SlideShare a Scribd company logo
1 of 20
METAL CERAMIC CROWN

Armamentarium :
Preparation steps :
Guiding grooves
Incisal or occlusal reduction
Labial or buccal reduction
Axial reduction of the proximal and lingual surfaces
Finishing
Metal ceramic crown
Indications :
1. Extensive tooth destruction – caries, trauma or existing previous
restorations
2. The need for superior retention and strength
3. An endodontically treated tooth in conjunction with a suitable
supporting structure (a post and core)
4. To recontour axial surface or correct minor malinclinations
5. Esthetics
6. If all ceramic crown is contraindicated
Contraindications :
1. Patients with active caries or untreated periodontal disease
2. Young patients with large pulp chambers
3. When more conservative retainer is technically feasible
4. Intact buccal wall
Advantages :
1. Superior esthetics as compared to complete cast crown.
2. Strength of cast metal is combined with the esthetics of an all ceramic
crown by reinforcing a brittle, more cosmetically pleasing material
through support derived from the stronger qualities are excellent.
3. excellent retentive qualities
Disadvantages :
1. Removal of substantial tooth structure.
2. Subject to fracture because porcelain is brittle.
3. Difficult to obtain accurate occlusion in glazed porcelain.
4. Shade selection can be difficult.
5. Inferior esthetics compared to all ceramic crown.
6. Expensive
7. Potential for periodontal disease as the facial margin of an anterior
restoration is often placed subgingivally.

Preparation of tooth for porcelain fused to metal crown
Armamentarium :
1. Round tipped rotary diamonds or carbides.
2. Foot ball or wheel shaped diamond
3. Flat – end tapered diamond
4. Finishing stones
5. Explorer and periodontal probe
6. Hatchet and chisel
Step - by – step procedures : The preparation is divided into 4 major steps
1. Guiding grooves ( Depth orientation grooves)
2. Incisal or occlusal reduction
3. Labial or buccal reduction
4. Axial reduction of the proximal and lingual surfaces
5. Final finishing of all prepared surfaces
Guiding grooves : Place 3 depth grooves one in the centre of the facial
surface and one each in the approximate locations of the mesiofacial and
distofacial line angles. Depth grooves in the facial wall are placed in2
directions. Incisally, parallel to the tooth contour cervically parallel to the
path of withdrawal. The grooves should be 1.3mm deep to allow for
additional reduction during finishing.
Place 3 depth grooves about 1.8 mm in incisal edge of an anterior
tooth to provide the needed reduction of 2 mm and allow finishing.
Incisal or occlusal reduction : Tapered round-tipped diamond.
The incisal reduction of an anterior tooth should be 2mm for adequate
material thickness to permit translucency in the completed restoration.
Posterior teeth generally require less (1.5mm) because esthetics is not as
critical.
Labial (buccal) reduction : Tapered flat – tipped diamond.
The reduction of the facial surface should have sufficient space to
accommodate the metal substructure and porcelain veneer. A minimum of
1.2 mm is necessary to produce restoration with satisfactory appearance
(1.5mm is preferable). The cervical shoulder is established at this stage.
Axial reduction of the proximal and lingual surfaces :
Sufficient tooth structure must be removed to provide a distinct
smooth chamfer of about 0.5 mm width. Tapered round-tipped diamond is
used to provide a taper of 6 degrees convergence from cervical to incisal or
occlusal.
As the lingual chamfer is developed extend it buccally into the
proximal to blend with the interproximal shoulder placed earlier.
A foot ball shaped diamond is used to reduce the lingual surface of
ant teeth approx 1mm deep to provide clearance in all excursions.
Finishing : The finishing of shoulder or beveled shoulder is done with a
tapered flat – tipped diamond or hand instrument. must extend at least 1mm
lingual to the proximal contact area. The bevel if selected should be as far
incisal as possible relative to the epithelial attachment. Tapered round –
tipped diamond or carbide is used to rounded all the line angles and the
completed preparation should have a satin finish free from obvious diamond
scratch masks.
PARTIAL VENEER CROWN
Definition, types
Indications
Contraindications
Advantages
Disadvantages
Armamentarium
POSTERIOR PARTIAL VENEER CROWN

