Sds Lec 4prinoftoothprep 121128141512 Phpapp01

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Transcript of Sds Lec 4prinoftoothprep 121128141512 Phpapp01

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    PRINCIPLES OF TOOTH

    PREPARION

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    PRINCIPLESOFTOOTH

    PREPARATION

    1. PRESERVATION OF TOOTH

    STRUCTURE.

    2. RETENTION AND RESISTANCE.

    3. STRUCTURAL DURABILITY.4. MARGINAL INTEGRITY.

    5. PRESERVATION OF PERIODONTIUM

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    PRESERVATION OF TOOTH

    STRUCTURE

    Partial veneer

    versus Full veneer

    crown

    Supra-gingivalmargin versus sub-

    gingival.

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    RETENTIONANDRESISTANCE

    Retention prevents removal of

    the restoration along the path ofinsertion or long axis of thetooth preparation.

    Resistance preventsdislodgement of the restorationby forces directed in an apicalor oblique direction andprevents any movement of the

    restoration under occlusalforces.

    Retention and resistance areinterrelated and often

    inseparable qualities.

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    RETENTION

    The essential elementof retention is twoopposing verticalsurfaces of the samepreparation.

    These may beexternal surfacessuch as the buccaland lingual walls of afull veneer crown(sleeve retention).

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    RETENTION

    The opposing surfacescan also be internal,such as the buccal andlingual walls of theproximal box of a inlay.

    An intracoronalrestoration resistsdisplacement by wedgeretention.

    Many restorations are acombination of the twotypes.

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    RETENTION AND RESISTANCE

    1. Taper

    2. Freedom ofdisplacement

    3. Length

    4. Substitution of

    internal features

    5. Path of insertion

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    TAPER

    Theoretically, the

    more nearly parallelthe opposing walls

    of a preparation, the

    greater is the

    retention.

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    TAPER

    Tooth preparation

    taper should be keptminimum because of

    its adverse effect on

    retention.

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    TAPER

    Optimum taper or total

    convergence of 16

    degrees achievable

    clinically while still

    affording adequateretention.

    Low as 10 degrees on

    anterior teeth and ashigh as 22 degrees on

    molar teeth.

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    STRUCTURAL DURABILITY

    Restoration must contain bulk of material that isadequate to withstand the forces of occlusion.

    This bulk must be confined to the space createdby the tooth preparation.

    Only this way the occlusion will be harmoniousand axial contours normal.

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    STRUCTURALDURABILITY

    1. Occlusal reduction.2. Functional cusp

    bevel.

    3. Axial reduction.

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    STRUCTURAL DURABILITY

    Occlusal reduction : One ofthe most important featuresfor providing adequate bulkof metal and strength to the

    restoration is occlusalclearance.

    For gold alloys- 1.5 mmclearance on the functionalcusp (lingual of maxillary

    molars and premolars andbuccal of mandibular molarsand premolars ).

    1mm clearance on thenonfunctional cusp.

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    Occlusal Reduction

    The basic inclinedplane pattern of theocclusal surfaceduplicated to produceadequate clearancewithout overshortening thepreparation.

    A flat occlusal surfacemay over shorten thepreparation.

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    Inadequate Occlusal Reduction

    Makes the restoration weaker.

    will not provide adequate space to allow

    good functional morphology under the

    anatomical grooves. The restoration easily perforated by

    finishing procedures or by wear in the

    mouth.

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    FUNCTIONAL CUSP BEVEL

    An integral part of

    occlusal reduction is the

    functional cusp bevel.

    A wide bevel placed on

    the functional cusp

    provides space for an

    adequate bulk of metal inan area of heavy occlusal

    contact.

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    Functional Cusp Bevel

    Lack of functional cusp bevel mayproduce several problems :

    1. Can cause a thin area or

    perforation.

    2. May result in over contouring

    and poor occlusion

    3. Over inclination of the buccal

    surface will destroy excessivetooth structure reducing

    retention.

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    AXIAL REDUCTION

    Plays an important role in securing space

    for an adequate thickness of the

    restorative material.

    Inadequate axial reduction will have thinwalls subject to distortion or result in over

    contouring the axial surface which could

    lead to periodontal problems.

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    STRUCTURAL DURABILTY

    There are other

    features that serve to

    provide space for metal

    that will improve the

    rigidity and durability ofthe restoration:

    1. Offset

    2. Occlusal shoulder

    3. Isthmus

    4. Proximal groove

    5. Box

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    MARGINAL INTEGRITY

    The restoration

    margin should closely

    adapt to thecavosurface finish line

    of the preparation to

    survive in the oral

    cavity.

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    MARGINAL INTEGRITY

    TO BEVEL,

    OR .

