@


These are pit and fissure type cavities

that involve the occlusal surfaces of
molars and premolars, the occlusal 2/3
of buccal and lingual surfaces of molars,
and the palatal pits in maxillary anterior
teeth.
i These are self-
self-cleansable areas.
However, they may get involved by
caries due to their inherent defective
structure as areas of imperfect
coalescence of lobes of calcification
of these teeth. These areas are
retentive for food and thus invite
caries.
   
 
 


  
 
m. A small surface opening which may remain
unnoticed until the lesion becomes of a
considerable size.
2. A conical spread in both enamel and
dentin, with the bases of cones at the
Amelo--Dentinal Junction, "A. J.D."
Amelo
3. Its rapid burrowing at the dento-
dento-enamel
junction. These lesions may involve one or
more surfaces and hence a simple or
compound cavity should be prepared.
 °  

 
Designing the Outline Form.

The outline form of a routine class I cavity

should describe a symmetrical design running in
sweeping curves along all pits, fissures, and
angular grooves between the cusps and with a
minimum width.
iThe mesial and distal margins are
placed midway between the bottom
of the proximal fossae and the
crest of the proximal ridges and in a
direction parallel to these ridges.
i The mesial and distal wall should
have a slant or slight divergence
from the pulpal floor outward to
avoid undermining the marginal
ridges.
iIn a bucco-Iingual direction, the cavity
is extended just sufficient to eliminate
the defective and susceptible tissues.
The lingual and the buccal wail should
be parallel to the respective tooth
surface.
i It must be reemphasized that the
outline form for class m cavities
should be very conservative since
they involve cleansable areas.
iIt is governed only by the extent of
caries in both enamel and dentin and
the amount of extension or need to
eliminate pits and fissures to secure
smooth margins.
 
  
 

  
i The resistance form here consists
chiefly of a pulpal wall parallel to the
occlusal plane with dentin walls at right
angles to it., i.e. Boxing the preparation.
i The form of this cavity provides
automatically for effective retention and,
therefore, no special retentive features
are required.
  



@ 
i In small size cavities, the carious dentin
should have been removed during making the
cavity extensions.
i In moderately deep and deep cavities, the
carious dentin is peeled off carefully at the
sides using large spoon excavators, and then
scooped out in few and large pieces.
i Only light pressure in a direction parallel to
that of the pulp is utilized. This is continued
until a sound dentin floor is reached.
 


 


iThe enamel walls of the cavity should be
finished free from any loose, short, or
undermined enamel, and trimmed to meet the
tooth surface at a right cavo-
cavo-surface angle.
iThis may be done by sharp and regular-
regular-
edged chisels and hatchets, plane fissure
burs, stones, or sand-
sand-paper discs.
iAll sharp corners in enamel must be rounded,
as they may contain short enamel rods.
 

  

 


A sharp explorer is then used to check

the details of the prepared cavity and to
loosen the tooth debris which are then
blasted out with warm air.
  
 
  
Armamentarium

High speed handpiece

Burs #330, 56
Hoe
Hatchet R&L
Wedel staedt chisel
  

The outline form is performed by first

gaining access through the enamel to
the carious dentin floor of the cavity
followed by making the necessary
cavity extensions.
i In case of initial carious lesions, access
is obtained by employing a small pear
but #330.
i In big carious lesions, access is obtained
easily by breaking down the undermined
enamel overlying the carious dentin,
using a suitable size chisel.
i In either case, access is started at the
most defective area of enamel, i.e., a
carious pit or fissure.
i The bur is held at a right angle to the
involved surface of, the tooth and light
pressure in an in-
in-and
and--out direction is
exerted. Cutting is continued until the
amelo--dentinal junction (A.D.J.) is
amelo
reached.
i The necessary cavity extensions
through pits, fissures, and deep
developmental grooves are made using a
#330 pear bur held at right angle to the
surface of the tooth.

iThe bur is rotated, and carefully

introduced through the opening just
obtained, so that its weak corners do not
touch the enamel and get dulled.
iWith the bur seated in the cavity just
below the amelo-
amelo-dential junction m/z-
m/z-m
mm. gentle pressure is applied in the
direction of required extension.

iDuring cutting, the bur should be kept

moving in-
in-and
and--out of the cavity and at
right angle to the tooth surface. In this
way, the bur will undermine and lift the cut
enamel, and at the same time unclog itself.
irovision of ample resistance and
adequate retention through boxing of
the preparation could be obtained.

iThis is obtained by using a #56 fissure

bur held perpendicular to the surface of
the tooth. All the line angle in dentin
must be squared up hoe excavators.
 r

 
iThe outline of these cavities usually
describes a triangle with its base faming
the gingival wall and its sides forming the
mesial and distal walls.

iThe gingival wall is placed at or

slightly occlusal to the height of contour
of the tooth.
iAll walls are extended just enough
to eliminate defective enamel and
dentin.

iThe enamel walls are planed in the

direction of enamel rods and
perpendicular to the axial wall.
iHoe excavators are used to smooth
the axial wall and make it parallel with
the external surface of the tooth.

iIt should be re-emphasize that the

shape of the cavity will be governed by
the extension of caries, accordingly the
outline of these cavities may be a
rounded or oval in shape.
 r



 
iIn case of occluso-
occluso-buccal and occluso
occluso--
lingual cavities extensions are made
through the fissures and towards the
respective surfaces.
iThe cutting is done in dentin at the
amelo--dntinal junction using a #56 bur
amelo
until the ocdusal ridge is undermined
and removed.
iIf the caries is still gingival to the
level of the pulpal seat, a step is
indicated: a #330 or 56 but is used
to cut the dentin at the amelo-
amelo-
dentinal junction, applying pressure
in a gingival direction and at the
same time moving the bur mesio-
mesio-
distally.
iThe enamel thus undermined, is broken
down with chisels.

iRetention grooves are then cut in

dentin along the axio-
axio-mesial and axio
axio--
distal line angles. The cavity walls and
margins are finished as previously
described.
iIn case of deeply-seated caries,
where removal of the carious dentin
will leave a round cavity floor,
flattening of which to obtain the
required resistance form, will expose
the pulp.
  
 
    

a) The cavity floor is covered with

a sub base of calcium hydroxide,
followed by a base of glass
ionomer cement which fills it to
the routine cavity depth.
b) A ledge is cut on the expense of
the buccal and lingual side walls
of the cavity for obtaining the
required resistance in sound
dentin.
 rinciples Rationale

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