PrinciplesofTooth

Preparation

RolaShadid,BDS,MSc,AssociateFellowAAID

Tooth structure is conserved by using the following guidelines

1.
2.
3.
4.
5.

Use of partial coverage rather than complete

coverage restoration
Preparation of teeth with minimum practical
convergence angle (taper) between axial walls
Preparation of the occlusal surface so that
reduction follows the anatomic planes to give
uniform thickness in the restoration
Preparation of the axial wall so tooth structure is
removed evenly if necessary teeth should be
orthodontically positioned
selection of conservative margin compatible with
other principles of tooth preparation

Preservation of tooth structure

Histologic studies showed that
specimen with dentin thickness greater
than 2 mm demonstrated very little or
no pulp response , while when cutting
was done within 1.5mm of the pulp,
23%of teeth developed an abscess

Reductionofaxialwallswithmaximalthicknessof

remainingdentinsurroundedthepulp

Preparationoftoothwithminimalpractical
convergenceangle(Taper)betweenaxialwalls

Preparationofocclusalsurfacefollowingthe
anatomicalcontourtogiveuniformreduction

Selectionofmarginalgeometrywhichisconservative

andcompatiblewithotherprinciples

Avoidanceofunnecessaryapicalextensionofthe
preparation

Over
reduction

Alsoyoushouldbecarefulabout:
1Adjacenttooth
byusingmatrixbandoftheadjacenttooth
cuttingintheenamelofpreparedtoothwith
finetaperedstone
2Softtissues
byusingmirrorortheflangeofsalivaejector

Retention&
Resistance

RETENTIONFORM
Thefeatureofatoothpreparation
thatresistsdislodgementofacrown
inaverticaldirectionoralongthe
pathofplacement.

RESISTANCEFORM
Thefeaturesofatoothpreparationthat
enhancethestabilityofrestorationand
resistdislodgementalonganaxisother
thanthepathofplacement
Itpreventsdislodgementofarestoration
byforcesdirectedinanapical,obliqueor
horizontaldirection.

Retention and resistance

1.
2.
3.
4.

Total occlusal convergence

Length of preparation
Diameter
Ratio of occlusocervical to
faciolingual dimension
5. Circumfencial morphology
6. Auxiliary retentive features
7. Cements

Total occlusal convergence

Factors that may create greater total

occlusal convergence
1. Posterior teeth are prepared with greater
total occlusal convergence than anterior
teeth
2. Mandibular teeth were prepared with
greater convergence than maxillary teeth
3. Faciolingual surfaces had greater
convergence than mesiodistal surfaces.
4. Abutments of fixed partial denture usually
prepared with greater total occlusal
convergence
5. Monocular vision created greater total
occlusal convergence than binocular vision

Parallel walls are impossible to

create in the mouth without
producing preparation undercuts.
The axial walls of the preparation
must taper slightly to permit the
restoration to seat.

 A tapered diamond or bur will impart

an inclination of 2 to 3 degrees to any
surface it cuts if the shank of the
instrument is held parallel to the
intended path of insertion of the
preparation.
Ideal convergence angle of 4-10 is
seldom achieved
Mack estimates that a minimum taper
of 12 degrees is necessary Just to
insure the absence of undercuts.

 Ataperortotal
convergenceof16
degreeshasbeen
proposedasbeing
achievableclinically
whilestillaffording
adequateretention.It
canbeaslowas10
degreeson
preparationsanterior
teethandashighas22
degreesonmolars

 Resistance is more sensitive than retention

to changes in convergence angle
As a rule we will go for the minimal
tapering without having undercuts in the
preparation

SURFACEAREAVS.RETENTION
Providedtherestorationhaslimitedpath
ofwithdrawal,thegreaterthesurfacearea
ofapreparation,thegreaterisits
retention.
Length..Crownswithlongaxialwalls
aremoreretentive
Molarcrownsaremoreretentivethan
premolarcrownsofsametaper

Thelongertheoccluso
gingivalheight,themorethe
surfacearea.

Themorediameterofprepared
teeth,themorethesurfacearea.