Three quarter crown :
Preparation steps :
Occlusal reduction
Axial reduction
Proximal groove placement
Buccocclusal contralevel
Occlusal offset
Finishing
Seven eights crown :
Preparation steps :
Occlusal reduction
Axial reduction
Groove placement, flaring and contralevel
Modified three – quarter crown :
Preparation steps :
Occlusal reduction
Axial reduction
Finishing
Anterior partial veneer crown :
Preparation steps :
Incisal and lingual reduction
Axial reduction and groove placement
Incisal offset and lingual pinhole
Finishing and flare
Pinledge preparation :
Indications
Contraindications
Advantages
Disadvantages
Preparation steps :
Design
Proximal reduction
Incisal and lingual reduction
Ledges and indentations
Pinhole preparation
Finishing
Inlays :
Indications
Contraindications
Advantages
Disadvantages
Armamentarium
Preparation steps :
Occlusal outline
Proximal box
Caries removal
Axiogingival groove
Gingival and proximal bevels
Occlusal bevel
Onlay :
Indications
Contraindications
Advantages
Disadvantages
Preparation steps :
Occlusal outline
Proximal boxes
Caries removal
Occlusal reduction
Centric cusp ledge
Gingival and proximal bevels
Occlusal bevel
Partial veneer crown : An extracoronal metal restoration that covers only
part of the clinical crown is considered to be a partial veneer crown. It can
also be referred to as a partial coverage restoration.
An intracoronal cast metal restoration is called an inlay or an onlay if
one or more cusps are restored. Several types of partial veneers exist.
For posterior teeth – three quarter, modified three – quarter, seven –
eights crown.
For anterior teeth – three quarter crown and pinledges
Indications :
1. Sturdy clinical crown of average length or longer
2. Intact buccal surface not in need of contour modification and well
supported by sound tooth structure.
3. No conflict between axial relationship of tooth and proposed path of
withdrawal of FPD
4. Retainers for a FPD or where restoration or alteration of the occlusal
surface is needed.
Contraindications :
1. Short teeth
2. High caries Index
3. Extensive destruction
4. Poor alignment
5. Bulbous teeth
6. Thin teeth
Advantages :
1. Conservative of tooth structure
2. Easy access to margins
3. Less gingival involvement than with complete cast crown
4. Easy escape of cement and good seating
5. Verification of seating simple
6. Electric vitality test feasible
Disadvantages :
1. Less retentive than complete cast crown
2. Limited adjustment of path of withdrawal
3. Some display of metal
Armamentarium :
1. Narrow (approx 0.8mm) round – tipped, tapered diamond (regular or
coarse grit) – Bulk reduction
2. Regular – size (approx 1.2 mm), round tipped, tapered diamond (fine
grit) or carbide – finishing.
3. Football shaped or wheel shaped diamond (regular grit)
4. Tapered and straight carbide fissure burs – boxes and ledges
5. Small, round carbide bur
6. Small – diameter twist drill – pinholes
7. Inverted cone carbide bur – offsets
8. Finishing stones
9. Mirror
10. Explorer and periodontal probe – assessing the direction and
dimension of the various steps.
11. Chisels – finish proximal flares and bevels.
POSTERIOR PARTIAL VENEER CROWN PREPARATION
Maxillary premolars three – quarter crown
The three – quarter crown preparation derives its name from the
number of axial walls involved. Except for a slight bevel or chamfer placed
along the buccocclusal line angle, the buccal tooth surface remains intact.
The other surfaces are prepared to accommodate a casting in the same
manner as a complete crown preparation, differing only in the need for axial
retention grooves.
Occlusal reduction :
Place depth grooves for the occlusal reduction with a tapered carbide
or narrow diamond in the development grooves of the mesial and distal
fossae and in the crest of the triangular ridge.
In the central groove they should be slight less (about 0.2 mm) than 1
mm deep to allow for finishing. On the centric (lingual) cusp they should
slightly less than 1.5 mm deep in the location of the occlusal contacts. Upon
completion of the occlusal reduction, a clearance of at least 1.5 mm should
exist on the centric cusp and atleast 1.0 mm on the noncentric cusp and in
the central groove. The buccal cusp may help obtain sufficient clearance
while maintaining the original occlusocervical dimension of the tooth.
Axial reduction : Place grooves for axial alignment on the center of the
lingual surface and in the mesiolingual and distolingual transitional line
angles. They should be parallel to the long axis of the tooth and should not
exceed half the width of the tip of the diamond (chamfer depth of 0.5 mm)
The proximal reduction is usually short of breaking the proximal
contact. The resulting flanges should be parallel to the linguoaxial
preparation, with the chamfer placed sufficiently cervical to provides atleast
0.6 mm of clearance with the adjacent tooth and the axial wall allowing for
a proximal groove of at least 4 mm of length occlusocervically.
Proximal groove placement : Tapered carbide bur is positioned against
the interproximal flange parallel to the path of withdrawal and a groove is
made perpendicular to the axial surface.
The groove need not be deeper than 1 mm at its cervical end but may
be deeper near its occlusal end.
Buccoocclusal contralevel : Connect the mesial and distal flares with a
narrow contralevel that follows the buccal cusp ridges. The level should
remain within the curvature of the cusp tip rather than extend on to the
buccal wall which can be placed with a diamond, or carbide or even a hand
instrument.
Primary purpose : To remove any unsupported enamel and thereby protect
the buccal cusp tip from chipping during function. If group function is
planned, a heavier bevel, chamfer or occlusal offset will be needed.
Occlusal offset : If additional bulk is needed to ensure rigidity of the
restoration, it can be provided with an occlusal offset which extends from
the proximal grooves along the buccal cusp.
It is essential for the structural durability of ant partial veneer crown.
Finishing : Round all sharp internal line angles with a fine – grit diamond
or carbide.
The flares should be straight and smooth with sufficient clearance
(min about 6 mm) between than and the adjacent tooth.
Maxillary molar three – quarter crown :
The principles used in a premolar preparation can also apply for a
maxillary molar with some additional leeway may exist for groove
placement because more tooth structure is present on molars than on
premolars. Because of their less prominent position in the dental arch, the
mesioproximal flare can sometimes be extended onto the buccal surface
without increasing esthetic liability.
Maxillary molar seven eights crown :
This preparation includes in addition to the surfaces covered by the
three quarter crown, the distal half of the buccal surface.
Mesial aspect – Resemble three – quarter crown and is protected by a
narrow contralevel or chamfer.
Distal aspect – Resembles complete crown.
A groove in the middle of the buccal surface is placed parallel to the
path of withdrawal.
Distal to this groove, the buccal surface is reduced in 2 planes.
The cervical paralleling the path withdrawal.
Occlusal following the normal anatomic contour. The lingual surface is also
reduced in 2 planes and the centric cusp levels are incorporated.
Occlusal reduction : Min measurement are the same as for the three quarter
crown preparation.
To delineate the extent of the lingual centric cusp bevel, they should
extend onto the lingual surface of the tooth.
On the lingual incline of the MB cups they will resemble depth cuts
for the three – quarter crown.
On the DB cusp they should be approx 0.8mm deep to provide
sufficient occlusal clearance for this noncentric cusp.
Concave shaping of the resulting MB incline may again prove useful
because it will permit the occlusocervical height of the cusp to be
maintained. When completed this bevel should provide 1.5 mm of clearance
in the ICP as well as the excursive movements of the mandible.
Axial reduction : Place 3 alignment groove in the lingual wall and transfer
the selected path of withdrawal to the DB transitional line angle area, where
a 4th alignment groove can be placed. Start the reduction in the middle of the
lingual surface. The mesial half is prepared like a three – quarter crown the
distal half like a complete crown.
Carry the facial reduction sufficiently mesial to include the buccal
groove.
Groove placement, flaring and contrabevel :
Place the mesial groove like the three – quarter crown place the
buccal groove parallel to the mesial groove and perpendicular to the
buccoaxial wall. Connect the 2 grooves with a smooth contrabevel that
follows the ridge of the MB cusp.
Adequate clearance must be established interproximally upon
completion.
Mandibular premolar modified three – quarter crown :
Mandibular partial veneer preparations are made more often on
premolars than on molars. They differ from maxillary molar three – quarter
crown preparations in 2 respect.
Additional retention is required because of the shorter crown lengths
of mandibular teeth.
The axial surface that is not prepared (the buccal) includes one
functional cusp. This means that additional tooth structure must be removed
to provide sufficient bulk of metal for strength.
Occlusal reduction :
Place 0.8 mm depth grooves on the buccal inclines of the lingual
cusps and 1.3 mm grooves on the lingual inclines of the buccal cusp. These
guiding grooves are once again placed to follow the basic groove and fissure
pattern of the occlusal surface.
Arial reduction :
Place guiding grooves on the lingual surface to parallel the proposed
path of withdrawal and the long axis of the tooth.
Prepare the mesial as already described for the three – quarter and
seven - eights crown.
Reduce the distal surface as for a complete crown extending the
preparation to the transitional line angle and onto the buccal surface.
Finishing : Place the mesial and buccal grooves as described for the seven –
eights crown. Another distal groove may be placed. To gain as much length
as possible, the grooves of the three-quarter crown should be slightly buccal.
Distal groove is slightly close to the center of the distal wall.
Connect the mesial and buccal grooves with a centric cusp chamfer
which must be heavy enough to allow 1.5 mm of clearance in the area of
occlusal contact.
A regular or thick diamond is used to place the chamfer which should
provide a protective “staple” linkage of alloy in the completed restoration.
Finally, all prepared surfaces are smoothed and the internal line
angles rounded.
Anterior partial veneer crown preparation :
Maxillary canine three – quarter crown
On a maxillary canine it involves the proximal and lingual surfaces
and leaves the facial surface intact.
Incisal and lingual reduction :
Place depth grooves for both the incisal bevel and the lingual
reduction.
The incisal bevel makes an angle of approx 45 degrees with the long
axis of the tooth. It is prepared with a round – tipped diamond which allows
for metal thickness

