This document discusses tooth preparation for class II amalgam restorations. It begins by outlining initial clinical procedures like marking occlusal contacts. It then describes the steps for preparing teeth that involve one or both proximal surfaces, including occlusal outline form, proximal outline form, and variations for different teeth. Key steps are punch cut entry, occlusal extension, proximal extension, axial wall preparation, and finishing. It also discusses secondary resistance/retention forms like proximal locks and grooves. The goal is to follow principles of cavity preparation for amalgam like including all caries, creating butt joint margins, and providing resistance and retention forms.

1. Dental materials
TOPIC : Tooth preparation for class ii AMALGAM RESTORATION
Done by : Divya Darsini .S
Second year BDS

2. SYNOPSIS :
• INTRODUCTION
• INITIAL CLINICAL PROCEDURES
• TOOTH PREPARATION FOR CLASS II AMALGAM RESTORATION THAT INVOLVE ONLY ONE
PROXIMAL SURFACE
INITIAL TOOTH PREPARATION
OCCLUSAL OUTLINE FORM
PROXIMAL OUTLINE FORM
PRIMARY RESISTANCE FORM
PRIMARY RETENTION FORM
FINAL TOOTH PREPARATION
REMOVAL OF ANY REMAINING DEFECTIVE ENAMEL AND INFECTION CARIOUS DENTIN
PULP PROTECTION
SECONDARY RESISTANCE AND RETENTION FORM
FININISHING THE PROXIMAL WALLS
VARIATION OF PROXIMAL SURFACE TOOTH PREPARATION
MANDIBULAR FIRST PREMOLAR
MAXILLARY FIRST MOLAR
MAXILLARY FIRST PREMOLAR
BOX ONLY PREPARATION
• TOOTH PREPARATION FOR CLASS II AMALGAM RESTORATION INVOLVE TWO PROXIMAL SURFACE
OCCLUSAL EXTENSION
PROXIMAL EXTENSION

3. EXAMPLES OF MODERATE CLASS II AMALGAM RESTORATION
MAXILLARY FIRST MOLAR
MANDIBULAR FIRST MOLAR
MANDIBULAR FIRST PREMOLAR
MANDIBULAR SECOND PREMOLAR
MODIFICATIONS IN THE TOOTH PREPARATION OF PROXIMAL SURFACE
SLOT PREPARATION FOR ROOT CARIES
ROTATED TEETH
ADJOINING RESTORATION
UNUSUAL OUTLINE FORM
• RESTORATIVE TECHNIQUE FOR CLASS II AMALGAM PREPARATION
DESENSITIZER PLACEMENT
MATRIX PLACEMENT
UNIVERSAL MATRIX
BURNISHING THE MATRIX BAND
PREPARING THE RETAINER TO RECEIVE THE BAND
PLACING THE BAND WITH RETAINER ON THE PREPARED TOOTH
WEDGING TECHNIQUE
ROUND VERSUS TRIANGULAR WEDGE
RIGID MATERIAL SUPPORTED SECTIONAL MATRIX
PRE-COUNTED SECTIONAL MATRIX STRIPS
CONDENSATION AND CARVING OF AMALGAM
REMOVAL OF THE MATRIX BAND AND CARVING COMPLETION
FINISHING AND POLISHING OF THE AMALGAM
QUADRANT DENTISTRY

4. introduction
Class II restoration restore the defects that affect one or both of the proximal surface of the
posterior teeth
INITIAL CLINICAL
PROCEDURE :
Occlusal contacts should be
marked with articulating
paper before tooth
preparation . Any opposing
‘plunging cusp’ need to be
re-contoured to reduce risk
of fracture of new
restoration
Class to amalgam in premolar and molar

5. TOOTH PREPARATION FOR CLASS II AMALGAM RESTORATION THAT INVOLVE ONLY
ONE PROXIMAL SURFACE
Bur used in class II tooth preparation
245 BUR

