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Tooth Prepration @futuredentistbot

The document provides steps for preparing teeth for porcelain fused to metal crowns. It involves placing depth orientation grooves, reducing the incisal edge to allow 2mm of porcelain thickness, reducing the facial surface in two planes parallel to the path of insertion and incisal edge, reducing the lingual surface and proximal walls with diamonds, and finishing with a chamfer bur to create a smooth transition from facial to lingual. The finished preparation has 1.2-1.5mm of reduction to allow sufficient porcelain thickness.

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0% found this document useful (0 votes)
56 views64 pages

Tooth Prepration @futuredentistbot

The document provides steps for preparing teeth for porcelain fused to metal crowns. It involves placing depth orientation grooves, reducing the incisal edge to allow 2mm of porcelain thickness, reducing the facial surface in two planes parallel to the path of insertion and incisal edge, reducing the lingual surface and proximal walls with diamonds, and finishing with a chamfer bur to create a smooth transition from facial to lingual. The finished preparation has 1.2-1.5mm of reduction to allow sufficient porcelain thickness.

Uploaded by

ابو العز
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Tooth

Preparation
Pre-Preparation Procedures
• Diagnose disease
• Eliminate pain/temporize
• Treat periodontal disease and modify if necessary
• Cleanout caries and old restorative material
• Determine pulpal status and treat if necessary
• Diagnostic wax-up if indicated
• Make stent for use in making temporary restoration

2 Aldominy .Dr 15 July 2020


Aim of preparation
1- Create enough space for workable
thickness of material.
2- Remove the plugging part and undercut
3- Bring the finishing line
4- Establishment the shoulder finishing line
5- adjust the path of insertion
Requirement of F.L. :-
1. It must be clear ,smooth and well defined.
2. It must be continuous from one surface to the other
3. It must lie on sound tooth structure.

Factors affecting selection of F.L.


1.Type of the restoration
2.Materials used in construction
3.The amount of occlussal force (stress)
Full veneer crowns

1. Full Metal Crown Full Coverage


2. Metal-Ceramic Crown
3. All Ceramic Crown Facing Ceramic
Preparation for full veneer crowns
The preparation includes : the all tooth surface.

The term:
Full crown,
Full cast crown
Complete crown can be used
interchangeably with Full veneer
crown to describe a restoration
made entirely of cast metal.
Clinical Procedure
following steps:
1.Occlusal Guiding Grooves
2.Occlusal reduction
3.Axial Alignment Grooves
4.Axial reduction
5.Finishing and Evaluation
6.Armamentarium
Preparation for full veneer crowns
Armamentarium
1. Hand piece 2. No. 171 L bur.
3. Round-end tapered diamond bur.
4. Short needle diamond
5. Torpedo diamond. ( chamfer diamond bur).
6. Chamfer carbide bur.
7. Red utility wax.
Preparation for full veneer crowns
Steps of preparation for full veneer crown
Depth-orientation Grooves (D.O.G):
Occlusal reduction
Before any reduction is carried out it is
important to assess the occlusion and note
any space already available between
opposing teeth.
STEP BY STEP PROCEDURE:-

