PRINCIPLES

CAVITY OF
RESTO SPS 1

PREPARATIO
N
Eliah Darla Faith D. Ramiro
Jasella Calagno

1
 TABLE OF CONTENTS
1 3
INTRODUCTION : PRINCIPLES
TOOTH OF CAVITY
PREPARATION PREPARATION

2
G.V. BLACK
CLASSIFICATION
2
 INTRODUCT
ION
3
 INTRODUCTION: CAVITY
PREPARATION
Cavity preparation is defined as the mechanical
alteration of a defective, injured or diseased tooth such
that placement of restorative material reestablishes
normal form (and therefore function) including esthetic
corrections, where indicated.

4
 CAVITY PREPARATION
THE OBJECTIVES OF TOOTH PREPARATION ARE TO:
I. conserve as much healthy tooth structure as possible,
II. remove all defects while simultaneously providing protection of the pulp–
dentin complex,
III. form the tooth preparation so that, under the forces of
mastication, the tooth or the restoration (or both) will
not fracture and the restoration will not be displaced
and
IV. allow for the esthetic placement of a restorative material

5
 CAVITY PREPARATION
TOOTH PREPARATION DESIGN TAKES INTO CONSIDERATION TWO
KEY PRINCIPLES:

1. THE NATURE OF THE TOOTH:

(the structure of enamel, the structure of dentin, the position of the pulp in the
pulp– dentin complex, the enamel connection to the dentin): Highly mineralized
enamel depends on the resiliency of its dentin support.

6
 (a) All enamel walls must consist of
either full-length enamel rods on
sound dentin. (An enamel wall with
this configuration is able to withstand
the forces associated with occlusal
loading)

(b)Full-length enamel rods on sound

dentin supported on preparation side
by shortened rods also on sound
dentin.

7
 CAVITY PREPARATION
2. THE NATURE OF THE MATERIAL TO BE USED FOR
RESTORATION OF THE DEFECT:
Tooth preparations must also include design features that take into account the
physical limitations of the planned restorative material.

Dental restorative materials are best considered in terms of their ability to survive
the stresses of the oral environment in comparison with natural tooth structure.

8
 G.V. BLACK
CLASSIFICA
TION
9
 CLASS I
The lesions involving the
occlusal surfaces of molars and
premolars , the occlusal 2/3 of
buccal and lingual surfaces of
molars, and the palatal pits in
anterior teeth.

10
 CLASS II
The lesions involving the
proximal surfaces of the
posterior teeth with
access established from
the occlusal surface.

11
 CLASS III
The lesions involving the
proximal surfaces of anterior
teeth which may or may not
involve a labial or a lingual
extension & not involving
incisal edge..

12
 CLASS IV

The lesions involving all

proximal surfaces of
anterior teeth which
involves the incisal edge.

13
 CLASS V
The lesions involving the
cervical third of all teeth,
including the proximal surface
of posterior teeth where the
marginal ridge is not included
in the cavity preparation.

14
 CLASS VI

Preparations on incisal
edges of anterior and cusp
tips of posterior teeth
without involving any other
surface come under class VI.

15
 PRINCIPLES
OF CAVITY
PREPARATIO
16
N
 1. ESTABLISHING OUTLINE FORM
2. OBTAINING RESISTANCE FORM
3. OBTAINING RETENTION FORM
4. OBTAINING CONVENIENCE FORM
5. REMOVING REMAINING CARIES
6. FINISHING CAVITY WALLS AND
MARGINS
7. PERFORMING TOILET OF THE CAVITY
17
 STAGES OF
CAVITY
PREPARATION
18
 INITIAL TOOTH
1
PREPARATION STAGE
INITIAL DEPTH AND OUTLINE FORM

2 PRIMARY RESISTANCE FORM

3
PRIMARY RETENTION FORM
4
CONVENIENCE FORM

19
 1
INITIAL DEPTH AND
OUTLINE FORM

20
 INITIAL DEPTH AND
OUTLINE FORM
DEFINITION:
Placing the cavity margins in the position they will occupy in the final
preparation except for finishing walls and margins.

