TOOTH PREPARATION

CONTENT
 Objectives
 Principles of tooth preparation
 Preparation of full veneer crowns
 Preparation of partial veneer crowns
INTRODUCTION
 Tooth preparation may be described as “ A
restoration that covers all the coronal tooth
surfaces.
 Mechanical preparation or chemical

treatment of the remaining tooth structure,

which enables it to accommodate a
restorative material without incurring
mechanical or biological failure.
OBJECTIVES OF TOOTH
PREPARATION
 Provision for retainer support.
 Preservation of periodontium
 Provision of acceptable finish lines
 Perform pragmatic axial preparation for

restoration contour (fluting of mass)

According to Rosenstiel, the principles
of tooth preparation are:
 Biologic:
 Conservation of tooth structure
 Avoidance of overcontouring
 Supragingival margin
 Harmonious occlusion
 Protection against tooth fracture
 Mechanical
 Retention form
 Resistance form
 Deformation
 Esthetic:
 Minimum display of metal
 Maximum thickness of porcelain
 Porcelain occlusal surfaces
 Subgingival margins
The basic principles on which tooth
preparation are :
 Preservation of tooth structure
 Retention and resistance
 Structurability and durability
 Marginal intergity
 Preservation of periodontiums
A. Biological and Mechanical
Considerations : 1.Preservation of
Tooth Structure
 Muller De Taper of Van stated that "the
perpetual preservation of what remains is
more important than the meticulous
replacement of what is lost.' Care should be
taken to prevent excessive preparation
 There should be minimal possible reduction
to the long-axis of the tooth done to obtain
the required characteristics.
 Grossly decayed teeth should be retained with
the help of dowel cores, cast posts and
onlays,etc.
2. Retention and Resistance Forms:
It can be defined as "the ability of the preparation to
prevent displacement of the restoration in a direction
opposite to the path of insertion".
 One of the major sources of retention in a fixed partial

denture is tensofriction
Retention can be classified as follows:
 Primary retention –
- Sleeve retention
- Wedge-type retention
 Secondary retention:

- Obtained by retentive features, like pins, boxes

and grooves, etc.(Secondary retention).
3. Taper
 The degree of taper is inversely
proportional to the retention form
 Zero-degree taper is the most
retentive but it is almost impossible
to obtain.
 The sum of the degree of taper is
called degree of convergence. For
optimum retention,4°-10°
convergence is sufficient
 Clinically normal taper is around
19°.
 Mandibular premolars are lingually
tilted by 9° ;hence, reduction,
should not be prepared
perpendicular to the occlusal
plane;instead the entire preparation
should be lingually inclined
Freedom of Displacement
 Limiting the freedom of
displacement from torquing and
twisting forces aid to increase the
resistance of the restoration.
 A single path of insertion provides
best retention.
 There will be loss of retention in
overtapered preparations because
of the formation of multiple paths
of removal.
 A proximal box prepared with its
walls at right angles to the pulpal
wall prevents sliding (rotation) of
the restoration.
 Length
 Greater the height of the crown,
better the retention of the
restoration.
 The length of crown improves
retention in two ways:
- First, the height of the prepared
tooth should be greater than the
tipping arc of displacement
- Second, increase height
increases the area of
cementation, improving
retention.
 There are 3 methods to
determine adequate height of a
preparation.
 Zuckermans circle
 Levi's perpendicular
 Substitution of internal features
 Internal features like proximal

grooves,boxes and retention pinholes can

be incorporated in the preparation to
improve retention
Indications: Substitution of internal features
should be done for the following cases
where retention is difficult to achieve:
• Overtapered preparations
• Partial veneer crowns.
• Absence of two opposing walls (due to
caries, etc.). Retention can be improved in
faulty preparations by the placement of
internal features, which are accurate and easy
to prepare.
B. Path of Insertion
 "It is an imaginary line along which
the restoration will be placed onto
or removed from the preparation.
 Accurately determined using a

surveyor as minor undercuts in the

preparation tend to be hidden by
the human binocular vision.
 Intraorally the preparation can be

evaluated/surveyed by viewing the

preparation on a mouth mirror
using one eye, 30 cm (12 inches)
away from the preparation
• A facial path of insertion is
generally avoided because it forms a
prominent unaesthetic cervical
margin.
• The mesiodistal inclination of
prepared tooth should be parallel to
the proximal inclinations of adjacent
teeth
C. Structural Durability
 The ability of restoration to withstand

