Operative Dentistry:

It is the art and science of diagnosis, treatment and prognosis of defects of teeth that do
not require full coverage restoration for correction. Such treatment should result in the
restoration of proper tooth form function and esthetics while maintaining the
physiologic integrity of teeth in harmonious relationship with adjacent hard and soft
tissue all of which should enhance the general health and welfare of the patients.
Fundamentals in cavity preparations:
Cavity preparation: It is defined as mechanical alteration of a defective, injured, or
diseased tooth in order to best receive a restorative material which will re-establish a
healthy state for the tooth including esthetic corrections where indicated along with normal
form and function.
What is the need for restoration?
1. Carious lesions
2. Replacements or repair of defective restorations eg. Improper proximal
contact, gingival, excess etc.
3. Restoration of fractured tooth
4. Restoration of form and function absent as a result of congenital malformation
5. Esthetic demands of the patients
6. To fulfill other restorative needs of the patient example:- Abutment tooth require
some kind of restoration for proper function
7. The tooth may be restored in a preventive sense

Objectives of cavity preparations:

1. Remove all defects and give necessary protections to the pulp
2. Locate the margins of the restoration as conservatively as possible
3. Form the cavity so that under the forces of mastication tooth or the restoration or
both will not fracture and restoration will not be displaced
4. Allow for the esthetic and functional placement of a restorative material
Classification:
According to the number of surfaces involved
Simple cavity - if only one surface is involved
Compound Cavity- if two surfaces are involved
Complex cavity- if more than two surfaces are involved
According to name of surfaces involved
Occlusal cavity- involving only occlusal surface eg. Simple cavity
MO cavity- involving mesial and occlusal surfaces (compound cavity) called
mesioocclusal cavity other is DO cavity
MOD cavity- involving mesial occlusal and distal surfaces
GV black’s classifications
According to black there are 5 classifications of cavities
Class I-All pits and fissures cavities/restorations are class 1.
There are 3 sub groups
1.Cavities or restoration on occlusal surface of posterior
teeth i.e premolars and molars
2. Cavities or restorations on occlusal 2/3 of the facial and lingual/palatal surface of
molars
3. Cavities or restorations on the palatal surface of upper central incisor below the
cingulum on pit region
Class II- cavities or restorations on the proximal surfaces of posterior teeth are classII
Class III- cavities or restorations on the proximal surface of anterior teeth that does not
involve incisal angle are class III
Class IV- cavities or restorations on the proximal surfaces of anterior teeth that do
involve the incisal angle are classIV
Class V- restorations or cavities on the gingival third of facial and lingual surface of all
teeth
Class VI- cavities or restorations involving the immune surface i.e. incisal edges of
anterior teeth or the occlusal cusp height of posterior teeth are classVI. (this
classfication has been added by sturdevant).
Cl I Cavity- 5 Walls
Point angles - 4
Line angles - 8
Class II - 8 walls
Point angles- 6
Line angles- 11
Class III- 4 walls
Line angles-6
Point angles-3
ClassIV- 8 walls
Line angles- 11
Point angles- 6
Class V- 5 walls
Line angles- 8
Point angles-4
Classifications based on radio graphical evaluation of proximal caries given by
Ben and Dankel et al:
E1- Radiolucency in outer half of enamel
E2- Radiolucency in innner half of enamel
D1- Radiolucency in outer 1/3 of inner dentin
D2- Radiolucency in middle 1/3 of dentin
D3- Radiolucency in inner 1/3 of dentin
It has been noted that 60-80% initial proximal lesion with radiolucencies in the outer
1/3 of dentin donot show cavitation. Therefore restorations are indicated only when a
radiolucent lesion has extended to D2 region where the probability of cavitation is
around 20-40% this delay is attempting the restoration at a later point of time is
justifiable, as cavitation is late event in proximal carious lesion, taking upto 1-5 years
in low to moderate risk patients. In such cases a change in oral environment on tip the
balance de mineralisation.
D)One more recent classification proposed by Mount and Humes in the year
1997:
This classification is based on site and size and complexity of the lesion
The proposed classification method recognises that there are only 3 sites on the tooth
crown that are likely to set initiation of Carious lesion, because of accumulation of
plaque.
Site 1- Pits,Fissures and enamel defect on occlusal surfaces of posterior teeth or other
smooth surfaces such as cingulum, pits on anterior teeth
Site 2- Approximal enamel immediately below contact areas with adjacent teeth
(anterior or posterior)
Site 3- Cervical third of the crown or following gingival recession the exposing root
surface
Lesion at all these sites can be classified by size according to extent of progression of
the lesion.
Size 1- Minimal involvement of dentin but beyond treatment by re mineralisation
Size 2- Moderate involvement of dentin remaining tooth structure is sufficiently strong
to support the restorations
Size 3- Enlarged beyond moderate remaining tooth structure is weakened to the extent
that cuspus or incisal edges are likely to fail if left exposed to occlusal oe incisal load
Size 4- Entensive caries with bulk loss of tooth structure

