Mistakes done Mistakes done during cavity during cavity preparation preparation and during and during

cavity fillingcavity filling

• The basis of preparation of dThe basis of preparation of dentalental hard hard tissues is the removal of carious tooth tissues is the removal of carious tooth tissue and ensure the retention of tissue and ensure the retention of restorations with regard to the prevention restorations with regard to the prevention of dental caries. of dental caries.

• Leaving carious material Leaving carious material onon cavity walls cavity walls and pulpal wall is the cause of secondary and pulpal wall is the cause of secondary or recurrent caries and their consequences.or recurrent caries and their consequences.

• During the treatment During the treatment of tooth decay of tooth decay we we need to watch out need to watch out to maintain healthy to maintain healthy dental pulp. dental pulp.

• The correct choice of preparation tools The correct choice of preparation tools and usand usage ofage of appropriate appropriate filling materialsfilling materials are are essential essential inin prevention of pain during prevention of pain during and after and after

preparation.preparation.

Trauma duringTrauma during preparation:preparation:

• UUssage of age of hand tools hand tools is conected with is conected with sense of sense of pressurepressure.. At low speed are At low speed are painful sensations equally divided painful sensations equally divided between the pressure, temperature and between the pressure, temperature and vibration. vibration.

• At high speed pain perception decreases At high speed pain perception decreases to pressure and vibration, but increases to pressure and vibration, but increases thermal stimulation. thermal stimulation. Having a Having a insufficient insufficient cooling of a prepared tooth surface may cooling of a prepared tooth surface may damage odontoblasts damage odontoblasts or or irreversiblirreversiblyy change the pulp.change the pulp.

AAbusive busive preparation preparation leads to roughening the leads to roughening the edges of the edges of the enamel and can influenceenamel and can influence: :

•     qualityquality of the of the filling, filling,

•     bonding strengthbonding strength of filling material with of filling material with cavity cavity wall , wall ,

•     quality quality of marginal sealof marginal seal

Sizing Sizing traumatrauma of of dental pulp will result dental pulp will result in in: :

• cellular changes cellular changes

•   hemorrhaghemorrhagiasias, which can lead to inflammation , which can lead to inflammation and necrosis of the pulp.and necrosis of the pulp.

• Painful sensations arise as a result of Painful sensations arise as a result of vibration of rotating tools that vibration of rotating tools that arare not e not well centered, or they are used for a long well centered, or they are used for a long time. time.

• Pain is increased in patients with Pain is increased in patients with damaged periodontal tissuedamaged periodontal tissue

• In terms of dental cariesIn terms of dental caries,, most important most important is lege is lege artis artis treatment of carietreatment of cariess. .

• Cavity Cavity preparation is preparation is based on the location of based on the location of tooth decay, rangetooth decay, range of loss of loss of dental hard tissues of dental hard tissues andand also depends on the used also depends on the used filling materialfilling material. .

• Complications can occur: Complications can occur:

• by by incomplete removal of carious dentin incomplete removal of carious dentin

• or or in in too radical removal of carious material, too radical removal of carious material, which may result in perforation of the pulp which may result in perforation of the pulp cavitycavity..

Rule of preventive Rule of preventive extension:extension:

•Violation of thViolation of thisis rule rule duringduring preparation of the cavity in preparation of the cavity in places habitually uncleanplaces habitually unclean,, the the amount of microbial plaqueamount of microbial plaque increasesincreases and caries formation and caries formation occurs.occurs.

• New composite materialsNew composite materials,, in a way in a way binding on hard dental tissues binding on hard dental tissues (mechanical, chemical) allow to reduce (mechanical, chemical) allow to reduce preparationpreparation procedures and conserve hard procedures and conserve hard dental tissues dental tissues ------ ppreventive fillings reventive fillings

By violation ofBy violation of fill fillinging retention retention rule rule can can reflect inreflect in::

• releasingreleasing the the fill fillinging

•     or inability or inability of application into the cavityof application into the cavity

