MODIFICATION OF

CAVITY
PREPARATION
IN
PRIMARY TEETH

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Classification
Modified by G.V. Black classification for primary
teeth.

CLASS I
Those pits & fissures of the occlusal
surfaces of the molars teeth and the buccal &
lingual pits of all teeth.

CLASS II
All proximal surfaces of molar teeth with
access established from the occlusal
surface.

CLASS III www.FourthMolar.com

All proximal surfaces of anterior teeth
 CLASS IV
All proximal surfaces of anterior teeth
which involves the incisal edge.

CLASS V
On the cervical third of all teeth, including
the proximal surface where the
marginal ridge is not included in the
cavity preparation.

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teps In The Cavity Preparation

Obtaining outline form

Obtaining resistance &
retention form
Obtaining convenience form
Removing remaining caries
Finishing enamel wall
Performing toilet of the cavity
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 Class I cavity preparation

External out line form :

Start preparation by penetrating the occlusal

surface with no.330 tungsten carbide bur. go
from distal to mesial.9
Include all deep & defective groves.
Contour the outline parallel to the mesial & distal
marginal ridge. Maintain a bulk of tooth
structure as the marginal ridge.
Maintain a width approximately as third the width
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of the occlusal table.
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 The Occlusal Form :
The extension of the occlusal portion of the cavity
preparation depends on the primary molar involved.
The occlusal portion usually is extended about one
half the way across in the primary maxillary
& mandibular first molar.
For the primary mandibular second molar extend
the step completely across the occlusal
surface.
The primary maxillary second molar preparation
includes only the nearest occlusal pit. The
transverse ridge is not included unless
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 Internal outline
form :
Penetrate approximately 1.5mm into the dentin.
Round the line angles ,provided the bur is kept somewhat vertical.
The pulpal floor is slightly concave. All internal line angles should be rounded.
Establish a sharp cavosurface angle. The wall are parallel or slightly undercut to the external
surface of the tooth.

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 Class I preparation design for
direct posterior composite resin
restoration :
Incipient pit & fissure lesions can be prepared by using a no. 2 small, round or a no.330
bur to carefully remove the carious enamel.

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 Class I carious lesions that extend further &
penetrate into the dentin, removing all the
carious dentin with round bur & spoon
excavators.

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 Class II cavity preparation for amalgum
restoration

Complete a class 1 cavity outline.

Use a no.330 bur to extend the occlusal outline through the
marginal ridge.
Extend the no.330 bur into the proximal surfaces. Keep the bur
parallel to the long axis of the tooth. Move the bur in a pendulating
motion from lingual to buccal.
Extend the proximal box gingivaly beneath the contact area to the
interproximal area. This area is determined by the clearance of an
explorer tip.

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 The axial wall, as determined by carious lesion depth,
should follow the contour of the tooth.
Use the enamel hatchet to remove any overhanging enamel
in the proximal box.

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 The principal features of the
occlusal form :
Outline the outline follows the fissure pattern so
prevent secondary caries
ing Aadjacent to the
smooth flowing restoration.
outline reduces stress & permits better packing of the amalgam.

of the amalgam.

Isthmus this should be between ¼ & ½ of the intercuspal distance

(approximately 1.5 mm)

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 Depth this should be 0.5 mm below the amelodentinal junction or

1.5-2.0
Depth thismm frombe
should the0.5
cavosurface
mm below angle (a).
the amelodentinal junction or

1.5-2.0 mm from the cavosurface angle (a).

Transverse & marginal ridges these should be at least 1 mm in width.

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This can be slightly divergent or a right angle otherwise they will

fracture.

Internal angles all internal angles should be rounded so as to limit

stress & to ensure that amalgam can be easily packed into these
regions.

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Pulpal floor this should be slightly concave.

Buccal & lingual walls these should be converging, so making the

cavity retentive. Also, the cavosurface angle needs to be a right angle
to ensure maximum strength at the enamel-amalgam junction.