6. INITIAL TOOTH PREPARATION
• OCCLUSAL OUTLINE FORM :
• STEP I : PUNCH CUT
• Enter the pit nearest to the involved proximal
surface with a punch cut using a no.245 bur
• Viewed from the proximal and lingual aspects , the
long axis of the bur should be parallel to the long
axis of tooth crown during cutting
• Proper depth of the initial entry cut is 1.5-2 mm . The
pulpal depth is usually 0.1-0.2 mm into the dentin .
This introduces the principles and technique of class II tooth preparation for an
amalgam restoration involving caries lesion on one proximal surface. Pre-operative
placement of a wedge[pre-wedging] in the space adjacent to the proximal surface
with caries lesion will create space between adjacent teeth
PUNCH CUT
ENTRY;PROXIMAL VIEW

7. • STEP II : OCCLUSAL EXTENTION
• Proper depth of the initial entry cut is 1.5-2 mm .the pulpal depth is usually 0.1-0.2
mm into the dentin .
• While maintaining the same depth and orientation , bur is moved to extend the
outline to include the central fissure and opposite pit ,if necessary
• Include all the carious occlusal pits and fissures in such a manner that sharp angles
in the marginal outline are avoided
• The isthmus width should be as narrow as possible , ideally should be ¼th of the
intercuspal distance
• Distal wall can be made occlusally divergent by tilting the bur, if the extension of
distal margin would reduce the dentinal support of marginal ridge

8. • Step III : OCCLUSAL DOVETAIL
• Dovetail prevents the proximal displacement of
the restoration . It is not required in outline
form of single step proximal box ,unless a
fissure is radiating from the occlusal pit
• Enameloplasty should be used where indicated
to conserve tooth structure
Completed occlusal step
• Step IV : PROXIMAL EXTENTION
• Before extending into the involved proximal marginal ridge , the final
location of the facial and lingual walls of the proximal box relative to the
contact area should be visualized , to prevent over extention of the occlusal
outline form [i.e., occlusal step] where it joins the proximal outline form
[i.e., proximal box]
• While maintaining the established pulpal depth and with bur parallel to the
long axis of the crown , the preparation is extended mesially , stopping
approximately 0.8 mm short of cutting through the marginal ridge into the
contact area

9. • The occlusal step in this region is made slightly wider labiolingually than in
the class I cavity preparation because additional width is necessary for the
proximal box
• The extension include part of mesial marginal ridge DEJ . The location of the
DEJ is an important guide in the developed of the proximal preparation
REVERSE CURVE
PROXIMAL MARGIN

10. • PROXIMAL OUTLINE FORM :
• Again visualize the desired final location of the facial and lingual walls of the
proximal box relative to the contact area
THE OBJECTIVES FOR EXTENTION OF PROXIMAL MARGINS ARE :
• Include all caries ,faults ,or existing restorative materials
• Create 90 degree Cavo surface margins [butt joint margins]
• Establish not more than 0.5 mm clearance with the adjacent proximal
surface facially, lingually and gingivally.
• Primary flare is the flare given from isthmus to the proximal Cavo
surface margin . This is done to bring the facial and proximal walls to
the facial and lingual embrasures

11. • STEP I : PROXIMAL DITCH CUT
• The initial procedure in preparation of outline form is the
isolation of the proximal enamel by giving the proximal
ditch cut
• Allow the end of the bur to cut a ditch gingivally along
the exposed DEJ . Two third at the expense of dentin and
one third at the expense of enamel . The 0.8 mm
diameter bur end will cut approximately 0.5 to 0.6 mm
into enamel
Proximal Ditch cut
• STEP II : GINGIVAL EXTENTION OF PROXIMAL WALL
• The ditch extended gingivally just beyond the caries or the proximal contact
, whichever it is greater .
• Ideally the extension of facial and lingual margins of proximal box should be
such that , it provides clearance of 0.2 – 0.3 mm from the adjacent tooth
• But the clearance greater than 0.5 mm is excessive unless indicated to
include caries , undermined enamel , or existing restorative material

