Professional Documents
Culture Documents
Cavity designs
for composite
restorations
Submitted by:
Aditi Chandra
Department of conservative dentistry
and endodontics
Definition
Indications
Partial veneers
Full veneers
Tooth color modification
Diastema closure
Contraindications
Advantages
Esthetics
Conservation of tooth structure:
Less extension
Uniform depth is not necessary
Mechanical retention usually is not necessary
Good retention,
Low microleakage,
Minimal interfacial staining
Increased strength of the remaining tooth structure
Disadvantages
Technique sensitivity
Polymerization shrinkage :
Marginal leakage
Secondary caries
Postoperative sensitivity
Mechanical alteration of a tooth to receive a restorative material which will return the
tooth and area to proper form, function, and esthetics.
To form the cavity so that under the masticatory forces the tooth and the restoration will
not fracture and the restoration will not be displaced.
To promote maintenance of integrity of hard and soft tissues of the oral cavity.
3. Shade selection:
Prior to drying of teeth.
According to manufactures shade guide or VITA shade guide.
Shade tab is held near the teeth to be restored & is partially covered with lip or operator
thumb
If proximal restoration will involve all contact area and /or extend subgingivally, insert wedge:
1. Depress the interproximal soft tissue.
2. Shields the dam & soft tissue from injury.
3. Produces separation of teeth.
B. Cotton rolls with or without retraction cord-:
Alternative method.
Minimal extension
Conventional
Beveled conventional
Modified
Box shape
Facial/lingual slot
Beveled conventional
Beveled conventional tooth preparations are similar to conventional preparations in that the
outline forms have external boxlike walls, but with some beveled enamel margins.
This design is most typical for class III, IV & V restorations.
Modified tooth preparation
Primarily indicated for the initial restoration of smaller, cavitated, carious lesions usually
surrounded by enamel & for correcting enamel defects.
Have neither specified walls configurations, nor specified pulpal or axial depths.
Have a scooped out appearance without definite internal line angles.
Pulpal depth is 1.5 mm or approximately 0.2 mm inside the DEJ --- not uniform.
Shallow fissures radiating from pits are treated by enameloplasty and subsequently restored
with composite.
Mandibular premolars often have 2 separate faulty occlusal pits located in areas of minimal
function.
Outline form of each pit is similar to class VI modified preparation with small diamond points.
Any shallow fissure that extends laterally from the pit is incorporated in the preparation by an
extended cavosurface bevel or flare.
Small radiating fissures also may be filled with sealant.
Pulpal floor and gingival seat are perpendicular to the long axis of the tooth.
Occlusal step
Facial, lingual proximal extensions --- visualized.
DEJ serves as a guide for preparing the proximal box portion of the preparation.
No. 330 or 245 diamond stone is used to enter the pit opposite the faulty proximal surface.
Diamond stone is held parallel to the long axis of tooth
Only faulty areas are included.
Initial pulpal floor depth: 1.5 mm - 0.2mm inside the DEJ
Occlusal walls converge occlusally.
Occlusal cavosurface angle is slightly obtuse.
Proximal extension
The preparation is now extended proximally on the affected side.
Cavity is widened faciolingually to the extent of the proximal caries.
The involved marginal ridge is thinned out to expose the proximal DEJ.
0.5mm of marginal ridge is preserved to prevent damage to adjacent tooth.
Proximal box
The preparation is now extended in the gingival direction to place the proximal ditch cut.
Extent of the ditch cut depends on the amount of caries.
Remaining proximal enamel is broken using a thinner diamond point so as to develop the facial
and lingual proximal walls.
Gingival floor kept flat with a cavosurface margin of 90 degree.
Gingival extension should be kept supragingivally.
Axial depth should be minimal into the proximal DEJ 0.2mm into the DEJ.
Extend subgingivally.
Despite of these disadvantages the pins are placed when a large amount of tooth structure is
missing.
MODIFIED CLASS IV TOOTH PREPARATION
Indicated for small or moderate lesions or traumatic defects.
Objective --- remove as little tooth structure as possible, and providing for appropriate retention
and resistance forms.
No initial tooth preparation is indicated for fractured Incisal corners, other than roughening the
fractured tooth structure.
Cavosurface margins --- beveled or flared.
Axial depth --- extent of the lesion, previous restoration or fracture.
No groove or cove retention form is indicated.
CLASS V COMPOSITE RESTORATIONS
Located in the gingival 1/3 of the facial or lingual surfaces of the tooth.
During shade selection it should be remembered ---tooth is darker in the cervical third.
Factors to be taken into consideration --- esthetics, caries activity, access to the lesion, moisture
control and patients age.
CONVENTIONAL CLASS V TOOTH PREPARATION
Indicated for lesion or defect entirely or partially on the facial or lingual root surface of a tooth.
Features of the preparation:
Axial depth --- 0.75 mm, provides adequate external wall width for:
Strength of the preparation wall.
Retention groove is not indicated when the periphery of the tooth preparation is located in
enamel.
Preparation on the root surface, depth of the axial wall --- 0.75 mm.
Bevel --- 45 degree to the external tooth surface and width of 0.25 0.5 mm.
Advantages are:
I. Increased retention due to greater surface area of etched enamel offered by the bevel.
II. Decreased microleakage due to increased bond strength between the enamel and the
composite.
III. Decreased need for groove retention form.
MODIFIED CLASS V TOOTH PREPARATION
Indicated for the restoration of small to moderate carious lesions.
Objective --- restore the lesion or the defect as conservatively as possible.
No effort to make the walls as butt joint.
No retention groove incorporated.
Preparation is scooped out resulting in divergent wall
Axial depth not uniform.
Presence of caries.
Most aberrant pit faults in enamel are restored best with use of a modified
preparation.
Outline form (includes extensions and depth) is dictated by the extent of the fault
and/or caries lesion.
Faults existing entirely in enamel are prepared with an appropriately sized round
diamond instrument by merely eliminating the defect.
Adequate retention is obtained by etching the enamel (the first step in applying
restorative materials).
When the defect includes carious dentin, the infected portion is removed also,
leaving a flared enamel margin.
CONCLUSION
Composites have unquestionably acquired a prominent place among the filling materials
employed in direct techniques. Their considerable aesthetic possibilities give rise to a variety of
indications.
Also, these materials conserve the tooth structure better because they are retained by adhesive
methods rather than depending on cavity design.
Nonetheless, it should not be forgotten that they are highly technique-sensitive, hence the need
to control certain aspects: correct indication, good isolation, choice of the right composite for
each situation, use of a good procedure for bonding to the dental tissues and proper curing are
essential if satisfactory clinical results are to be achieved.
REFERENCES