PRINCIPLES OF TOOTH

PREPARATION
FIVE Principles of
tooth preparation

STRUCTURAL
PRESERVATION RETENTION AND PRESERVATION
DURABILITY OF MARGINAL
OF TOOTH RESISTANCE OF THE
THE INTEGRITY.
STRUCTURE. FORM. PERIODONTIUM.
RESTORATION.
PRESERVATION OF TOOTH STRUCTURE.

Only limited
amount of sound
tooth structure
should be removed.
Partial coverage
Minimum taper
Follow anatomic
planes
 RETENTION AND RESISTANCE

RETENTION – Prevents removal of the

restoration along the path of insertion or
long axis of tooth preparation.

Resistance - prevents removing of the

restoration by forces directed in an apical
direction and prevents any movement of
the restoration under occlusal forces.
 FACTORS AFFECTING RETENTION
&
resistance
a- TAPER
b- FREEDOM OF DISPLACEMENT
c- LENGTH
d- SUBSTITUTION OF INTERNAL FEATURES
e- PATH OF INSERTION
 Retention

THE IMPORTANT PART OF RETENTION IS

2 OPPOSING VERTICAL SURFACES IN THE
SAME PREPARATION.
 TAPER
The walls ( buccal and lingual) of the
preparation should not be exactly
parallel for the restoration to seat
properly.
The walls should taper slightly. The
external walls should converge
occlusally
Each wall must have A taper of 3 degrees.
So A total of 6 degrees should be there
for full preparation.
WHAT HAPPENS IF YOU TAPER THE
RESTORATION MORE

IN TAPER IN RETENTION
GREATER THE SURFACE AREA OF THE
PREPARATION GREATER IS THE
RETENTION.
 FREEDOM OF DISPLACEMENT
Single path of insertion the restoration will be
more retentive.
 OCCLUSO-CERVICAL LENGTH
Occluso gingival length
affects both retention and
resistance form of the
restoration.
Recommended minimum
length

for molars = 4 mm &

for premolars and anterior =

3 mm
 OCCULOCERVICAL
DIMENSION
• Length must be great enough to interfere
with the arc of casting pivoting about a
point on the margin on the opposite side of
restoration
• The shorter wall does not afford this resistance

• Shorter wall should have as little taper as

possible
 RATIO OF
OCCULOCERVICAL/INCISOCERVICAL
DIMENTION TO FACIOLINGUAL
DIMENTION
• Prep on smaller tooth will have short
rotational radi for the arch of displacement
& incisal portion of the wall will resist
displacement
 D – SUBSTITUTION OF INTERNAL
FEATURES
Groove, box and pinhole can be made to
increase retention.

GROOVES
PATH OF INSERTION
• The path of insertion should
be parallel to long axis of
tooth.
• Tipped tooth – path should be
perpendicular to occlusal
plane
• Tipped on
adjacent tooth in
edentulous
space.
HOW TO VIEW
 STRUCTURAL DURABILITY
Restoration must contain a
bulk of material that is
adequate to withstand the
forces of occlusion

1. Occlusal reduction/clearance
2. Functional cusp bevel.
3. Axial reduction.
Maintain the occlusal anatomy.
Flat plane will reduce length of walls and will reduce
retention.
 Occlusal reduction

• Occlusal clearance for all metal crown

1.5mm for functional cusp
1 mm for non functional cusp
Occlusal clearance for metal -
ceramic crown
1.5mm for functional cusp
1mm - 1.2 mm for non
functional cusp
Occlusal reduction for all
ceramic crown is 2mm for
both cusps.
 Inadequate Occlusal Reduction

• Makes the restoration weaker.

• Will not provide adequate space to allow
good functional morphology under the
anatomical grooves.
• The restoration will be easily perforated by
finishing procedures or by wear in the
mouth.
 2 - 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
in an area of heavy
occlusal contact.
Lack of functional cusp bevel may produce 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
excessive tooth structure reducing retention.
 PROBLEMS IF BEVEL IS NOT
PLACED
• Extremely thin casting at the junction of
occlusal and axial reduction
• Overcontouring of restoration and
deflective occlusal contact
 If an attempt is made to obtain space for an
adequate bulk in a normally contoured
casting without a bevel,the result will be
overcut axial surface.
 3 - AXIAL REDUCTION

Plays an
important role in
securing space
for an adequate
thickness of the
restorative
material.
• Thin walls/ weak restoration
• OR
• OVERCONTOURED – PLAQUE
ACCUMULATION
MARGINAL INTEGRITY
• FINISH LINE - The peripheral
extension of a tooth preparation
• Close adaptation of restoration
margin to CAVOSURFACE FINISH
LINE of the preparation.
 FINISH LINE GEOMETRY
GUIDELINES FOR MARGIN DESIGN
• ease of preparation without underextentiom or
overextention enamel
• Ease of identification in imp and die
• A distinct boundary to which wax pattern can be
finished
• Sufficient bulk of material so that wax pattern can
be handled without distortion
• Conservation of tooth structure
Whenever possible the finish
line should be placed in an area
where the margins can be
finished by the dentist easily
and kept clean by the patient.

