CLASS II AMALGAM

Design Principles

CLASS II

Class II cavitated caries lesions

Class II cavitated caries lesions

opaque white haloes identify areas of

enamel undermining and decalcification
from within

radiographic appearance of
the Class II caries lesion

E1 lesion
confined to outer
half of enamel

E2 lesion
reaches into inner
half of enamel

cavitated lesion
spreading radiolucency
at DEJ

Primary Caries

E2

D1

Primary Caries
D2

D3

D1

Accepted Terminology

Jargon

extending into proximal

extending gingivally
preparing a proximal box

dropping a box
deepening cervically

The Class II cavity prepared to receive amalgam has two parts

the occlusal portion

design principles are the same as for the Class I cavity

the proximal portion or proximal box

design principles will be presented now

names of walls for the the occlusal portion of the Class II cavity
are similar to the Class I

Class II

Class I

BUCCAL WALL

Class II
DISTAL
WALL

MESIAL
WALL

BUCCAL WALL

LINGUAL WALL

DISTAL
WALL

Class I

LINGUAL WALL

PULPAL FLOOR

Class II

Class I

PULPAL FLOOR

names of walls for proximal portion of Class II cavity

DISTAL WALL

LINGUAL
WALL

BUCCAL
WALL

GINGIVAL SEAT

BUCCAL
WALL

LINGUAL
WALL

BUCCAL
OCCLUSAL
WALL

BUCCAL
PROXIMAL
WALL

LINGUAL
OCCLUSAL
WALL

LINGUAL
PROXIMAL
WALL

AXIAL
WALL

names of line angles for proximal portion of Class II cavity

AXIO-PULPAL
LINE ANGLE
AXIO-LINGUAL
LINE ANGLE

AXIO-BUCCAL
LINE ANGLE

BUCCO-GINGIVAL
LINE ANGLE

LINGUO-GINGIVAL
LINE ANGLE
AXIO-GINGIVAL
LINE ANGLE

names of cavosurface margins for proximal portion of Class II cavity

BUCCAL
PROXIMAL
CAVOSURFACE
MARGIN

LINGUAL
PROXIMAL
CAVOSURFACE
MARGIN

GINGIVAL
CAVOSURFACE MARGIN

names of point angles for proximal portion of Class II cavity

AXIOBUCCOGINGIVAL
POINT ANGLE
BUCCOGINGIVOCAVOSURFACE
POINT ANGLE

AXIOLINGUOGINGIVAL
POINT ANGLE
LINGUOGINGIVOCAVOSURFACE
POINT ANGLE

PROXIMAL OUTLINE FORM

PRINCIPLE

RATIONALE

straight
B & L outlines near
parallel to long axis of
tooth
gingival outline
perpendicular to long axis
of tooth

conservative of tooth
structure
resists forces of occlusion

EXTENSION
a balance between
conservation of
tooth structure and
the need for access
and to remove
defective tooth
structure

PROXIMAL EXTENSION
PRINCIPLE

RATIONALE

encompasses carious
tissue
eliminates
unsupported enamel
encompasses
contiguous fissures
encompasses
contiguous
restorations

eliminates infected
tissue
eliminates weakened
tooth structure
reduces risk of
secondary caries
maximizes restoration
lifespan

PROXIMAL EXTENSION
PRINCIPLE

RATIONALE

clears adjacent tooth by

0.5mm (0.3 - 0.65mm)

access for matrix band

allows inspection of
restoration margin
access for finishing

PROXIMAL DEPTH
proximal depth is M-D dimension of proximal box

PROXIMAL DEPTH
proximal depth is M-D dimension of proximal box

Syn: axial depth

NOT pulpal depth

PROXIMAL DEPTH
PRINCIPLE

RATIONALE

0.5mm into dentin

1.25 - 1.5 mm measured
at level of gingival seat

sufficient bulk of
amalgam to prevent
fracture
maximum thickness of
dentin protecting pulp

AXIAL WALL
PRINCIPLE

RATIONALE

smooth
straight O-G, parallel to
long axis of tooth
parallels curvature of
tooth surface B-L

optimize adapatation
of amalgam to wall
uniform bulk of
amalgam to prevent
fracture
maximum pulpal
protection

AXIO-PULPAL LINE ANGEL

PRINCIPLE

RATIONALE

rounded or beveled

reduces risk of
amalgam fracture

GINGIVAL SEAT
PRINCIPLE

RATIONALE

smooth, flat, straight

perpendicular to long
axis of tooth M-D & B-L
enamel planed at margin

optimize adaptation of
amalgam to walls
resists forces of occlusion
elimination of friable
enamel
plane margin enamel

A-A

BUCCAL & LINGUAL WALLS

PRINCIPLE

RATIONALE

smooth, straight G-O

wall nearest functional
cusp convergent 6 G-O
wall nearest nonfunctional cusp parallels
long axis of tooth

optimize adaptation
of amalgam to walls
helps lock restoration in
tooth (retention)
preserves strength of
cusps (resistance form)
FC

NFC

tangent

BUCCAL & LINGUAL WALLS

PRINCIPLE

RATIONALE

angle with proximal

cavosurface 90-110
(measured to tangent)

optimizes strength of
both amalgam and
enamel at margin

nt
e
g
n
ta

90

110

tang
ent

the cavosurface angle is defined as the angle

in metal at the margin of a restoration

90 70

BUCCAL & LINGUAL WALLS

PRINCIPLE

RATIONALE

proximal cavosurface
angle is 70-90
(measured to tangent)

optimizes strength of
both amalgam and
enamel at margin

90

90 70

110

PROXIMAL RETENTION GROOVES

PRINCIPLE

RATIONALE

placed in B&L proximal

walls 0.5mm deep to DEJ
directed laterally, not pulpally
extending from G seat to A-P
line angle
0.5mm deep gingivally,
fading away occlusally
rounded cross-section

provides mechanical lock

against displacement
proximally
prevents encroachment on
pulp
prevents undermining
enamel
maximizes retention while
minimizing weakening of
tooth

CAVITY REFINEMENT
PRINCIPLE

RATIONALE

internal line angles welldefined but not sharp

maximizes amalgam
resistance to
dislodgement
reduces stress
concentration & risk
of subsequent tooth
fracture

cusp fracture

CAVITY REFINEMENT
PRINCIPLE

RATIONALE

B-G and L-G line angles

have slight radius

reduces stress
concentration & risk
of subsequent tooth
fracture
difficult to condense
thick amalgam into
sharp point angles

CAVITY REFINEMENT
PRINCIPLE

cavosurface margins
well-defined & wellsupported

RATIONALE

easier to visualize &

carve following
condensation
optimize adaptation of
amalgam to margins
eliminates weak tooth
structure
maximizes marginal
integrity

CAVOSURFACE MARGINS

cavosurface margin
unsupported, rough

tooth surface

enamel

poorly defined

CAVOSURFACE MARGINS

cavosurface margin
unsupported, rough

tooth surface

amalgam

enamel

poorly defined

ditching

CLEANLINESS
PRINCIPLE

RATIONALE

cavity is free of debris

& moisture

facilitates adaptation
of amalgam to the
cavity
improves physical
properties of the
restoration by
elimination of voids
& foreign material

TISSUE PRESERVATION
PRINCIPLE

RATIONALE

rubber dam intact

adjacent tooth
undamaged
gingival soft tissues
not unduly
traumatized

isolation important to
quality of result
prevention of postoperative sensitivity,
inflammation, &
nidus for further
caries attack