TOOTH PREPARATION

FOR ALL CERAMIC

CROWN

Dr. N. Kulashekar Reddy MDS

Asst Professor
College Of Dentistry, Jazan
Introduction
• All-ceramic inlays, onlays, veneers, and crowns are some
of the most esthetically pleasing prosthodontic
restorations.
• Because there is no metal to block light transmission, they
can resemble natural tooth structure better in terms of
color and translucency than can any other restorative
option.
• Their chief disadvantage is their susceptibility to fracture,
although this is lessened by use of the resin bonded
technique.
All ceramic systems
• Powder slurry

• Castable

• Machinable

• Hot pressed

• Glass infiltrated
Glass infiltrated/ Powder slurry or slip
casting

Eg: inceram spinell, optec hsp

Pressable ceramics: eg: Emax
Machinable ceramics: CAD - CAM

Eg: LAVA, Procera

General requirements
• Complete ceramic crowns should have relatively even

thickness circumferentially.

• For the hot-pressed ceramic crown (IPS Empress* or

OPC†), usually about 1 to 1.5 mm is needed to create an

esthetically pleasing restoration.

• Incisally, a greater ceramic thickness may be required.

 Indications
• High esthetic requirement.
• Considerable proximal caries.
• Incisal edge reasonably intact.
• Endodontically treated teeth with post-and –cores.
• Favourable distribution of occlusal load.

Contraindications
• When superior strength is warranted and metal-
ceramic crown is more appropriate.
• Significant caries with insufficient coronal tooth
structure for support.
• Thin teeth faciolingually.
• Unfavourable distribution of occlusal load.
 Advantages
• Excellent esthetics
• Good tissue response even for subgingival margins.
• Slightly more conservative of facial wall than metal
ceramic

Disadvantages:
• Reduced strength compared to metal ceramic crown.
• Proper preparation extremely critical
• Among least conservative preparations
• Brittle nature of material
• Can be used as single restoration only
A, Inadequately fitting all-ceramic crowns have led to recurrent caries and gingival
recession around these central incisors.
B, The gingival defect was corrected by minor periodontal recontouring, the teeth
were reprepared, and new all-ceramic crowns were provided.
Unfavorable occlusal loading such as this edge-to-edge relationship
on the lateral incisor is a contraindication to the allceramic crown,
particularly in view of the parafunctional activity of this patient.
Armamentarium
 PORCELAIN JACKET CROWN PREPARATION

Depth orientation grooves: A flat end

tapered diamond is first aligned with the
incisal portion of the facial surface and two
vertical cuts are made to the full diameter of
the diamond, fading out at the “break”
where the curvature of the facial surface is
the greatest. Three similar grooves are
made maintaining the same instrument
parallel to the gingival segment of the facial
surface. Two incisal orientation grooves 2.0
mm deep are made.
 Incisal reduction: A flat end
tapered diamond is used to
reduce the incisal edge by 2.0
mm keeping the plane of the
reduced surface parallel to
the former incisal edge. A
round wheel diamond may
also be used for incisal
reduction.
 Facial reduction, incisal half: A flat
end tapered diamond is used to
remove the tooth structure remaining
between the orientation groove in the
incisal portion of the facial surface.
 Facial reduction, gingival half:
A flat end tapered diamond is used to
reduce the gingival segment and
extend well into the proximal surface.
Extend the facial reduction through
the proximal surfaces with the flat
end tapered diamond producing a
shoulder in the process.
 Lingual reduction: A small
round diamond with a head 1.4
mm in diameter is used to make
four depth orientation cuts. A
small round wheel diamond is
used to create a concave
surface over the lingual surface
of the tooth incisal to the
cingulum.
 Lingual axial reduction: A flat end
tapered diamond is employed for
axial reduction to prepare the
vertical lingual wall. Blend the
reduction of each axial surface with
that on the adjacent axial surface.
Axial finishing: No: 171 bur is
used to smooth the axial surfaces
and to round all distinct positive
angles on the preparation.
Shoulder finishing: No: 957 bur is
used for preparing a smoothly cut
shoulder perpendicular to the line of
force or to the long axis of the tooth.
The features of all ceramic crowns preparation for a porcelain jacket
crown on an anterior tooth and the function served by each.
All-ceramic crown preparation. A, Labial view. B, Lingual view.
To prevent stress concentrations in the ceramic, all internal line
angles should be rounded.
The shoulder should be as smooth as possible to facilitate the
technical aspects of fabrication.
 POSTERIOR ALL CERAMIC CROWN PREPARATION

Occlusal reduction: A large round end

tapered diamond is used to place depth
orientation grooves on triangular ridges
and major grooves.

The final occlusal reduction should be 1.5

mm to 2.0 mm deep. Remove the tooth
structure remaining between the depth-
orientation grooves with the large round-
end tapered diamond.
Functional cusp bevel: The large round
end tapered diamond is used to
produce depth orientation grooves in
the facial incline of the facial cusp. A
minimum of 1.5 mm of clearance is
necessary.
Facial and lingual axial reduction: The
large round end tapered diamond is
used to obtain axial reduction ranging
from 1.0 to 1.5 mm by making depth
orientation grooves and removing the
tooth structure between them. The axial
reductions are carried out as far as
possible into the proximal embrasures.
Complete axial reduction: A short needle diamond is used to begin the
proximal axial reduction without touching the adjacent tooth. The axial
reduction interproximally is complete by running the round end tapered
diamond.
Preparation finishing: round end tapered carbide bur is used to
finish the axial surfaces and the functional cusp bevel.
The features of a cast ceramic crown preparation for
an all ceramic crown on a posterior tooth and the
function served by each.
References
• Contemporary fixed prosthodontics. Rosentiel
• Fundamentals of fixed prosthodontics . Shillingburg