CAVITY DESIGN LINE

ANGLE AND POINT ANGLE

Presented By,
Anubha Saxena
PG II nd year

CONTENT
INTRODUCTION
CAVITY PREPARATION DEFINITION
FACTORS AFFECTING CAVITY
PREPARATION
CLASSIFICATION
STAGES OF CAVITY PREPARATION

Introduction
Dr. G.V. Black
Chicago, Illinois
1836-1915
"The Grand Old Man of Dentistry"
The basic principles governing the design
of cavity and steps in their preparation
was first suggested by American Dentist
and teacher Dr.G.V.Black in the first
decade of last century.

Definition of Cavity preparation

The mechanical alteration of
a defective, injured, or
diseased tooth in order to
best receive a restorative
material which will reestablish a healthy state for
the tooth including esthetic
corrections where indicated,
along with normal form and
function.

Factors affecting tooth

Preparation
GENERAL

PATIENTS

FACTORS
Diagnosis
Prevention
Interception
Preservation
Restoration

FACTOR
Economic status
Age
Choice of Material

Classification
G.V. Black Classification
Modification of G.V.Black
Classification
Graham J Mount
V.K. Sikri

TOOTH PREPARATION
TERMINOLOGY :
Simple tooth preparation
-Only one tooth surface is
involved.
Compound tooth
preparation Only two
tooth surface is involved.
Complex tooth preparation
Involves three or more
surfaces.

Terminology in Cavity
Preparation
Definition
Cavity-Cavity is defined as
a defect in enamel or dentin
resulting from pathologic process
of dental caries(breach in the
continuity of the surface integrity
of tooth).
The term cavity was used to
describe a carious lesion in a
tooth that has progressed to the
point that part of tooth structure
had been destroyed.

Tooth preparation walls

INTERNAL WALL-An

internal is
prepared surface that does not
extend to external tooth surface.
AXIAL WALL An axial wall is an
internal wall parallel with the long
axis of the tooth.
PULPAL WALL- A pulpal wall is an
internal wall that is perpendicular
to the long axis tooth and occlusal
of pulp.

External wall An external wall is

prepared surface that extend to the
external tooth surface
Floor / seat-A floor is a prepared
wall that is reasonably flat and
perpendicular to the occlusal forces
that are directed occlusogingivally.
Enamel wall Enamel wall is that
portion of a prepared external wall
consisting of enamel.
Dentinal wall- The dentinal wall is
that portion of a prepared external
wall consisting of dentin ,in which
mechanical features can be located.

CAVITY PREPARATION ANGLES :

Line angle : It is the junction of two planar surfaces of
different orientation along a line. internal line
angle and an external line angle.
Internal line angle : Is a line angle whose apex points into
the tooth
e.g. FP.
External line angle : Is a line angle whose apex points away
from the tooth e.g. ap.
Point angles : A point angle is junction of three planal
surfaces of different orientation.

Cavo surface angle :

The cavo surface angle is the angle of the tooth
structure formed by the junction of a prepared cavity
wall and the external surface of the tooth.

Line angles & point angles

Cavo-surface angle

Classification of cavity

Class I
Class II
Class III
Class IV
Class V
Class VI
G. V. Black

CLASS I CAVITY

1) Pits & fissures

2) Occlusal surface of premolars & molars
3) Occlusal 2/3 rd of buccal & lingual surface
4) Lingual surface of maxillary incisors


CLASS II CAVITY
1) Restoration on Proximal
surface of posterior teeth


CLASS III CAVITY
1)Restoration on the proximal
surface of the anterior teeth that
do not involve incisal edge.


CLASS IV CAVITY
1)Restoration on the proximal
surface of anterior teeth that do
involve the incisal edge .


CLASS V CAVITY
1) Restoration on the gingival
third of the facial / lingual
surfaces of all teeth.

CLASS VI CAVITY

1) Restoration on incisal edge of anterior

teeth and occlusal cusp height of posterior
teeth.
2) It is given by Simon.

Stages of Cavity Preparation

INITIAL STEPS OF CAVITY PREPARATION

 FINAL STEPS OF PREPARATION

1. Outline Form and Initial Depth

Definition:
placing the cavity margins in the
positions they will occupy in the final
preparation except for the finishing
enamel walls and margins;
preparing an initial depth of 0.2~0.8 mm
pulpally of the dentinoenamel junction.

