Class II.
Defects affecting one or both
proximal surfaces of posterior
teeth.
Location:
Class II.
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Origin:
Proximal surface below the contact point
Propagation of dental caries from
the occlusal surface
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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)
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Diagnosis
 Visual changes of tooth structure
 Transillumination
 Radiography
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Bite wing
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D1 – projasnění do ½ tlouš´tky skloviny
D2 – projasnění na hranici skloviny a dentinu
D3 – projasnění do dentinu
D4 - projasnění sahající do dřeňové dutiny
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Sedelmayer
RTG vyšetření – Bite Wing
4 stupňový
grading
Filling materials
 Amalgam
 Composite materials
 Glass ionomer cements
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Preparation - amalgam
 Conventional preparation acc. to the
Black´s rules
 Slot preparation
 Large preparation – cusp(s) involved
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Preparation - adhesive materials
(composites, glass ionomers)
 Conventional preparation for
composites
 Adhesive slot
 Tunnel preparation
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Occlusal cavity
Proximal cavity - box
Conventional preparation
amalgam
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Pulpal wallsAxial wall
Gingival wall
Isthmus
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Access to the cavity
From the occlusal surface
Through the undermined enamel
Separation using wooden wedges is useful
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Pre op
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Access to the cavity
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Breaking the thin enamel layer out of the cavity
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Remove of the gingiva
that grows into the cavity
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Cavosurface margin and
extention for prevention
Proximal box:
Vestibullary and orally – axial walls (the border
between the oral/vestibular and proximal
surface.
Below the free gingiva (0,5 mm)
Occlusal
Class I.
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v
Pichlerovo p.
P. americké
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Retention
 Occlusal cavity
 Undercuts
 Grooves
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Axiální stěny
divergují gingiválně
Rýhy a zářezy
Autoretention
Grooves
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Resistance
 No undermined enamel
 No sharp edges
 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
if cusp replacing)
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Excavation of carious dentin
Rounded bur
(Caries Detector, Kuraray,
Japonsko; Caries Marker,
VOCO,Německo)
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Finishing of the walls of the
cavity
 Red coded diamond bur
 Chisel on the gingival wall (if in enamel)
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Final check
 Goog light, miror
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Pulpal wall
Axial wall
Gingival wall
Isthmus
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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
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Matrices
 Ivory I retainer Ivory 1
 Hawe Neos retainer Ivory 8
 Tofelmire matrix and retainer
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Wedges
 Wooden wedges
- tighten the matrix band
- compress the gingiva
- separate the teeth
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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
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Amalgamators
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Condensation of amalgam
 Condensor – with the straight front
 Power driven condensation
How big should the front be?
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Base
 Zinkoxidphosphate cement
 Zinkoxidkarboxylate cement
 Glass ionomer cement
 Zinkoxideugenol
On pulpal walls only!
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The base must be hardened
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Amalgam
Retention
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Instruments
 Preparation
 Filling
 Finishing and polishing
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Cpátko
tyčinkové
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Ořezávač -Frahm
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Sapin
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Discoid-cleoid
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Amalgam carrier
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