site site 1 site 2 site 3

(pit and (below (gingival

fissure) contact third)
area)
size minimal 1 1 1
size moderate 2 2 2
size enlarged 3 3 3
size extensive 4 4 4

Terminology:
Cavity Preparation Walls
Internal walls: It is a prepared cavity wall that does not extend to the external tooth
surface eg. Axial wall Pulpal wall
External walls: It is a prepared cavity surface that extends to the external tooth surface
and such a wall takes the name of the tooth surface that wall is toward eg. Mesail ,
Distal , Buccal , Lingual walls.
Axial Wall- It is an internal wall parallel with the long axis of the tooth
Pulpal Wall- It is an internal wall that is both perpendicular to the long axis of the
tooth and occlusal of the pulp.
Floor- It is a prepared cavity wall which is reasonably flat and perpendicular to those
occlusal forces that are directed occlusogingivally (parallel to long axis of tooth) eg.
Pulpal and Gingival walls . This increases the resistance form of the restored tooth
against post restorative fracture
Enamel Wall- Portion of prepared external wall consisting of enamel
Dentinal Wall- It is that portion of prepared external wall consisting of dentin which
may contain retention features.
Line Angle: It is a junction of two planal surfaces of different orientations along the
line
Internal Angle- It is a line angle whose apex points into the tooth eg. FP
External Angle- It is a line angle whose apex points away from the tooth eg. GP
Point Angle- It is a junction of three planal surfaces of different orientation eg.dfP ,
MfP , dlP , MlP
Cavosurface Angle-It is the angle of tooth structure formed by junction of prepared
cavity wall and external surface of the tooth
Actual junction is referred to as cavosurface margin or cavity margin.
It differs with location on the tooth, the direction of enamel rods on the prepared wall
or the type of restorative material be used.
STAGES AND STEPS IN CAVITY PREPARATION
1.Initial cavity preparation stage
2.Final cavity preparation stage
A. Initial cavity preparation steps
Step 1- Outline form and initial depth
Step 2- Primary resistance form
Step 3- Primary retention form
Step 4- Convenience form
B.Final cavity preparation steps
Step 5- Removal of any remaining enamel pit/fissure and or infected dentin and or old
restorative material if indicated.
Step 6-Pulp protection
Step 7- Secondary resistance form and retention form
Step 8- Procedure for finishing external walls
Step 9- Cleaning, inspecting, varnishing, conditioning
Outline form and initial depth
Definition- Establishing the outine form means
1.Placing the cavity margins in the position will occupy in the final preparation, except
the finishing enamel walls and margins
2.Preparing an initial depth of 0.2mm (0.5mm when restoring with direct gold) into
dentin for pit and fissure cavities and 0.2-0.8mm into dentin for smooth surface
cavities (greater on root surfaces)
Otherwisw the depth into dentin is not to extend 0.2-0.5mm (most important) (depth is
from DEJ)
Why to go deeper than DEJ?
3 Reasons:
1.To avoid seating the restoration on the very sensitive DEJ where maximum
intercuspation of dentinal tubules exist
2.To give bulk for the restorative material
3.To allow the restoration to face advantage of dentin elasticity during insertion and
function
Principles of outline form:
3 basic principles are:
1.All friable and or weakened enamel should be removed
2.All faults should be included
3.All margins should be placed in a positon to afford good finishing of the margins of
the restoration
Factors in determining outline form:
1.Extent of caries lesion, defect, or faulty old restoration since the objective is to
extend to sound tooth structure except in pulpal direction
2.Esthetic considerations – affects the choice of restorative material and also design of
cavity preparation
3.Occlusal relationship
4.Adjacent tooth contour
5.Cavosurface marginal configuration
Features of establishing step-1:
1.Preserving cuspal strength
2.Preserving marginal strength
3.Minimizing faciolingual extensions
4.Using enameloplasty
5.Connecting two close (less than 0.5mm apart) faults on cavity preparation
6.Restricting the depth of restoration into dentin to a 0.2-0.5mm for pit and fissure and
0.2-0.8mm for smooth surface caries.
Outline form and initial depth for pit and fissure:
3 factors to be considered:
1.The extent to which enamel has been involved by the carious process.
2.The extensions that must be made along the fissures to achieve sound and smooth
margins
3.To have a pulpal depth of approximately 2mm and usually a max. depth into dentin
of 0.2mm this pulpal depth measured in relation to fissure is 1.5mm
Rules to follow for Class 1:
1.(a) Extend the cavity margins until sound tooth structure is obtained and no
unsupported and weakened enamel remains.
(b) Avoid terminating the margins on extreme eminences such as cusp heights or ridge
crest.
(c) Ideally cavity width should be 1/3 to 1/4 of buccolingually width of tooth surface
measured from resp. cusp heights.
(d) Buccal and Lingual wall should be placed at the junction of middle 1/3 and
(e) If the extension is one half or more of the cusp incline , conideration should be
given to capping cusp.
If the extension is 2/3 the cusp capping is most often the proper procedure. This will
remove the margination from the area of masticatory stress.