The first step in tooth preparation is to establish the initial depth and then, at
that depth, extend the walls of the preparation until the junction between the
enamel and supporting dentin is uncompromised.

The peripheral walls determine the overall outline of the preparation, which is
referred to as the outline form.

21
 PRINCIPL
ES
22
 INITIAL DEPTH AND
OUTLINE FORM
PRINCIPLES:

The outline form is designed, regardless of the type of tooth preparation,

such that
I. All unsupported or weakened (friable) enamel is usually removed,
II. All faults are included and
III. All preparation margins are usually placed in a position that allows
inspection and finishing of the subsequent restoration margins

23
 INITIAL DEPTH AND
OUTLINE FORM
FACTORS INFLUENCING OUTLINE FORM:

These conditions affect the outline form and often dictate the
extensions and include:
I. The extent of carious lesion defect or faulty old restoration.
II. Esthetic considerations
III. Corrective occlusal relationships
IV. Cavosurface marginal configuration

24
 INITIAL DEPTH AND
OUTLINE FORM
PIT AND FISSURE CAVITIES:

I. No unsupported enamel, extend cavity margins to sound tooth

structure.
II. Include all fissures that are faulty.
III. When 2 pits and fissures cavity have less than 0.5 mm of sound tooth
between them, they should be joined together to eliminate weak
enamel between them.
IV. Avoid terminating the margins on extreme eminences such as cusp
heights or ridge crest.
V. Extend margins to allow sufficient access

25
 INITIAL DEPTH AND
OUTLINE FORM
SMOOTH SURFACE CARIES:

I. Extend to sound dentin

II. Extend gingival margins of cavities apically on contact to provide
specified clearance between the gingival margin and the adjacent
tooth.
III. External facial and lingual margins in proximal tooth preparations
usually are extended into the respective embrasures to provide
specified clearance between the prepared margins and the adjacent
tooth.

26
27
28
 2
PRIMARY
RESISTANCE FORM

29
 PRIMARY RESISTANCE
FORM
DEFINITION:
May be defined as the shape and placement of the preparation walls (floors)
that enable the remaining tooth structure, as well as the anticipated
restoration, to withstand masticatory forces primarily oriented parallel to
the long axis of the tooth.

30
 PRINCIPL
ES
31
 PRIMARY RESISTANCE
FORM
PRINCIPLES:

FIRST PRINCIPLE OF MINIMAL EXTENSION

Carefully controlled extension of the preparation walls allows conservation of the
dentin support of adjacent cusps (and marginal ridges when possible), which
helps to maintain maximum strength and therefore resistance to fracture during
the cyclic loading of mastication.

32
 PRIMARY RESISTANCE
FORM
PRINCIPLES:

SECOND PRINCIPLE OF HORIZONTAL FLOORS

The relatively horizontal pulpal and gingival walls, prepared perpendicular to the
tooth’s long axis, help the restoration resist occlusal forces and limit the
likelihood of tooth fracture from wedging effects caused by opposing cusps.

33
 PRIMARY RESISTANCE
FORM
PRINCIPLES:

THIRD PRINCIPLE OF ROUNDED LINE ANGLES

To have a slight rounding (coving) of internal line angles to reduce stress
concentrations in tooth structure.

Rounding of external angles within the tooth preparation (e.g. axiopulpal line
angles) limits the likelihood of stress concentration in the corresponding surface
of restorative materials, which increases resistance to fracture of the restorative
material.

34
35
36
 PRIMARY RESISTANCE
FORM
PRINCIPLES:

FOURTH PRINCIPLE OF RESTORATIVE MATERIAL THICKNESS

Preparation design must allow for adequate thickness of restorative materials
to ensure adequate primary resistance to restoration fracture.

37
 PRIMARY RESISTANCE
FORM
PRINCIPLES:

FIFTH PRINCIPLE OF RESTORATIVE MATERIAL THICKNESS

It may be necessary to reduce cusps that no longer have sufficient dentin
support, and cover (or envelope) them with an adequate thickness of
restorative material in order to provide resistance to fracture of the tooth
and/or the restorative material.

