Lecture 4, Principles of Cavity Preparation (2) - Outline-Handout
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JustDen09Lecture 4, Principles of Cavity Preparation (2) - Outline-Handout
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JustDen09Principles of Cavity Preparation II
4. Convenience form: The form or shape of the preparation that provides adequate observation, accessibility and easy of operation in preparing & restoring the tooth -All parts of the cavity must be visible for examination. -Proper convenience form is a requirement for all operative procedures. Final Tooth Preparation Stage 5. Removal of any remaining enamel pit or fissure, infected dentin or old restorative material if indicated. - Removal of remaining enamel pit or fissure - Removal of defective old restorative material - Removal of infected dentin 6. Pulp protection, if indicated. - Dentin is the best isolator against irritation to the pulp.
There should be 2.0 mm of bulk (either remaining tooth structure, liner, and/or base). The base provide protection against mechanical, thermal and chemical irritants.
7. Secondary Resistance & Retention Forms: a. Mechanical preparation features: 1. Retention locks, grooves, and coves 2. Groove extension 3. Skirts 4. Pins, slots,, steps, & amalgampins b. Placement of etchant, primer, or adhesive on prepared walls: 1. Enamel wall etching 2. Dentin treatment
8. Procedures for Finishing the External Walls of the Tooth Preparation: The further development, when indicated, of a specific cavosurface design & degree of smoothness or roughness that produces the maximum effectiveness of the restorative material being used Objectives: 1. Create the best marginal seal possible between the restorative material & the tooth structure. 2. Afford a smooth marginal junction. 3. Provide maximum strength for both the tooth structure & restorative material. 9. Final Procedures: Cleaning, Inspecting, and Sealing:
Cleansing & dryness of the cavity for inspection. Sometimes, certain medicaments can be applied to the cavity prior to the restorative step.
Sequence of Caries Removal
Entry is made in conventional manner with a high speed fissure bur. Ideal depth & width are established, ignoring the carious tooth structure. Caries extending beyond the limits of the ideal preparation is removed with the largest round bur that will fit into the area. The caries removal process should begin peripherally in the DEJ areas. Caries in areas involving potential exposures, such as the axial and pulpal walls should be removed last. The criterion followed for caries removal is hardness which can be checked with spoon excavator. Only those areas that are soft should be removed. After all caries has been removed, the preparation is reevaluated for undermined enamel, resistance form and retention form. All undermined enamel areas should be removed with the high speed fissure bur and an attempt made to reestablish lost retention and resistance form. The pulpal floor should be flattened only at ideal depth The entire floor should not be reduced to include one isolated carious area.
Midterm Practical Exam
Exam: Class I cavity preparation and restoration on lower 6. The Exam period is 1 hour. Come 15 minutes earlier to be ready for the exam. Make sure that the tooth is marked before you start, you are not allowed to change the marked tooth during the exam. Finish cavity preparation and then ask for grading of the cavity preparation (10 marks). Do your amalgam restoration and then ask for grading of the amalgam (5 marks). Work should all be done inside the phantom head.
