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Part I: Terminology and widths
A. J. Hunter, B.D.S., M.D.&., Dunedin, New Zealand D.R.D.R.C.S., and A. R. Hunter, B.D.S., M.D.S.
The terms bevel, chamfer, and shoulder are widely used to describe crown margin designs. However, as no clear definition of the essential feature(s) of each design has been universally accepted, the same term often describes margins of widely differing width andlor configuration. Similarly “bevel angles” are not consistently defined. While tradition favors the use of thinner marginal designs, many of the reasons advanced for their superiority are questionable in the light of contemporary research. Use of marginal widths beyond the absolute minimum demanded of the material may contribute to overcoming some of the persistent problems identified with fixed prosthodontic replacement of natural teeth. These include overcontour, porcelain debonds, poor esthetics, and fit. It is suggested that the problems associated with underpreparation and the potential advantages of wider preparations need reemphasis. (J PROSTHET DENT 1990;64:548-52.)
00th preparation for fixed prosthodontics requires a decision regarding the marginal configuration. The design dictates the shape and bulk of the casting and influences the fit at the margin.l Although many factors such as materials, esthetics, and access influence this selection, most dentists probably have a “preferred” design, However, there is disagreement about what constitutes ideal marginal geometry and width. These articles review the issues involved and discuss the implications of research into the clinical longevity of crowns related to the marginal design. Part I discusses terminology and margin width, while Part II reviews the theoretical and practical marginal geometry.
At present there is no universally accepted basis for classifying margin designs, and many texts avoid verbal definitions in favor of illustrations.1-6 Unfortunately, this approach does not clearly distinguish the “essential” feature(s) of each design and therefore illustrations of chamfers or shoulders are often misleading (Fig. I). Chamfers have been defined on the basis of their marginal width and/or geometry. Jacobsen and Robinson7 stated that a width greater than 0.3 mm at its cervical termination precluded any margin being called a chamfer. Others’? 6 g consider an obtuse angled gingival termination or curved cross-sectional shape to be fundamental for chamfers. Bell et al.1° described a chamfer preparation with a reduction of 1.5 mm, rounded internal line angles, and a cavosurface angle of 135 degrees. However, their shoulder preparations were identical except for cavosurface angle, and this feature was crucial in classifying marginal designs. However, illustrated examples demonstrating rounded in-
ternal line angles and cavosurface junctions of approximately 90 degrees have also been termed chamfersir, r2 Similar problems arise with attempts to define. shoulders. Many classify a flat shoulder as one that makes a 90degree angle with the vertical axial wall of the preparation.2l 8,g,I3 This classification presumably relies on width to determine the marginal type, while the angulation from the vertical axial wall indicates marginal direction (for example, 135-degree shoulder). With any classification based on width, substantial differences arise with changes in marginal angulation. Some shoulders may exhibit slip joint geometry (135-degree shoulders) but others may not (go-degree shoulders). Shoulders have also been defined using marginal geometry, where the discriminating features are an external cavosurface angle of 90 degrees and a corresponding butt joint of restoration/tooth at the margin.‘? 3l5,lo Depending on the apical extent of the preparation, and the axial profile of the tooth, a go-degree shoulder using this classification may often appear similar to a 135-degree shoulder as defined by McLean and Wilson.i3 Bevels are another recommended marginal design because they incorporate geometric principles to minimize marginal discrepencies. l, 12,14, I5 It is important to realize that bevel angulation may be assessed from different planes (Fig. 2). Some authorities define the angle of the bevel as the angle between the created bevel surface and the preparation surface that has been bevelled,13*I4916-18 while others describe it as the angle between the created bevel surface and the external surface of the tooth.3, lo*igs2i The former definition of bevel angulation will be used throughout these articles. For convenience, Kuwata22 classified margins on the basis of their “margin angle.” This is the angle formed between a vertical projection from the external surface of the tooth and its prepared surface (Fig. 2, angle b). He