The most important aspect in the evaluation of a suspicious cusp is the

judgment of the amount of remaining dentin support.

38
 FLAT FLOOR

A. Resistance form of tooth

provided by flat pulpal
and gingival floor.

B. In case of rounded pulpal

floor, the rocking motion
of restoration results in
wedging force which may
result in failure of
restoration.

39 BOX-SHAPED
PREPARATION
 EXCEPTION:

Pulpal wall is flat in all cases except

in lower 1st premolar ,where the
lingual cusp is very small & buccal
cusp is pronounced with very large
pulp horn.

40
 3
PRIMARY
RETENTION FORM

41
 PRIMARY RETENTION
FORM
DEFINITION:
Primary retention form is the shape or form of the preparation that prevents
displacement or removal of the restoration by tipping or lifting forces. In
many respects, retention form and resistance form are accomplished at the
same time.

that shape or form of the conventional preparation that resists

displacement or removal of the restoration from tipping or lifting
forces.

42
 PRINCIPL
ES
43
 PRIMARY RETENTION
FORM
PRINCIPLES:

PRIMARY RETENTION FORM FOR AMALGAM RESTORATIONS

• Amalgam restoration of a Class I or II preparation is retained by developing
external tooth walls that converge occlusally.
• In this way, when the amalgam is placed in the preparation and hardens, it
cannot be dislodged.
• The occlusal convergence should not be excessive which would result in
unsupported enamel rods at the cavosurface margin.

44
45
 PRIMARY RETENTION
FORM
PRINCIPLES:

PRIMARY RETENTION FORM FOR COMPOSITE RESTORATIONS

• Composite restorations are primarily retained in the tooth by micromechanical
and, depending on the adhesive, chemical bonding that is established between
the restoration and the tooth structure.

• In such restorations, the preparation surface of the enamel and dentin are
etched (demineralized) by creation of acidic conditions and then infiltrated
with resin-based adhesive materials before placement of the composite.

46
 PRIMARY RETENTION
FORM
PRINCIPLES:

PRIMARY RETENTION FORM FOR CAST METAL RESTORATIONS

1. Cast metal intra-coronal restorations, referred to as inlay restorations, rely on
diverging vertical walls that are almost parallel.

During the initial tooth preparation, the preparation walls are designed not only to
provide for draw (for the casting to be placed into the tooth) but also to provide
for an appropriate small angle of divergence (2–5 degrees per wall) from the line
of draw (to enable retention of the luted restoration).

47
 PRIMARY RETENTION
FORM
PRINCIPLES:

PRIMARY RETENTION FORM FOR CAST METAL

RESTORATIONS
2. In Class II preparations involving only one of the two proximal
surfaces, an occlusal dovetail may aid in preventing the tipping of the
restoration by occlusal forces.

48
 PRIMARY RETENTION
FORM
PRINCIPLES:

PRIMARY RETENTION FORM FOR CAST METAL

RESTORATIONS
3. The other primary retention form for cast metal restorations is the use
of a luting agent that bonds the restoration to the tooth structure.

49
 4
CONVENTION
FORM

50
 CONVENIENCE FORM
DEFINITION:
Convenience form is the shape or form that provides adequate
observation, accessibility and ease in the preparation and
restoration of the tooth.

FEATURES:
• Severe caries destruction may necessitate the extension of distal,
mesial, facial or lingual walls so as to gain adequate access to deeper
areas of the preparation.

51
 CONVENIENCE FORM
FEATURES:
• Extension of the proximal walls, so as to obtain clearance with an
adjacent proximal surface, may afford better access for the finishing
of preparation walls, the placement of the matrix and the finishing of
the restoration margins.

• The cavosurface margin of the preparation should be related to the

selective restorative material for the purpose of convenience to
marginal adaptation.

