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Six principle of cavity preparation: 6

1. Outline form 2. Resistance and retention form 3. Convenience form 4. Removal of remaining caries dentine 5. Finishing of the enamel walls and margin 6. Toilet of cavity

Steps of cavity preparation:

There are two steps:

1. Initial 2. Final

Black suggested following precautions:2

Provision of definitive mechanical retention in the cavity Extension into nearby deeps pits and fissure for prevention of recurrent caries Removal of infected and affected enamel and dentine from all surfaces Removal of even healthy tissue/structure to gain access good visibility Cavosurface margin should be self cleansing area.

Classification of cavities:1
Class I Class II Class III Class IV Class V Class VI Another classification was improved by CHANDRA, by division and subdivision.

MOD, meso-ocluso distal MB, mesio-buccal DO, disto occlusal

Simple, compound, complex 1. Simple: termed simple if only one tooth surface is involved. 2. Compound: Two surfaces are involved. 3. Complex: preparation involving three or more surface. Tooth preparation walls: Internal wall: prepared surface that does not extend to the external tooth surface Axial wall: internal wall parallel with the long axis of the tooth Pulpal wall: internal wall that is perpendicular to the long axis of the tooth External wall: prepared surface that extend to external tooth surface Floor: prepared wall that is reasonably flat and perpendicular to the occlusal forces that are directed occlusogingivally. Line angles, point angles: Line angle: the junction of two different orientations along the line. Point angle: the junction of three planel surface of different orientation.

Secondary retention device:

Slots, Locks, Grooves, Skirts, Pins.

Difference between proposed classification and equivalent classification4 Proposed classification Site 1- Pits and fissures and smooth surface Size 0- fissure seal Size 1- minimal surgery Size 2- equivalent to black class 1 Size 3- requires protection of remaining tooth structure Size 3- lost cusp or similar Site 2- contact area, all teeth Size 0- surface demineralization Size 1- beyond remineralization Size 2- moderate involvement Size 3- requires protection of remaining tooth structure Size 4- bulk loss of tooth structure Equivalent Black classification Class 1- Pits and fissures Not classified Not classified Class 1 Class 1 Class 1 Class 2 contact area, posterior teeth Not classified Not classified Class 2 Class 2 Class 2 Class 3- contact area, anterior teeth Not classified Not classified Class 3 Class 3 Class 3 Class 4- Incisal edge lost, anterior tooth Not classified Not classified Class 4 Class 4

Site 3- cervical third Size 0- surface demineralization Size 1- minimal intervention Size 2- more extensive Size 3- a proximal root surface Size 4- two or more surfaces

Class 4 Class 5- cervical third Not classified Not classified Class 5 Class 2 Class 5

Class I:
Pit and fissure caries, or caries occur on the occlusal surface of posterior teeth .or facial and 5 lingual pits in posterior teeth.

Conservative tooth preparation is recommended to protect the pulp preserve the strength of the tooth.

Class1 tooth preparation on max: molar

Illulustring tooth prep: walls f, d, m, l, p

Line angles, fp,df,dp,dl ,lp ml,mp,mf ,Point angles,


Initial cavity preparation steps: 2

Outline form and initial depth Primary resistance form Primary retention form Convenience form Secondary retention form

1. Outline form and initial depth

Class I cavity preparation is Started by entering the deepest or most carious pits using a round carbide bur at high speed with air water spray. The long axis of bur is held perpendicular to the plane visualized for pulpal floor; include all susceptible fissures in the outline form. This phenomenon of Extension for Prevention was first suggested by Marshall Ebb and was later adopted by Black. Extended the cavity margins to the place they will occupy in the final cavity preparation.1,6

Outline Form

Factors guide:
Extension of caries lesion, esthetic consideration, relationship of approximating and opposing teeth restorative material to be used. Initial depth is 0.2 to 0.8mm.

Primary resistance form:

Make a box shape cavity, establish extension of the external walls of the cavity preparation should be kept as small as possible; floor should be flat to resist the Occulsal stresses. Which

help the tooth to resist Occulsal masticatory forces without any displacement, cusp and ridges with dentine support should not be undermined. The extensions of the external