PRINCIPLES

AND
CONCEPTS OF CAVITY
PREPARATION

• Chinthamani Laser Dental College

INTRODUCTION
CLASSIFICATION
 BLACK’S CLASSIFICATION

Class I lesion
Lesions that begin in the structural defects of teeth such as pits, fissures
and defective grooves.

Locations include
• Occlusal surface of molars and premolars
• Occlusal two-thirds of buccal and lingual surfaces of molars
• Lingual surface of anterior tooth
Class II Lesions

They are found on the proximal surfaces of the bicuspids and molars.
• Areas for class II decay involve:
– Two-surface restoration of a posterior tooth.
– Three-surface restoration of a posterior tooth.
– Four- or more surface restoration of a posterior tooth.
Class III lesions

Lesions found on the proximal

surfaces of anterior teeth
that do not involve or
neccesitate the removal of the
incisal angle.
 CLASS IV LESIONS
Lesions found on the proximal
surfaces of anterior teeth
that involves the incisal angle.
FIG. 48-9 CLASS IV RESTORATION.
Class V lesion

Lesions that are found on the gingival third of the facial and lingual surfaces
of the anterior and posterior teeth.

Class VI

Lesions involving cuspal tips and incisal edges of teeth.

 OTHER MODIFICATIONS
CHARBENEU’S CLASSIFICATION
• Class II: Cavities on single proximal surface of bicuspids and molars.
• Class VI: Cavities on both mesial and distal proximal surfaces of
posterior teeth that will share a common occlusal isthumus.
• Lingual surfaces of upper anterior teeth
• Any other usually located pit or fissure involved with decay.
 STURDEVANT ’S
CLASSIFICATION
CAVITY
Simple cavity FEATUREA cavity involving only one tooth
surface

Compound cavity A cavity involving two surfaces of

a tooth

Complex cavity A cavity involves more than two

surfaces of a tooth.
 FINN’S MODIFICATION OF BLACK’S CAVITY
PREPARATION FOR PRIMARY TEETH

• Class I: cavities involving the pits and fissures of the molar teeth
and the buccal and lingual pits of all teeth.
• Class II: cavities involving proximal surface of molar teeth with
access established from the occlusal surface.
• Class III: cavities involving proximal surfaces of anterior teeth
which may or may not involve a labial or a lingual extention.
Class IV:
• Cavities of the proximal surface of an anterior tooth which involve the
restoration of an incisal angle.
Class V
• Cavities present on the cervical third of all teeth of all teeth including
proximal surface where the marginal ridge is not included in the cavity
preparation.
 BAUME’S CLASSIFICATION

• Pit and fissure cavities

• Smooth surface cavities
 CLASSIFICATION BY MOUNT
AND HUME[1998]
• This new system defines the extent and complexity of a cavity and at
the same time encourages a conservative approach to the preservation
of natural tooth structure. This system is designed to utilize the healing
capacity of enamel and dentin.
 THE THREE SITES OF CARIOUS
LESIONS

• SITE I:
• Pits, fissures and enamel defects on occlusal surfaces of posterior teeth
or other smooth surfaces.
• Proximal enamel immidiately below areas in contact with adjacent
teeth.
• The cervical one-third of the crown or following gingival recession, the
exposed root
 THE FOUR SIZES OF CARIOUS
LESION
• Size 1–minimal involvement in dentin just beyond
treatment by remineralisation alone
• Size 2-moderate involvement of dentin. Following cavity
preparation, remaining enamel is sound well supported by
dentin and not likely to fail under normal occlusal load. The
remaining tooth structure is sufficiently strong to support
the restoration.
• Size 3-the cavity is enlarged beyond
moderate .the remaining tooth structure is weakened to the
extent that cusps or incisal edges are split or are likely to
fail or left exposed to occlusal or incisal load. The cavity
needs to be further enlarged so that the restoration can be
designed to provide support and protection to the remaining
tooth structure.
Size 4-extensive caries with bulk loss of tooth structure has
already occurred.
 PRINCIPLES OF CAVITY
PREPARATION

Conventional concept [Black’s concept]

• Incisors and canine

• Molars and premolars

• Gingival third cavities

PRINCIPLES OF CAVITY
PREPARATION
PRINCIPLES OF CAVITY
PREPARATIONCONT’D
FINAL CAVITY PREPARATION
 PATIENT PREPARATION FOR
RESTORATIVE PROCEDURES

