10. Class V Amalgam Preparation/ Restoration Flashcards
• class 5 is called the cervical lesion-in cervical 1⁄3
• not prepping in GRD she’s giving us the tooth
• why amalgam?–b.c,esp if high risk,only gets better as it ____ • can’t do if ____ + ____ won’t work
◦ if partial denture w/ ____ hooks it may have a hook here so you want
◦ metal and not plastic
erodes
bloody
wet
metal
“Class V” Carious Lesions: Smooth Surface Cervical Lesions ! Originates in the \_\_\_\_ of the tooth ! Occurs on \_\_\_\_ surfaces of tooth ! \_\_\_\_ or \_\_\_\_ ! \_\_\_\_ surfaces most common
! Normally found ____ rather than radiographically
! Most often found in patients with poor oral hygiene
• if present MD then it's a class 2-just a lass 2 that extend s down to cervical 1⁄3 ◦ class 5 therefore has to be \_\_\_\_ or \_\_\_\_ • can be anterior or posterior(just don't use \_\_\_\_ on anterior) • most common is \_\_\_\_-found in ppl w/ poor oral hygiene
cervical third smooth anterior posterior facial/buccal
clinically
B
L
amalgam
facial
“Class V” Carious Lesions: Smooth Surface Cervical Lesions
! Sometimes ____ inflammation is present
! Carious lesion can occur below the \_\_\_\_ also ---! gingival \_\_\_\_ present ---! Called Root Caries ( \_\_\_\_ caries ) ! Not \_\_\_\_ caries ---! cementum
gingival CEJ recession senile enamel
“Class V” Carious Lesions: Smooth Surface Cervical Lesions
! Smooth surface lesion:
! Cones of decay have ____ relationship at the DEJ
! Caries begins as a ____ line around the gingival part of the tooth
! Area of ____
(demineralization, hypocalcification)
apex to base
white
decalcification
“Class V” NON Carious Lesions: Cervical NON Carious Lesions
Three types of non carious Class V lesions:
1. ____
2. ____
3. ____
! Ditched cervical areas usually on ____ surfaces
! A restoration is placed to prevent further loss of tooth structure and reduce sensitivity of teeth
- Abrasion – ____ Shaped Defect
Example: ____ Abrasion
◦ don’t restore unless you feel the crown will ____ or Pt is ____
abrasion erosion abfraction facial wedge/"V" tooth brush crumble sensitive
“Class V” NON Carious Lesions:
Cervical NON Carious Lesions
- Chemical Erosion – ____ Shaped Defect
Example: ____ fruit juices and other ____ agents wash over the surface and dissolve the enamel away - Abfraction – ____ Shaped Defect over ____
Fracture of enamel at the ____ due to stress/flexure of the teeth buccolingually
Example: ____
irregular cup citrus acidic wedge/"V" time CEJ bruxism/grinding
“Class V” Preparation: Outline Form
! No ____ to direct
the outline form
! Outline form is determined ____, but not entirely, by the extent of the ____
! Lesion has a tendency to spread laterally toward ____ angles
! Usually widest ____
! The ____ and chalky areas of ____ (hypocalcification) should be included in the outline.
! The outline should be free flowing, with no ____ cavosurface angles
• no outline to follow - no anatomy
• bonding-clean it all up, no ____ enamel
◦ amalgam: follow ____ form
• class 5 spreads MD towards transitional lines
◦ try to envision transitional lines then center prep around lesion
◦ no sharp corners - amalgam hates those!
pits and fissures mainly caries transitional line horizontally carious lesion decalcification sharp
unsupporting
resistance
“Class V” Preparation: Outline Form
! The ____ extensions are difficult to define since the lesions vary so greatly
! The Mesial and Distal borders are usually defined by the ____
ideal
transitional lines
“Class V” Preparation: Outline Form
! The ____ is centered in the outline
! The mesial and distal walls follow the mesial and distal ____ angles
! The gingival wall is ____ to, and ____mm above the gingival margin
! The occlusal wall is ____ mm above the gingival wall and is ____ to the gingival wall
lesion transitional line parallel 1 1.5 parallel
“Class V” Preparation: Convenience Form
! You need to see and access the carious lesion for removal and restoration
! Many times gingival tissue displacement with a ____ clamp is necessary
“Class V” Preparation: Depth
! Ideal depth is just into ____
! The occlusal wall needs to penetrate more enamel so it will be slightly deeper, ____ mm
! The gingival wall will be less deep due to thinning enamel near the CEJ, ____ mm
- convenience form: might need to wrap around transitional line, may need to use clamp to push skin away, or surgically remove tissue
- stop 0.5 mm into dentin b.c this is only class ____ lesion
- enamel gets thinner towards CEJ-don’t ____ axial wall cuz tooth naturally tapers itself
gingival retraction
dentin
1.5
1
1
slant
“Class V” Preparation: Resistance Form
The Mesial and Distal Walls ____ towards the transitional line angles
! the external surface is ____
! The walls ____ the enamel rods
! Walls create a 90 degree cavosurface angle – “____”
!The Occlusal and Gingival walls are ____ to the external surface
diverge convex parallel butt joint parallel
“Class V” Preparation: Resistance Form
! Preparations have to be ____ to enamel rods
! Enamel rods have to be supported by ____
! All preparations must end in ____ to give
bulk to amalgam
! Preparation needs to have ____ butt joint
“Class V” Preparation: Retention Form
! Grooves are placed all along the ____ and ____ walls at their ____ wall line angles
parallel
dentin
dentin
90o
incisal
gingival
axial
“Class V” Preparation: Steps
! Rough out cavity preparation using a 330 pear bur
! Place 2 or 3 depth holes
! Then use a sweeping motion from the mesial to distal
! End of the bur will form the axial wall in a curve which will parallel external surface of tooth
! ____ wall should be just in dentin
! Mesial wall depth: ____ mm ! Distal wall depth: ____ mm
axial
- 5
- 5
“Class V” Preparation: Steps
! Continue to refine outline form with 330 bur
! Extend cavity preparation almost to designed
outline of gingival and proximal walls
! Establish ____ depth
! With 330 bur, prepare divergent mesial and distal walls – tilt the bur
! Can use 171 carefully
uniform
“Class V” Preparation: Steps
! Extend the preparation into proximo-incisal corners
! All four corners are gently and smoothly rounded
! Retention Grooves
! Placed in the incisal and gingival walls at the ____ angle intersections – LOW SPEED
! CANNOT be placed in the ____ wall
“put burr ____ to surface you’re cutting” - said this multiple times
• draw line that’s 1mm thick then take burr + make it wider-want ____mm
occlusal-gingivally
• grooves: NOT perpendicular! - ____
axial
perpendicular
2.5-3
angled
