We have two lecture about principles of cavity preparation, today : is the 1st one and today we will talk

about objective of tooth preparation-1 factor affecting tooth preparation-2 stages and steps of tooth preparation-3 first of all the definition of the tooth preparation : is the mechanical alteration of defective ,injured or diseased tooth to best receive a restorative material that if we have an injured ,traumatized, fractured or tooth with decay we do a cavity preparation on it in order to restore it with restorative material and here we prepare it in certain form to retain the restorative material and as we know each restorative material has it's own form of cavity that adapt with it's characteristics , we do this process of restoration in order to reestablish the healthy state of the tooth for normal function and esthetic along with normal . form and function :Objective of tooth preparation ?Why we do tooth preparation remove all defect (carious region) and protect the pulp that -1 during our preparation we mustn't injured the pulp cuz our goal is the pulp protection we will have a lecture about pulp .protection through cavity preparation extend the restoration as conservatively as possible this -2 mean we must do the minimal preparation that we mustn't extend the preparation beyond what we need we must be
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conservative as much as possible only remove the necessary amount of tooth structure form the tooth preparation so that under masticatory force -3 the tooth or the restoration will not fractured or displaced this mean neither the restored tooth get fractured nor the restoration come out after the restoration we must do the preparation in proper way in order to withstand masticatory force and other forces in the mouth we do tooth preparation in order replacement of the -4 restorative material to enable the pnt to use his tooth in it's normal function and to provide the pnt with acceptable form .(of the teeth (esthetic replacement

:Factors affecting tooth preparation Which is the factor that determine the different form of tooth preparation here it is diagnosis-1 knowledge of dental anatomy -2 patient factor-3 conservation of tooth structure-4 restorative material factors-5 diagnosis: is important factor that affect our choices of cavity preparation and the material we use that in our diagnosis we decide the type of restorative and the form of the cavity the reason for r placing the restoration in the tooth for -1 function or esthetic purpose, that our choices of material will .be different in different purpose
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the Periodontal and pulpal status is very important in -2 diagnosis esthatic factor which affect the choice of material -3 relationship with other treatment plans: imagine we are -4 gonging to restore the lower 6 assume we want to do class II and the lower 4 and 5 is missing here treatment plan for this tooth will different cuz here we consider the whole treatment plan of all teeth that we are going to remove the caries and do the restoration but if we consider the treatment the risk potential of the pnt for other dental caries : assume -5 that the pnt has a lot of caries and his potential for developing anther legion is high this mean we arent going to give the pnt very expensive restorative material cuz the possibility to develop recurrent caries around this expensive restorative is . high so in this case we use less expensive material knowledege of dental anatomy :knowledge of dental -2 : anatomy lead to prepare a perfect cavity cross picture of the tooth both internally and externally must -1 be visualized the thickness of enamel ,also the thickness of dentine and -2 the position of the pulp must be known to know how much to enter inside the tooth ,to know where the enamel ended and the exact position of the pulp that when we do class I or class II our objective is to remove the caries region and at the same time protect the pulp from getting injured ,to maintain the pulp we should know the exact thickness to know while doing the tooth preparation how we far from the pulp, soo we must
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know the exact thickness of enamel and dentine ,if u look to the slid u see that the thickness of enamel occlusally is higher than proximally so we can go in enamel for 1.5mm and we still in enamel but if we do 1.5mm in proximal surface we will reach the dentine and the pulp here is close to the outer part of the tooth soo when we do class VI or root caries we should know that we are very close to the pulp than if we go occlusally or class I cavity preparation anther thing that with age the pulp get recession due to formation of secondary and tertiary dentine soo the pulp horn in young pnt is high put in old pnt it's low sooo it's easier to protect the pulp in older . people relation to other supporting tissue :bone and PDL are -3 supporting tissue that if the legion where very close to them ,here is a special consideration that some time we need to make fracture in gingiva to be able to access to the legion if the legion where subgingivally and sometime we need to . remove some of the bone to be able to restore the tooth : patient factor -3 the patient knowledge and appreciation for good dental -1 health :that if the pnt is appreciate or the work of the dentist this mean u can put money and time in restoring the tooth but if the pnt doesn't appreciate the work so ur tendency to do the work is less pnt economic status :if a pnt can't afford a very expensive -2 restoration then we give him another choice that usually we .give the pnt a list of restorative and the prices of it the pnt age : related to the anatomy of the tooth and how it -3 differ according to the age we talk about it before also the health status of the pnt affected for example very old pnt can't
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withstand a long work we mustn't do a complicated restoration for those pnt and we do the restoration in minimal time conservation of the tooth structure : related to tooth -4 structure itself that we must preserve it as much as possible preservation the vitality of the tooth by avoiding the -1 application of poor or careless operative procedure on the tooth :we said that when we use high speed hand piece we should use a water why? Cuz if we work without water this will irritate the pulp and cause pulpal damage and this tooth ended with root canal treatment and later on we may need extraction of the tooth sooo we will enter a sequences of endless treatment planning that if we don't caring about the tooth restoration should be made as small as possible that when it -2 small it mean more protection for the pulp and it maintain the tooth structure also.. anther thing that as the prepared cavity increase the complication in the restoration will be increased and there will be difficulty in restoration sooo it will be hard .to maintain the tooth function and esthetic small tooth preparation result in restorations that has little -3 effect on both inter-arch and intra- arch relationship as will as esthetic : intra-arch mean relation between the tooth and the adjacent teeth ya3ni relation between the teeth in the same arch for example if we have a tooth with class I cavity here there is no effect on adjacent tooth cuz class I is occlusal only but in class III it is occlusal mesial or occlusal distal then it have effect on the adjacent tooth that when we make class II we may injured the adjacent tooth . Inter arch occur between opposing arch by affecting the occlusion this happen
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when the restoration don't retain the original shape of the tooth it may higher or lower than the original occlusal plane if it is higher it may cause trauma to the opposing teeth in the opposing arch, but if it is lower it may affect the opposing teeth by super eruption as u know that the teeth prevent themselves from super eruption ..but if the restoration where .small the affecting on adjacent or opposing will be less restorative material factors: this mean that the cavity -5 preparation form depend mainly on the type of the restorative material there are different type of restorative material but here in operative dentistry we will talk about amalgam vs resin composite only amalgam vs resin composite :the cavity preparation for -1 amalgam differ from the cavity prepared for composite in amalgam we need mare resistant and retention form but in composite it depended mainly on adhesive sooo that the removal of tooth structure in composite bkon more minimal . than in amalgam the ability to isolate the operating field: it mean,, moisture -2 control,, in composite it is more important than in amalgam both of them need moisture control but in composite it is more, that if we couldn't do moisture control we wont use composite but rather than we use amalgam the extension of the caries: for example if we have weaken -3 tooth structure that after remove all carious region we end in a very thin tooth structure in this case if we put amalgam the tooth may fracture but here in this case we must use composite cuz it make bonding it more strengthening for the .tooth
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Sooooo these are the factors that affect the tooth preparation

