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PRINCIPLES OF TOOTH
PREPARATION
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
PRINCIPLES OF TOOTH
PREPARATION
1. PRESERVATION OF TOOTH
STRUCTURE.
2. RETENTION AND RESISTANCE.
3. STRUCTURAL DURABILITY.
4. MARGINAL INTEGRITY.
5. PRESERVATION OF PERIODONTIUM
www.indiandentalacademy.com
PRESERVATION OF TOOTH
STRUCTURE
• Partial veneer
versus Full veneer
crown
• Supra-gingival
margin versus sub-
gingival.
www.indiandentalacademy.com
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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).
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
RETENTION AND RESISTANCE
1. Taper
2. Freedom of
displacement
3. Length
4. Substitution of
internal features
5. Path of insertion
www.indiandentalacademy.com
TAPER
• Theoretically, the
more nearly parallel
the opposing walls
of a preparation, the
greater is the
retention.
www.indiandentalacademy.com
TAPER
• Tooth preparation
taper should be kept
minimum because of
its adverse effect on
retention.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
STRUCTURAL DURABILITY
1. Occlusal reduction.
2. Functional cusp
bevel.
3. Axial reduction.
www.indiandentalacademy.com
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. www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.www.indiandentalacademy.com
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
www.indiandentalacademy.com
MARGINAL INTEGRITY
• The restoration
margin should closely
adapt to the
cavosurface finish line
of the preparation to
survive in the oral
cavity.
www.indiandentalacademy.com
MARGINAL INTEGRITY
• TO BEVEL,
OR ….
NOT TO BEVEL
www.indiandentalacademy.com
FINISH LINE CONFIGURATION
1. Chamfer
2. Heavy chamfer
3. Shoulder
4. Radial shoulder
5. Shoulder with bevel
6. Knife edge
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
PREPARATION FOR FULL
VENEER CROWN
PP- 139-141
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
FULL VENEER CROWN
Variations of the full veneer crown are
1. Metal-ceramic crown.
2. All-ceramic crown.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
Full Metal Crown Preparation
OCCLUSAL CLEARANCE :
Is checked by having the
patient to close on red
utility wax held over the
preparation.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
Full Metal Crown
Preparation
STEP NO : 4
Initial proximal axial
reduction with short
needle diamond
followed by the round-
end tapered diamond.
www.indiandentalacademy.com
Full Metal Crown Preparation
STEP NO : 6
Seating groove with
171L bur.
www.indiandentalacademy.com
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.
www.indiandentalacademy.com
Full Veneer Crown Preparation
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com

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Principles of tooth preparation (2)/ orthodontic seminars

  • 1. PRINCIPLES OF TOOTH PREPARATION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. PRINCIPLES OF TOOTH PREPARATION 1. PRESERVATION OF TOOTH STRUCTURE. 2. RETENTION AND RESISTANCE. 3. STRUCTURAL DURABILITY. 4. MARGINAL INTEGRITY. 5. PRESERVATION OF PERIODONTIUM www.indiandentalacademy.com
  • 3. PRESERVATION OF TOOTH STRUCTURE • Partial veneer versus Full veneer crown • Supra-gingival margin versus sub- gingival. www.indiandentalacademy.com
  • 5. 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. www.indiandentalacademy.com
  • 6. 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). www.indiandentalacademy.com
  • 7. 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. www.indiandentalacademy.com
  • 8. RETENTION AND RESISTANCE 1. Taper 2. Freedom of displacement 3. Length 4. Substitution of internal features 5. Path of insertion www.indiandentalacademy.com
  • 9. TAPER • Theoretically, the more nearly parallel the opposing walls of a preparation, the greater is the retention. www.indiandentalacademy.com
  • 10. TAPER • Tooth preparation taper should be kept minimum because of its adverse effect on retention. www.indiandentalacademy.com
  • 11. 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. www.indiandentalacademy.com
  • 12. 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. www.indiandentalacademy.com
  • 13. STRUCTURAL DURABILITY 1. Occlusal reduction. 2. Functional cusp bevel. 3. Axial reduction. www.indiandentalacademy.com
  • 14. 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. www.indiandentalacademy.com
  • 15. 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. www.indiandentalacademy.com
  • 16. 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. www.indiandentalacademy.com
  • 17. 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. www.indiandentalacademy.com
  • 18. 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. www.indiandentalacademy.com
  • 19. 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.www.indiandentalacademy.com
  • 20. 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 www.indiandentalacademy.com
  • 21. MARGINAL INTEGRITY • The restoration margin should closely adapt to the cavosurface finish line of the preparation to survive in the oral cavity. www.indiandentalacademy.com
  • 22. MARGINAL INTEGRITY • TO BEVEL, OR …. NOT TO BEVEL www.indiandentalacademy.com
  • 23. FINISH LINE CONFIGURATION 1. Chamfer 2. Heavy chamfer 3. Shoulder 4. Radial shoulder 5. Shoulder with bevel 6. Knife edge www.indiandentalacademy.com
  • 24. 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. www.indiandentalacademy.com
  • 25. 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. www.indiandentalacademy.com
  • 26. 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. www.indiandentalacademy.com
  • 27. 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. www.indiandentalacademy.com
  • 28. PREPARATION FOR FULL VENEER CROWN PP- 139-141 www.indiandentalacademy.com
  • 29. 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. www.indiandentalacademy.com
  • 30. FULL VENEER CROWN Variations of the full veneer crown are 1. Metal-ceramic crown. 2. All-ceramic crown. www.indiandentalacademy.com
  • 31. 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. www.indiandentalacademy.com
  • 32. 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. www.indiandentalacademy.com
  • 33. 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 www.indiandentalacademy.com
  • 34. 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. www.indiandentalacademy.com
  • 35. 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. www.indiandentalacademy.com
  • 36. 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. www.indiandentalacademy.com
  • 37. 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. www.indiandentalacademy.com
  • 38. Full Metal Crown Preparation OCCLUSAL CLEARANCE : Is checked by having the patient to close on red utility wax held over the preparation. www.indiandentalacademy.com
  • 39. 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. www.indiandentalacademy.com
  • 40. Full Metal Crown Preparation STEP NO : 4 Initial proximal axial reduction with short needle diamond followed by the round- end tapered diamond. www.indiandentalacademy.com
  • 41. Full Metal Crown Preparation STEP NO : 6 Seating groove with 171L bur. www.indiandentalacademy.com
  • 42. 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. www.indiandentalacademy.com
  • 43. Full Veneer Crown Preparation www.indiandentalacademy.com