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TOOTH PREPARATION

FOR CROWN

INTRODUCTION

Tooth preparation is defined as the mechanical treatment of


dental disease or injury to hard tissue that restores a tooth to
original form. Perceptive diagnosis & disciplined tooth
preparation can determine the success of a fixed
prosthodontic. Reduction of the tooth structure is preceded by
a mental image of the design of the artificial crown.
Sound preparation design enhance longevity for the majority of
cast restoration. The current focus is an conservative
preparation that is noninvasive & the minimally involves
dentin.
Dentistry is changing from macro preparation to an environment
of molecular chemistry I.e. esthetic bonding.
Diagnosis & disciplined tooth preparation are essential to
successful fixed prosthodontic.

HISTORY
Egyptian are the first known efforts to enamel a
substructure with a ceramic veneer
Chinese ceramists developed porcelain which was
characterized by verification, translucency,
Hardness and impermeability
In seventeenth century Europeans attempted of
developing porcelain of similar quality. This lead to
the knowledge of basic component kaolin and
feldspar
In the second half of the eighteenth century
Fauchard and others attempted to use porcelain
for dental applications.

HISTORY
End of 1800:porcelain was successfully used
for dental prosthesis.
Mid 1950s-a dental porcelain was developed
with a coefficient of thermal expansion similar
to the exisisting dental casting alloys
Later 1950-metal ceramic restoration became
commercially available
1970s-1980s the term Porocelain fused to
metal was commonly used

FINISH LINE
CONFIGURATION

CHAMFER

The finish gingival line for veneer metal restoration is the chamfer.
Finish line shows least stress.
It can be cut by the tip of a round end diamond.
The margin of the cast restoration that fits against it combines an acute
edge with a near by bulk of metal.

HEAVY CHAMFER
The heavy chamfer is used to provide a 90degree
cavosurface angle with a large radius rounded
internal angle.
Created by round end diamond.
It provide better support to ceramic crown.

SHOULDER
Shoulder has been the choice for all ceramic crown.
The wide ledge provides resistance to occlusal force &
minimizes stress that might lead to fracture of the porcelain.
Produces space for healthy restoration contours & maximum
esthetic.
Require more destruction of tooth.

RADIAL SHOULDER
Its a modified form of shoulder finish line.
After preparing of shoulder, a small radius rounded internal angle is
instrumented by an end cutting parallel sided carbide finish bur & finish is
completed by modified bin angle chisel.
Cavosurface angle is 90degree and width is slightly lessened by classic
shoulder.
Support for ceramic restoration wall is good.
Destruction of tooth is equal to that required for classic shoulder.

SHOULDER WITH BEVEL


Its utilized as a finish line for 3/4th crowns, facial finish line of metal crown
where esthetic is not critical or where shoulder is already present.
Its a good finish line for preparation with extremely short wall.
By adding the bevel, it is possible to create an acute edge of metal at the
margin.
Should not be used routinely for all ceramic crown.

KNIFE EDGE
Ultimate finish line for an acute margin of metal but can
create a problem.
The thin margin of the restoration that fits this finish line may
be difficult to accurately wax or cast.
The use of knife edge can result in over countered restoration.
Have to be used on the lingual surface of mandibular
posterior teeth, teeth with very convex axial surface & on the
surface toward which a tooth may have tilted.

PORCELAIN JACKET
CROWN

PORCELAIN JACKET
CROWN
The PJC is the most esthetic restoration for duplicating individual anterior
teeth.
Adequate tooth restoration is created to achieve space for the porcelain
bulk required for strength of the restoration.
Pulpal & occlusal relationships are carefully examined before the PJC is
prepared.
Porcelain can withstand with compressive strength but susceptible to
fracture from shearing force.
Size & position of the pulp is determined before selecting PJC.

INCISAL REDUCTION
The incisal reduction is perpendicular to the long axis of the
tooth & 2mm apical to contemplated edge of the finish
restoration.

Initial the reduction was preformed in the flat plane perpendicular to the
long axis of the tooth.
It is now modified to the inclination of the mandibular teeth, usually at
45degree angle to the long axis of tooth in a normal occlusion relationship.

AXIAL REDUCTION
o The mesial & distal areas are first reduced to 2-5degree taper with establishing a
shoulder at this time with long taper diamond. This help to isolate the tooth.

o The facial reduction is done by flatened diamond or No.700 carbide bur to remove
the labial surface while establishing a preliminary shoulder.
o The incisal 2/3rd of the facial surface should be inclined to provide uniform porcelain
& ensure suitable esthetic.

