L6 Principles of Cavity Preparation 1 PDF

Principles of cavity preparation I Beh Yew Hin Department of Restorative Dentistry  Learning objectives To describe the terminology of tooth 01 preparation To identify the walls and angles of tooth 02 preparations To describe the classification of lesions and 03 to...

Principles of cavity preparation I Beh Yew Hin Department of Restorative Dentistry  Learning objectives To describe the terminology of tooth 01 preparation To identify the walls and angles of tooth 02 preparations To describe the classification of lesions and 03 tooth preparations  Introduction Loading… Not all pathological lesions requires surgical intervention When surgical intervention is indicated, our job is to limit the damage and restore the function of the tooth The role of surgical restorative treatment Restore form Restore function Restore aesthetics Nomenclature Anatomical planes  Nomenclature Mesial Distal Buccal / Labial Loading… Lingual / Palatal Occlusal Dental planes  Nomenclature WALLS Prepared surfaces of tooth preparation Line angle 1 ANGLES Junction of 2 or more walls of tooth preparations Wall 1 Wall 2 LINE ANGLE Angle formed by 2 walls Point angle Line angle 2 POINT ANGLE Wall 3 The convergence of 3 walls/planes Line angle 3 Glossary of Prosthodontic Terms 9th edition  Nomenclature WALLS e b Prepared surfaces of tooth preparation c a d  Nomenclature WALLS Prepared surfaces of tooth preparation  Nomenclature LINE ANGLE Junction of 2 or more walls of tooth preparations Distal Buccal Lingual  Nomenclature POINT ANGLE The convergence of 3 walls/planes Distal Buccal Lingual  Classification of tooth preparation Black’s classification (1908) 01 The father of modern dentistry Loading… Extension for prevention Classification was linked to cavity form STILL… most widely used until today Greene Vardiman Black (1836–1915)  Classification of tooth preparation Extension for prevention – still relevant? WHY? Classification of tooth preparation Based on location of cavity or caries Class Class Class Class Class Class I II III IV V VI Class I Occlusal/palatal pit and fissure Class II Proximal of posterior teeth Class III Proximal of anterior teeth Class IV Proximal of anterior teeth with incisal involvement Class V Cervical third of anterior/posterior teeth Class VI Cusp tip or incisal edge  CLASS I Occlusal or pit and fissures (both anterior and posterior teeth)  CLASS II Proximal surface of posterior teeth  CLASS III Proximal surface of anterior teeth  CLASS IV Proximal surface of anterior teeth with incisal involvement CLASS V Cervical third  CLASS VI Cusp tip or incisal edge  Classification of tooth preparation Newer classification is required considering Caries classification and cavity design shall be a different entity. Not LINKED. Variations in cavity design based on lesion. Caries aetiology and its prevention strategies has Pitts, N., Zero, D., Marsh, P. et al. Dental caries. Nat Rev Dis Primers 3, 17030 (2017). https://doi.org/10.1038/nrdp.2017.30 better understanding.  Classification of tooth preparation 02 Mount and Hume classification (1997) Relatively new classification Based on site and size Recording the actual state of caries activity/stage Considerations was given to the preventive strategies and adhesive dentistry Monitoring is possible  Classification of tooth preparation 02 Mount and Hume classification (1997) Determine SITE SITE 1 Occlusal Black’s (pit & fissure Class I including palatal Class VI pit) SITE 2 Proximal Black’s (anterior & posterior) Class II Class III Site 3 Cervical third/root Black’s surface Class V  Classification of tooth preparation 02 Mount and Hume classification (1997) Determine SIZE Size 0 First stage of caries/white spot Size 1 Minimal cavitation with dentin involvement Remineralisation is not possible Size 2 Moderate involvement of dentin. Remaining tooth structure is still strong to support the restorative material. Size 3 Beyond moderate Caries may involved cusp tip or incisal edge Cavity design need to be modified to allow restorative material to support the remaining tooth structure. Size 4 Extensive Loss of cusp/incisal edge  Classification of tooth preparation 02 Mount and Hume classification (1997) Site 1 Site 2 Site 3  Classification of tooth preparation 02 Mount and Hume classification (1997) site:1 ; size: 0 Site:2 ; size: 1  Classification of tooth preparation 02 Mount and Hume classification (1997) site:3 ; size: 2 site:1 ; size: 3  Classification of tooth preparation 02 Mount and Hume classification (1997) site:1 ; size: 4 site:2 ; size: 4  Classification of tooth preparation 03 International Caries Detection and Assessment System (ICDAS) New classification system developed in 2002 Regarded as a better classification to cater clinical practice, education/academic, research and public health. Adopted in many countries including Malaysia (including FGG) Some used it as modified ICDAS (mICDAS)- example KKM  Classification of tooth preparation 03 International Caries Detection and Assessment System (ICDAS) 2 number coding system for each surface Caries code + restoration code Loading… More will be covered in ICDAS lecture  [Acknowledgement] Dr. Tew for contributing to the contents of this lecture