2.Extend the cavity margin to include all the fissure that can’t be eliminated by
enameloplasty.
3.Restricting the depth of preparation
4.When 2 pit end fissure cavities have been less than 0.5 mm of sound tooth structure
b/w them they should be joined to eliminate a weak enamel wall b/w them.
5.Extend the outline to provide sufficient access for proper cavity preparation.
In extending fissures or connecting pits and fissures on occlusal surfaces of teeth, the
margin usually donot assume a straight line , rather they are in smooth curves which
preserves as much strong cusp structures as possible
For premolar(max.)- Outline form is of butterfly shape.
The most narrow preparation is b/w cusp heights FL as much of cuspal incline as
possible should be preserve
For smooth surface cavities: (CLII,III,IV)
Rules:
1.Extend the cavity margins untill sound tooth structure is obtained and no
unsupported or weakened enamel remains
2.Avoid terminating the margins on extreme eminances such as cusp heights or ridge
crest
3. Extend the margin to allow sufficient access for proper manipulative procedures.
4.Restrict the axial wall pulpal depth of proximal preparation to a max. of 0.2mm
5.Extend the gingival margin of cavities apically of contact to provide a min.clearance
of 0.5 mm b/w the gingival margin and the adjacent tooth.Otherwise this gingival
extension is to sound tooth structure and no farther.
6.Extend the facial and ligual margins proximal cavity preparations into the resp.
Embrasures to provide specified clearance b/w the prepared margin and adjacent
tooth.Purpose is to place the margins away from close contact with adjacent tooth so
that margins can be visualised,instrumented and better clean and also it is self
cleansing area also.
7.Occlusal outline is governed by some rules as that of cl-I
ClassIII-while extending the proximal surface incissally in class III preparation , it is
acceptable to position the incisal margin in the area of contact.
Class V- outline form is governed ordinary only by extent of the lesion, except
pulpally. Therefore extension mesially , gingivaly distally and occlusaly is limited to
thatwhen sound tooth structure is reached. During the cavity preparation , the bur depth
is usually no deeper than 0.8-1.25mm pulpally from the original tooth structure.
At gingival wall-Axial wall depth is .8mm without an enamel portion (i.e.margin is on
root surface)
At the occlusal Wall-Axial wall pulpal depth is .5mm from DEJ.
Enamaloplasty:It is grinding away a shallow enamel developmental fissure or pit to
create a smooth saucer shaped surface which is self cleansing or easily cleaned , as
well as an area that enhances proper finishing of restorations whose margins crosses it.
The procedure can also be applied to some shallow smooth surface enamel defects
If less than 1/3 the depth of wall then enameloplasty
If more than 1/3 the depth- then include it in the cavity preparation
If it is often required at the end of the fissure
-enameloplasty doesn’t extend the preparation
-restorative material is not placed in the recontoured area
-it is also applied to supplemental groove extended upto cuspal incline
-shallow fissure that crosses a facial or a lingual ridge.
Primary resistance form:
Definition: it may be defined as that shape and placement of the cavity walls that best
enables both the restoration and the tooth to withstand w/o fracture, masticatory forces
delivered principally in the long axis of the tooth.
The relatively flat pulpal and gingival walls prepared perpendicular to the tooth in long
axis resist forces in the long axis of tooth and prevent tooth fracture from wedging
effects.
Principles:
1.To utilize the box shape with relatively flat floor which helps the tooth to resist
occlusal loading by virtue of being at right angles to those forces of mastication that
are directed in the long axis of tooth.
2.To restrict the extension of the external walls to allow strong cusp and ridge areas to
remain with sufficient dentin support.
3.To haveslight rounding of internal line angles.
4.In extensive cavity preparation, to cap weak cusps and envelope or include enough of
a weakened tooth to resist fracture of the tooth by forces both in the long axis and
obliquely directed.
5.To provide enough thickness of restorative material to prevent its fracture under load.
Factors: need to develop resistance form depends on several factors.
1.Occlusal contact potential on both the restoration and the remaining tooth structure.
Greater the occlusal force and contacts- greater the potential for future fracture
2.Amount of remaining tooth structure very large tooth may require less resistance
form consideration even though extensively involoved with caries because remaining
tooth structure is still bulky enough to resist fracture.
3.Type of restorative material
Amalgam requires a min. thickness of 1.5mm
Cast metal requires 1mm in area of wear
Porcelain requires 2mm to resist bulk fracture
4.Bonding - bonding amalgam, composite etc
Features: to enhance primary resistance form
1.Relatively flat floor
2.Box shape
3.Inclusion of weakened tooth structure
4.Preservation of cusps and marginal ridges
5.Rounded internal line angles
6.Adequate thickness of restorative material
7.Seats on sound dentin peripheral to excavations of infected dentin
8.reduction of cusps for capping when indicated
All class-I cavity preparations will have a mortise shape i.e. each wall and floor in the
form of a flat plane , meeting each other at definate line and point angles.
In case of very large cavity preparation , there should be atleast 3 seats peripheral to an
excavation of infected dentin , and the restoration material will have stable contact
with tooth (four seats are even better). Thus when the forces are applied to the tooth ,
they don’t cause rocking of the restoration.

