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PRINCIPLES OF TOOTH
     PREPARION
PRINCIPLES OF TOOTH
       PREPARATION

1. PRESERVATION OF TOOTH
   STRUCTURE.
2. RETENTION AND RESISTANCE.
3. STRUCTURAL DURABILITY.
4. MARGINAL INTEGRITY.
5. PRESERVATION OF PERIODONTIUM
PRESERVATION OF TOOTH
         STRUCTURE

• Partial veneer
  versus Full veneer
  crown

• Supra-gingival
  margin versus sub-
  gingival.
RETENTION AND RESISTANCE
• Retention prevents removal of
  the restoration along the path of
  insertion or long axis of the
  tooth preparation.

• Resistance prevents
  dislodgement of the restoration
  by forces directed in an apical
  or oblique direction and
  prevents any movement of the
  restoration under occlusal
  forces.

•    Retention and resistance are
    interrelated and often
    inseparable qualities.
RETENTION

• The essential element
  of retention is two
  opposing vertical
  surfaces of the same
  preparation.
• These may be
  external surfaces
  such as the buccal
  and lingual walls of a
  full veneer crown
  (sleeve retention).
RETENTION
• The opposing surfaces
  can also be internal,
  such as the buccal and
  lingual walls of the
  proximal box of a inlay.

• An intracoronal
  restoration resists
  displacement by wedge
  retention.

• Many restorations are a
  combination of the two
  types.
RETENTION AND RESISTANCE


1. Taper
2. Freedom of
   displacement
3. Length
4. Substitution of
   internal features
5. Path of insertion
TAPER


• Theoretically, the
  more nearly parallel
  the opposing walls
  of a preparation, the
  greater is the
  retention.
TAPER


• Tooth preparation
  taper should be kept
  minimum because of
  its adverse effect on
  retention.
TAPER
• Optimum taper or total
  convergence of 16
  degrees achievable
  clinically while still
  affording adequate
  retention.

• Low as 10 degrees on
  anterior teeth and as
  high as 22 degrees on
  molar teeth.
STRUCTURAL DURABILITY




• Restoration must contain bulk of material that is
  adequate to withstand the forces of occlusion.
• This bulk must be confined to the space created
  by the tooth preparation.
• Only this way the occlusion will be harmonious
  and axial contours normal.
STRUCTURAL DURABILITY


1. Occlusal reduction.
2. Functional cusp
   bevel.
3. Axial reduction.
STRUCTURAL DURABILITY
• Occlusal reduction : One of
  the most important features
  for providing adequate bulk
  of metal and strength to the
  restoration is occlusal
  clearance.
• For gold alloys- 1.5 mm
  clearance on the functional
  cusp (lingual of maxillary
  molars and premolars and
  buccal of mandibular molars
  and premolars ).
• 1mm clearance on the
  nonfunctional cusp.
Occlusal Reduction
• The basic inclined
  plane pattern of the
  occlusal surface
  duplicated to produce
  adequate clearance
  without over
  shortening the
  preparation.
• A flat occlusal surface
  may over shorten the
  preparation.
Inadequate Occlusal Reduction



 • Makes the restoration weaker.
 • will not provide adequate space to allow
   good functional morphology under the
   anatomical grooves.
 • The restoration easily perforated by
   finishing procedures or by wear in the
   mouth.
FUNCTIONAL CUSP BEVEL

• An integral part of
  occlusal reduction is the
  functional cusp bevel.
• A wide bevel placed on
  the functional cusp
  provides space for an
  adequate bulk of metal in
  an area of heavy occlusal
  contact.
Functional Cusp Bevel
Lack of functional cusp bevel may
   produce several problems :
1. Can cause a thin area or
   perforation.
2. May result in over contouring
   and poor occlusion
3. Over inclination of the buccal
   surface will destroy excessive
   tooth structure reducing
   retention.
AXIAL REDUCTION



• Plays an important role in securing space
  for an adequate thickness of the
  restorative material.
• Inadequate axial reduction will have thin
  walls subject to distortion or result in over
  contouring the axial surface which could
  lead to periodontal problems.
STRUCTURAL DURABILTY
•    There are other
     features that serve to
     provide space for metal
     that will improve the
     rigidity and durability of
     the restoration:
1.   Offset
2.   Occlusal shoulder
3.   Isthmus
4.   Proximal groove
5.   Box
MARGINAL INTEGRITY