1- Guiding grooves.
Or Depth-orientation Grooves (D.O.G):
Preparation for full veneer crowns
1. Occlusal Reduction:
The tooth structure remaining between the
orientation grooves is removed
A wide bevel is placed on the functional cusp,
Occlusal clearance is checked by having the patient
close on a 2.0 mm thick of red utility wax . Any
part of the preparation that has insufficient
occlusal clearance will be detectable as a thin spot
in the wax. Additional tooth structure should be
removed from the indicated areas and rechecked.
On completion, check that a minimum clearance
of 1.5 mm has been established on functional
cusps and at least 1.0 mm on nonfunctional cusps.
Alignment Grooves for Axial Reduction.
After the occlusal reduction is
completed, three alignment grooves are
placed in each buccal and lingual wall with
a narrow, round-end, tapered diamond.
One is placed in the center of the wall,
and one in each mesial and distal
transitional line angle
Recommended dimensions for a complete
cast crown.
- On (functional cusps : the occlusal clearance should be equal
to or greater than 1.5 mm.
- On nonfunctional cusps, a clearance of at least 1 mm is
needed.
- The chamfer should allow for approximately 0.5 mm of
metal thickness at the margin.
Preparation for full veneer crowns
2. Buccal and Lingual Surfaces Reduction
The Buccal and Lingual walls are reduced with a torpedo diamond
(Chamfer diamond bur.)
3. Proximal Surfaces Reduction:
The initial proximal cuts are made with a short needle
(short - thin )diamond bur.
This bur is worked through the proximal area in occlusogingival or
buccolingual "sawing" motion, carefully avoiding the adjacent teeth.
After remove the proximal contact ,then use the chamfer diamond bur
to complete preparation.
4. Finishing and smoothening the preparation.
The finishing line, all of the axial surfaces and occlusal surface are
smoothed with a chamfer carbide finishing bur.
Preparation for full veneer crowns
Special care should be taken that the finishing line will be
smooth and continuous.
The final step (if necessary ) in the preparation is the
placement of a seating groove, it will prevent any rotational
tendencies during cementation, and it will help guide the
casting to place. It is formed with a no. 171L bur and placed
on the buccal surface of mandibular preparations and lingual
of maxillary preparations.
On preparations for long span bridge there should be a
buccal and lingual groove to increase the resistance to
mesiodistal movement.
The features of a preparation for full metal crown and the
function served by each
Preparation for full veneer crowns
Special care should be taken that the finishing line will be
smooth and continuous.
The final step (if necessary ) in the preparation is the
placement of a seating groove, it will prevent any rotational
tendencies during cementation, and it will help guide the
casting to place. It is formed with a no. 171L bur and placed
on the buccal surface of mandibular preparations and lingual
of maxillary preparations.
On preparations for long span bridge there should be a
buccal and lingual groove to increase the resistance to
mesiodistal movement.
The features of a preparation for full metal crown and the
function served by each
The completed preparation is characterized
by a smooth, even chamfer; a 6-degree
taper; and gradual transitions between all
prepared surfaces.
Preparation for porcelain fused to metal
The PFM Restoration is a combination of an esthetic
porcelain veneering material and a metal substructure by
fusing a layer of porcelain bonded to a thin metal casting
or coping which fits over the tooth preparation.
Preparation for porcelain fused to metal
Steps of preparation for porcelain fused to metal crown
1) Depth-orientation grooves:
With a flat-end tapered diamond bur, we place three depth-depth grooves
,on the labial and two on the incisal surface. These will be in two
planes: the cervical portion which parallels the long axis of the
tooth, this plane will determine the path of insertion of the complete
restoration; the incisal portion will provide the space needed for the
porcelain veneer. The depth these grooves should be 1.2-2mm.and
can be obtain by periodontal probe.
2) Incisal reduction:
Remove the remaining tooth structure of the incisal edge with a flat-end
diamond bur on the anterior tooth that should allow 2mm.thickness to
permit translucency in the complete restoration. Posterior teeth
generally require less (1.5mm.).
3) Labial reduction:
Remove the remaining tooth structure between grooves. The labial cut
should be in two sets: one set parallel the incisal half of labial surface.
.And other set parallel to the gingival half
(A) the facial surface should be reduced in two planes; one nearly parallel with the
path of insertion, and one parallel with incisal two third of the facial surface of tooth.
(B) Reduction only in the plane parallel with the path of insertion may result in
insufficient space for porcelain in the incisal one-third. This is a common error
(C) one plane reduction which creates adequate a space for the restoration in both
the shoulder and incisal areas will come dangerously close to the pulp in the
midfacial area and may also produce an over tapered
Facial redaction
-Facial reduction ,incisal half end tapered diamond

-The incisal portion of the facial surface is reduced with diamond


remove the tooth structure remaining between the orientation
groove
Facial redaction
-facial redaction. gingival half by flat end tapered diamond.

- When gingival redaction be sure that the gingival redaction extends well into
the proximal surface .if the redaction is less than 1.2 mm is done for porcelain
fused to metal or 1.4mmfor porcelain –fuse-to noble metal teeth restoration
the redacting interproximal is wider than the diameter of
diamond ,so it is safe to favor the proximal contacts by keeping some
tooth structure between the adjacent and the instrument
Preparation for PFM
- The reduction is done with flat-end tapered diamond bur creating
shoulder finishing line at the cervical margin.
- 1.2-1.5mm.is necessary to permit the ceramic to produce a restoration
with satisfactory appearance.
- The reduction is carried around labioproximal line angles
to a point 1 mm lingual to the proximal contacts. The
resulting wings of tooth structure serve on:
a- Resistance and retentive function. b- Conserve of tooth
Structure.
4) Lingual and proximal reduction:
The lingual surface is reduced with a small wheel diamond to obtain a
minimum of 0.7 mm of clearance with the opposing teeth. If the
lingual surface will be veneered with porcelain should have 1 mm
of clearance.
Don't remove the junction between the cingulum and the axial wall
because it will result in decrease in surface area for retention, pulp
exposure, over convergence . . ……..
Lingual redaction
- Lingual redaction small wheel diamond