    NOT TO BEVEL

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    FINISH LINE CONFIGURATION

    1. Chamfer

    2. Heavy chamfer

    3. Shoulder4. Radial shoulder

    5. Shoulder with bevel

    6. Knife edge

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    CHAMFER

    The preferred gingival

    finish line for full veneer

    metal restoration.

    This finish line exhibitleast stress to the

    underlying cement.

    It can be cut with round-end tapered diamond.

    Conservative type when

    compared with shoulder

    finish line.

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    PRESERVATION OF THE

    PERIODONTIUM

    The placement of finish lines has a direct

    bearing on the ease of fabrication and theultimate success of the restoration.

    The best results can be expected from

    margins that are as smooth as possibleand are fully exposed to cleansing action.

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    MARGIN PLACEMENT

    Whenever possible thefinish line should beplaced in an area wherethe margins can be

    finished by the dentisteasily and kept clean bythe patient.

    In addition,finish linesmust be placed so that

    they can be duplicated bythe impression withouttearing or deformation.

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    MARGIN PLACEMENT Finish line should be

    placed in enamelwhenever possible.

    Supra-gingival versussub-gingival margin.

    Many situations in

    which sub-gingivalmargins areunavoidable.

    1. Caries

    2. To increase retention

    3. Esthetics4. Extension of previous

    restoration

    5. Trauma.

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    PREPARATION FOR FULL

    VENEER CROWN

    PP-139-141

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    PREPARATION FOR FULL

    VENEER CROWNS

    SELECTION

    Full veneer crown exhibits superior retention

    and resistance when compared with partial

    veneer crown.

    Selection becomes mandatory when the

    abutment tooth is small and the

    edentulous span is long.

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    FULL VENEER CROWN

    Variations of the full veneer crown are

    1. Metal-ceramic crown.

    2. All-ceramic crown.

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    FULL VENEER CROWN

    INDICATIONS :

    1. Extensive coronal destruction due to

    caries or trauma.

    2. Endodontically treated tooth.

    3. Necessity for maximum retention and

    strength.

    4. To correct minor malinclination.

    5. To correct occlusal plane.

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    FULL VENEER CROWN

    Contra-indication :

    Full coverage should not be used in mouths

    with uncontrolled caries.

    It does not protect the tooth against the

    biological causes of caries.

    Caries must be controlled by other means

    before any restoration can be successful.

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    FULL METAL CROWN

    PREPARATIONARMAMENTARIUM :

    1. Hand piece

    2. No : 171L bur

    3. Round-end tapered

    diamond

    4. Short needle diamond

    5. Torpedo diamond

    6. Torpedo bur7. Red utility wax

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    FULL METAL CROWN

    PREPARATION

    STEP NO :1

    OCCLUSAL REDUCTION

    1.5 mm of clearance of

    functional cusp and 1mm

    on the nonfunctional

    cusp.

    Depth orientation grooves

    are placed on the

    occlusal surface withround end tapered

    diamond.

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    Full metal crown preparation

    Occlusal reduction :

    A round-end tapereddiamond is used to placethe grooves on the ridges

    and the primary groovesof the occlusal surface.

    If there is already someclearance with theopposing tooth because

    of malposition- groovesshould not be made asdeep.

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    Full Metal Crown Preparation

    OCCLUSAL REDUCTION :

    The occlusal reduction

    should follow theconfiguration of the

    geometric inclines that

    make the occlusal surface

    of any posterior teeth.

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    Full Metal Crown Preparation

    STEP NO : 2Functional cusp bevel with

    round-end tapereddiamond.

    A wide bevel is placed on

    the functional cusp-depthorientation grooves arealso helpful in thisreduction.

    Functional cusp bevel is

    integral part of occlusalreduction.

    Failure to place this bevelcan produce thin castingor poor morphology.

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    Full Metal Crown Preparation

    OCCLUSAL CLEARANCE :

    Is checked by having the

    patient to close on redutility wax held over the

    preparation.

    Full Metal Crown

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    Full Metal Crown

    PrepSTEP NO : 3

    Buccal and lingual walls arereduced with the round-

    end tapered diamond.The

    sides of the diamond will

    produce the desired axialreduction while the tip

    forms the chamfer.

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    Full Metal Crown

    Preparation

    STEP NO : 4

    Initial proximal axial

    reduction with short

    needle diamond

    followed by the round-end tapered diamond.

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    Full Metal Crown Preparation

    STEP NO : 6

    Seating groove with

    171L bur.

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    Full Veneer Crown Preparation

    STEP NO : 5

    Axial finishing- round-

    end tapered diamond.

    All axial surfaces aresmoothed including

    all point angles. The

    finish line should be

    smooth and

    continuous.

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    Full Veneer Crown Preparation

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