Full crown Indications 1-For badly decayed, fractured, traumatized teeth, and as individual restorations.

2-As a retainer for bridge and RPD. 3-To correct mal alignment and mal occlusion. 4-Endodontic treated teeth will become brittle because A-non-vital tooth. B-access opening. So the tooth will be week and need full coverage 5-Best retention and resistance.

PFM (anterior)

PFM (posterior) 1-Teth are short, tapered, round or lack well developed cingulum 2-Patient with occlusal habit that place heavy forces on the restoration 3-As retainer for RPD 4-To correct minor, malalignment and mal occlusion 5-Severly destructive tooth 6-Endodontically treated tooth and tooth with post and core 7-Correction if abutment tooth for RPD 8-Long span bridges

Three-quarter (anterior) 1-Anterior teeth as a retainer for FPD 2-As a splint for periodontically involved teeth But the teeth should have the following chch 1-The coronal tooth is intact or minimally restored 2-Anormal coronal form exists (not conical) 3-There is an average crown length When the restoration is to be used as retainer for a fixed prosthesis, the following also are to be consider A-The abutment teeth are in normal axial alignment B-Short lever arm C-Average occlusal forces

Three-quarter (posterior) 1-For posterior teeth as a single restoration for teeth that have lost moderate amount of tooth structure with intact buccal wall or as retainer for posterior FPD

Contraindications

1-Bulky sound tooth . 2-Eshetic critical area 4- Short edentulous span.

1-Young patient due to large pulp chamber and incomplete crown eruption. 2-Patient with active caries and untreated periodontal disease. 3-Intact abutment teeth in short span ridges. 4-When the teeth can be satisfactory restored with a more conservative restoration.

1-Conservative if compared to PFM 2-Retentive resistance more than partial coverage 3-More structural durability 4-More marginal integrity 5-Easier to do

1-Stronger than all ceramic 2-Superior marginal fit over all ceramic 3-Better esthetic than cast restoration

1-Glazed porcelain is the most esthetically durable and biocompatible restorative material for teeth (resist wear and plaque adhesion) 2-The metal substructure provide support to the porcelain and hence less liable to fracture than the all porcelain crown 3-The metal substructure allowed the fabrication of fixed partial denture

1-Teeth that have short clinical crown because the retention may not be adequate. 2-Extensivlely damaged teeth. 3-as retainer for long span ridges. 4-Patients with active caries or periodontal disease. 5-For endontically treated teeth, because insufficient tooth structure remain 6-Thin teeth of restricted labiolingual dimension 1-Conservative because it requires less sound tooth structure reduction 2-Less opportunities for periodontal trauma because less restoration margins r in close proximity to gingival 3-Reduced pulpal and periodontal insult during preparation 4-Magins in accessible area to the dentist for finishing and to patient for cleaning 5-Good seating for the restoration coz the luting

Advantages

1-Less conservative than RPD 2-Plaque accumulation 3-Galvanic current 4-metal display 5-Coverage for extra tooth structure

Preparation is not conservative as cast restoration

4-The natural appearance can be closely matched by characterization with internal and/or external staining techniques 5-The preparation of the PFM is much easier than that of the partial coverage restoration 1-Need a less conservative preparation 2-Less esthetic qualities than the all porcelain crown 3-Needs special equipment and expensive armentarium 4-Fracture liability of the porcelain veneering 5-facial gingival finish line should be carried subgingivally and consequently more potential for gingival involvement and periodontitis 6-Difficult of making an accurate shade reproduction due to metal

agent can escape more easily 6-The uncovered labial or buccal surface permits vitality testing

Disadvantages

1-less retention and resistance than complete coverage crowns 2-more difficult preparation 3-some metal is displayed in the restoration

1-occlusal reduction 2-functional cusp reduction 3-lingual surface reduction 4-proxiaml surface reduction 6-finishing of the preparation Are done for structure durability Depth orientation grooves: 1mm or 1.5 mm groves we connect them together following the anatomy of the tooth in lower teeth: 1.5mm occlusal reduction in buccal cusps (functional cusps) 1mm for lingual cusps