0.7 mm. The design of the incisal bevel should prevent

contact between opposing teeth and the incisal margin. The original
configuration of the facial surface should be presented.
The lingual reduction is done with a foot ball or wheel – shaped
diamond and it should have 1mm of clearance for metal.
Axial reduction and groove placement : To enhance the retention and
resistance form, place a slightly exaggerated chamfer on the lingual aspect
of the tooth and a guiding groove in the middle of the lingual wall. The
groove is placed with a round – tipped diamond which allows for 0.5 mm of
metal thickness at margin. The axial reduction extends into interproximal
about 0.4 mm lingual of contact area and it should be parallel to incisal two
thirds of labial surface.
Incisal offset and lingual pinhole : Anterior PVC require a means of
reinforcement for preserving the casting’s integrity, so on incisal offset or
groove is needed to create a band of thicker metal to provide a “staple
configuration” which provides additional rigidity and resistance against
bending of the casting.
An inverted cone diamond or carbide is used to prepare the offset by
connecting the mesial and distal groove. It prevent against lingual
displacement and should have a V configuration.
Pin-hole is placed in the cingulerm area lightly off enter to improve
the retention and resistance of the preparation and it should be approx 2mm
which is prepared with a tapered carbide fissure bur and half round bur.
Proximal grooves should parallel to incisal two thirds of labial surface
and it should resists lingual displacement. Lingual wall of groove meets
proximal wall at angle of 900 degrees with a Tapered carbide. Fissure bur
and half round bur.
Finishing and flare : Fine – grit tapered diamonds (large and small) or
carbide are used for finishing. All surfaces should be smooth and the buccal
wall of groove flared to break proximal contact resulting is a cavosarface
angle of 900 with no unsupported enamel remaining.
Pinledge preparation :
Indications :
1. Undamaged anterior teeth in caries – free mouth
2. Alteration of lingual contour of maxillary anterior teeth or alteration
of occlusion.
3. Anterior splinting
Contain dictations :
1. Poor oral hygiene
2. Large pulps
3. Thin teeth
4. Nonvital teeth
5. Carious involvement
6. Problems with proposed path of withdrawal of FPD
Advantages :
1. Minimal tooth reduction
2. Minimal margin length
3. Minimum gingival involvement
4. Optimum access for margin finishing and hygiene
5. Adequate retention
Disadvantages :
1. Less retentive than complete coverage
2. Alignment can prove difficult
3. Technically demanding
4. Not usable on nonvital teeth
Maxillary Central Incisor pinledge : Three designs of pinledge
preparations
1. Conventional pinledge involving only the lingual surface of the tooth
2. Pinledge with a proximal slice
3. Pinledge with a proximal groove
Design :
A line is marked along the height of contour of the incisal edge and
on the proximal wall to include the area needed for a connector,
The lingual chamfer is placed immediately adjacent to the crest of the
marginal ridge.
Proximal Reduction :
Prepare the proximal slice with a tapered diamond. The primary
purpose is to provide sufficient reduction to allow adequate metal in the area
for a subsequent connector.
Incisal and lingual reduction :
Prepared the incisal bevel with the diamond inclined slightly toward
the lingual. Sufficient clearance provides functional contact on metal rather
than on the junction between metal and tooth structure. The desired metal
thickness is 1mm, except in the area close to the margin.
Perform the lingual reduction with a football – or wheel – shaped
diamond. Metal thickness of 1mm is required in the ICP and throughout
excursive movements.
Ledges and indentations : The ledges are prepared with a straight carbide
fissure bur with the ledges parallel to one another when viewed from lingual
and from incisal. Maximum width is 1mm. The incisal edge is 2 to 2.5 mm
cervical to the incisal edge or one fourth of the total height of the
preparation from the incisal edge. The cervical ledge is placed on the crest
of the cingulum at the centre of the cervical ¼ th of the of preparation.
The indentations are prepared with a straight. Carbide fissure bur in
the left and right sides of the incisal ledge and slightly off center in the
cervical ledge to prevent subsequent pulp exposure when the pinholes are
placed.
The indentation should provide at lest 0.5 mm of space for metal
reinforcement around opening of pinhole.
Pinhole preparation : Sink pilot channels with either a small round bur or a
small twist drill. Pinholes are prepared with a tapered carbide bur and it
must be between 2 and 3 mm deep. The minimal width of ledge around
pinholes is 0.5 mm
Bevel the junction between pinhole and indentation with a round bur
slightly large than the largest diameter of the pinhole.
Finishing : It is done with finishing stones on carbides. All surface must be
as smooth as possible to facilitate removal of this delicate wax pattern from
die.
INLAYS
Indications :
1. Small carious lesion in otherwise sound tooth
2. Adequate dentinal support
3. Low carries rate
4. Patient’s request for gold instead of amalgam or composite resin.
Contraindications :
1. High caries Index
2. Poor plaque control
3. Small teeth
4. Adolescents
5. Poor dentinal support requiring a wide preparations
Advantages :
1. Superior material properties
2. Longevity
3. No discoloration from corrosion
4. Least complex cast restoration
Disadvantages :
1. Less conservative than amalgam
2. May display metal
3. Gingival extension beyond ideal
4. “Wedge” retention
Class II inlay preparation :
Armamentarium :

Carbide burs are usually used for inlay or only

preparation, but diamonds can be substituted if preferred :
1. Tapered carbide burs
2. Round carbide burs
3. Cylindrical carbide burs
4. Finishing stones
5. Mirror
6. Explorer and periodontal probe
7. Chisels
8. Hatchet
9. Gingival margin trimmers
10. Excavators
11. High – and low – speed handpieces
12. Articulating film
Occlusal outline : It is prepared with a tapered carbide which includes the
central groove, avoids centric contacts, includes dovetail or pinhole for
resistance, approx 1.8 mm deep.
Proximal box : It is done with a tapered carbide bur and it follows the
curvature of the original tooth structure.
Caries removal ; Carries is removed with a excavator or round bur and a
place a cement base to restore the excavated tissue in the axial wall or
pulpal floor.
Axiogingival groove : It is placed with a gingival margin trimmer at the
junction of axial and gingival walls at the base of the proximal box to
enhance resistance form and prevent distortion of the wax pattern during
manipulation and is 0.2 mm deep.
Gingival and proximal bevels : Are placed with a thin, tapered carbide or
diamond. The gingival bevel is at 45 – degrees and it should be 0.8 mm
wide. Proximal bevels are prepared on the buccal and lingual walls with the
tapered bur oriented in the path of withdrawal.
Occlusal bevel : It is prepared with a round carbide or stone to create a
hollow – ground bevel or chamfer and to avoid. Centric contacts. The
occlusal bevel should improve marginal fit and allow finishing of the
restorations.
MOD Onlay:
Indications :
1. Worn on carious teeth with intact buccal and lingual cusp.
2. MOD amalgam requiring replacement.
3. Low carries rate.
4. Patients; request for gold instead of amalgam
Contraindications :
1. High caries Index.
2. Poor plaque control.
3. Short clinical crown or extruded teeth.
4. Lesions extending beyond transitional line angles.
Advantages :
1. Support of cusps
2. High strength
3. Longevity
Disadvantages :
1. Lacks retention
2. Less conservation than amalgam
3. May display metal
4. Gingival extension beyond ideal
Mod onlay preparation :
Occlusal outline : It includes the central, buccal and lingual grooves and it
is about 1.8 mm deep and done with a tapered carbide bur.
Proximal bones : are prepared with a tapered carbide bur and it follows the
curvature of the original tooth structure.
Carries removal : Carries are removed by a excavator or round bur and the
tissues are replaced with base and to allow adequate dentin for resistance
and retention.
Occlusal Reduction : It should follow anatomic contours and it is about 1.5
mm deep on centric cusp and 1.0 mm on the noncentric cusps and done with
a tapered carbide bur.
Centric cusp ledge : It should be about 1.00 mm wide (before beveling )
and about 1.0 mm apical to centric contact done with a tapered carbide bur.
Gingival and proximal bevels : It is done with a thin, tapered carbide and
should be about 45 degrees and 0.8 mm wide
Bevel the noncentric and centric cusps. Where additional bulk at the
margin is needed, a chamfer should be substituted for the straight bevel with
a round – tipped diamond.
Complete the preparation by rechecking the occlusal clearance in all
excursions and assessing for smoothness

More Related Content

What's hot

Failures Of Dental Amalgam
Failures Of Dental AmalgamFailures Of Dental Amalgam
Failures Of Dental Amalgamshabeel pn
 
Principles of tooth preparation
Principles of tooth preparationPrinciples of tooth preparation
Principles of tooth preparationrakeshrakz
 
Types Of Matrix Retainer & Parts Of Retainer
Types Of Matrix Retainer& Parts Of RetainerTypes Of Matrix Retainer& Parts Of Retainer
Types Of Matrix Retainer & Parts Of RetainerSyed Shayan
 
All ceramic crown preparation seminar
All ceramic crown preparation seminarAll ceramic crown preparation seminar
All ceramic crown preparation seminarMoataz AboDief
 
Rationale of endodontics
Rationale of endodonticsRationale of endodontics
Rationale of endodonticsalka shukla
 
Pit and fissure sealants
Pit and fissure sealantsPit and fissure sealants
Pit and fissure sealantsRamniq Kaur
 
Provisional restoration
Provisional restorationProvisional restoration
Provisional restorationIAU Dent
 
Obturation techniques
Obturation techniquesObturation techniques
Obturation techniquesMaulee Sheth
 
Impression procedures for removable partial denture
Impression procedures for  removable partial dentureImpression procedures for  removable partial denture
Impression procedures for removable partial dentureShiji Antony
 
Finish lines (3) final
Finish lines (3) finalFinish lines (3) final
Finish lines (3) finalms khatib
 
