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CLASS I AMALGAM

Design Principles
Dental Amalgam Composite Resin
macro mechanical micro mechanical
Retentive (opposing walls, (bonding)
Form grooves, mortise-form)

Resistance right angle butt joints, bevel enamel, feather edge


Form, adequate bulk, smooth acceptable
Restorative & flat walls
Material
right angle butt joints, lesion dictates form, preserve
Resistance remove all unsupported unsupported enamel
Form, Tooth enamel

Proximal break contact with contact with adjacent tooth


Clearance adjacent teeth acceptable
CLASS I
CLASS I
Appearance of
Class I caries
lesion on
bitewing radiograph
Accepted Terminology Jargon Lay Terms
preparing a cavity prep drilling
cavity preparation prepping hole
prepared cavity
Accepted Terminology Jargon Lay Terms
extend widen widen
extension deepen deepen
incorporate chase drill out
MESIOBUCCAL DISTOBUCCAL
CUSP CUSP

DISTAL
CUSP

MESIOLINGUAL DISTOLINGUAL
CUSP CUSP
BUCCAL WALL

DISTAL
MESIAL WALL
WALL

LINGUAL WALL
PULPAL FLOOR
OUTLINE FORM
FEATURE RATIONALE

• smooth flowing, • angular contours can chip


during condensation
gentle curves
• angular contours can
concentrate stresses &
lead to restoration fracture
• easier to find when
carving back fresh
amalgam
Angular Irregularities
INVAGINATION EVAGINATION

• susceptible to fracture • difficult to condense into


during condensation
EXTENSION
a balance between
conservation of
tooth structure and
the need for access
and to remove
defective tooth
structure
EXTENSION
PRINCIPLE RATIONALE
• encompasses carious • eliminates infected
tissue tissue
• eliminates • eliminates weakened
unsupported enamel tooth structure
• encompasses • reduces risk of
contiguous fissures secondary caries
• encompasses • maximizes restoration
contiguous lifespan
restorations
BUCCO-LINGUAL EXTENSION
PRINCIPLE RATIONALE

• extends far enough up B • margin in sharp


& L grooves to anatomy difficult to
terminate on gentle finish & keep clean
contours
MB
DB

L
BUCCO-LINGUAL EXTENSION
PRINCIPLE RATIONALE

• extend minimally in area • provides convenience


of triangular ridges form while preserving
(optimally: isthmus cusp strength
width is <1/3 intercuspal
distance)
MESIO-DISTAL EXTENSION
PRINCIPLE RATIONALE

• stop short of marginal • preserve strength of


ridge crests marginal ridge
(resistance form)
MESIO-DISTAL EXTENSION
PRINCIPLE RATIONALE

• groove extensions kept • preserve strength of


narrow cusps (resistance
form)
OCCLUSAL DEPTH
PRINCIPLE RATIONALE
• sufficient bulk of
• 0.5mm into dentin amalgam to prevent
• about 2 mm measured at fracture
triangular ridge • maximum thickness of
dentin protecting pulp
PULPAL FLOOR
PRINCIPLE RATIONALE

• smooth & flat • uniform bulk of


amalgam to prevent
• parallel to occlusal table
fracture
• best resistance to
occlusal stresses &
forces of condensation
BUCCAL & LINGUAL WALLS
PRINCIPLE RATIONALE

• smooth • optimize adaptation


of amalgam to walls
• curved mesio-distally
• elimination of weak
• straight pulpo-occlusally tooth structure
BUCCAL & LINGUAL WALLS
PRINCIPLE RATIONALE
• helps lock restoration in
• convergent 6° pulpo- tooth (retention)
occlusally under • keep amalgam from being
triangular ridges too thin at margins
• divergent 6° pulpo- (resistance form)
• preserves strength of
occlusally in groove cuspal ridge (resistance
extensions form)
A-A’ B B-B’
A

A’
B’
MESIAL & DISTAL WALLS
PRINCIPLE RATIONALE

• smooth • optimize adaptation


of amalgam to walls
• straight & divergent 6°
pulpo-occlusally • elimination of weak
tooth structure
• preserves strength of
marginal ridge
(resistance form)
C-C’

C
C’
CAVITY REFINEMENT
PRINCIPLE RATIONALE

• internal line angles well- • maximizes amalgam


defined but not sharp resistance to
dislodgement
• reduces stress
concentration & risk
of subsequent tooth
fracture
CAVITY REFINEMENT
PRINCIPLE RATIONALE
• easier to visualize &
• cavosurface margins carve following
regular, well-defined, condensation
well-supported • optimize adaptation of
amalgam to margins
• eliminates weak tooth
structure
• maximizes marginal
integrity
CAVOSURFACE MARGINS

cavosurface margin
unsupported, rough poorly defined
tooth surface

enamel
CAVOSURFACE MARGINS

cavosurface margin
unsupported, rough poorly defined
tooth surface

amalgam enamel
CAVOSURFACE MARGINS

cavosurface margin
unsupported, rough poorly defined
tooth surface

amalgam enamel
CLEANLINESS
PRINCIPLE RATIONALE

• cavity is free of debris • facilitates adaptation


& moisture of amalgam to the
cavity
• improves physical
properties of the
restoration by
elimination of voids
& foreign material
CLASS I AMALGAM

