Questions and Answers
Where are Class II lesions found?
On the proximal surfaces (sides) of posterior teeth.
What kind of cavity is a Class II lesion?
A smooth surface cavity.
Where are Class II lesions typically found in regard to contact points?
Mesially and distally below the contact points.
Explain the difference between D1, D2, and D3 caries.
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How do you know whether a box would be mesial or distal on a mandibular 2nd premolar?
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What does an MOD prep indicate?
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How would you classify the Class II by complex?
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If you have caries that involve three surfaces, how would you classify it?
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Describe how the progression of Class II lesions begins.
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Describe Class II caries progression.
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What is the clinical appearance of smooth surface caries?
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What would you likely find if a patient has a purple-gray tint on their premolar?
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Describe noncavitated caries.
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Describe cavitated caries.
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Why is the occlusal surface normally included in a Class II prep?
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What area is not included in the maxillary molar prep outline for a Class II?
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Transverse ridge is a feature of what premolar?
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Why do you not include the transverse ridge in the mandibular first premolar Class II prep?
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What is a slot prep? When is it used?
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Name the different surfaces in the proximal box.
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Name the horizontal aspects of the Class II prep.
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The gingival floor needs to always be cut to the point where there is no contact left with the adjacent tooth.
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What is a line angle?
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What is a point angle?
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Name all the line angles you'd find in a Class II.
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What is a linguoaxiogingival point angle?
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Is a linguopulpal line angle convergent or divergent?
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What is the most retentive part of the box?
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Where do we condense first in the box?
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A Class II prep box should be convergent.
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The walls of the box in the Class II prep are __________ to the occlusal table and ____________ to the long axis of the tooth.
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How far down does your box go?
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Why is a mandibular first premolar hard to do?
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Do the mandibular molars have a dovetail?
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A maxillary molar MO: only the _____ portion of the occlusal surface is included.
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A maxillary molar DO: only the _____ portion of the tooth is included.
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What burs do you need to do Class II preps?
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What is the small hatchet width?
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What is the large hatchet width?
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What is the isthmus width for external outline form?
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For retention purposes, the proximal portion of the Class II will be wider _______________ at the gingival level and narrower at the __________________.
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A wooden wedge can be placed gingival to what? Should it come in from the buccal or lingual?
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What can you place interproximally to prevent damage to adjacent teeth?
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Where do you start your box?
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The proximal box is thinned with the bur as specified before, but leave _______________________
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Proximal box placement and size is dictated by what?
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Clearance between the teeth is ______, measured with the tip of the explorer along the entire buccal, lingual, and gingival walls of the box.
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Occlusogingivally, our axial wall should be at least ______ long.
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Clinically, we go gingivally until we ______________________.
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It is often easiest to break contact where?
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Do you often need a reverse S curve on the lingual?
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What would you do about a sharp axiopulpal line angle?
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When do we do a dovetail?
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Facial and lingual walls form a 90-degree surface with the proximal surface of the tooth called a?
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Study Notes
Class II Amalgam Preparation Overview
- Class II lesions occur on the proximal surfaces of posterior teeth.
- These cavities are classified as smooth surface cavities.
Cavity Classification
- Class II lesions are commonly found mesially and distally below contact points.
- Caries can be classified into three categories:
- D1: Enamel to outer third of dentin (mild)
- D2: Middle third of dentin (moderate)
- D3: Inner third closer to pulp chamber (deep)
Cavity Preparation and Design
- An MOD (mesial-occlusal-distal) preparation involves two boxes indicating caries on three surfaces.
- Class II cavities are termed compound as they involve two surfaces, while three surfaces indicate a complex cavity.
- The progression of Class II lesions begins with broad decalcification of enamel.
Caries Progression
- Decay initially forms a cone shape that spreads horizontally at the dentin-enamel junction (DEJ), forming a cone toward the pulp.
- Clinical appearance of smooth surface caries can be subtle, sometimes showing only opacity over the marginal ridge.
Types of Caries
- Noncavitated caries exhibit a surface intact with possible opacity and superficial radiolucency.
- Cavitated caries show visual or tactile breaks in the surface and may be accompanied by discoloration or radiolucency beyond DEJ.
Class II Preparation Details
- The occlusal surface is usually included in Class II preparations for convenience form and future caries prevention.
- For maxillary molar preparations, intact oblique ridges are not included.
Instrumentation and Techniques
- Class II preparation uses burs similar to Class I: 330 pear, 245 elongated pear, and 170 tapered fissure.
- The width of the hatchet for premolars is 1.0 mm, and for molars, it is 1.5 mm.
Box Configuration
- A Class II box starts proximal at the occlusal pit and should be wider buccolingually at the gingival level but narrower at the occlusal level.
- Clearance between adjacent teeth during preparation should be 0.5 mm.
Special Features in Preparation
- The proximal box's size is determined by the contact point, ensuring the gingival floor is cut to avoid any remaining contact.
- A sharp axiopulpal line angle should be rounded to ensure smooth transitions.
Matrix and Wedges
- Wooden wedges are placed gingival to the contact area, ideally coming from the lingual side.
- A matrix band can be used interproximally to protect adjacent teeth during restoration.
Miscellaneous
- The lingual and axillary walls should ideally create a converging form in preparation.
- Dovetail preparation is specific to premolars lacking two lingual cusps to enhance retention.
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Description
This quiz covers the overview of Class II amalgam preparations, focusing on cavity classification, preparation design, and caries progression. It details the specific characteristics of Class II lesions and their clinical implications in dentistry.