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
⚫ Elimination od 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
hygiene)
Total dephth: 1 – 1.25 mm. If on root
surface -0,75 mm
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