Definition:
These are pit and fissure type cavities that involve the occlusal surfaces of molars and premolars, the occlusal 2/3 of buccal and lingual surfaces of molars, and the palatal pits in maxillary anterior teeth.

 These are self-cleansable areas. self-

However, they may get involved by caries due to their inherent defective structure as areas of imperfect coalescence of lobes of calcification of these teeth. These areas are retentive for food and thus invite caries.

These lesions are clinically characterized by:
unnoticed until the lesion becomes of a considerable size. 2. A conical spread in both enamel and dentin, with the bases of cones at the AmeloAmelo-Dentinal Junction, "A. J.D." 3. Its rapid burrowing at the dento-enamel dentojunction. These lesions may involve one or more surfaces and hence a simple or compound cavity should be prepared.

1. A small surface opening which may remain

and angular grooves between the cusps and with a minimum width.Simple occlusal cavities Designing the Outline Form. . fissures. The outline form of a routine class I cavity should describe a symmetrical design running in sweeping curves along all pits.

The mesial and distal margins are placed midway between the bottom of the proximal fossae and the crest of the proximal ridges and in a direction parallel to these ridges. .

. The mesial and distal wall should have a slant or slight divergence from the pulpal floor outward to avoid undermining the marginal ridges.

. the cavity is extended just sufficient to eliminate the defective and susceptible tissues. The lingual and the buccal wail should be parallel to the respective tooth surface.In a bucco-Iingual direction.

It is governed only by the extent of caries in both enamel and dentin and the amount of extension or need to eliminate pits and fissures to secure smooth margins. . It must be reemphasized that the outline form for class 1 cavities should be very conservative since they involve cleansable areas.

therefore.. no special retentive features are required.Obtaining the Resistance and Retention Forms  The resistance form here consists chiefly of a pulpal wall parallel to the occlusal plane with dentin walls at right angles to it. Boxing the preparation. . i.e.  The form of this cavity provides automatically for effective retention and.

and then scooped out in few and large pieces. . the carious dentin is peeled off carefully at the sides using large spoon excavators.Removal of Carious Dentin  In small size cavities.  In moderately deep and deep cavities.  Only light pressure in a direction parallel to that of the pulp is utilized. the carious dentin should have been removed during making the cavity extensions. This is continued until a sound dentin floor is reached.

short. stones.Planning of Enamel Walls The enamel walls of the cavity should be finished free from any loose. or undermined enamel. and trimmed to meet the tooth surface at a right cavo-surface angle. sandAll sharp corners in enamel must be rounded. . plane fissure burs. or sand-paper discs. cavoThis may be done by sharp and regularregularedged chisels and hatchets. as they may contain short enamel rods.

.Performing of the toilet of the cavity A sharp explorer is then used to check the details of the prepared cavity and to loosen the tooth debris which are then blasted out with warm air.

Operative Procedures Armamentarium High speed handpiece Burs #330. 56 Hoe Hatchet R&L Wedel staedt chisel .

.Procedure The outline form is performed by first gaining access through the enamel to the carious dentin floor of the cavity followed by making the necessary cavity extensions.

access is started at the most defective area of enamel.In case of initial carious lesions. access is obtained easily by breaking down the undermined enamel overlying the carious dentin. a carious pit or fissure. using a suitable size chisel.. access is obtained by employing a small pear but #330.  In big carious lesions.  In either case. i.  .e.

D. .J. Cutting is continued until the ameloamelo-dentinal junction (A. The bur is held at a right angle to the involved surface of. the tooth and light pressure in an in-and-out direction is in-andexerted.) is reached.

and carefully . fissures.through pits. so that its weak corners do not touch the enamel and get dulled.  The necessary cavity extensions The bur is rotated. introduced through the opening just obtained. and deep developmental grooves are made using a #330 pear bur held at right angle to the surface of the tooth.

gentle pressure is applied in the direction of required extension. the bur should be kept moving in-and-out of the cavity and at in-andright angle to the tooth surface. . the bur will undermine and lift the cut enamel. and at the same time unclog itself. In this way.With the bur seated in the cavity just below the amelo-dential junction 1/z-1 amelo1/zmm. During cutting.

. This is obtained by using a #56 fissure bur held perpendicular to the surface of the tooth. All the line angle in dentin must be squared up hoe excavators.Provision of ample resistance and adequate retention through boxing of the preparation could be obtained.

.Buccal Pit Cavities The outline of these cavities usually describes a triangle with its base faming the gingival wall and its sides forming the mesial and distal walls. The gingival wall is placed at or slightly occlusal to the height of contour of the tooth.

The enamel walls are planed in the direction of enamel rods and perpendicular to the axial wall.All walls are extended just enough to eliminate defective enamel and dentin. .

Hoe excavators are used to smooth the axial wall and make it parallel with the external surface of the tooth. accordingly the outline of these cavities may be a rounded or oval in shape. . It should be re-emphasize that the shape of the cavity will be governed by the extension of caries.