Sloped shoulder (on axial wall) or go-degree shoulder. Marginal widths below 0. The minimum marginal width of a crown is largely determined by the dental materials used. Margin illustrations.4. considered that margin angles between 0 and 30 degrees gave bevelled margins. based on the preparation axial wall.“23 or the “minimal marginal cement thickness. as these margins are often indistinct on the impression and die. Long chamfer. The former has been described as the “vertical discrepancy. overcontoured restorations are commonly produced to obtain sufficient bulk of restorative material to ensure functional rigidity. “15t24 the “horizontal discrepancy.4 Crown fabrication is also a problem. A practical system for classifying margins was advanced by Pardo. 180 degrees -a = b.s. d. in practice the horizontal designs are often wider. preparation of knife-edge margins has been considered to. A go-degree shoulder was considered a horizontal margin and the 135degree shoulder was considered an inclined vertical design. b and c. Angle b is the angle formed by the created bevel surface with the external surface. Flat or go-degree shoulder. and those between 61 and 90 degrees were shoulders.1. also called margin angle. those between 31 and 60 degrees were chamfers.be relatively easy. marginal widths may vary. others consider that achieving a definite finish line with a knife-edge configuration is also difficult and requires careful preparation.26knife-edges are not a preferred design72l5 and should be restricted to specific clinical sit549 THE JOURNAL OF PROSTHETIC DENTISTRY .26However.25 These include regular chamfers and knife edges (including feather and chisel edges) that would seldom be wider then 0. Within these general parameters. Bevel angles. note differing exit profiles.1. l.6-8 Because minimal reduction is required. based on cavosurface angle. 7 Although sometimes recommended for routine use. with designs exhibiting minimal axial reduction favored when possible. e. Although this classification emphasized the importance of exit configuration while ignoring margin width.11s 21 : d :3 e Fig. 1. These discrepancies may be the result of inaccuracies inherent in crown fabrication. 3). while the maximum width is limited by the desire to preserve both a suitable coronal core and pulp vitality.“14 or the “marginal adaptation. a. concepts related to marginal width and geometry can usually be discussed independently. or a combination of these factors.CROWN MARGINAL CONFIGURATIONS.“16 The discrepancy at right angles to the two opposing surfaces has been referred to as the “marginal opening. l2 who broadly categorized margins into the two main classes of inclined vertical or horizontal.s. and the term “sealing” to describe the horizontal discrepancy observed at right angles to the two opposing surfaces.3 mm. 2. are conservative.“23 The least confusing terminology is the use of the term “seating” to describe the vertical discrepancy at the external margin. Another source of confusion is the different terminology for describing discrepancies between the casting and the tooth. an inability to correctly seat the crown during cementation. 7 In addition. PART I Fig. and their geometric configuration improves the marginal seal. Angle a is the angle formed by the created bevel surface with the surface that has been bevelled.“14 the “marginal opening measured verticaIly. These discrepancies are commonly measured at the external margin of the crown or at right angles to the two opposing surfaces (Fig. MARGINAL WIDTH For simplicity. Chamfers.3 mm The cited advantages of thin margins are that these designs allow for intraoral finishing of the crown margins.
8.20*2s. Alloys with Brine11 hardness numbers greater than 84 or 100 are unsuitable for burnishing. increases in crown contour usually compromise gingival health by impeding plaque removal29 ‘921. disks and stones can be effective in achieving marginal closure.or with an explorer.6 and unsuitable for marginal finishing unless modified with a beve1. limited access for instruments precludes marginal finishing. 3. a. ’ bulky. often referred to as shoulders.27 Greater axial reduction (up to 0. and clearer impressions and dies. Behrend23 considered that burnishing of margins was impossible with the current hard alloys.3 mm uations such as their use in extremely bell-shaped teeth.8.32 believed that there was a direct relationship between the location of restorative margins and the ability to evaluate them by sight 550 Margin widths greater than 0. Although Gilboe and Thayer 27accepted that type 3 gold possessedlimited ductility.6s~25This increased width allows easier evaluation of the margin at all stages and reduces the chances of an overcontoured casting.5s l5 Fig. According to Gilboe and Thayer.2gv 33 the time available is limited as these procedures must be completed while the cement remains fluid. while allowing adequate rigidity. However. 27 Some believe that with good oral hygiene. and considered shoulders unnecessarily destructive. while McLean and Wilson13 noted that the pressures and distortion of metal. associated with the technique.2g in NOVEMBER 1990 VOLUME 64 NUMBER 6 . Seating discrepancy. While possessing these practical advantages. These advantages include improved control of crown contours and esthetics. 33 The limited ductility and high yield strength of many alloys also limits the effectiveness of finishing procedures. and pulpal response were considered. 