-Than lingual redaction by small wheel diamond begin of lingual surface


By round diamond with diameter 1.4 mm.
-Reduce the cingulum portion of the lingual surface with the small wheel
diamond be carefully over reduction at this point will produce retention
deficiency that will be hard to compensate for later.
-lingual axial reduction torpedo diamond and carbide finishing bur.
-Facial axial finishing

Round
- over any sharp angles on the incisal angle or along the
edges of the incisal notch and smooth any under cuts. That they are parallel with
or slightly lingual inclination to path of insertion of the perpetration.
Preparation for porcelain fused to metal
The lingual aspect of the proximal walls and lingual axial
surface are reduced with the chamfer diamond bur. (After
removed the proximal contacts with long thin tapered
diamond bur).
5) Finishing and smoothing:
The lingua and proximal axial surfaces are smoothed with the chamfer
(torpedo) carbide bur
A radial fissure bur is used to smooth the labial surface and forming a
radial shoulder finish line.
All angles and edges on the preparation
are rounded with the sides of the bur to
facilitate seating of the restoration later.
Preparation for porcelain fused to metal
The lingual aspect of the proximal walls and lingual axial
surface are reduced with the chamfer diamond bur. (After
removed the proximal contacts with long thin tapered
diamond bur).
5) Finishing and smoothing:
The lingua and proximal axial surfaces are smoothed with the chamfer
(torpedo) carbide bur
A radial fissure bur is used to smooth the labial surface and forming a
radial shoulder finish line.
All angles and edges on the preparation
are rounded with the sides of the bur to
facilitate seating of the restoration later.
A, Completed preparation. Note that the transition from
incisal to axial walls is rounded, and a distinct 90-degree
or slightly sloping shoulder has been established.
B, Even chamfer width and a smooth transition between
lingual and axial surfaces. The chamfer is distinct and
blends smoothly into the facial shoulder.
The proximal surface divided into two
portions;
the buccal portion beyond the contact
finished with shoulder finish line,
while the lingual portion finished with
chamfer finish line
July 15, 2020 Dr. Siham Sais 37
The features of a preparation for PFM crown on a
posterior tooth and the function served by each .
Preparation for all –ceramic crown
All -ceramic inlays, onlay, veneers, and
crowns are some of the most esthetically
pleasing prosthodontic restorations.
Different ceramic system
Aluminous core ceramics
Slip cast ceramics
Heat pressed ceramics
Machined ceramics
Machined and sintered ceramics
Metal reinforced system
Preparation for all –ceramic crown
Armamentarium
1. Hand piece. 2. Flat-end tapered diamond bur. (Shoulder Bur).
3. Small wheel diamond. 4. Long needle diamond
5. Radial fissure bur. 6. Red utility wax.
Important Notes:

1) The finishing line should be radial


shoulder.
2) The amount of tooth structure that
should be removed is
a- 1.5 from the incisal.
B- 1.0 mm from other surfaces.
Preparation for all –ceramic crown
Steps of preparation for all-ceramic crown
1)Depth-Orientation Grooves ( D.O.G ):
With a flat-end tapered diamond bur, Place depth-
guiding grooves on the labial and incisal
surfaces
2)Incisal reduction:
Remove the remaining tooth structure of the incisal edge
with a flat-end diamond bur that should allow at least 1.5
mm. thickness to permit translucency and good strength
in the completed restoration.
Preparation for all –ceramic crown
3) Labial (buccal) reduction:
Remove the remaining tooth structure between grooves; the labial cut
should be in two steps: one step parallel to the incisal half of labial
surface
And one step parallel to the gingival half, the reduction is done with
flat-end tapered diamond bur creating a shoulder finishing line at the
cervical margin.
4)Lingual and proximal reduction:
The lingual surface is reduced with a small wheel diamond Without over
reduced the junction between the cingulum and the lingual axial wall.
The lingual aspect of the proximal walls and lingual axial surface are
reduced with the flat-end tapered diamond. (After removed the
proximal contacts with a long thin tapered diamond bur).
porcelain jacket crown(PJC).

