C & B

C&B lec#:4 Done by: Ruba Sameer
Dr. Mousa Marashdeh Date: 11-3-09
‫بس‬
‫م الله الرحمن الرحيم‬
:In this lecture we will talk about
Bridges configuration -
Biomechanical principles of tooth preparation -
Bridges configuration
Last lecture we ended up with bridges configuration which is a
.'separated chapter in the book 'shillingburg
It will be a quick revision for bridge configuration because the
.principles almost mentioned in the abutment evaluation lecture
This chapter is divided into simple design bridges and complex design
bridges, you are requested for simple design bridges(which means single
..tooth replacement bridges) and canine replacement bridges
Dr. said: There is few details in the book, you have to come cross them,
this details will be more clear when we get resin-bonded bridges lecture..
((I added them next
Usually, we replace the central incisor using resin-bonded bridges,

conventionally they used to be 2 wings, one on each side of the adjacent
.central and lateral incisors
Lateral incisor is the same, 1st premolar also the same( upper and
lower), but in the 2nd premolar we start talking about conventional
bridges, those bridges that are luted using conventional cement which
…are: GIC, RMGI
When you go back to the book they are talking about three-quarter
crown retainers, and in the treatment plan I mentioned that three-quarter
crown retainers are not the best, the best is full veneer crowns, so I need
you to escape this little piece of details from the book and not to use
three-quarter crown because we don't recommend this crown in this
.institute, so you go for full veneer crown to retain conventional bridges
1st molar again it's a conventional bridge where we use the lower 7 and
.lower 5 as conventional retainers
All the mentioned bridges are simple bridges by design because you
.have single missing tooth
In canine replacement bridges, it's again single tooth replacement
bridges, but I mentioned last lecture that they aren't along the
interabutment line, so we have a torque, unfavourable leverage, or
unfavourable load distribution, then conventional bridge won't work, I
..mean 2 abutments won't work
1
In canine replacement bridges we use the lateral, central and 1st

premolar as retainers, so we use double abutments in the “mesial side”,
by that we consider the central incisor a secondary abutment, and
secondary abutment should have more or less, comparable
crown-root ratio, comparable periodontal ligament surface area,
comparable retention and resistance features, then you can use double
abutments on the mesial side, but you can't use distal secondary
abutment, you can't use 4 and 5 and lateral incisor, because the lateral
incisor is quite weak and if you use it alone mesially, this bridge is going
to fail, but if we use lateral and central they will reinforce themselves, the
.same is applicable in the lower canine
Examples: to replace the 5 we make conventional bridge using the 4 and

6 as retainers with full veneer crowns. And to replace the lateral incisor
.we use a resin-bonded bridge
In the book there is details where you can't use resin-bonded bridges you
need to come cross them, it will be more obvious and clear when I
…discuss with you the resin-bonded bridges lecture
:From the book

Simple fixed partial dentures
Missing: maxillary central incisor
Abutments: central incisor and lateral

.incisor
.Retainers: resin-bonded retainer
.Pontic: metal-ceramic
. Abutment-pontic root ratio: 1.9
Missing: madibular central incisor
Abutments: central incisor and lateral

.incisor
.Retainers: resin-bonded retainers
2
Missing: maxillary lateral incisor
.Abutments: central incisor and canine

Missing: mandibular lateral incisor
.Abutments: central incisor and canine

Missing: maxillary 1st premolar
.Abutments: canine and 2nd premolar

Retainers: resin-bonded retainers, if
.teeth are unblemished
3
Missing: mandibular 1st premolar
.Abutments: canine and 2nd premolar

Retainers: resin-bonded retainers, if teeth
.are unmarred
Missing: maxillary 2nd premolar
.Abutments: 1st premolar and 1st molar

.Retainers: full veneer crowns
Missing: mandibular 2nd premolar
.Abutments: 1st premolar and 1st molar