Primary retention form:

It is that shape or form of the preparaed cavity that resists displacement or removal of
the restoration from tipping or lifting forces.
Prinicipal means of retention are:
1.Frictional retention- depends upon 4 factors
(a)Surface area of contact between tooth structure and restorative material greater the
surface area- greater the frictional component of retention
(b)Opposing walls or surface involoved
More walls or surfaces- greater frictional component of retention
(c)Parallelism and non-parallelism
Higher degree of parallelism b/w opposing walls- produce greater frictional retention
(d)Proximity- greater the proximity of restorative material to tooth structure, greater
the retention
2.Elastic deformation of dentin- changing the position of dentinal walls and floors
microscopically by using condensation within dentin is proportional limit, can add
more gripping action by the tooth on the restorative material
3.Inverted truncated cone or undercuts- improve retention provided they are filled
with restorative material.
4.Dove tail – it is a modification of occlusal outline form for the sake of additional
retention
For amalgam restoration:
Class-I and class-II – retention by convergence of external walls occlusally (2-4
degree)
Convergence should not be overdone for fear of leaving unsupported enamel rods
For class-II – occlusal convergence of proximal portion in addition to providing
retention serves other purpose also.
It allows slight facial or lingual extension pr of oximal portion in the gingival area
while conserving marginal ridge thus, reducing the forces of mastication on critical
areas of the restoration
In cavosurface angle where the proximal facial and lingual walls meet the MR is as
because of this convergence.
For class III and V: external walls diverge outwardly to provide strong enamel margins
so retention covers and grooves are prepared in the dentinal walls to provide retention
Bonding amalgam to the tooth using adhesive systems provide some retention and
reduces microleakage.
Composites develop micromechanical bond to the etched and conditioned tooth surface
and thus retained this way.
Cast metal intracoronal restoration – close parallelism is the principal retention form
for cast metal restoration.
Since exact parallelism can create technical problems in processing and in getting final
materials into and out of the preparation , a slight divergence of opposing walls
intracoronaly is essential to facilitate cast fabrication with minimum errors.
Average of taper given is 2-5 degree
The degree of divergence needed is dependent primarily on the length of the prepared
cavity walls , the greater the longitudinal height of the walls , the more the divergence
recommended (but with in the range).
In class-II occlusal dovetail aids in preventing the tipping of restoration of restoration
by occlusal forces.
Goldfoil – inherent retention comes from elastic compression developed in the dentin
as a result of condensation of the foil.
Convenience form:
it is that shape or form of the cavity that provides for adequate observation, and ease
of operation in preparing restoring the cavity
-Extension of distal, mesial, facial, and lingual wall to gain access to deeper part of
preparation
-Hold fort- convenience points for starting of foil condensation by accentuating the
point angle in the lingual area proximal portion
-Occlusal divergence- for class II cast restoration
-Extending proximal preparation beyond proximal contacts.
Final cavity preparation stages:
Removal of any remaining ename pit/fissure and/or Infected dentin
and/or old restorative material:
It is elimination of any infected carious tooth structure or faulty restorative material
left in the tooth after initial cavity preparation
Keeping the pulpal and axial wall at the same depth , only the infected dentin is
removed.
It is generally agreed that large areas of soft caries are best removed with spoon
excavators by flaking up the caries around the periphery of the infected mass and
peeling it off in layers.
Regarding the removal of harder , heavily discoloured dentin , opinions vary for the
use of spoon excavators , round steel burs , round carbide burs
Round carbide burs , with air coolant and round slow speed is the best method
For both removal of caries and old restorative material
Removal of old restorative material:
1.Because of esthetics
2.To anticipate needed retention
3.Radiographic evidence of caries beneath retention
4.Tooth pulp symptomatic
5.Periphery is not intact

