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\title{~~~~~~~~~ A new cavity classification LOV/DD~~~~~~~~~~~~}



\author[1]{Oleksandr Bulbuk}%
\author[1]{Olena Bulbuk}%
\author[1]{Mykola Rozhko}%
\affil[1]{Ivano-Frankivsk National Medical University}%


\vspace{-1em}



  
  \date{April 22, 2026}


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\selectlanguage{english}
\begin{abstract}
\textbf{Background} : Previous research have established -- in the
problem solving of diagnosis and treatment of hard tissues defects, a
significant role belongs to the choice of tactics treatment tooth
destruction. This work aims to study the diagnosis problems and cavity
classification, what will facilitate objectification of diagnostic and
therapeutic approaches in the dental treatment of patients with this
disease.

\textbf{Methods} : For differential estimation of defects in teeth and
for a precise assessment of the strength of the composition
''tooth-restoration'', we conducted a mechanic-mathematical modeling of
contact interaction of restoration with tooth tissues. We also conducted
anthropometric studies cavities all kinds and different groups of teeth.

\textbf{Results:} The first division of the~cavities~we have conducted
in depth lesions: depth of destruction (DD).~The next division we
conducted on several parameters:~\textbf{Location of defects,~Occlusion
load,~Volume of defects} (LOV)\textbf{.~} As a result of the study, was
proposed the cavity classification LOV/DD, is offered the method choice
algorithm of treatment hard tissues defects, which is based on
classification LOV/DD, and can serve as a selection criterion in the
treatment of such pathologies.

\textbf{Conclusion:} The proposed classification fills the obvious gap
in academic representations of hard tissue defects, suggests the
prospect of reaching a consensus on differentiated diagnostic and
therapeutic approaches in the treatment of patients with this disease.

\textbf{Keywords: cavity classification, diagnostics, restoration,
algorithm of treatment.}%
\end{abstract}%



\sloppy






\textbf{}

\textbf{}

\textbf{Problem statement and analysis of the recent research}

Since the complications arising after various types of restoration are
often caused by mistakes made by doctors at the stage of choosing a
treatment method, the problem of choosing a method for treating hard
tissue defects (cavities) requires a thorough study and development of
new approaches in accordance with the principles of evidence-based
medicine.1-3

When choosing the method of restoring the damaged crown of the tooth and
making the diagnosis, one can consider the index of destruction of
occlusal surface of tooth (IDOST) proposed by Milikievich for Class I
and II carious lesions. To date, the determination of the degree of the
destruction of the occlusal surface of the tooth is one of the most
important factors in choosing a treatment method (fillings, onlays or
crowns). This index is used today in the post-Soviet countries for the
diagnosis and choice of a method for treating cavities.4 The global
dental community relies on other indicators: ``intercuspal distance'',
SI/STA.5

At the current stage of dentistry development, the dynamic growth of new
knowledge, technologies and materials has significantly changed the
methods of treating cavities.6

Based on the meta-analysis of literature, it was concluded that
complications arising after various types of restorations are often
associated with mistakes made by doctors at the stage of choosing a
treatment method. Thus, the problem of choosing a method for treating
cavities requires a thorough study and development of new approaches in
accordance with the principles of evidence-based medicine.

\textbf{The objective of the study --} develop anatomical and functional
classification cavities, as a basis for the application of
differentiated diagnostic and therapeutic approaches in dental
treatment.

\textbf{Methods}

For differential assessment of the extent of cavities and precise
estimation of the strength of the composition ``tooth-restoration'', we
conducted mechanical and mathematical modeling of contact interaction of
restoration with dental tissues. We conducted anthropometric studies
using methodology proposed by us. Anthropometric study of all types of
cavities of different groups of teeth was carried out as well.7-8

\textbf{Results of the research and their discussion}

We relied on the well-known prototypes of SI/STA classification proposed
by Mount GJ and Hume WR (1998), and modified by Lasfargues JJ et al.
(2000).6,9 On the basis of conducted experimental researches,10 own
scientific hypotheses, meta-analysis of scientific literature, clinical
experience, we have developed the cavity classification.