destruction due to external forces is known as

structural durability.
 Adequate reduction during preparation is

mandatory to obtain adequate thickness of

restoration.
 The amount of reduction required for

structural durability depends on the type of

restorative material being used and the
design of restoration.
1. Occlusal Reduction
 Occlusal strength is the

most vital as most of the

forces affecting the
restoration, act directly on
the occlusal surface.
 Inadequate clearance

may lead to a weaker

restoration prone to
fracture.
 2. Functional Cusp Bevel
 It is provided to increase the

thickness of otherwise thin

occlusoaxial junction of
restoration
 Additional thickness in this

region is necessary because the

functional cusp of the tooth is
the one which bears the
maximum load during
mastication.
 Prepared on the palatal cusps

of maxillary and buccal cusps of

mandibular posterior teeth.
3. Axial Reduction
 Adequate axial reduction is

necessary for structural

durability.
 Inadequate axial reduction

may lead to over-contoured

proximal surfaces, which
can lead to periodontal
problems
 Required taper should be

obtained, during axial

reduction. Over-reduction
will lead to loss of
retention.
 Other features, which increase durability,
are:
 Offset
 Groove
 Occlusal shoulder
 Isthmus
 Proximal box
Marginal Integrity
 Marginal adaptation and the

seating of the restoration affect

marginal integrity.
 Poor marginal adaptation will

lead to percolation of oral fluids

(marginal leakage) and
secondary caries.
 The margin of a restoration

should be preferably placed

supragingivally because it has
the following advantages:
- It can be easily finished.
- Easy to maintain.
- Easy to identify and
reproduce during
impression- making
 Finish Line Configurations
A finish line should have the
following characteristics:
Shallow bevels nearly parallel to

the cavosurface should be avoided

because the restoration will be too
thin at this area and may chip
easily.
 The discrepancy decreases with

the increase in angulation of the

bevel
 The bevel should not produce a

very acute margin which can lead

to fracture.
 Over reduction may lead to

formation of lip of unsupported

1. Chamfer
 This finish line possesses a

curved slope from the axial

wall till the margin
 . It can be produced using a

torpedo diamond point.

 The same diamond point

when used to reduce more

tooth structure will form a
deep chamfer finish line.
 It is the finish line of choice

for cast metal restorations

and lingual margins of metal
ceramic restorations.
 A chamfer will have the following
characteristics:
 Less stress and good success rate.
 Heavy chamfer is used to provide

90°cavosurface angle with large rounded

radius.
 Internal angle (done with round-end-tapered

diamond).
 Improper reduction will produce an

undesirable fragile piece of enamel (lipping).

 A bevel can be added to the heavy chamfer for

cast metal preparation

2. Shoulder
 This finish line has a gingival

finish wall perpendicular to

the axial surfaces of the teeth
 If the marginal wall is at

120°to the axial walls, then it

is termed a sloping shoulder
 Generally, a shoulder finish

line is preferred for all

ceramic restorations where
sufficient thickness of the
margin is required for
structural durability
 Radial shoulder
 It is done with flat end tapered diamond and end-

cuI.E.4. Shoulder with a Bevel It is similar to a

shoulder finish line, but an external bevel is
created on the gingival margin of the finish line9
 It is used as a gingival finish line on the proximal

boxtting parallel side carbide-finishing bur.

4. Shoulder with a Bevel
 It is similar to a shoulder finish line,but an external bevel

is created on the gingival margin of the finish line

 It is used as a gingival finish line on the proximal box of

inlays and onlays

 Advantages of a finish line bevel

• Aids in contouring the restoration.

• Improves burnishability.
• Minimizes the marginal discrepancy
• Prevents unsupported preparedmargins from chipping
5. Shoulderless or Feather Edge
Preparation
• It is similar to a knife-edge preparation
but is marginally thinner
• It has the same disadvantages as knife-
edge
• Chisel-edge preparations are similar to
feather-edge margins but it is marginally
thicker.
6.Knife-edge
It is an extremely thin finish line.
It is similar to a sloping shoulder with a
very thin margin • Difficult to wax up and
cast
• Difficult to produce a smooth margin
• Susceptible to distortion
• Overcontoured restorations may result
while building the bulk of the margins
 Preservation of Periodontium
• The placement of finish lines
influences the fabrication of the
restoration and the final outcome of
the treatment.
• The finish lines should be placed in
an accessible region so that the
margins of the restoration can be
easily finished by the dentist and
effectively cleaned by the patient.
• The finish lines should be such
that it can be reproduced in the
impression.
• It should also facilitate the easy
removal of the impression without
any tear or deformatio
 Armamentarium and Instrumentation:
 Hand chisels : used to accentuate the facial and lingual.
 Torpedo diamonds followed by torpedo carbide burs ; used to

