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Difference Between Amalgam
& Composite Class I & II
Cavity Preparation
Ibtissam Itani
Maya Kabbara
Nancy Itani
Sana Jardal...
vs.
Content
1. General comparison between amalgam and composite
2. Class I cavity preparation
a. Modified class I
3. Class II ...
Amalgam Composite
Esthetics Contraindicated Highly esthetic
Technique Sensitivity &
Isolation
Restorations that cannot be ...
Class I
Amalgam vs. Composite
1. The enamel must be supported with dentin to over
come the fracture.
Similarities
2. All angles must be rounded to preve...
1. Outline
Amalgam
• Includes all pits &
fissures and other
areas prone to caries
• width cavity within
1/4 to 1/3 intercu...
2. Retention
Amalgam
• Macromechanical retention
 undercuts: diverging
mesial & distal walls
smoother prepared walls
• R...
3. Resistance Form
Amalgam
 Resistance requires
bulkiness of cavity
Composite
3. Depth depends on extent of
defect  can ...
Resistance Form
Amalgam
• Cavosurface Angle = 90° to
protect enamel rods
 occlusal cavosurface bevel
is contraindicated
C...
Modified Class I
Amalgam vs. Composite
Amalgam
1. Box shaped appearance
Composite
1. Scooped out appearance
3. occlusolingual
restoration used when
lingual fissu...
Class II
Amalgam vs. Composite
Class II
Amalgam Composite
Conventional Modified
1. Outline
Amalgam
• The occlusal
outline form of
proximal box is
determined
primarily by:
1. bucco-lingual
position of th...
…Outline
Amalgam
• Bucco proximal
margin, linguo
proximal
margin &
gingival floor
should be
extended to
include caries
& b...
Amalgam
• Slot preparation:
Modified class
II cavity for
placement of
RMGIs (Resin
Modified Glass
Ionomer)
• Presence of i...
2. Retention
Amalgam
• Rounded grooves within dentin at bucco
and linguo- proximal walls and gingival
floor
Conventional C...
• for smaller restorations
• preparation design: more rounded, less boxlike, & less uniform
in extension or depth compared...
• when only proximal surface is faulty, with
no lesions on the occlusal surface
• No beveling or secondary retention
indic...
References:
• Roberson, T. (2006). Sturdevant's art and science of operative
dentistry (5th ed.). St. Louis, Mo.: Mosby.
•...
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Comparison between Class I and Class II amalgam and composite resin restoration

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  1. 1. Difference Between Amalgam & Composite Class I & II Cavity Preparation Ibtissam Itani Maya Kabbara Nancy Itani Sana Jardali Yara Ismail
  2. 2. vs.
  3. 3. Content 1. General comparison between amalgam and composite 2. Class I cavity preparation a. Modified class I 3. Class II cavity preparation 1.Outline 2.Retention 3.Resistance
  4. 4. Amalgam Composite Esthetics Contraindicated Highly esthetic Technique Sensitivity & Isolation Restorations that cannot be well isolated More technique sensitive & restoration that can be appropriately isolated Durability Long-lasting if handled well According to the ADA, expected lifetime can be comparable to that of amalgam in Class I & II if material’s handled well Location Posterior teeth Anteriors & esthetically prominent areas in posterior teeth Cavity size more extensive (moderate-to-large) Class I restorations most small Class I restorations Mechanical properties Higher mechanical properties Less mechanical properties  more subjected to wear Caries Risk Patients w/ bad oral hygiene  less risk of recurrent caries due to self-sealing properties Patients w/ good oral hygiene  high rate of recurrent caries due to polymerization shrinkage Hazards on practitioner More hazardous due to mercury Hazardless Repair Can’t be repaired Can be repaired
  5. 5. Class I Amalgam vs. Composite
  6. 6. 1. The enamel must be supported with dentin to over come the fracture. Similarities 2. All angles must be rounded to prevent stress magnitude on the tooth structure. 3. The walls must be either parallel or perpendicular to the long axis of the teeth to decreases the forces. Incorrect Correct
  7. 7. 1. Outline Amalgam • Includes all pits & fissures and other areas prone to caries • width cavity within 1/4 to 1/3 intercuspal distance Composite Limited to defected areas and does not have to extend to all pits & fissures  Most conservative manner
  8. 8. 2. Retention Amalgam • Macromechanical retention  undercuts: diverging mesial & distal walls smoother prepared walls • Retention is dependent on design of cavity Composite • micromechanical retention Rough surfaces of prepared walls • Sometimes, a dentinal retention groove or enamel bevel  to enhance the retention form
