Class II.: Defects affecting one or both proximal surfaces ...Defects affecting one or both proximal surfaces of posterior teeth . lroubal@med.muni.cz 2 Symptoms No symptoms ... -Provide

ClassClass II. II. cavitycavity preparationpreparation

ClassClass II.:II.:

DefectsDefects affectingaffecting oneone oror bothboth proximalproximalsurfacessurfaces ofof posteriorposterior teethteeth. .

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SymptomsSymptoms

�� No No symptomssymptoms

�� IncreasedIncreased sensitivity (sensitivity (coldcold, , sweetsweet))

�� RetentionRetention ofof foodfood

�� DefectDefect ((cariouscarious lesionlesion isis open open –– thethe enamelenamel isis

brokenbroken))

�� Bite sensitivity (Bite sensitivity (whenwhen cariouscarious lesionlesion isis open)open)

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DiagnosisDiagnosis

�� VisualVisual changeschanges ofof toothtooth structurestructure

�� TransilluminationTransillumination

�� RadiographyRadiography

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Sedelmayer

RTG vyšetření RTG vyšetření –– BBiteite WWinging

4 stupňový grading

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PreparationPreparation -- amalgamamalgam

�� ConventionalConventional preparationpreparation accacc. to . to thethe BlackBlack´s ´s

rulesrules

�� Slot Slot preparationpreparation

�� LargeLarge preparationpreparation –– cuspcusp(s) (s) involvedinvolved

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PreparationPreparation -- adhesiveadhesive materialsmaterials

�� ConventionalConventional preparationpreparation forfor compositescomposites

�� AdhesiveAdhesive slot slot

�� TunnelTunnel preparationpreparation

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Occlusal cavity Proximal cavity - box

Conventional preparation

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Pulpal wallsAxial wall

Gingival wall

Isthmus

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Access to Access to thethe cavitycavity

FromFrom thethe occlusalocclusal surfacesurface

ThroughThrough thethe underminedundermined enamelenamel

SeparationSeparation usingusing woodenwooden wedgeswedges isis usefuluseful

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Pre op

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Access to the cavity

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CavityCavity borderborder andand extentionextention forfor

preventionprevention

ProximalProximal box: box:

AxialAxial wedgeswedges

UnderUnder thethe free gingivafree gingiva

OcclusalOcclusal

ClassClass I. I. cavitycavity preparationpreparation

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American rule

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Zásada retenceZásada retence

�� Kotvení pomocnou kavitou na žvýkací ploše Kotvení pomocnou kavitou na žvýkací ploše ––

kotvení na rybinukotvení na rybinu

�� Obráceně divergentní preparací kavity Obráceně divergentní preparací kavity

aproximálníaproximální

�� Preparace rýh a zářezůPreparace rýh a zářezů

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Axiální stěny divergují gingiválně

Rýhy a zářezy

Autoretention

Grooves

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ResistanceResistance

�� No No underminedundermined enamelenamel

�� No No sharpsharp wedgeswedges

�� IsthnusIsthnus isis 1/3 1/3 –– 1/4 1/4 intercuspidalintercuspidal distancedistance

�� AnglebetweenAnglebetween axialaxial andand gingivalgingival wallwall: 90°, : 90°, oror 85°85°

�� WidthWidth ofof gingivalgingival wallwall is1 mm is1 mm atat leastleast

�� ThicknessThickness ofof thethe fillingfilling 2 2 –– 4 mm (4mm 4 mm (4mm cuspcuspreplacingreplacing))

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Cavosurface angle

G. wall

Isthmus

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ExcavationExcavation ofof cariouscarious dentindentin

RoundedRounded burbur

(Caries Detector, Kuraray, Japonsko; Caries Marker, VOCO,Německo)

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FinishingFinishing ofof cavitycavity wallswalls

�� RedRed codedcoded diamonddiamond burbur

�� ChiselChisel on on thethe giongivalgiongival wallwall ((ifif in in enamelenamel))

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CavityCavity controlcontrol

�� GoogGoog lightlight, , mirormiror

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Pulpal wallAxial wall

Gingival wall

Isthmus

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Matrix Matrix placementplacement

�� Matrix Matrix primarilyprimarily isis usedused whenwhen a a proximalproximal surfacesurface

isis to to bebe restoredrestored

TheThe objectivesobjectives: :

-- ProvideProvide proper proper contactcontact

-- ProvideProvide proper proper contourcontour

-- ConfineConfine thethe restorativerestorative materialmaterial

-- ReduceReduce thethe amountamount ofof excessexcess materialmaterial

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MatricesMatrices

�� IvoryIvory I I retainerretainer IvoryIvory 11

�� HaweHawe NeosNeos retainerretainer IvoryIvory 88

�� TofelmireTofelmire matixmatix andand retainerretainer

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WedgesWedges

�� WoodenWooden wedgeswedges

-- tightentighten thethe matrix bandmatrix band

-- compresscompress thethe gingivagingiva

-- separatseparat thethe teethteeth

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WedgingWedging

�� Slip Slip thethe matrix band matrix band overover thethe toothtooth ))apicalapical to to thethe

gingiva gingiva marginmargin –– 0,5, 0,5, -- 1 mm)1 mm)

�� TightenTighten thethe matrix, matrix, checkcheck itit withwith probeprobe

�� PlacePlace a a wedgewedge

�� TurnTurn thethe retainerretainer ¼ ¼ counterclockwisecounterclockwise

�� ContourContour thethe bandband

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Trituration!

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CondensationCondensation ofof amalgamamalgam

�� CondensorCondensor –– stamenstamen isis thethe bestbest oneone

�� PowerPower drivendriven condensationcondensation

HowHow bigbig thethe stamenstamen shouldshould bebe????

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???

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BaseBase

�� ZinkoxidphosphateZinkoxidphosphate cementcement

�� ZinkoxidkarboxylateZinkoxidkarboxylate cementcement

�� GlassGlass ionomerionomer cementcement

�� ZinkoxideugenolZinkoxideugenol

On On pulpalpulpal wallswalls onlyonly!!

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The base must be hardened

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AmalgamAmalgam

RetentionRetention

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Sedelmayer

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InstrumentsInstruments

�� PreparationPreparation

�� FillingFilling

�� FinishingFinishing andand polishingpolishing

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Cpátko tyčinkové

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Ořezávač -Frahm

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Carver Sapin

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Carverdiscoid-cleoid

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Amalgam carrier

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