Pulp protection:
Remaining dentin thickness (effective depth) is the minimum thickness of sound dentin
separating the pulpal tissue from the carious lesion
The decision regarding of pulpal protection depends on RDT
Depending upon RDT excavations can be of 3 types:
Shallow excavation RDT>2mm
Moderate excavation RDT>0.5-2mm
Deep excavation RDT>0.5mm
For amalgam:
For shallow excavation – only sealer or varnish is used
For moderate excvation – base and then sealer or varnish is used
For deep excavation –
Ca(OH)2 + base + sealer (or varnish)
For gold inlays and onlays :
Shallow excavation – only cement (luting agent)
Moderate excavation – base followed by luting agent
Deep excavation –
Ca(OH)2 + Base + cement
Composite restoration
Shallow excavation – only dentin bonding system
Moderate excavation – only dentin bonding system
Deep excavation – Ca(OH)2 + dentin bonding system
Secondary resistance and retention form:
Most compound and complex cavities need these additional features
There are of 2 types:
1.Mechanical features
2.Cavity wall conditioning features
Mechanical features:
Retention locks and grooves
Longitudinally oriented retention locks and grooves: to provide additional retention for
proximal portions of cavity preparations
Locks – for amalgam
Grooves – for cast metal
Transversely oriented grooves for class III and V amalgam and root surface cavity for
composite
For proximal locks of class II amalgam (longitudinal) they are prepared to counter
proximal displacement
There are 4 characteristics:
1.Position – refers to axiofacial and axiolingual line angle of initial cavity preparation
2.Translation – refers to the direction of movement of the axis of the bur
3.Depth – refers to the extent of translation (0.5mm at the gingival floor level)
4.Occlusogingival orientation – refers to the tilt of the bur which dictates the occlusal
height of the lock, given a constant depth
These locks are thought to increase retention of the proximal portion against movement
proximally
Also increase the resistance form of restoration against fracture at the junction of
proximal occlusal portions
Retention coves – they are appropriately placed undercuts for the incisal retention of
class III amalgams . Occlusal portion of some amalgam restoration . Some class V
amalgam and sometimes for gold foil restorations.
Groove extensions – by extending the cavity on to facial and lingual surface to include
facial and lingual groove.
-enhance the retention an additional of cast restoration by providing an additional
vertical wall
-improve resistance form by enveloping the tooth
Skirts – used for cast restorations around transitional longitudinal angles, improves
both retention and resistance
Pins , slots , steps and amalgapins – all increase retention especially for large
restorations
Pot holes – 0.5-1mm deep and 0.2-0.3 mm DEJ
Cavity wall conditioning features:
For bonded restorations which utilizes porcelain , composite , amalgam , or GIC
Conditioning consists of etching the enamel by an appropriate acid resulting in
microscopic undercuts in which bonding material is mechanically bound.
Dentin conditioning: also for bonded restorations dentin bonding agent for composite
porcelain
Glass ionomer: material for GIC and some other restorations
Lastly luting agent

Procedure for finishing external walls:

Definition: Finishing the cavity walls in the further development when indicated of a
specific cavosurface design and degree of smoothness that produces the max.
effectiveness of the restorative material being used.
Objectives:
1.Create the best marginal seal possible b/w the restorative material and the tooth
surface
2.Afford a smooth marginal junction
3.Provide a max. strength of both the tooth and the restorative material at the margin
Factors to be considered:
1.Direction of enamel rods
2.Support of enamel rods both at DEJ and laterally
3.The type of restorative material
4.Location of margin
5.Degree of smoothness desired
Direction of enamel rods:
Theoretically, enamel rods radiate from DEJ to the external surface and are
perpendicular to the tooth surface
Rods converge from DEJ towards concave enamel surface (i.e. centre of
developmental grooves)
Rods diverge outwardly towards convex surfaces (i.e. height of cusps and ridges)
In the gingival third - rods incline slightly apically
Operator should finish all enamel walls so that all rods foming the enamel wall have
their inner ends resting on sound dentin
The strongest enamel margin is that margin which is composed of full length enamel
rods that are supported on the cavity side by shorter enamel rods, all of which extend
to sound dentin
The shorter enamel rods the full length enamel rods which forms the margin, thus
increasing the strength of enamel margins.
Design of cavosurface angle:
For Amalgam- 90 degree because of low edge strength or friability of Amalgam 80-90
degrees.Because of incline planes of cusp and coverging walls of the cavity
preparation. Automatically desirable 90 degrees butt joint junction is obtained and very
little additional cavity preparation is required.
M & D walls- Divergent
For Amalgam Restoration:
Only gingivalfloor is beveled when enamel is still present. This is necessary bacause of
gingual orientation of enamel rods in cervical area.
A bevel of 15-20 degree is placed only on enamel portion of the wall in order to
remove unsupported enamel rods, and to provide 90 degree CSA placed with GMT.
Bevels: Given for intracoronal cast gold/metal and composition restoration.
Bevel is a plane of cavity wall or floor directed away from cavity preparation.
Types: Size types
a.Partial bevel-involve part of enamel wall, not exceeding 2/3 not used in cast
restoration , except to time weak enamel rods.
b.Short bevel-includes the entire enamel wall, but not dentin used mostly for type 1
and type 2 cast metal alloys.
c.Long bevel-all of enamel and up to one half of dentin
Advantage- preserves internal ‘boxed up’ resistance and retention features of the
preparation.Used for 1st three classes of cast material.
d.Full bevel-includes all of the dentinal and enamel walls of the cavity wall or floor
Disadv.- Deprives the preparation of internal resistance & retention.
e.Counter bevel-for capping cusps , this type is given opposite to an axial cavity wall,
on the facial or ligual surface of the tooth and will have gingual inclination facially or
lingually.
f.Hollow ground(concave bevel)-All the above mentioned bevel are in the form of flat
plane but the last 3 can be prepared in a concave form this allows more space for cast
material bulk, improves materials castability, retention and better resistance to stresses
and ideal for class IV and class V cast materials.
A)Partial Bevel B)Short Bevel
C)Long Bevel D)Full Bevel
E)Counter Bevel F)Hollow Bevel
Class I- holds a Pt alloys, I,II,III,IV gold alloys
Class II- low hold alloys, Gold content less than 50%
Class III- non gold, Pd bared alloys
Class IV- Ni- Cr bared alloys
Class V- Castable, moldable ceramics
Occlusal Cavosurface Margins
For cast restoration: angle of bevel (occlusal) is 30-40 degree to produce 30-40
marginal metal
If less than 30 degree-Metal will be too thin and weak