Length of preparation vs.

resistance
Becausetheaxialwallocclusaltothefinish
lineinterfereswithdisplacement,thelength
andinclinationofthatwallbecomefactors
inresistancetotippingforces.
Theshorterthewall,themoreimportantits
inclination
Thewallsofshorterpreparationsshould
haveaslittletaperapossibletoincreasethe
resistance.

Widthofprep.vsresistance
Anarrowtoothcanhavegreater
resistancetotipping.
Thepreparationonthesmallertoothwill
haveashortrotationalradiusforthearc
ofdisplacement,andtheincisalportionof
theaxialwallwillresistdisplacement.
Thelongerrotationalradiusonthelarger
preparationallowsforamoregradualarcof
displacement,andtheaxialwalldoesnot
resistremoval

 Parkeretalfoundthatapproximately
95%ofanteriorpreparationsanalyzed
hadresistanceform,whileonly46%of
thoseonmolarsdid.

 Resistancetodisplacementforashort
walledpreparationonalargetoothcanbe
improvedbyplacinggroovesintheaxial
walls.
Ineffect,thisreducestherotationalradius,
andthatportionofthewallsofthegrooves
neartheocclusalsurfaceofthepreparation
willinterferewithdisplacement

Ratio of occlusocervical to
faciolingual dimension
The longer the faciolingual dimension of
prepared molars compared with other
teeth and shorter occlusogingival
dimension compared with anterior teeth
produce a lower ratio and lower resistance
to dislodgment of molar crown

 Weed and Baez recommended that the

occlusocervical / faciolingual ratio should
be 0.4 mm or higher for all teeth

STRESSCONCENTRATION
Iflineanglebetweenaxialandocclusal
surfaceissharp,itleadstoconcentration
ofstressesaroundthatjunction
Inducedstressesexceedsthestrengthof
thecement
Leadstocohesivefailureofcement

TYPEOFRESTORATIONVSRETENTION
Fullveneercrownhasexcellentretention
whencomparedtopartialveneercrown
becausereducingthepathofinsertionto
anarrowrange.

TYPEOFRESTORATIONVSRESISTANCE
Partialcoveragerestorationmayhave
lessresistancethanacompletecrown
becauseithasnobuccalresistancearea

SurfaceRoughness
Adhesionofdentalcementsdepends
primarilyonprojectionsofthecement
intomicroscopicirregularities.
Jorgensenfoundretentionofcastings
cementedwithZnPO4cementontest
dieswitha10tapertobetwiceasgreat
onpreparationswith40mscratches
than10m.
Retentionincreaseswhenrestorationis
roughenedorgrooved

Materialsbeingcementedvs
retention

Retentionisaffectedbyboththecasting
alloyandthecorematerial.
Morereactivethealloyismoreadhesion.
Basemetalalloysarebetterretained
thanlessreactivehighgoldcontent
metals.
Typeoflutingagent:Studiesshowthat
adhesiveresincementsaremore
retentivethanconventionalZnPO4and
GICcements

PHYSICALPROPERTIESOFLUTING
AGENTVSRESISTANCE
Resistancetodeformationisaffectedby
physicalpropertiesofthelutingagent,
suchascompressivestrengthand
modulusofelasticity
Adhesiveresin>GIC>ZnPO4>
Polycarboxylate>ZOE

Auxiliary retentive features

Internalfeaturessuchasthegroove,thebox
form,andthepinhole

 Secondaryretentivefeaturesdoesnot
significantlyaffecttheretentionbecause
thesurfaceareaisnotincreased
significantly.
Butwherethesefeatureslimitsthepath
ofwithdrawal,retentionisincreased

 Kentetalreportedamarkeddifference
betweenthedegreeoftaperoffullcrown
preparations(18.4to22.2degrees)andthat
ofboxesandgroovesintheaxialsurfaces
ofthosepreparations(7.3degrees).

