Sie sind auf Seite 1von 41

Class II Amalgam preparation

Occlusal cavity preparation


l Tooth 36 MOD amalgam preparation can be considered as the extension of Class I cavity preparation (36O) l So we first prepare tooth 36 occlusal cavity

Outline form
l The peripheral extension of the cavity preparation l Depends on the extension of caries on CEJ (Cementum Enamel Junction) l Should has no undermined enamel l Depth: 0.5mm in dentin

OUTLINE-occlusal cavity
l The occlusal extension l Pencil mark along the occlusal groove l Buccal, lingual, mesial and distal extension

Occlusal Cavity Preparation


l Use or #169 high speed bur l Fulcrum: tooth #34 l The direction of the bur is perpendicular to the occlusal surface (you can mark the depth of the bur)

Occlusal Cavity Preparation


l Get depth along the occlusal groove, at this stage: 1.82.0mm

Occlusal Cavity Preparation


l Extend cavity to idea outline (high speed #245 bur) l Cavity depth: 2.02.5mm l The depth of the occlusal cavity should be at least 1.5mm, to get the enough strength of amalgam filling

Occlusal Cavity Preparation


l Extend occlusal cavity to idea outline from l Get idea depth and width of the occlusal cavity l Smooth cavity floor with slow speed #56 bur l Enamel chisel can also be used to help smooth the cavity floor

Occlusal Cavity Preparation

l Idea isthmus width: 1.25-1.5mm l Angle hatch with 1mm width can pass easily l Smallest amalgam condenser can fit all area of the preparation

Occlusal Cavity Preparation

l Finished Class I (occlusal ) Cavity preparation

Proximal Box Preparation Occlusal part

l Pencil mark placed to indicate buccal and lingual extension l Reverse Curve

Proximal Box Preparation Occlusal part


l Wedge placed to protect the adjacent tooth l Matrix band can also be used

Proximal Box Preparation Occlusal part


l Inside the marginal ridge, extend the preparation to mesial, distal, buccal and Lingual, make a !T" groove (#169 high speed bur)

Proximal Box Preparation Occlusal part


l Round the corner of the !T" groove as left picture to finish the mesial and distal part of extension and form reverse curve l Leave thin marginal ridge to protect the adjacent teeth

Proximal Box Preparation Occlusal part

l Round the four corner l Get the reverse curve l Still keep the depth

Proximal box preparation


l Measure the depth of proximal box l 1mm below the contact

Proximal box preparation


l Use#245 or # 2 round high speed bur at the middle of the proximal wall, get the idea depth l Reserve a thin proximal tooth structure to protect the adjacent tooth (Proximal view removed the proximal tooth structure in order to show the procedure)

Proximal box preparation

l Move the bur buccally to get desire extension l Pay attention to the direction of the bur (form convergent proximal box)

Proximal box preparation

l Move the bur lingually to get desire extension l Pay attention to the direction of the bur (form convergent proximal box)

Proximal box preparation


l #546 high speed bur l Lightest pressure cervically Provide inverse tapered proximal wall l Reserve a thin proximal tooth structure to protect the adjacent tooth (proximal view removed the proximal tooth structure in order to show the procedure)

Proximal box preparation

Enamel hatch l Break the thin proximal wall

Proximal box preparation

Enamel hatch l Extend proximal wall

Proximal box preparation

Enamel hatch: Smooth gingival floor

Proximal box preparation

l Enamel hatch l Prepare the cavo-surface margin of the proximal surface

Proximal box preparation


l #56 slow speed bur l Lightest pressure cervically l Smooth the cervical wall l Provide inverse tapered proximal wall l Wedge protect the adjacent tooth

Proximal box preparation


l Axial wall is follow the surface of proximal l The width of gingival wall is 0.5mm into dentin (approximately 1.0-1.25mm)

Proximal box preparation


Gingival marginal trimmer l Place two bevel -- Bevel of cervical enamel -- Bevel of axio-pulpal line angle

Proximal box preparation


Retension groove l 1/2 round bur l Location: on bucall & lingual proximal wall, inside CEJ, 0.5mm in dentin l Depth: 1/2 bur diameter l Start at gingival floor, extend occlusally to the height of pulpal floor

Evaluation- Outline Form


l Centered in fissure system l Provide adequate convenience form l As conservative as possible l Buccal and Lingual groove extend half way between central groove and edge of occlusal table

Evaluation-Isthmus
l Correct isthmus position l Isthmus width: 1.25-1.50mm

Evaluation-Pulpal floor
l Flat pulp floor l Pulp floor perpendicular to long axis of clinical crown l Cavity depth: 2.02.5mm

Evaluation-Occlusal cavity wall


l Parallel to the long axis of crown or slightly converge l Nearly form right angle to pulp floor l Round internal right angle

Evaluation-Proximal box
l Broken buccal and lingual proximal contact l Just allow the tip portion of the explore pass

Evaluation-Proximal box

l Open gingival contact just enough space to pass the tip of the explore

Evaluation-Proximal box
l Convergent buccal and lingual wall l Parallel gingival and axiopulpal wall

Evaluation-Proximal box

Axial wall l Parallel to gingival cavosurface

Evaluation-Proximal box

Axio-pulpal lingle angle l Beveled l Smooth

Evaluation-Proximal box

l Retention groove l Inside CEJ (0.5mm) l From cervical floor extend to the height of pulp floor l Depth: half diameter of # round bur

Evaluation-finish

l Smooth and regular cavity floors, walls and margins l Rounded and smooth line angles and point angles

Evaluation-adjacent teeth

l No damage to other part of the tooth l No damage to adjacent tooth

Example of notes
l MH: Medical history updated $ no changes. l IO: Tooth #36, vital to cold with controls, percussion(-) / probing (-) mobility(-). l RAD: Tooth#36 MOD gross caries, deep to dentin l DX: Tooth #36 MOD caries l TX: Anaesthetized by 1 carpule of lidocaine 2% (1:000,00 epinephrine) via IAN and long buccal nerve. Rubber dam isolation. Pre-wedging. Periphery cleared, caries excavated. Retention grooved placed. Tofflemire matrix placed and wedged. Contacts burnished. Calcium hydroxide (Dycal) and Vitrobond placed over areas close to pulp. Copal varnish placed in 2 coats. Permite admix amalgam condensed, carved. Occlusion clear. Post-carve burnish. Restoration flosses well with tight contacts. Pt comfortable. Pt advised of possible post-op sensitivity.

Das könnte Ihnen auch gefallen