Dr shabeel's presentations Dr shabeel's presentations
!N!T!AL PREPARAT!ON !N!T!AL PREPARAT!ON
1. 1. OCCLUSAL REDUCT!ON OCCLUSAL REDUCT!ON F!RST STEP !S THE REDUCT!ON OF THE CUSPS F!RST STEP !S THE REDUCT!ON OF THE CUSPS WH!CH !NPROvES THE WH!CH !NPROvES THE ACCESS AND v!S!B!L!TY FOR SUBSEQUENT STEPS ACCESS AND v!S!B!L!TY FOR SUBSEQUENT STEPS !N TOOTH PREPARAT!ON. !N TOOTH PREPARAT!ON. EFFEC!ENCY OF THE CUTT!NC !NSTRUNENT AND EFFEC!ENCY OF THE CUTT!NC !NSTRUNENT AND THE A!R THE A!RWATER COOL!NC SPRAY. WATER COOL!NC SPRAY. !T !S EAS!ER TO ASSESS THE HE!CHT OF THE !T !S EAS!ER TO ASSESS THE HE!CHT OF THE RENA!N!NC CL!N!CAL CROWN OF THE TOOTH. RENA!N!NC CL!N!CAL CROWN OF THE TOOTH. US!NC THE NO.271 US!NC THE NO.271 CARB!DE BUR HELD CARB!DE BUR HELD PARALLEL TO THE LONC PARALLEL TO THE LONC AX!S OF THE CROWN, AX!S OF THE CROWN, PREPARE 2 mm DEEP PREPARE 2 mm DEEP PULPAL FLOOR ALONC PULPAL FLOOR ALONC THE CENTRAL CROOvE. THE CENTRAL CROOvE. THE OCCLUSAL THE OCCLUSAL PREPARAT!ON !S PREPARAT!ON !S EXTENDED FAC!ALLY EXTENDED FAC!ALLY AND L!NCUALLY ]UST AND L!NCUALLY ]UST BEYOND THE CAR!ES TO BEYOND THE CAR!ES TO SOUND TOOTH SOUND TOOTH STRUCTURE, TO vER!FY STRUCTURE, TO vER!FY NEED FOR CUSP NEED FOR CUSP CAPP!NC. CAPP!NC. W!TH THE S!DE OF THE W!TH THE S!DE OF THE NO.271 CARB!DE BUR, NO.271 CARB!DE BUR, PREPARE UN!FORN 1.S PREPARE UN!FORN 1.S mm DEEP DEPTH CUTS mm DEEP DEPTH CUTS ON THE RENA!N!NC ON THE RENA!N!NC OCCLUSAL SURFACE. OCCLUSAL SURFACE. THEY ARE USUALLY THEY ARE USUALLY PLACED ON THE CREST PLACED ON THE CREST OF THE TR!ANCULAR OF THE TR!ANCULAR R!DCES AND !N THE R!DCES AND !N THE FAC!AL AND L!NCUAL FAC!AL AND L!NCUAL CROOvE REC!ONS. CROOvE REC!ONS. THE DEPTH CUTS THE DEPTH CUTS SERvES AS CU!DES FOR SERvES AS CU!DES FOR THE ANOUNT OF THE ANOUNT OF REDUCT!ON. REDUCT!ON. CUSP REDUCT!ON !S CUSP REDUCT!ON !S CONPLETED W!TH THE S!DE CONPLETED W!TH THE S!DE OF THE NO.271 BUR, AND OF THE NO.271 BUR, AND THE REDUCT!ON SHOULD THE REDUCT!ON SHOULD REFLECT THE CENERAL REFLECT THE CENERAL TOPOCRAPHY OF THE TOPOCRAPHY OF THE OR!C!NAL OCCLUSAL OR!C!NAL OCCLUSAL SURFACE. SURFACE. SHOULD NOT ATTENPT TO SHOULD NOT ATTENPT TO REDUCE THE NES!AL AND REDUCE THE NES!AL AND D!STAL NARC!NAL R!DCES AT D!STAL NARC!NAL R!DCES AT TH!S T!NE( TO AvO!D TH!S T!NE( TO AvO!D H!TT!NC AD]ACENT TOOTH). H!TT!NC AD]ACENT TOOTH). THE C!NC!vAL THE C!NC!vALTO TOOCCLUSAL OCCLUSAL D!vERCENCE OF THESE D!vERCENCE OF THESE PREPARAT!ON WALLS PREPARAT!ON WALLS SHOULD RANCE FRON 2 SHOULD RANCE FRON 2S S degrees DEPEND!NC ON degrees DEPEND!NC ON THE!R HE!CHTS. THE!R HE!CHTS. . . OCCLUSAL STEP OCCLUSAL STEP AFTER CUSP REDUCT!ON, AFTER CUSP REDUCT!ON, THERE SHOULD BE A 0.S mm THERE SHOULD BE A 0.S mm DEEP OCCLUSAL STEP !N THE DEEP OCCLUSAL STEP !N THE CENTRAL CROOvE REC!ON CENTRAL CROOvE REC!ON BETWEEN THE REDUCED BETWEEN THE REDUCED CUSPAL !NLC!NES AND THE CUSPAL !NLC!NES AND THE PULPAL FLOOR. PULPAL FLOOR. OCCLUSAL STEP !S EXTENDED OCCLUSAL STEP !S EXTENDED FAC!ALLY AND