RETENTION & RESISTANCE


FORM
The lingual surface of the tooth is reduce in two planes

A cingulum shoulder is placed with a flat- ended tapered diamond to create


0.75mm shoulder in the cingulum with 2-5degree taper.

A flame or wheel shaped diamond is used to form the lingual concavity of


the anterior teeth.

If the preparation is formed on canine, this portion of reduction has


commonly two concave due to canine lingual ridge.

MARGINAL DEVELOPMENT &


An end cutting bur heldREFINEMENT
perpendicular to the shoulder is indicated for
lowering margins.
A sharp chisel is an excellent instrument for removal of undermined
enamel & finishing line.

The axial walls are smoothed to the complete the preparation, while sharp
angles are rounded.
The labial gingival finish line is rarely supra gingival, so special attention
is directed to the soft tissue.

COMMON ERRORS IN PJC


1. Excessive PREPARATION
taper of proximal surface.
2. Insufficient tooth reduction on the facial surface.
3. Inadequate tooth reduction of the lingual surface
for clearance & diminished strength for porcelain.
4. Variable shoulder width.
5. Shoulder not placed far enough apically.
6. Under cuts at the axis gingival line angle.
7. Rough tooth surface preparation.

FULL METAL
CROWN

FULL METAL CROWN


When all the axial surface of a posterior tooth
have been attacked by decalcification or caries or
when those surface have been previously restored.
The tooth is candidate for a full metal crown.
The preparation of full metal crown is less
destructive than that required for either metal
ceramic or all ceramic crown.
The full veneer crown is a restoration that replace
lost structure & imparts some measure of
structural support of tooth.

OCCLUSAL REDUCTION
Reduction begun by creating about 1.5mm of clearance on the functional
cusp & 1mm on the nonfunctional cusp.
Depth orientation grooves are placed on the occlusal surface of the tooth
to provide an easy reference to determine when reduction is sufficient.
A round ended tapered diamond bur is used to place the grooves.
The tooth structure remaining between the grooves is removed to
accomplished the occlusal reduction.

FUNCTIONAL CUSP BEVEL


A wide bevel is placed on the functional cusp, with rounded
ended tapered bur.
Depth orientation grooves are also helpful to obtain the bevel.
The functional cusp bevel placed on the buccal inclines of
mandibular buccal cusp & lingual inclines of maxillary
lingual cusp.
The functional cusp bevel are placed with a no.171L bur.

BUCCAL & LINGUAL


The buccal & lingual REDUCTION
walls are reduced with a torpedo diamond.

A definite, even finish line is necessary to enable the fabrication of a well


fitting restoration & the chamfer is the best for providing the bulk needed
for strength while still allowing good adaptation.

The proximal cuts are made with a short needle diamond.


Thin diamond is worked through the proximal area in an occlusogingival
or buccolingual sawing motion.
Torpedo diamond is introduced to plane the walls while simultaneously
forming a chamfer as the interproximal gingival finish line.

FINAL PREPARATION
All the axial surfaces are smoothed with carbide finishing bur.
Special care should be taken in rounding the corners to insure that the
finish line will be smooth & continuous.

The final step in the preparation is to placement of a seating groove.


The groove is placed with a no.171L bur & is placed on the buccal surface
of mandibular & lingual surface of the maxillary preparation.

METAL CERAMIC
CROWNS
Also called porcelain fused to metal restoration,
consists of a ceramic layer bonded to a thin cast
metal.
Such restoration combines the strength &
accurate fit of a cast metal crown with a the
cosmetic effect of ceramic crown.
Friedlander et al found the metal ceramic
crown 2.8 times strong & more longevity than
ceramic alone.

ANTERIOR METALCERAMIC
CROWN
A uniform reduction of approximately 1.2mm is needed over

the entire facial surface.


To achieve adequate reduction, the facial surface must be
prepared in two planes.
If reduced in one plane, that is extension of gingival plane, the
incisal edge will protruded, resulting in a bad shade match.
If its prepared in the incisal aspect, the facial surface will be
over tapered & too close to pulp.
If index is prepared before the preparation is begun, help to
+ve check on reduction produce by preparation.
If the contour of the exiting tooth is are correct the index can
be prepared intraorally if not should be made from diagnostic
cast.

TOOTH PREPARATION
Labial grooves should be cut in two sets.
One set parallel with the gingival half of the
labial surface & one set parallel with the
incisal half of the labial surface.
Grooves should be 1.2mm deep.

