Download Free Medical Classification of cavities PowerPoint Presentation

Classification of cavities PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Dental Amalgam, which is titled "Classification of cavities", to know about the classification of cavity /caries.

Tags : Dental Amalgam, Classification, cavities, cavity, caries

Published on : Jul 01, 2021 | Views : 4128 | Downloads : 13

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

DR PRITI D DESAI ASSOCIATE PROFESSO CONSERVATIVE AND ENDODONTIC DENTISTRY GURUNANAK INSTITUTE OF DENTAL SCIENCE AND RESEARCH, PANIHATI KOLKATA-127 1
Slide 2-

Classification of cavities Dr G.V. black gave the first classification of cavities more than a hundred years ago. It is still being widely used and universally accepted. Dr. G V Black originally divided the lesion in five categories. Dr. Simon had later added the sixth category. 2
Slide 3-

Dr G V Black The scientific foundation for objectives of restoration were also laid down by Dr. G. V .Black more than hundred years. The technique of the preparation of cavities by Dr GV Black placed on a more definite scientific basis for cavity preparation. 3
Slide 4-

Dr G V Black Three principle used for cavity preparation according to Dr G V Black Box shape cavities Beveling of enamel margins where require Extension for prevention 4
Slide 5-

Dr G V Black classification of cavity /caries Divide caries or cavity in to five category Class – I Class - II Class – III Class - IV Class – V Dr Simon added sixth category later Class -VI 5
Slide 6-

Class I cavity/caries Cavities on occlusal surface of premolar and molars Cavities on occlusal 2/3 of buccal and lingual surfaces of molars Cavities on lingual surface of maxillary incisors 6
Slide 7-

Class I cavity/caries 7
Slide 8-

Class I cavity/caries 8
Slide 9-

Class II cavity/caries Cavities occurring on proximal surface of molars and premolars are class II 9
Slide 10-

Class II cavity/caries 10
Slide 11-

Class II cavity/caries 11
Slide 12-

Class III cavity/caries 12 Cavities on proximal surface of anterior teeth that do not involve the incisal angle are class III cavities or caries
Slide 13-

13
Slide 14-

Class IV cavity/caries 14 Cavities on the proximal surface of anterior teeth that do involve incisal edge are class IV.
Slide 15-

Class IV cavity/caries 15
Slide 16-

Class V cavity/caries 16 Cavities on the gingival third of the facial or lingual surfaces of all teeth are class V.
Slide 17-

Class V cavity/caries 17
Slide 18-

Class VI cavity/caries 18 Cavities on the incisal edge of anterior teeth or the occlusal cusp heights of posterior teeth are class IV
Slide 19-

Class VI cavity/caries 19
Slide 20-

Class I cavity/caries Line angle Mesiobuccal line angle Msiolingual line angle Distobucaal line angle Distolingual line angle Faciopulpal lien angle Linguopulpal line angle Mesiopulpal line angle Distopulpal line angle Point angle Mesio-bucco-pulpal point angle Mesio-linguo-pulpal point anlge Disto-bucco-pulpal point angle Disto-linguo-pulpal point angle. 20 20
Slide 21-

Class I cavity 21
Slide 22-

Class II cavity/caries Line angle Disto-facial Facio-pulpal Axio-facial Facio-gingival Axio-gingival Linguo-gingival Axio-lingual Axio-pulpal Disto-lingual Disto-pulpal Linguo-pulpal Point angle Disto-facio-pulpal Axio-facio-pulpal Axio-facio-gingival Axio-linguo-gingival Axio-linguo-pulpal Disto-linguo-pulpal 22
Slide 23-

Class II cavity 23
Slide 24-

Class III cavity/caries Line angle Faciog-ingival Linguo-gingival Axio-gingival Axio-lingual Axio-incisal Axio-facial Point angle Axio-faxcio-gingival Axio-linguo-gingival Axio-incisal 24
Slide 25-

Class III cavity 25
Slide 26-

Class IV cavity/caries Line angle Facio-gingival Linguo-gingival Mesio-facial Mesio-lingual Mesio-pulpal Facio-pulpal Linguo-pulpal Axio-gingival Axio-lingual Axio-facial Axio-pulpal Point angle Axio-facio-pulpal Axio-linguo-pulpal Axio-linguo-gingival Axio-facio-gingival Disto-facio-pulpal Disto-linguo-pulpal 26
Slide 27-