• The restoration
  margin should closely
  adapt to the
  cavosurface finish line
  of the preparation to
  survive in the oral
  cavity.
MARGINAL INTEGRITY


• TO BEVEL,
OR ….
NOT TO BEVEL
FINISH LINE CONFIGURATION
1.   Chamfer
2.   Heavy chamfer
3.   Shoulder
4.   Radial shoulder
5.   Shoulder with bevel
6.   Knife edge
CHAMFER
•   The preferred gingival
    finish line for full veneer
    metal restoration.
•   This finish line exhibit
    least stress to the
    underlying cement.
•   It can be cut with round-
    end tapered diamond.
•   Conservative type when
    compared with shoulder
    finish line.
PRESERVATION OF THE
       PERIODONTIUM

• The placement of finish lines has a direct
  bearing on the ease of fabrication and the
  ultimate success of the restoration.
• The best results can be expected from
  margins that are as smooth as possible
  and are fully exposed to cleansing action.
MARGIN PLACEMENT
• Whenever possible the
  finish line should be
  placed in an area where
  the margins can be
  finished by the dentist
  easily and kept clean by
  the patient.
• In addition,finish lines
  must be placed so that
  they can be duplicated by
  the impression without
  tearing or deformation.
MARGIN PLACEMENT
•    Finish line should be
     placed in enamel
     whenever possible.
•    Supra-gingival versus
     sub-gingival margin.
•    Many situations in
     which sub-gingival
     margins are
     unavoidable.
1.   Caries
2.   To increase retention
3.   Esthetics
4.   Extension of previous
     restoration
5.   Trauma.
PREPARATION FOR FULL
   VENEER CROWN


      PP- 139-141
PREPARATION FOR FULL
       VENEER CROWNS
SELECTION
Full veneer crown exhibits superior retention
 and resistance when compared with
 partial veneer crown.
Selection becomes mandatory when the
 abutment tooth is small and the
 edentulous span is long.
FULL VENEER CROWN

Variations of the full veneer crown are
1. Metal-ceramic crown.
2. All-ceramic crown.
FULL VENEER CROWN
INDICATIONS :
1. Extensive coronal destruction due to
   caries or trauma.
2. Endodontically treated tooth.
3. Necessity for maximum retention and
   strength.
4. To correct minor malinclination.
5. To correct occlusal plane.
FULL VENEER CROWN
Contra-indication :
Full coverage should not be used in mouths
   with uncontrolled caries.
It does not protect the tooth against the
   biological causes of caries.
Caries must be controlled by other means
   before any restoration can be successful.
FULL METAL CROWN
             PREPARATION
ARMAMENTARIUM :
1. Hand piece
2. No : 171L bur
3. Round-end tapered
   diamond
4. Short needle diamond
5. Torpedo diamond
6. Torpedo bur
7. Red utility wax
FULL METAL CROWN
           PREPARATION
STEP NO :1
OCCLUSAL REDUCTION
1.5 mm of clearance of
   functional cusp and 1mm
   on the nonfunctional
   cusp.
Depth orientation grooves
   are placed on the
   occlusal surface with
   round end tapered
   diamond.
Full metal crown preparation
• Occlusal reduction :
A round-end tapered
    diamond is used to place
    the grooves on the ridges
    and the primary grooves
    of the occlusal surface.
If there is already some
    clearance with the
    opposing tooth because
    of malposition- grooves
    should not be made as
    deep.
Full Metal Crown Preparation

OCCLUSAL REDUCTION :
The occlusal reduction
  should follow the
  configuration of the
  geometric inclines that
  make the occlusal surface
  of any posterior teeth.
Full Metal Crown Preparation
STEP NO : 2
Functional cusp bevel with
  round-end tapered
  diamond.
A wide bevel is placed on
  the functional cusp-depth
  orientation grooves are
  also helpful in this
  reduction.
Functional cusp bevel is
  integral part of occlusal
  reduction.
Failure to place this bevel
  can produce thin casting
  or poor morphology.
Full Metal Crown Preparation
OCCLUSAL CLEARANCE :

Is checked by having the
   patient to close on red
   utility wax held over the
   preparation.
Full Metal Crown
                       Prep
STEP NO : 3
Buccal and lingual walls are
  reduced with the round-
  end tapered diamond.The
  sides of the diamond will
  produce the desired axial
  reduction while the tip
  forms the chamfer.
Full Metal Crown
  Preparation