Retainers: metal-ceramic crown on
.premolar and full veneer crown on molar
Missing: maxillary 1st molar
.Abutments: 2nd premolar and 2nd molar

.Retainers: full veneer crowns
4
Missing: mandibular 1st molar
.Abutments: 2nd premolar and 2nd molar

Retainers: metal-ceramic crown on
premolar and full veneer crown on
.molar
.Pontic: all-metal hygienic
Canine replacement bridges
Missing: maxillary canine
Abutments: central incisor, lateral

.incisor and 1st premolar
.Retainers: metal-ceramic
Missing: mandibular canine
Abutments: central incisor, lateral incisor

.and 1st premolar
.Retainers: metal-ceramic
5
Biomechanical principles
of tooth preparation
We will go for further details in fixed prosthodontics, the first lecture
was definitions, second lecture was treatment planning either about
extracoronal, intracoronal or replacement bridges, third lecture was about
abutment evaluation mainly for bridges, now and in this specific time you
should be able to formulate a treatment plan for your patient, if you do
that then you are able to start fabrication of this prostheses, I assume if I
asked any body of you about replacement or restoration of any tooth in
terms of fixed prosthodontics you should be able to tell me what is your
restoration, if you all reach this stage then the next step is how to
.fabricate your prostheses
(…Midterm exam will have a lot of questions about treatment plan)
Today we are going talk about proper work, we decide the treatment
..plan and we go to the next step which is tooth preparation
Tooth preparation will be only for crown and bridges, we won't talk
about intracoronal restoration.. we will talk mainly about extracoronal
restoration, some concepts might be valid for both but you need mainly to
..focus on extracoronal restoration
:Principles of preparation
When you prepare a tooth for any reason actually, for fillings, crown or
:bridges, there are 5 main principles you need to follow them
.A. preservation of tooth structure
.B. retention and resistance
.C. structural durability
.D. marginal integrity
.E. preservation of periodontium
A. Preservation of tooth structure
Generally in dentistry you have to be conservative, it means you don't☻

need to cut teeth unnecessarily, at the same time you need to cut enough
.tooth structure to make a durable restoration
There is equation between durable, strong, and stable restoration,☻
there is a limit, a red line you don't have to cross it and there is extra or
.unnecessary tooth removal which could sacrifice your tooth structure
6
retentive, strong and stable restoration is a golden aim, and removal☻

of enough tooth structure to achieve the goal is mandatory, but there is no
.need to remove sound tooth structure which could endanger it's integrity
Imagine that you need to make a metal-ceramic crown, and for ☼ ►

metal-ceramic crown you need to reduce the occlusal surface about 1.5-
2mm, this is the least amount of tooth structure to be reduced, if you
decide to make metal-ceramic crown you don't need to cut 3mm because
this is unnecessary cut and you are sacrifice your tooth structure, at the
same time you can't cut only 1mm because less than 1.5-2mm you will
have weak restoration, weak structure and weak material. Then you need
to stop at a border line where this is the optimum reduction you need, and
beyond this you sacrifice your tooth structure, also you sacrifice your
.restoration
You need to be conservative without compromising the principles of ☼
..further issues
If you sacrifice more tooth structure, as any other tissue, you will ☼
.(endanger its integrity (pulp, periodontium and structures
Look at the table (the last page in the slides) for mandibular teeth, ☼
there is a double line underlining the lingual surface of the incisor, the
lingual wall is 0.6mm enamel and 0.9mm dentin, imagine that you need
1.5mm for metal-ceramic crowns, what does that mean?? You are
encroaching the pulp, then in such a scenario, your treatment planning
should not include a crown which need such tooth destruction, you can
use for example all-ceramic crowns that need 1mm, then it's more safe to
use all-ceramic crown in lower central incisors rather than to use metal-
..ceramic crowns
If you have to use metal-ceramic crowns you need to prepare your pulp
first which means making endodontic treatment for the tooth. You have
.to consider all of these things in your treatment plan
Another thing, If you use all-ceramic crown and you need 1mm only ☼
reduction, you don't need to go for 1.5mm because you will encroach the
pulp. So this is unnecessary cut, and if you go for 0.5mm which is less
.than you need then the crown will be weak
So you need to decide which type of crown, many reason behind it, one
of them is the amount of tooth structure you need to remove, and how
.much you will damage the integrity of the tooth
7
B. Resistance and retention
Retention prevents the removal (displacement) of the restoration☻