12. • Ideally the gingival margin should clear the adjacent tooth by only 0.5 mm
, which may be measured with the slide of explorer
Gingival
extension of
proximal wall
The faciolingual dimension of the proximal
ditch is greater at the lingual level than at
the occlusal level to provide occlusal
convergence of the facial and lingual
proximal box walls

13. • STEP III : PREPARATION OF AXIAL WALL
• It is an prepared wall that is parallel to the long axis of the tooth and it is always
placed in dentin to obtain
resistance and elasticity of dentin
bulk of the restoration
placement of retentive locks
• Length of the axial wall : 0.4 – 0.6 mm from the axiopulpal line angle to
axiogingival line angle
• The axial wall should be straight or convex but it should never be concave
• It should follow the contour of proximal surface
• PREPARATION OF GINGIVAL SEAT
• It is an external cavity wall that is perpendicular to the long axis of the tooth
• It is extended beyond the contact area up to the proximal lesion whichever is
more . This also help in providing a contact clearance gingivally
• It is made flat so that the masticatory force are distributed equally
 The width of gingival seat : 0.6 – 0.8 mm [premolars]
0.8 – 1.0 mm [molars]
 It consists of 2/3 of dentin ,1/3 of enamel

14. • STEP IV : PROXIMAL EXTENTION OF PROXIMAL BOX
• In completing the proximal extensions , next make two cuts , one starting at the
facial limit of the proximal ditch and the other starting at the lingual limit ,
extending toward and perpendicular to the proximal surface [until the bur is
nearly through the enamel at contact level]
• The side of the bur may emerge slightly through the surface at the level of the
gingival floor

15. ISOLATION OF PROXIMAL ENAMEL

16. • STEP V : BREAKING THE PROXIMAL WALL
• A matrix band may be used around the adjacent tooth to prevent marring its
proximal surface
• The isolated enamel , if still in place , may be fractured out with a spoon
excavator or by additional movement of the bur
• To protect the gingiva and the rubber dam when extending wall gingivally , a
wooden wedge should already be in place in the gingival embrasure to depress the
soft tissue and rubber dam

17. • With the enamel hatchet , the bin angle chisel , or both , cleave away any
remaining undermined proximal enamel , establishing the proper direction to
the mesiolingual and mesiofacial wall
• Proximal margins having cavosurface angles of 90 degree are indicated

18. PRIMARY RESISTANCE FORM :
• Pulpal and gingival walls being flat and perpendicular to the forces and
perpendicular to the forces directed to the long axis of the tooth
• Restrict the extension of the walls to allow strong cusps and ridges to remain
with sufficient dentin support
• Restricting the occlusal outline form to areas receiving minimal occlusal
contact
• Reverse curve optimizing the strength of both the amalgam and tooth
structure at the junction of the occlusal step and proximal box
• Rounding off the internal line angles
• Providing the enough thickness of the restorative material
PRIMARY RETENTION FORM :
• Occlusal convergence of facial and lingual walls
• Dovetail design of occlusal step [when present]

19. FINAL TOOTH PREPARATION
REMOVAL OF ANY REMAINING DEFECTIVE ENAMEL AND INFECTION CARIOUS DENTIN
• Accomplished in the same manner as in the class I Preparation
• Infected carious dentin is removed with a slowly revolving round bur of appropriate
size or a discoid type spoon excavator or both

20. • The presence of infected dentin carious dentin on a portion of either the pulpal
wall [floor] or axial wall does not indicate deepening the entire wall
• Infected carious dentin on axial wall does
not call for preparing axial wall towards the
pulp as shown by dotted lines . It should be
removed with round bur

21. • A partial extension of a facial or lingual wall is permissible if:
 The entire wall is not weakened
 the extension remains accessible and visible
 sufficient gingival seats remain to support the restoration
 a but joint fit at the amalgam and enamel margin
[90 degree amalgam angle and 90 degree Cavo surface
angle] is possible
PULP PROTECTION :
• It is desirable to have approx. 2 mm bulk beneath the pulp and metallic
restoration which may be dentin , liner or a base
• Liner / base – mechanical ,chemical ,thermal pulp protection and act as a
barrier that protects the dentin