If greater than 40 degree- will be too thick and therefore difficult to burnish.
Gingival bevel- 30 degree to provide lap sliding fit at this area.
Functions of bevel:
1.Strong enamel margin:- bevels create obtuse angle marginal tooth structure, which is
bulkiest and strongest.
2. It provide acute angled marginal cast alloy, which is more easily burnished and
adapted and thus permits marginal seal in slightly undersized casting.
3.Reduces the error factor by 3-4 fold at margin as compared to their internal
dimensions.
4.Improve retention form because of direct frictional component b/w casting and the
tooth
5.Counter bevels and hollow ground bevels improves resistance form.
6.They are “flexible extensions’ of cavity preparation allowing the inclusion of surface
defects , supplementary grooves.
7.Gingual bevels can bring the margins to cleansable or protected areas.
8. Lap sliding fit is produced.
For composite Restorations:
-Bevel advocated because of the advantages of the acid etchant technique.
-Increased retention because of increased surface area.
-More effective etch obtained by etching the cut ends of enamel rods.
-Adjacent minor defects can be included
-Esthetic quality may be enhanced by creating an area of gradual increase in composite
thickness form the margins to the bulk
9.Cleaning, inspecting , varnishing , conditioning.
In newer books- cleaning, inspecting, sealing
The usual procedure is to free the preparation of visible debris with warm water from
the syringe and then to remove the visible moisture with a few light surges of air from
the air syringe.
(Dentin bonding system need moist surface of dentin for bonding)
After cleaning , visual inspection to confirm the appropriateness of the cavity
preparation.
Varnish type liners should extend to cover enamel & dentin for amalgam but only
dentin in case of cast restoration.
For Composite Restoration:
Etching  Applying bonding agent than resoration
Bonding system for amalgam also have conditioning bonding agents. Also bacterial
penetration has to be avoided. So use of DBA for bonded restorations, a sealer for non
bonded restoration will likely become a universal procedure.
Infected and Affected dentin:
Zone of dentinal caries beginning Pulpally:
1. Zone of fatty degeneration Tonie’s fibres.
2.Zone of dentinal sclerosis characterised by deposition of Ca salts in DT.
3.Zone of decalcification of dentin , a narrow zone preeceding bacteria invension
4.Zone of bacteria invansion of decalcified but intact dentin.
5.Zone of decomposed dentin.
In Dentin Caries – by Fusayama
Outer layers- infected dentin
Inner layers- affected dentin
In cavity preparation , it is desirable that only infected dentin can be removed, leaving
the affected dentin which then may be re-mineralised in a vital tooth following
completion of restoration treatment.
As softening front always preceeds the discolouration front which in turn always
preeced the bacterial front ( Fusayama’s observation)
Zone 3- affected dentin
Zone 4&5 – infected dentin
infected dentin- (bacteria present) is irreversibly denatured , not re-mineralizable and
must be removed.
Affected dentin- is reversibly denatured , not infected , re-mineralizable and should be
preserved.
To detect clinically criteria is:
-Degree of discolouration
-Testing the area for hardness by the feel of an explorer line or a slowly revolving bur.
But some problems are:
1.Discolouration may be very slight for acute waves.
2.Hardness felt by hand is an in exact guide.
Alteration Method: Application of 1% solution acid red(a food dye) in propylene
glycol to disclose infected dentin.
In Chronic caries: It is advisable to remove all discoloured dentin (because bact front
close to discolouration front).
In Acute:Some discolouration may be left (bacteria front well behind discolouration
front).

