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Amalgam Cavity Lecture
Amalgam Cavity Lecture
Amalgam Cavity Lecture
Restoration
1
Definition of Operative Dentistry
Form the cavity so that both the restoration and tooth can
withstand the load of mastication.
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
walls
angles
Floor
Cavity
Class I
Class II
Class III
Class IV
Class V
Class VI
—G.V.Black in 1908
Nomenclature
1
0
Cavity Line angle Point angle
Class l 8 4
Class 2 11 6
MOD 14 8
Class lll 6 3
Class lV 11 6
Class V 8 4
1
1
There are many angles in a cavity
prepared cavity such as:
1
2
Cavosurface angle
1
3
Cavosurface margin
1
4
Principles of
tooth preparation
for amalgam
15
Step 1: Outline Form and Initial Depth
Convenience Form
Stages and Steps in Cavity
preparation
Definition:
placing the cavity margins in the positions they
will occupy in the final preparation.
using enameloplasty
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
37
Extend the margin mesially and distally but do not involve marginal
ridges. These walls should have dovetail shape to provide retention to
the restoration
38
Primary Resistance Form
Definition:
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.
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
Final cavity preparation stage….
Definition:
Finishing the preparation walls is the further development of a
specific cavosurface design and degree of smoothness that
produces the maximum effectiveness of the restorative
material being used.
Finishing the external walls
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
Class l designs
80
Class l, design 1
Caries penetration into dentin does
not exceed 0.5-1mm
Width- I/4 intercuspal distance
Low caries index
81
General shape
82
Mesio distal cross section
• Pulpal Floor mesio-distally is flat and
perpendicular to the long axis of the tooth
30
31
86
Out line form
• Extent of caries
• Extent for convenience
• Location of gingiva
• Convexity of proximal surface
• Location and extent of contact areas
Resistance form
Occlusal loading and its effects
87
Tensile stress
Compressive stress
Small cusps
Large cusps 46
Reverse curve
89
90
Class ll, Design 1
Conventional design
Indications
91
Proximal box
93
Class ll, Design 2 (moderate design )
Indications
•Moderate to small sized proximal lesions
•In stress concentration area
•Width not exceeding 1/4 of intercuspal distance
Mesiodistally 54
Class ll, Design 3 (conservative design )
•Involves primarily proximal surface and very limited part
of occlusal Surface, not extending beyond adjacent
triangular fossa
•Sound occlusal crossing ridges
•Minimal loading areas
Internal anatom55y
General shape
Gingival margin
97
Class ll, Design 4 (Simple design )
•Proximal surface only
• Indications; Decay restricted to contacting or proximal
surface without undermining marginal ridges
Diastema or adjacent tooth is missing
98
Bucco-lingual
Cross section
Occlusal-gingival
Cross section
99
Class ll, Design 5
Part of proximal surface ,with a limited access area on facial
or lingual surface
Indications •:1)Preparation will have 4 surrounding walls
•small proximal lesions
•Marginal ridge intact
•Does not involve contact area
10
1
Class ll, Design 7
(Combinations of class ll with class V )
Shape A : junctions between the class ll and class V via,the
Proximal , crossing the axial angles
Shape B : via buccal / lingual groove
ShapeA Shape B
10
2
Class ll, Design 8
10
3
Class lll
Amalgam is usually not indicated for anterior teeth due to
its esthetic , but distal surface of the cuspid is a unique
location
Indications;
1 The lesion does not involve or undermine the distal
slope of cuspid
2bulky walls will remain, incisally, after removal of
Undermine tissues
3 the labials axial angle is intact
4the restoration will be directly loaded by vertical
forces
10
5
Internal anatomy ;
Axial convex
Depth - .5
from DEJ
Rete ntion
points :
Depth 1 to
2 mm in
dentin
10
6
Class lV
Indications :
•Incisal angle is undermined
•Labial and lingual walls intact
10
8
Class V cavity
Involvement :smooth surfaces apical to height of contour
on facial and lingual surfaces of all teeth eg ; erosion,
abrasion , hypoplasia, aplasia
Bilateral extension 73
Class VI
11
3
Retention coves
11
4
Retention locks
11
5
Tooth preparation for pin amalgam
11
6
Pin location
11
7
Cavosurface angle
11
8
Conclusion
Although composite resins and crown and bridge
restorative dental techniques receive much attention,
amalgam was once most extensively used restorative
material.
If it is used with care in minimal cavities, the restoration,
the tooth and the occlusion will all last longer!
TOXICITY reported.
11
9
Thank you