22. • Remaining dentin thickness 0.5 – 1 mm zinc phosphate cement , glass
monomer cement base is used followed by calcium hydroxide liner
• The base insulates the pulp from thermal changes , bonds to the dentin,
releases fluoride and is strong enough to resist the forces of condensation

23. SECONDARY RESISTANCE AND RETENTION FORM
• Using the gingival margin trimmer to bevel or round the axiopulpal line angle
PROXIMAL RETENSION LOCKS
 Placed on axiofacial and axiolingual line angles
 Terminate at axiopulpal point angle
 Prepared with no.169L bur
 There are four characteristics or determinants of proximal locks :
1.position
2.translation
3.depth
4.occlusogingival orientation

24. Proximal retention locks

25. • POSITION :
 Refers to the axiofacial and axiolingual line angles of initial tooth
preparation it is important to note that retention locks should be placed
0.2 mm inside the DEJ , regardless of the depth of the axial wall and
axial line angles
• TRANSLATION :
 refers to the direction of movement of the axis of the bur i.e., parallel to
DEJ
• DEPTH :
 Refers to the extent of translation [i.e., 0.5 mm at gingival floor level]
• OCCLUSOGINGIVAL ORIENTATION :
 Refers to the tilt of the no.169L Bur, which dictates the occlusal height
of the lock ,given a constant depth
PROXIMAL RETENTION LOCKS

26. • RETENTION GROOVES :
 Placed on axiofacial and axiolingual line angles
 Extend from the gingival floor to the occlusal surface
 Prepared with no.1/4 round bur with head diameter of 0.5
mm or no.1/8 bur with head diameter of 0.4mm
 In preparation with deep proximal box grooves should be in
the proximal walls just inside the DEJ and not in the corners
of the box

27. FOUR CHARACTERISTICS OF RETENSION GROOVES

28. FININISHING THE PROXIMAL WALLS :
• There should be no unsupported enamel and marginal irregularities present
• There should but joint relation between the tooth and amalgam
• Cavo surface [20 degree] at the gingival margin can be given by G.M.T to
remove the unsupported enamel rods
• When the gingival margin is positioned gingival to the cementoenamel
junction [CEJ] on the tooth root , the bevel is not indicated

29. VARIATION OF PROXIMAL SURFACE TOOTH PREPARATION
MANDIBULAR 1ST PREMOLAR
• The support of the small lingual cusp may be
conserved by preparing the occlusal step more at
the expense of tooth structure facial to the
central groove than lingual
• The lingual cusp may need to be reduced for
capping if the lingual margin of the occlusal step
extends more than two thirds the distance from
the centre fissure to the cuspal eminence
• SLOPING PULPAL FLOOR :
 This preparation is done in the mandibular 1st
premolar because of a short lingual cusp and
also due to the lingual inclination of the tooth
 This preparation coincides with the occlusal
morphology of the tooth
• For the preparation that will not cross the
transverse ridge, prepare the proximal box before
the occlusal portion to prevent removing the tooth
structure that will form the isthumus
• The bur axis is parallel to the tooth crown which is
tilted slightly lingually, pulpal Wall is facially
inclined

30. MAXILLARY FIRST MOLAR :
• Extension into the enamel oblique ridge is
avoided whenever possible to maintain
possible to maintain the cross-splinting
strength is provided to the tooth
• It may require extending through the
oblique ridge to unite the proximal
preparation with the occlusal step
• Cutting through the oblique ridge is
indicated only if :
 The ridge is undermined with caries
 It is crossed by a deep fissure
 Occlusion portion of the separate MO
and DO outline forms leave less than 0.5
mm of the tooth structure between
them