• Fillings are loaded with Fillings are loaded with mastication presure,mastication presure, therefore the type of material used determines therefore the type of material used determines the need for sufficient depth preparation to the need for sufficient depth preparation to ensure resistance ensure resistance in fillingin filling: :

• Shallow cavitiesShallow cavities-- do not provide sufficient do not provide sufficient material strength and the bite can break material strength and the bite can break the the fillingfilling

• High fillHigh fillinging can becan be damage damaged duringd during adjusting adjusting occlusion and articulation occlusion and articulation

• Broken fillings can irritate the marginal Broken fillings can irritate the marginal periodontium (acute papillitis, a paro. periodontium (acute papillitis, a paro. aabscess)bscess)

• For the depth of preparatFor the depth of preparateded cavity cavity are valid: are valid: • PrinciplesPrinciples of of resistance resistance in in fillings fillings • IImportant is the mportant is the rangerange of carious of carious massmass • Size of the pulp cavity (patient's age, the Size of the pulp cavity (patient's age, the

anatomy of the teeth) anatomy of the teeth) • Danger of perforation requires gentle Danger of perforation requires gentle

preparation and preparation and finishing withfinishing with hand tools. hand tools. • The important thing is to ensure sufficient The important thing is to ensure sufficient

resistance resistance of the filling of the filling against the against the masticationmastication pressure,pressure, and and also the remaining dental hard also the remaining dental hard tissues (tissues (cuspscusps rule) Pichler rule) Pichler

• In the prevention of sec. In the prevention of sec. ccariesaries, in , in amalgam fillingsamalgam fillings isis important important that the that the edge edge ofof cavity cavity will be formed by enamel will be formed by enamel founded by dentinfounded by dentin

• When using compositesWhen using composites main aim main aim is to is to ensure mechanical retention ensure mechanical retention of the fillíngof the fillíng

• Insufficient slope Insufficient slope of of enamel enamel will bewill be reflectereflected in insuficient marginal seald in insuficient marginal seal and and may lead to secondary cariesmay lead to secondary caries

Preventive aspects Preventive aspects duringduring cavit cavity filly fill

• The formation of sec. caries orThe formation of sec. caries or insuficient insuficient qualityquality of of fill fillinging may also may also be the result of be the result of incorect work procedureincorect work procedure

• most common mistakemost common mistake in amalgame in amalgame fillingsfillings is the wrong choice of the is the wrong choice of the bandband, the , the lack of attachment lack of attachment mainly in mainly in II.classII.class cavitiescavities (injury (injury of of dento-gingival dento-gingival attachment, gingivitis) attachment, gingivitis)

• wwet working fieldet working field

• Damage to the marginal gingiva Damage to the marginal gingiva can also can also occuroccure ine in wrong choice of wrong choice of interdental interdental wedgewedge

• If the If the bandband is poorly sealed, condensing is poorly sealed, condensing amalgam amalgam extrude ower the extrude ower the cavitycavity edge edge into the interdental space and the removal into the interdental space and the removal of of it it can can be harmfull tobe harmfull to marginal gingiva marginal gingiva

• Lack of condensationLack of condensation strength leads strength leads to to unhomogenicunhomogenic fill fillinging

• The presence of gaps between the filling The presence of gaps between the filling and theand the dental tissues dental tissues requires requires renewal of renewal of thethe filling filling

• In In composite materials composite materials we need to we need to consider the consider the polymerization shrinkage, polymerization shrinkage, determindetermininging the suitability the suitability of of use of use of different forms of compositedifferent forms of composites s

PrPreventive aspects eventive aspects inin finishing finishing ofof fillings fillings

• Poorly adjusted height Poorly adjusted height of of fillfilling caning can cause cause breakage breakage and drop-out of fillingand drop-out of filling

• High fillings can High fillings can also also cause acute or chronic cause acute or chronic damage damage of periodontal tissue of the toothof periodontal tissue of the tooth

• InIn prevention of prevention of secsec. caries. caries is important the is important the final polishing of the surface and edges of final polishing of the surface and edges of fillings fillings

• PPolished surface olished surface also also ensures ensures minominor storage r storage of of microbial microbial film film

Thank you for Thank you for

your your

attention .attention .