Preclinical dentistry II. 2 Class II. second part Class II. – modifications for amalgam l Conventional preparation l l Slot l l Large cavities – replacement of the cusp (cusps), combination with the cavity on vestibular/oral surface Class II. 3 I:\Lékárníci\Šmardová.JPG Origin: Proximal surface below the contact point Propagation of dental caries from the occlusal surface kavity2 Occlusal cavity Proximal cavity MO or OD cavity MOD lroubal@med.muni.cz 6 lroubal@med.muni.cz 7 slothotovo Slot is a cavity that is open on occlusal surface. It is limited on the proximal ridge Slot preparation Slot for amalgam lAccess to the caries lesion - through the enamel wall - breaking out of the enamel lamella - excavation of carious dentin lroubal@med.muni.cz 10 vychozistav Pre op preparačni nastroje lroubal@med.muni.cz 11 zacatekpreparacekavity Access to the cavity vylomeni Slot for amalgam lAutoretention -Grooves -Divergency towards gingiva -Convergency and divergency of axial walls in horizontal plane(towards proximal space) Slot for amalgam l l Rule of the gingival wall l-1 mm wide l-90% angle towards the pulpal wall l-outer line beveled if in enamel l-horizontal groove l utoretence slotak Wardovaprep Sedelmayer slotbazant Sedelmayer J. Amalgám – zapomenuté řemeslo. Brno, 2000. Bažant V. Konservační zubní lékařství, SPN Praha,1962. slot1 Slot cavity lLimited on proximal ridge lAxial walls are divergent towards gingiva lThe proximal box has a typical picture of fish tail lThere are grooves: -One horizontal in gingival wall -Two vertical in axial walls orezani okraju sikmitka dlatka orezani okraju sikmitka dlatkovakci Large defects lIn vital teeth if the cusp has been undermined due to dental caries lLarge defects in non vital teeth – amalgam overlays lCombination with the cavity on vestibular/oral surface preparaceag8 Cusp has been removed The thickness of the filling 3 – 4 mm (at the cusp) Retention Grooves, pins, slots preparaceag4 preparaceag5 preparaceag3 preparaceag preparaceag1 Parapulpal pins Intrapulpal posts (root canal posts) Retention in the endodontic cavity vrubove Impressionpost_3 Large amalgam restoration - overlays l l agdots agdostvylest lroubal@med.muni.cz 23 Amalgam lExact work! sturdevandt1 sturdevandt2 sturdevandt5 sturdevandt6 lroubal@med.muni.cz 24 sturdevandta2 sturdevandta1 sturdevandtc1 sturdevandtc3 sturdevandtb1 sturdevandtb2 Basic modifications Rules for large restorations lClear and sharp outlines – cavosurface margin l l Thickness of the amalgam (the cusp 3 – 4 mm) lAutoretention -Grooves -Pins, slots -Parapulpal pins -Intrapulpal posts – root canal posts lResistance – acc to general rules l l Composites - indication lSmall – moderate cavities l -Good level of oral hygiene -No heavy occlusal stress -Dry operating field - Preparation for adhesive materials – composites lNo extension for prevention (adhesion) lNo grooves lNo undercuts lRounded box lBevel the axial walls and the outer edge od the gingival wall lSmall isolated cavities are possible Cavity for amalgam Cavity for composite Bevel on the gingival wall Preparation do not bevel!!! If out of enamel Bevel of enamel on axial walls Amalgam Composite material Placement of the material Correct 47 kreplovahorni1 kreplova2 kreplova3 kreplova5 48 l OptiDamAnteriorOutlined-200Width-Prod OptiDamPosteriorOutlined-200Width-Prod OptiDamFrameOutlined-200Width-Prod kreplova2 Matrices for composites in class II. lMatrix band + matrix retainer l lSegmental matrix + separator matricepalodontinsitu2 model2tr18 matricepalodontinsitu3 palodontkleste1 palodonkleste slot1 slot2 Sedelmayer slot3 slot4 Alternative preparation – adhesive slot sonicapr1 sonicapr2 sonickomp1 sonickomp2 sonickomp3 sonicoktrajkavity soniczboku1 soniczboku2 l postrusek3 postrusek4 postrusek5 l postrusek93 VYLEŠTĚNO l postrusek7 postrus8 postrusek92 tunel1 tunel2 tunel3 Tunnel preparation logosov tunel1a tuneldetail1 logosov 1202161355_8 tunelpovyplni tunel logosov tunel1 tunel2 1.Low caries risk 2.Proximal ridge without infraction 3.Good cooperation 4.Small caries lesion 1.Magnification(Loups or microscope) 2. Miniinstruments 4. GIC in capsules or composite 5. BW post op Glassionomer and class II. lTemporary filling – first phase for the sandwich technique l lTunnel filling (preparation)