PRINCIPLES OF TOOTH

PREPARATION.
Tooth preparation is defined as the process of removal of diseased
and/or healthy enamel, dentin and cementum to shape a tooth to
receive a restoration.
GPT 9
BIOLOGIC PRINCIPLES
1. PREVENTION OF DAMAGE
ADJACENT TEETH
• Iatrogenic damage to adjacent tooth is common error
• Damaged proximal area susceptible to caries
Method of prevention
i. Metal matrix band around adjacent tooth
ii. Use of proximal enamel being prepared
SOFT TISSUES
• Mouth mirror
• Aspirator tip
• Flanged saliva ejector
PULP
Pulpal damage may be due to –
• Increased depth of preparation
• Heat generated by – excessive pressure
high rotational speed
condition of cutting instrument
improper application of coolant
• Prevented by – high speed hand piece intermittently with feather touch
sharp diamond bur with directing water spray
CONSERVATION OF TOOTH STRUCTURE
• Using partial coverage than complete coverage when possible
• Minimum practical taper
• Occlusal surface should follow anatomic plane
• Selection of compatible finish line with the type of restoration
• Avoidance of subgingival margins unless indicated
• Preparation of axial surface – depth orientation grooves
proper width of diamond points
MARGIN INTEGRITY
Margin: The outer degree of crown, inlay or other restoration
Finished line: Terminal portion or peripheral extension of the prepared tooth
MARGHIN PLACEMENT
Can be placed by :
• Supragingival
• Equigingival
• Subgingival
Supragingival
Advantage
• Placed on enamel
• Easy to prepare without trauma to soft tissue
• Easily finished
• Impression making is less traumatic to soft tissues and easy to reproduce
• Easy to evaluate fit of restoration
• Maintained easily
Subgingval
Indications
• Subgingival caries, erosion, or restoration
• Metal ceramic restorations
•Additional retention – short crowns
•Root sensitivity
• modification of axial contour
• Proximal contact – gingival crest
MARGIN GEOMETRY
Characteristics:
• Ease of preparation
• Ease of identification
• Distinct boundary
• Sufficient strength
• Conservation of tooth structure
MARGIN ADAPTATION
• Junction between cemented restoration and tooth – recurrent caries,
periodontal diseases
• Smooth and even margin
• 10 microns – cast metal
• 50 microns – ceramic
MECHANICAL CONSIDERATION
Mechanical principles
• Retention form
• Resistance form
• Structural durability
RETENTION FORM
The feature of a tooth preparation that resists dislodgement of a crown in a
vertical direction or along the path of placement.
Determined by
• Magnitude of dislodging forces
• Geometry of preparation
i. Taper
ii. Surface area
iii. Freedom of displacement
iv. Stress concentration
v. Type of restoration
• Path of insertion
• Roughness of surfaces being cemented
• Materials being cemented
• Type of luting agent
RESISTANCE FORM
The feature of a tooth preparation that enhances the stability of a restoration
and resists dislodgement along an axis other than the path of placement
Factors affecting resistance form:
• Magnitude and direction of dislodging forces
• Geometry of tooth preparation
i. Occluso-gingival length
ii. Grooves, proximal boxes and pinholes
iii. Types of luting agent
STRUCTURAL DURABILITY
Factors affecting structural durability:
• Occlusal reduction
• Functional cusp bevel
• Axial reduction
AESTHETIC CONSIDERATION
• Partial veneer crowns with intact labial surface
• Metal ceramic restoration with ceramic coverage facially
• All ceramic restoratons
THANK YOU