In addition,finish lines must be

placed so that they can be
duplicated by the impression
without tearing or deformation.
When ever possible the margin
should be supra-gingival.
 1 – SUPRA GINGIVAL

2 – SUB GINGIVAL
Advantages of supra-gingival margins

1. Easier
2. Accurate
3. Easily finised.
4. cleanable.
5. Impressions are more
easily made, with less
potential for soft tissue
damage.
6. Restorations can be
easily evaluated at
recall appointments.
• Sub-gingival
margins of
cemented
restorations have
been identified as
a major factor in
periodontal
disease,
particularly where
they encroach on
the epithelial
attachment.
• Dental caries,
• cervical erosion,
• or restorations extend
sub-gingivally,
• and a crown-lengthening
procedure is not
indicated.
• The proximal contact area extends to the
gingival crest.
1. Additional retention is needed.
2. The margin of a metal-ceramic crown is to be
hidden behind the labio-gingival crest for esthetics.
FINISH LINE CONFIGURATION

Chamfer
Heavy chamfer
Shoulder
Shoulder with bevel
Knife edge
 CHAMFER
• For full veneer metal
restoration.
• Lingual margin of M-
Ceramic crown
• Porcelain laminate
veener.
• Conservative in
comparison to
shoulder finish
line.
 CHAMFER MARGIN

• ADV
• Distinct,easily identifiable
• Provide room for adequate bulk of metal
• Can be placed with precision
• DISADV
• Care is needed to avoid unsupported lip
of enamel
 SHOULDER
• Labial surface of metal ceramic
restoration.
• All ceramic restoration
• It can be prepared with flat /round end
tapered diamond.
 SHOULDER

ADV
• Provide bulk of restorative material which
provide good contour and good esthetics
• Wide ledge provide resistance to occlusal
forces & minimizes stresses that might lead
to fracture of porcelain
DISADVANTAGES

• Destruction of more tooth structure

• Sharp 900 internal line angle concentrates stresses
in the tooth which might cause coronal fracture
 RADIAL SHOULDER

• Modified form of shoulder finish line

• A small radius internal line angle is

instrumented by end cutting parallel side
carbide finishing bur

• Stress conc is less than a classic shoulder &

support for ceramic restoration is good.
 SHOULDER WITH BEVEL
• for inlay and onlay restoration.
• Labial surface of Metal ceramic restoration in
patient with low smiling lip line
 SHOULDER WITH BEVEL

• INDICATION
• Facial surfaces of metal ceramic restoration where
a metal collar (as opposed to porcelain labial
margin) is used
• DISADV
• Less conservative so should not be used routinely
• It extends the prep apically
 BEVEL

INDICATION

If a ledge or shoulder already exists

possible
from dental caries,cervical erosion or
previous restoration
 ADVANTAGE
• Allows cast metal margin to be burnished
against tooth structure

• To minimize the marginal descripancy

• To protect unprepared tooth surface from

chipping
 KNIFE EDGE
• for lingual surface of
mandibular molars
and tilted teeth.
• It is prepared with
fine tapering fissure
diamond.
KNIFE EDGE

ADV
• Conservation of tooth structure
DISADV
• Fail to provide adequate bulk at margin
• overcontoured margin
• Difficult to read on gypsum dies
• Margins are prone to distortion during
porcelain firing
PRESERVATION OF THE PERIODONTIUM
The placement of
finish lines has a
direct bearing on
the ease of
fabrication and the
ultimate success of
the restoration.
The best results can
be expected from
margins that are as
smooth as possible
and are fully
exposed to
cleansing action.
• BIOLOGIC CONSIDERATIONS - which affect the
health of oral tissues
• MECHANICAL CONSIDERATIONS - which affect
the integrity and durability of restorations.
• ESTHETIC CONSIDERATIONS - which affect the
appearance of the patients.
 BIOLOGIC CONSIDERATIONS
• PREVENTION OF DAMAGE
DURING TOOTH
PREPARATION
• ADJACENT TOOTH – a
metal matrix band around
adjacent tooth OR
• Use the proximal enamel of
the tooth being prepared
for protection of adjacent
structures.
• Soft tissues – Protect tongue
when the lingual surfaces of
mandibular molars are being
prepared.

• Pulp – tooth preparations

must take into
considerations the
morphology of dental pulp
chamber.
 Causes of Injury
• Temperature – Excessive pressure, higher
rotational speeds and type, shape and
condition of cutting instrument may all
increase generated heat.
• Use water spray/ coolant