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Cariology & Operative DentistryBasic

Black's classification

G. V. Black classified caries and cavities by where they are on the tooth: Classes I to V, and Class VI was added later.
Diagram of Black's classes. The gray area is the lesion in each class.
Diagram of Black's classes. The gray area is the lesion in each class.Photo: Jessr6544 · Public domain, Wikimedia Commons

What you need to know

  • Class I: pits and fissures. Occlusal surface of molars and premolars, buccal and lingual pits of molars, and palatal surface of upper incisors.
  • Class II: proximal surfaces (mesial or distal) of molars and premolars.
  • Class III: proximal surfaces of incisors and canines, without involving the incisal angle.
  • Class IV: proximal surfaces of incisors and canines that do include the incisal angle.
  • Class V: gingival (cervical) third of the facial or lingual surface of any tooth.
  • Class VI (added by Simon): incisal edges or cusp tips, for example from wear.
  • Today there are newer systems, such as ICDAS, that also measure how advanced the lesion is.
Real example: an extracted premolar with a Black's Class II amalgam restoration (on a proximal surface).
Real example: an extracted premolar with a Black's Class II amalgam restoration (on a proximal surface).Photo: HROP · Public domain, Wikimedia Commons

Terms in plain words

ProximalSurface of the tooth that touches the neighboring tooth (mesial or distal).
Incisal angleThe corner of the edge of an incisor or canine.
Gingival thirdThe part of the crown closest to the gums.

For the exam

Caries on the distal surface of a canine that has broken the incisal angle. Which class is it?

Show answerHide answer

Class IV.

Sources

  1. Sturdevant's Art and Science of Operative Dentistry. Elsevier (textbook).
  2. Pai S, et al. Association of age with class VI composite restoration. Bioinformation. 2020. View source
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