Class IV cavity/caries 27
Slide 28-

Class V cavity/caries Line angle Axio-gingival Axio-incisal Axio-mesial Axio-distal Mesio-incisal Mesio-gingival Disto-incisal Disto-gingival Point angle Axiodistogingival Axiodistoincisal Axiomesiogingival axiomesioincisal 28
Slide 29-

Class V cavity/caries 29
Slide 30-

Drawback of black’s classification Blacks classification is simple, easily followed and universally accepted still in certain area of teeth caries occur have been overlooked in that like Carious lesion at line angle of different teeth are not included. Carious lesions on the labial surface of anterior teeth other than cervical third are not included 30
Slide 31-

Drawback of black’s classification Carious lesion on the lingual surface of anterior teeth other than in the cervical third are not included Proximal lesions whether at one side or two sides are taken in one class.
Slide 32-

Modification of black’s classification Black’s parameter for classification were controlled by number of factors. These factors are still being followed with slight modification to it. Removal of tooth structure to gain access and to improve visibility Removal of all traces of affected dentin from the floor of cavity 32
Slide 33-

Modification of black’s classification Provision of mechanical retentive designs. Concept of extension for prevention Keeping cavo-srface margins at self cleansing areas.
Slide 34-

Modification of black’s classification With advent of newer adhesive materials different cavity designs are followed. Concept of black is controversial and debatable. Tunnel preparation and slot preparation were introduced to avoid undue cutting of marginal ridge. 34
Slide 35-

Modification of black’s classification Mechanical retention design in cavities has been questioned as acid etching and bonding provide sufficient retention claimed by researchers but theses concept is also challanged and it says that it s not ideal substitute of retention form of cavity as given by BLACK. The concept of extension for prevention and keeping proximal margin in self cleansing area has also been questioned Inspite of this the validity of these principle in operative dentistry still exist.
Slide 36-

Another classification of carious lesion and cavities Given by Mount 1998. He has classified cavities according to site ans size. He expresses a carious lesions by site and size. 36
Slide 37-

Mount classification Theses classification is according to site and size of lesion. (1)- minimal involvement of dentin-treatments is by remineralization (2)-moderate involvement of dentin-treatments by cavity preparation and remaining sound enamel is saved and support restoration 37
Slide 38-

Mount classification (3)-the cavity is enlarged beyond moderate size. Tooth is weakened by lesion except cusps and incisal edges are split or likely to fail if left exposed to occlusal or incisal load. (4)- extensive caries with bulk loss of tooth structure has already occured 38
Slide 39-

Mount classification 39
Slide 40-

Mount’s classification It provide option for treatment planning, keeping in mind treatment by adhesive restoration but these classification is not used commonly because There is always a subjectivity in deciding the size of lesion. Treatment planning varies with operator to operator 40
Slide 41-

Mount’s classification Carious sites are also missing like blacks classification Contact caries whether on one side or two side is considered as one only which is misleading. Root caries and crown caries are clubbing
Slide 42-

Classification of tooth preparation Keeping in view the simplicity and acceptability of black’s classification is used most commonly. Classification is based on the observed freqauncy of carious lesions on certain aspect of tooth. Although relative frequency of caries locations may have changed over the years the still original classification is used and various classes also are used to identify restorations. 42
Slide 43-

Classification of tooth preparation Classification of tooth preparation that primarily relates to comparison between the more historical tooth preparation is known as conventional preparation and altered preparation designed referred to as Beveled conventional preparation Modified preprations 43
Slide 44-

Conventional tooth preparation Conventional tooth preparation for amalgam includes Uniform pulpal or axial wall depths Cavosurface margin design that results in 90 degree restoration margin Primary retention from derived from occlusally converging vertical walls Beveled conventional preparation with beveling the some accessible enamel margins. Modified preparation design may not have uniform axial or pulpal depths or occusally converging vertical walls. 44
Slide 45-

