Biomechanical Principles of

Tooth Preparation in FPD

Guided by :
Dr. S. R. Godbole
Dr. Md. Abid Zahir Hussain

Presented by : Dipti Rane

Introduction
 Tooth Preparation
The process of removal of diseased &/or healthy
enamel and dentin & cementum to shape a tooth to
receive a restoration. (G.P.T-8)

The mechanical treatment of dental disease or injury

to hard tissues that restores a tooth to original form.

Tylman’s 8th ed
 Objectives of tooth preparation

Reduction of the tooth in miniature to

provide retainer support.
Preservation of healthy tooth structure to secure
resistance form.
Provision for acceptable finish lines.
Performing pragmatic axial tooth reduction to
encourage favorable tissue response.
Tylman’s 8th ed. Pg no 113.
 Biologic
Conservation of tooth structure Mechanical
Avoid overcontouring Retention form
Supragingival margin
Resistance form
Harmonious occlusion
Protection against Deformation
fracture

Esthetic
Minimum display of metal
Max thickness of porcelain
Porcelain occlusal surface
Subgingival margin

Rosenstiel 4th ed pg no 209

Biologic Considerations
Prevention of damage to adjacent teeth

Matrix band
Proximal enamel lip

Tooth is wider at the

contact area than the
CEJ by 1.5mm.
 Prevention of soft tissue damage

Aspirator tip Flanged saliva ejector

Mouth mirror

Cotton rolls Rubber dam

Protecting gingival margin

Placing retraction cord

before tooth preparation
 Prevention of damage to pulp

Causes of pulpal injury

Temperature

Chemical irritation

Bacterial action
Temperature

Do not use excessive pressure -use feather light

touch with burs on the tooth

Higher rotational speeds – above 1,00,000 rpm

vibrations least perceptible to pulp

Cutting instruments

Sharper the bur – less the heat generated

 Coolants

• Air spray- dessication of dentinal tubules

• Air water spray- prevents heat build up

prevents clogging
improves visibility &
cutting efficiency

Heat should not be raised > 46 degC

Sturdevant’s Operative Dentistry

Chemical action
Dental materials – resins, luting agents

Zinc oxide eugenol – obtundent action on pulp

Zinc phosphate – antimicrobial properties

(PH 3.5)

Glass ionomer – releases fluoride

Cavity varnish- forms a barrier

Dentin desensitizers – seal & desensitize dentin

after tooth preparation
 Bacterial action

All carious dentin should be removed

Indirect pulp capping not recommended

Preoperative radiographs and pulp vitality tests

essential.
Conservation of tooth structure
Use of partial coverage restorations rather than
complete coverage restorations.

Preparation of teeth with the minimum practical

convergence angle (taper) between axial walls
 Taper

The convergence of two opposing external

walls of a tooth preparation as viewed in a
given plane. (GPT-8)

Excessive taper results in

considerable loss of
tooth structure.
Occlusal surface reduction should follow the
anatomic planes

Selection of a conservative margin compatible with

the other principles of tooth preparation

Avoidance of unnecessary apical extension of

the preparation
Preparation of axial surfaces such that maximum
thickness of tooth structure is retained.
Axial reduction

Crown should duplicate contours and profile of

the original tooth.

Avoid overcontouring.
 Margin Placement

Whenever possible, the margin of the preparation

should be supragingival

Subgingival margins often

lead to the periodontal disease
Supragingival Margin: coronal to the gingival

crest.

Equi gingival margin at the gingival crest

Subgingival Margin apical to the free gingival

margin.

JPD 1990; 64: 636-42.

Advantages of supragingival margins

They can be easily finished.

They are more easily kept clean.

Impressions are more easily made .

Less potential to soft tissue damage.

Restorations can be easily evaluated at recall

appointments.
INDICATION OF SUBGINGIVAL
MARGIN

Caries, erosion, restoration extending subgingivally

Additional retention is desired

Short clinical crowns

Esthetics

Root sensitivity

Modification of axial contour is indicated

 Feather edge

Advantage: Conservation of tooth structure

Disadvantage: Does not provide sufficient bulk

Indications: Not recommended

 Chisel Edge

Advantage: Conservation of tooth structure.