23. with the efficacy of the examination becoming increasingly questionable the more subgingival the margin. Marginal widths greater than 0. 23. 23The dentist’s ability to objectively evaluate the cervical margins of crowns appears to be limited. and where the type of alloy permitted the use of rotary instruments for burnishing (cited by Scharer2g). 2. Increased tooth reduction also facilitates contour changes in the crown. Even if objective evaluation were possible. Others agreed. Gardiner15 also concluded that burnishing was not a practical way of achieving marginal closure for type 3 gold and ceramometal alloys.‘? 5-7* 20* 27-2g These procedures include spinning and swaging.28p30-32 Assif et a1. 4o-42 Fankhauser.‘.3 mm. Diagram illustrating discrepancies between castings and teeth. but burnishers appear ineffective in reducing discrepancies. particularly in approximal and subgingival locations. Tylman and Malonesstated that shoulders were difficult to prepare on posterior teeth. microleakage. Conversely. the use of disks and stones to move metal to the margins. increased structural rigidity.2gl33 Where accesspermits.13. they maintained that thin cervical margins did allow for bending of the metal to improve the marginal seal.5s 13. although this can be compensated for by effective die spacing. have been unpopular. minor changes in crown contour ( + 1 mm) do not significantly affect gingival health. chamfers retain the benefits of the thinner knife-edge design. particularly if a chamfer could be placed. Sealing discrepancy.3’ Despite their unpopularity. cited by Scharer. 4*7s 331 34 The thickened wax patterns resulting from wider margins also exhibit increased casting shrinkage. and that their routine use was difficult to justify when stress analysis. Others2g*36also consider ceramometal alloys unsuitable for burnishing.27 an advantage of bevelled shoulder preparations were that they allowed the incorporation of physiologic contours in both the temporary and final crown. 3gHowever. Many consider that thin margins (including bevels) are desirable because they allow for marginal closure through finishing procedures.3 mm7) is required for chamfers that many consider the “ideal ” gingival finish line for cast restorations.‘. permitting guide planes for removable prostheses. or flattening contours to facilitate plaque control.%. the advantages of wider margins over thinner designs should be considered. and burnishing to bend the crown margin toward the tooth. others consider intraoral finishing procedures for gingival margins difficult and impractica16* 15. Stiffler in 1980 reported a 50% reduction in the marginal opening if accessible. 6. could crack porcelain bonded to these alloys. 21.l* 4.l.34g 35 Although margin finishing of complete cast crowns during cementation is often recommended.
g Picard reiterated that a poor impression. Inadequate preparation is cited as the reason for many of the problems associated with crowns. CONCLUSION Tradition has favored thin marginal designs. it may be desirable to increase the marginal width of preparations toward the upper limit of the recommended range. 43. 56 or to a thermal expansion mismatch between porcelain and alloy. Another advantage of greater axial reduction is that it permits a greater thickness of restorative material. this principle is not an absolute contraindication to increasing marginal width beyond the minimum to accommodate the materials being used. particularly at the internal line angles. with suggestions ranging from 1 to 2 mm. 5s The desire to enhance esthetics without sacrificing strength is a crucial consideration when using ceramometal restorations. These studies indicated that the problem of overcontour was not confined to ceramometal restorations and that small increases in contour can adversely influence gingival health. 13*52 Whatever the exact cause. will produce a poor die and ultimately lead to a poor final result. 31.5.23s 43. Many consider that increasing the bulk of metal. there are variations in opinion regarding the margin reduction required for ceramometal restorations. thus ensuring rigidity during function. The ability of dental technicians to produce anatomic crown contours while working to the minimum possible thickness of material has also been overestimated. the size of the discrepancy was significantly greater with ceramometal crowns. 48* 4g.50 reported that porcelain fractures and “debonds” were the second highest cause of failure with ceramometal crowns. Thin finish lines have been advocated in the belief that they allow marginal closure through intraoral finishing and contribute to the maintenance of pulpal vitality. 53 Thus increased marginal widths (shoulders) have usually been recommended as a method of minimizing these discrepancies51. The rate of porcelain failure due to flexure appears to be related to the thickness of the metal substructure and to occlusal factors.ss*43High reflectance of the opaque layer. Walton et a1. 