 Kent et al found that grooves and boxes

had less convergence than the
convergence of the axial wall to enhance
resistance

Circumferential morphology
Pyramidal tooth preparations
provided increased resistance
because they had corners
when compared with conical
preparation. So it is
important to preserve
facioproximal and
linguoproximal corners of
tooth preparation
Prepared mandibular molars
are rectangular while
maxillary molars are
rhomboidal and premolars and
anterior teeth possess an oval
form

PathofInsertion
Itisanimaginarylinealongwhichthe
restorationwillbeplacedontoor
removedfromthepreparation.
Itisofspecialimportancewhen
preparingteethtobefixedpartial
dentureabutments,sincethepathsofall
theabutmentpreparationsmustparallel
eachother.

Pathofinsertion

Paralleltothelongaxisofthe
tooth

Paralleltotheincisal2/3ofthe
tooth

Thepathofinsertionmustbeconsideredin
twodimensions:
Faciolingually:thefaciolingual
orientationofthepathcanaffectthe
estheticsofmetalceramicorpartial
veneercrowns.
Mesiodistally

Structural durability
Arestorationmusthavesufficient
strengthtopreventpermanent
deformationduringfunction
Theabilityofarestorationtowithstand
destructionduetoexternalforces

Structural durability
Adequatetoothreductionocclusal
reductionfunctionalcuspbevelaxial
reduction
Alloyselection
Metalceramicframeworkdesign
Margindesign

Occlusal reduction
Zurcherman has shown that the placement of
inclined planes on occlusal surfaces of a crown
preparation rather than flat surface increases
resistance form

Functional cusp bevel

This includes wide bevel
on the lingual surface
inclines of maxillary
lingual cusps and buccal
inclines of mandibular
buccal cusps, this will
provide space for
adequate bulk of metal in
an area of heavy occlusal
contact

Axial reduction

MarginPlacement

Biologicwidth
Itisthedimensionofspacethatthehealthy
gingivaltissuesoccupyabovethealveolar
bone.Itreferstothecombinedconnective
tissueepithelialattachmentfromthecrest
ofthealveolarbonetothebaseofthe
sulcus(2mm;connectivetissue1.07mmand
epithelium0.97mm).
Evaluationofthebiologicalwidthby
radiographs,probing,andsoundingof
bone

Locationofrestorativemargins
Supragingival
Equigingival
Subgingival

Indications for subgingival margins

Wheretoplacesubgingival
margin?
Wearhang reported that a
conventional tooth brush could
remove plaque only to a point
0.5mm subgingivally, so it is
important to ensure that
restorations are placed no deeper
than 0.5mm into sulcus when this is
possible

Wheretoplacesubgingival
margin?
Itisgenerallytaughtthatthegingival
marginshouldneverenterthesulcusby
morethanhalfthedepthofthesulcus.In
theaveragecasethisequalsadepthof1.0
mmorless,withlessbeingfavored

Wheretoplacesubgingival
margin?
No margin should be placed nearer than 0.5
to 1.0 mm from the attachment area in
healthy sulcus
Some authors suggested that restorative
margins should end 3-4 mm coronal to the
alveolar crest, they assumed the biologic
width is 2mm and additional 1mm will keep
the margin 1mm above the coronal extent
of junctional epithelium
Gingival attachment is more reliable
reference point than marginal gingiva

Technique
Packingasmalllengthofretractioncordinthe
areaofthesulcustoreceivethesubgingival
marginworksverywell.
Makeamentalnoteoftherelativerelationship
ofthefreegingivalmarginandroughedin
finishlinepriortopackingthecord.Even
smallcordsoftenachieveremarkablegingival
retraction.Youmaynotneedtoplacethe
marginasfarapicallyasthelevelofthecord.

Technique
Thelingualandapproximatelyhalfofthe
interproximalmarginsshouldremainsupragingival
(ifpossible).
Thelabialandlabialonehalfoftheinterproximal
marginsarebroughtdowntoornearthelevelofthe
retractioncord.
Bespecificallyawareofkeepingtheinterproximal
marginsubgingivaluntilitwillnolongerbevisible
whenviewedatanangle.Thisisafrequentareaof
marginvisibility,especiallyforporcelainveneers.