prepare a chamfer finish line. •

- Flat-end-tapered diamonds followed by H158 carbide finishing
bur : used for radial shoulders.
- Flame diamonds followed by flame-finishing burs :used for
gingival bevels and conservative proximal flares.
- Abrasive paper discs :used to smoothen the finish lines of
vertical flares.
- Grooves, boxes, offsets and isthmus can be smoothened with
No. 169L, 170C and 171L non-dentate tapered burs.
- Cross-cut or dentate burs : to remove old restorations but they
produce horizontal ridges on the tooth surface. Hence, they
cannot be used for planning tooth surfaces.
- Small diamond points with air-water spray in a highspeed
handpiece can precisely remove tooth structure and also produce
a smooth finish when compared with conventional procedures.
All Metal Full Veneer Crowns
 It is usually given for posterior teeth.
 Armamentarium :

• Handpiece
• No.: 171L bur
• Round-end tapered diamond
• Short needle diamond
. Torpedo bur
• Red utility wax
Occlusal Reduction
 The principle is to achieve an
occlusal clearance of 1.5 mm for
the functional cusps and 1.0 mm
for the non-functional cusps
 This provides adequate metal
thickness to resist fracture under
occlusal load.
 Fractured or malposed teeth may
require lesser tooth reduction.
 Depth orientation grooves should
be placed on the occlusal surface
to act as a reference guide for the
required amount of occlusal
reduction.
 A round-end tapered diamond
is used to place grooves on the
cuspal inclines and the primary
grooves of the occlusal
surface .
 The tooth structures between
the orientation grooves are
removed following the occlusal
cuspal inclines of the abutment
tooth.
 The reduction should be
smooth without any rough
spots.
 A functional cusp bevel is placed
using a round-end tapered
diamond, on:
- The palatal inclines of maxillary
palatal cusps .
- Buccal inclines of mandibular
buccal cusps.
 The angulation of the bevel should

be parallel to the inner inclination

of the opposing cusps
 Occlusal clearance is verified by

asking the patient to close on a 2.0

mm thick red utility wax. Insufficient
clearance can be detected as a thin
spot on the wax and it is reduced
accordingly until there are no spots
on the wax.
Axial Reduction
 The buccal and lingual walls reduced

with a torpedo diamond as it has the

advantage of forming the chamfer
finish line alongwith the axial
reduction.
 Chamfer finish line provides adequate

bulk of metal along with a good

adaptation.
 The proximal reduction started with a

short needle diamond in a sawing

motion to break the contact
pointwhich done in an occlusogingival
or buccolingual direction.
 After gaining enough space, torpedo

diamond is used to prepare the

proximal surface and establish the
finish line.
 The axial surfaces smoothened with a

torpedo carbide finishing bur.

Seating Groove
 A seating groove is made on the buccal surface

of mandibular teeth and on the palatal surface of

maxillary teeth.
 It is usually made on the axial surface with the

greatest bulk, using a No. 171L diamond .

 Its prevent the rotation of the crown during

cementation and acts as a guide during insertion

of the crown.
 Buccal and lingual grooves can be placed for

preparations involving long-span fixed partial

dentures
Metal-Ceramic Full Veneer Crowns
 It is also known as Porcelain-Fused-to-Metal

restoration.
 It has a thin metal coping with a facial

ceramic layer.
 This crown has the strength and accurate fit

of a metal crown and esthetics of a ceramic

crown.
 They stronger than all ceramic crowns and can be
used as a fixed partial denture retainer.
 For ceramic veneering, a cutback design is

provided on the facial surface of the metal coping

in order to provide space for the ceramic layer and
the lingual reduction is similar to a full metal crown
The procedure for tooth preparation for metal
ceramic crowns varies according to their location.
Next we shall discuss about anterior and posterior
metal ceramic preparations
 Preparation for Anterior Metal-Ceramic Full
Veneer Crowns
 Armamentarium

