Class V Dental Preparation Flashcards

Class V Preparation and Restoration Overview

• Class V preparations involve smooth surface carious lesions located on the gingival third of the facial or lingual surfaces of teeth.

Indications for Class V Preparation

• Indicated for caries, erosion, abrasion, recession, and sensitivity.

Preparation Characteristics

• Horizontal cross-section details are crucial in procedural preparation.

Depths of Preparation

• Occlusal depth: 1.5 mm (deeper)
• Gingival depth: 1.25 mm (shallower)

Preparation Directions

• Begin by outlining from line angle to line angle.
• Utilize a number one round carbide bur, holding perpendicular to the buccal/lingual surface.
• Use a pear-shaped carbide bur to extend the outline form to cover the entire carious lesion.
• M-D extension should reach M-D line angles as per clinical caries presence.
• O-G extension determined by criterion in clinical settings.

Ideal Preparation Specifications

• Maintain a 1 mm distance from the free gingival margin.
• Extend prep from line angle to line angle at the intersection of facial and distal/mesial areas.
• Height of preparation should be 2 mm from incisal/occlusal to gingival/cervical margin.

Bur Specifications

• 330 bur: 2 mm head size designed for cavity preparation.
• 256 bur: 3-3.5 mm head size used in restorations.
• 245 bur specifics are not detailed but is crucial for precise cavity shaping.

Non-Carious Cervical Lesions (NCCL)

• NCCLs are characterized by loss of hard dental tissue near the cemento-enamel junction, often presenting as wedge-shaped grooves on buccal surfaces due to abrasion or abfraction.

Causes of Abrasion

• Factors contributing to abrasion include hard brushing, abrasive dentifrices, use of hard-bristled toothbrushes, tobacco chewing, and ill-fitting partial denture clasps.

Abfraction Insights

• Occurs due to occlusal stresses, such as bruxism and clenching, leading to enamel loss.

Importance of Addressing NCCLs

• Primary reasons include preventing dentinal hypersensitivity, caries development, root fractures, pulpal damage, maintaining esthetics, and periodontal health.

Treatment Justification for Class V NCCLs

• Patients' dental histories guide treatment; probing questions regarding symptoms are vital.
• Educate on proper brushing techniques and correct occlusal stresses.
• Preventive measures include desensitizing toothpaste, fluoride treatments, and dentin bonding agents.

Restoration Options for Carious and Non-Carious Teeth

• Anterior restorations: glass ionomer (fluoride-releasing), resin modified glass ionomer, resin composite.
• Posterior restorations: amalgam, gold, glass ionomer, resin modified glass ionomer, resin composite.

Retention and Resistance Forms

• Amalgam and gold materials follow specific retention and resistance form principles.

Additional Restorative Material Considerations

• RDI (Reparative Dental Indication) is essential; ensure shade selection occurs prior to RDI placement and involves the patient.

Suggested Hand Instruments for Preparation

• Perio probe: measures cavity design outline from free gingival margin to the gingival margin of the prep.
• Flat blunt instruments: used to retract gingival tissue during cavity design.
• Wedelstaedt Chisel (15-15-3): utilized for cleaving enamel.
• The 330 pear-shaped bur helps in measuring the height from gingival to occlusal cavo-surface margin effectively.