Principles :
1.All friable and weakened enamel
should be removed.
2.All fault should be included
3.All margin should be placed in
a position to afford good
finishing of margins of

PROCEDURE

 Features:
1.Preserving cuspal strength.
2.Preserving marginal ridge.
3.Minimizing facio-lingual
extension.
4.Using enameloplasty
5.Connectiong two close
faults of the tooth which are < 0.5 mm apart
6.Restricting depth of penetration into dentin
for pits and fissure-0.2

1.Preserving cuspal strength

-avoiding termination of the margin on
extreme eminence, such as cusp height
-if extension of primary groove includes
half / > of cusp incline, then CUSP
CAPPING consider.

2. Preserving marginal ridge strength

Remaining Marginal ridge should be greater than
1.6 mm for premolar & 2mm for molar

If Remaining Marginal ridge

will be less than 1.6 mm there
there may be the chances of
fracture due to undermining
the ridge.

 Direction of mesial & distal walls

When >1.6 mm
thickness width is
remained at mesial
/distal marginal ridge ,
then mesial / distal
wall should be
parallel.

When less than/= 1.6

mm thickness width is
remained at mesial
/distal marginal ridge ,
then mesial / distal
wall should be
divergent.

3. Minimizing facio lingual Extension

- Minimizing facio lingual Extension ,which
prevents the weakening of cusp.
- For conservative class I CAVITY
facio-lingual width should be 1 to 1.5 mm

4. Depth of preparation
Restricting depth of penetration into dentin
for pits and fissure-0.2
for smooth surface-0.2 to 0.8
Because,
1.To avoid the seating
of the restoration on
the very sensitive DEJ.
2.To give the bulk of
restoration.
3.To take advantages of
dentin elasticity during
insertion and function.

5. Enameloplasty
This is the procedure of reshaping the enamel surface by
making it rounded / Saucered ,the area becomes cleansable and
finishable.
It is indicated when remaining fissure is not greater than 1/3 rd
of enamel thickness.

Outline form for class I

The outline form varies from one tooth to another .
Premolars Upper premolars have Dumb- bell shape with
their ends triangular.
In lower premolar are confined to pit only
but if they involve entire occlusal surface ,then
they resemble like upper premolar.
In tricuspid lower premolar it will assume Y-shape

Class I
upper premolar

Class I
lower premolar

Class I & II Outline form for

MOLARS
Preparation in lower molars have an elongated
shape mesio-distally with three lateral extensions.
In upper molars if cavity involves all the occlusal
surfaces ,the preparation elongated mesio-distally .
If the oblique ridge is not involved the mesial
preparation will assume kidney shape & distal will
appear as heart shape .
In class II the shape of proximal box is Inverted
Truncated Cone.

Mandibular

Maxillary Occlusal view Proximalview

Classoutline form

Class II outline form

Position of Gingival floor

In class II cavity preparation
,gingival margin should be
extended apically of
proximal contact to provide
a minimum of 0.5 mm
clearence between the
gingival margin and djacent
tooth.

Position of Embrassure wall

Isthmus
By G.V.BlackAdvocate that class II cavity

preparation with isthmus width

equal to 1/3rd of intercuspal distance.
By Vale & BroonerIt should be 1/4th of intercuspal
distance.

 The axio-pulpal line angle should be

beveled to reduce the concentration of
stresses and provide grater bulk of
material in the isthmus area, which is
liable to fracture.

Final location for the facial and lingual

Walls of proximal box relative to the contact
area
REVERSE CURVE When viewed
from occlusal outline form of class II cavity
particularly in max . teeth the proximal contact
lies towards the buccal surface whereas the
groove line occurs in the central portion of th
occlusal table. This disparity necessitates
occlusal outline with a REVERSE CURVE.

Advantages
1.It preserve the triangular ridge of cusp
2.Facilitates formation of 90angle
between proximal wall & the tangent of
proximal surface.

Initial cavity preparation stage

Step 1
Step 2
Step 3
Step 4

Outline form and initial depth

Primary resistance form
Primary retention form
Convenience form

2. Primary Resistance Form

Definition:
It is defined as that shape and placement of
the cavity walls that best enable both the
restoration and the tooth to withstand,
without fracture, when masticatory forces
delivered principally in the long axis of the
tooth.

Primary Resistance Form

Principles:
To utilize the box shape with a relatively
flat floor to resist occlusal loading by
virtue of being at right angles to
mastication force;
To restrict the extension of the external
walls (keep as small as possible) to
allow strong cusp and ridge areas to
remain with sufficient dentin support;

Primary Resistance Form

Principles:
To have a slight rounding of internal
line angles to reduce stress
concentration in tooth structure;
To provide enough thickness of
restorative material to prevent its
fracture under load.