 D.A. Orkin et al and J.Valderhang et al

found out that there was significant
difference in bleeding between the
subgingival crowns and contralateral
teeth without crowns but the difference
was negligible with supragingival crowns
Hatchy J. Sttler concluded that in the
presence of subgingival restoration, the
degree of gingival inflammation is
significantly greater in association with
narrow (less than 2mm ) zones of
keratinized gingiva than with those
greater than 2mm

The extent of disease depends

on:
contour of restoration,
relative position of cervical
margin,
precision of fit,
restorative material used

Marginal contours : Lang et al reported that

overhanging margin not only accumulate more
plaque but the plaque undergoes a change in
composition to that usually associated with
destructive periodontitis
Surface roughness :Donnan and Prince
evaluated the plaque accumulation in metal
ceramic restoration and discovered the order of
decreasing plaque accumulation:
Aluminum oxide (greatest), opaque porcelain,
polished metal, glazed porcelain (least)
In term of smoothness (generally):
glazed porcelain > gold > polished amalgam
>composite
Marginal fit : the severity of periodontal disease
was elevated with greater subgingival marginal
discrepancy

 Surgical crown lengthening of crown

is necessary if restorative margin
would terminate at or below
alveolar crest

If restorative margin would terminate at

or below alveolar crest surgical lengthening
of crown is necessary , the procedure
involves reflection of full thickness flap to
expose alveolar crest around the teeth in
question, the distance from the bone crest
to margin of tooth preparation can be
measured with periodontal probe, the
distance should be 3-4 mm if the bony
crest is not reduced. At least 6-8 weeks
must elapse to allow for proper healing.

MARGINAL GEOMETRY OR
FINISH LINE
CONFIGURATION

Themargindesigndependson:
typeofrestoration,
toothmorphology,
positionandalignmentoftheteeth
inthearch,
esthetics

Guidelinesformargindesign
Easeofpreparationwithoutoverextensionor
unsupportedenamel
Easeofidentificationintheimpressionandonthedie
Adistinctboundarytowhichwaxpatterncanbefinished
Conservationoftoothstructure
Sufficientbulkofmaterialforestheticandstrengthofthe
restoration.
Themostimportantconsiderationinselectingacervical
margindesignisitsabilitytoconsistentlyandpredictably
provideexcellentmarginalintegrity.

Featheredge

Chisel

Chamfer Bevel

Shoulder

Sloped
Shoulder

Beveled
Shoulder

The shoulderless (featheredge)

margin
Conservation of the tooth structure
Permits an acute margin of the metal
Insufficient removal of tooth structure at
cervical area. (Results in overcontouring )
Impossible to identify the margin of prep.
No control over reduction of cervical tooth
structure
No control in placem. of subgingival margin
Poor resistance to marginal distortion during firing
of porcelain to the gold alloy.
difficult to accurately wax and cast
more susceptible to distortion in the mouth when
the casting is subjected to occlusal forces

Indications for featheredge

Not recommended
It may have to be used
on the lingual surface
of mandibular
posterior teeth,
On teeth with very
convex axial surfaces,
and on the surface
toward which a tooth
may have tilted.
Could be Used for the
full metal crown prep

The shoulder (Butt joint) margin

Adequate removal
of tooth structure
at cervical area.
It is possible to
identify the
margin of prep.
Good control over
reduction of
cervical tooth
structure

The shoulder (Butt joint) margin

Control in placem.of
subgingival margin
Adequate resistance
to marginal distortion
during firing of
porcelain to the
metal alloy.
It does require the
destruction of more
tooth structure than
any other finish line.

The shoulder (Butt joint)

margin
Finishlineofchoicefortheallceramic
crownandporcelainlabialmargin
Thewideledgeprovidesresistanceto
occlusalforcesandminimizesstressesthat
mightleadtofractureoftheporcelain.It
producesthespaceforhealthyrestoration
contoursandmaximumesthetics.

The shoulder (Butt joint)

margin
Thesharp,90degree
internallineangle
associatedwiththe
classicvarietyofthis
finishline
concentratesstressin
thetoothandis
conducivetocoronal
fracture.