• Laboratory knife with a No. 25 blade

• Silicone putty and accelerator
• Handpiece
• Flat-end tapered diamond
• Small wheel diamond
• Long needle diamond Torpedo diamond
 Preparation of an index :
• An index is made before the preparation to check
for reduction produced by the preparation.
• If the tooth has proper contours the index can be
made intraorally.
If the tooth is extensively damaged or the existing
contours are to be changed by the restoration, the
index is made from the preoperative wax-up on the
diagnostic cast.
 • A half scoop of putty elastomer
is kneaded with adequate
accelerator.
 The kneaded mix is adapted over
the entire facial and lingual
surface of the tooth to be prepared
plus the facial and lingual surfaces
of at least one adjacent tooth.
 It is allowed to polymerize for two
minutes.
 The index is removed from the
teeth. It is used to cut along the
incisal edges of index to split into
labial and lingual half.
 Labial half cut transversly to form
incisal and gingival half.
 Labial reduction
 Depth-orientation grooves are placed on the

labial and incisal surfaces using a flat-end

tapered diamond point
 The depth of reduction can be measured using

the uncut outer surface of the remaining tooth

structure as a guide
• If the reduction is done without these grooves,
more time will have to be wasted in checking for
reduction for index.
 The labial grooves should be atleast 1.2 mm in
depth to provide adequate thickness of ceramic.
Insufficient reduction will lead to: -
 A poorly contoured restoration that lacks in
aesthetics and it may affect the health of the
surrounding gingival.
 Two labial groove prepared:
- One set should be parallel with the gingival half of
the labial surface.
- Other should parallel with incisal half of labial
surface
 After completing the depth orientation grooves,
islands of enamel formed between the depth
orientation grooves should be reduced to the
depth of the grooves using the same bur
• Facial reduction should be done in two planes,
namely incisal and gingival planes with a flat-end
tapered diamond point
 The amount of reduction verified
by placing the corresponding
halves of the index over the
prepared tooth.
 The labial reduction is extended
across the labio-proximal line
angles and the proximal contacts
to a point about1.0 mm lingual to
the proximal contacts.
 This region where the labial and
lingual reduction meet (labial
reduction is 1.2-2.0 mm deep and
the lingual surface is 0.7-1.0 mm
deep) is described as a wing
preparation.
Incisal reduction
 After the labial reduction, incisal grooves (2.0 mm deep) should

be made across the incisal edge. The bur should be held at a

direction perpendicular to the incisal half of the labial reduction
 It is done using a flat-end tapered diamond following the plane

of the unprepared incisal edge

 The incisal reduction is useful :

- Improving the instrument's access near the axial surfaces

- Improving the access for placement of the gingival finish line .
- Improving the incisal translucency in the finished restoration.
Lingual reduction
 The cingulum should be reduced
with a small wheel diamond to
obtain a minimum clearance of 0.7
mm with the opposing teeth. 1.0
mm clearance is needed if a
ceramic veneer is given
 The junction between the lingual
wall and the cingulum should not
be over-reduced. A short lingual
wall will have reduced retention.
 The lingual wall of the reduced
lingual surface should be parallel to
the gingival half of the labial
surface . It can also be reduced
along with proximal reduction.
 Proximal reduction
• A long needle diamond point is used to
break the contact and gain access into the
proximal region without damaging the
adjacent teeth.
• Mostly reduced during the wing preparation
(a part of labial reduction)
• The lingual aspect of the proximal surface
and the remaining lingual wall are reduced
using a torpedo diamond point
• The axial surfaces and the chamfer finish
line are smoothened with a torpedo bur.
. An H158-012 radial fissure bur use to
smoothen labial surface. All the angle and
edges are rounded with the sides of bur and
end of bur is used to form a radial shoulder
finish line.
. RS-1 binangle chisel with rounded corners
used to finish radial shoulder finish line and
removed the unsupported lip of enamel.
 Preparation of Posterior Metal Ceramic
Full Veneer Crowns
 It is used as an aesthetic replacement of

missing teeth in the appearance zone,

namely maxillary premolars, maxillary first
molars and mandibular first premolars.
Disadvantage:
Additional tooth reduction is essential to
provide adequate thickness for ceramic
facing.
 More expensive than full metal crowns.
 Increase risk of failure as it may fracture

easily.
Armamentarium
.Laboratory knife with no. 25 blade
• Silicone putty and accelerator
• Handpiece
• Flat-end tapered diamond
• Round-end tapered diamond
• Short needle
• Torpedo diamond
• Torpedo bur
• No. 171L bur
• H158-012 radial fissure bur
. RS-1 binangle chisel
Preparation of Index
 An index is prepared with silicone

putty. The procedure is similar to the

one mentioned in anterior metal
ceramic
Occlusal reduction
 Depth orientation grooves are made

with a round end tapered diamond

point along the cuspal inclines .
 It should be atleast 1.5 to 2.0 mm

reduction for ceramic coverage.