31. MAXILLARY FIRST PREMOLAR
• A class II preparation involving the mesial surface requires attention because the
mesiofacial embrasure is esthetically prominent
• The occlusogingival preparation of the facial wall of the mesial box should be
parallel to the long axis of the tooth instead of converging occlusally to minimize
in the faciogingival corner of the restoration
• The facial extension of the mesiofacial proximal wall should be minimal and
margins may be placed lingual to the facial contact

32. BOX ONLY PREPARATION
• A proximal box that is prepared without occlusal
step
• When restoring a small,cavitated , proximal
lesion in a teeth with neither occlusal fissures
nor a previously inserted occlusal restoration , a
proximal box preparation without an occlusal
step has been recommended
• This preparation should be limited to
 A proximal surface with a narrow proximal
contact and
 When the involved marginal ridge has no
occlusal contact
• To minimize retention ,the box only preparation
should have following characteristics
 Facial and lingual walls that almost oppose
each other should recommended
 Facial and lingual proximal walls converge
occlusally
 Retention grooves are mandatory in box
only preparation

33. • TOOTH PREPARATION FOR CLASS II AMALGAM RESTORATION INVOLVE TWO
PROXIMAL SURFACE
• This section describes factors to consider when amalgam is used in moderate
and large class II restoration .
• OCCLUSAL EXTENSION
• Requires extending grooves that are fissured .capping cusps that are
underlined , or extending the outline form up the cuspal inclines
• Grooves extension occurs at the same initial pulpal floor depth [i.e.,1.5mm]
but follows the DEJ as the groove is extended in a facial or lingual direction
• This extension will usually require some alteration in the orientation of the
bur : a slight lingual tilt when extending in a facial direction , a slight facial
tilt when extending in a lingual direction .

34. • PROXIMAL EXTENSION
• Larger class II restoration will often require larger proximal box
preparation
• Extensive proximal boxes are usually prepared the same as a more
conservative proximal box , but may require modification .
• The increased dimensions of a large proximal box usually require the use
of retention locks or other secondary retention form features
• If the proximal box is extended onto the root surface , the axial wall
depth is no longer dictated by the DEJ .
• Axial wall depth of approximately 0.8 mm.

35. EXAMPLES OF MODERATE CLASS II AMALGAM RESTORATION
MAXILLARY FIRST MOLAR
• The mesioocclusodistal tooth preparation of
the maxillary first molar may require extending
through oblique ridge to unite the proximal
preparation with the occlusal text
• Extend is indicated only if
 The ridge is undermined by the caries
lesion
 It is crossed by the deep fissure
MANDIBULAR FIRST MOLAR
• The distal cusp on the mandibular first
molar may be weakened when positioning
the distofacial wall and margin
• Facial extension of the distofacial margin to
clear the distal contact often places the
occlusal outline in the centre of the cusp ;
this indicates relocation of the margin to
provide a sound enamel wall an 90 degree
amalgam that is not on a cuspal eminence

36. MANDIBULAR FIRST PREMOLAR
• When the mesioocclusodistal amalgam tooth preparation need for first
premolar, the support of small lingual cusp may be conserved by preparing the
occlusal step more at the expense of the tooth structure facial to the central
groove than lingual
• The bur is slightly tilted lingual to establish correct pulpal wall direction
MANDIBULAR SECOND PREMOLAR
• A moderate mesioocclusodistal
preparation on the mandibular second
premolar that had a moderately sized
MOD carious lesion

37. MODIFICATIONS IN THE TOOTH PREPARATION OF PROXIMAL SURFACE
SLOT PREPARATION FOR ROOT CARIES :
• When caries is present in the proximal aspect without involving the marginal
ridge
• Indicated in cases of gingival recession having root surface caries gingival to
the proximal aspect
• When the adjacent tooth is missing
• Preparation for class II restoration with facial or lingual access are sometimes
referred to as KEY HOLE PREPARATION
• The tooth preparation is usually approached from the facial and has the form
of a slot
• Prepare retention groove with no.1/4 ,bur into the occlusoaxial and
gingivoaxial line angles, 0.2 mm inside the DEJ or 0.3 to 0.5 mm inside the
cemental cavosurface margin
• The depth of these grooves is one half the diameter of the bur head and the
bur is directed to bisect the angle formed by the junction of occlusal and axial
walls