• Inform the patient of the procedure to be performed and what to

expect during the treatment.
• Position the patient correctly for the dentist and the type of
procedure.
• Explain each step as the procedure progresses.
RECENT CONCEPT
 IATROGENIC FACTORS
AFFECTING DENTAL PULP
CLASS I CAVITY
• Incipient lesion
• #34 inverted cone bur is used to penetrate the enamel and 0.5mm or less
into the dentin
• Grooves and fissures is completed
• Smoothen the walls and finish the cavity
• Occlusal enamel walls will be approximately parallel to the axis of the tooth
• Pulpal wall flat and smooth.
Extensive area
#2 or #4 round bur can be used to enter and remove the decay
Bur should run at a slower speed
Light feather touch to sweep out deepest penetrations of decay.
Smoothen the enamel walls and finishing is done
• Final occlusal outline form will consist of sweeping curves and be
devoid of sharp angles.
• Bevel on the enamel should not be placed at the cavosurface angle
because of poor edge strength of amalgam.
CLASS II CAVITIES
PROXIMAL BOX-
• The farther the gingival wall is carried down, the deeper pulpally must be
the axial wall to maintain the proper 1mm width .
GINGIVAL WALL-
• Width should be approximately 1mm
AXIAL WALL-
• Smaller restoration flat
• Larger restoration-curve to parallel the outside contour
• CONVERGENCE-the proximal box line angles and walls should converge toward
the occlusal approximately following the buccal and lingual surfaces of the tooth.
• 90 degree cavosurface angle shold be maintained.
• LINE ANGLES-the buccogingival and linguogingival line angles can be very
slightly rounded.
• CAVOSURFACE-the buccal and lingual walls should be at right angles to the
surface of the tooth and in the direction of enamel rods.
• CERVICAL ENAMEL RODS- at the cervical margin the rods incline slightly
toward the occlusal.
• RETENTION-retention grooves may be placed into the buccoaxial and lingual-
axial line angles ,but in a fashion which will not undermine the enamel walls.
• ISTHUMUS WIDTH-on the occlusal surface the isthumus width should rarely
exceed the width of a channel cut.
• AXIOPULPAL LINE ANGLE-this can be rounded with a bur or hand instrument
by sharp enamel hatchets.
PULPAL WALL-
the pulpal wall may be flat or rounded slightly and should be
preparedso it is about 0.5mminto the dentin
OCCLUSAL WALL-
the buccal and lingual walls of the occlusal step may converge
slightly as they approach the occlusal surface.
OCCLUSAL DOVETAIL-
this should be extended to include the susceptible or carious areas
of each specific tooth. The outline form should be
rounded,smooth,and graceful with a definite lock on the
occlusal.
 SPECIFIC MODIFICATIONS

• DEEP PROXIMAL CARIES

• SMALL FIRST MOLARS

• THIN CUSPS
 DIFFERENCES IN CAVITY
PREPARATION FOR PRIMARY AND
PERMANENT TEETH
 PRIMARY TEETH
DEPTH OF THE CAVITY 0.5mm into dentin
OCCLUSAL TABLE Occlusal table is narrow as the
buccolingual width of the
tooth is less
CONTACT POINT /POINT Because of the presence of
contact area, buccal and
lingual margins of the
interproximal box must extend
far enough towards the
embrasure at the gingival
margin to make them
accessible for cleaning.
PERMANENT TEETH
0.2mm into dentin
Occlusal table is wider than
the primary teeth
Because of the presence of
contact area, buccal and
lingual margins of the
interproximal box don’t have
to extend too far into the
embrasure.
MARKED CERVICAL Because of the marked
CONSTRICTION cervical constriction the
floor of the cavity can
become too narrow if placed
more gingivally
The cervical constriction is
not that marked therefore
sufficient width of the floor
of interproximal box can be
maintained.

ISTHUMUS OF THE Isthumus is narrow because Isthumus is wider compared to

CAVITY the buccolingual width of the primary teeth.
tooth is less.cavities with wide
isthumus can lead to fracture
of the tooth.

BEVEL IN CAVOSURFACE Bevel is not given in the Bevel is given in the gingival
MARGIN OF GINGIVAL cavosurface margin of gingival seat
SEAT seat

OCCLUSAL ASPECT OF Must be kept narrow to Its not that narrow

THE PROXIMAL BOX prevent weakening of the cusp
GINGIVAL SEAT They are placed clear of
PLACEMENT contact with the adjacent
tooth, so that the margins of
the restorations can be
cleaned.
BUCCAL AND LINGUAL Because of the wider contact
WALLS OF THE area the buccal and the lingual
PROXIMAL BOX walls of the interproximal
diverge buccally and lingually
to clear the contact area.
MOD CAVITY Should not be restored for
amalgam alone.
It is not that wide.
Because of the prasence of
contact point the buccal and
the lingual walls of the
interproximal need not be
diverged towards the
embrasure.
It may be restored with
amalgam.
 THANK YOU
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