 Reduction is completed by joining the

strips of tooth structure left between

the depth orientation grooves.
 The reduction should follow the

occlusal morphology
 • A functional cusp bevel is prepared on the
palatal inclines of maxillary palatal cusps and on
the buccal inclines of mandibular buccal cusps.
• The bevel should be 1.5 mm deep for metal
coverage and 2.0 mm deep for metal with ceramic
veneer.
• Placement of depth orientation grooves and
occlusal reduction is done to described full veneer
crown preparation.
 Facial reduction
• It is also done in two planes similar
to anterior teeth. One plane should
be parallel to the cuspal inclines and
the other plane should be parallel to
the long axis of the tooth
• Facial reduction should be done
with the flat-end tapered diamond
point aligned parallel to the occlusal
third of the facial surface.
• Three vertical depth orientation
grooves should be made on the
occlusal third of the facial surface.
These grooves should fade out
gingivally.
 Subsequently, the diamond point
is aligned parallel to the gingival
third of the buccal surface and the
sides of the diamond point are
used to prepare the tooth with the
diamond point tip in a
supragingival position.
 Vertical depth orientation grooves
are also placed along the line
angles of the tooth.
 Facial reduction should be atleast
1.2 mm for base metal ceramic
crown and 1.4 mm for noble metal
ceramic crowns to have an ideal
contour and adequate opacity.
 Proximal reduction
• It is started with a short needle diamond point to avoid
damage to the adjacent teeth.
. Bur can be moved either in an up-down motion on the
facial aspect of the interproximal region or in a facio-lingual
motion on the occlusal aspect of the inter-proximal region .
• It is done to attain adequate separation between the
teeth without overtapering the abutment or damaging the
adjacent teeth.
The proximal walls are planed using the needle diamond
bur
 Lingual reduction
It is done with a torpedo diamond

Tooth reduction is done on the lingual

and proximal walls to attain a chamfer

finish line.
Shoulder is than planed with RS-1

binangle chisel which preserve

rounder internal line angle.
Lip or enamel/reverse bevel are

remove to avoid any interference.

A narrow bevel of 0.3mm wide is

made on shoulder with a tip of flame-

shaped diamond, bevel should be
narrow and finished with H48L-010
flame shaped carbide finishing bur.
All-Ceramic Full Veneer Crowns
It provides the best aesthetics.
 As ceramic is brittle in nature, it is susceptible to fracture.

It is mostly used as a replacement of missing anterior

teeth especially incisors.

A Half-Moon fracture of an all-ceramic crown is the most

common form of failure. It usually occurs in:

- Teeth with an edge to edges
- Deep bite cases
- Teeth with short crown
- Over-shorthened preparation
 Armamentarium
• Handpiece
• Flat-end tapered diamond
• Small wheel diamond
• HI58-012 radial fissure bur
• RS-1 binangle chisel
Labial Reduction
 Depth orientation grooves prepared using a flat-end

tapered diamond.
 The grooves should be 1.2 to 1.4 mm deep on the

labial surface and 2.0 mm deep on the incisal

surface. The first set of three labial grooves is made
parallel to the gingival third of the facial surface.
 A second set of two grooves is made parallel to the

incisal two-thirds of the uncut labial surface. This

two-plane reduction on the facial surface provides
adequate aesthetics without affecting the pulp.
 Tooth structure left between the grooves is removed

following the morphology of tooth to a depth of 1.2

to 1.4mm.
 Incisal Reduction
It is done along with the preparation of the labial

surface.
Depth orientation grooves should be made

across the incisal edge. They should be about 2.0

mm deep.
 Islands of enamel between these grooves should

be reduced using a flat-end tapering diamond bur.

 The incisal reduction should be perpendicular to

the plane of the incisal half.