Theradialshoulder
Amodifiedformofshoulderfinishline
Asmallradiusroundedinternalangleis
instrumentedbyanendcuttingparallel
sidedcarbidefinishingbur,andfinishingis
completedwithaspeciallymodifiedbin
anglechisel.
Thecavosurfaceangleis90degrees,and
shoulderwidthisonlylessenedbythe
roundedinternalangle.

135 sloping shoulder

Veryusefulpreparation
tousewherethelabial
shoulderforMCcrowns
isextendingwellintothe
rootface,e.g.canines
withmarkedgingival
recession.Thefinishing
linecanbeplacedsub
gingivallyandtheaxio
gingivalfloorlineangle
leftatahigherlevel.

135 sloping shoulder

provides for more conservative
preparation especially in root
surface
it requires metal collar
porcelain butt margin is not
recommended with the sloping
shoulder

The shoulder-bevel

It is obtained by preparing
shoulder at the height of healthy
gingival margin, then adding 0.51.25 mm bevel.
It has the same advantages of
straight shoulder with optimum
opportunity of marginal fit
provided by the bevel

 The beveling removes

unsupported enamel, may allow
some finishing of the metal, &
minimize margin discrepency.

Used for ceramo-metal, full metal

 This design can also be used for the

facial finish line of metal-ceramic
restorations where gingival esthetics
are not critical. It can be used in
those situations where a shoulder is
already present, either because of
destruction by caries or the presence
of previous restorations.
It is also a good finish line for
preparations with extremely short
walls, since it facilitates axial walls
that are nearly parallel.

A shoulder or sloped shoulder is

preferred to shoulder with bevel for
ceramometal restorations due to
biological & esthetic considerations
(the metal margin can be thinned to a
knife edge & hidden in the sulcus
without the need for positioning the
margin closer to the epithelial
attachment)

Chamfer
Conservative type
when compared with
shoulder finish line.
control over
reduction of cervical
tooth structure,
control in placem.of
subgingival margin

Chamfer
Margin of prep.is distinct
Degree of marginal
distortion during firing of
porcelain directly related
to the thickness of metal
at the margin


Chamfer

The preferred gingival finish

line for full veneer metal
restoration and the metal
only portion of MC crown

Chamfer

Porcelain margin is not recommended

because it will lack mechanical
resistance and depth of translucency

Heavychamafer
Aheavychamferisusedtoprovidea90degree
cavosurfaceanglewithalargeradiusrounded
internalangle
Itiscreatedwitharoundendtapered
diamond.
Inthehandsofanunskilledoperator,this
instrumentcancreateanundesirablefragile
"lip"ofenamelatthecavosurface.
Theheavychamferprovidesbettersupportfor
aceramiccrownthandoesaconventional
chamfer,butitisnotasgoodasashoulder.

Margin forms for MC

Metal collar
Metal feather edge
(Disappearing margin)
Porcelain margin

Margin forms for MC

Metal collar
Advantages :
1. good marginal seal
2. preservation of periodontal health
3. rigidity during cementation
4. wide facial metal collar (.8mm) gives
sufficient rigidity against distortion
caused by porcelain shrinkage in
comparison of the feather edge collar
5. can be used with any of the finish
lines described previously

Disadvantages :
1. difficult to conceal in a shallow
crevice or with a thin translucent
gingival margin
2. they display in case of gingival
recession
3. display of metal becomes very clear
with high lip line

Metal featheredge (Disappearing

margin)
Reduction of the labial metal collar has
been described as: feather edge ,
triangular formation , hairline collar .
The metal and opaque layer porcelain meet
simultaneously on the external edge of the
tooth preparation
Shoulder preparation is needed for this
design to provide rigidity of metal in the
cervical area

Disadvantages :
1. the design is technique sensitive and
difficult to achieve without overcontouring
the cervical aspect or exposing opaque
layer
2. difficult finishing and polishing ,
microscopically the surface remains rough
3. marginal adaptation after porcelain firing is
subject to some distortion ,