Other terms used commonly Extension for prevention Enameloplasty Prophylactic odontomy Pits and fissure sealant Bevel 45
Slide 46-

Extension for prevention 46 It is the extension of the cavity preparation in to areas that are caries susceptible e.g. all pit and fissure in occlusal cavity. This principle was conceived by Marshall ebb and later adopted by DR GV Black .
Slide 47-

Extension for prevention But nowadays instead of extension for prevention clinicians are doing conservative preparation and caries immunity provided by preventive measure like fluoride therapy, improved hygiene, and diet control, enameloplasty and pit and fissure sealant.
Slide 48-

Enameloplasty It is conservative procedure in which narrow pits and fissure in the enamel can ground off with a flam shaped bur to a smooth saucer shaped surface that is easily cleaned. 48
Slide 49-

Enameloplasty 49
Slide 50-

Prophylactic odontomy It is conservative procedure in which the developmental pits and fissures are minimally cut and restored with amalgam. 50
Slide 51-

Prophylactic odontomy 51
Slide 52-

Pits and fissure sealant It is a procedure in which resin sealant is applied on to the deep pit and fissure without cutting any tooth structure. 52
Slide 53-

Pits and fissure sealant 53
Slide 54-

Bevel According to dictionary bevel means any angle other than 90 between the planes and surfaces. Bevels are given at various surface of cavity preparation and tooth for proper marginal adaptation of restoration to tooth. 54
Slide 55-

Bevel Bevel are defined as any abrupt incline between the two surfaces of prepared tooth or between the cavity wall and the cavo-surface margin in the prepared cavity. 55
Slide 56-

Bevel 56
Slide 57-

Bevel Bevels are basically given to reduce the marginal errors ( that is space between restoration and tooth surface). 57
Slide 58-

Bevel Different types of bevels are Ultra short /partial bevel : it involves part of the enamel only. 58
Slide 59-

Short bevel it involve the entire enamel wall 59
Slide 60-

Long bevel it involve all enamel wall and up to one half of the dentinal wall 60
Slide 61-

Full bevel it includes all the enamel and dentinal wall 61
Slide 62-

Hollow bevel it is concave preparation involving only enamel or enamel and part of the dentin 62
Slide 63-

Inverted bevel it is an incline in the labial shoulder for metal ceramic crowns. 63
Slide 64-

Enamel pattern Direction of enamel rods (prism) For better understanding long axis of crown is taken as reference point Rods at the centre of the occlusal surface always lean to pits or fissure towards the axis of the crown. the stronger the inclination of the cusp greater the degree of such slant. 64
Slide 65-

Enamel pattern On periphery of the occlusal surface near the tips of the cusp and crests of the marginal ridges the rods are inclined toward cusp tips or crest away from the long axis of the crown. 65
Slide 66-

Enamel pattern In between the centre and periphery of the occlusal surfaces the rods are parallel to the long axis of the crown Rods at the incisal or occlusal third of the axial surface incline incisally or occlusaly making average of plus(plus means toward incisal or occlusal)with the perpendicular to long axis of the crown at this area. 66
Slide 67-

Enamel pattern Rods at gingival third of the any surface incline by an average of minus(towards the gingiva) from the perpendicular to long axis of the crown at this area. 67
Slide 68-

Enamel pattern Rods at the gingival third of the axial surface incline by an average of minus (towards the gingiva) from the perpendicular to the long axis of the crown at this area. Rods or the middle third of the axial surface perpendicular to long axis of the crown 68
Slide 69-

Enamel pattern 69
Slide 70-

Thickness pattern of enamel Maximum thickness at tip of cusp and crest of triangular, marginal and crossing ridge Thickness decreases from occlusal surface to the depth of the pits, fissure, and grooves 70
Slide 71-

Thickness pattern of enamel Enamel thickness decreases towards gingivally on the axial surface and with least thickness at the cervico-enamel junction 71
Slide 72-

Thickness pattern of enamel Anterior teeth maximum thickness of enamel at incisal edge Lingual enamel plats are generally thinner than the facial and which is more apparent in anterior teeth than posterior teeth 72
Slide 73-