1-depth orientation grooves 2-incisal reduction 3-axial reduction 4-marginal placement 5-finishing

1-Occlusal reduction 2-Axial reduction 3-marginal placement 4-Seating grooves 5-Finishing

1-lingual reduction 2-proxiaml reduction 3-proximal grooves 4-incisal offset 5-incisal bevel

1-occlusal reduction 2-functional cusp bevel 3-lingual reduction 4-proximal reduction 5-proximal grooves 6-proximal flares 7-occlusal offset 8-buccal cusp bevel

Steps

We do depth orientation grooves for even thickness reduction then remove tooth structure in between We use flat-end tapered diamond bur to do 2mm reduction

steps

In upper teeth: 1mm occlusal reduction in buccal cusps 1.5mm for lingual cusps Functional cusps should be beveled after the occlusal reduction

We do depth orientation grooves for even thickness reduction then remove tooth structure in between We use 170 or 171 tapered fissure bur and round-end tapered diamond bur In lower teeth: 2mm reduction in the bucaal cusps (functional cusps) 1mm reduction in lingual cusps In upper teeth: 1.5mm reduction for both buccal and lingual cusps (functional cusps)

Done with small wheel stone, the incisal edge is reduced along the mesio-distal length.labio-lingually the cut is inclined lingually with 45 degree to the long axis of the tooth. The labial margin of the reduction should end just before the inciso-labial angle. In the canine reduction follow the natural mesial and distal inclines of the incisal edge(two planes),while for incisors, flat plane is cut from mesial to distal

Depth grooves done on the occlusal surfaces with round-end tapered diamond bur, the reduction then completed by reducing the tooth structure remaining between the depth grooves In lower teeth: 1-1.5mm reduction from buccal cusps 2- 1mm reduction from lingual cusps In upper teeth: 1-1.5 mm reduction from lingual cusps 2- 1mm reduction from buccal cusps

ior)

Functional cusp bevel Is done on both upper teeth (on lingual cusps) and lower teeth (on buccal cusps) with round end tapered diamond bur and bur no.171 the depth is 2mm Angle between functional cusp bevel and functional cusp slope should be 45 degree -To follow the morphology of the tooth -Stability and support -Prevent fracture -Prevent PDL injury -Lateral torque prevention

Done to increase retention and resistance and marginal integrity. In buccal and lingual reduction we use the turbido bur. the bur must be tilted occlusally, if not under

Labial reduction; -We do depth orientation grooves in two planes to avoid pulp exposure 1- Parallel to gingival 1/2 2- Parallel to incisal 1/2 -We use flat end tapered

Buccal and lingual walls reduction then proximal walls reduction We use flat end tapered diamond bur (shoulder finish line) hold it parallel to the long axis of the tooth otherwise undercut or

Functional cusp bevel Done with round end tapered only on maxillary teeth .the bevel extends on the central groove from the mesial to the distal .the difference between maxillary and mandibular teeth that is the buccal cusps of mandibular teeth are the functional cusps so the location of the occlusal finish line on the buccal surface will be different. It will be 1mm gingival to the occlusal contact this result in metal coverage .The occlusal shoulder in buccal aspect of the buccal cusp served as the same purpose of the offset in maxillary teeth so there is no need for an offset in mandibular preparation. Lingual reduction: Lingual reduction: Is made in 2 steps Eliminate the undercut A-reduction of the cervical to the height of lingual surface from contour done with round the crest of the end tapered. cingulum to the incisal -Mesiodistally follow the edge. We do first contour of the tooth orientation groves by -Occlusocervically parallel small round diamond to the path of insertion

Axial reduction

cut will occur. Or we use the round end tapered diamond bur and hold it parallel with the long axis of the tooth To open the contact we use long thin tapered diamond for anterior teeth And short thin tapered diamond bur for posterior teeth We finish the preparation 0.5-1mm from supraginigval.