38. SLOT PREPARATION FOR ROOT CARIES

39. ROTATED TEETH
• Tooth preparation for rotated teeth follows the same principles as
for normally aligned teeth
• When the tooth is rotated 90 degrees and the proximal lesion is on
the facial or lingual surface or orthodontic correction is declined
or ruled out , the preparation may require an isthmus that
includes the cuspal eminence
• If the lesion is small , consideration should be given to the slot
preparation

40. ADJOINING RESTORATION
• It is permissible to repair or replace a defective portion of an existing amalgam
restoration if the remaining portion of the original restoration retains adequate
resistance and retention form
• Where the two restoration adjoin , care should be taken that the outline of the second
restoration does not weaken the amalgam margin of first
UNUSUAL OUTLINE FORM
• Usually seen in mandibular third molars
having unusual groove pattern

41. • RESTORATIVE TECHNIQUE FOR CLASS II AMALGAM PREPARATION
DESENSITIZER PLACEMENT
• A dentin desensitizer is placed on the prepared tooth structure per
manufacturer instruction .
• Excess moisture is removed without desiccating the dentin
MATRIX PLACEMENT
• The primary function of the matrix is to enable proper
restoration of anatomical contours and contact areas
The qualities of matrix are :
• Rigidity
• Establishment of proper anatomic contour
• Restoration of correct proximal contact relation
• Prevention of the gingival excess
• Convenient application
• Ease of removal

42. UNIVERSAL MATRIX
• The universal matrix system is ideally indicated when three surface that is
[mesial ,occlusal ,distal ] of the posterior tooth have been prepared
• This system is commonly used in two surface restoration
• The advantage of tofflemire retainer is that it may be positioned on the facial
or lingual aspect of the tooth

43. TYPES OF BAND :
• UNCONTOURED BANDS :
 The conventional flat universal matrix band must be shaped
[burnished] to reproduce natural contour and resultant proximal
contact
 Two thickness bands are
 0.05 mm
 0.038 mm
• PRE-CONTOURED BANDS :
 Pre-contoured bands for the universal retainer are commercially
available and need no adjustment before being placed in retainer or
after being positioned around teeth

44. BURNISHING THE MATRIX BAND :
• This means that the metal band is intentionally deformed occlusolingually
with the with suitable hand instrument to produce a rounded or convex
surface that produces restorative that is in contour with the adjacent
proximal surface
• The nos .26-28 is generally recommended for burnishing the band

45. PREPARING THE RETAINER TO RECEIVE THE BAND :
• STEP 1 : The larger of the knurled nuts is turned contour until the locking vice is
positioned adjacent to the guide channel on the end of the retainer
• STEP 2 : Next , while holding the large nut the dentist turns the smaller knurled nut
counter clock wise until the pointed spindle is free
• STEP 3 : The band is folded to form a loop and to be positioned in the retainer
[occlusal edge of band first ]
• STEP 4 : The spindle is tightened against the band in the locking wise

46. PLACING THE BAND WITH RETAINER ON THE PREPARED TOOTH :
• STEP 1 : If the proximal wedges are used during the tooth preparation , the
wedges are removed at this point and matrix band is fitted around the
tooth
• STEP 2 : Once the matrix band is placed , the larger knurled nut is rotated
clockwise to tighten the band slightly . Ideally the band should be
positioned 1mm apical to the gingival margin or deep enough to be
engaged by the wedge and 1-2mm above the adjacent marginal ridge to
allow for adequate condensation of amalgam in the marginal ridge areas

47. WEDGING TECHNIQUE :
• After the matrix contour and extension are evacuated a wedge is placed
in the gingival embrasure. The length of the wedge should approx. 1 to
2 cm
SINGLE WEDGING TECHNIQUE
• Place matrix retainer in place
• Take a wedge and place the pointed edge from lingual or
buccal embrasure whichever is bigger
• Wedge the band tightly against the tooth