Isolation in dentistry
Isolation in dentistryIsolation in dentistry
Isolation in dentistryPiyush Verma
 
Post insertion instructions in complete denture patients
Post insertion instructions in complete denture patientsPost insertion instructions in complete denture patients
Post insertion instructions in complete denture patientsMathew Thomas Maliael
 
Removable partial denture
Removable partial dentureRemovable partial denture
Removable partial dentureDr. Almas A
 
Complete denture case history
Complete denture case historyComplete denture case history
Complete denture case historyRavi banavathu
 

What's hot (20)

Failures Of Dental Amalgam
Failures Of Dental AmalgamFailures Of Dental Amalgam
Failures Of Dental Amalgam
 
Principles of tooth preparation
Principles of tooth preparationPrinciples of tooth preparation
Principles of tooth preparation
 
Types Of Matrix Retainer & Parts Of Retainer
Types Of Matrix Retainer& Parts Of RetainerTypes Of Matrix Retainer& Parts Of Retainer
Types Of Matrix Retainer & Parts Of Retainer
 
Tooth preparation for partial veneer crwns
Tooth preparation for partial veneer crwnsTooth preparation for partial veneer crwns
Tooth preparation for partial veneer crwns
 
All ceramic crown preparation seminar
All ceramic crown preparation seminarAll ceramic crown preparation seminar
All ceramic crown preparation seminar
 
Post and core
Post and corePost and core
Post and core
 
Rationale of endodontics
Rationale of endodonticsRationale of endodontics
Rationale of endodontics
 
RPI system
RPI systemRPI system
RPI system
 
Pit and fissure sealants
Pit and fissure sealantsPit and fissure sealants
Pit and fissure sealants
 
Clasp Designs - Dr. devi
Clasp Designs - Dr. deviClasp Designs - Dr. devi
Clasp Designs - Dr. devi
 
Provisional restoration
Provisional restorationProvisional restoration
Provisional restoration
 
Obturation techniques
Obturation techniquesObturation techniques
Obturation techniques
 
Impression procedures for removable partial denture
Impression procedures for  removable partial dentureImpression procedures for  removable partial denture
Impression procedures for removable partial denture
 
Finish lines (3) final
Finish lines (3) finalFinish lines (3) final
Finish lines (3) final
 
Complex amalgam restorations
Complex amalgam restorationsComplex amalgam restorations
Complex amalgam restorations
 
Isolation in dentistry
Isolation in dentistryIsolation in dentistry
Isolation in dentistry
 
Primary impression
Primary impressionPrimary impression
Primary impression
 
Post insertion instructions in complete denture patients
Post insertion instructions in complete denture patientsPost insertion instructions in complete denture patients
Post insertion instructions in complete denture patients
 
Removable partial denture
Removable partial dentureRemovable partial denture
Removable partial denture
 
Complete denture case history
Complete denture case historyComplete denture case history
Complete denture case history
 

Viewers also liked

The metal ceramic crown preparation
The metal ceramic crown preparationThe metal ceramic crown preparation
The metal ceramic crown preparationguest33a456f1
 
Preparation of partial veneer crown
Preparation of partial veneer crownPreparation of partial veneer crown
Preparation of partial veneer crownHimanshu Khatri
 
Dr Saransh Malot Partial veneer presentation preparation and classification
Dr Saransh Malot Partial veneer presentation preparation and classification Dr Saransh Malot Partial veneer presentation preparation and classification
Dr Saransh Malot Partial veneer presentation preparation and classification Saransh Malot
 
Types of crown & bridges
Types of crown & bridgesTypes of crown & bridges
Types of crown & bridgesDr. Yumna
 
Tooth preparation for Metal ceramic crowns.
Tooth preparation for Metal ceramic crowns.Tooth preparation for Metal ceramic crowns.
Tooth preparation for Metal ceramic crowns.srinivaslalluri
 
partial coverage restorations
partial coverage restorationspartial coverage restorations
partial coverage restorationsIAU Dent
 
Tooth preparation for full veneer crowns /certified fixed orthodontic course...
Tooth preparation for full veneer crowns  /certified fixed orthodontic course...Tooth preparation for full veneer crowns  /certified fixed orthodontic course...
Tooth preparation for full veneer crowns /certified fixed orthodontic course...Indian dental academy
 
Types of bridges/fixed orthodontics courses
Types of bridges/fixed orthodontics coursesTypes of bridges/fixed orthodontics courses
Types of bridges/fixed orthodontics coursesIndian dental academy
 
Principles of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial DenturesPrinciples of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial DenturesVinay Kadavakolanu
 
classification and configuration for fixed partial dentures/dental courses
classification and configuration for fixed partial dentures/dental coursesclassification and configuration for fixed partial dentures/dental courses
classification and configuration for fixed partial dentures/dental coursesIndian dental academy
 
Biomechanics of tooth preparation/ orthodontics website
Biomechanics of tooth preparation/ orthodontics websiteBiomechanics of tooth preparation/ orthodontics website
Biomechanics of tooth preparation/ orthodontics websiteIndian dental academy
 
partial veneer crowns /certified fixed orthodontic courses by Indian dent...
  partial veneer crowns   /certified fixed orthodontic courses by Indian dent...  partial veneer crowns   /certified fixed orthodontic courses by Indian dent...
partial veneer crowns /certified fixed orthodontic courses by Indian dent...Indian dental academy
 
Complete cast crown preparation
Complete cast crown preparationComplete cast crown preparation
Complete cast crown preparationfaezahasbullah
 
Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...
Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...
Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
 
All Ceramic Restorations
All Ceramic RestorationsAll Ceramic Restorations
All Ceramic Restorationscdindal
 
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...Indian dental academy
 
Posterior tooth preparations/dental crown &bridge course by Indian dental aca...
Posterior tooth preparations/dental crown &bridge course by Indian dental aca...Posterior tooth preparations/dental crown &bridge course by Indian dental aca...
Posterior tooth preparations/dental crown &bridge course by Indian dental aca...Indian dental academy
 

Viewers also liked (20)

The metal ceramic crown preparation
The metal ceramic crown preparationThe metal ceramic crown preparation
The metal ceramic crown preparation
 
Preparation of partial veneer crown
Preparation of partial veneer crownPreparation of partial veneer crown
Preparation of partial veneer crown
 
Dr Saransh Malot Partial veneer presentation preparation and classification
Dr Saransh Malot Partial veneer presentation preparation and classification Dr Saransh Malot Partial veneer presentation preparation and classification
Dr Saransh Malot Partial veneer presentation preparation and classification
 
Types of crown & bridges
Types of crown & bridgesTypes of crown & bridges
Types of crown & bridges
 
Tooth preparation for Metal ceramic crowns.
Tooth preparation for Metal ceramic crowns.Tooth preparation for Metal ceramic crowns.
Tooth preparation for Metal ceramic crowns.
 
partial coverage restorations
partial coverage restorationspartial coverage restorations
partial coverage restorations
 
4.cgc prep
4.cgc prep4.cgc prep
4.cgc prep
 
Tooth preparation for full veneer crowns /certified fixed orthodontic course...
Tooth preparation for full veneer crowns  /certified fixed orthodontic course...Tooth preparation for full veneer crowns  /certified fixed orthodontic course...
Tooth preparation for full veneer crowns /certified fixed orthodontic course...
 
Types of bridges/fixed orthodontics courses
Types of bridges/fixed orthodontics coursesTypes of bridges/fixed orthodontics courses
Types of bridges/fixed orthodontics courses
 
Principles of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial DenturesPrinciples of tooth preparation in Fixed Partial Dentures
Principles of tooth preparation in Fixed Partial Dentures
 
classification and configuration for fixed partial dentures/dental courses
classification and configuration for fixed partial dentures/dental coursesclassification and configuration for fixed partial dentures/dental courses
classification and configuration for fixed partial dentures/dental courses
 
Biomechanics of tooth preparation/ orthodontics website
Biomechanics of tooth preparation/ orthodontics websiteBiomechanics of tooth preparation/ orthodontics website
Biomechanics of tooth preparation/ orthodontics website
 
PFM
PFMPFM
PFM
 
partial veneer crowns /certified fixed orthodontic courses by Indian dent...
  partial veneer crowns   /certified fixed orthodontic courses by Indian dent...  partial veneer crowns   /certified fixed orthodontic courses by Indian dent...
partial veneer crowns /certified fixed orthodontic courses by Indian dent...
 