.along the path of insertion or along the long axis of the tooth preparation
Resistance prevents the dislodgment of the restoration by forces☻
.directed in any direction except the direction of the path of insertion
The important pit in crown and bridges is the resistance, because you☻
need the retention for one direction of force ( the direction of path of
..insertion) and you need the resistance for multiple directions of forces
In the oral cavity we have more non long axis directing forces, and if we
put the crown, it will move buccally or lingually, mesialy or distally if it
was bridge, but if it move upward, the only thing to do that, is to eat a
sticky food or try to remove it, so for one direction of force we need the
retention and for multiple directions of forces we need the resistance,
then we conclude that the resistance is more important than the
retention but you can't say I can have resistant crown but not retentive,
.you need them both but the priority is for the resistance
Both of them are interrelated topics and together they are called☻
stability, you need a stable restoration which means a retentive and
..resistant restoration
we fix the restoration to the tooth structure by cement(in conventional☻
prostho) or screw(in implants), the strongest cement can't replace proper
retentive and resistant feature, which means if you depend solely on
cement your restoration will fail, you need something else to help the
cement to prevent the dislodgement of the restoration, these things are the
preparation features or what is called geometric configuration of your
.preparation
When we talk about retention and stability we don't talk about☻
cement, the cement is an adjunct to help you stabilize your restoration
(it's not the primary retaining and stabilizing forces for the restoration), if
you don't have enough geometric configuration in your preparation, your
.restoration will be dislodged
Geometric configuration must place cement under compression when☻
.possible
:Direction of forces►
When you consider the geometry of your preparation, you need to☼
consider the direction of forces, the best force or reaction of the cement
.is the compressive force and the worst thing is the shear force
:In the picture below notice
A. tensile force
B. shear force
8
C. oblique force( which could be divided into shear and compressive

.(forces
D. compressive force
Shear
Tensile Force
Force
Compressive
Oblique Force
Force
When you prepare a tooth you have to consider that, whenever☼

possible put your cement under compression and avoid shear, this is by
…principles and we will see later how we apply it
I spoke about retention and resistance and I mentioned that the geometric
configuration of your preparation is very essential, this geometry is
:affected by
Taper .1
Freedom of displacement .2
Length .3
Substitution of internal features .4
Path of insertion .5
Taper .1
.Taper is the relationship between 2 opposing surfaces☻
The opposing surfaces of tooth structure must converge/diverge☻
occlusally slightly with no undercuts to allow seating the final
.restoration
The opposing surfaces must be converge occlusally in case of
extracoronal restoration (crowns), and diverge occlusally in case of
intracoronally restorations…the reason for that is because you need no
undercut to allow seating the final restoration, which means if you have
intracoronal restoration for example amalgam, what do you do in
amalgam?? We make undercut, we bring the inverted bur and walk all
9
around the walls, but we don't have problems with these undercuts
.because we can condense plastic restorations
In fixed prosthodontics it's vice versa, I need it without undercuts and
flare upward, because when we bring the inlay or onlay, this shape will
.allow us to seat them without problems
So we need it diverge occlusally in intracoronal restoration and converge
.occlusally in extracoronal restoration
The relationship between the 2 opposing walls mesial and distal, ☻
buccal and lingual is called taper.. and the relationship between the long
.axis of the tooth and one of these single walls is called inclination
The more the parallel the opposing surfaces, the better the stability of ☻
.the restoration. More forgiving in big teeth
Look at this premolar(in the next picture), there is an intracoronal☼►