Primary Resistance Form

Feature:
Box shape
Relatively flat floors
Inclusion of weakened tooth structure
Preservation of cusps and marginal ridges
Rounded internal line angles
Adequate thickness of restorative materials
Reduction of cusps for capping if indicated

Flat pulpal floor prevents rocking of the restoration which produce

wedging forces

Exception

Pulpal wall is flat in all cases

except in lower 1st
premolar ,where the lingual
cusp is very small & buccal
cusp is pronounced with very
large pulp horn. So in this
case we have to make flat
pulpal floor which is parallel
to imaginary line joining the
tips of the and lingual cusp.

Rounding of line angles prevents stress concentration & provide

resistance form
&
Shows strongrst enamel margin by full length of enamel rods

 th intercuspal
distance

Facio-lingual width
should be not more than
th the intercuspal
distance . As minimum
tooth structure is
removed, it increases the
resistance of tooth.

The type of restorative material

also dictates resistance form need
Silver amalgam needs thickness -1.5 mm
Cast metal needs thickness
-1to2mm
Porcelain needs thickness
- 2 mm

Initial cavity preparation stage

Step 1
Step 2
Step 3
Step 4

Outline form and initial depth

Primary resistance form
Primary retention form
Convenience form

3. Primary Retention Form

Definition:
primary retention form is the shape
or form of conventional preparation
that resists displacement or removal
of the restoration from tipping or
lifting forces.
In many respects retention and resistance form
are accomplished in the same cutting procedure.

Principal means of retention

Frictional retention 1.Greater surface area (length, width,
depth)produces greater frictional component.

2.Parallel walls / convergent wall

provide greater frictional retention
3.Proximity bringing the restorative material
closer to tooth structure during insertion provide
greater frictional retention component.

4.Elastic deformation of dentin during

condensation within dentin proportional limit can
add more gripping action.

4.Inverted truncated cones

-In class II cavity preparation ,
proximal surface have inverted
truncated cones shape
-It prevents the occlusal displacement
of restoration in class II Cavity.

6. Dovetail
In Class II Cavity
-Dovetail provide retention in class II
cavity .
-It prevents lateral displacement of
restoration in class II cavity.

In Class I Cavity
-In class I ,it is given for the purposeful
modification in outline usually for

EXTENSION FOR PREVENTION

Primary Retention Form

Principles:
For Amalgam restoration:
-developing external cavity walls that
converge occlusally.
-Adhesive system provide retention by
micromechanically bonding amalgam to
tooth structure.

Primary Retention Form

Principles:
Composite restoration:
a mechanical bond between the material
and conditioned, prepared tooth structure.

Initial cavity preparation stage

Step 1
Step 2
Step 3
Step 4

Outline form and initial depth

Primary resistance form
Primary retention form
Convenience form

4 . Convenience Form
Conception:
The shape or form of the cavity that
provides for adequate observation,
accessibility, and ease of operation
in preparing and restoring the cavity.

Convenience Form
Principles:
Allow access for caries removal
Allow access for restoration placement
Allow access to margins for finishing,
evaluation and cleaning

Convenience Form

-In class II cast restoration divergence of

vertical wall
-extending proximal preparation beyond
proximal contact
-In class III cavity convenience form mainly
through lingual side.
- In class I & V , divergence of wall of cavity
in INLAY

Final cavity preparation stage

Step 5 Removal of any remaining infected
dentin or old restoration, if indicated
Step 6 Pulp protection
Step 7 Secondary resistance & retention form
Step 8 Procedure for finishing external walls
Step 9 Final procedures

6. Removal of any remaining

infected dentin or old
restoration, if indicated
Definition:
The elimination of any infected carious
tooth structure or faulty restorative
material left in the tooth after initial
cavity preparation.

Removal of dentinal caries using round burs and spoon excavators

Removal of dentin depends on the two

condition
whether it is affected or infected?
Affected dentin
-Does not contain microorganisms
-can be remineralise by
restorative mean.
-it is accepted to allow
affected dentin to
remain in prepared
tooth.

Infected dentin
-It contain microorganisms
-can not be remineralise
by restorative mean.
-it should be removed
during cavity
preparation.

