Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

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Chapter 2
Table 2.1
Black’s classification of carious lesions versus current terminology.
Black’s classification
Current terminology
Class I
Affecting pits and/or fissures also termed
occlusal lesions
Class II
Affecting the proximal surfaces of posterior teeth
Class III
Affecting the proximal surfaces of anterior teeth
Class IV
Affecting the proximal surfaces of anterior teeth
and involving the incisal angle
Class V
Affecting the cervical surfaces
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Anusavice
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as a preservative approach to the operative management
of dental caries and associated lesions.
To be able to prepare teeth efficiently and effectively, it is essential
to understand the processes of the diseases of teeth, have a detailed
working knowledge of tooth anatomy
4
, the structure and properties
of the tooth tissues and pulp biology, and have a clear under-
standing of the basic principles of occlusion. In addition, one must
understand the mode of action, functions and limitations of the
instrumentation used to shape and fashion enamel and dentine in the
oral environment.
The process of preparing teeth may be considered to comprise the
following stages.
Gaining access
In order to remove caries, create the required form of preparation, and
enable restorative materials to be placed, adapted and contoured to
restore form and function, it is generally necessary initially to cut
through and then cut away part of the enamel of the tooth to be
treated. Even when the tooth contains a large lesion, it is generally
necessary to gain access using a friction-retained, water-cooled, 
diamond bur held in an air turbine handpiece. If the lesion to be
treated is associated with an existing restoration, the whole restora-
tion may need to be removed using the air-turbine handpiece; 
however, increasingly the benefits of repairing rather than replacing
existing restorations are being acknowledged.