57.44 The consequences of underpreparation are usually worse than those associated with preparations that are wider than the absolute minimum required by the restorative material.2p 21* 23.44. Overcontoured crowns are a common problem. a review of the literature indicates that the efficacy of intraoral finishing procedures should be reassessed. While conservation of tooth structure is desirable. He attributed this finding to weak metal substructures that were distorted during the fabrication process. both being significantly higher than in the uncrowned controls.5g According to Gilboe and Thayer. 58 Overcontoured crowns are unlikely to blend with natural counterparts due to their poor shape and adverse effect on gingival tissues. Karlsson44 found that although ceramometal and acrylic resin veneered crowns had a similar “frequency” of poor marginal adaptation. then wider margins allow easier fabrication of appropriately contoured crowns while also improving rigidity and esthetics. Increased bulk is useful where the impression material possesseslimited tear strength. this distortion is a common problem.CROWN MARGINAL CONFIGURATIONS. and others have reported that 25% to 80% of complete cast crowns are overcontoured.27 the increased width associated with bevelled shoulders facilitates the placement of gingival retraction cord. particularly at the impression stage is crucial to ensuring an acceptable crown and is a major advantage of wider preparations. However.4s+ 4gBecause optimal esthetics depend on adequate reduction. impressions. and dies. Grass0 et a1.5 mm. 51 Distortion of ceramometal substructures can occur during crown fabrication.2 Karlsso# discovered that a “significant” number of ceramometal restorations were overcontoured approximally. without overcontouring.5g stated that shoulder preparations made impression making difficult. increases resistance to marginal distortion. while the increased bulk of impression material at the gingival margin results in more accurate impressions and dies. particularly bruxism. especially for multiple preparations.2p 13x *a 51-54 This distortion has been attributed to temperature-related creep of the alloy53v55.27 Crown flexure predisposes to cement failure. particularly at the margins. with the consequence that there is a tendency to “underprepare” teeth. The ability to accurately evaluate margins.41 particularly approximallf13. Unfortunately.50 Good marginal integrity. Experience with shoulder prepara551 . Shoulders are commonly well defined’ and according to some create the clearest finish line. Some consider flat or sloped shoulders difficult to prepares l8 or impractical with small teeth or when excessive root surfaces are exposed. 44 and with ceramometal restorations.4g reported comparatively low rates of porcelain fracture. If maintaining a normal emergence profile is important. 4gAlthough Karlsson44 and Coornaert et a1. but a high proportion of ceramometal restorations are judged unacceptable by patients due to poor esthetics. 2g.45-47 Parkinson47 reported that although cast crowns were less overcontoured than ceramometal restorations.48.15. 52. In contrast.48. ‘32. The effect of increased margin widths on the ease of the clinical procedures is disputed. THE JOURNAL OF PROSTHETIC DENTISTRY is another common esthetic problem with ceramometal restorations’s All these problems can be minimized by providing “adequate” marginal width to accommodate both metal and porcelain. differences in plaque scores were not significant. Perhaps the greatest effect of increased margin widths clinically is the ease of evaluating preparations. Schweikert2’j and Panno et a1. PART I 1979 reported that minor changes in contour led to increased gingival bleeding and that many ceramometal crowns were overcontoured by a mean value of 0. and harmonious contour are all important in achieving optimal esthetics. even of a good preparation.46 suggested that unsuitable embrasures and contours were a greater problem with crowns than were inadequate gingival cavosurface margins. and with ceramometal crowns there is the additional hazard of porcelain failure. suitable margin location.
Svare CW.51:338-42. Current theories of crown contour. 13. J PROSTHET DENT 1983. 14.HUNTER AND HUNTER tions suggests that margin widths exceeding 0. If the advantages of increased preparation were stressed. Nicholls JI.49:663-73. 41. 46. 1983265. 58.333-4.3 mm are not usually incompatible with pulpal vitality. Kuwata M. Facial and lingual contours of artificial complete crown restorations and their effects on the periodontium. J PROSTHETDENT 198$53:24-g.214. Becker CM. Schaberg TV. 47. Assif D. Sapkos S. To bevel or not to bevel? Br Dent J 1975. Butt joint versus bevelled gold margin in metal-ceramic crowns. In: Dental ceramics. Carbeneau GT. Rosenstiel E. 17.36:523-31. Gihnore HW. J PROSTH~ DENT 1983. Robinson PB.51:213-7. Walton JN. placement.25:642-9. Stand J Dent Res 1980. Parkinson CF. 7th ed. J PROSTHET DENT 1963. Gardiner FM.178.43:149-55. Bates DJ. Ostlund LE. 32. J PROSTHET DENT 1966.311. 33. dentists might be encouraged to increase marginal widths where possible. 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