Incisal reduction is done with flat end tapered diamond, so that its parallel
the inclination of the unprepared incisal edge.
Allow to easy instrument access to axial surface & gingival finish line.

Reduction of the incisal portion of the labial surface is done by flat end
tapered diamond bur.
All tooth structure is planed off to the depth of orientation grooves.

The gingival portion of the labial surface is


likewise reduced to the depth of the groove
with flat-end tapered diamond
The reduction is carried around the
labioproximal angle to a point 1mm lingual to
the proximal contacts

The lingual surface is reduced with a small wheel diamond to


obtain a minimum of 0.7mm of clearance with the opposing
teeth.
Those portion of the lingual surface that will have a ceramic
veneer should have 1mm clearance.
The junction between the cingulum & the lingual wall must not
be over reduced.

A long needle diamond is used to break the contact


and complete access through the proximal areas to
minimize the chances of nicking the adjacent teeth
Lingual aspect of the proximal wall as well as the
lingual surface reduced by Torpedo diamond.
Smoothed with the torpedo bur, accentuating the
chamfer on the lingual & proximal surface at the
same time.

An H158-012 radial fissure bur is used to


smooth the labial surface.
All the angles & edges are rounded with
the side of the bur.
At the same time that the labial surface is
being planed by the side of the bur, the
end is forming a radial shoulder finish
line.

POSTERIOR METAL
CERAMIC CROWN
The use of metal-ceramic crowns on posterior
teeth allows the creation of an esthetic
restoration on a posterior tooth.
Maxillary premolars, 1st molar & mandibular
premolars are in esthetic zone.
Maxillary 2nd molar, mandibular molars may
required metal ceramic crown if patient will not
accept full metal crown.
Before the preparation is begun, silicon putty
will add to all the tooth surface to prepare index
for guidance for tooth preparation.

OCCLUSAL REDUCTION
Begun by making depth orientation grooves with a roundended diamond.
In the area where ceramic coverage will be, reduction should
be 1.5-2mm.
The occlusal reduction will be complete by removing strips of
intact enamel between grooves.

FUNCTIONAL CUSP
REDUCTION
Required uniform
bulk of restoration on the lingual inclination

on the maxillary lingual cusp & facial inclination on


mandibular facial cusp.
Depth orientation grooves should be reduce 1.5mm if coverage
will be metal or 2mm if ceramic.
The functional cusp bevel is completed by removing tooth
structure between grooves.
No.172L bur used to smooth the occlusal reduction.

FACIAL REDUCTION
Flat-end tapered diamond is used to placed three vertical grooves in the
occlusal portion of the facial surface & two orientation grooves are placed
near the line angle of the tooth.
The full diameter of the bur must cut into the tooth.
All tooth structure between the grooves in the occlusal segment of the
facial surface should remove with flat-end tapered diamond.
The gingival portion of facial surface is reduced & extend into the
proximal surface.
Reduction should be 1.2- 1.4mm

AXIAL REDUCTION

o The proximal reduction is begun with short needle diamond.


o Narrow diameter allows interproximal reduction with out
niking adjacent teeth by up & down motion of the facial accept
of interproximal or it can be used on the occlusal portion with
a faciaolingual movement.
o Initially objective is to achieve separation between the teeth
with out over tapering the parallel walls.

The lingual axial wall is reduced with a torpedo diamond.


Enough structure is removed from both the lingual & proximal
axial wall to create a distinct chamfer finish line & axial
surface adjacent to it are smoothed with a torpedo carbide
finish bur.
Axial surface veneered with only metal, finish with chamfer &
that with ceramic finished with shoulder with H158-02 radial
fissure bur.
At the lingual most extension of the facial reduction , lingual
to proximal contact, result vertical wall or wing of the tooth
structure.

The radial shoulder, started with flat end


tapered diamond at the facial reduction, is
finished now with radial fissure bur.
The 1mm wide shoulder is smoothed by
placing it with the RS-1 modified binangle
chisel which will preserve the rounded internal
angle created by the radial fissure bur.

Occasionally shoulder with bevel is the finish line choice.


When esthetic needs are not as critical or dental technician is
unable to consistently produce a precise all ceramic margins.
A narrow bevel of 0.3mm can be placed on the shoulder with
the tip of a flamed shaped diamond.
The bevel is finished with an H48L-010 flame shaped carbide
finishing bur to create a finish line that is as clear as possible.