Principles of cavity

preparation
Steps of cavity preparation
1. Outline form and initial depth
2. Primary resistance form
3. Primary retention form
4. Convenience form
5. Removal of any remaining infected dentin or old restoration
6. Pulp protection
7. Secondary resistance and retention form
8. Finishing the external walls
9. Cleaning, inspecting and sealing
1. OUTLINE FORM AND INITIAL DEPTH
Definition:

- Placing the cavity margins in the positions they will occupy

in the final preparation except for the finishing enamel walls
and margins;
- Preparing an initial depth of 0.2~0.8 mm pulpally of the
dentinoenamel junction.

Principles :

- All friable and weakened enamel should be removed.

- All fault should be included
- All margin should be placed in a position to afford good
finishing of margins of restoration
 1. OUTLINE FORM AND INITIAL DEPTH
Features:

- Preserving marginal ridge (remaining marginal ridge should be

greater than 1.6mm for premolar and 2mm for molar)
- Minimizing facial-lingual extension.
- Connecting two close faults of the tooth which are < 0.5 mm
apart
- Restricting depth of penetration into dentin for pits and fissure-
0.2, for smooth surface-0.2 to 0.8
2. PRIMARY RESISTANCE FORM
Definition:
It is defined as that shape and placement of the cavity walls that best enable both the
restoration and the tooth to withstand, without fracture, when masticatory forces delivered
principally in the long axis of the tooth.
 2. PRIMARY RESISTANCE FORM
Principles:

- To utilize the box shape with a relatively flat floor to resist

occlusal loading by virtue of being at right angles to mastication
force;
- To restrict the extension of the external walls (keep as small as
possible) to allow strong cusp and ridge areas to remain with
sufficient dentin support;
- To have a slight rounding of internal line angles to reduce stress
concentration in tooth structure;
- To provide enough thickness of restorative material to prevent
its fracture under load.
3. PRIMARY RETENTION FORM
Definition:
- Primary retention form is the shape or form of conventional preparation that resists
displacement or removal of the restoration from tipping or lifting forces.
- In many respects retention and resistance form are accomplished in the same cutting
procedure.
 3. PRIMARY RETENTION FORM
Principles:
For Amalgam restoration:
- Developing external cavity walls that
converge occlusally.
- Adhesive system provide retention by
micromechanical bonding amalgam to tooth
structure.
For Composite restoration:
A mechanical bond between the material
and conditioned, prepared tooth structure.
4 . CONVENIENCE FORM
Conception:
The shape or form of the cavity that provides for adequate observation, accessibility,
and ease of operation in preparing and restoring the cavity.
Principles:
- Allow access for caries removal
- Allow access for restoration placement
- Allow access to margins for finishing, evaluation and cleaning
5. REMOVAL OF ANY REMAINING INFECTED DENTIN OR
OLD RESTORATION, IF INDICATED

Definition:
The elimination of any infected carious tooth structure or faulty restorative material
left in the tooth after initial cavity preparation.
5. REMOVAL OF ANY REMAINING INFECTED DENTIN OR
OLD RESTORATION, IF INDICATED
Affected dentin
- Does not contain microorganisms.
- Can be remineralised by restorative mean.
- It is accepted to allow affected dentin to remain in the prepared tooth.
Infected dentin
- It contain microorganisms.
- Can not be remineralised by restorative mean.
- It should be removed during cavity preparation.
 5. REMOVAL OF ANY REMAINING INFECTED DENTIN OR
OLD RESTORATION, IF INDICATED

- Soft decay can be best removed using spoon excavator by

flaking up the caries
- Hard decay, heavily discolored should removed using
very low speed bur.
- Care should have to take during removal as pulp may
infected by forcing microorganisms into dentinal tubules
through excessive pressure.
 6. PULP PROTECTION
Principle:
- Using liners or bases.
- To protect the pulp or to aid pulpal recovery or both.
- LINERS- are zinc oxide or calcium hydroxide that
can be applied to tooth surface in relatively thin film
to protect dentin from residual reactants.
- BASES-Are those cements used in thicker
dimensions beneath permanent restoration to
provide for mechanical, chemical ,thermal
protection of the pulp.
- If the remaining dentin overlying the pulp is 2mm
then no need for liners But if it is less than 2mm
,pulp protection is mandatory.
 7. SECONDARY RESISTANCE AND RETENTION
FORMS

Mechanical forms

- When lingual walls are absent or inadequate

in proximal preparation, then retention form
can be improved by facial skirt extension.
- The bevels for cast metal may improve
retention form
- Primarily to afford a better junctional
relationships
- Bevels margins increases the surface area of
etchable enamel
7. SECONDARY RESISTANCE AND RETENTION
FORMS
Cavity wall conditioning form:
- In addition to mechanical alteration to tooth structure certain bonding agents also
provide some extent of retention & resistance form
- Such treatment require in bonded restoration like porcelain , composite , or amalgam
materials
 8. FINISHING THE EXTERNAL WALLS
Definition:
Is the further development of a specific cavosurface design and degree of smoothness that
produces the maximum effectiveness of the restorative material being used.
Objectives:
- To create the best marginal seal possible between the restorative material and tooth
structure;
- To afford a smooth marginal junction;
- To provide maximum strength of both the tooth and the restorative material at and near the
margin.
8. FINISHING THE EXTERNAL WALLS
The Design of the cavosurface angle: depending on the material.
- Amalgam: 90°(Cavosurface margin 90°-Butt joint) Help to minimize the marginal
deterioration of restoration by locating the margins away from the enamel
eminence where occlusal forces may be concentrated.
- Composite: beveling 30°~ 40° Is indicated primarily in larger restoration because
the potential for retention increased by increasing the surface area of enamel
available for etch.
9. Final procedures
- Water, air or combination of both
- Dry cotton pellets are very efficient and safer way to dry preparation
- Using cavity cleaner
- Scraping preparation walla with sharp hand instruments
- Irrigate the cavity with saline before drying
- Inspecting the cavity for any remaining debris
- Sealing the cavity
- Composite requires etching, priming and bonding before insertion of restoration