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G. V. BLACK'S CLASSIFICATION OF DENTAL CARIES
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CLASS 1
- Restorations on:
Occlusal surface of molars and premolars.
- Facial and lingual surfaces of molars.
- Lingual surface of maxillary incisors.
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CLASS 2
- Restorations on the proximal surfaces of posterior teeth.
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CLASS 3
- Restorations on the proximal surface of anterior teeth that does not involve incisal angle
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CLASS 4
- Restorations on the proximal surfaces of anterior teeth involving the incisal edge
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CLASS 5
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Restorations on the gingival third of the facial or lingual surfaces of all teeth
- Retention grooves placed in Occusal & Gingival area.
- Gingival depth- 0.75-1 mm
- pulpal wall is absent
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CLASS 6
- Restorations on the incisal edge of anterior teeth or occlusal cusp heights of posterior teeth.
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BUR BLADE DESIGN
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Design of dental bur:
- The bur head may be divided into 6 or 8 blades (also called teeth, flutes)
- Each flute or blade has a leading side "FACE", and a trailing side "Back" with an angle in between, called the "flute Angle" or blade angle.
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RAKE ANGLE
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An angle created between the face of the blade with the radius of the bur.
- SIGNIFICANCE
- The rake angle may be positive, Zero (radial), and
negative, depending on whether the radial line is ahead,over-lying or tailing the face of the blade respectively.
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CLEARANCE ANGLE
- The space between each two, successive blades
- space where the chips formed during the cutting procedures collect and get eliminated
- Too small, the formed chips will remain in-between the bur blades, causing its clogging generation of more heat and loss of effectiveness.
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CONCENTRICITY
- measurement of symmetry of bur head
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RUNOUT
- This is a dynamic test measuring the accuracy with which all blade tips pass through a single point when the instrument is rotated.
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MODIFICATIONS
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Reduced number of crosscuts
- Since at high speed, crosscuts tends to produce rough surface, newer burs have reduced number of crosscuts.
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Extended head lengths
- Burs with extended head length have been introduced so as to produce effective cutting with very light pressure.
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CLASSIFICATION OF HAND INSTRUMENTS
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CUTTING HAND INSTRUMENTS
- Excavators
- ordinary hatchets
- Hoes
- Angle formers
- spoons
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chisels
- Straight
- Curved
- Bin angled
- enamel hatchets
- Gingival marginal trimmer
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OTHER CUTTING INSTRUMENTS
- Knives
- Files
- Scalers
- Carvers
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NON-CUTTING HAND INSTRUMENTS
- Amalgam Condensors
- Mirrors
- Explorers
- Probes
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PRINCIPLES OF CAVITY PREPARATION
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Initial cavity preparation:
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Step 1: Outline form and initial depth.
- initial depth of 0.2-0.8mm pulpally into dentin.
- gingival margin of the cavity must provide minimal clearance of 0.5mm with the adjacent tooth.
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RULE FOR CUSP CAPPING
- <1/2 Cusp involved
- No cusp Capping
- 1/2 -2/3 cusp involved
- consider capping
- >2/3 Cusp involved
- mandatory cusp Capping
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Step 2: Primary resistance form.
- shape and placement of the cavity walls that best enable both the restoration and tooth to withstand masticatory forces along long axis of the tooth, without fracture
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Features
- Relatively flat floors
- Box shape cavity
- Preservation of cusps and marginal ridges
- Rounded internal and external line angles.
- Cusp capping when indicated.
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Minimum Thickness of Restorative Material
- Amalgam
- 1.5 mm
- Cast metal
- 1-2 mm
- Porcelain
- 2 mm
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Step 3: Primary retention form.
- shape or form of the prepared cavity that resists displacement or removal of the restoration from tipping or lifting forces.
- Occlusally converging external wall & occlusal dovetail
- retention grooves or coves are the primary retention forms.
- Mechanical bond using acid etching and dentin bonding agents.
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Step 4: Convenience form.
- shape or form of the cavity that allows adequate observation, accessibility and ease of operation in preparing and restoring the cavity.
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Final cavity preparation
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Step 5: Removal of carious dentin
- infected dentin must be removed & affected dentin must be selectively removed depending on RDT.
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Step 6: Pulp protection
- 2mm of bulk must be there between restoration and pulp. This is called as Effective Dentinal Depth
- It may include dentin,liner or base
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Step 7: Secondary resistance and retention forms
- Locks, pins, slots, steps and amalgapins provide the secondary retention form.
- Pins and slots increase both retention and resistance forms
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Step 8: Procedures for finishing external walls.
- cavosurface angle of 90° produce maximal strength for both enamel and the restorative materials.
- Step 9: Cleaning, inspecting, conditioning.
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INSTRUMENTATION
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Instrument Formula
- Given by GV Black
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3 no Instrument Formula
- First unit-Width of the blade in tenths of a millimeter.
- Second unit-Length of the blade in millimeter.
- Third unit - Angle the blade forms with the axis of the handle in centigrade.
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4 no Instrument Formula
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First unit-Width of the blade in tenths of a millimeter.
- eg GMT
Angle former
- Second unit - Angle the cutting edge forms with the axis of the handle in centigrade.
- Third unit-Length of the blade in millimeter.
- Fourth unit - Angle the blade forms with the axis of the handle in centigrade.