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 FEATURE
Simple cavity A 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 PERMANENT TEETH

DEPTH OF THE CAVITY 0.5mm into dentin 0.2mm into dentin

OCCLUSAL TABLE Occlusal table is narrow as Occlusal table is wider

the buccolingual width of than the primary teeth
the tooth is less

CONTACT POINT Because of the presence Because of the presence

/POINT of contact area, buccal of contact area, buccal
and lingual margins of the and lingual margins of the
interproximal box must interproximal box don’t
extend far enough have to extend too far
towards the embrasure at into the embrasure.
the gingival margin to
make them accessible for
cleaning.
MARKED CERVICAL Because of the marked
CONSTRICTION cervical constriction the
floor of the cavity can
become too narrow if
placed more gingivally
ISTHUMUS OF THE Isthumus is narrow
CAVITY because the buccolingual
width of the tooth is
less.cavities with wide
isthumus can lead to
fracture of the tooth.
BEVEL IN CAVOSURFACE Bevel is not given in the
MARGIN OF GINGIVAL cavosurface margin of
SEAT gingival seat
OCCLUSAL ASPECT OF Must be kept narrow to
THE PROXIMAL BOX prevent weakening of the
cusp
The cervical constriction
is not that marked
therefore sufficient
width of the floor of
interproximal box can be
maintained.
Isthumus is wider
compared to primary
teeth.
Bevel is given in the
gingival seat
Its not that narrow
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
WALLS OF THE contact area the buccal
PROXIMAL BOX and the lingual 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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