Disadvantage: Location of margin is difficult

thus produces overcontouring

Indication: Occasionally on the tilted tooth,

Not acceptable
 Bevel

Advantage: Removes unsupported enamel,

allows finishing of metal

Disadvantage: Extends preparation into sulcus

Indication: Facial margins of maxillary partial

coverage restoration, inlays, onlays
Chamfer
Advantages: Distinct margin, adequate bulk,
easier to control

Disadvantages: unsupported lip of enamel

Indications: Cast metal restorations, lingual

margin of metal ceramic crowns
 Shoulder

Advantages: Bulk of material.

Disadvantages: Less conservative.

Indications: Facial margins of metal ceramic

crowns, all ceramic crowns
Sloped shoulder

Advantages: Bulk of material, reduce

unsupported enamel.

Disadvantages: Less conservative.

Indications: Facial margins of metal ceramic

crowns.
 Shoulder with bevel

Advantages: Bulk of material, removes

unsupported enamel
Disadvantages: Less conservative, extends
preparation subgingivally.
Indications: Facial margin of metal ceramic
crown.
Margin adaptation

d = D sin m
 Occlusal considerations

Careful analysis with preoperative radiographs

Diagnostic preparation and waxing procedure

Optimal occlusal clearance

MECHANICAL CONSIDERATIONS
Providing Retention form

Providing Resistance form

Preventing Deformation of the

restoration
Retention form

It is the ability of a preparation to prevent

removal of restoration along its path of
insertion.
 Factors To be considered For Retention

1. Magnitude of the dislodging forces.

2. Geometry of the tooth preparation.
3. Roughness of the fitting surface of the
restoration.
4. Materials being cemented.
5. Type of the luting agent.

Rosenstiel pg no 226
1. Magnitude & direction of dislodging
force

Forces that tend to remove a restoration are small

compared to those tend to seat it.

It depends on the stickiness of the food and the

surface area of the restoration being pulled
2. Geometry of the Tooth Preparation

2 opposing vertical surfaces in same preparation

provide retention
Extracoronal restoration -Sleeve retention

Intracoronal restoration -Wedge retention

 Taper

Jorgensen and Kaufman et al have demonstrated

that as retention decreases as taper is increased.

D.C.N.A 2001: 85 :363-376

A taper of 2.5 to 6.5° has been suggested
as optimum.

To produce 6º Angle of convergence, the

opposing axial wall should have an
inclination of 3°.

Shillingburg – 6°
Ward – 3-12°
Tylman – 2-5° per side
Evaluation of Taper

Correct method Incorrect method

 Retention is improved by limiting the number of
paths of withdrawl.

Maximum retention is achieved

when there is only one path

Short, over tapered preparation

less retentive due to infinite number of paths.

 Surface area

Longer preparation will have

more surface area & will be more
retentive.

Wider preparation with large

diameter will have greater
retention than a narrower
preparation of same length
 Full veneer crown is more retentive than a partial
veneer.

To create more retentive forms grooves, pinholes

or boxes are substituted for missing axial walls.

The groove should be distinct

& perpendicular to the adjoining
axial surfaces
3. Surface roughness

When the internal surface of a restoration is very

smooth, retentive failure occurs at the cement-
restoration interface.

If the restoration is roughened retention increases.

It is most effectively prepared by air-abrading the

fitting surface with 50 µm of alumina
4. Type of restorative material

More reactive the alloy, more adhesion with luting

agents.

Base metal alloys > Gold alloys

 5. Type of luting agent

Adhesive resin cements are most retentive

followed by Glass Ionomer Cement, zinc
polycarboxylate & zinc phosphate and zinc oxide
eugenol

Film thickness of luting agent

< 25 µm Shillingburg
Resistance form

It is the ability of the preparation to

prevent dislodgement of the restoration by
forces directed in oblique, apical or
horizontal direction.
 Occlusogingival length

Decreasing the length of preparation decreases the

resisting area.

Crown with long axial walls resist

strong tipping force.
 Tooth width

Crown on the narrow tooth have greater resistance

to tipping than on the wider tooth.

Crown On the narrower tooth has shorter radius of

rotation resulting in lower tangent line & large
resisting area.
Taper

Resisting area decreases as the taper increases.

