CLASS V TOOTH
PREPERATION AND
CERVICAL NON CARIOUS
LESIONS
INTRODUCTION
Class V Caries:
Smooth surface
carious lesions
located on the
gingival/ cervical third
of labial/ buccal or
more rarely the
NON CARIOUS
CERVICAL LESION
• Class V lesion resulting from factors
other than dental caries is known as
non carious cervical lesion (NCCL).
*Attrition
*Abrasion
*Abfraction
*Erosion
ATTRITION
• It can be defined as surface tooth
structure loss resulting from direct
frictional forces between contacting
teeth
• Continuous age dependent process
usually physiologic
• Affects occluding surfaces and results in
flattening of their inclined planes and in
facet formation
ATTRITION
ABRASION
• Defined as surface loss of tooth structure
resulting from direct friction forces
between the teeth and external objects or
from frictional forces between contacting
teeth components in the presence of an
abrasive medicine
• Pathologic process
• Sometimes abrasion rate is faster than the
dentin deposition rate - direct or indirect
ABRASION
ABFRACTION
• Cervical wedge shaped defects or
abfractures caused by strong eccentric
occlusal forces
• Caused due to excessive occlusal stresses
and only a single tooth may be affected
leaving the neighboring teeth uninvolved
• More number of teeth are affected in
bruxists and in older patients
• The lingual surfaces of mandibular teeth
ABFRACTION
EROSION
• Defined as the loss of tooth structure
resulting from chemico-chemical acts in
the absence of specific microorganism.
• Popular theories of causes and
pathogenesis:
-Ingested acid -Excessive tensile
stresses at -Salivary citrates the
tooth clinical cervix
-Secreted acids -Refused acids
EROSIO
N
DIAGNOSIS
• Diagnosis is mostly done by
careful visual inspection
• Non cavitated:
- No signs of cavitation after
visual inspection or tectile
examination
- location: where dental
plaque accumulates; close tp
gingival margin.
- surface characteristics
matted appearance when the
tooth is dried. (not glossy)
• Cavitated lesion
- there is visual break down of
the tooth surface, enamel is not
intact.
- active lesion - having soft walls
and fl oors.
The following indicates that the
lesion is arrested.
-shiny white or brown lesion,
often well exposed due to
recession; the lesions are not
plaque covered.
TOOTH PREPARATION
• It varies slightly
depending on the
type and
extension of the
defect being
restored.
schematic view of class V
defects - shallow saucer
shaped and deep notch
shaped
PREPARATION FOR SMALL OR
MODERATE CLASS V LESIONS
• lesions that do not extend onto the
root surface
• The objective is to restore the lesion or
defect as conservative as possible. It
includes decalcified and hypoplastic areas
located in the cervical third of the teeth.
• Initial preparation is accomplised with a
round diamond or carbide bur eliminating
the entire enamel lesion or defect.
• Tooth preperation for class V abrasion or
erosion area usually requires only
roughening of the internal walls with a
CLASS V LESIONS THAT EXTEND ONTO
THE ROOT SURFACE
• 90 degree cavosurface margin with uniform
depth of the axial line angles.
• Initiated with a tapered fissure carbide bur (no.
271) or similar shaped diamond is used at high
speed with air water spray.
• All the external preparation walls should be
visible from fcaial position. (outwardly
divergent)
• The bevel is given with flame shaped or round
diamond instrument, resulting in approximately
45 degrees to the external tooth surface &
prepared to a width of at least 0.5 mm
CAVITY PREPARATION
• No. 1 or 2 round bur is used for initial
punch cut.
• Tapered fi ssure no. 701 bur or tapered
diamond is used to extend the cavity in a
mesiodistal direction.
• Axial wall depth should not be more than
0.75 mm
i) 0.2 mm into dentin
ii) 0.5 mm if a retention grove is
planned & the margin is still in enamel.
• Cavosurface angle is 90 degrees to follow
the direction of enamel rods, hence
THANK
YOU
PRESENTED BY:
SHEANA MARIE ANGELIC D.
BAYES