 STEP NO : 4
   Initial proximal axial
  reduction with short
  needle diamond
  followed by the round-
  end tapered diamond.
Full Metal Crown Preparation


STEP NO : 6
Seating groove with
  171L bur.
Full Veneer Crown Preparation
STEP NO : 5
Axial finishing- round-
  end tapered diamond.
All axial surfaces are
  smoothed including
  all point angles. The
  finish line should be
  smooth and
  continuous.
Full Veneer Crown Preparation
 prin of tooth prep
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prin of tooth prep

  • 2. PRINCIPLES OF TOOTH PREPARATION 1. PRESERVATION OF TOOTH STRUCTURE. 2. RETENTION AND RESISTANCE. 3. STRUCTURAL DURABILITY. 4. MARGINAL INTEGRITY. 5. PRESERVATION OF PERIODONTIUM
  • 3. PRESERVATION OF TOOTH STRUCTURE • Partial veneer versus Full veneer crown • Supra-gingival margin versus sub- gingival.
  • 4. RETENTION AND RESISTANCE • Retention prevents removal of the restoration along the path of insertion or long axis of the tooth preparation. • Resistance prevents dislodgement of the restoration by forces directed in an apical or oblique direction and prevents any movement of the restoration under occlusal forces. • Retention and resistance are interrelated and often inseparable qualities.
  • 5. RETENTION • The essential element of retention is two opposing vertical surfaces of the same preparation. • These may be external surfaces such as the buccal and lingual walls of a full veneer crown (sleeve retention).
  • 6. RETENTION • The opposing surfaces can also be internal, such as the buccal and lingual walls of the proximal box of a inlay. • An intracoronal restoration resists displacement by wedge retention. • Many restorations are a combination of the two types.
  • 7. RETENTION AND RESISTANCE 1. Taper 2. Freedom of displacement 3. Length 4. Substitution of internal features 5. Path of insertion
  • 8. TAPER • Theoretically, the more nearly parallel the opposing walls of a preparation, the greater is the retention.
  • 9. TAPER • Tooth preparation taper should be kept minimum because of its adverse effect on retention.
  • 10. TAPER • Optimum taper or total convergence of 16 degrees achievable clinically while still affording adequate retention. • Low as 10 degrees on anterior teeth and as high as 22 degrees on molar teeth.
  • 11. STRUCTURAL DURABILITY • Restoration must contain bulk of material that is adequate to withstand the forces of occlusion. • This bulk must be confined to the space created by the tooth preparation. • Only this way the occlusion will be harmonious and axial contours normal.
  • 12. STRUCTURAL DURABILITY 1. Occlusal reduction. 2. Functional cusp bevel. 3. Axial reduction.
  • 13. STRUCTURAL DURABILITY • Occlusal reduction : One of the most important features for providing adequate bulk of metal and strength to the restoration is occlusal clearance. • For gold alloys- 1.5 mm clearance on the functional cusp (lingual of maxillary molars and premolars and buccal of mandibular molars and premolars ). • 1mm clearance on the nonfunctional cusp.
  • 14. Occlusal Reduction • The basic inclined plane pattern of the occlusal surface duplicated to produce adequate clearance without over shortening the preparation. • A flat occlusal surface may over shorten the preparation.
  • 15. Inadequate Occlusal Reduction • Makes the restoration weaker. • will not provide adequate space to allow good functional morphology under the anatomical grooves. • The restoration easily perforated by finishing procedures or by wear in the mouth.
  • 16. FUNCTIONAL CUSP BEVEL • An integral part of occlusal reduction is the functional cusp bevel. • A wide bevel placed on the functional cusp provides space for an adequate bulk of metal in an area of heavy occlusal contact.
  • 17. Functional Cusp Bevel Lack of functional cusp bevel may produce several problems : 1. Can cause a thin area or perforation. 2. May result in over contouring and poor occlusion 3. Over inclination of the buccal surface will destroy excessive tooth structure reducing retention.
  • 18. AXIAL REDUCTION • Plays an important role in securing space for an adequate thickness of the restorative material. • Inadequate axial reduction will have thin walls subject to distortion or result in over contouring the axial surface which could lead to periodontal problems.
  • 19. STRUCTURAL DURABILTY • There are other features that serve to provide space for metal that will improve the rigidity and durability of the restoration: 1. Offset 2. Occlusal shoulder 3. Isthmus 4. Proximal groove 5. Box
