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DEFINITION

Smooth surface lesions located on the


gingival third of labial, buccal and
more rarely the lingual surfaces of all
teeth.
Limitations:

Always simple lesions as it involves one


surface of a tooth.
These lesions have the following
clinical characteristics:

1. Caries is not only the reason of cavitation,


abrasion and erosion may also responsible
for their causation.
2. The carious lesion usually starts as a white
or chalky line or area near the center of the
gingival 1/3 of the labial or buccal surfaces of
teeth. If it occurs on the lingual surface, it is
usually associated with denture clasps.
3. Marked sensitivity.

4. Tendency to spread mesially and distally


near the axial angles of teeth, it may
pass the axial angle of the tooth and
unite with a Class II, III or IV cavity.
5. Bell-crowned teeth, and teeth with
markedly convex surfaces, are more
susceptible to this type of caries.
6. It occurs less frequently than the other
types of caries.
7. It is usually affects multiple teeth. This
indicates that the patient has a high caries
susceptibility and requires careful extensions of
cavity outline.
8-It is more frequent among old-aged patients
and is called senile caries, yet it is not
uncommon in childhood and adolescence and
is often associated with improper oral hygiene
and presence of bacterial plaque. In case of
old aged individuals, caries may be found to
extend gingivally and affect the cementum of
the root. Sensitivity will increase and the
caries may tend to recur around the margins
in cementum.
Application of Principles:

The Outline Form:


A. General shape:
“Ferrier design, conventional or typical“

This is the most recent and accepted now.


Generally the classical Class V cavity usually
describe a trapezoidal outline with straight
margins and round corners, with the short
arm being the gingival.
Principles Rationale

I. OUTLINE FORM - Conforms to the


rounded trapezoid in tooth shape, typical
gingival 1/3. caries location, and
site of plaque
accumulation.
B. Location of margins

Occlusally: It has to be at, but not


including the height or just past the
height of contour of the tooth or just
include the defective area of the tooth.
Principles Rationale

A. Occlusal /incisal outline More esthetic and


is straight and parallel to harmonious.
the occlusal plane.
Proximally: Far enough mesially and
distally to include only the defective
and/or the decalcified tooth tissues, yet
not encroaching on the axial angles of
the tooth, and placed just opposite the
axial angles of the tooth.
Gingivally: At or ideally in the
occlusal portion of the gingival
sulcus space. In cases of gingival
recession, the gingival margin
should be located supragingivally.
Resistance and Retention Forms:

a. Resistance Form:
No resistance form necessary for these
preparation because they are not subjected to a
direct functional loading.

A minimum dept of 0.5 mm in dentin is


required for a uniform bulk of amalgam for
strength of the material.
b. Retention Form
For retention, however, as the mandible
moves in lateral excursion, the lingual
slopes of the buccal and lingual cusps of
maxillary teeth load the buccal slopes of the
buccal and lingual cusps of mandibular
teeth.
 Assume that we have a facial Class V
restoration in the lower molar tooth, as
illustrated in the diagram, and so the tooth is
firmly seated in bone, the tooth structure of the
crown can move from position (1) to position (2),
making a v-shape opening at the margin (usually
the occlusal one), together with a facial
component of force driving the restoration
facially. So, retention will be placed in the
occlusal (or incisal) and gingival walls in the
form of grooves or retentive holes.
If the occlusal margins approximate the
facial or lingual cusps or marginal ridges, it
is advisable to make the occlusal walls
devoid of any occlusal grooves as this may:

i. undermine the structure of these cusps or


marginal ridges.
ii. display the restorative through the enamel
and, therefore, causes objectionable
esthetics.
 Although these locations are not
mandatory in premolars and in prominent,
easily cleansable molar tooth surfaces,
locating the margins apical to the height of
contour should be decided upon only after
carefully considering the cleansing ability and
plaque control technique of the patient as
well as the natural pattern of cleansing these
teeth.
Internal anatomy:
1. In a mesio - distal cross section:

i. The axial wall will be smooth and slightly


curved mesiodistally, following the
curvature of the facial or lingual surface.
This is to provide resistance to the forces of
condensation and to provide a maximal pulp
protection.
ii. Mesial and distal walls, will appear
divergent or flare mesially and distally
respectively, going with the direction of
enamel rods to form 90° cavo-surface
angle. This is to provide strength for
the tooth and the amalgam margins
and to prevent undermined the enamel
walls.
2. In an occluso - gingival
longitudinal section:
i. The axial wall:

Will be seen as flat to slightly convex


occluso-gingivally depending on the extent
of the preparation occluso-gingivally. This
will provide maximal pulp protection,
while maintaining a uniform minimum
dept of 0.5m in dentine.
ii. Occlusal or incisal wall:
It can appear in one of two ways:

a. Smooth and straight forming a 90° cavo-


surface angle following the direction of
enamel rods. This is to facilitates
condensation and the adaptation of the
amalgam restoration and at the same time it
prevents undermining of enamel rods.
b. If the occlusal margins is located at,the
middle third of the facial or lingual
surfaces, it will be formed of two planes; a
grooved internal plane, and is made of
dentin, and an outer amelo-dentinal plane
going with the direction of enamel rods.
This will provide a mechanical retention
lock in occlusal wall without undermining
the enamel rods.
iii. Gingival wall:
Also it can vary in appearance, depending on
its location, if it is located on enamel, it
requires a small cavo-surface bevel. This will
protect the very short gingival enamel rods
from fracture during condensation and, at the
same time, it terminates the gingival wall with
its enamel wall going with the direction of the
enamel rods, thus, eliminates the unsupported
rods.
In such a manner it appears with two
planes; an internal grooved plane made
of dentinand an outer flat plane made
of enamel.
 If the gingival wall is located on cementum
of the root, it also appears with two planes,
an internal grooved plane made of dentin
and an outer flat plane made of dentin and
cementum.
 All internal line angles in dentine must be
squared up except those on the corners,
they must be rounded. Also, all point angles
must be rounded. This is to facilitate
condensation of amalgam.
Convenience form:

 The trapesiodal shape with rounded corners


and the isolation of the field of operation
using the rubber dam will provide a better
conveniency for cavity preparation and
restoration.
Removal of carious dentine:
As described before.
Finishing of enamel walls and
margins:

 Enamel margins should be smoothened and


should be provided with 90° cavo-surface
angle . The gingival bevel is to be placed on
the gingival walls that are terminated by
enamel and not where the preparation
terminates in cementum.
Cavity Debridement

As described before.
This Form of the Cavity :

1. Meets the general principles of cavity


preparation.
2. Exhibits a pleasant appearance, and
3. Is easier to restore.
Armamentarium

1. Rubber dam , punch , clamp forceps and


clamp no. 212.
2. Burs nos. 330 , 256 , 1/2, 1 , 35 .
3. Hand instruments : curved chisel, mon -
angle hoe , hand excavator.
Instrumentation Resume for the Class
V Preparation
1. No. 256 or 335 bur for penetration and extension
of the outline .
2. Axial wall located with the same burs.
3. If required , caries is removed with a slow -
speed round bur , as dictated by convenience .
4. Hand excavator may be advised.
5. Gingival and incisal retention placed with no. ¼
or ½ bur.
6. Enamel is finished and beveled with a no. 15
Wedelstaedt chisel and 7901 or 242 bur.
Principles Rationale

B. Gingival outline is Will allow maximum


straight and parallel to retention to be placed
the occlusal outline. in cavity walls if
occlusal and gingival
outlines are parallel.
Principles Rationale

C. Mesial and distal Conforms to the


outline is straight and shape of the tooth.
parallel to the mesial
and distal tooth
outline in the gingival
1/3.
II. Extensions
 Conservation of tooth structure is the basis
for all cavity preparation; therefore, extend
only far enough to remove defective tooth
structure and create sufficient access
(convenience form) for instrumentation and
insertion of restorative material. In
addition, access for finishing and
maintenance of the restoration must be
provided.
Principles Rationale

A. Circumscribe Eliminates weak or


1. Decay, decalcification, defective tooth
and defects. structure so that
2. Enamel unsupported by margins of the
dentin. restoration will
3. Eroded, abraded areas. terminate on sound
4. Existing restorations tooth structure
(extension for
prevention).
Principles Rationale