restoration, imagine the gingival floor is wider than the occlusal access,
would this restoration fit in?? of coarse not, it's impossible to enter some
thing wide, rigid and non-flexible into a narrow opening, then you need
your walls to be divergent occlusally. Extracoronal restorations or crowns
.are vice versa, we need to converge the walls occlusally
The angle they meet with, which is 6°, this is taper or angle of☼
convergence. The angle between the long axis of the tooth and the
preparation wall which is 3° is the inclination, and we create this by using
inclined bur, so the inclination is related to the bur. Taper is related to the
.angle which composed of 2 inclinations
When you prepare your tooth, the ideal taper is to be parallel to get☼
the best stability with the least tooth destruction, and to avoid the loss of
geometrical configuration, but with very parallel walls the restoration
won't fit in easily, so we make a little taperness, which is about 6°, this is
the ideal, but it's unfortunately unachievable and we can't create it in the
patient mouth, by making slight taperness, it will guarantees a good
geometrical configuration for best retention and resistance and it
.guarantees full seating of the restoration
If you look at the diagram(in the same picture) the Y-axis represent☼
the retention or the stability force and the X-axis represent the degree of
taper, at 5° or 6° you need 100 grams to displace your restoration , the
.more you go for 'more taperness' the less the retention
The 20° of taper is the critical point, beyond it you will lose a lot of your
retention and stability, above it you can achieve reasonable good
.retention and stability features plus saving the structure of the tooth
The best taperness or the achievable taper is 16°, you can achieve it in
the clinic, give you a good retention and stability and allow the seating of
10
your restoration. If you achieve something above it this is fine but try to
…achieve any thing under it, so 16° is your target but the ideal is 6°
TAPERNESS
Type a quote from the]
INCLINATION document or the summary of
3° 3°
an interesting point. You can
position the text box anywhere
6° in the document. Use the Text
Box Tools tab to change the
formatting of the pull quote
[.text box
Freedom of displacement .2
Best retention and resistance is achieved with a single path of☻
.withdrawal
The addition of auxiliary features (grooves and boxes.. ) will limit☻
.the paths of withdrawal to one
.The greater the surface areas, the better the stability☻
If you look at diagram A in the lower picture, the restoration can be☼►
placed and displaced along all of these arrows, if you start adding feature
like a grooves and boxes it will limit the number of paths of insertion and
removal, and we will end up with one path of insertion(diagram B).
☼ Imagine you have a crown and on the fitting surface of it we have
something protruding outward, they won't get into the preparation unless
.. you orient it well and seat it
All auxiliary features (grooves, boxes, pin holes..) help you to☼
minimize the number of paths of insertion and removal, if you have less
number of paths of withdrawal this mean automatically that you have less
.chance of displacement
This is how you create more retention and more resistance by☼
modification of your preparation rather than depending on the cement
.itself
11
Last time we said that in bridges we need buccal and lingual grooves☼►
.because the movement is mesiodistal
Imagine you prepare these grooves on this premolar(in the lower☼
picture), the only force which will let the grooves to resist movement is
buccal or lingual forces, so this is shear forces, which is the worst and to
minimize its effect we need to adjust our preparation and geometry, one
.of these adjustments is to create a grooves
Notice that in the previous picture the grooves help us to minimize☼
the number of paths of withdrawal and in this picture they help us to
.resist the shear forces
When you design your geometry, you consider where are shear☼
forces and compressive forces then you adjust your preparation to let the
.shear forces to be minimal and compressive forces to be maximal
Look at diagram B, the grooves are flared, and you have three-☼
quarter crown, if you push the restoration with the direction of the arrow,
let us say buccally, the restoration will flex outward with excessive
forces, if you have definitive walls like in diagram A the force will be
perpendicular to the tooth structure then the chance of displacement is
less. In other words, as we are aiming parallel walls for extracoronal
restoration we need parallel walls for our features (grooves, boxes, pin
holes..) because you need to let the forces applied to the tooth structure
to be perpendicular rather than in oblique direction that will lead to
.displace and flex the restoration
12
Length .3
.the longer and the larger the preparation, the better the retention ☻
length/width ratio is very critical specially in posterior teeth (not ☻
less than 0.4) for resistance. which means after you prepare your tooth,
the cervicoocclusal dimension should be at least 0.4 of the mesiodistal
dimension. Example: if the width was 10mm the length must be 4mm,
this is the minimum otherwise you sacrifice the retention and the
.resistance
In anterior teeth, they are narrow teeth but the minimum length is 3mm
.(correct it in the slides), otherwise you can't restore your crown
short wide preparation should be modified by auxiliary features like☻
.grooves and boxes which will improve the stability
If you have lower molar with a length/width ratio of 0.3, this is
insufficient to retain or stabilize a crown, if you need to improve it you
have to create a grooves, which needs parallel walls to reduce the shear
.forces
Retention►
The longer the preparation the better the retention, this is goes mainly☼
with surface area, so also the wider the preparation the better the
.retension
Retention increases inversely with surface area and when un-☼
.polished
Retention is just expresses itself along the long path of insertion,☼
.then adding any surface area will enhance the retention
Any increase in the surface area(by increase length or width) will☼
result in improvement of retention, but this is not applicable for
.resistance
:Oblique forces and resistance►