Porcelain margin
Advantages:
1. esthetic improvement because of :
a. facial metal collar elimination
b. depth in cervical translucency
c. possibility of light transmission
through the root area
2. less plaque accumulation than metal
because of low adhesive forces
between plaque and ceramics

 porcelain margin is used with shoulder finish line

(1.2mm wide ) internally rounded at a 90-100 angle
to root surface with regular and smooth outline

 chamfer and sloping shoulder finish lines are

contraindicated with porcelain margin because :
a. porcelain margin would be very thin and prone
to chipping
b. difficult to achieve satisfactory marginal
adaptation because porcelain shrinkage occurs
toward the greatest bulk during firing

Porcelain construction :
various techniques of porcelain margin
construction have been described using :
platinum matrix , refractory dies , separating
varnish , wax, or resin binders
with conventional porcelain margin materials
rounded edges with rough and
heterogeneous surfaces were more likely to
occur using direct lift off technique than
platinum matrix substrates

For all metal restorations, chamfer finish line

are frequently used the advantages of
chamfer finish line
1. They produce the less stress and marginal
opening of metal
2. They are easy to form with a tapered round
end diamond instrument
3. They posses adequate bulk for restoration
4. They are visible on prepared teeth
5. Their depth is sufficient to permit the
concept of normal axial contour .

Standardmetalceramiccrowninvolving
onlytheanatomicalcrownandwhere
aestheticsisofprimaryimportance
LabialFlatshoulder(90)
LingualDeepchamferwithmetalcollar

ANTERIORMETALCERAMIC
CROWNS
AUNIFORM
REDUCTIONOF
APPROXIMATELY
1.2MMISNEEDED
OVERTHEENTIRE
FACIALSURFACE.

ANTERIORMETALCERAMIC
CROWNS
TOACHIEVEADEQUATE
REDUCTIONWITHOUT
ENCROACHINGUPONTHE
PULPFACIALSURFACE
PREPAREDINTWO
PLANESTHAT
CORRESPONDROUGHLY
TOTHETWOGEOMETRIC
PLANESPRESENTONTHE
FACIALSURFACEOFAN
UNCUTTOOTH

ANTERIORMETALCERAMIC
CROWNS
FACIALSURFACE
PREPAREDINONE
PLANETHATHAS
ADEQUATEFACIAL
REDUCTIONINTHE
GINGIVALASPECT:
Inadequatespacefora
sufficientthicknessof
ceramicmaterialPoorly
contouredrestorationaffecting
bothesthetic&healthofthe
surroundinggingiva.

ANTERIORMETALCERAMIC
CROWNS
FACIALSURFACE
PREPAREDINONE
PLANETHATHAS
ADEQUATEFACIAL
REDUCTIONINTHE
INCISALASPECTFACIAL
SURFACEOVERTAPERED
ANDTOOCLOSETOTHE
PULP.

ARMAMENTARIUM

ANTERIORMETALCERAMIC
CROWNS
SILICONEINDEX
MADEBEFORE
TOOTH
PREPARATION
TOOTHBADLY
BROKENDOWN,
INDEXMADEONWAXED
UPDIAGNOSTICCAST.

ANTERIORMETALCERAMIC
CROWNPREPARATION
PLACEMENTOFDEPTH
ORIENTATION
GROOVES(1.2MM)
THELABIALGROOVES
CUTINTWOSETS
1. ONESETPARALLEL
WITHTHEGINGIVAL
HALFOFLABIAL
SURFACE
2. ONESETPARALLEL
WITHTHEINCISAL
HALFOFLABIAL
SURFACE

ANTERIORMETALCERAMIC
CROWNPREPARATION

ANTERIORMETALCERAMIC
CROWNPREPARATION

ANTERIORMETALCERAMIC
CROWNPREPARATION
INCISAL
REDUCTION
(2MM)
ROUNDEND
TAPEREDDAIMOND.

ANTERIORMETALCERAMIC
CROWNPREPARATION

Inadequate incisal reduction

results in poor incisal
translucency

ANTERIORMETALCERAMIC
CROWNPREPARATION
LABIALREDUCTION
(INCISALHALF)
ROUNDEND
TAPEREDDAIMOND.

