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CLASS II

➢ SMOOTH surface lesions

➢ Occur on PROXIMAL SURFACES
of MOLARS & PREMOLARS
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Spread of smooth surface caries
in enamel & dentin
In Enamel
Cone shape
Base towards outer E surface
& apex toward DEJ
In Dentin
Cone shape
Base towards DEJ
& apex towards the pulp
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How to diagnose ??
• Tactile………………by mirror & probe a
curved probe is indicated
*lesion my appear chalky white
*Marginal ridge may be discolored
Marginal ridge may be discolored
• Radiographic………….bite wing radiographs

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It could be
• Simpleonly Mesial (M) orDistal (D)
• compound ………..two surfaces
p
Mesio-occlusal (MO) or
Disto-occlusal (DO)
• Complex ……more than 2 surfaces
Mesial-occlusal- Distal (MOD)
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Simple class II
• Prepared Only when there is direct
access to the proximal surface such as:
- an isolated tooth
- wide interproximal embrasure
• Trapezoidal in shape with
occlusal,gingival,buccal &lingualwalls
located in the embrasures
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But this is not always possible
to do a simple class II
So
Th
i l f i ACCESSED
The proximal surface is ACCESSED
through the occlusal surface
Compound or Complex
Extension for convenience

Page 8
CAVITY PREPARATIONS FOR
CLASS II LESIONS
The usual form of a class II cavity
preparation comprises three parts:
1. The occlusal portion
2. The proximal portion
3. Connected together by an ISTHMUS
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The occlusal part follows the same fundamentals
as for class I
• Depth ………………1.5
Depth ………………1.5 – 2mm (0.5 mm in dentin)
• Flatpulpalfloor
pp
• Parallelism of adjacent walls
• Undercuts ………………..
except that
except that the external outline is extended
the external outline is extended
proximally toward the defective proximal
surface
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The outline form of the proximal box depends
on several factors:
i Extent of caries:
Extent of caries:
i. Extent of caries:
Extent of caries:
mostly caries are around the contact area
ii. Convexity of the proximal surfaces
Convexity of the proximal surfaces
Convexity of the proximal surfaces:
more convex
smaller contact area
less extension
iii. Caries & plaque indices
Caries & plaque indices
Caries & plaque indices: indices
iv. Masticatory load
Masticatory load
Masticatory load: load
more extension
minimal bucco-lingual width
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Objectives for extension
of proximal margins
• Include all caries , faults ,or existing
restorative material
• Create 90° cavosurface margins
( i.e. butt joint margins)
• Establish (ideally) not more than 0.5 mm
clearance with the adjacent proximal surface
facially,
facially, lingually
lingually
lingually, & gingivally
gingivally
(could be checked by the tip
of a sharp explorer)
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The proximal outline is an INVERTED
TRUNCATED CONE with
➢ GINGIVA L wall forming the base
&
➢ FACIAL /BUCCAL and
➢ FACIAL /BUCCAL and
LINGUAL walls forming its sides
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Inverted truncated cone
Proximal box is
• Wider at the gingival area than the
occlusal
i.e.
• Buccal & lingual
Buccal & lingual walls are converging
occlusally following the outer contour
following the outer contour
of the buccal & lingual surface
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INVERTED TRUNCATED
CONE
Contributes
Contributes RESISTANCE
& RETENTION
RETENTION to the proximal box

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* Buccal & lingual walls
B &L proximal margins are extended :
• To include caries
SO
T
• Extended to B & L embrasures To break
contact with the adjacent tooth (0.3
contact with the adjacent tooth (0.3-0.5mm)
Tip of an explorer should pass through easily
(convenience)
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➢ located in the GINGIVAL
EMBRASURE just Below the
*GINGIVAL WALL (floor)
j
contact area (0.5
contact area (0.5-1mm)
➢ Formed of both enamel & dentin
➢Parallel to the occlusal surface
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➢ Width about 0.1
Width about 0.1-1.5mm
depending on the tooth to be
prepared

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• The gingival wall could extend to
reach cementum
so
sometimes
so
width of gingival wall will be less than
1mm (approximately 0.7
1mm (approximately 0.7-0.8mm)
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*AXIAL WALL
• Axial wall is parallel to the long axis of the
tooth gingivo
tooth gingivo-occlusally
occlusally
withslightslantingtowardsthepulpalfloor
g
g
pp
g
g
pp
g
g
pp
g
g
pp
i.e. tapered occlusally (forming an obtuse
angle with the pulpal floor)……………why?????
To increase thickness of amalgam
At the isthmus portion ……..
& so increase resistance
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• Placed into dentin
o.5-o.8 mm from DEJ
o.8 mm from DEJ
The axial wall should parallel the
facio-lingual contour
lingual contour
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Connects the
Connects the occlusal
& proximal boxes
Wdh
bl
Wdh
bl
Wdh
bl
Wdh
bl
• Width ……………………….narrow as possible
-¼ intercuspal distance
¼ intercuspal distance
(1-1.5mm wide)
1.5mm wide)
Resistance

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The facial (buccal) & the lingual walls
of the occlusal cavity at the ISTHMUS
portion should approach the proximal
surface at a
right angle (butt joint)
Resistance
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so
These walls may, therefore, be cut into:
1. a uniform curve
2. straight line
3. reverse "s
3. reverse "s-curve" (facially)
curve" (facially)
3
(
y)
(
y)
(
y)
(
y)
Depending on:
i. the occlusal anatomy of the tooth
the occlusal anatomy of the tooth
ii. the position and size of contact area
the position and size of contact area
iii. the width of the embrasures
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Usually
The lingual embrasure is wider
than the buccal embrasure
So in such cases
Th
fhb
Th
fhb
Th
fhb
Th
fhb
Theextensionofthebucco
Theextensionofthebucco–
proximal wall into the embrasure
leads to excessive cutting of the
buccal cusp
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To avoid this
A reverse curve
reverse curve (S shape curve)
(S shape curve) is
made in the
made in the buccal proximal wall so as
buccal proximal wall so as
to :
• Have a butt joint with the cavosurface
j
margin
• Have a dentin supported bucco
Have a dentin supported bucco –
proximal wall
Resistance
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Ideal extension
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Each part of the cavity
should have its own
resistance and
retentive features
(self dependent)
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• Prepare occlusal box
• Extension to the involved proximal surface
How to prepare ??
• Prepare the axial wall uniformly 0.5 mm in dentin
• Extend cavity buccal, lingual & gingival
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Resistance and retention are
h
db
h
db
h
db
h
db
achieved by…………..?????
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Extra means of retention………..???
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Finishing of enamel
h
margins…………how.???????
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•A
type of preparation which
preserves as much tooth structure as
possible
• Access is also gained through the marginal
ridge of the affected mesial or distal surface
& no further extension to the occlusal
surface