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 Proximal walls these should converge so as to
meet at the marginal ridge, while allowing
only the tip of an explorer to pass between the
margins of the box & the adjacent tooth.
Resistance form this should be built in so as to
prevent lateral displacement of the
restoration.
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 The principal features of the
proximal box :
Gingival floor this should be located just below the contact area with
the adjacent tooth.
Axial wall the width (a) of the floor of the box should be
approximately 1mm….and be parallel to the external proximal
surface….this prevents the pulp from being exposed to excessive
trauma during preparation.

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Buccal & lingual walls these should be convergent, parallel

appropriate external surface & make a cavosurface angle of 90*.

Cavosurface angle this angle on the buccal & lingual sides of the
proximal box should be 90*.

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Internal angles the angle between the axial wall & the gingival floor

should be rounded…….

…….as should the axiopulpal line angle. This gives the maximum
thickness of amalgam with the minimum of stress in this area.

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 Class II preparation design for
direct posterior composite
resin restoration :
Lutz et al. have suggested adhesive restoration
designs cavity size is as small as technically
possible. The cavity form has been designed to
minimize micro leakage at the cavosurface margins.

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 When class II carious lesions exist
on posterior teeth in the absence
of class I lesion
Modified slot preparation this involves access to the carious lesion from either the
occlusal, buccal or lingual direction. After removal of all carious tooth structure, remove
the grossly undermined tooth structure. Then place a bevel on all cavosurface
margins.

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A proximal slice-type
preparation :

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 Tunnel-style
preparation :

If a class I lesion is being prepared & there is an adjacent class II carious lesion, tunnel-style
preparation can be applied.
Objective to maintain the sound enamel in the marginal ridge area.
First ideal class I cavity preparation done, when it is completed prepare a small tunnel
toward the proximal carious area using a small, round bur.
The marginal ridge can therefore be maintained intact.

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 Class III cavity preparation lingual lock

Extension the lock should be positioned to one side of the midline in

the middle one third of the lingual surface.

outline Outline the lock should have a smooth flowing & rounded.
Bevel a 45 bevel increases surface area for retention.

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 Isthmus as in a class II cavity the isthmus should have rounded
margins & be large enough to accommodate amalgam & composite.
area.

as to afford maximum strength at the restoration enamel junction.

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Depth extended 0.5mm into dentine & follow the contour of
external surface.

Resistance form the lock is intended to prevent the restoration from

being dislodged. Therefore it should be resist lateral displacement

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 Proximal
box : Extension in order to be self cleansing the box
should extend just beyond the contact area of
the adjacent tooth to as to allow the tip of a
probe to be passed between the cavity wall & the adjacent
tooth.

Outline this may be curved or triangular (with the apex incisally

positioned) with gently curving rounded margins.

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Axial wall this should follow the contour of the external surface.

Depth the interproximal box ideally should extend just into the
dentine.

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 Additional retention may be gained from a pit
placed at the gingivo- labial junction or
grooves in the dentine running parallel to the pulpal
wall of the box.
Maxillary primary canine dovetail is on the lingual
surface.
Mandibular primary canine dovetail is on labial
surface.

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 Class IV cavity preparation

For class IV fractured incisal edges, use a tapered diamond bur

to obtain a bevel on the entire incisal & gingival cavosurface
margin.
The bevel extending about 2mm or at least 1mm beyond the
fractured margin & tapered.
Additional retention, if needed, may be obtained by the use of
the lingual dovetail.

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 Class V cavity preparation

The outline form should be limited to the carious

lesion & any adjacent decalcified areas.
Cavity may be kidney shaped.
The no.330 bur can be used to cut the cavity.
Dentinal undercuts for mechanical retention will
be placed if the pear shaped bur is used.

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 Class III cavity preparation
Primary incisors teeth the earliest access is from the labial side. Use an inverted
cone bur.
The gingival cavity wall should incline slightly occlusally.
Cavity depth should be 0.5mm pulpal to the amelodentinal junction.
The interproximal area of the cavity should be shaped like the letter c when
observed directly.

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