diamond bur to do 1.5 mm reduction to do shoulder with bevel (bevel is done to decrease area of exposed cementum. -We use enamel chisel, such as hachet or biangle chisel to remove undermined edge of tooth structure. We use the chisel also to produce smooth finish line. -Wings: is left standing in each proximal area, lingual to the proximal contact so the metal wont display. It1- preserve tooth structure 2-and adds some torque and rotational resistance.

over tapering will occur For lingual reduction we use turbido bur. or we use the round end tapered diamond bur (chamfer finish line) To open the contact we use short thin tapered diamond bur

bur then reduction done using a small wheel diamond bur. Even reduction of 0.7mmm should be made. In canine the reduced lingual surface should be made in two planes while the incisors the entire surface is concave. B-reduction of the area of the crest of the cingulum to the crest of the gingiva to eliminate the under cut cervical to height of contour this is done using tapered diamond stone with round end

with slight occlusal convergence Proximal reduction: Started by gaining proximal axes with thin tapered diamond then followed by round end tapered to complete the reduction and form chamfer finish line Final extension to buccal surface by thin tapered diamond .the proximal surfaces must be parallel to each other and path of insertion with slight occlusal convergence

Lingual reduction: Depth of reduction is 0.7mm.done by 1-round bur 2-foot ball 3-wheel. 4-turbido 2,3 are used above the cingulum 1,4 below the cingulum to make heavy chamfer finish

Proximal reduction: Initial reduction is done with long needle diamond then a small diameter tapered round end diamond bur is used to insure chamfer finish line with the depth of cut from 0.3-0.5mm

line. Proximal wall reduction: -Initial reduction is done with long needle diamond then a small diameter tapered round end diamond bur is used to insure chamfer finish line. -2_3 degree taper on each side. Gingival marginal placement: -The end cutting bur no. 957, but is only used to smoothen the SHOULDER finish line and to move the shoulder subgingivally But usually we dont use it. -The internal angle should be rounded to reduce stress concentration.

Others

We may use retentive grooves if the tooth is too short so we need extra means of retention Wings at the end of the shoulder are done for: 1-prevent horizontal movement 2-preserve tooth structure. 3-Marginal placement

Proximal grooves: Should be parallel to the incisal 2/3 of the labial surface. Mesiodistally the grooves should be parallel to each other with slight incisal convergence. We use a taper fissure bur no. 170 at the mesial surface to make a depth of 1mm and extenf gingivally to its full length and the second groove is done on the distal surface parallel to the first one just ending short to the chamfer. Incisal offset: The grooves r connected with an incisal offset using a no.171 bur. the offset is a definite step on the sloping lingual surface. On a canine it forms a V shape, but on incisor it is a line follow the incisal edge

Proximal grooves: It must be placed on the buccal half on the proximal surface at the line between the buccal and middle third of proximal surfaces. This increases the bulk of tooth structure lingual to the grooves to resist lingual displacing force. -The I shape groove is the satisfactory form because the lingual form of the groove is prepared to be at right angle to the proximal surface preventing the restoration to be displaced lingually -The box like form is indicated in case of proximal caries or when is made to receive the female portion of precision attachment -The V shaped groove is rarely used due to its reduced retentive quality but it is mainly used for anterior three quarter preparation.

Incisal bevel: A 0.5mm incisal bevel is placed on the labioincisal finish line using a flame diamond bur

Proximal flare: The buccal wall of the groove is then flared buccally by a flame diamond to remove any unsupported tooth structure. The flare should be extended far enough to be reached by the explorer but not so far as to cause display of metal Occlusal offset: Done with no.171 bur .the offset is a 1mm wide ledge on the lingual incline of the buccal cusp. It connects the groove and plays a major role in the casting rigidity by tying together the proximal grooves. With end cutting bur smooth the offset insuring that it will be a flat ledge. Buccal cusp bevel: Place a narrow occlusal finish bevel along the occlusobuccal line angle with a flame diamond about 45 degree relative to buccal surface .the bevel should be no more than 0.5mm wide.

Full crown

Anterior PFM

Posterior PFM

Anteior three quarter

Maxillary posterior three quarter

Mandibular posterior three quarter

SCORPION DENTIST
Helped by: angel dentist and miss dentist, pic. By lemo and strawberry.