The first division was made according to the depth of destruction (DD):

0 -- the cavity is not determined (demineralization, discolorite,
changes in the anatomical shape of the tooth).;

1 -- defeat of enamel and initial defeat of dentin, cavity depth within
the outer 1/3 dentin;

2 -- moderate defeat of dentin, depth of cavity in the middle third of
dentin;

3 -- deep dentin damage, depth of the cavity within the circle of the
pulp dentin,

4 -- teeth after endodontic treatment.

The next division we conducted on several parameters: location of
defects (L), occlusion load (O), volume of cavity (V). All the cavities
were divided into 4 groups (LOV) (Fig. 1 ):

\emph{Group 1:}

\begin{itemize}
\tightlist
\item
  Cavities~in the area of natural pits and fissures;
\item
  Cavities with one and two-sided defects on incisors and fangs up to \selectlanguage{ngerman}½
  of the length of the cutting edge with the preserved vestibular
  surface and the optimum amount of dentin on it;
\item
  Cavities \selectlanguage{russian}сervical area of all groups of teeth and free operational
  access to them.\emph{Group 2 :}
\end{itemize}

\begin{itemize}
\tightlist
\item
  Cavities on molars and premolars of type O, with a preserved wall not
  less than 20\% of the diameter of the crown of the tooth;
\end{itemize}

\begin{itemize}
\tightlist
\item
  Cavities on molars and premolars of the type OM (OD) and MOD without
  damage to the supporting humps and the thickness of the retained walls
  of not less than 20\% of the diameter of the crown of the tooth;
\item
  Cavities on incisors and fangs with a lesion of the vestibular surface
  to one third.
\end{itemize}

\emph{Group 3:}

\begin{itemize}
\tightlist
\item
  Cavities type O in premolars and molars with a wall thickness of less
  than 20\% of the diameter of the crown of the tooth;
\item
  Cavities type OM (OD), MOD with a defeat of one supporting cusp in
  molars;
\item
  Cavities type OM (OD), MOD in premolars and molars with preservation
  of wall thicknesses less than 20\% of the diameter of the crown of the
  tooth;
\item
  Cavities on incisors with a lesion of 1/3 to \selectlanguage{ngerman}½ length of the cutting
  edge;
\item
  Cavities on incisors and fangs with lesion of the vestibular tooth
  surface up to 1/2 of the crown width;
\item
  horizontal tooth defeat to 1/3 crown height;
\end{itemize}

\emph{Group 4:}

\begin{itemize}
\tightlist
\item
  Cavities on premolars of type OM (OD), MOD with a lesion of one cusp;
\item
  Cavities of molars of type OM (OD), MOD with lesions of two or more
  cusps;
\item
  Cavities on incisors with a lesion of the cutting edge more than ½ its
  width;
\item
  Cavities on fangs with a lesion of more than ½ crown width;
\item
  horizontal tooth defeat at ½ and more crown height.
\end{itemize}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image1/image1}
\caption{{Couldn't find a caption, edit here to supply one.
{\label{div-410707}}%
}}
\end{center}
\end{figure}

\textbf{Figure 1.} Classification LOV/DD

We called our classification LOV/DD. After removal of the affected
tissues, we measured using a micrometer in the front group of teeth of
the width of the preserved vestibular surface, and in the lateral group
of teeth, the thickness of the preserved wall. Based on these
measurements, we performed the diagnosis using LOV/DD (Fig. 2 ).\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image2/image2}
\caption{{Couldn't find a caption, edit here to supply one.
{\label{div-626308}}%
}}
\end{center}
\end{figure}

\textbf{Figure 2.} Classification LOV/DD (measurements)

We propose to write it in the form of a fraction, where the numerator
indicates the location of defects - LOV, and the denominator indicates
the depth of decay - DD. For example: 1/0, 1/1, 1/2, 1/3, 1/4, 2/0, etc.
For all types of cavities localized in the cervical margin of a tooth,
we used the classification being previously described by us, where the
numerator indicated the level of the cervical location of the cavity. To
describe the depth of the location of the cavity margin line towards the
gingival level, we used the index, the value of which was equal to the
distance (expressed as an integer in millimeters) from the level of the
epithelial attachment to the deepest point of the cavity margin line. If
the bottom of the cavity was located supragingivally, we put the ``+''
sign in front of the index; if the bottom of the cavity was located
subdingivally, we put the ``-'' sign in front of the index; if the
bottom of the cavity was located at the level of the epithelial
attachment, we used the `` index.11

If the cavity had marginal decay of two or more sides - we chose the
deepest cavity for our classification. For example: 2+1 /3, 30/4 etc.