  9. 9. 3. Resistance Form Amalgam  Resistance requires bulkiness of cavity Composite 3. Depth depends on extent of defect  can be stopped short of the dentinal-enamel junction if the caries process also stops before the dentin is reached 1. pulpal depth: not necessarily uniform but usually 1 – 2 mm 1. Pulpal depth = min. 1.5 mm (floor must consist of dentin) 2. Axial wall: Should be uniform = 0.2 – 0.5 mm inside DEJ 2. Axial wall: Not necessarily uniform 3. If caries extends deeper than pulpal depth of 1.5 mm, only the carious area is excavated and a flat seat is established around to not affect retention form
  10. 10. Resistance Form Amalgam • Cavosurface Angle = 90° to protect enamel rods  occlusal cavosurface bevel is contraindicated Composite • Cavosurface Angle ≥ 90° to: 1. Increase surface area of enamel to be etched to strengthen micromechanical bond 2. Esthetic blending of composite w/ tooth structure 3. Ends of enamel rods are more effectively etched, producing deeper microundercuts than when only the sides of the rods are etched
  11. 11. Modified Class I Amalgam vs. Composite
  12. 12. Amalgam 1. Box shaped appearance Composite 1. Scooped out appearance 3. occlusolingual restoration used when lingual fissure is connected w/ the distal oblique groove & distal pit on occlusal aspect 2. bur must be slightly inclined distally to conserve the dentinal support & strength of marginal ridges & distolingual cusp 2. Undermined marginal ridge can be left in extensive preparation & strengthened by composite bonding
  13. 13. Class II Amalgam vs. Composite
  14. 14. Class II Amalgam Composite Conventional Modified
  15. 15. 1. Outline Amalgam • The occlusal outline form of proximal box is determined primarily by: 1. bucco-lingual position of the contact 2. extent of the carious lesion Conventional Composite • used for moderate to very large Class II composite restoration Occlusal outline Occlusal outline Same principles in Class I cavity preparation except that external outline is extended proximally toward defective proximal surface
  16. 16. …Outline Amalgam • Bucco proximal margin, linguo proximal margin & gingival floor should be extended to include caries & break the contact with the adjacent tooth Conventional Composite • What dictates the facial, lingual, and gingival extension of the proximal box? 1. The extent of the carious lesion 2. Amount of old restorative material • not required to extend the proximal box beyond contact with the adjacent tooth Proximal boxProximal box
  17. 17. Amalgam • Slot preparation: Modified class II cavity for placement of RMGIs (Resin Modified Glass Ionomer) • Presence of infected carious dentin on portion of either pulpal floor or axial doesn’t indicate deepening entire wall.
  18. 18. 2. Retention Amalgam • Rounded grooves within dentin at bucco and linguo- proximal walls and gingival floor Conventional Composite 1. No dovetail 3. Gingival bevel 2. Cavosurface bevel to increase surface area • Gingival divergence faciolingual width at gingiva greater than the occlusal 3. No gingival bevel 2. No cavosurface bevel 1. Occlusal dovetail required for retention
  19. 19. • for smaller restorations • preparation design: more rounded, less boxlike, & less uniform in extension or depth compared to conventional Composite Modified Class II conservatively remove the fault create 90-degree cavosurface margins or greater remove friable tooth structure
  20. 20. • when only proximal surface is faulty, with no lesions on the occlusal surface • No beveling or secondary retention indicated • proximal box not extended onto occlusal surface by more than 2 - 2.5 mm beyond location of the proximal marginal ridge • lesion on proximal surface but access to lesion is possible through facial/lingual surface rather than through the marginal ridge in a gingival direction  Direct access for caries removal Box-only tooth preparation Facial/Lingual Slot Preparation Composite Modified Class II
  21. 21. References: • Roberson, T. (2006). Sturdevant's art and science of operative dentistry (5th ed.). St. Louis, Mo.: Mosby. • http://iust.edu.sy/courses/class%20i%20and%20ii%20direct%20comp osite%20and%20other%20tooth-colored%20restorations%20(1).pdf • http://ccnmtl.columbia.edu/projects/virtechs2006/pdfs/opclass2prepha ndout.pdf

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