 Lingual Reduction
• Cingulum should be reduced with a small wheel
diamond.
• Care should be taken to prevent over-reduction at the
junction between the cingulum and lingual wall. A short
lingual wall reduces the retention of the restoration.
• The reduction of lingual axial surface is done with a
flatend tapered diamond
• The lingual wall should be parallel to the gingival portion
of the labial wall.
 Proximal Reduction
 Its preparation is similar to anterior metal ceramic

crown except that a radial shoulder finish line is

provided along the entire preparation.
 The shoulder should be atleast 1.0 mm wide and

should be in uniform contour along the line angles of

the restoration
The axial walls are smoothened with an H158-012

radial fissure bur.

 RS-1binangle chisel used to smoothen the shoulder.
 Preparation of partial veneer
crowns
 The partial veneer crown is a conservative
restoration.
 They are used in cases where minimal retention

is sufficient and abutment tooth is healthy.

 Here, crown does not cover entire abutment and

facial surface of the abutment is left intact for

superior aesthetics.
 Advantages
• Conservation of tooth structure.
• Improved access for finishing by the dentist and for

cleaning by the patient.

• Improved periodontal health

• The partial veneer crown can be completely seated

during cementation.
• Marginal fit on partial veneer crown easily identified.

• Unveneered portion of enamel used for electric pulp

testing.
Maxillary Posterior Three-quarter
Crowns:
 It is usually a partial veneer crown with an
intact buccal surface.
 It is usually used in maxillary posterior teeth
where aesthetics is not a major concern.
Armamentarium
 Handpiece
 Round-end tapered diamond
 Short needle diamond
 Torpedo diamond
 Torpedo bur
 No . 169L bur
 Flame bur
 Flame diamond
 Enamel Hachet
Occlusal Reduction
• Depth orientation grooves should
be made using a round-end
tapered diamond bur
• The grooves should be 1.5 mm
deep on the functional cusps, 1.0
mm deep on the nonfunctional
cusps
• The grooves should be only about
0.5 mm deep on the occlusobuccal
angle line to minimize the display
of metal.
. A functional cusp bevel placed on
palatal or outer incline of palatal
cusp. It should be 45° to long axis
of preparation.
Axial Reduction
 All axial surfaces are usually reduced using

torpedo bur.
 Started by reducing diamond point bur
 Care should be taken to avoid over inclination

of the lingual wall

 Reduction should be extended into proximal

surfaces without damaging the adjacent tooth

 All sharp angles should be rounded
 After breaking the contact, proximal reduction is

carried out. Proximal reduction should also be

done with a torpedo diamond .
Placement of Additional
Features:
 Proximal grooves
 Grooves are usually placed to

increase the retention.

 An outline of the preparation

should be drawn on the occlusal

surface using a sharp pencil.
 Using the outline as an index, a

small 1 mm deep grove is

formed on proximal surface,
known as template.
 After examining the alignment

and direction, the groove is

extended up to a point 0.5 mm
occlusal (above) to the finish
line.
 Grooves should be parallel to

long axis of the abutment.

Proximal flare
• Flare is a flat plane on the facial wall of a groove. The facial
wall of the proximal groove should be extended such that it
forms a line angle with the facial surface. This produces a
proximal flare
• It is cut using the tip of a flame diamond in an outward
direction from the groove.This is done in order to avoid
overextension. It can also be made with a wide enamel chisel.
• The flare is smoothened with a carbide bur using short and
crisp strokes to avoid roundening of the finish line.
Occlusal offset
 It is a 1.0 mm wide ledge on

the lingual incline of the

facial cusp. It should connect
the two proximal grooves .
 It is prepared with a No.

171L bur
• It forms an inverted'V‘ and
it provides space for a truss
of metal to form a
reinforcing staple
• The junction between the
lingual slope of the facial
cusp and the upright wall of
the offset should be
rounded.
Buccal bevel
• It is made with a No. 17 bur
• A 0.5 mm bevel is placed along the bucco-
occlusal finish line perpendicular to the path of
insertion
• It extends over the mesial and distal corners and
blends into the proximal flare
Variations in Posterior
Partial Crowns
1. Proximal boxes: Modified
three-quarter crowns can be
fabricated with proximal boxes
instead of grooves for better
retention
2. Mandibular posterior three-
quarter crowns
 They vary from maxillary

preparations in the following

aspects:
- The occlusal finish line on the
buccal surface is gingival to
the occlusal contact.
 An occlusal shoulder is prepared on the buccal
aspect of buccal cusps. It connects the proximal
grooves and strengthens the bucco-occlusal margin.
 Offset need not be placed on the lingual inclines of

the buccal cusps.

