Peculiarities of

preparation of carious Dental caries

cavities of different An infectious disease with progressive
classes in deciduous destruction of tooth substance, beginning
and permanent teeth in on the external surface by
demineralization of enamel
children
Th.J.Zwemer
Mosby’s dental dictionary, 1998
As. prof. N.Bidenko

Cross section of occlusal Removing of infected

caries enamel and dentine
demineralising
infected enamel
Providing of access to
and dentine carious lesion
sclerotic or Necrectomy
transparent
dentin

reparative dentin

Atraumatic restorative
Methods of removing of treatment (ART, 1994)
carious tissues
- manual
(Atraumatic Restorative Treatment)
- chemo-mechanical
- mechanical (using of rotary instruments)
- kinetic cavity preparation
- laser cavity preparation

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Dental excavators and Atraumatic restorative
enamel knives treatment

Atraumatic restorative
treatment

Chemomechanical Chemomechanical
preparation preparation

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 Chemomechanical Foot-treadle drill by
preparation: J.B.Morrison (1871)
☺ 
Doesn’t provide for
Is painless
removing of enamel
Is spared margins and cavity
forming
Provides better Requires using only
adgesion glass ionomer
cements for cavity
filling
Requires protection of
mucosa
Takes a long time

Dental burs Diamond burs

Diamond burs Diamond burs: ISO

Colour of Dispersiveness Size of Purpose
ring particles
(mkm)
Black SC (super coarse) 150-180 fast removal of
dental tissue
Green С (coarse) 125-150 fast removal of
dental tissue
Without M, S (medium) 88-125 universal removal
ring of dental tissue
Red F (fine) 50-70 polishing of
prepared dental
tissue
Yellow CF (super fine) 20-40 finishing of
composite fillings
White UF (ultra fine) 10-15 high-gloss
polishing

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 Modern dental burs
Dental burs: types

Fissurotomy Original

Fissurotomy Micro STF

SmartPrep Burs for

Fissurotomy Micro NTF
(SS White) micpopreparati
on (Komet)
Komet)

Kinetic cavity preparation

Dental burs: indications

Blade burs Diamond burs

Dentin Enamel
Filling materials Filling materials
except
amalgama

Laser preparation of
Kinetic cavity
hard dental tissues
preparation:
☺  Er:YAG (2940 nm)
Is painless Is expensive
Requires preventoin
Is spared of aspiration of
Eliminates particles
Air pollution
vibration and noise
Is impossible if cavity
has not the straight
access
Without tactile control

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 Laser preparation of
Tooth preparation
hard dental tissues:
☺  Removing of infected enamel and
Is painless Is very expensive dentine
Removes mainly only Is impossible if cavity
damaged dentin has not the straight Ensuring the appropriate shape of
access
Doesn’t overheat up
Without tactile control
cavity
tissues
Its’ distant results is
Improves adhesion not well investigated
Prevents secondary
caries
Is very quick

G.V.Black Black’s preparation

What must provide What must provide

cavity shape
Retention – the inherent property of a
restoration to maintain its position
without displacement under stress
cavity shape
Form resistance – the shape given to a
prepared cavity to enable the
restoration and remaining tooth
structure to withstand masticatory stress

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 What must provide What must provide
cavity shape cavity shape
Convenience form is the shape or form Preparation of margins
of the cavity that provides for adequate
observation, accessibility, and ease of
operation in preparing and restoration
the cavity

Cavity preparation
one of the various operations in
which carious material is removed
from teeth and biomechanically
correct forms are established in the
teeth to receive and retain
restorations
Objectives of cavity
preparation
to remove all defects and give the necessary
protection to the pulp
to locate the margins of the restoration as
conservatively as possible
to form the cavity so that under the force of
mastication the tooth or the restoration or
both will not fracture and restoration will not
be displaced
to alloy for the esthetic and functional
placement of a restore material