In ideally tapered preparation, the resisting area

covers less than half the axial walls.
 To provide adequate resistance minimum
occlusocervical dimension for

Incisors & premolars 3mm

Molars 4mm

With 10 -20 deg of taper

Occlusocervical/ incisocervical dimension

(DCNA 2004 :48 :359-385 )
 Rotation around vertical axis

Partial veneer crown without grooves has little

resistance to rotation.

Grooves provide resistance

by blocking arc of rotation.

Path of insertion

It is an imaginary line along which the restoration

will be placed onto or removed from the
preparation
Evaluate preparation in mouth
The walls of a groove must be perpendicular to
rotating forces to resist displacement.

Grooves also help in limiting the path of

placement.
Grooves should be placed parallel to the long
axis of the tooth.

In anterior teeth it should be parallel to incisal

two thirds of the facial surface.
 Occlusal Reduction

• For gold alloys- 1.5mm on functional cusps &

1mm on nonfunctional cusp.

• Metal ceramic crowns- 1.5 to 2mm on functional

cusps & 1 to 1.5mm on nonfunctional cusp.

• All ceramic- 2mm clearance.

Functional cusp bevel
Often tipped tooth are short of occlusal plane
& require less reduction than tooth in normal
occlusion.

Uniform reduction will produce excessive

occlusal clearance & shortened axial walls.
Axial Reduction

Adequate axial reduction creates space for bulk of

metal within normal contours of tooth.

Inadequate axial reduction results in thin, weak

walls or a restoration with bulky, plaque
promoting contours.
Preventing deformation of restoration

Alloy selection – Type III or IV gold alloys

Base metal alloys

Alloy thickness –
Base metals 0.3- 0.5 mm
Gold alloys 0.7 mm

Margin selection- Sufficient bulk for restoration

ESTHETIC CONSIDERATIONS

Proper case history & intraoral examination

Assessment during smiling, talking etc.

Patients esthetic requirements

Patient prefer restorations which looks more

natural

No display of metal
Colour , translucency

Harmonious transition from restoration to

tooth margin

Contour, shape

Masking of metal

Lip line
All ceramic crowns

An incisal/occlusal reduction 2mm

Facial and lingual reduction -1.2mm

Margin - shoulder
Porcelain laminate veneers

Facial reduction of 0.5 mm

Proximal reduction extended to gingival crest

leaving contact area intact.

Margin -heavy chamfer

Metal ceramic crown

• Facial Reduction - minimum 1.5 mm.

• Incisal reduction - 2 mm
• Lingual Reduction – 0.5 mm
 Gingival porcelain

Porcelain labial margin

Summary
Form of prepared teeth & amount of tooth
structure removed are important contributors to
the mechanical, biological and esthetic success of
the overlying crown or FPD.

Therefore it is important to develop clinical

guidelines that can be used to optimize success in
fixed prosthodontics.
 REFERENCES
1. Shillingburg HT. Fundamentals of fixed prosthodontics. 3rd ed

2. Rosenstiel SF. Contemporary fixed prosthodontics 4th ed

3. Tylman’s Theory and Practice of Fixed Prosthodontics. 8th ed

4. Parker MH. Resistance form in tooth preparation . D.C.N.A 2004,48:

387-396.

5. Goodacre CJ. Designing tooth preparations for optimal success.

D.C.N.A 2004,48: 359-385.

6. Gilboe DB. Fundamentals of extracoronal tooth preparation. J

prosthet Dent 2005;94:105-7.

7. Parker MH. A technique to determine a desired preparation axial

inclination. J prosthet Dent 2003;90:401-5.

8. Donovan TE. Cervical margin design with contemporary esthetic

restoration. D.C.N.A 2004,48: 417-431

9. Shillingburg: Fundamentals of tooth preparations for cast metal and

porcelain restorations

10. Sturdevant’s Operative Dentistry. 4th ed

11. Summitt JB, Robbins JW. Fundamentals of operative dentistry 3rd ed

12. Shovelton DS, Kantorowicz GF. Inlays,Crowns & Bridges. A clinical

Handbook. 5th ed

13. Goodacre CJ. Tooth preparations for complete crowns. J prosthet

Dent 2001;85:363-76.
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