we said oblique forces are very common in the oral cavity, imagine ☼
you have oblique force on the right diagram in the lower picture, there is
13
something called arc of rotation which represented by p1, p2, p3, if you
need to displace your restoration with the direction of the arrow, there is
something called pivot point (center of rotation) that located on the finish
line and where the rupture of the restoration occur, if you make a
perpendicular line from this point crossing the preparation, then any
area below this line won't resist displacement (non-resistance area), and
any area above it will resist displacement (resistance area). And what is
.your aim?? To increase the resistance area
Arc of rotation
Resistance area
Non-resistance area
Pivot point
:Preparation width and resistance►

If you have long restoration, what it will have, higher resistance☼
.area or less?? There will be higher resistance area
.If you have wider restoration, it will have less resistance area☼
The reason that this perpendicular line will go more distance and the
more it goes it will go up as well, so the resistance area will be less in
wide preparation. (see the comparison between wide and narrow
.(preparation in the lower picture
Remember retention enhanced by increasing the surface area,☼
whatever the surface area is: length, mesiodistal dimension or
buccolingual dimension, but resistance increasing directly with length
.and narrow preparation
14
:Oblique forces, auxiliary features and resistance►

If we consider resistance is more important than retention then I need☼
to adjust any wide preparation, and this happens by grooves, boxes… and
these auxiliary features won't only reduce the number of paths of
insertion and resist the shear forces, also it will reduce the arc of
.displacement
In the lower picture, look at diagram C and compare it with diagram☼
A, in diagram A there is no modification and the resistance area is the
dark area only, in diagram C we have 2 arc of displacement: r1 and r2, r2
is shorter, this mean that we have a good resistance area created by the
groove, again if you have parallel walls in your groove you will enhance
.your resistance
:Oblique forces, taper and resistance►

We said previously that resistance and retention enhanced by☼
geometry, So your geometry is very important for the stability of your
.restoration
When we talk about taper, we mention that it's important to have as☼
parallel surfaces as possible, the reason behind it is that the more parallel
the surfaces, the better is the stability because you have larger area of
.resistance
Look at diagram A in the lower picture, the surfaces are very parallel☼
and the whole area is an area of resistance, because if you have oblique
force and the pivot at the finish line, the perpendicular line will go to the
other finish line, because if you increase the taper a little bit, it will
become higher a little bit and the dark area will become less, then the
resistance will become less as in diagram B. If you go for further
taperness this perpendicular line will go higher and the dark area will be
.much less, which means the resistance will be less as in diagram C
…So taper play a crucial role in resistance
15
:substitutions of internal features .4