Preparation Technique
Plaster tooth #30
2X normal size
#245
rounded straight fissure bur
3.5mm head length
1mm
4mm
3mm
initial penetration
in central pit
perpendicular to
occlusal table
penetrate 3mm
(length of cutting head)
will translate into
4mm at B & L walls
extend down central
groove toward
M & D fossae
keep bur perpendicular to
occlusal table & spatially
at the same level to create
a flat pulpal floor
stop short of M & D pencil lines
leave room for refinement
extend into B & L grooves
stop short of pencil lines
tip bur slightly to create
divergent M & D walls

45°

22°

45°
0° 11°
22°

45°
0° 6° 11°
22°

45°
tip bur slightly to create
divergent MB, DB, & L
groove terminuses
shape B & L walls into smooth flowing curves
perpendicular to the pulpal floor
extended to the pencil line
be careful not to widen the B & L groove extensions
round off sharp corner at
D triangular ridge without
encroaching on cusp
measure occlusal depth
with perio probe
at triangular ridge
create 6° convergence
at base of triangular
ridges
large straight hatchet smooth pulpal floor with
primary cutting edge

smooth vertical walls and


sharpen cavosurface margin with
secondary cutting edge
self-evaluate in CLASS I AMALGAM PREPARATION EVALUATION

pencil before STUDENTS: Please evaluate your work prior to asking faculty to do so. Mark your assessment in pencil.
DEVIATION

SIGNIFICANT
seeking instructor This step is important in order for your instructor to help you develop appropriate self-assessment skills.

SEVERE
SLIGHT
NONE
evaluation PREPARATION FEATURES/PRINCI P L E S ERRORS LOCATION 2 1 0 -1
I. OUTLINE FORM
A. smooth, regular, flowing curves rough irregular
II. EXTENSION
A. includes contiguous pits & fissures does not include
B. bucco-lingual extensions
1. e x t e n ds into B & L grooves underextended overextended
2. e x t e n ds minimally at triangular ridges overextended at triangular ridge
C . m e sio-distal extensi o n
1. short of marginal / oblique ridge overextended
2. m i n i mal width of B and L grooves underextended overextended
III. OCCLUSAL DEPTH/PULPAL FLOOR
A. depth = 1.5 - 2.5mm at triangular ridges <1.5 but 1.0 <1.0
>2.5 but 3.0 >3.0 but 3.5 >3.5
B. smooth and flat rough or uneven
C . p a rallel to occlusal table slants
IV. OCCLUSAL WALLS
A. smooth rough
B. straight pulpo-occlusally not straight pulpo-occlusally
C. converge at triangular ridges over-convergent not convergent divergent
D. diverge at groove extensions over-divergent not divergent convergent
C d i verge at mesial & distal walls over-divergent not divergent convergent
V. CAVITY REFINEMENT
A. line angles well-defined line angles indistinct
B. cavosurface smooth, crisp, supported rough nicked indistinct unsupported ename l
VI. TISSUE PRESERVATION, RUBBER DAM ISOLATION, CLEANLINESS
A. preparation is clean preparation is contaminated
B. rubber dam is intact rubber dam is torn
C. uninvolved tooth structure intact d a m a ge is: slight moderate severe
D. soft tissue is intact soft tissue dama g e
Name Date Tooth 30 Surfaces O TOTAL (possible 1 2 )
Practical ID# (for practical exam only) PLASTER TOOTH
INSTRUCTOR SIGNATURE
Rubber Dam isolation full LR quadrant
Use W8A retainer ligated
planned: 30-O Class I cavity preparation for amalgam
imagine there is a Class I caries lesion
30-O

#245 has 3.5mm head length

occlusal depth 2.0mm (±0.5) measured at base of triangular ridge


#245 has 3.5mm head length
extend into M & D fossae, stay shy of marginal ridges

extend into MB, DB & L grooves, stay shy of cusp ridges


#245 has 3.5mm head length
1. round irregularities in perimeter walls,
2. add slight divergence at marginal ridges
and ends of groove extensions,
3. add slight convergence at base of triangular ridges,
4. smooth pulpal floor & refine internal line angles
self-evaluate before
seeking instructor evaluation

#245 has 3.5mm head length