B. Occluso-gingival Provides sufficient


extensions access for
1. Occlusally to the height instrumentation
of contour (or to the and condensation
occlusal extent of the and for prevention.
lesion)
2. Gingivally to the
gingival extent of the
lesion (frequently
subgingivally near the
C.E.J.)
Principles Rationale

C. Mesio-distal extention Extention for


is to the line angles of prevention, more
the tooth (or to the esthetic and
extent of the lesion harmonious.
mesially and distally).
III. RESISTANCE/RETENTION
FORM
Principles Rationale
A. Depth
1. 0.5 mm in dentin A minimum depth is
required to provide
2. 1-1.25 mm (may vary
retention and uniform bulk
slightly depending on of amalgam for strength of
size of tooth, thickness of material – further tooth
enamel and extensions); reduction is unnecessary and
occlusally 1.5 – 1.75 mm may result in pulpal
depth may be required encroachment or sensitivity.
to achieve 0.5 mm in
dentin.
Principles Rationale
B. Axial Wall
1. Smooth Easier to adapt amalgam
2. Slightly curved to smooth walls provides
mesiodistally. resistance to forces of
3. Straight or slightly condensation and
curved occlusogingivally provides maximumal
depending on the extent pulpal protection while
of the preparation maintaining uniform
occlusogingivally. minimum depth (0.5 mm
in dentin).
Principles Rationale

C. Mesial and distal walls

1. Smooth and straight Facilitates


occlusogingivally. condensation,
adaption.
Principles Rationale

2. Flare mesially and provides strength for the


tooth and amalgam
distally respectively margins (prevents
to form 900 metal undermined enamel and
margins). provides a 700 - 900
amalgam margin) –
Resistance form.
Principles Rationale

D. Occlusal or incisal wall


1. Smoothly and straight Facilitates
mesiodistally. condensation,
adaption.
Principles Rationale

2. Forms a 900 Prevents undermining


cavosurface angle of enamel rods, assists
(occlusal wall is parallel in providing retention
to the enamel rods – 900 by opposing the
to a tangent to the gingival wall which
external surface). forms an acute
gingivocavosurface
angle.
Principles Rationale

3. Occlusal retention – Provides retention


two undercuts .5 mm – a mechanical lock
deep in the dentin of in occlusal wall
the occlusal wall at the without
occluso-axial line angle undermining
(one mesially and one enamel rods.
distally)
Principles Rationale

E. Gingival wall
1. Smooth and Facilitates
straight condensation,
mesiodistally. adaption.
Principles Rationale

2. Gingival retention – Provides


an acute axio- mechanical lock to
gingival angle (700). retain the amalgam
(primary
retention).
Principles Rationale

3. If terminated on A small enamel bevel


enamel requires a small protects the very
cavosurface bevel. short gingival
enamel rods from
fracture during
condensation, and
eliminates
unsupported rods.
Principles Rationale
IV. CAVITY FINISH
A. Line Angles
1. Axial line angles are Increase retention
well defined and
conform to the
configuration of the
cavosurface outline
form (internal
outline).
Principles Rationale

2. Mesio – occlusal, Facilitates


mesio-gingival, condensation.
disto-occlusal, and
disto-gingival walls
form rounded line
angles.
Principles Rationale

B. Point angles are Facilitates


rounded condensation
Principles Rationale

C. Cavosurface margins
1. Well defined Well defined, sound
cavosurfaces are required
2. Strong (sound) to resist condensation
forces and produce a well
adapted, durable tooth
restoration margin which
will resist
plaqueaccumulation and
prevent recurrent caries.
Principles Rationale

D. Cleanliness - the a clean, dry cavity


preparation will allow
cavity must be free
more intimate
of moisture and adaptation of amalgam
debris. to the cavity walls. An
amalgam which is placed
in a dry environment will
have superior physical
properties to one placed
in a moist environment.
Principles Rationale
V. TISSUE/DAM PRESERVATION

A. The rubber dam damage of the dam


is intact. will cause leakage
and loss of isolation
(moisture
contamination).
Principles Rationale

B. Surrounding conserves natural


enamel, dentin, and tooth structure
eliminates post-
cementum are operative pain
preserved inflammation.
undamaged.
Principles Rationale

C. Soft tissue undamaged.

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