Preparation for all –ceramic crown


5) Finishing and smoothing:
All of the axial walls should be smoothed with a radial fissure bur
forming a radial shoulder finish line
All angles and edges on the preparation are rounded with the sides of
the bur to facilitate seating of the restoration later.

The features of a preparation for an anterior restoration:

the shape line and point angle should be beveled with fine bur to avoiding
the stress concentration
RGS 3

Measure clearance with RGS 3


Instrument fits loosely
All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance Vertical Lingual
Wall
retention and
resistance

Axial Reduction Concave Cingulum


retention and Reduction
resistance structural durability
structural durability

Rounded Line
Angles
structural durability
All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance

Margin design should result in favorable stresses distribution.


All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance

Axial Reduction
retention and
resistance
structural durability
All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance

Axial Reduction
retention and
resistance
structural durability

Rounded Line
Angles
structural durability
All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance

Axial Reduction Concave Cingulum


retention and Reduction
resistance structural durability
structural durability

Rounded Line
Angles
structural durability
All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance Vertical Lingual
Wall
retention and
resistance

Axial Reduction Concave Cingulum


retention and Reduction
resistance structural durability
structural durability

Rounded Line
Angles
structural durability
All Ceramic Crown
Preparation Design & Function

Modified Shoulder
marginal integrity
structural durability
periodontal
preservation
resistance Vertical Lingual
Wall
retention and
resistance

Axial Reduction Concave Cingulum


retention and Reduction
resistance structural durability
structural durability

Rounded Line
Angles
structural durability
Design Specifications
• Incisal reduction 1.5 – 2.0 mm

• Facial reduction 1.2 – 1.4 mm

• Lingual reduction 1.0 – 1.2 mm

• Marginal reduction 1.0 – 1.2 mm

All Ceramic Crown


15 July 2020 Aldomini .Dr 56
How many use Putty Index?
Here are some other aspects that you need to consider:
Take a pre-preparation putty impression – cut it from buccal to
palatal in middle of crown - to use as a preparation guide

Consider metal collars where possible, as this will reduce the


extent of cervical tooth preparation. This is beneficial for teeth that
have evidence of gingival recession and exposed root dentine.

‘Winged’ PFM preparation


We want you to measure the tips of your burs and
understand how much tooth needs to be removed.
What is a Correct Tooth Preparation?
Removal of tooth structure does not weaken the tooth
• Amount of reduction follows the requirements of restoration
• Resist displacement in all directions
• Presence of optimum tooth height
• Finish line that can accommodate robust margin with close
adaptation
• Provide optimal space for crown which is sufficiently thick to prevent
fracture, distortion or perforation

Incorrect Tooth Preparation


• Unnecessary reduction
• Endangers the pulp
• Lack of retention and resistance features
• Finish line that cause micro leakage
• Inadequate space for crown which is thin
and may cause fracture, distortion or
perforation
Unless clearance during lateral and protrusive movements has been checked, it
is very easy to end up with a crown which occludes satisfactorily in the
intercuspal position, but which interferes during excursions.
Ensure occlusal clearance in both ICP and excursions
Guidelines PFM
Margin Shape/Location
– 0.75 - 1.0 mm shoulder on facial
– Shoulder at 90 degrees to cavosurface (if undermind
enamel will develop make beveling for the shoulder
using flame shape carbide bur or diamond with a
width 0.5 mm)
– Internal angle of shoulder rounded (Radial shoulder)
– 0.5 mm chamfer on lingual
– Interproximal: chamfer transition
– 0.5 mm subgingivally
– Follow contours of gingiva
– Smooth margins
summary
Finishing Reduction indication contraindication Notice
line

Full-metal chamfer 1-1.5mm Maximum Esthetic is We must avoid in


Crown strength needed anterior teeth
retention are
needed

Porcelain – L: chamfer L: 0.7-mm When Large pulp- More common used.


fused to metal shoulder :b B:1.2-1.4 strength and short crown
with bevel mm esthetic are
needed

Full-ceramic shoulder 1.5-2mm Requirement Requirement Unit now It is not


crown of high more recommended on
esthetic conservative posterior teeth.

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