Ellis Classification and Class 4 Composite Prep

Ellis Classification of Fractures

• Ellis Class I: Fracture remains confined to enamel.
• Ellis Class II: Fracture extends into dentin.
• Ellis Class III: Fracture reaches pulp causing pain; typically requires endodontic therapy, such as root canal treatment.

Class 4 Composite Preparation for Teeth #8 or #9

• The preparation shape should correspond to the extent of the fracture.
• Internal retention should be established in the dentin area.
• Continuous bevel marginally at the external cavosurface margin (facial, lingual, incisal, and gingival).
• The outline form for Class 4 preparation involves a diagonal fracture covering at least half of the facial width at the incisal edge.
• Adhere to the original fracture or decay geometry; do not extend preparation beyond fracture.

Creating the Fracture for Class 4 Composite Preparation

• The fracture zone is prepared by removing the discolored area using a tapered diamond bur.
• Ensure the gingival part of the fracture aligns just below the proximal contact.

Internal Preparation in Dentin for Class 4

• Internal preparation should be confined to dentin for enhanced restoration retention.
• Use a #330 pear-shape carbide bur or a #33 1/2 bur, removing dentin to a depth of 1 mm.
• Depth measurement can be done with a perioprobe for accuracy.

Beveling Techniques for Class 4 Preparation

• Begin beveling on the external facial surface using a tapered diamond bur; avoid extending bevel to internal prep.
• Bevel width should be 2 mm on the facial part of preparation; do not attempt gingival margin beveling at this stage.
• Continue the bevel on the lingual surface with a width of 1 mm and include the incisal angles.

Beveling the Gingival Margin

• Protect adjacent teeth using a steel matrix and wedge before beveling the gingival margin.
• Carefully extend the bevel onto the gingival margin after ensuring proper protection.

Class 4 Composite Restoration

• Complete the final prep before bonding the restoration; ensure all previous steps are followed meticulously for optimal results.
• Post-beveling and internal prep adjustments, finalize the restoration technique in accordance with the established guidelines.

This quiz focuses on the Ellis classification of tooth fractures and the principles of Class 4 composite preparation for teeth #8 or #9. You'll learn about the different classes of fractures and the specific techniques required for effective composite restoration. Test your knowledge on fracture management and dental preparation methods.