.It's grooves, boxes and pin holes☻
.used when needed☻
parallelism is important for their opposing walls and easier to achieve☻
than preparation walls. So parallelism applies on external walls as well as
.on the walls of auxiliary retentive features
:Path of insertion .5
.we are aiming all the time for one path of insertion ☻
to reduce the number of paths of insertion, what we did?? We did ☻
.grooves, boxes.. so you adjust your geometry
.it is usually along the long axis of the tooth ☻
the stability is affected, which is resistance and retention, so if you ☻
have multiple path of insertions; the stability will be poor, and if you
.have one path of insertion; you will have a good stability
.(aesthetic and biology will be affected (explained later ☻
.in bridges, all abutments should have common path of insertion ☻
You remember in treatment plan, if you plant for a bridge you need to
create a single path of insertion for both preparation, and I mentioned
sometimes you have to sacrifice unnecessary tooth structure to create this
parallelism, if you have inclined 7 and you want to replace 6 , you need
to create a retainer on the 5 and 7 and you need to cut unnecessarily from
the mesial surface of the 7 to have common path of insertion, by this
unnecessary cut you sacrifice in retention and resistance because you are
sacrifing the taper. If you have parallel teeth from the start, then the
mesiodistal taper and buccolingual taper can be created perfectly with
16° here and 16° there to have common path of insertion. If you have a
tooth which is very tilted, so you need to cut much more from the tooth
.structure
16
look at diagram A in the lower picture, this path of insertion is along☼►

the long axis of the tooth, provided you have no tilted tooth, the more
.safe definition it should be parallel to the adjacent contact area
Diagram C, the molar is tilted mesially, if you create the path of insertion
along the long axis of the tooth, when you try to insert your crown it will
be blocked by the distal surface of the 5(the dark spot). in this scenario
??what is the solution
we prepare a crown which is parallel with the adjacent contact areas as in
diagram D, so your aim is to create a preparation which is parallel with
the adjacent contact area and this is applicable all the way through, but
parallel with the long axis is not applicable all the way through, because
when the tooth is tilted, the path of insertion will be interfered by the
.adjacent tooth
This is another example, the preparation in the anterior teeth,☼►

usually, it's along the long axis of the tooth, but if you put it more
lingually or more labially it will affect the excellence of aesthetic and
.pulp tissue
17
:From the book

In the above picture, the path of insertion should be parallel the long axis
.(of the tooth (diagram A
If the path is directed facially, the prominent facioincisal angle may
(create aesthetic problems of over-contouring.(diagram B
However, if the path is directed lingually, the facial surface will intersect
the lingual surface, creating a shorter preparation. It also may encroach
.the pulp
C. Structural durability
when I talked about preservation of tooth structure, I mentioned ☻

that we have compromise, you need to cut enough tooth structure to
fabricate strong restoration, and you should not cut unnecessarily because
you will endanger the integrity of the tooth, and you should not cut less
because you will endanger the restoration, this is called structural
..durability
restoration must contain enough bulk of material and have enough ☻
.thickness to withstand the occlusal forces
this bulk must be confined to the space created by tooth ☻
preparation, it means if I need for metal-ceramic crown 1.5mm occlusal
reduction and I prepared only 0.5mm, so the technician will add another
1mm to have a good thickness of the material, but when you seat it in the
patient mouth there will be 0.5mm which is for fitting and 1mm out of
the contours, how it will affect?? It will interfere with the occlusion, with
.the contour of the tooth because you are adding extra material
:The techniques for that including
.occlusal reduction .1
.functional cusp bevel .2
.axial reduction .3
.reinforcing struts .4
occlusal reduction .1
how much you need to cut of the occlusal surface, depends on the ☻
type of the material that you will use(1-1.5mm for gold, 1.5-2mm for
metal-ceramic crown, 2mm for all-ceramic),these numbers are your
minimum preparation, and try to avoid extra cut to avoid damaging the
.tooth, also try to avoid undercut to avoid damaging the restoration
should keep the same morphology, it means for example if you ☻
prepare a molar, after you finish, you must get a smaller molar, which
means 2mm reduction is homogenous all the way through; in the fissures,
18
cusps, fossa.. so you are creating a mini molar, you can't reduce from the
cusp 2mm and leave the fissures and cut only 1mm, so you have to be
.homogenous on the occlusal surface
.inclined surfaces may not need tooth preparation ☻
in the lower picture, if you look at diagram A (ideal cut), the☼►

