MODIFICATIONS OF CAVITY PREPARATION IN primary teeth

Guided by:
Dr. Dr. Dr. Dr. Dr. naveen mittal (h.o.d.) jaspal singh (m.d.s.) varun sardana (m.d.s.) anshul sharma (m.d.s.) kapildev gupta (m.d.s.)

Submitted by: Nency jain 2008-2009

Contents:
* DEFINITION INTRODUCTIONMODIFIED GV BLACK CLASSIFICATION OF CAVITY PREPARATION OTHER MODIFICATIONS FINNS MODIFICATION OF BLACKS CAVITY PREPARATION FOR PRIMARY TEETH TYPES OF CAVITIES CLASS I CAVITY PREPARATION CLASS II CAVITY REPARATION CLASS III CAVITY PREPARATION

DEFINITIONCAVITY PREPARATION-

Cavity preparation is the mechanical alteration of a diseased or injured tooth to receive a restorative material, in order to return the tooth to

STEP OF CAVITY PREPARATIONDuring cavity cutting , vital pulp should not be exposed, otherwise there will be very severe pain and filling of tooth will become complicated requiring direct pulp capping This will delay the final filling process by about six to eight weeks.

1.

Obtaining outline form

2.Obtaining resistance and retention form

3.Obtaining convenience form 4.Removing remaining caries 5.Finishing of the 6.Toilet
cavity walls

of the cavity.

modified gv black CLASSIFICATION OF CAVITY PREPAR

Class I cavity: Pit and fissure caries of the occlusal surface of the molar teeth and the buccal and lingual pits of all teeth. Class II cavity: Proximal surface of molar and premolar teeth with access established from the occlusal surface. Class III cavity: Proximal surface of anterior teeth, not involving incisal edge. Class IV cavity: Cavities of the proximal surface of anterior teeth which involve the incisal angle.

Class V cavity: Cavities founds on the cervical third of all the teeth including the proximal surface, where the marginal ridge is not included in the cavity preparation.

Class VI cavity: Restoration on the incisal edge of anterior teeth or the occlusal cusp height of posterior teeth are class VI.

OTHER MODIFICATIONSCHARBENEUS MODIFICATIONA-Class II: Cavities on single proximal surface of bicuspid and molar. B-Class VI: cavities on both mesial and distal proximal surface of posterior teeth that will share a common occlusal isthmus.

FINNS MODIFICATION OF BLACKS CAVITY PREPARATION FOR PRIMARY Class I: Cavities involving the pits and fissures of the molar teeth and the buccal and lingual TEETHpits of all teeth.
Class II: Cavities involving proximal surface of molar teeth with access established from the occlusal surface. Class III: Cavities involving proximal surface of anterior which may or may not involve a labial or a lingual extension.

All the principles of cavity preparation of permanent teeth also hold good for he primary teeth. However, a few factors have to be taken into consideration while restoring the primary teeth.these includeThe smallar tooth dimension of the deciduous dentition. The thin enamel covering the teeth.

CLASSIFICATION OF CARIES ACCORDING CARIES TO MOUNT G.J.(1997) CLASSIFIED DENTAL BASED ON SITE AND SIZE- OF SITE AND SIZE Site 1-Pits, fissures and enamel on occlusal CARIOUS LESION- surfaces. surface of posterior teeth smooth
Site 2-Includes lesions in the approximal enamel in relation to contact areas of posterior and anterior teeth. Site 3-Includes lesion in the cervical one third of the crown of all the teeth. Size 0-The earliest lesion that can be identified as the initial stage of demineralization. This

Size 1(mild)-minimal surface cavitation with involvement of dentine just beyond treatment by remineralization alone. Some from of restoration is required to restore the surface and prevent further plaque accumulation. Size 2 (Moderate)-Includes lesions which are moderate in size and are having adequate tooth structure to support the restoration. The lesion following cavity preparation should have sound enamel well supported by dentine and not likely to fail under normal occlusal load. The remaining tooth is sufficiently strong to support

TYPES OF CAVITIESClick to edit Master text styles Second level Third level Fourth level Fifth level

RECENT CONCEPT OF The present day dentistry is based on the CAVITY PREPARATIONprinciple of Constriction with conviction.