11-13 PFM preparation
11-13 PFM preparation11-13 PFM preparation
11-13 PFM preparation
 
Complete cast crown preparation
Complete cast crown preparationComplete cast crown preparation
Complete cast crown preparation
 
Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...
Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...
Metal free ceramics /certified fixed orthodontic courses by Indian dental aca...
 
All Ceramic Restorations
All Ceramic RestorationsAll Ceramic Restorations
All Ceramic Restorations
 
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
Posterior tooth preparations /certified fixed orthodontic courses by Indian d...
 
Posterior tooth preparations/dental crown &bridge course by Indian dental aca...
Posterior tooth preparations/dental crown &bridge course by Indian dental aca...Posterior tooth preparations/dental crown &bridge course by Indian dental aca...
Posterior tooth preparations/dental crown &bridge course by Indian dental aca...
 

Similar to Metal ceramic and partial veneer crown/certified fixed orthodontic courses by Indian dental academy

tooth preparation-partial veneers
tooth preparation-partial veneerstooth preparation-partial veneers
tooth preparation-partial veneersshabeel pn
 
Posterior tooth preparationscertified fixed orthodontic courses by Indian den...
Posterior tooth preparationscertified fixed orthodontic courses by Indian den...Posterior tooth preparationscertified fixed orthodontic courses by Indian den...
Posterior tooth preparationscertified fixed orthodontic courses by Indian den...Indian dental academy
 
The partial veneer crown , inlay and onlay.pptx
The partial veneer crown , inlay and onlay.pptxThe partial veneer crown , inlay and onlay.pptx
The partial veneer crown , inlay and onlay.pptxMuddaAbdo1
 
Types of tooth preparations
Types of tooth preparationsTypes of tooth preparations
Types of tooth preparationsIshani Sharma
 
Partial veneer crown preparations
Partial veneer crown preparationsPartial veneer crown preparations
Partial veneer crown preparationsFirefarhana
 
Principles of tooth preparation
Principles of tooth preparationPrinciples of tooth preparation
Principles of tooth preparationpragy mallik
 
posterior partial veneer crown preparation
posterior  partial veneer crown preparation posterior  partial veneer crown preparation
posterior partial veneer crown preparation Atheer Ahmed
 
Atypical Tooth Preparation.pdf
Atypical Tooth Preparation.pdfAtypical Tooth Preparation.pdf
Atypical Tooth Preparation.pdfOSamaTarek11
 
3. TOOTH PREPRATION.ppt
3. TOOTH PREPRATION.ppt3. TOOTH PREPRATION.ppt
3. TOOTH PREPRATION.pptDrkddutta
 
Retainer in FPD
Retainer in FPD Retainer in FPD
Retainer in FPD Hind Tabbal
 
crown lec1- principles of tooth preparation(v.good)
crown lec1- principles of tooth preparation(v.good)crown lec1- principles of tooth preparation(v.good)
crown lec1- principles of tooth preparation(v.good)Yahya Almoussawy
 
Biomechanical Principles of Tooth Preparation in FPD.ppt
Biomechanical Principles of Tooth Preparation in FPD.pptBiomechanical Principles of Tooth Preparation in FPD.ppt
Biomechanical Principles of Tooth Preparation in FPD.pptPoojaN84
 
Stainless steel crown (Dr AMBILI AYILLIATH)
Stainless steel crown (Dr AMBILI AYILLIATH)Stainless steel crown (Dr AMBILI AYILLIATH)
Stainless steel crown (Dr AMBILI AYILLIATH)MINDS MAHE
 
SEMINAR -inlay cavity designs
SEMINAR -inlay cavity designsSEMINAR -inlay cavity designs
SEMINAR -inlay cavity designsSindhuVemula1
 
Partial veneer crown preparation
Partial veneer crown preparationPartial veneer crown preparation
Partial veneer crown preparationfaezahasbullah
 
Tooth preparation
Tooth preparationTooth preparation
Tooth preparationDr Ambalika
 

Similar to Metal ceramic and partial veneer crown/certified fixed orthodontic courses by Indian dental academy (20)

tooth preparation-partial veneers
tooth preparation-partial veneerstooth preparation-partial veneers
tooth preparation-partial veneers
 
Posterior tooth preparationscertified fixed orthodontic courses by Indian den...
Posterior tooth preparationscertified fixed orthodontic courses by Indian den...Posterior tooth preparationscertified fixed orthodontic courses by Indian den...
Posterior tooth preparationscertified fixed orthodontic courses by Indian den...
 
The partial veneer crown , inlay and onlay.pptx
The partial veneer crown , inlay and onlay.pptxThe partial veneer crown , inlay and onlay.pptx
The partial veneer crown , inlay and onlay.pptx
 
Types of tooth preparations
Types of tooth preparationsTypes of tooth preparations
Types of tooth preparations
 
Partial veneer crown preparations
Partial veneer crown preparationsPartial veneer crown preparations
Partial veneer crown preparations
 
Principles of tooth preparation
Principles of tooth preparationPrinciples of tooth preparation
Principles of tooth preparation
 
posterior partial veneer crown preparation
posterior  partial veneer crown preparation posterior  partial veneer crown preparation
posterior partial veneer crown preparation
 
Complete cast crown
Complete cast crownComplete cast crown
Complete cast crown
 
Atypical Tooth Preparation.pdf
Atypical Tooth Preparation.pdfAtypical Tooth Preparation.pdf
Atypical Tooth Preparation.pdf
 
prin of tooth prep
 prin of tooth prep prin of tooth prep
prin of tooth prep
 
Onlay
OnlayOnlay
Onlay
 
3. TOOTH PREPRATION.ppt
3. TOOTH PREPRATION.ppt3. TOOTH PREPRATION.ppt
3. TOOTH PREPRATION.ppt
 
Retainer in FPD
Retainer in FPD Retainer in FPD
Retainer in FPD
 
crown lec1- principles of tooth preparation(v.good)
crown lec1- principles of tooth preparation(v.good)crown lec1- principles of tooth preparation(v.good)
crown lec1- principles of tooth preparation(v.good)
 
Biomechanical Principles of Tooth Preparation in FPD.ppt
Biomechanical Principles of Tooth Preparation in FPD.pptBiomechanical Principles of Tooth Preparation in FPD.ppt
Biomechanical Principles of Tooth Preparation in FPD.ppt
 
Stainless steel crown (Dr AMBILI AYILLIATH)
Stainless steel crown (Dr AMBILI AYILLIATH)Stainless steel crown (Dr AMBILI AYILLIATH)
Stainless steel crown (Dr AMBILI AYILLIATH)
 
SEMINAR -inlay cavity designs
SEMINAR -inlay cavity designsSEMINAR -inlay cavity designs
SEMINAR -inlay cavity designs
 
Inlay
InlayInlay
Inlay
 
Partial veneer crown preparation
Partial veneer crown preparationPartial veneer crown preparation
Partial veneer crown preparation
 
Tooth preparation
Tooth preparationTooth preparation
Tooth preparation
 

More from Indian dental academy

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian dental academy
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Indian dental academy
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeIndian dental academy
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesIndian dental academy
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Indian dental academy
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  Indian dental academy
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Indian dental academy
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesIndian dental academy
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Indian dental academy
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesIndian dental academy
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Indian dental academy
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesIndian dental academy
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Indian dental academy
 

More from Indian dental academy (20)

Indian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdomIndian Dentist - relocate to united kingdom
Indian Dentist - relocate to united kingdom
 
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...
 
Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india Invisalign -invisible aligners course in india
Invisalign -invisible aligners course in india
 
Invisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics praticeInvisible aligners for your orthodontics pratice
Invisible aligners for your orthodontics pratice
 
online fixed orthodontics course
online fixed orthodontics courseonline fixed orthodontics course
online fixed orthodontics course
 
online orthodontics course
online orthodontics courseonline orthodontics course
online orthodontics course
 
Development of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant coursesDevelopment of muscles of mastication / dental implant courses
Development of muscles of mastication / dental implant courses
 
Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  Corticosteriods uses in dentistry/ oral surgery courses  
Corticosteriods uses in dentistry/ oral surgery courses  
 
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...
 
Diagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental coursesDiagnosis and treatment planning in completely endntulous arches/dental courses
Diagnosis and treatment planning in completely endntulous arches/dental courses
 
Properties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic coursesProperties of Denture base materials /rotary endodontic courses
Properties of Denture base materials /rotary endodontic courses
 
Use of modified tooth forms in complete denture occlusion / dental implant...
Use of modified  tooth forms  in  complete denture occlusion / dental implant...Use of modified  tooth forms  in  complete denture occlusion / dental implant...
Use of modified tooth forms in complete denture occlusion / dental implant...
 
Dental luting cements / oral surgery courses  
Dental   luting cements / oral surgery courses  Dental   luting cements / oral surgery courses  
Dental luting cements / oral surgery courses  
 
Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  Dental casting alloys/ oral surgery courses  
Dental casting alloys/ oral surgery courses  
 
Dental casting investment materials/endodontic courses
Dental casting investment materials/endodontic coursesDental casting investment materials/endodontic courses
Dental casting investment materials/endodontic courses
 
Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  Dental casting waxes/ oral surgery courses  
Dental casting waxes/ oral surgery courses  
 
Dental ceramics/prosthodontic courses
Dental ceramics/prosthodontic coursesDental ceramics/prosthodontic courses
Dental ceramics/prosthodontic courses
 
Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  Dental implant/ oral surgery courses  
Dental implant/ oral surgery courses  
 
Dental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry coursesDental perspective/cosmetic dentistry courses
Dental perspective/cosmetic dentistry courses
 
Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  Dental tissues and their replacements/ oral surgery courses  
Dental tissues and their replacements/ oral surgery courses  
 

Metal ceramic and partial veneer crown/certified fixed orthodontic courses by Indian dental academy