preparation on the molar is exactly the same shape but with 1-1.5
..(reduction, so you create a small molar (mini shape of the original tooth
diagram B (under cut), the cusps are cut but the fissures are remained
without preparation, so when you create a crown, this area will be very
.thin to prevent the interference with the opposing tooth
So if we don't have sufficient tooth structure, the technician has 2 options
either to create thin restoration and this is weak and it tends to fracture, or
.to make it thick and it will interfere with the opposing occlusion
diagram C (extra cut), if you try to create 2mm without following the
morphology and in the area of the fissures you cut 2mm and cut the
whole tooth at this level, so in certain areas you cut more than 2mm, for
example in the area of the cusps you will cut 4mm, assuming the cusp
.height is 2mm
.Inclined planes may not need preparation☼►

If you look at diagram A, let us say that the ideal preparation is to☼
cut 2mm, the mesial side of the lower molar is inclined, there is already
space between it and the opposing tooth, in this case you don't need to cut
unnecessary tooth structure to create 2mm, say there is a space of 1mm
so you can cut further 1mm and you end up with something like in
diagram B, and when the technician build the crown there will be a
.contact on the mesial side without problems
19
functional cusp bevel .2

The buccal cusp is the functional cusp in the lower arch-
The palatal cusp is the functional cusp in the upper arch-
.A wide bevel on the functional cusp to withstand heavy forces ☻
The functional cusp bevel is the area where we need to create further ☻
space because this area represent the centric stop where the opposing
tooth meet and where the load occur (excessive load area), so you create
a bevel of 45° on the cusps to create more space, we talk about 2.5mm
.reduction in this area so the bevelling is about 0.5mm
:From the book

In the next picture, look at the functional cusp bevel on the buccal☼►
.cusp
Lack of functional cusp bevel can cause a thin area or perforation in ☼

.the casting, also may result in over-contouring
20
axial reduction .3
we need to create a space, this space usually 1.2mm for metal- ☼►
ceramic crowns , 1mm for all ceramic , for gold or all-metal crowns we
talk about 0.7mm.. It’s more conservative to do metal-crown for posterior
teeth rather than to do metal-ceramic crown. But you can't do metal
.crowns anteriorly because it's not aesthetic
:From the book

In the above picture, diagram A represent an ideal axial reduction.
Inadequate axial reduction can cause thin walls and a weak restoration
.((diagram B), or a bulbous, over-contoured restoration (diagram C
(Reinforcing struts(trusses .4
We can join the grooves by struts which are another simple grooves, it's
.a reinforcing design, just to enhance the structural durability
.Notice the reinforcing struts in the next picture
21
D. marginal integrity
Your crown or restoration should meet the tooth at a margin which is ☻

