Principles of Tooth Preparation

The design of a preparation for a cast restoration and the execution of that design are governed by
five principles:
1. Preservation of tooth structure
2. Retention and resistance
3. Structural durability
4. Marginal integrity
5. Preservation of the periodontium

PRESERVATION OF TOOTH STRUCTURE
What are the tooth structures that we need to preserve?
Enamel, Dentin, Pulp, Surrounding tooth structure
How?
By producing an intact tooth surface that can be maintained while producing a retentive and
strong restorations
Conserve what is left
Mechanical- Retention and resistance

RETENTION AND RESISTANCE
Retention: Ability of the restoration to resist forces from the long axis or path of insertion (vertical)
Resistance: Prevents the dislodgement of restoration from apical forces (horizontal), oblique forces
and under occlusal forces
Factors that may affect Rentention and Resistance
o Taper
o Freedom of displacement
o Length
o Substitution of internal features
o Path of insertion

Taper
Axial walls of the preparation should be tapered slightly.
Why?
Permit seating of the restoration
Prevent undercut
o Undercuts will produce marginal leakage
o Will not be even in stress distribution
Minimize stress concentration
More parallele, more straigt, but
If it is parallele/ straight- you cant see the path of insertion
The optimum convergence is 2.5 6.5 (faciolingually)
15-30 is a compromised retention and resistance
The mesial and distal should be nearly parallel or have a taper of 5 to 10



Freedom of displacement
Limit the path of insertion (Achieve a long parallel axial walls and grooves)
More paths of insertion, the more ways you can put it in. Which means it can move
more
Torquing and twisting force ( there must be a wall perpendicular [90]to the direction of
force )

Length
Longer preparation, more surface area, more retentive.
A long preparation, may produce inadequate thickness of labio-incisal porcelain.
The preparation should be 2/3 the length of the anatomical crown.
The thicker the cement, the less retentive
Crown is too Long- too much forces will be applied, over under reduced
Crown is too Short- over reduced

Path of Insertion
Imaginary line along which the preparation will be placed onto or removed from the
preparation
2 dimensional ( f-l and m-d)
Parallel to the long axis f-l
Parallel to the contact areas of adjacent teeth m-d

STRUCTURAL DURABILITY
Occlusal reduction
Trace central, buccal, lingual grooves
Identify cusp tips
Mark the bur 2mm
Drill the central groove, make a line
Follow the cusp
Functional cusp bevel
Axial reduction

MARGINAL INTEGRITY
Margin placement
Supra Gingival- Top of gingiva (.5-1mm)
Equi Gingival- Equal to gingiva
Sub Gingival- Under gingiva
Margin adaptation
Smoothness and Roughness
Rough- more retentive, but can accumulate plaque
Smooth- less retentive, but less plaque
Non functional cusp
Buccal-Upper, Lingual- Lower
Functional cusp
Lower-Buccal, Upper-Lingual
Bevel
To angulate the cusp (for distal occlusal forces)
Functional cusp
Room for restoration
Margin Geometry
Shoulder: 90
Buccal cusp- .75-1mm (Round end bur)
Lingual cusp (Flat end bur)
Chamfer: lingual- .7 (Round end bur)
Feather edge: For reaching the cementum (Long needle)

PRESERVATION OF PERIODONTIUM
Without the ability and desire of the patient to maintain his or her teeth and periodontium, any treat-
ment will ultimately fail.
Biologic Width- 3mm (85% of people)
Ideal Composition: 1mm Sulcular gingiva | 1mm Attached eptihelium | 1mm Connective tissue

As a dentist our aim is to re-establish a well functioning oral relationship that is biologically and mechanically
sound as well as esthetically pleasing.
Read chapter 9 =)