According to our research, we proposed an algorithm for choosing a
method dental treatment, based on the classification we proposed (Table
1).

\textbf{Table 1. Algorithm choice of dental treatment}\selectlanguage{english}
\begin{longtable}[]{@{}ll@{}}
\toprule
\begin{minipage}[b]{0.47\columnwidth}\raggedright\strut
Type of treatment\strut
\end{minipage} & \begin{minipage}[b]{0.47\columnwidth}\raggedright\strut
Systematization LOV/DD\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.48\columnwidth}\raggedright\strut
Direct restoration\strut
\end{minipage} & \begin{minipage}[t]{0.48\columnwidth}\raggedright\strut
Cavities 1/0, 1/1, 1/2, 1/3, 1/4; Cavities 2/0, 2/1, 2/2, 2/3, 2/4;
Cavities 3/0, 3/1, 3/2\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.48\columnwidth}\raggedright\strut
Indirect restoration\strut
\end{minipage} & \begin{minipage}[t]{0.48\columnwidth}\raggedright\strut
Cavities 3/3, 3/4 Cavities 4/1, 4/2 Cavities 4/0*\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.47\columnwidth}\raggedright\strut
Crowns\strut
\end{minipage} & \begin{minipage}[t]{0.47\columnwidth}\raggedright\strut
Cavities 4/3, 4/4**\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

*The tactics of treating such patients with cavities of 4/0 depend on
the etiology and depth of the change in the color of the tooth.
Currently, such teeth are treated by external or internal bleaching or
by less conventional methods: indirect restoration and artificial
crowns.

**The tactics of treating such patients with cavities of 4/4: use of a
fiber post is recommended.

In the available medical literature, we did not find any works devoted
to the questions of clear cavity classification. At the present stage of
the development of dentistry, the dynamic growth of new knowledge,
technologies and materials significantly changed the methods of treating
defects of dental hard tissues.12 In clinical cases where the cavity is
located subdingivally, the ``Cervical Margin Relocation'' (CMR) can be
used. During the period of dentistry development, various CMR techniques
have been developed and studied gaining popularity among dental
practitioners; however, there is no clear classification of gingival
cavities.3,13-16

The importance of dental restoration using fiber posts is being
discussed as well. After endodontic treatment of teeth, it is
recommended to use a fiber post, as there is a greater loss of dental
tissue, i.e. the decisive factor in choosing the method of treatment is
the amount of lost hard tissue. 3,17-20

In the SI/STA classification system, there is no clear distinction
between isolated carious cavities, located on one tooth surface, and
combined lesions that involve several surfaces. The disadvantage of this
classification is the characteristics of mainly chewing teeth, without
involving the anterior ones.3,15

The choice between direct and indirect restoration is complicated by the
fact that it does not depend on the objective factors. It depends on the
dentist's knowledge, habits, preferences and stereotypes concerning the
treatment of such pathologies; the patient's consent, financial
capabilities and other factors that have nothing to do with the methods
of evidence-based medicine, i.d. the absence of a cavity classification
formed a methodological gap in treatment of this pathology.

\textbf{Conclusions}

In our opinion, the proposed classification filled the obvious gap in
academic ideas of cavities, suggested the prospect of reaching a
consensus on differentiated diagnostic and therapeutic approaches in
treatment of patients with this disease. The algorithm we developed for
choosing a method for treating cavities based on the classification we
proposed can serve as a criterion for choosing the treatment of this
pathology.

\textbf{References}

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\item
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