-LINGUAL SURFACE OF
MOLARS AND PREMOLARS
c. LINGUAL PIT IN ANTERIORS

CLASS II

a. CARIES AFFECTING PROXIMAL SURFACE OF POSTERORS

MOST COMMON SITE – BELOW THE CONTACT AREA

CLASS III

a. PROXIMAL SURFACE OF ANTERIORS

BEST RESTORATION FOR DISTAL SURFACE OF MAXILLARY

CANINE IS AMALGAM

CLASSIV

a. CARIES AFFECTING PROXIMAL SURFACE AND INCISAL

EDGE →COMPOSITE

CLASS V

a. LEAST COMMON CARIES – GINGIVAL THIRD

i. Extend of the cavity depends on extend of caries
ii. Placement of walls depends on the orientation of enamel
rods
b. Best Restoration is Direct Filling Gold
c. Best Esthetic Restoration is Microfilled Composite – Better polishing due to smaller
piller particle

ROOT CARIES/ SENILE CARIES –not in GV Blacks classification. root caries doesn’t
have enamel - .5-.8 mm below DEJ. Needed chemical bonding material. Best filling material
is GIC. Best esthetic restoration is RM- GIC(Resin modified GIC)
 PRINCIPLES OF CAVITY PREPERATION

INITIAL PREPERATION
1. INITIAL DEPTH AND OUTLINE FORM
2. PRIMARY RESISTANCE FORM
3. PRIMARY RETENTION FORM
4. CONVENIENCE FORM
FINAL PREPERATION
5. PULP PROTECTION
6. SECONDARY RETENTION
7. FINISHING THE CAVITY
8. TOILETING THE CAVITY

1. INITIAL DEPTH AND OUTLINE FORM

First Step (not caries removal)
Depth should be .5 mm
Base of the cavity should be in dentin
Cusp Capping – to protect weakened cusp. Include cusp in cavity preparation
Amalgam preparation → 2.5 mm
→Amalgam Shoeing
→Counter Bevel

Bevel is given in Anteriors. Bevel is contraindicated in posteriors

Most common Bevel used is long bevel

2. PRIMARY RESISTANCE FORM

After filling tooth and restoration should not break
1. Pulpal floor should be flat
2. Line angles should be rounded
3. Adequate thickness of cavity
4. Cavo surface margin should be 90o (Butt Joint)
5. Gingival Bevel (use Gingival Margin Trimmer) (to remove unsupported enamel)
a. Needed In permanent teeth (gingivaly directed enamel rods)
b. Not needed In primary (occlusaly directed enamel rods)
 DIFFERENCE BETWEEN PRIMARY AND PERMANENT TEETH

3. PRIMARY RETENTION FORM

a. Occlusal convergence (for amalgam)
b. Occlusal divergence (2o to 5o )(for inlay and onlay)
c. Dove tail (for proximal retention in class II cavity)

4. CONVENIENCE FORM
a. Width of the amalgam cavity should by 1/4th of inter cuspal distance
 5. PULP PROTECTION (if indicated)
a. If remaining caries is present after cavity preparation remove caries using a
small round bur
b. Pulp protection depends on Remaining Dentin Thickness(RDT)
i. If RDT is >2 mm no pulp protection is needed
ii. If RDT is <2 mm cavity liners are needed
→ 1- 2mm ZnOEugenol ( Eugenol property – sedative/obtudant effect)
→0.5-1mm CaOH2

Only cavity liner used under Composite is Calcium Hydroxide (because eugenol inhibits
polymerisation)

Sandwich Technique – GIC is placed as a base. Once GIC is set do acid etch and then we can
place composite.
Cavity liner in composite is Ca(OH)2

6. SECONDARY RETENTION & RESISTANCE FORM

Sometimes after removing all caries if we need extra retention
a. Slot preparation
i. Using #33 inverted cone bur make a canal in base of cavity
b. Coves
i. Using a round bur make a depression at line angle and point angle
c. Grooves
d. Pins (amalgam pin/ pin retained restoration)(indication is grossly destructed
teeth)(advantage is single appointment)(inlay, onlay needs multiple visit)
i. Cemented pins : pin hole should be larger than pin- apply luting then
place (least retentive pin)(least stress on dentin)
ii. Friction lock : pin hole slightly smaller pin- press it inside- due to friction
it will stay
iii. Self threaded : very small pin hole –pin have thread in it- put it and rotate
it. (most retentive pin)(gives highest stress on dentin)
Eg Thread Mate System(TMS) types of TMS pins (minim, minuta,
regular, minikin) Minikin is the commonly used pin in TMS

Number of pin needed is 1 pin per missing cusp. Minimum distance between 2 pins should
be 3-5 mm. Minimum depth of pin in dentin is 2 mm

Treatment of Accidental pulp exposure while placing pin – place CaOH2 in pin coronal to
pulp and Permanent filling (pin point exposure, recently exposed pulp and iotrogenic caries)
Number of pin needed is 1 pin per missing cusp. Minimum distance between 2 pins should
be 3-5 mm. Minimum depth of pin in dentin is 2 mm
7. FINISHING THE CAVITY
Remove unsupported enamel
a. Enamel hatchet (class II cavity proximal wall)
b. Chistel (Class I cavity including proximal surface)
c. GMT (gingival seat)
d. Angle former (sharpen line angles for Direct Filling Gold)
In class II cavity #245 bur is used to prepare gingival seat

8. TOILETING THE CAVITY

Last Step of cavity preperation
Remove Smear Layer – Dentin Debris