  • 20. MARGINAL INTEGRITY • The restoration margin should closely adapt to the cavosurface finish line of the preparation to survive in the oral cavity.
  • 21. MARGINAL INTEGRITY • TO BEVEL, OR …. NOT TO BEVEL
  • 22. FINISH LINE CONFIGURATION 1. Chamfer 2. Heavy chamfer 3. Shoulder 4. Radial shoulder 5. Shoulder with bevel 6. Knife edge
  • 23. CHAMFER • The preferred gingival finish line for full veneer metal restoration. • This finish line exhibit least stress to the underlying cement. • It can be cut with round- end tapered diamond. • Conservative type when compared with shoulder finish line.
  • 24. PRESERVATION OF THE PERIODONTIUM • The placement of finish lines has a direct bearing on the ease of fabrication and the ultimate success of the restoration. • The best results can be expected from margins that are as smooth as possible and are fully exposed to cleansing action.
  • 25. MARGIN PLACEMENT • Whenever possible the finish line should be placed in an area where the margins can be finished by the dentist easily and kept clean by the patient. • In addition,finish lines must be placed so that they can be duplicated by the impression without tearing or deformation.
  • 26. MARGIN PLACEMENT • Finish line should be placed in enamel whenever possible. • Supra-gingival versus sub-gingival margin. • Many situations in which sub-gingival margins are unavoidable. 1. Caries 2. To increase retention 3. Esthetics 4. Extension of previous restoration 5. Trauma.
  • 27. PREPARATION FOR FULL VENEER CROWN PP- 139-141
  • 28. PREPARATION FOR FULL VENEER CROWNS SELECTION Full veneer crown exhibits superior retention and resistance when compared with partial veneer crown. Selection becomes mandatory when the abutment tooth is small and the edentulous span is long.
  • 29. FULL VENEER CROWN Variations of the full veneer crown are 1. Metal-ceramic crown. 2. All-ceramic crown.
  • 30. FULL VENEER CROWN INDICATIONS : 1. Extensive coronal destruction due to caries or trauma. 2. Endodontically treated tooth. 3. Necessity for maximum retention and strength. 4. To correct minor malinclination. 5. To correct occlusal plane.
  • 31. FULL VENEER CROWN Contra-indication : Full coverage should not be used in mouths with uncontrolled caries. It does not protect the tooth against the biological causes of caries. Caries must be controlled by other means before any restoration can be successful.
  • 32. FULL METAL CROWN PREPARATION ARMAMENTARIUM : 1. Hand piece 2. No : 171L bur 3. Round-end tapered diamond 4. Short needle diamond 5. Torpedo diamond 6. Torpedo bur 7. Red utility wax
  • 33. FULL METAL CROWN PREPARATION STEP NO :1 OCCLUSAL REDUCTION 1.5 mm of clearance of functional cusp and 1mm on the nonfunctional cusp. Depth orientation grooves are placed on the occlusal surface with round end tapered diamond.
  • 34. Full metal crown preparation • Occlusal reduction : A round-end tapered diamond is used to place the grooves on the ridges and the primary grooves of the occlusal surface. If there is already some clearance with the opposing tooth because of malposition- grooves should not be made as deep.
  • 35. Full Metal Crown Preparation OCCLUSAL REDUCTION : The occlusal reduction should follow the configuration of the geometric inclines that make the occlusal surface of any posterior teeth.
  • 36. Full Metal Crown Preparation STEP NO : 2 Functional cusp bevel with round-end tapered diamond. A wide bevel is placed on the functional cusp-depth orientation grooves are also helpful in this reduction. Functional cusp bevel is integral part of occlusal reduction. Failure to place this bevel can produce thin casting or poor morphology.
  • 37. Full Metal Crown Preparation OCCLUSAL CLEARANCE : Is checked by having the patient to close on red utility wax held over the preparation.
  • 38. Full Metal Crown Prep STEP NO : 3 Buccal and lingual walls are reduced with the round- end tapered diamond.The sides of the diamond will produce the desired axial reduction while the tip forms the chamfer.
  • 39. Full Metal Crown Preparation STEP NO : 4 Initial proximal axial reduction with short needle diamond followed by the round- end tapered diamond.
  • 40. Full Metal Crown Preparation STEP NO : 6 Seating groove with 171L bur.
  • 41. Full Veneer Crown Preparation STEP NO : 5 Axial finishing- round- end tapered diamond. All axial surfaces are smoothed including all point angles. The finish line should be smooth and continuous.
  • 42. Full Veneer Crown Preparation