Thickness pattern of enamel As age increases the thickness of the enamel decreases at the occluding area with the result of attrition and also as the mineralization and dehydration of enamel increase by age, the brittleness erasing tendency of enamel also increases. 73
Slide 74-

caries Caries is multifactorial microbial infectious disease of hard structure of tooth characterized by demineralization of inorganic substance and destruction of organic substance of the tooth 74
Slide 75-

Classification of caries Morphology of teeth /Location of caries Severity and Progress of caries Age pattern 75
Slide 76-

caries 76
Slide 77-

Primary caries The original carious lesion in the tooth is referred to as the primary caries. depending upon its location on the tooth it may be pits and fissure caries or smooth surface caries. 77
Slide 78-

Primary caries 78
Slide 79-

Secondary cries Secondary cries is caries begins around or beneath the restoration. Its occurrence is suggestive of an improper seal between the tooth and restoration where micro leakage may occur predisposing to the development of caries. it also referred to as recurrent caries 79
Slide 80-

Secondary cries 80
Slide 81-

Incipient caries Incipient caries is just beginning of the caries activity and the lesion, is evident as a white opaque area on the surface of the enamel. surface inflicted by incipient caries are fairly hard and only minor surface roughing may be present. Hypo plastic white area and incipient carious lesion both look same but in case of hypo plastic area it visible irrespective of whether the tooth surface is a dry or wet while incipient caries become visible only when the tooth surface is dried. 81
Slide 82-

Incipient caries 82
Slide 83-

Incipient caries Incipient caries are at reversible state that it can be rematerialize provided oral hygiene measure are followed and plaque removed and controlled. This remineralised lesion may continue to be white or turn brownish black because of external staining. such dark areas are referred to as arrested caries, they are hard to touch and appear even when the tooth surface is dry or wet. 83
Slide 84-

Advanced or cavitated caries Caries that has progresses to the dentino-enamel junction and is no longer reversible is called advanced or cavitated caries. Here overlying enamel breaks down. at this stage the lesion can not be rematerialized and require cavity preparation and restoration for treatment. 84
Slide 85-

Advanced or cavitated caries 85
Slide 86-

Acute caries Caries of a rapid onset and spread is referred to as acute caries. E.g. nursing bottle caries or rampant caries. Lesions are light yellow in color, soft and highly infectious. 86
Slide 87-

Acute caries 87
Slide 88-

Chronic caries Caries of a slower onset and spread is referred to as chronic caries. Lesion may be present in only few location in the mouth. they are hard and dark brown to black in color. their dark color because of enough time for external staining to occur 88
Slide 89-

Chronic caries 89
Slide 90-

Pits and fissure caries Caries beginning in the pits and fissure of teeth is referred to as pit and fissure caries. Pits and fissure are those areas of the teeth where there is imperfect coalescence of development enamel lobes. because of incomplete fusion of enamel theses areas are susceptible to food impaction and hence caries. While grooves and fosse are area where there is perfect coalescence of developmental enamel lobes which makes them less susceptible to cries 90
Slide 91-

Pits and fissure caries 91
Slide 92-

Pits and fissure caries Pits and fissure caries begins as small point penetration at bottom of pit and fissure ,from here it fans along the enamel rods to the dentino-enamel juction. on reaching dentino- enamel junction caries spreads laterally at the junction and then penetrates towards the pulp through the dentinal tubules. 92
Slide 93-

Pits and fissure caries Diagrammatically pits and fissure caries can be seen as two cones ,base to base, apex of the enamel cone at the point of entry in enamel and the apex of the dentin cone towards the pulp. 93
Slide 94-

Pits and fissure caries 94
Slide 95-

Pits and fissure caries Pits and fissure caries has pin point origin so it may not visible clinically in early stages until the caries has spread largely, undermining the enamel in which case the lesion is seen as a bluish discoloration of the tooth or as a cavitation after the overlying unsupported enamel has been lost under the forces of mastication 95
Slide 96-

Pit and fissure caries/cavities Cavities involving the pits and fissure of the anterior and posterior teeth are referred to as pit and fissure cavities. Pits and fissure on the occlusal surface of premolar and molars and occlusal 2/3 rd of buccal and lingual surface of upper incisors Any other surface where the pit is abnormally present 96
Slide 97-