ANTERIORMETALCERAMIC
CROWNPREPARATION
LABIALREDUCTION
(GINGIVALHALF)
ROUNDEND
TAPEREDDAIMOND

ANTERIORMETALCERAMIC
CROWNPREPARATION
LINGUAL
REDUCTION
(0.71MM)
SMALLWHEEL
DAIMOND.

ANTERIORMETALCERAMIC
CROWNPREPARATION
SMOOTHENING
THESHARPANGLES

ANTERIORMETALCERAMIC
CROWNPREPARATION
RADIALSHOULDER
MODIFIEDFORMOF
SHOULDER
SMALLRADIUS
INTERNALANGLE
WITH90DEGREE
CAVOSURFACE

ANTERIORMETALCERAMIC
CROWNPREPARATION

POSTERIORMETAL
CERAMICCROWNS

POSTERIORMETAL
CERAMICCROWNS
STEPNO:1
OCCLUSALREDUCTION
FOLLOWEDBY
FUNCTIONALCUSP
BEVEL

POSTERIORMETALCERAMIC
CROWNS
STEPNO:2
DEPTH
ORIENTATION
GROOVES

POSTERIORMETALCERAMIC
CROWNS

STEPNO:3
FACIALREDUCTION
OCCLUSALHALF

POSTERIORMETALCERAMIC
CROWN
STEPNO:4
FACIALREDUCTION
GINGIVALHALF

POSTERIORMETALCERAMIC
CROWN
STEPNO:5
PROXIMAL
AXIAL
REDUCTION

POSTERIORMETALCERAMIC
CROWN
STEPNO:6
LINGUALAXIAL
REDUCTION

POSTERIORMETALCERAMIC
CROWN
STEPNO:7
AXIALFINISHING

POSTERIORMETAL
CERAMICCROWN

POSTERIORMETAL
CERAMICCROWN

POSTERIORMETAL
CERAMICCROWN

The recommended dimensions

for metal ceramic crown

Metal ceramic crown prep.

Removeanyunsupportedenamel

Avoidtraumatizinggingivaduring
subgingivalpreparation

CommonFaultsinPreparation
Insufficientremovalofbuccalorlabialenamel
particularlyatthelabioincisalonethirdofthe
preparation
Insufficientremovalofocclusalenamelin
posteriorteethparticularlyatthecusptips
Insufficientremovaloflingualenamelwhich
mayforcetheceramisttowidenhisocclusal
tableorreducethegoldcopingthicknesswhich
canincreasetheriskofmetaldeformation.

CommonFaultsinPreparation
Failuretoroundoffallinternallineandpoint
angles,therebycreatingstressconcentration
areaswhichmaycausepopoffofthe
porcelainveneer.
Flatteningocclusaltablesinthepreparation
insteadoffollowingthelineofthecuspangles.
Inadequateremovalofapproximalenamel,
particularlyonthefrontteeth,leaving
insufficientspaceformetalandporcelainatthe
cervicalthirdofthetooth.

Some guidelines for preparing teeth

for metal ceramic complete crown:
The total occlusal convergence
should range between 10 and 20
degrees.
The minimal occlusocervical
dimension of molars should be 4 mm
when prepared with 10 to 20
degrees total occlusal convergence.

 Many molars need auxiliary grooves

or boxes to enhance resistance
form.
Axial grooves/boxes should be used
routinely with mandibular molars .
When tooth conditions and esthetics
permit, finish lines should be
located supragingivally.

 Check the sub-gingival margins for

any deposits of calculus. These
must be removed prior to taking the
impression. In particular, calculus in
the approximal regions is much more
easily removed at the time of crown
preparation and often can be
present despite careful preoperative prophylaxis.

 Immediate dentine sealing of

prepared teeth with a dentine
bonding agent (DBA) removes the
smear layer, seals patent dentine
tubules, halts bacterial ingress,
reduces postoperative sensitivity
and results in superior bonding of
the definitive restoration when
using a resin-based cement.

References
PrinciplesofToothPreparations;
PreparationsforFullCoverageCrowns,
FundamentalsofFixedprosthodontics,4th
Ed.Shillingburg,Quintessencepublishing.