INTERNATIONAL PEER REVIEW

CLASS II AMALGAM

RESTORATION – 36MO Leung Kwan Yu, Steve

BDS II - Class 2019, The University of Hong Kong

instruments

Mirror

Periodontal probe

Hatchets

Gingival margin trimmers

Tofflemire matrix retainer

Amalgam carrier

Condensers

Carvers

Straight probe

Burnishers

ONE. mesial box preparation

ONE. mesial box preparation

Identify contact point

ONE. mesial box preparation

Identify contact point

Just below

contact

Where carious lesion

most likely occur

ONE. mesial box preparation

Start cutting a mesial box of about 2-3mm, with a tungsten carbide 330 bur on high speed handpiece

Retention form

ONE. mesial box preparation

Pendulum movement of

bur helps create this Retention form

Start cutting a mesial box of about 2-3mm, with a tungsten carbide 330 bur on high speed handpiece

ONE. mesial box preparation

Hachet remove mesial wall

Resistance to fracture

ONE. mesial box preparation

Checking with condenser

ONE. mesial box preparation

Gingival margin trimmer remove unsupported enamel smoothen edges and walls

Axiopupal line angle usually

bevelled or rounded to reduce

stress concentrating at that area

ONE. mesial box preparation

Checking with straight probe that all margins are smooth

Axiopupal line angle usually

bevelled or rounded to reduce

stress concentrating at that area

ONE. mesial box preparation

A box with caries removed,

and with contact broken on lingual, buccal and gingival surfaces

TWO. occlusal preparation

Occlusal cavity improves

retention

About 2-3mm deep

Start with central pit. Then cut

a slot down to mesial box Isthmus for

retention

THREE. filling amalgam

Tofflemire matrix and retainer Wrapped around 36

A wedge can be placed to

allow better adaptation

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

THREE. filling amalgam

Tofflemire matrix and retainer Wrapped around 36

A wedge can be placed to

allow better adaptation

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

The use of rubber dam is

also recommended to

prevent the newly placed

amalgam from contamination

by moisture.

Strength and corrosion

resistance of the amalgam

may be affected adversely

if it is contaminated by

moisture.

If the alloy contains zinc, such

contamination may result in

delayed expansion.

THREE. filling amalgam

SDI lojic+: platinum modified,

high silver, non-gamma 2

spherical amalgam

Mix the amalgam

with amalgamator (brand: SDI

ultramat 2); 8 seconds

Place the first increment of

amalgam and condense

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

THREE. filling amalgam

Condense after adding each

increment

Condenser and

Mortonson 2 condenser

Overfill the cavity slightly

SDI lojic+ (slow set)

pick up and condensing time: 4 minutes;

carving time: 6 minutes

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

THREE. filling amalgam

Run a straight probe tip along

proximal surface to create

marginal ridge, and remove

excess amalgam

Carefully remove the retainer,

then the matrix band

Carve from marginal ridge

towards centre of tooth

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

THREE. filling amalgam

PK Thomas Burnisher

Ball Burnisher

Burnishing to obtain smoother

surface, before polishing

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

THREE. filling amalgam

Finishing and Polishing 24

hours after placement

In slow speed handpiece with

water spray

Use burs from coarse to fine

Finishing burs:

Dome-shaped, pear-shaped,

flame-shape, green stone

Polishing rubber points:

Brownie, greenie,

super greenie

Tooth isolation Amalgam trituration Filling Carving Burnishing Finishing & Polishing

You may want to discuss…

References

Banerjee, A. (2011). Pickard's manual of operative

dentistry. Oxford university press.