CLASS V AMALGAM

Design Principles

CLASS V

OCCLUSAL WALL
DBC DC MBC

DISTAL WALL

MESAL WALL GINGIVAL WALL

MBC

DBC

AXIAL WALL

OUTLINE FORM
PRINCIPLE RATIONALE

rounded trapezoid in gingival third G & O outline straight & parallel to occlusal table

conforms to usual lesion location provides retention

EXTENSION
a balance between conservation of tooth structure and the need for access and to remove defective tooth structure

EXTENSION
PRINCIPLE RATIONALE

encompasses carious tissue eliminates unsupported enamel encompasses contiguous restorations

eliminates infected tissue eliminates weakened tooth structure maximizes restoration lifespan

OCCLUSO-GINGIVAL EXTENSION
PRINCIPLE RATIONALE

occlusally to height of contour or extent of lesion gingivally to extent of lesion (frequently subgingival)

provides access (convenience form)

MESIO-DISTAL EXTENSION
PRINCIPLE RATIONALE

to line angles of tooth or extent of lesion

provides access (convenience form)

AXIAL DEPTH
PRINCIPLE RATIONALE

depth 0.5mm into dentin (1-1.25mm gingivally, 1.51.75mm occlusally)

sufcient bulk of amalgam to prevent fracture sufcient O & G wall length for retention

1.5-1.75mm 1-1.25mm

AXIAL WALL
PRINCIPLE RATIONALE

smooth curved M-D straight O-G parallels surface

optimize adapatation of amalgam to wall uniform bulk of amalgam to prevent fracture maximum pulpal protection
A-A

A B

B-B

B A

MESIAL & DISTAL WALLS

PRINCIPLE RATIONALE

smooth diverge creating 90 cavosurface angle

optimize adaptation of amalgam to walls optimizes strength of both amalgam and enamel at margin
B-B

OPTIMUM CAVOSURFACE ANGLE FOR AMALGAM

amalgam cross-section of amalgam restoration margin 90 butt joint enamel surface of tooth

weak amalgam margin

weak enamel margin

OPTIMUM CAVOSURFACE ANGLE FOR AMALGAM

amalgam cross-section of amalgam restoration margin 90 butt joint enamel surface of tooth

weak amalgam margin

weak enamel margin

OCCLUSAL WALL
PRINCIPLE RATIONALE

smooth straight mesio-distally 90 cavosurface angle

optimize adaptation of amalgam to walls easier to visualize & carve following condensation optimizes strength of both amalgam and enamel at margin opposes G-wall (retention)

OCCLUSAL RETENTION
PRINCIPLE RATIONALE

retention groove 0.5mm deep placed in occlusal wall 0.5mm deep to DEJ

only required when preparation is overextended occlusally because occlusal & gingival walls will be divergent

GINGIVAL WALL
PRINCIPLE
RATIONALE

smooth straight mesio-distally 70 axio-gingival angle plane enamel at cavosurface margin to 90

optimize adaptation of amalgam to walls easier to visualize & carve following condensation helps lock restoration in tooth (retention) elimination of weak tooth structure

70 90

angles of gingival wall

axial wall

axio-gingival angle 90 70 cavosurface angle

gingival wall

plane enamel at cavosurface margin to 90

90

CAVITY REFINEMENT
PRINCIPLE RATIONALE

internal line angles welldened but not sharp

maximizes amalgam resistance to dislodgement reduces stress concentration & risk of subsequent tooth fracture

CAVITY REFINEMENT
PRINCIPLE RATIONALE

angles between O, M, G, & D walls rounded

reduces stress concentration & risk of subsequent tooth fracture difcult to condense viscous amalgam into sharp external angles

CAVITY REFINEMENT
PRINCIPLE
RATIONALE

cavosurface margins regular, well-dened, well-supported

easier to visualize & carve following condensation optimize adaptation of amalgam to margins eliminates weak tooth structure maximizes marginal integrity

CLEANLINESS
PRINCIPLE RATIONALE

cavity is free of debris & moisture

facilitates adaptation of amalgam to the cavity improves physical properties of the restoration by elimination of voids & foreign material

CLASS V AMALGAM

Preparation Technique

CEJ

#245 rounded straight ssure bur 3.5mm head length

create trench near O-line

maintain even depth just shy of bur head length (3mm) as trench follows curvature of surface from M to D

keep bur perpendicular to surface as it curves from M to D

this creates a at occlusal wall and a curved axial wall

starting shy of 3 mm allows room for rening the axial wall later

create a second trench near the G-line this one is less than 2mm deep (1/2 length of bur head)

cut connecting trenches with matching depths

remove intervening plaster

rough out axial wall maintain curvature & O-G depth change

begin M & D walls just shy of pencil line keep bur perpendicular to surface of tooth

M & D walls should be divergent axial wall should curve from M to D

the target axial depth is 3mm occlusally 2mm gingivally

being slightly shy of these measures is preferable at this point to allow room for smoothing

nishing with the primary & secondary cutting edges of a hatchet

nishing with the primary cutting edges of a chisel

plane gingivo-axial angle to 70 with gingival margin trimmer

plane the gingival cavosurface margin enamel

nished walls should just reach the pencil line

self-evaluate before seeking instructor evaluation

accomplished: 30-O Class I cavity preparation for amalgam

planned: 30-F Class V cavity preparation for amalgam

imagine there is a Class V caries lesion

draw outline with gingival line at FGM

bench instructor approval recommended

Bow

Double-Bowed 212 Retainer

For gingival retraction Li beak

Fa beak

To increase gingival retraction facially, bend lingual beak incisally

212 retainer used to retract the gingiva

begin 1.5mm deep (<1/2 bur head length)

extend mesially & distally

axial wall depth approx. 1.5mm-more occlusally, less gingivally

extend walls to pencil lines

may need to remove 212 to create divergent M & D walls

nish walls with chisel, 111 hoe, or hatchet

Wedelstaedt chisel

111 hoe

set gingival wall to 70 with gingival margin trimmer

self-evaluate before seeking instructor evaluation