: stage and steps of tooth preparation

Stage and steps of tooth preparation

outline form & initial depth -1 primary resistance form-2 primary retention form-3 convenience form 4

Initial stage Final stages removing of any remaining infected -5 dentine pulp protection if indicated-6 secondary resistance & retention form-7 proceduer for finishing external walls-8 final procedure :cleaning, inspecting and -9 sealing

we have initial and final stage for each stage we have steps these stages for learning purpose with time we will get used to do tooth preparation .from 1 to 9 step they are continuous stage but we dived them into initial and final stage we are going to explain each of them out line form & initial depth : first the outline form is the form -1 of the cavity ... the extension of the cavity , where it end , where it begin ya3ni the final margin after we finish the procedure ex in class 1 it include central pit,mesial and distal pits ,central groove ,half of the buccal groove. So after we do the cavity .our cavity shouldn't extend more than this
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now initial mean that we shouldn't enter the whole cavity from the beginning we do initial depth first then extend depending on the extend of the caries but initially we do the initial depth which is 0.2-0.8mm here the 0.2 and 0.8 mm is how much we go in dentine only cuz the whole cavity should be 1.5-2mm and cuz the different in the thickness of enamel occlusally and proximally as we said before the enamel is thicker occlusally than proximally therefore we go 0.2mm in dentine occlusally to give the whole cavity depth which is 1.5-2mm as will as we go 0.8mm in dentine proximally to give the whole depth of the cavity which is 1.5-2mm cuz the thickness of enamel here is less f r7 nnsal b dentine akter so the 0.2 for occlusally and the 0.8 for proximally here there are 3 principle we should consider it while doing this :step all weaken enamel should be removed :which is the -1 (unsupported enamel (by dentine all fault should be include : faults are the pits and fissure -2 should be included all margins should be placed in position to afford good -3 finishing of the margin of restoration: the finishing margins should be in certain point that provide better finishing in other word when I do my cavity I should think about the restoration and how I do it so the margin shouldn't be in pits or fissure cuz it will be difficult to do the restoration primary resistant form: y3ni when am doing my cavity -2 preparation I should do it in a shape that will resist the fracture for the tooth and the restorative material enable them to withstand the compression forces in the mouth ..that in our mouth there are different forces according to it's direction
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(tension,tear,fliction) but here in "primary resistant form" we talk about compression force (which is the perpendicular to (the tooth surface or along the long axis of the tooth : principle of resistant form for amalgam should be box shape and flat floor cuz the -1 disturbance of the force will be even but if it wasn't in box shape the possibility to remove the restorative material is high keep the cavity as small as possible : that the cavity -2 preparation should be conservative as we said the initial cavity should be 0.2mm in DEJ but the caries may extend more than 0.2mm but it may not even on the floor here we should remove the caries but we shouldn't put all the cavity floor on one level just remove the necessarily amount of tooth structure that cuz if we remove large amount of tooth structure the tooth become weaken and the resistant for the tooth will decreased sooo remember we shouldnt give all the cavity floor to the level of the caries.but how we maintain the box shape in this case? By putting a liner we will talk about later on rounded well-defined internal line angle: line angle heh -3 elte8a2 tow walls and the box shape of course has a line angle those line angle should be well defined in other word we must have buccal wall and lingual wall and pulpal floor(in the pic in the slid) we must defined each wall of the cavity but here elt8a2 el line angle lazm ma ekon sharp it should be rounded why? Cuz if they sharp there will be stress point stress point cause fracture to the tooth provide enough thickness of restoration material to prevent -4 it's fracture : that as we know amalgam is brittle material so the thickness of amalgam should be 1.5-2mm of amalgam to prevent fracture
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cap cups or include weakened tooth structure within the -5 restoration: doch doesn't comment on this point but I think it's obvious looooooooole$...doch stop here so the lecture is ended excuse me for being soo late and for any mistakes if it's **** being finally I want to thnx our CR Bader Ali and 3beer Al-hamarneh for there great effort "Allah ya36ekom 1000 3afeh" and I want to thnx all who participate in summarizing lecture cuz they spend their precious time to do it for our batch and all of us must . participate cuz we must cooperate and work with each other (special thnx to my lovely friends maram jaradat ( GOD bless u (esra'a daraghmeh (the kindest I ever seen doa'a baker(love ur smile) and to whole dof3a love u all and just wishing 4 all of u happy semester full of success and surprises .and to be successful dentist in the future

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