Class VI

AMALGAM
RESTORATION

Ashley M. De Vera
CLASS VI

– Class VI lesion is sometimes referred to “Simon’s

Modification”.
This is both mesial and distal proximal surface
of bicuspid and molars that when restored will
share a common isthmus or cavities in the insisal
edges of anterior or cusp tip of posterior teeth
– The Class VI tooth preparation is used to restore the
incisal edge of anterior teeth or the cusp tip regions of
the posterior teeth.
– Such tooth preparations are frequently indicated where
attrition has removed the enamel to expose the
underlying dentin.
– Wear pattern occurs more often in geriatric patients
– Once the softer dentin is already exposed, it wears faster than
the surrounding enamel, resulting in “Cupped-out” areas.
– As the dentin support is lost, the enamel begins to fracture
away, exposing more dentin and often causing sensitivity.
- Sensitivity to hot and cold is a frequent compliant with
Class Vi lesions, and some patients are bothered by food
impaction in deeper depressions.
– Class VI tooth preparations is also indicated to restore the
hypoplastic pit occasionally found on cusp tips.
Composite is generally used to restore Class VI
preparations (anteriors)
AMALGAM may be selected for posterior Class VI
preparation because of its;
 Wear resistance
 Longevity
Class VI Amalgam Preparation…

 For the isolation you may use cotton rolls.

 Enter the area with a small tapered fissure bur (No. 169L
bur)
 Extend to a sufficient size to place the cavosurface margin
on enamel that has sound dentin support
 The preparation walls may need to diverge occlusally to
ensure a 90-degrees cavosurface margin.
A depth of 1.5 mm is sufficient to provide bulk of
material for strength.
Retention of the restoration is ensured by the small
under cuts along the internal line angels.
Inserting, carving and polishing are similar to
procedures described in Class 1..
‼ Be careful not to remove the supporting
dentin…
‼ Conservative tooth preparation is particularly
important because it is easy to undermine
enamel on incisal edge or cusp tips
For MOD…

√ Occlusal Preparation..
External outline –butterfly shaped
-occlusal outline form should form a devoid or
sharp angles and the margins of which are located on smooth
enamel.
- dovetail are more parallel to the marginal
oblique ridges to prevent leaking of stress bearing area.
 Internal outline
-Cavity depth is .2-.5mm beyond DEJ
- Pulpal floor should be flat.
-Line angles and point angles are definite and sharp.
 Proximal box
- Proximal box should be bend smoothly(s-curve/reverse
curve)
Insertion of Amalgam

 Placement of matrix and tuffle mire and a wooden wedge on the

proximal area, to restore or bring back the anatomic proximal
contour and contact areas.
 Mixing of amalgam.
 Using an amalgam carrier, inject the load of mix into the proximal
areas and condensed on the gingival floor.
√ Immediately removed excess amalgam from gingival margin using
a explorer.
√ Carve the proximal areas to contour.
√ Use discord and cleoid carver to smooth and carve the anatomy of
the tooth.
√ Carefully remove the wooden wedge and truffle mire

Amalgam must be allowed to set for at least 24 hours

Finishing and Polishing….

 Using the finishing bur, slightly smooth the entire occlusal surface
of amalgam.
 A shaped rubber abrasive point may be used to polish occlusal
anatomy.
 With a brush, polish the entire surface with a wet mix of pumice.
 Polish the entire surface with rubber cup using flour of pumice.
THANKYOU!