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Therapeutic Dentistry Exam Questions:

Carious cavities by black Questions 31-40

31. Classification of carious cavities by Black?

32. Stages of cavity preparation for I and V classes?

1. Anaesthetizing
2. Disclosure: open and enlargement of carious cavity, use round burs
3. Nectroctomy – total or partial
4. Formation of carious cavity for placement of filling
5. Smooth out the edges of the enamel
33. Basic principles of preparation and formation of cavities?

1. Establishing outline form


a. Extend the preparation of cavity to sound enamel
b. Extend the preparation for prevention – remove some healthy tissue to prevent propagation of caries
c. Provide adequate access – hence cavity must be large enough so that all the carious tooth structure is
removed
d. Provide resistant form – the restorative material and remaining supportive tooth structure must be able to
withstand occlusal forces
2. Provide retention form: to prevent restorative material from falling out e.g. retentive grooves for amalgam and
acid itching for enamel
3. Remove caries and treat the pulp:
a. Use slow hand piece
b. Use dentinal liners or cements to protect the dental pulp from bacterial penetration, sensitivity to heat and
stimulate the production of secondary dentine
4. Finish the preparation walls
5. Clean the preparation
6. Final evaluation of the preparation

34. Features of V class cavity preparation? For class V preparation, it should be an oval shape, walls and the bottom
should at right angle, and bottom is convex because of pulp proximity at cervical area thus preventing pulp exposure
35. Features of I class cavity preparation?

Cavity preparation should be with straight walls at right angle to the bottom, shape of the cavity should be cylindrical,
square, rhombic, x like

36. Stages of cavity preparation of these classes?

Common stages of dental hard tissues preparation


1. Anaesthetizing
2. Disclosure (opening and enlargement) - use round burs of same size as the cavity
3. Necrotomy – Removal of pathological tissue using an excavator
4. Formation of carious cavity for filling – use fissure and inverted cone burs
5. Finishing and polishing the edge of enamel

Elements of carious cavity include: bottom, floor, walls, edges and corners

A cavity preparation may have a:

1. Main Cavity: is prepared in place of pathological process


2. Additional cavities: are prepared on healthy tissue for retention of restorative materials

General rules for preparation of cavities

1. Surface of floor to wall at right angles


2. Form a cavity box – except for class v- use an oval shape
3. Floor of cavity should be flat or resemble occlusal surface

37. Basic principles of preparation and formation of cavities II, III, IV classes by Black?

Class 2: if there is no neighboring tooth and the cavity is below the equator it is formed on the proximal surface. If the
access is complicated, a cavity is extended to the occlusal surface and an additional cavity is formed there, the additional
cavity occupies 1/3 to ¼ length of the occlusal surface.

Class 3: the prepared cavity should have the shape of a triangle, it may be extended to the lingual surface where an
additional cavity is formed there.

Class 4: an additional cavity is formed either in the area of incisal edge or on the palatal/lingual surface within the limits
of dentin

39. Complications during the preparation of cavities II, III, IV classes by Black?

40. The definition of "contact point"?

Restorations involving interproximal surfaces i.e. class 2 or class 4. The restoration of contact point will prevent the
development of further periodontal diseases.
Instruments used: matrix band is placed to help retain the restorative material during placement, to give shape to the
proximal surface of the restoration and to allow close adaptation of the restorative material to the cavity. Common types
of restorative material include:
1. Siqveland: straight band and a holder. Both the band and the holder are removed from the tooth directly
sometimes results in removal of the part of newly packed amalgam
2. Tofflemine: in this system the holder is removed before the bend, this may prevent removal of the restoration with
the bend
3. Circumferential matrix: no holder, the band is tightened by spring mechanism
4. Ivory: metal band replaces only one proximal wall and therefore can’t be used for the cavities involving both
proximal walls

The next step is to place a wedge at the cervical region of the band normally from buccal aspect – functions of the wedge:
 Help retain band space
 Shapes the band at cervical margin of tooth
 Prevents excess material at the cervical area of the cavity forming a ledge
 It separates the teeth slightly so that when the matrix band is removed there is no space between the adjacent teeth
and a tight contact is formed

38. Features of additional cavity formation during the preparation of II class by Black?