A

lesion developing on the proximal surface of posterior teeth under the contact area because it is a protected area.

Develops

 The

lesion is covered on the occlusal side by sound enamel it is protected by the adjacent

Proximally

tooth

 The

least destructive path to make a cavity in this tooth is through the occlusal enamel

Class II cavity has two parts 1. Occlusal dovetail 2. Proximal box Called as MO (mesio-occlusal) or DO (disto-occlusal) depending on involved side

 Mark

the primary grooves and fossa on the involved (proximal) half of occlusal surface the marking to the marginal ridge just beyond the contact area into the buccal and lingual embrassure

Continue

3.0 mm

Width of bur #245 is 0.8 mm

 To

make a uniform cutting To give an idea about the required cutting

1.5 mm

 This

gives you the desired shape of the walls and floors of the cavity preparation (retention form and resistance form)

 Insert

the bur 1.5mm into the tooth in the central fossa/pit This gives a sense about the desired depth It has to be maintained

 Move

the bur along the cusps and into the marked pits and fissures Apply light intermittent pressure to prevent burning of tooth. Always keep the bur perpendicular to occlusal table

 The

bur is moved at the desired depth up to mesial fossa or distal fossa(involved side) and into the buccal and lingual grooves.

Dont
Dont

cross the centre unless involved

make the cavity wider than 1-1.5 bur thickness.

 With

triple syringe(three in one) Should be done intermittently To have an idea about the cavity features

 From

the class I, extend the bur at the same depth towards the marginal ridge to the edge of the proximal contact(dont go all the way to the proximal surface) should be done for both the buccal and lingual embrassure(already marked)

Same

 The

thin layer of structure is fractured and removed using a chisel or hatchet (can be done after the next step) buccal and lingual wall should clear the adjacent tooth by 0.5mm( probe just entering between the two)

The

 Inside

the involved proximal margin (1-1.5 bur thickness) the cavity is extended gingivally to clear the gingival contact area by 0.5mm

Keep

the bur slanting in the opposite direction gingival floor should follow external surface

The

 Buccal Lingual

wall(side of 245 bur) wall(side of 245 bur) floor( base of 245 bur)

Gingival Axial

wall (side of 245 bur)

Pulpal floor

Axial wall gingival floor

 The

part joining the proximal box and the occlusal dove tail Isthmus

 It

is an external angle Should be rounded with hatchet or bur Can create stresses in restoration which result in fracture of filling at the isthmus

Axiopulpal line angle

 Axial

wall is slanting away from the proximal side ( to provide thick amalgam) by moving the bur gingivally in an arc form the bur at an angle away from the involved side

Made

Keep

 The

gingival floor should not be more than 1-1.5 bur thick margin of the gingival floor is also beveled with GMT

The

 Smooth

curves all around (free from any loose, short, or sharp margin) Definite walls and angles All pits and fissures be removed(marked) Preparation centered on central developmental groove Walls of the proximal box just clearing the contact area

 Maintain

uniform depth(1.50 mm) The flat pulpal and gingival walls Definite but round internal and external angles Enamel margin( 90-CSA) including the walls of the proximal box Smooth curves

 Maintain Not

minimal width

more than two bur thickness

Keep

a minimal width of gingival floor(11.5 bur thickness) of the margin of gingival floor

Beveling

1-1.5 bur thickness

 Macro Slight

mechanical retention

convergence of the side of bur gives the required occlusal convergence. dislodgement is prevented by occlusal dovetail and proximal grooves

Proximal

 The

cavity has to be wide enough for easy manipulation Make the cavity according to the size of condensors

To remove any minute irregularities in the walls unsupported enamel from the buccal and lingual and proximal walls. Bevel the margin of gingival floor Bevel the axiopulpal line angle Hold the instrument parallel to the wall or a bevel will develop

I. Outline form:

Extension

Properly extended

Over extended

Under extended

Width

1 -1.5 mm

Wide

Narrow

Proximal outline

0.5 mm of the contact area

Wide

Narrow (closed contact)

II. Resistance form:

Pulpal floor

0.5 mm below DEJ Flat Parallel to the occlusal plane

Deep Irregular

Shallow Not parallel to the occlusal plane

Marginal ridge

Preserved

Undermined

Mesial / distal wall

Divergent

Convergent

Line angles

Rounded

Sharp

Axial wall

0.5 mm below DEJ

Deep

Shallow

Isthmus

Properly extended

Wide

Narrow

III. Retention form:

Buccal & lingual walls

Slightly converge

Over converge

Diverge

Dovetail

Prepared

absent

Thank you