lenka.roubalikova@ti
scali.cz
1
Classification acc. to Black
 Class I.
Pit and fissure caries
lenka.roubalikova@ti
scali.cz
2
Classification acc. to Black
 Class II.
Proximal surfaces in premolars and molars
lenka.roubalikova@ti
scali.cz
3
Classification acc. to Black
 Class III.
Proximal surfaces of incisors and canines
without lost any part if incisal edge
lenka.roubalikova@ti
scali.cz
4
Classification acc. to Black
 Class IV.
Proximal surfaces of incisors and canines with
lost an incisal ridge
lenka.roubalikova@ti
scali.cz
5
Classification acc. to Black
 Class V. cervical lesions
lenka.roubalikova@ti
scali.cz
6
Preparation of cavities
Basic rules
Access to the cavity
Outlines – cavosurface margin (extention for
prevention)
Principles of retention
Principles of resistance
Excavation of carious dentin
Preparation of borders – finishing
Control
lenka.roubalikova@ti
scali.cz
7
Protection of dentin wound
 Dentin wound should be covered –
protection of dental pulp against irritation
Physicial
-thermal
-osmotic
Chemical
Combination
lenka.roubalikova@ti
scali.cz
8
Protection of dentin wound
Isolation
Filling (small cavities)
Base (moderate – large cavities- depth 2mm and
more approx.)
Adhesive systems ( composite materials)
lenka.roubalikova@ti
scali.cz
9
Filling
 Filling replaces lost hard dental tissue
anatomically and functionally
 Always different properties in
comparison to hard dental tissues.
lenka.roubalikova@ti
scali.cz
10
Base is made usually
of zinkoxidphosphate cement
It is placed only on pulpal wall
Preparation of the cavity I.st
class acc. to Black
 Cavities in fissures and pits
 (Occlusal surfaces of premolars and
molars and in f. coeca)
F. Coeca: buccal surfaces of lower
molars,
Palatal surfaces of lower molars, palatal
surfaces of upper incisors (mostly
lateral)
Morphology
of fissures
Biofilm
Caries
All pit and fissure restorations
(fillings)
They are assigned in to three groups.
R. on occlusal surface of premolars and molars
R. in foramina coeca – usually on occlusal two thirds
of the facial and lingual surfaces of molars.
R.on lingual surface of maxillary incisors.
Materials: Amalgam, composite.
Amalgam:
Pertinent material qualities and propeties
Strength
Longevity
Easy of use
Clinically proven sucess
Access to the cavity
 From the occlusal surface using the
fissure bur (or diamond burs, see
below).
Cavosurface margin
 Ideal outline includes all occlusal pits
and fissures. If crista transversa (1st
lower premolar)or obliqua (1st and 2nd
upper molar)are not affected, it is
strongly recommended no to prepare
them.
 Cavosurface margin is located in the
middle of the distanc between the
bottom of the fissure and the cusp
Cavosurface margin is in ½ distance between
bottom of the fissure and the cuso
Crista obliqua
M1 M2 M3
M1 M2 M3
Upper jaw
Lower jaw
Molars
Premolars Crista transversa
Lower P1
Retention principles
 Prepare the box – the bottom is in
dentin
 Undercuts can be prepared, the
proximal ridges must not be weakened!
Retention principles
 Box in dentin
Box (remember rounded edges)
Box with undercut
Resistance principles
 Box – space for amalgam 1,5 – 2 mm
 Keep the facial and lingual margin extensions as
minimal as possible between the central groove and
the cusp tips. Max 1/2
 Extending the outline to include fissures, thereby
placing the margins on relatively smooth sound tooth
structure.
 Minimally extending into the marginal ridge without
removing dentinal support.
 Never leave the enamel undermined
 All corners are round, the bottom smooth.
Removal of carious,
infected, dentin
 Spoon excavator or a slowly revolving ,
round carbid bur of appropriate size.
The pulpal wall and pulp chamber
Finishing and polishing
 Fine grit diamond bur.
Final control
 Wash and dry the cavity
 Check the praparation in good illumination
Preparation is limited on the caries lesion
1,5 mm deep
Undercuts can be prepared
If the caries undermined the occlusa enamel,
prepare the cavity on the occlusal surface.