.the finish line
Finish line: is the line where the restoration meets the preparation, and☻
the restoration must be will adapted to the finish line to prevent any
.(marginal defect (recurrent caries, periodontal problems
The restoration must closely adapt to the cavosurface finish line of the ☻
.preparation
the configuration of the finish line will affect the bulk of material, ☻
.adaptation, seating and aesthetics
We will continue this topic in the next lecture enshaAllah
E. Preservation of periodontium
.We will talk about it in a separate lecture
The End
: ‫بالنهاية حابة اوجه تحية ل‬
‫ زينببب)بببدنا‬,‫ جمانببة شمسبباه‬,(..‫ جمانببة حسببن) يببا بابببا سببناني واوا‬,(..‫شهد قعببدان) غلبتببك معببي‬
‫ امل‬,‫ مجد الصيدلي‬,‫ فاطمة الطائي‬,‫ فرح عبد المعيد‬,‫ نور حمدان‬,(..‫ سناء) هدافة الدفعة‬,(..‫كعكة‬
,‫ ملببك‬,‫ سببكينة‬,‫ زينببات‬,‫ شببيرين‬,‫ رونببزى‬,‫ فببرح القببرم‬,‫ لينببا‬,‫ داليا‬,‫ مرام ونور الرحمون‬,‫العمري‬
....‫ ميمنة‬,‫ اسيل الرفاعي‬,‫ ايمان الراس‬,‫ فكرية‬,‫ نجلء‬,‫ منى‬,‫ نادية‬, ‫اروى‬
,‫ عمببار‬,‫ اميببن محاجنببة‬,‫ باسل‬,‫ امين مدلج‬,‫ اياس خليلية‬, (..‫عبدال عوضي)شكراً على المساعدة‬
......‫ نعيم‬,‫ معاذ‬,‫ محمد شعبان‬,‫ محمد خزعلي‬,‫محمود‬
‫تمت وبحمد الله‬

…Best wishes for you all
Ruba Sameer Aburima
22

C & B

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

C & B

Uploaded by

Copyright:

Available Formats

C&B lec#:4 Done by: Ruba Sameer

Dr. Mousa Marashdeh Date: 11-3-09

Usually, we replace the central incisor using resin-bonded bridges,

In canine replacement bridges we use the lateral, central and 1st

Examples: to replace the 5 we make conventional bridge using the 4 and

:From the book

Missing: maxillary central incisor

Abutments: central incisor and lateral

Missing: madibular central incisor

Abutments: central incisor and lateral

Missing: maxillary lateral incisor

.Abutments: central incisor and canine

Missing: mandibular lateral incisor

.Abutments: central incisor and canine

Missing: maxillary 1st premolar

.Abutments: canine and 2nd premolar

Missing: mandibular 1st premolar

.Abutments: canine and 2nd premolar

Missing: maxillary 2nd premolar

.Abutments: 1st premolar and 1st molar

Missing: mandibular 2nd premolar

.Abutments: 1st premolar and 1st molar

Missing: maxillary 1st molar

.Abutments: 2nd premolar and 2nd molar

Missing: mandibular 1st molar

.Abutments: 2nd premolar and 2nd molar

Canine replacement bridges

Missing: maxillary canine

Abutments: central incisor, lateral

Missing: mandibular canine

Abutments: central incisor, lateral incisor

A. Preservation of tooth structure

Generally in dentistry you have to be conservative, it means you don't☻

retentive, strong and stable restoration is a golden aim, and removal☻

Imagine that you need to make a metal-ceramic crown, and for ☼ ►

B. Resistance and retention

Retention prevents the removal (displacement) of the restoration☻

C. oblique force( which could be divided into shear and compressive

When you prepare a tooth you have to consider that, whenever☼

Look at this premolar(in the next picture), there is an intracoronal☼►

:Oblique forces and resistance►

:Preparation width and resistance►

:Oblique forces, auxiliary features and resistance►

:Oblique forces, taper and resistance►

:substitutions of internal features .4

look at diagram A in the lower picture, this path of insertion is along☼►

This is another example, the preparation in the anterior teeth,☼►

:From the book

when I talked about preservation of tooth structure, I mentioned ☻

in the lower picture, if you look at diagram A (ideal cut), the☼►

.Inclined planes may not need preparation☼►

functional cusp bevel .2

:From the book

Lack of functional cusp bevel can cause a thin area or perforation in ☼

:From the book

Your crown or restoration should meet the tooth at a margin which is ☻

.We will talk about it in a separate lecture

‫تمت وبحمد الله‬

You might also like