52
 PRINCIPL
ES
53
 CONVENIENCE FORM

PRINCIPLES:
• Allow access for caries removal.
• Allow access for restoration placement.
• Allow access to margins for finishing, evaluation, and cleaning

54
 CONVENIENCE FORM

FORMS OF CONVENIENCE:
1. Extension of walls
2. Refinement of line and point angles
3. Outward divergence of vertical walls

55
 FINAL TOOTH PREPARATION
1 REMOVALSTAGE
OF DEFECTIVE RESTORATIVE
MATERIAL AND/OR SOFT DENTIN
2 PULP PROTECTION
3 SECONDARY RESISTANCE AND RETENTION
FORMS
4
PROCEDURE FOR FINISHING EXTERNAL WALLS

5 FINAL PROCEDURES: DEBRIDEMENT AND

INSPECTION
56
 FINAL STAGES OF TOOTH
PREPARATION
After initial stages of the preparation, the prepared tooth should be
carefully examined.
 
The remaining carious portion should be removed only after the initial
tooth preparation has been completed. It provides two advantages:
 
1. It allows optimal visibility and convenience form for removal of
remaining carious lesion.

2. Completion of the initial preparation permits immediate placement

of a base and the restoration.

57
 1
REMOVAL OF DEFECTIVE
RESTORATIVE MATERIAL
AND/OR SOFT DENTIN

58
 REMOVAL OF DEFECTIVE RESTORATIVE MATERIAL
AND/OR SOFT DENTIN

DEFINITION:
Removal of any remaining enamel pit or fissure, infected dentin, and/or
old restorative material is the elimination of any infected carious tooth
structure or faulty restorative material left in the tooth after initial tooth
preparation.

After the establishment of external and internal outline form, if any of the
remaining carious tooth structure or defective restorative material is left in
tooth, it is to be removed in this stage.

59
 REMOVAL OF DEFECTIVE RESTORATIVE MATERIAL
AND/OR SOFT DENTIN

Once the caries lesion has been fully exposed (via the initial preparation),
careful pulpal and/or axial extension is accomplished so as to remove
defective restorative material and/or soft dentin (formerly known as
infected dentin) as indicated.

60
61 REMOVAL OF DENTINAL CARIES USING ROUND BURS AND SPOON EXCAVATORS
 2
PULP PROTECTION

62
 PULP PROTECTION
Although the placement of liners and bases is not a step in tooth
preparation in the strict sense of the word, it is a step in adapting the
preparation for receiving the final restorative material.

The reason for using traditional liners or bases is to either protect the
pulp or to aid pulpal recovery or both.

However, often, neither liners nor bases are needed. When the
thickness of the remaining dentin is minimal.

63
64
 PULP PROTECTION
How to protect pulp

● (1) removal of infected dentin should continue until

the remaining dentin feels as hard as normal dentin.
● (2) heavy pressure should not be applied
● (3) air or air water coolant.

65
 PULP PROTECTION
LINERS:
Liners are relatively thin-film materials that are used to cover deep
dentin in order to limit dentinal tubular fluid flow, and to create a
protective thermal/physical barrier

BASES:
The term base is used to describe the placement of materials, used
in thicker dimensions, beneath permanent restorations to provide
for mechanical, chemical and thermal protection of the pulp.

66
 3
SECONDARY
RESISTANCE AND
RETENTION FORMS

67
 SECONDARY RESISTANCE AND
RETENTION FORMS
After removal of any remaining enamel pit or fissure, infected dentin, and/or
old restorative material additional resistance and retention features may be
deemed necessary for the preparation. Many compound and complex
preparations require these additional features.

This step is needed in complex and compound tooth preparations where added
preparation features are used to improve the resistance and retention form of the
prepared tooth.

68
 SECONDARY RESISTANCE AND
RETENTION FORMS
The secondary retention and resistance forms are of two types:
I. Mechanical preparation features and
II. Treatments of the preparation walls with etching, priming, and
adhesive materials.

The second type is not really considered a part of tooth preparation but,
rather, the first step for the insertion of the restorative material.