Retentive lock given by

169 L (elongated tapered fissure inverted cone bur 331/2 or ¼ round axiolingual point
0.5mm in diameter at point angle and diminishing in depth occlusally, terminating at
axiolinguopulpal point angle.
When the axiofacial and axiolingual line angles are less than 2mm in length than
extended into enamel to disappear midway b/w DEJ and enamel margin.
Slots: 0.5-1mm deep lingually
2-3mm in length FL
0.2-0.3mm inside DEJ
Pot holes: 0.5-1mm deep with ½ or 1 bur. 0.2-0.3mm wide DEJ.
Extension for prevention:-
For smooth surface – cavity prepration is extended to self clensing area to prevent
reoccurrence of caries.
For pit and fissure – extension is necessary to remove remaining enamel defects. This
principle is called extension for prevention.
MODERN CONCEPT:-
This concept is given because of relative caries provided by preventive measures.
  Fl-application- improved oral hygiene and proper diet
Inclusion of full length enamel fissures has been reduced to treatment that
conserves tooth structure such as
 Enameloplasty
 Pit and fissure sealants
 Preventive resin restoration
 Conservative composite restoration

Prophylactic odontomy
Not used. Minimally cutting open the defect and filling with amalgam.

Isthmus
It is the junction between the occlusal part of a restoration and the proximal, facial or
lingual part.
At this pt. most deletavious tensuile stresses under any type of loading.
 Fulcrum of bending occurs at axiopulpal line angle.
Stresses increase closer to the surface of restorstion away from that fulcrum.
Tensile stresses predominate at marginal ridge area of PO restoration.
Materials tend to fail therefore starting from the surface near the marginal ridge
and proceed toward axioplupal line angle.
A. Theoretical solution for this might be:-
1)To increase the bulk at axiopulpal line angle thereby placing surface
stresses away from fulcrum
 But this result in increased stresses in restoration, a deepend cavity
prep. ,very
close to pulp anatomy.
2)Bring the axioplupal line angle closer to the surface.
 This reduces the bulk of amalgam.
Combination of first and second solution:- i.e increasing amalgam bulk near the
marginal ridge while bringing the axiopulpal line angle away from that stress area and
closer to the surface can be achieved.
Simply by slanting the axial wall towards the pulpal floor.
Rounded axiopulpal line angle- avoid conc. Of stress.

REVERSE CURVE
when the facial and lingual margins on the occ. surface approach the proximal surface
,they should be prepared so as to meet the proximal surface at a rt. angle.
Secondly these walls should terminate past the contact area in the corresponding
facial and lingual embrasures.
If the occ. portion is narrow(Fl) in order to make this rt. angle with the proximal
surface they must be located either within the contact area or past the axial line
through the cusp.
This situation is unacceptable :-
It would not include all uncleansable area.
Unnecessarly involves the sound tooth structure.
On the other hand to continue the sweeping curves, facial and lingual cavosurface
angles proximally would not be rt. angled.
To solve this problem normal direction of sweeping curves is reversed when it is
necessary to include wide contact areas. This feature allows involvement of
contact area as well as termination of proximal margins in embrasures.
This feature is almost always necessitated on the facial proximal wall and
occasionally for lingual wall.
This design preserves tooth structure at this critical marginal area.
Provides rt. angle cavosurface.
Includes all uncleansable broad contacts.