class i [lecture by dr.wedad etman @amcofam]

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Page 1: Class I [Lecture by Dr.Wedad Etman @AmCoFam]
Page 2: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Class I lesion affects

�The pit and fissures of posterior teeth Surfaces involved are:Surfaces involved are:

–Occlusal surfaces of premolars & molars

–Occlusal 2/3 of the facial & lingual surfaces of molars

� Palatal surfaces of maxillary incisors

Page 3: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Spread of pit &fissure caries in

enamel & dentin

In enamelCone shape

Base towards DEJ

& apex toward the surface& apex toward the surface

In dentin (Spreads more rapidly than enamel)

Cone shape

Base towards DEJ

& apex towards the pulp

Page 4: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Class I could be :• Simple occlusal cavity S.O.C

• Compound class I (two surfaces)

* Occluso buccal O.B.C

* Occluso lingual or palatal O.L.C /O.P.C

• Complex class I (more than two surfaces)

* occluso bucco lingual O.B.L.C

• Buccal pit

• Paltal pit in anterior

Page 5: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

CLASS I SIMPLE OCCLUSAL CAVITY

(OCCLUSAL SURFACE ONLY)

Page 6: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Outline form

Varies in shape according to theVaries in shape according to the

number of cusps

and orientation of pits ad fissures

Page 7: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Resistance form is obtained by

• Outline placed equidistance from the defective pits ,fissures on smooth ,soundtooth structure

• Sufficient width to include the defects, • Sufficient width to include the defects,

pits & fissures and permit insertion of small condenser for placement of amalgam

But otherwise as narrow as possible

(preservation of tooth structure)

Page 8: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Extension for prevention

Black suggested that it was necessary to

• remove additional tooth structure to gain access

Resistance

• remove additional tooth structure to gain access

& visibility

• extend the cavity to self-cleansing areas to

AVOID RECURENT CARIES

Black’s cavity width

1/3 intercuspal distance

Page 9: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

CONSERVATIVE APPROACHE

Introduction of amalgams with better properties

& the use of smaller instruments

Resistance

� Cavity width (faciolingual width)

,/- intercuspal distance

(not more than ,-,./ mm)

No extension for prevention

Page 10: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

A Conservative cavity preparation

• Saves tooth structure

Minimize pulpal irritation

Resistance

• Minimize pulpal irritation

• Strong tooth structure,

marginal integrity &

restoration longevity

Page 11: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

� Outline should consist of smooth

curves on occlusal surface

(no sharp line angles)

Resistance

To avoid stress concentration

Page 12: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Box form (mortis form)

* flat floor

* definite line & point angles

Resistance

Distribution of force

Page 13: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Cavosurface margin is 90° butt joint

• Remove any undermined enamel (enamel

supported with dentin)

Resistance

Page 14: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Depth * 0.5mm below DEJ (cavity in dentin)

* The whole cavity depth is about

1.5 - 2 mm

from cavity margin to pulpal floor

Resistance

from cavity margin to pulpal floor

Pulpal floor

D

Page 15: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

�Minimal extension into the marginal ridge (only enough to remove the defect) without removing dentinal support

� Mesial & distal walls

* divergent occlusally(≥≥≥≥ 10°) to follow

Resistance

* divergent occlusally(≥≥≥≥ 10°) to follow

the direction of enamel rods & prevent undermining of the marginal ridge

Page 16: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Join weekend ridge between two cavities (<0.5 mm apart)

Resistance

Page 17: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Retention form

Is obtained through

• Converging Buccal and lingual walls occlusally (undercut)

• Parallelism of the walls

• Griping action of dentin

Page 18: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Extra means of retention

Grooves

Retention

Prepared at the line angle between floor of the cavity & its walls with

a ¼ round bur

Page 19: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Establishing RESISTANCE & RETENTION

(depth & width of the cavity)

gives adequate convenience

Convenience form

gives adequate convenience

to instrumentation ,removal of

decay & insertion of the

restoration

Page 20: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

If there is spot of caries

remaining in the cavity

Infected carious dentin should be removed by:

• Excavators (spoon or discoid) • Excavators (spoon or discoid)

soft caries

• Large carbide Rose head at low speed

hard caries

* Until the tooth structure feels hard & firm

* lesion is lighter in color

Page 21: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

The removal of carious dentin should not affect resistance form

Create a flat floor peripheral

to the excavated area

Page 22: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Compound class I

cavity cavity

Page 23: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

It involves two surfaces

• Occlusal surface

• Buccal or Lingual grooves OF molars

Compound class I

• Buccal or Lingual grooves OF molars

Page 24: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

� Occlusal box follows the same principles for class I simple occlusal cavity

� After preparing the occlusal cavity

* #245 bur is held ⊥ to the pulpal floor &

parallel to the long axis of the tooth crown

Cavity preparation

parallel to the long axis of the tooth crown

* moved towards the buccal/lingual

direction along the fissure maintaining uniform depth until the bur reaches the buccal/lingual surface

Page 25: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• The step is prepared keeping the bur parallel to the buccal/ lingual surface of the corresponding groove

So The axial wall will follow the contour of

the buccal/lingual surface at a the buccal/lingual surface at a

uniform depth of 0.5mm inside

the DEJ (0.2mm is permissible)

• Axiopulpal line angle is

rounded

Resistance

Page 26: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Extend the lingual box gingivally to terminate at the buccal/lingual groove creating a flat gingival seat for

…………. Resistance …………. Resistance

• Gingival wall meets the tooth surface at 90°& the axial wall makes an obtuse angle with the pulpal floor ……………..Resistance

Page 27: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

• Mesial & distal walls of the B/L BOX are made parallel to each other with slight occlusal convergence ………………………………..Retention

• Mesial & distal walls are butt joint with the cavity margins………………… Resistancecavity margins………………… Resistance

Page 28: Class I [Lecture by Dr.Wedad Etman @AmCoFam]

Pit & fissure on facial or lingual surface

only(buccal pit /paltalpit)

• Shape varies (oval –round-oblong) depending

upon the extent of caries

• Walls continually joined & slightly convergent • Walls continually joined & slightly convergent

towards the cavosurface margin

• Axial wall follows the contour of the

buccal/lingual surface