  • 1. METAL CERAMIC CROWN Armamentarium : Preparation steps : Guiding grooves Incisal or occlusal reduction Labial or buccal reduction Axial reduction of the proximal and lingual surfaces Finishing
  • 2. Metal ceramic crown Indications : 1. Extensive tooth destruction – caries, trauma or existing previous restorations 2. The need for superior retention and strength 3. An endodontically treated tooth in conjunction with a suitable supporting structure (a post and core) 4. To recontour axial surface or correct minor malinclinations 5. Esthetics 6. If all ceramic crown is contraindicated Contraindications : 1. Patients with active caries or untreated periodontal disease 2. Young patients with large pulp chambers 3. When more conservative retainer is technically feasible 4. Intact buccal wall Advantages : 1. Superior esthetics as compared to complete cast crown. 2. Strength of cast metal is combined with the esthetics of an all ceramic crown by reinforcing a brittle, more cosmetically pleasing material through support derived from the stronger qualities are excellent. 3. excellent retentive qualities Disadvantages : 1. Removal of substantial tooth structure. 2. Subject to fracture because porcelain is brittle. 3. Difficult to obtain accurate occlusion in glazed porcelain. 4. Shade selection can be difficult. 5. Inferior esthetics compared to all ceramic crown. 6. Expensive
  • 3. 7. Potential for periodontal disease as the facial margin of an anterior restoration is often placed subgingivally. Preparation of tooth for porcelain fused to metal crown Armamentarium : 1. Round tipped rotary diamonds or carbides. 2. Foot ball or wheel shaped diamond 3. Flat – end tapered diamond 4. Finishing stones 5. Explorer and periodontal probe 6. Hatchet and chisel Step - by – step procedures : The preparation is divided into 4 major steps 1. Guiding grooves ( Depth orientation grooves) 2. Incisal or occlusal reduction 3. Labial or buccal reduction 4. Axial reduction of the proximal and lingual surfaces 5. Final finishing of all prepared surfaces Guiding grooves : Place 3 depth grooves one in the centre of the facial surface and one each in the approximate locations of the mesiofacial and distofacial line angles. Depth grooves in the facial wall are placed in2 directions. Incisally, parallel to the tooth contour cervically parallel to the path of withdrawal. The grooves should be 1.3mm deep to allow for additional reduction during finishing. Place 3 depth grooves about 1.8 mm in incisal edge of an anterior tooth to provide the needed reduction of 2 mm and allow finishing. Incisal or occlusal reduction : Tapered round-tipped diamond. The incisal reduction of an anterior tooth should be 2mm for adequate material thickness to permit translucency in the completed restoration. Posterior teeth generally require less (1.5mm) because esthetics is not as critical.
  • 4. Labial (buccal) reduction : Tapered flat – tipped diamond. The reduction of the facial surface should have sufficient space to accommodate the metal substructure and porcelain veneer. A minimum of 1.2 mm is necessary to produce restoration with satisfactory appearance (1.5mm is preferable). The cervical shoulder is established at this stage. Axial reduction of the proximal and lingual surfaces : Sufficient tooth structure must be removed to provide a distinct smooth chamfer of about 0.5 mm width. Tapered round-tipped diamond is used to provide a taper of 6 degrees convergence from cervical to incisal or occlusal. As the lingual chamfer is developed extend it buccally into the proximal to blend with the interproximal shoulder placed earlier. A foot ball shaped diamond is used to reduce the lingual surface of ant teeth approx 1mm deep to provide clearance in all excursions. Finishing : The finishing of shoulder or beveled shoulder is done with a tapered flat – tipped diamond or hand instrument. must extend at least 1mm lingual to the proximal contact area. The bevel if selected should be as far incisal as possible relative to the epithelial attachment. Tapered round – tipped diamond or carbide is used to rounded all the line angles and the completed preparation should have a satin finish free from obvious diamond scratch masks. PARTIAL VENEER CROWN Definition, types Indications Contraindications Advantages Disadvantages Armamentarium
  • 5. POSTERIOR PARTIAL VENEER CROWN Three quarter crown : Preparation steps : Occlusal reduction Axial reduction Proximal groove placement Buccocclusal contralevel Occlusal offset Finishing Seven eights crown : Preparation steps : Occlusal reduction Axial reduction Groove placement, flaring and contralevel Modified three – quarter crown : Preparation steps : Occlusal reduction Axial reduction Finishing Anterior partial veneer crown : Preparation steps : Incisal and lingual reduction Axial reduction and groove placement Incisal offset and lingual pinhole Finishing and flare Pinledge preparation : Indications Contraindications Advantages
  • 6. Disadvantages Preparation steps : Design Proximal reduction Incisal and lingual reduction Ledges and indentations Pinhole preparation Finishing Inlays : Indications Contraindications Advantages Disadvantages Armamentarium Preparation steps : Occlusal outline Proximal box Caries removal Axiogingival groove Gingival and proximal bevels Occlusal bevel Onlay : Indications Contraindications Advantages Disadvantages Preparation steps : Occlusal outline
  • 7. Proximal boxes Caries removal Occlusal reduction Centric cusp ledge Gingival and proximal bevels Occlusal bevel Partial veneer crown : An extracoronal metal restoration that covers only part of the clinical crown is considered to be a partial veneer crown. It can also be referred to as a partial coverage restoration. An intracoronal cast metal restoration is called an inlay or an onlay if one or more cusps are restored. Several types of partial veneers exist. For posterior teeth – three quarter, modified three – quarter, seven – eights crown. For anterior teeth – three quarter crown and pinledges Indications : 1. Sturdy clinical crown of average length or longer 2. Intact buccal surface not in need of contour modification and well supported by sound tooth structure. 3. No conflict between axial relationship of tooth and proposed path of withdrawal of FPD 4. Retainers for a FPD or where restoration or alteration of the occlusal surface is needed. Contraindications : 1. Short teeth 2. High caries Index 3. Extensive destruction 4. Poor alignment 5. Bulbous teeth 6. Thin teeth
  • 8. Advantages : 1. Conservative of tooth structure 2. Easy access to margins 3. Less gingival involvement than with complete cast crown 4. Easy escape of cement and good seating 5. Verification of seating simple 6. Electric vitality test feasible Disadvantages : 1. Less retentive than complete cast crown 2. Limited adjustment of path of withdrawal 3. Some display of metal Armamentarium : 1. Narrow (approx 0.8mm) round – tipped, tapered diamond (regular or coarse grit) – Bulk reduction 2. Regular – size (approx 1.2 mm), round tipped, tapered diamond (fine grit) or carbide – finishing. 3. Football shaped or wheel shaped diamond (regular grit) 4. Tapered and straight carbide fissure burs – boxes and ledges 5. Small, round carbide bur 6. Small – diameter twist drill – pinholes 7. Inverted cone carbide bur – offsets 8. Finishing stones 9. Mirror 10. Explorer and periodontal probe – assessing the direction and dimension of the various steps. 11. Chisels – finish proximal flares and bevels.
  • 9. POSTERIOR PARTIAL VENEER CROWN PREPARATION Maxillary premolars three – quarter crown The three – quarter crown preparation derives its name from the number of axial walls involved. Except for a slight bevel or chamfer placed along the buccocclusal line angle, the buccal tooth surface remains intact. The other surfaces are prepared to accommodate a casting in the same manner as a complete crown preparation, differing only in the need for axial retention grooves. Occlusal reduction : Place depth grooves for the occlusal reduction with a tapered carbide or narrow diamond in the development grooves of the mesial and distal fossae and in the crest of the triangular ridge. In the central groove they should be slight less (about 0.2 mm) than 1 mm deep to allow for finishing. On the centric (lingual) cusp they should slightly less than 1.5 mm deep in the location of the occlusal contacts. Upon completion of the occlusal reduction, a clearance of at least 1.5 mm should exist on the centric cusp and atleast 1.0 mm on the noncentric cusp and in the central groove. The buccal cusp may help obtain sufficient clearance while maintaining the original occlusocervical dimension of the tooth. Axial reduction : Place grooves for axial alignment on the center of the lingual surface and in the mesiolingual and distolingual transitional line angles. They should be parallel to the long axis of the tooth and should not exceed half the width of the tip of the diamond (chamfer depth of 0.5 mm) The proximal reduction is usually short of breaking the proximal contact. The resulting flanges should be parallel to the linguoaxial preparation, with the chamfer placed sufficiently cervical to provides atleast 0.6 mm of clearance with the adjacent tooth and the axial wall allowing for a proximal groove of at least 4 mm of length occlusocervically.
  • 10. Proximal groove placement : Tapered carbide bur is positioned against the interproximal flange parallel to the path of withdrawal and a groove is made perpendicular to the axial surface. The groove need not be deeper than 1 mm at its cervical end but may be deeper near its occlusal end. Buccoocclusal contralevel : Connect the mesial and distal flares with a narrow contralevel that follows the buccal cusp ridges. The level should remain within the curvature of the cusp tip rather than extend on to the buccal wall which can be placed with a diamond, or carbide or even a hand instrument. Primary purpose : To remove any unsupported enamel and thereby protect the buccal cusp tip from chipping during function. If group function is planned, a heavier bevel, chamfer or occlusal offset will be needed. Occlusal offset : If additional bulk is needed to ensure rigidity of the restoration, it can be provided with an occlusal offset which extends from the proximal grooves along the buccal cusp. It is essential for the structural durability of ant partial veneer crown. Finishing : Round all sharp internal line angles with a fine – grit diamond or carbide. The flares should be straight and smooth with sufficient clearance (min about 6 mm) between than and the adjacent tooth. Maxillary molar three – quarter crown : The principles used in a premolar preparation can also apply for a maxillary molar with some additional leeway may exist for groove placement because more tooth structure is present on molars than on premolars. Because of their less prominent position in the dental arch, the mesioproximal flare can sometimes be extended onto the buccal surface without increasing esthetic liability.
  • 11. Maxillary molar seven eights crown : This preparation includes in addition to the surfaces covered by the three quarter crown, the distal half of the buccal surface. Mesial aspect – Resemble three – quarter crown and is protected by a narrow contralevel or chamfer. Distal aspect – Resembles complete crown. A groove in the middle of the buccal surface is placed parallel to the path of withdrawal. Distal to this groove, the buccal surface is reduced in 2 planes. The cervical paralleling the path withdrawal. Occlusal following the normal anatomic contour. The lingual surface is also reduced in 2 planes and the centric cusp levels are incorporated. Occlusal reduction : Min measurement are the same as for the three quarter crown preparation. To delineate the extent of the lingual centric cusp bevel, they should extend onto the lingual surface of the tooth. On the lingual incline of the MB cups they will resemble depth cuts for the three – quarter crown. On the DB cusp they should be approx 0.8mm deep to provide sufficient occlusal clearance for this noncentric cusp. Concave shaping of the resulting MB incline may again prove useful because it will permit the occlusocervical height of the cusp to be maintained. When completed this bevel should provide 1.5 mm of clearance in the ICP as well as the excursive movements of the mandible. Axial reduction : Place 3 alignment groove in the lingual wall and transfer the selected path of withdrawal to the DB transitional line angle area, where a 4th alignment groove can be placed. Start the reduction in the middle of the lingual surface. The mesial half is prepared like a three – quarter crown the distal half like a complete crown.
