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Class II Amalgam Preparation

Lecture Number Five by Dr. Sohail Abbas Khan http://helpingdentists.blogspot.com

Class II Amalgam Preparation

Lecture Number Five by Dr. Sohail Abbas Khan http://helpingdentists.blogspot.com

Class II Amalgam Preparation

1 of 21

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Class II Amalgam Preparation

  • 2. PREPARATION OF AN IDEAL CLASS II CAVITY CARIOUS LESIONS ON PROXIMAL SURFACES.
  • 3. STEPS IN CAVITY PREPARATION FOLLOW THE PROCEDURE FOR PREPARING CLASS I. MARK THE OUTLINE WITH A LEAD PENCIL AND OPEN IT WITH ½ ROUND BUR. BURS # 245 & 330 ARE IDEAL FOR PRODUCING OCCLUSAL CONVERGENCE OF THE FACIAL AND LINGUAL WALLS. 3MM
  • 4. ORIENTATION OF THE BUR IS THE KEY IN PREPARATION.LONG AXIS OF THE BUR MUST BE PARALLEL TO THE CROWN OF THE TOOTH.
  • 5. WITH A SWEEPING DRAG, MAINTAINING THE SAME DEPTH AND BUR ORIENTATION, CUT THE TOOTH TOWARDS MESIAL PIT. THIS WILL PRODUCE A FLAT PULPAL FLOOR. REMEMBER NOT TO MOVE THE BUR AGAIN AND AGAIN,OTHERWISE YOU WILL WIDEN THE ISTHMUS.
  • 6. EXTEND THE PREPARATION DISTO FACIALLY AND DISTO LINGUALLY TO INCLUDE FISSURES THAT RADIATE FROM THE PIT, WITH A SLIGHT OCCLUSAL CONVERGENCE. REMEMBER TO MAINTAIN THE BUR ORIENTATION AND DEPTH AND MAKE SURE THE BUR IS NOT STOPPED DURING THE WHOLE PROCEDURE.
  • 7. VARIOUS STEPS IN OCCLUSAL PREPARATION. (NOTE THE ANGULATION OF THE BUR)
  • 8. VARIOUS STEPS IN OCCLUSAL PREPARATION. (CONTINUED)
  • 9. VARIOUS STEPS IN OCCLUSAL PREPARATION. (CONTINUED) EXTEND THE PREPARATION PROXIMALLY BUT MUST STOP 0.8MM SHORT OF MARGINAL RIDGE.
  • 10. WITH A LEAD PENCIL, MARK THE EXTENSION OF THE FACIAL AND LINGUAL WALLS OF THE PROXIMAL BOX RELATIVE TO THE CONTACT AREA. PREPARING A PROXIMAL BOX
  • 11. CREATE A REVERSE CURVE IN AN OCCLUSAL OUTLINE. THIS WILL RESULT WHEN DEVELOPING THE MESIO FACIAL WALL PERPENDICULAR TO THE ENAMEL ROD DIRECTION. HOWEVER, THE REVERSE CURVE ON THE LINGUAL ASPECT WILL BE MINIMAL. ESTABLISH 0.5 MM CLEARANCE WITH THE ADJACENT PROXIMAL SURFACE FACIALLY, LINGUALLY AND GINGIVALLY.CHECK CLEARANCE WITH THE TINE OF EXPLORER.
  • 12. PREPARING A PROXIMAL BOX (CONTINUED) MAKE A DITCH,VERY CLOSE TO CONTACT, ENTERING HALF OF THE 245 BUR (245 BUR IS 3 MM LONG).THE REQUIRED DEPTH OF PULPAL FLOOR IS BETWEEN 1.5 TO 2 MM. THE BUR MUST NOT STOP ROTATING WHILE CUTTING IN THE CAVITY. POSITION THE BUR IN THE PULPAL FLOOR NEXT TO REMAINING MARGINAL RIDGE.MOVE THE END OF THE BUR TO CUT A DITCH GINGIVALLY ALONG THE EXPOSED DENTINOENAMEL JUNCTION.THIS WILL CUT 0.5 MM INTO DENTINE AND 0.2 TO 0.3 MM INTO ENAMEL.
  • 13. MOVE THE BUR FACIALLY AND LINGUALLY ALONG THE DEJ. EXTEND THE DITCH GINGIVALLY AND TILT THE BUR LIGHTLY TOWARDS MESIAL.DURING PREPARATION, KEEP CHECKING THE DEPTH WITH PERIODONTAL PROBE. PROXIMAL DITCH CUT MUST BE DIVERGENT GINGIVALLY WHICH IS ACHIEVED BY THE SHAPE OF 245 BUR.
  • 14. FINISHING OF THE CAVITY WALLS: REMOVE ANY IRREGULARITIES FROM THE MARGIN AND REMOVE UNSUPPORTED ENAMEL BY USING CHIESELS, HATCHETS TO ESTABLISH FINAL FACIAL, LINGUAL AND GINGIVAL MARGINS. USING GMT(GINGIVAL MARGIN TRIMMER, BEVEL THE AXIOPULPAL LINE ANGLE AND GINGIVAL MARGIN.
  • 15. USING GMT, CREATE THE BEVELS IN GINGIVAL AND AXIOPULPAL WALL. MAKE BEVEL ON OCCLUSAL WALL.
  • 16. WALLS AND FLOORS OF CAVITY PREPARATION LINE ANGLES OF THE CAVITY PREPARATION BUCCAL (FACIAL) WALL AXIAL WALL LINGUAL WALL CAVOSURFACE MARGIN PULPAL WALL GINGIVAL WALL AXIAL WALL LINGUAL WALL GINGIVO-BUCCAL AXIO-PULPAL AXIO- GINGIVAL PULPO-LINGUAL AXIO-LINGUAL AXIO-PULPAL GINGIVO-LINGUAL AXIO-GINGIVAL
  • 17. VARIOUS WALLS CREATED DURING CLASS II PREPARATION RIGHT ANGLE NO BEVEL ROUNDED ENAMEL WALL PARALLELS DIRECTION OF RODS ONLY – NO BEVEL ACUTE AXIO- GINGIVAL ANGLE RETENTIVE GROOVE AMALGAM RIGHT ANGLE
  • 18. MEASUREMENTS OF THE PREPARED CAVITY
  • 19. EXAMPLES OF CLASS II CAVITY PREPARATION
  • 20. EXAMPLES OF CLASS II CAVITY PREPARATION
  • 21. REASONS FOR FAILURE IN CAVITY PREPARATION EXTERNAL OUTLINE FORM INTERNAL FORM FINISH