Blacks concept of cavity preparation was based on Extension for prevention.

The following principles should be considered while preparing a cavity according to the recent conceptCavity designs should be dictated under the site and extent of the lesion and not by any preconceived notion of mechanical interlocking patterns.

The first choice of a restorative material should be one that display some degree of biological activity and will therefore assist in the process of remineralization and healing of remaining tooth structure. Only one part of the tooth crown that is irretrievably degenerated and broken down should be removed and the reminder even though demineralization and softened, should be retained and remineralized. The first function of the restoration will be to

Modified CLASS I CAVITY PREPARATION- isthmus should not Due to the narrow occlusal table
be more than 1/3rd the intercuspal distance in the case of a small carious lesion. The depth should not be more than 0.5 mm. into dentin. The pulpal floor should be flat.any remaining carious should be removed using round bur in slow speed.

CLASS I CAVITY PREPARATI ON

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MODIFIED CLASS II CAVITY PREPARATION- the Due to the presence of broad contact areas,
The wall of the proximal box should meet the occlusal walls in a straight to avoid any stress points. The walls of proximal box should not be flared as it would lead to unsupported enamel. The isthmus should not exceed 1/3rd the inercuspal width in primary molars.

gingival floor of the proximal box should be wide so as to place the margins in self-cleansing areas.

Retention can be improved by a U- shaped retention groove along the amelodentinal junction of the proximal box. When the cavity margins exceed that of an ideal preparation particularly in the case of a mandibular first primary molar, it is recommended that ad overlay of the distobuccal cusp be prepared. The weakened cusp is reduced to the level of the pulpal floor of the occlusal preparation. Mesiodistally the cusp should not be reduced

The proximal box should allow the passage of an explorer tip between its margins and adjacent tooth in all three directions, buccally, gingivally and lingually.

CLASS II CAVITY PREPARATIONCavity preparation and modification from the

PROXIMAL BOX- Deciduous teeth have more constriction cervically.

cavity in permanent teeth include the following-

The danger of pulp exposure is increased very much if gingival wall is made more cervically and axial wall is formed more toward the pulp. in deep proximal caries when it extend below the contact point, proximal box is

PULPAL WALL- It should be about 0.5mm in dentin and made concave to avoid injury to pulp horn and exposing the pulp. During finishing of pulpal floor, care should be taken in the mesiobuccal area not to expose the pulp horn.

AXIOPULPAL LINE ANGLE-It should be roundepd

CLASS II CAVITY PREPARATI ON

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PREPARATION OF CLASS I &CLASS II CORRECT Click to edit Master text styles Second level &INCORRECTClick to edit Master text styles

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CLASS III CAVITY PREPARATION- outline is When the contact is open the

triangular with base towards the gingival aspect of the cavity. Gingival cavity wall is inclined occlusally to parallel the enamel rod direction. Retention pits can be placed at the axiobuccogingival and axiolinguogingival point angles.

CLASS III CAVITY PREPARATION-

CLASS IV CAVITY PREPARATIONIn anterior teeth, if

incisal angle is Click to edit Master text styles involved along with proximal caries, then it Second level Third level comes under class IV Fourth level Fifth level cavity.

CLASS V CAVITY which is A cavity present at the gingival PREPARATION Click to edit Master text styles third or cervical third
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of any tooth comes under class V cavity. It is in kidney shape.

CLASS VI CAVITY PREPARATIONIn GV Black

classification, description of class VI cavity is not given. It was added later on. It includes cavities, both on mesial and distal surface of molar that when restored, share a common occlusal isthmus, mesioocclusal cavities and

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REFERENCESHOBHA TONDON 2nd EDITION SATISH CHANDRA SHALEEN CHANDRA RK BALI Click to edit Master text styles
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