  • 12. Carry the facial reduction sufficiently mesial to include the buccal groove. Groove placement, flaring and contrabevel : Place the mesial groove like the three – quarter crown place the buccal groove parallel to the mesial groove and perpendicular to the buccoaxial wall. Connect the 2 grooves with a smooth contrabevel that follows the ridge of the MB cusp. Adequate clearance must be established interproximally upon completion. Mandibular premolar modified three – quarter crown : Mandibular partial veneer preparations are made more often on premolars than on molars. They differ from maxillary molar three – quarter crown preparations in 2 respect. Additional retention is required because of the shorter crown lengths of mandibular teeth. The axial surface that is not prepared (the buccal) includes one functional cusp. This means that additional tooth structure must be removed to provide sufficient bulk of metal for strength. Occlusal reduction : Place 0.8 mm depth grooves on the buccal inclines of the lingual cusps and 1.3 mm grooves on the lingual inclines of the buccal cusp. These guiding grooves are once again placed to follow the basic groove and fissure pattern of the occlusal surface. Arial reduction : Place guiding grooves on the lingual surface to parallel the proposed path of withdrawal and the long axis of the tooth. Prepare the mesial as already described for the three – quarter and seven - eights crown.
  • 13. Reduce the distal surface as for a complete crown extending the preparation to the transitional line angle and onto the buccal surface. Finishing : Place the mesial and buccal grooves as described for the seven – eights crown. Another distal groove may be placed. To gain as much length as possible, the grooves of the three-quarter crown should be slightly buccal. Distal groove is slightly close to the center of the distal wall. Connect the mesial and buccal grooves with a centric cusp chamfer which must be heavy enough to allow 1.5 mm of clearance in the area of occlusal contact. A regular or thick diamond is used to place the chamfer which should provide a protective “staple” linkage of alloy in the completed restoration. Finally, all prepared surfaces are smoothed and the internal line angles rounded. Anterior partial veneer crown preparation : Maxillary canine three – quarter crown On a maxillary canine it involves the proximal and lingual surfaces and leaves the facial surface intact. Incisal and lingual reduction : Place depth grooves for both the incisal bevel and the lingual reduction. The incisal bevel makes an angle of approx 45 degrees with the long axis of the tooth. It is prepared with a round – tipped diamond which allows for metal thickness 0.7 mm. The design of the incisal bevel should prevent contact between opposing teeth and the incisal margin. The original configuration of the facial surface should be presented. The lingual reduction is done with a foot ball or wheel – shaped diamond and it should have 1mm of clearance for metal. Axial reduction and groove placement : To enhance the retention and resistance form, place a slightly exaggerated chamfer on the lingual aspect
  • 14. of the tooth and a guiding groove in the middle of the lingual wall. The groove is placed with a round – tipped diamond which allows for 0.5 mm of metal thickness at margin. The axial reduction extends into interproximal about 0.4 mm lingual of contact area and it should be parallel to incisal two thirds of labial surface. Incisal offset and lingual pinhole : Anterior PVC require a means of reinforcement for preserving the casting’s integrity, so on incisal offset or groove is needed to create a band of thicker metal to provide a “staple configuration” which provides additional rigidity and resistance against bending of the casting. An inverted cone diamond or carbide is used to prepare the offset by connecting the mesial and distal groove. It prevent against lingual displacement and should have a V configuration. Pin-hole is placed in the cingulerm area lightly off enter to improve the retention and resistance of the preparation and it should be approx 2mm which is prepared with a tapered carbide fissure bur and half round bur. Proximal grooves should parallel to incisal two thirds of labial surface and it should resists lingual displacement. Lingual wall of groove meets proximal wall at angle of 900 degrees with a Tapered carbide. Fissure bur and half round bur. Finishing and flare : Fine – grit tapered diamonds (large and small) or carbide are used for finishing. All surfaces should be smooth and the buccal wall of groove flared to break proximal contact resulting is a cavosarface angle of 900 with no unsupported enamel remaining. Pinledge preparation : Indications : 1. Undamaged anterior teeth in caries – free mouth 2. Alteration of lingual contour of maxillary anterior teeth or alteration of occlusion.
  • 15. 3. Anterior splinting Contain dictations : 1. Poor oral hygiene 2. Large pulps 3. Thin teeth 4. Nonvital teeth 5. Carious involvement 6. Problems with proposed path of withdrawal of FPD Advantages : 1. Minimal tooth reduction 2. Minimal margin length 3. Minimum gingival involvement 4. Optimum access for margin finishing and hygiene 5. Adequate retention Disadvantages : 1. Less retentive than complete coverage 2. Alignment can prove difficult 3. Technically demanding 4. Not usable on nonvital teeth Maxillary Central Incisor pinledge : Three designs of pinledge preparations 1. Conventional pinledge involving only the lingual surface of the tooth 2. Pinledge with a proximal slice 3. Pinledge with a proximal groove Design : A line is marked along the height of contour of the incisal edge and on the proximal wall to include the area needed for a connector, The lingual chamfer is placed immediately adjacent to the crest of the marginal ridge.
  • 16. Proximal Reduction : Prepare the proximal slice with a tapered diamond. The primary purpose is to provide sufficient reduction to allow adequate metal in the area for a subsequent connector. Incisal and lingual reduction : Prepared the incisal bevel with the diamond inclined slightly toward the lingual. Sufficient clearance provides functional contact on metal rather than on the junction between metal and tooth structure. The desired metal thickness is 1mm, except in the area close to the margin. Perform the lingual reduction with a football – or wheel – shaped diamond. Metal thickness of 1mm is required in the ICP and throughout excursive movements. Ledges and indentations : The ledges are prepared with a straight carbide fissure bur with the ledges parallel to one another when viewed from lingual and from incisal. Maximum width is 1mm. The incisal edge is 2 to 2.5 mm cervical to the incisal edge or one fourth of the total height of the preparation from the incisal edge. The cervical ledge is placed on the crest of the cingulum at the centre of the cervical ¼ th of the of preparation. The indentations are prepared with a straight. Carbide fissure bur in the left and right sides of the incisal ledge and slightly off center in the cervical ledge to prevent subsequent pulp exposure when the pinholes are placed. The indentation should provide at lest 0.5 mm of space for metal reinforcement around opening of pinhole. Pinhole preparation : Sink pilot channels with either a small round bur or a small twist drill. Pinholes are prepared with a tapered carbide bur and it must be between 2 and 3 mm deep. The minimal width of ledge around pinholes is 0.5 mm
  • 17. Bevel the junction between pinhole and indentation with a round bur slightly large than the largest diameter of the pinhole. Finishing : It is done with finishing stones on carbides. All surface must be as smooth as possible to facilitate removal of this delicate wax pattern from die. INLAYS Indications : 1. Small carious lesion in otherwise sound tooth 2. Adequate dentinal support 3. Low carries rate 4. Patient’s request for gold instead of amalgam or composite resin. Contraindications : 1. High caries Index 2. Poor plaque control 3. Small teeth 4. Adolescents 5. Poor dentinal support requiring a wide preparations Advantages : 1. Superior material properties 2. Longevity 3. No discoloration from corrosion 4. Least complex cast restoration Disadvantages : 1. Less conservative than amalgam 2. May display metal 3. Gingival extension beyond ideal 4. “Wedge” retention
  • 18. Class II inlay preparation : Armamentarium : Carbide burs are usually used for inlay or only preparation, but diamonds can be substituted if preferred : 1. Tapered carbide burs 2. Round carbide burs 3. Cylindrical carbide burs 4. Finishing stones 5. Mirror 6. Explorer and periodontal probe 7. Chisels 8. Hatchet 9. Gingival margin trimmers 10. Excavators 11. High – and low – speed handpieces 12. Articulating film Occlusal outline : It is prepared with a tapered carbide which includes the central groove, avoids centric contacts, includes dovetail or pinhole for resistance, approx 1.8 mm deep. Proximal box : It is done with a tapered carbide bur and it follows the curvature of the original tooth structure. Caries removal ; Carries is removed with a excavator or round bur and a place a cement base to restore the excavated tissue in the axial wall or pulpal floor. Axiogingival groove : It is placed with a gingival margin trimmer at the junction of axial and gingival walls at the base of the proximal box to enhance resistance form and prevent distortion of the wax pattern during manipulation and is 0.2 mm deep. Gingival and proximal bevels : Are placed with a thin, tapered carbide or diamond. The gingival bevel is at 45 – degrees and it should be 0.8 mm
  • 19. wide. Proximal bevels are prepared on the buccal and lingual walls with the tapered bur oriented in the path of withdrawal. Occlusal bevel : It is prepared with a round carbide or stone to create a hollow – ground bevel or chamfer and to avoid. Centric contacts. The occlusal bevel should improve marginal fit and allow finishing of the restorations. MOD Onlay: Indications : 1. Worn on carious teeth with intact buccal and lingual cusp. 2. MOD amalgam requiring replacement. 3. Low carries rate. 4. Patients; request for gold instead of amalgam Contraindications : 1. High caries Index. 2. Poor plaque control. 3. Short clinical crown or extruded teeth. 4. Lesions extending beyond transitional line angles. Advantages : 1. Support of cusps 2. High strength 3. Longevity Disadvantages : 1. Lacks retention 2. Less conservation than amalgam 3. May display metal 4. Gingival extension beyond ideal Mod onlay preparation : Occlusal outline : It includes the central, buccal and lingual grooves and it is about 1.8 mm deep and done with a tapered carbide bur.
  • 20. Proximal bones : are prepared with a tapered carbide bur and it follows the curvature of the original tooth structure. Carries removal : Carries are removed by a excavator or round bur and the tissues are replaced with base and to allow adequate dentin for resistance and retention. Occlusal Reduction : It should follow anatomic contours and it is about 1.5 mm deep on centric cusp and 1.0 mm on the noncentric cusps and done with a tapered carbide bur. Centric cusp ledge : It should be about 1.00 mm wide (before beveling ) and about 1.0 mm apical to centric contact done with a tapered carbide bur. Gingival and proximal bevels : It is done with a thin, tapered carbide and should be about 45 degrees and 0.8 mm wide Bevel the noncentric and centric cusps. Where additional bulk at the margin is needed, a chamfer should be substituted for the straight bevel with a round – tipped diamond. Complete the preparation by rechecking the occlusal clearance in all excursions and assessing for smoothness