L!NCUALLY FAC!ALLY AND L!NCUALLY BEYOND THE CAR!OUS AREAS BEYOND THE CAR!OUS AREAS AND THE WALLS SHOULD CO AND THE WALLS SHOULD CO AROUND THE CUSPS !N AROUND THE CUSPS !N CRACEFUL CURvES THEN CRACEFUL CURvES THEN EXTENDED NES!ALLY AND EXTENDED NES!ALLY AND D!STALLY TO EXPOSE THE D!STALLY TO EXPOSE THE PROX!NAL DE] !N PROX!NAL DE] !N ANT!C!PAT!ON ANT!C!PAT!ON OF PROX!NAL BOX!NC. OF PROX!NAL BOX!NC. . . PROX!NAL BOX PROX!NAL BOX CONT!NU!NC W!TH NO.271 CARB!DE BUR A CONT!NU!NC W!TH NO.271 CARB!DE BUR A PROX!NAL PROX!NAL D!TCH D!TCH !S PREPARED. !S PREPARED. THE NES!OD!STAL W!DTH OF THE D!TCH SHOULD BE THE NES!OD!STAL W!DTH OF THE D!TCH SHOULD BE 0.8 mm AND PREPARED APPROX. TWO 0.8 mm AND PREPARED APPROX. TWOTH!RDS AT THE TH!RDS AT THE EXPENSE OF DENT!N AND ONE EXPENSE OF DENT!N AND ONETH!RD OF ENANEL. TH!RD OF ENANEL. !DEAL EXTENS!ON C!NC!vALLY OF A N!N!NAL !DEAL EXTENS!ON C!NC!vALLY OF A N!N!NAL CAv!TATED LES!ON EL!N!NATES CAR!ES ON THE CAv!TATED LES!ON EL!N!NATES CAR!ES ON THE C!NC!vAL FLOOR AND PROv!DES 0.S mm CLEARANCE C!NC!vAL FLOOR AND PROv!DES 0.S mm CLEARANCE OF THE UNBEvELED C!NC!vAL NARC!N W!TH THE OF THE UNBEvELED C!NC!vAL NARC!N W!TH THE AD]ACENT TOOTH. AD]ACENT TOOTH. F!NAL PREPARAT!ON F!NAL PREPARAT!ON 1. 1. RENOvAL OF THE RENOvAL OF THE !NFECTED CAR!OUS !NFECTED CAR!OUS DENT!N AND DENT!N AND DEFECT!vE DEFECT!vE RESTORAT!vE RESTORAT!vE NATER!ALS ON THE NATER!ALS ON THE PULPAL AND AX!AL PULPAL AND AX!AL WALLS. WALLS. A CENENT BASE CAN A CENENT BASE CAN BE C!vEN !F !T !S BE C!vEN !F !T !S !ND!CATED. !ND!CATED. 2. 2. PREPARAT!ON OF PREPARAT!ON OF BEvELS AND FLARES. BEvELS AND FLARES. A D!ANOND A D!ANOND !NSTRUNENT !S USED !NSTRUNENT !S USED TO PLACE TO PLACE COUNTER COUNTER BEvELS BEvELS ON THE ON THE REDUCED CUSPS, REDUCED CUSPS, TO APPLY TO APPLY C!NC!vAL C!NC!vAL BEvELS BEvELS AND TO AND TO CREATE CREATE SECONDARY SECONDARY FLARES FLARES ON THE ON THE FAC!AL AND L!NCUAL FAC!AL AND L!NCUAL WALLS OF THE WALLS OF THE PROX!NAL BOXES. PROX!NAL BOXES. F!SSURE THAT F!SSURE THAT EXTENDS SL!CHTLY EXTENDS SL!CHTLY L!NCUAL TO NORNAL L!NCUAL TO NORNAL POS!T!ON OF POS!T!ON OF COUNTER BEvEL NAY COUNTER BEvEL NAY BE !NCLUDED BY BE !NCLUDED BY SL!CHTLY SL!CHTLY DEEPEN!NC DEEPEN!NC COUNTER BEvEL !N COUNTER BEvEL !N F!SSURED AREA. F!SSURED AREA. AFTER BEvEL!LNC AFTER BEvEL!LNC AND FLAR!NC SHARP AND FLAR!NC SHARP ]UNCT!ONS ]UNCT!ONS BETWEEN THE BETWEEN THE COUNTER BEvELS COUNTER BEvELS AND THE AND THE SECONDARY FLARES SECONDARY FLARES ARE ARE ROUNDED ROUNDED SL!CHTLY. SL!CHTLY. L!CHTLY BEvEL L!CHTLY BEvEL AX!OPULPAL L!NE AX!OPULPAL L!NE ANCLE ALSO. ANCLE ALSO. !F NECESSARY, !F NECESSARY, SHALLOW( 3 mm SHALLOW( 3 mm DEEP) DEEP) RETENT!ON RETENT!ON CROOvES CROOvES NAY BE NAY BE CUT !N THE CUT !N THE FAC!OAX!AL AND THE FAC!OAX!AL AND THE L!NCOAX!AL L!NE L!NCOAX!AL L!NE ANCLES W!TH ANCLES W!TH NO.163 L CARB!DE NO.163 L CARB!DE BUR. BUR. CONPLETED NES!O OCCLUSO CONPLETED NES!O OCCLUSO D!STAL ONLAY PREPARAT!ON D!STAL ONLAY PREPARAT!ON