. The cutting is done in dentin at the ameloamelo-dntinal junction using a #56 bur until the ocdusal ridge is undermined and removed.Buccal and Lingual Extensions In case of occluso-buccal and occlusoocclusoocclusolingual cavities extensions are made through the fissures and towards the respective surfaces.

a step is indicated: a #330 or 56 but is used to cut the dentin at the ameloamelodentinal junction. . applying pressure in a gingival direction and at the same time moving the bur mesiomesiodistally.If the caries is still gingival to the level of the pulpal seat.

The cavity walls and margins are finished as previously described. .The enamel thus undermined. Retention grooves are then cut in dentin along the axio-mesial and axioaxioaxiodistal line angles. is broken down with chisels.

In case of deeply-seated caries. will expose the pulp. where removal of the carious dentin will leave a round cavity floor. flattening of which to obtain the required resistance form. .

The following technique is used: a) The cavity floor is covered with a sub base of calcium hydroxide. followed by a base of glass ionomer cement which fills it to the routine cavity depth. .

b) A ledge is cut on the expense of the buccal and lingual side walls of the cavity for obtaining the required resistance in sound dentin. .

.

Principles Rationale I. regular curves. OUTLINE FORM ² Smooth flowing. Angular irregularities in the outline are susceptible to fracture during condensation ² a smooth flowing outline is easier to visualize and carve following condensation. .

sufficient extension of cavity preparations is necessary to ensure access (convenience form) for instrumentation. insertion and finish of the restorative material. .II. and maintenance of the restoration (prevention). EXTENSIONS ² Conservation of tooth structure is the basis for all cavity preparations in order to preserve the strength of the tooth. However. removal of defective tooth structure.

) which are susceptible to recurrent caries and facilities oral hygiene procedures (extension for prevention). fissures. etc. Pits and fossae 4. Existing restorations Rationale eliminates defective tooth structure and eliminates areas (pits. Major fissures and grooves 5. Caries and decalcifications 2. . Enamel unsupported by sound dentin 3.Principles A. Extensions circumscribe: 1.

Rationale to allow a smooth tooth-restoration margin to be created (easier to finish and keep clean). Bucco ² lingual extension 1. Extend fully in areas of buccal and lingual grooves to terminate on smooth surfaces. .Principles B.

Principles Rationale to preserve the strength and function of the cups while eliminating susceptible grooves or defective tooth structure (must be wide enough to allow condensation). . 2. Extend minimally in areas of triangular ridges (optimal isthmus width is ¼ intercuspal distance or less) terminating on smooth surfaces.

to preserve a uniform bulk (strength) to the mariginal ridges. Mesio-distal extension 1. . Rationale to preserve strength of marginal ridges.Principles C. 2. Parallel the contour of the marginal ridge. Stop short of the marginal ridge crest.

Principles Rationale to preserve strength of cusps while eliminating susceptible grooves and/or defective tooth structure (must be at least as wide as the narrowest condenser). terminating on smooth tooth structure. Groove extensions are kept narrow (mesiodistally) where possible (consistent with access for condensation and outline form). 3. .

If marginal ridge is unsupported or very thin it should be included. resulting in a Class II preparation. If not included the marginal ridge may fail (amalgam will be stronger than the unsupported enamel) .Principles Rationale 4.

. Minimum depth is required to provide sufficient bulk to prevent fracture and retain the amalgam. RESISTANCE/ RETENTION FORM A. 2 mm measured at triangular ridges).Principles Rationale III. Depth = ½ mm into dentin (approx.

Pulpal floor 1.Principles B. resists occlusal stress (resistance form) and forces of condensation. . Smooth and flat 2. Parallel to the occlusal plane Rationale Uniform thickness of restorative material.

. Smooth and curved mesio-distally. Smooth and straight pulpo-occlusally.Principles C. 2. Buccal and lingual walls 1. Rationale Facilitates adaptation of amalgam and elimination of weak tooth structure.

Converge slightly pulpo-occlusally in areas of triangular ridges (60). . To provide mechanical lock or retention to the occlusal portion and crate bulk at the margins.Principles Rationale 3.

protects buccal and lingual surfaces from being undermined (RESISTANCE FORM).Principles Rationale 4. .Diverge slightly pulpo-occlusally in buccal and lingual groove extensions (60).

.Principles D. Mesial and distal wall 1. Smooth and straight Rationale facilitates adaptation of amalgam and elimination of weal tooth structure.

protects marginal ridge form being undermined or weakened (enamel must be supported be dentin) .Principles Rationale 2. Diverges slightly pulpo-occlusally (forms an obtuse angle with pulpal floor).

CAVITY FINISH A.Principles IV. Pulpo-occlusal line angle is well defined (no point angles are present) and follows general configuration of cavosurface outline. . Rationale increases retention of the amalgam restoration and preparation is more easily visualized.

Cavosurface margins 1. provides marginal integrity.Principles . . Sound (well supported) Rationale easier to visualize and carve. Sharp (well defined) 2.

Principles Rationale C. . Cleanliness ² cavity is free of debris and moisture. facilitates adaptation of amalgam to the cavity and improves the physical properties of the restoration by elimination of void or foreign material.

. prevention of postoperative pain and inflammation. Adjacent soft tissue (perio-dontium) is intact Rationale preserves isolation.Principles V. conservation of tooth structure. Rubber dam is intact B. eliminates moisture. TISSUE RESERVATION A. Adjacent tooth structure and restorations are intact C.

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