48. PIGGYBACK WEDGING :
• In this technique two wedges are used
• One larger wedge is inserted as used normally , while
another small wedge is inserted above the larger one
• It is indicated in cases of shallow proximal box with
gingival recession
• This is a technique provides closer adaptation and
contour of the matrix band
DOUBLE WEDGING :
• Two wedges are used
• One is inserted from buccal embrasure and another
from lingual embrasure
• This technique is used in
• Spacing between adjacent teeth where the
single wedge is not sufficient
• Widening the proximal box in buccolingual
dimension

49. WEDGE WEDGING :
• In this technique two wedges are used
• One wedge is inserted from the lingual embrasure area while
another is inserted from the wedge and matrix band at right
angle to first wedge
• They are primarily indicated while the treating of mesial
aspect of first premolar

50. ROUND VERSUS TRIANGULAR WEDGE :
• Some situation required a triangular wedge that is modified to conform to the
approximating tooth contours
• The rounded toothpick wedge is usually the wedge of choice with
conservative proximal boxes, because its action is more occlusal than
triangular wedge
• The triangular wedge is recommended for a preparation of deep gingival
margin

51. MODIFIED TRIANGULAR WEDGE

52. RIGID MATERIAL SUPPORTED SECTIONAL MATRIX
• The alternative to the universal matrix band is the use of a properly
contoured sectional matrix that is rigid enough to resist condensation
pressure
• Examples : light cured , thermoplastic , quick setting rigid PVS materials

53. PRE-COUNTED SECTIONAL MATRIX STRIPS :
• Commercially available sectional matrix strips are pre contoured and
ready for application in tooth
• These have limited applications when used for amalgam because of their
rounded contour

54. CONDENSATION AND CARVING OF AMALGAM
• Proper condensation of amalgam results in
close material adaptation to the
preparation walls and minimal inclusion of
internal voids
• STEP 1 :Condensation should occur in the
proximal boxes first by enough
amalgam with the amalgam carrier to fill
the gingival portion about 1 mm
• STEP 2 :Additional amalgam is carefully
condensed against the proximal margins
of the preparation and into proximal
retention grooves
• STEP 3 : The procedure of adding and
condensing continues until the amalgam
reaches the level of pulpal wall
• STEP 4 : The occlusal margins are covered
by at least 1 mm using a large condenser
,ensuring that the marginal ridges are well
condensed ,especially in the marginal
ridge

55. REMOVAL OF THE MATRIX BAND AND CARVING COMPLETION :
• STEP 1 : The retainer is removed from the band after
turning the small knurled nut contour counter clock wise
to retract the pointed spindle
• STEP 2 : the end of the index finger may be placed on
the occlusal surface of the tooth to stabilize the band as
the retainer is removed
• STEP 3 : The number 110 pliers are used to tease the
band free from one contact area at the time pushing or
pulling the band in linguo occlusal direction
• STEP 4 : The wedge may be left in place to provide
separating of the tooth while the matrix band is
removed , and then finally wedge is removed

56. FINISHING AND POLISHING OF THE AMALGAM
• Finishing and polishing of the occlusal surface of the class II amalgam should
follow the approach presented in the general concepts 0f guiding restoration
with amalgam restoration
• Finishing and polishing of the proximal surface may be indicated where the
proximal amalgam is accessible
• The area usually includes the facial , lingual margins and occlusal contact areas

57. QUADRANT DENTISTRY
• When several teeth is involved in a quadrant have caries lesions the
experienced dentist usually treats them all at the same appointment rather
than individually
• Quadrant dentistry increases efficiency and reduces chair time for the patient
• Use of rubber dam is particularly important in the quadrant dentistry
• For maximal efficiency , when a quadrant of amalgam tooth preparation is
planned , each rotatory or hand instrument should be used on every tooth
where it is needed before being exchanged