Black’s classification of
Black’s preparation
carious cavities
I Pit and fissure cavities
II Cavities on the proximal
surfaces of posterior teeth
III Cavities on the proximal
surfaces of anterior teeth that
do not involve the incisal angle
IV Cavities on the proximal
surfaces of anterior teeth that do
involve the incisal angle
V Cavities of the gingival third of
the facial or lingual surfaces of all
teeth

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 Adhesive abilities of
Blacks preparation
filling dental materials
Carious lesion
Low High
Amalgam Polycarboxylate
Phosphate cement cement
Silicate cement Glass ionomer
Silicophosphate cement
Outlines of prepared cavity
cement Composites
Compomers

Blacks principles of The concept of biological

preparation (1936) appropriation
Preventive extension of
1. Preventive extension of removed Carious lesion cavity approximately
on 1 mm
zone.
2. Taking into account retention and
resistance.
3. Providing for convenience form for
Fluorisation of areas
filling. Outlines of prepared cavity subjected to caries

4. Removing of all carious dentin. Method of "biological Modification by

expediency" S.I.Vice, 1965
5. Preparing of cavity margin, removing (I.G. Lukomskii, 1948)
unsupported enamel.

The method of preventive The method of preventive

filling (R.J.Simonsen et al.,
1980)
Minimal preparation of tooth tissues
only in a carious lesion area with the
subsequent filling to "immune zones"
filling (R.J.Simonsen et al.,
1980)
Combining operative treatment with
sealing of fissures and fluorisation

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 The method of preventive Concept of minimal
filling (R.J.Simonsen et al., intervention by G.J.Mount
1980) (2000)
Taking into account properties of filling wide using of preventive measures,
materials and individual including remineralisation
cariesresistancy minimal intervention cavity designs
using of bioactive restorative materials
to restore the lesions.

Peculiarities of a primary
teeth preparation
During the preparation of cavities in
extension for prevention primary teeth it is necessary:
to adhere to principles of painless
preparation
to take into account anatomic
of extension
prevention of extension peculiarities of a structure of a
temporary teeth
to prefer sparing preparation

Peculiarities of a primary Average thickness of

teeth preparation: primary dentin in childs
instruments teeth
Surface Deciduous Permanent
teeth teeth
Fissurotomy Micro STF Occlusal 1,80 mm 2,85 mm
Approximal 1,40 mm 2,30 mm
Burs for paediatric dentyistry
by d-r H.Sellmann Bur №330

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 Stages of tooth Stages and steps in
preparation cavity preparation
Initial cavity preparation stage
providing for access to the caries Step 1. Outline form and initial depth
necrectomy (removal the carious Step 2. Primary resistance form
Step 3. Primary retention form
tissues from walls and floor of carious Step 4. Convenience form
cavity) Final cavity preparation stage
Step 5. Removal of any remaining enamel pit/fissure,
cavity formation and/or infected dentin, and/or old restorative material if
indicated
processing of edges of a cavity Step 6. Pulp protection
Step 7. Secondary resistance and retention form
Step 8. Procedures for finishing external walls
Step 9. Final procedures: cleaning, inspecting, varnishing,
conditioning.
Th.M.Roberson et al., 2005

Class I cavity preparation Class I cavity preparation

Conventional preparation Conventional preparation and
conservative preparation

Class I cavity preparation:

Class II cavity preparation
deciduous teeth

Curzon M.E.J. et al., 1996; Pinkham J.R. et al., 2005

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Class II cavity preparation Class II cavity preparation

Curzon M.E.J. et al., 1996

Class II cavity preparation: Class II cavity preparation:

deciduous teeth modifications
The methods of slot-preparation

Pinkham J.R. et al., 2005

Class II cavity preparation:

Class III cavity preparation
modifications
The method of tunnel preparation

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Class III cavity preparation:
Class IV cavity preparation
deciduous teeth

Curzon M.E.J. et al., 1996; Welbury R.R., 1997; Pinkham J.R.et al., 2005

Class V cavity preparation

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