Pit and fissure cavities 97
Slide 98-

Smooth surface caries Caries involving the smooth surface of the teeth are referred to as smooth surface caries Following are the areas where these may be present Cavities on the proximal surface of incisors, canines, premolars, molars. Cavities in the gingival third of the facial and lingual surface of all the teeth 98
Slide 99-

Smooth surface cavity 99
Slide 100-

Smooth surface caries In smooth surface caries initially it involves a large area of enamel on its outer surface caries then spreads along the enamel rods to dentino-enamel junction. At junction it spread laterally and then towards the pulp through the dentinal tubules. Diagrammatic lesion shows two cones the apex of the enamel cone contact the base of the dentin cone. 100
Slide 101-

Smooth surface caries 101
Slide 102-

Caries pattern 102
Slide 103-

Root surface caries Root surface caries is begins on the roots of teeth that have been exposed to the oral environment and covered with plaque for quite some time. Progression of this type of caries is rapid and hence should be detected and check in time. Because increasing number of elderly who retaining teeth the prevalence of root caries is also increasing for past few years. Root caries also referred to as senile caries. 103
Slide 104-

Root surface caries 104
Slide 105-

Residual caries Caries that remains after the cavity preparation has been completed is referred to as residual caries.which may have been left behind either intentionally by the operator or by accident. Residual caries at the dentino-enamel junction or enamel walls is not acceptable. 105
Slide 106-

Residual caries 106
Slide 107-

Caries Caries in dentin grossly divided in to two zones Infected dentin or outer zone and Affected dentin or inner zone 107
Slide 108-

Affected dentin Affected dentin is characterized by reversible denatured collagen which is not infiltrated with bacteria and is remineralizable. Affected dentin can be left behind during cavity preparation. it either remineralize or remain sterile once cavity is thoroughly restored 108
Slide 109-

Infected dentin Infected dentin is characterized by irreversible denatured collagen which infiltrated with bacteria and is not remineralizabel. Infected dentin should be removed while doing cavity preparation. 109
Slide 110-

Affected dentin & Infected dentin Clinically it is difficult to precisely distinguish between the two zones of dentin caries but guide that helps in distinguishing between them is as follows- Infected dentin is darker than the affected dentin Infected dentin is softer to touch than the affected dentin. 1% solution of acid red in propylene glycol is used to stain infected dentin 110
Slide 111-

Affected dentin & Infected dentin 111
Slide 112-

112
Slide 113-

113
Slide 114-

114
Slide 115-

ppt slide no 115 content not found
Slide 116-

Line Angle Internal line angle – External line angle Point Angle Cavo-surface angle
Slide 117-

Axial Wall Pulpal Wall Internal wall External wall Floor or Seat Enamel Wall Dentinal Wall
Slide 118-

118
Slide 119-

119
Slide 120-

120
Slide 121-

121
Slide 122-

122
Slide 123-

123
Slide 124-

124
Slide 125-

125
Slide 126-

126
Slide 127-

127
Slide 128-

128
Slide 129-

129
Slide 130-

130
Slide 131-

131
Slide 132-

132
Slide 133-

133
Slide 134-

134
Slide 135-

135
Slide 136-

136
Slide 137-

137
Slide 138-

138
Slide 139-

139
Slide 140-

140
Slide 141-

141
Slide 142-

142
Slide 143-

143
Slide 144-

144
Slide 145-

145
Slide 146-

146
Slide 147-

147
Slide 148-

148
Slide 149-

149
Slide 150-

150
Slide 151-

151
Slide 152-

152
Slide 153-

153
Slide 154-

154
Slide 155-

155
Slide 156-

156
Slide 157-

157
Slide 158-

158
Slide 159-

159
Slide 160-

160
Slide 161-

161
Slide 162-

162
Slide 163-

163
Slide 164-

164
Slide 165-

165
Slide 166-

166
Slide 167-

167
Slide 168-

168
Slide 169-

169
Slide 170-

170
Slide 171-

171
Slide 172-

172
Slide 173-

173
Slide 174-

174
Slide 175-

175
Slide 176-

176
Slide 177-

177
Slide 178-

178