APPROXIMAL CARIES

APPROXIMAL CARIES

1. CLASS II

   • Caries develops below contact point
   • Difficult to detect clinically
   • Rely on bw radiographs as well as radiographs

2. TREATMENT OF CLASS III

   • Caries often found next to gingival margin
   • Often contaminated with blood
   • Use rubber dam where possible
   • access caries from palatal/lingual - where poss leave labial enamel
   • Remove caries from adj and leave unsupported enamel

3. CLASS III

   • Much rarer than class II
   • Develops below contact point
   • Easier to detect clinically
   • Restoration is by direct access

4. DIAGNOSIS

   • Visual inspection
   • Transillumination
     • Bw's

5. WHEN TO INTERVENE

   • If caries is confined to enamel, leave and apply fluoride
   • if into ADJ, cavitated, visible on bw

6. GAINING ACCESS TO APPROXIMAL CARIES - POSTERIOR

   • Occlusally cutting through marginal ridge
   • occ, bucc, ling leaving marginal ridge intact
   • direct access if adjacent tooth is missing

7. CLASS II CAVITY DESIGN FOR NON ADHESIVE (AMALGAM)

   • GV BLACK
   • mechanical retentive features
   • Resistance and retentive features

8. Outline form

   • gain access occ leaving slither of enamel
   • using exc or ging marg trimmer remove slither of enamel
   • remove caries and clear contact point
   • tidy margins, remove unsupported enamel
   • resistance and retentive forms included
   • line if necessary and place amalgam

9. MOD CAVITY PREP

   • Each side of cavity prepared seperately
   • occ section kept as narrow as poss

10. MATRIX BANDS

    • To retain material in cavity
    • to restore contact point
    • Tofflemire or Sqiveland

11. TUNNEL PREP

    • Gains access to caries and leaves marg intact
    • only indicated for small lesions
    • approach ling,bucc, occ
    • ADVANTAGES - conserves tooth tissue
      • DISADVANTAGES - difficult, marg ridge prone to #
    • not always good access to caires