-Soft decay can be best removed using spoon

excavator by flaking up the caries
-Hard decay, heavily discolored should
removed using very low speed bur.
-care should have to take during removal as
pulp may infected by forcing microorganisms into dentinal tubules through
excessive pressure.

Final cavity preparation stage

Step 5 Removal of any remaining infected
dentin if indicated
Step 6 Pulp protection
Step 7 Secondary resistance & retention form
Step 8 Procedure for finishing external walls
Step 9 Final procedures

6. Pulp protection
- Using liners or bases
- to protect the pulp or
- to aid pulpal recovery or both.
LINERS-liners are volitile /aquous
suspension /dispersion of zinc oxide or calcium
hydroxide that can be applied to tooth surface in
relatively thin film & are used to effect a
particular pulpal response.

BASES-Are those cements used in thicker

dimensions beneath permanent restoration to
provide for mechanical, chemical ,thermal
protection of the pulp

Final cavity preparation stage

Step 5 Removal of any remaining infected
dentin if indicated
Step 6 Pulp protection
Step 7 Secondary resistance & retention form
Step 8 Procedure for finishing external walls
Step 9 Final procedures

7. Secondary resistance and

retention forms
Most compound and complex cavity
preparations require additional
resistance and retention form.
The exception being those preparations
that are very conservative.

Secondary resistance and retention

forms
Mechanical forms
Cavity wall conditioning form

Mechanical form:
Retention locks, grooves, and coves
Groove extensions
Skirts
Beveled Enamel Margins
Pins, Slots, Steps, Amalgampins

Retention locks
for amalgam

Proximal Grooves
for cast restoration

Incisal retention
coves

Incisal & Gingival

retention groove

Groove extensions & skirts

When lingual wall

absent or inadequate in
proximal preparation,
then retention form can
be improved by facial
skirt extension.

Pins slots steps & amalgampins

Dentin slots

Amalgampins

Beveled Enamel margins

-The bevels for cast metal may improve retention form
-Primarily to afford a better junctional relationship
-Beveled margins increases the surface area of etchable enamel

Cavity wall conditioning form

Placement of etchant , Primer , Adhesive on
prepared wall
-in addition to mechanical alteration to tooth
structure certain bonding agents also provide
some extent of retention & resistance form
-such treatment require in bonded restoration
like porcelain , composite , or amalgam
materials

Micromechanical retention of bonding system to dental

enamel

Final cavity preparation stage

Step 5 Removal of any remaining infected
dentin if indicated
Step 6 Pulp protection
Step 7 Secondary resistance & retention form
Step 8 Finishing external walls
Step 9 Final procedures

8. Finishing the external walls

Definition:
is the further development of a
specific cavosurface design and
degree of smoothness that produces
the maximum effectiveness of the
restorative material being used.

Finishing the external walls

Objectives:

To create the best marginal seal possible

between the restorative material and tooth
structure;
To afford a smooth marginal junction;
To provide maximum strength of both the
tooth and the restorative material at and
near the margin.

The strongest enamel margin is that margin

which is composed of full-length enamel rods
that are supported on the cavity side by shorter
enamel rods, all of which extend to sound dentin.

Finishing the external walls

The design of the cavosurface angle
The degree of smoothness of the wall

The design of the cavosurface angle:

depending on the material
amalgam: 90(Cavosurface margin 90-Butt joint)
Help to minimize the marginal deterioration of
restoration by locating the margins away from the
enamel eminence where occlusal forces may be
concentrated.

composite: beveling 30~ 40

Is indicated primarily in larger restoration
because the potential for retention increased by
increasing the surface area of enamel available
for etch.

Occlusal
cavosurface
margin

Proximal
cavosurface
margin

Vertical section of Class II Tooth preparation

-a slight bevel is given to remove unsupported
enamel rods

Gingival Bevel placed with an

instrument
Gingival marginal trimmer

Final cavity preparation stage

Step 5 Removal of any remaining infected
dentin if indicated
Step 6 Pulp protection
Step 7 Secondary resistance & retention form
Step 8 Procedure for finishing external walls
Step 9 Final procedures

Final procedures
cleaning
inspecting
Sealing

References
1.Sturdevants- Art and Science Of Operative Dentistry
2.Marzouk Modern Theory and Practice
3.G.V. Black Work on operative dentistry
3.Vimal Sikri- Textbook of Operative Dentistry
4.Journal of Australia- Conservative Dentistry
5.American Dental Association Document
6.Vale Cavity preparation
7.www.googleimages.com
8.www.dentalacademy/images/cavity preparation.com