Class II

SMOOTH surface lesions Occur on PROXIMAL SURFACES of MOLARS & PREMOLARS

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

How to diagnose ??
Tactile by mirror & probe a
curved probe is indicated *lesion my appear chalky white *Marginal ridge may be discolored

Radiographic.bite wing radiographs

It could be
Simple only Mesial (M) or Distal (D) compound ..two surfaces
Mesio-occlusal (MO) or Disto-occlusal (DO)

Complex more than surfaces

Mesial-occlusal- Distal (MOD)

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

But this is not always possible to do a simple class II

So
The proximal surface is ACCESSED through the occlusal surface

Extension for convenience

Compound or Complex

CAVITY PREPARATIONS FOR CLASS II LESIONS

The usual form of a class II cavity preparation comprises three parts: . The occlusal portion
. The proximal portion . Connected together by an ISTHMUS

The occlusal part follows the same fundamentals as for class I Depth 1.5 2mm (0.5 mm in dentin) 1 Flat pulpal floor Parallelism of adjacent walls Undercuts .. except that the external outline is extended proximally toward the defective proximal surface

The outline form of the proximal box depends on several factors: more extension i. Extent of caries: mostly caries are around the contact area surfaces: ii. Convexity of the proximal surfaces
more convex extension smaller contact area less

indices: iii. Caries & plaque indices load: iv. Masticatory load load

minimal bucco-lingual width

indices

Objectives for extension of proximal margins

Include all caries , faults ,or existing restorative material
Create 90 cavosurface margins 90 ( i.e. butt joint margins) Establish (ideally) not more than 0.5 mm clearance with the adjacent proximal surface lingually, facially, lingually, & gingivally (could be checked by the tip

of a sharp explorer)

The proximal outline is an INVERTED TRUNCATED CONE with GINGIVA L wall forming the base

&
FACIAL /BUCCAL and LINGUAL walls forming its sides

Inverted truncated cone

Proximal box is Wider at the gingival area than the occlusal i.e. Buccal & lingual walls are converging occlusally following the outer contour of the buccal & lingual surface

INVERTED TRUNCATED CONE

Contributes RESISTANCE & RETENTION to the proximal box

SO

* Buccal & lingual walls

B &L proximal margins are extended : To include caries Extended to B & L embrasures To break contact with the adjacent tooth (0.3-0.5mm)

Tip of an explorer should pass through easily

(convenience)

* GINGIVAL WALL (floor)

located in the GINGIVAL EMBRASURE just Below the (0 contact area (0.5-1mm) Formed of both enamel & dentin Parallel to the occlusal surface

Width about 0.1-1.5mm depending on the tooth to be prepared

 The gingival wall could extend to reach cementum

sometimes

so
width of gingival wall will be less than 1mm (approximately 0.7-0.8mm)

* AXIAL WALL
Axial wall is parallel to the long axis of the gingivotooth gingivo-occlusally with slight slanting towards the pulpal floor 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

 Placed into dentin

The axial wall should parallel the faciofacio-lingual contour

o.5 o.8 o.5-o.8 mm from DEJ

Connects the occlusal & proximal boxes

Width .narrow as possible .narrow

- intercuspal distance (1-1.5mm wide)

Resistance

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

so
These walls may, therefore, be cut into: 1. a uniform curve 2. straight line "s3. reverse "s-curve" (facially) Depending on:
i. the occlusal anatomy of the tooth ii. the position and size of contact area iii. the width of the embrasures

Usually

The lingual embrasure is wider than the buccal embrasure

So in such cases The extension of the bucco proximal wall into the embrasure leads to excessive cutting of the buccal cusp

To avoid this A reverse curve (S shape curve) is made in the buccal proximal wall so as to : Have a butt joint with the cavosurface margin Have a dentin supported bucco proximal wall

Resistance

Ideal extension

Each part of the cavity should have its own resistance and retentive features (self dependent)

How to prepare ??
Prepare occlusal box Extension to the involved proximal surface Prepare the axial wall uniformly 0.5 mm in dentin Extend cavity buccal, lingual & gingival

Resistance and retention are achieved by..?????

Extra means of retention..???

Finishing of enamel marginshow.???????

 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

 The buccal & lingual walls & meet the surface to provide of the tooth at lingoaxially bucccoaxially &