Class II. cavity preparation Defects affecting one or both proximal surfaces of posterior teeth. lroubal@med.muni.cz 2 Symptoms  No symptoms  Increased sensitivity (cold, sweet)  Retention of food  Defect (carious lesion is open – the enamel is broken)  Bite sensitivity (when carious lesion is open) lroubal@med.muni.cz 3 Diagnosis  Visual changes of tooth structure  Transillumination  Radiography lroubal@med.muni.cz 4 lroubal@med.muni.cz 5 lroubal@med.muni.cz 6 lroubal@med.muni.cz 7 Sedelmayer RTG vyšetření – Bite Wing 4 stupňový grading lroubal@med.muni.cz 8 Preparation - amalgam  Conventional preparation acc. to the Black´s rules  Slot preparation  Large preparation – cusp(s) involved lroubal@med.muni.cz 9 Preparation - adhesive materials  Conventional preparation for composites  Adhesive slot  Tunnel preparation lroubal@med.muni.cz 10 Occlusal cavity Proximal cavity - box Conventional preparation lroubal@med.muni.cz 11 Pulpal walls Axial wall Gingival wall Isthmus lroubal@med.muni.cz 12 Access to the cavity From the occlusal surface Through the undermined enamel Separation using wooden wedges is useful lroubal@med.muni.cz 13 Pre op lroubal@med.muni.cz 14 Access to the cavity lroubal@med.muni.cz 15 lroubal@med.muni.cz 16 Skalpel Kauter Laser Temporary filling lroubal@med.muni.cz 17 Cavity border and extention for prevention Proximal box: Axial wedges Under the free gingiva Occlusal Class I. cavity preparation lroubal@med.muni.cz 18 American rule lroubal@med.muni.cz 19 lroubal@med.muni.cz 20 Retention  Occlusal cavity – auxilliary cavity  Undercuts  Grooves lroubal@med.muni.cz 21 Axiální stěny divergují gingiválně Rýhy a zářezy Autoretention Grooves lroubal@med.muni.cz 22 Resistance  No undermined enamel  No sharp wedges  Isthmus is 1/3 – 1/4 intercuspidal distance  Angle between axial and gingival wall: 90°, or 85°  Width of gingival wall is 1 mm at least  Thickness of the filling 2 – 4 mm (4mm cusp replacing) lroubal@med.muni.cz 23 Cavosurface angle G. wall Isthmus lroubal@med.muni.cz 24 Excavation of carious dentin Rounded bur (Caries Detector, Kuraray, Japonsko; Caries Marker, VOCO,Německo) lroubal@med.muni.cz 25 Finishing of cavity walls  Red coded diamond bur  Chisel on the giongival wall (if in enamel) lroubal@med.muni.cz 26 lroubal@med.muni.cz 27 lroubal@med.muni.cz 28 lroubal@med.muni.cz 29 lroubal@med.muni.cz 30 Cavity control  Goog light, miror lroubal@med.muni.cz 31 Pulpal wall Axial wall Gingival wall Isthmus lroubal@med.muni.cz 32 Matrix placement  Matrix primarily is used when a proximal surface is to be restored The objectives: - Provide proper contact - Provide proper contour - Confine the restorative material - Reduce the amount of excess material lroubal@med.muni.cz 33 Matrices  Ivory I retainer Ivory 1  Hawe Neos retainer Ivory 8  Tofelmire matix and retainer lroubal@med.muni.cz 34 Wedges  Wooden wedges - tighten the matrix band - compress the gingiva - separate the teeth lroubal@med.muni.cz 35 lroubal@med.muni.cz 36 Wedging  Slip the matrix band over the tooth )apical to the gingiva margin – 0,5, - 1 mm)  Tighten the matrix, check it with probe  Place a wedge  Turn the retainer ¼ counterclockwise  Contour the band lroubal@med.muni.cz 37 lroubal@med.muni.cz 38 Trituration! lroubal@med.muni.cz 39 Condensation of amalgam  Condensor – stamen is the best one  Power driven condensation How big the stamen should be?? lroubal@med.muni.cz 40 lroubal@med.muni.cz 41 lroubal@med.muni.cz 42 lroubal@med.muni.cz 43 lroubal@med.muni.cz 44 lroubal@med.muni.cz 45 lroubal@med.muni.cz 46 lroubal@med.muni.cz 47 ??? lroubal@med.muni.cz 48 lroubal@med.muni.cz 49 Base  Zinkoxidphosphate cement  Zinkoxidkarboxylate cement  Glass ionomer cement  Zinkoxideugenol On pulpal walls only! lroubal@med.muni.cz 50 lroubal@med.muni.cz 51 The base must be hardened lroubal@med.muni.cz 52 Amalgam Retention lroubal@med.muni.cz 53 lroubal@med.muni.cz 54 Sedelmayer lroubal@med.muni.cz 55 Instruments  Preparation  Filling  Finishing and polishing lroubal@med.muni.cz 56 Cpátko tyčinkové lroubal@med.muni.cz 57 Ořezávač -Frahm lroubal@med.muni.cz 58 Modifikace kavit II. třídy  Složená kavita  Slotová kavita  Náhrada hrbolku – amalgámová dostavba lroubal@med.muni.cz 70 Ořezávač - Sapin lroubal@med.muni.cz 71 Ořezávač discoid-cleoid lroubal@med.muni.cz 72 Nosič amalgámu lroubal@med.muni.cz 73