69
 SECONDARY RESISTANCE AND
RETENTION FORMS
MECHANICAL FEATURES:

SKIRTS:
● Skirts are prepared for providing
additional retention in cast restorations.
● They increase the total surface area of
the preparation.
● Skirts can be prepared on one or all four
sides of the preparation depending upon
the required retention.

70
 SECONDARY RESISTANCE AND
RETENTION FORMS
MECHANICAL FEATURES:

AMALGAM PINS:
● Amalgam pins are vertical posts of amalgam
anchored in dentin.
● Dentin chamber is prepared by using inverted
cone bur on gingival floor 0.5 mm in dentin
with 1 to 2 mm depth and 0.5 to 1 mm width.
● Amalgam pins increase the retention and
resistance of complete restoration.

71
 SECONDARY RESISTANCE AND
RETENTION FORMS
MECHANICAL FEATURES:

72
 SECONDARY RESISTANCE AND
RETENTION FORMS
MECHANICAL FEATURES:

PINS:
● Different types of pins of various shapes and sizes are used to provide
additional retention.
● They can be used in all types of restorations like amalgam, composite
and cast restorations.

BEVELED ENAMEL MARGINS:

● Beveling of the preparation, margins increases the surface area and thus
the retention in composite restorations.

73
 SECONDARY RESISTANCE AND
RETENTION FORMS
MECHANICAL FEATURES:

74
 SECONDARY RESISTANCE AND
RETENTION FORMS
ENAMEL WALL ETCHING:
● Etching results in microscopic roughness, which increases the surface area and thus helps in enhancing the
micromechanical retention.

● • Dentin conditioning (etching and priming): Etching and priming of the dentin surface done in some
restorative materials increases the retention.
●  
● • Adhesive luting cements: Adhesive luting cements increase the retention of indirect restorations

75
 4
PROCEDURE FOR
FINISHING
EXTERNAL WALLS

76
 PROCEDURE FOR FINISHING
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.

Finishing of the enamel margins should be done irrespective of restorative

material used. During finishing there occurs the further enhancement of the
cavosurface design and smoothness that produces the maximum adaptation
of restoration to the walls and the margins and maximum effectiveness of
restoration.

77
 PROCEDURE FOR FINISHING
EXTERNAL WALLS
OBJECTIVES:
I. To create the best marginal seal possible between the restorative
material and tooth structure;
II. To afford a smooth marginal junction.
III. To provide maximum strength of both the tooth and the restorative
material at and near the margin.

78
 PROCEDURE FOR FINISHING
EXTERNAL WALLS
THE DESIGN OF THE CAVOSURFACE ANGLE: DEPENDING ON
THE MATERIAL
AMALGAM: (90 degree – 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: (BEVELLING 30 – 40 degree)

Is indicated primarily in larger restoration because the potential for
restoration increased by increasing the surface area of enamel
available for etch.

79
 5 FINAL
PROCEDURES:
DEBRIDEMENT AND
INSPECTION

80
 FINAL PROCEDURES: DEBRIDEMENT AND
INSPECTION
DEFINITION:
Debridement (cleaning) of the tooth preparation involves use of the air/water
syringe to remove visible debris with water and then excess moisture with a few
light bursts of air.

In some instances, debris clings to walls and angles despite the aforementioned
efforts, and it may be necessary to loosen this material with an explorer or small
cotton pellet.

Complete debridement allows careful inspection of the preparation so as to ensure

adherence to all principles of preparation design.

Any final changes may then be accomplished, as indicated, followed by steps to

disinfect the preparation.
81
82
 THANK
YOU!
83
 REFERENCES:
● https://www.slideshare.net/rupalibalpande/princi
ples-of-cavity-preparation-by-dr-rupali
● https://www.juniordentist.com/outline-form-cavit
y-preparation.html
● https://www.slideshare.net/abhinavmudaliar9/ste
ps-of-cavity-preparation
● https://cden.tu.edu.iq/images/New/2016/
Lectures/Dr.muthanna/3/Lecture_4.pdf

84 CHAPTER 11