Class Ii Amalgam Cavity Preparation For Amalgam
Class Ii Amalgam Cavity Preparation For Amalgam
Class Ii Amalgam Cavity Preparation For Amalgam
FOR
AMALGAM
& DESIGN VARIATIONS
CONTENTS
I) Definition .
II) Tooth preparation governing factors.
1) Outline form.
2) Resistance form.
3) Retention form.
III) Instrumentation.
1) Outline form.
2) Primary resistance form.
3) Primary retention form.
4) Removal of defective E & old restorations.
5) Pulp protection.
6) Secondary resistance & retention.
7) Final procedures.
IV) Designs of cavity preparations.
V) Variations of one proximal tooth surface
preparations.
VI) Modifications in tooth preparation.
VII) Extended Cl II amlagam.
VIII) Cl II perp. in primary teeth.
IX) Conservative preparations.
X) References .
CLASS II CAVITY
PREPARATION FOR AMALGAM
DEFINITION:
A Class II cavity preparation is the proximo-
facial (lingual), proximo-occlusal (or
combination there of) tooth preparation.
It is part of mechanotherapy for a smooth
surface lesion, involving the proximal surfaces
of molars & premolars.
TOOTH PREPARATION
INITIAL PREPARATION-
Governing factors:
OUTLINE FORM:
Following factors dictate the outline
form;
A) Proportional size of caries in
enamel to that in dentin, their
relative size to that of
uncleansable prox. areas:
i) Forward (pit) decay: caries cone
in E < uncleansable area
i) Backward decay: caries cone does
not undermine all enamel.
iv) Esthetics.
v) Tooth position.
RESISTANCE FORM:
A) Occlusal loading & its effects:
Proximal portion:
Unilateral inverted truncated cone.
In upper teeth lingual inverted
truncated cone only.
Lower teeth buccal inverted truncated
cone only.
This feature done on functional side only.
if on E one plane.
F – L cross section:
2 axial walls one prox. & another F / L .
Rounded axio- axial line angle.
Proximal axial wall slightly slanted towards the access side.
6) Cl II , design 6 :
Involvement : the O, P & part of the F & L surfaces.
Indications: a) the cusp length is double or more its
width.
b) Cusp completely missing or undermined.
c) Foundation for cast restor. required.
d) Doubtful prognosis endodontically & peridontically.
e) Badly broken down teeth that need to be prepared
prior to endo/ortho tr.
General shape :
O & P parts similar to design 1 or 2.
F & L parts rectangular in outline.
Location of margin :
O & P portion similar to design 1 or 2.
F & L portions in areas at / occlusal to the ht.
of contour of the F & L surfaces.
Do not place margin in grooves.
If margin comes near a groove include in
cavity prep.
In areas apical to the ht.of contour F & L
same as G 3rd of prox.surfaces.
Internal anatomy:
O & P similar to design 1 or 2.
Rules to prep.a cusp:
1) Cusp to be replaced reduce 1.5-2.0mm
from opposing cuspal elements.more on
functional cusp.
2) Cusp cut flat in the form of table, with
rt.angled cavo-surface margins.
3) Mini length : width 1:1
4) If cusp undermined tabled until there is
intact E supported by sound D.
5) Remaining part of cavity should have
sufficient retention.
6) Never place pins on tables which will
accommodate amalgam cusps/part of cusps.
7) In multiple tables junction rounded.
7) Cl II , design 7 :
Involvement : Shape A junction b/w the Cl II
& Cl V via proximal, crossing the axial angle.
General shape :
O portion similar to design 1 or 2.
P-F & P- F portion if unilateral extension F/L
L shaped.
Bilateral inverted T shaped.
Shape B : junction b/w the Cl II & Cl V is
through the occlusal via the B &/ L groove.
General shape:
O & P portions design 1 or 2.
F & L portions inverted T shaped.
8) Cl II , design 8 :
Involvement : 2 or more surfaces of an endo. tr.
tooth that does not requirec post retention.
Indications: a) tooth has sufficient pulp chamber
to accommodate retaining, self resisting
amalgam bulk ( mini.2mm in 3Ds)
b) Post endo. Pulp chamber has atleast 2
opposing intact walls.
c) Tooth contains sufficient large root canals
to accommodate amalgam at its O 1/3rd
(mini.1.5mm)
d) A foundation is needed for reinforcing restor.
General shape : similar to design 6.
Internal anatomy:
Rules to arrive to the finished product;
1) Excavate residual RC filling from
pulp chamber. Bare dentin exposed.
2) Large RC that can accommodate an
amalgam 1.5mm RC filling
removed to 3-4mm depth.
3) If possible “square up” surrounding walls.
4) In bulky portions of the surrounding walls
cut flat ledges receive most of the occlusal
loading.
G floor flat.
Mechanical retention:
If prox.box/slot wide amalgam bonding /
self threading pins placed
horizontally/vertically.
Slot prep. for root caries: (KEY-HOLE
PREPARATION/ FACIAL/LINGUAL
SLOT PREPARATION)
Usually approached from F form of
slot.
Depth axially0.75-1mm at G aspect if
no E pr.
1-1.25mm at O wall, if margin in E.
If O margin in E axial depth 0.5mm
inside the DEJ.
Retention grooves O-A & G-A line
angles.
0.2mm inside the DEJ or 0.3-0.5mm
inside the cemental cavo-surface margin.
Depth of the groove1/2 the diameter of
the bur head(0.25mm)
2) ROTATED TEETH:
Outline form for M-O tooth prep. on rotated
teeth differs.
prox.box displaced F / L.
When rotated 900 prox.prep on F/L surface.
3) ADJOINING RESTORATION:
It is permissible to repair /replace a defective
portion of an existing AgF restor. if
remaining portion of the original restor.
adequate rete. & resist. Form.
Intersecting margins of the 2 restor. at
rt.angles as much as possible.
4) ABUTMENT TEETH FOR RPD:
If rest seat is planned in restor. need
additional extension.
0.5mm (mini) of AgF b/w rest seat & margins.
Cavo-surface 900
1mm.
A-P line angle rounded.
3) Bevel.
CONSERVATIVE CAVITY
PREPARATIONS
TUNNEL PREPARATION:
Advantages :
1) Preserves marginal ridge.
2) Contact area not disturbed.
3) Risk of over hang minimal.
Disadvantages :
1) Complete excavation of caries not feasible.