Restorative dentistry III.
Class V. making fillings
Class V.
̶ Cervical defects
- Dental caries
- Non carious lesions (erosion, abrasion,
V shaped defects)
Types of defects
̶ Caries
̶ Erosion
̶ Abrasion
̶ V shaped defects
Choice of material
➢Amalgam (posterior area)
➢Composite (mainly in anterior teeth where the defect is situated in
enamel)
➢Glassionomer: caries defects, esp deeper, situated out of enamel,
higher caries risk,middleterm temporary.
V.Class Amalgam
̶ Posterior area
Access
̶ Removal of the undermined enamel
- Burs or diamonds (pear), tapered fissure bur
̶ Separation of the gingiva– temporary filling guttapercha, fermit,
clip, zinkoxidsulfate cement, cavit, provimat).
̶ Ablation of ingrown gingiva – surgical (scalpel, laser, high
frequency current)
Cavosurface margins
Gingival: axial dephth of 0,5 mm inside the
DEJ.
Extention of the preparation incisally,
Gingivally: 0,5 mm subgingivally
mesially and distally: to axial walls
Or: untill the cavosurface margins are positioned
in
sound dental structure. (small cavities, good oral
Retention
̶ Box 0,75 – 1,25 mm deep, undercuts,
Depht
Gingivally: axial dephth of 0,5 mm inside the
DEJ.
Total dephth: 1 – 1.25 mm. If on root
surface -0,75 mm
Resistance
No occlusal forces
Gingival margin
Mesial and
distal margin
Occlusal margin
The bottom of the cavity follows the convexity of the crown.
Filling
Base – pulpal wall
Amalgam – portion by portion, condensor with straight front,
burnisher (spatula).
Class V. composit
➢ Aesthetic area
̶ Margin in enamel
Preparation for composite,
making filling
Cavity is limited on caries lesion only
Enamel must be beveled
Etching, priming + bonding
Placement of composite
Matrices
Transparent cervical matrices
Matrix band acc. to Belvedere
Laser
Rotační nástroj
Class V. glassionomer
̶ Cavities with margins in cementum
̶ Or also in enamel or partly in enamel (in patients with worse level
of oral hygiene)
Glassionomer
̶ Bonds chemically
➢Realease fluoride ions
➢Thermal expansion similar to dentin
➢Acceptable aesthetics
Preparation for glassionomer
making filling
̶ Cavity is limited on carious lesion only
̶ Margins sholud be smoothen (no bevel)
̶ Conditioner (polyacrylic acid) -20 s
̶ Washing
̶ Placement of glassionomer (one bulk)
̶ Matrix (transparent or aluminium cervical
̶ matrix)
Matrices for glassionomers
̶ Cervical transparent matrices with the holder for lightcuring
composites and glassionomers
Matrices for glassionomers
̶ Cervical foils
Hawe adaptable metal cervical
matrices have a specially
treated aluminium surface and
are suitable for all self-curing
composites and glass
ionomers.
Combination of materials
̶ Glassionomer – replaces lost dentin
̶ Composite – replaces lost enamel
base of glassionomer
Composite
Connection
Glassionomer – tooth:
chemical
Composite – tooth:
micromechanical
Composite – glassionomer
Micromechanical.
Choice of materials
Glassionomer Combination Composite
Or amalgam in posterior area