Class I, II & VI

Amalgam Restoration
 Class 1 restorations restore defects on the occlusal surface of posterior teeth,
occlusal thirds of facial & lingual surfaces of molars, lingual surfaces of maxillary
anterior teeth.
 Class 2 restorations restore defects that affects one or both of the proximal
surfaces of posterior teeth.
 Class 6 restorations restore rare defects affecting cusp tips of posterior teeth or
the incisal edges of anterior teeth.

Qualities & Properties of Amalgam for Class 1, 2 & 6

Strength Longevity Ease of use Clinically Interfacial seal
proven over time.
success

Indications & Contraindications for Class 1, 2 & 6

INDICATIONS CONTRAINDICATIONS
Where esthetics are not important Esthetically prominent areas of
posterior teeth
Moderate to large defect Small to moderate class 1 & 2 defects
that can be well isolated
Area of heavy occlusal contacts Small class 6 defects
No isolation possible
Cavity extend to root surface
Foundation for crown
In a tooth that serves as an abutment
for RPD

Advantages & Disadvantages of Amalgam in 1, 2 & 6

ADVANTAGES DISADVANTAGES
Ease of use More complex & large tooth preparation
Simplicity of procedure Non esthetic appearance

Clinical Technique for Class 1 Amalgam Restoration

We will first study conservative class 1 amalgam restoration, after that we will learn
Extensive class 1 restoration.

Conservative Class 1 Amalgam Restoration.

In this we restore the small class 1 tooth defects which protect the pulp, preserve
the strength of tooth and reduce deterioration of amalgam, enhances marginal
integrity and restoration longevity.

INITIAL CLINICAL PROCEDURES

A. Anesthesia
B. Isolation with rubber dam or cotton rolls
C. Pre-operative occlusal assessment
D. TOOTH PREPARATION

Initial Tooth Preparation in Conservative Class 1 Amalgam Restoration

 The outline form for class 1 amalgam include the defective pits & fissures in a
way that sharp angles in the marginal outline are avoided. (fig; 14-2)
 The Resistance form for class 1 amalgam restoration are as under;
o Extending around the cusps to conserve tooth structure and prevent the
internal line angles from approaching the pulp horns too closely.
o Keeping the facial and lingual margin extensions as minimal as possible
b/w central groove and the cusp tips.
o Extending the outline to include fissures, placing the margins on relatively
smooth, sound tooth structure.
o Minimally extending into marginal ridges (only include defect) without
removing dentinal support.
o Eliminating a weak wall of enamel by joining two outlines that come close
together (i.e. <0.5 mm apart)
o Extending the outline form to include enamel undermined by caries.
o Using Enameloplasty on the terminal ends of shallow fissure to conserve
tooth structure.
o Establishing an optimal, conservative depth of the pulpal wall.
 A No. 245 with head length of 3mm and a tip diameter of 0.8 mm or a smaller No.
330 bur is recommended to prepare conservative class 1 amalgam tooth
preparation. (fig; 14-2 B & C)
o Its shape is made in such a manner that it automatically produces occlusal
convergence and rounded line angles.
 Class 1 tooth preparation begins by entering the bur 245 in the deepest and most
carious pit.
Fig; 14-3.
o Bur should be parallel to long axis of tooth.
o When pits are equally defective, then distal pit is entered first.
 It provides better visibility of mesial extension.
 The bur should be placed in such a manner that the distal surface of
bur should be directly over the distal pit to prevent extension into
marginal ridge.
o Initial depth should be 1.5 – 2 mm inside DEJ measured from central
fissure or 0.1 – 0.2 mm inside into dentine from DEJ.
 If you are using No.245 bur then its half-length represent the initial
depth, means half of bur should be inside the tooth to get initial
depth of 1.5 – 2mm.