3. Seven-eighth crowns:
 A Seven-eighth crown is a three quarter crown

which extends to about half (mesial or distal) of the

buccal surface.
4. Reverse three-quarter crown: It is used on
mandibular molars with an intact lingual surface.
 As the name suggests, these crowns are opposite

to three quarter crowns. That is, these crowns

cover the proximal and buccal surface and leave
the lingual surface intact.
 It is used on fixed partial denture abutments with

severe lingual inclination.

 It preserves tooth structure by avoiding the need

for a full veneer crown.

5. Proximal half crown:
 It is a three quarter crown

rotated at 90° in which the

distal surface is left intact
 It is used as a retainer over

mesially tilted mandibular teeth.

 Grooves parallel to the mesial

surface should be placed on the

distal end of the buccal and
lingual axial walls .
 An occlusal offset connecting

the axial grooves should be

prepared. It functions to
strengthen the disto-occlusal
margin, improves the retention
and resistance of the
restoration, and acts like a
countersink and prevents the
mesial displacement of the
Anterior Three-quarter Crowns
It is a restoration which does not cover the
facial surface
 The main disadvantage is the unaesthetic

display of metal near the incisal edge.

 It can be used as a retainer for short-span

fixed partial dentures with caries-free

abutments. It is usually placed faciolingual
bulk.
Design Considerations
The factors to be considered to avoid
metal display are:
• Path of Insertion and Placement of

Grooves The path of insertion should

be parallel to the incisal onehalf to
two-thirds of the labial surface.36
This path requires a slight lingual
inclination to the grooves . This type
of placement not only increases the
length of the groove, but also helps
to provide a more apical and labial
placement for the base of the
groove.
• If the groove is placed labially, the

labioincisal corners are over-reduced

leading to display of metal. If the
base of the grooves is moved too
lingually, the length is reduced
Armamentarium:
• Handpiece
• Small wheel diamond
• Small round diamond
• Long needle diamond
• Torpedo diamond
• Torpedo bur
• No: 169Lbur
• No: 170Lbur
• Flame diamond
• Flame bur
• Enamel hatchet
Lingual reduction
• A small wheel diamond is used
to create a concave lingual
reduction incisal to the
cingulum.
• A clearance of at least 0.7 mm
with the opposing teeth should
be established.
• Depth orientation grooves are
placed on the lingual surface
with a small round diamond
and the islands tooth structure
formed between the depth-
orientation grooves are
reduced .
 The cingulum reduction in
incisors should form a smooth
concave depression. But in
canines, it should be done in
two planes with a slight ridge
extending inciso-gingivally
along the center of the lingual
surface.
 The lingual axial wall reduced
using a torpedo diamond
point and a chamfer finish line
is established. The inclination
of the diamond point should
be parallel to the path of
insertion (i.e. the incisal two-
thirds of the labial surface).
Incisal reduction
• It is done using a small wheel diamond
• The reduction should follow the contour to the
uncut incisal edge.
• The reduction should be about 0.7 mm deep
at the junction between the incisal edge and
the lingual surface.
• The reduction forms a flat plane on the
incisors but it follows the mesial and distal
cuspal inclines on the canine.
Proximal reduction
• It is started with a lingual approach using a
long needle diamond in an up-down sawing
motion.
Placement of Additional
Features :
Proximal grooves
• These grooves are placed as far

labially as possible without

undermining the labial enamel.
• An outline of the grooves

should be marked on the linguo-

incisal area of the preparation
with a pencil.
• A 1.0 mm deep template for the

first groove is prepared within

the outline using a No: 170L bur.
• The second groove is prepared

in a similar manner
Proximal flare
 The flare should be prepared to

make the labial wall of the

groove meet the labial surface
in a sharp line angle
 A flare should be started in the

gingival end with the thin-

tipped flame diamond.
 It is finished using a flame bur

to form a smooth flare with a

sharp, definite finish line.
 A wide enamel chisel can be

used to produce a very minimal

extension.
 Incisal Offset
• It is made with a No. 170L bur.
• It is placed on the sloping lingual surface near the opposing
occlusal contact.
• It should connect the proximal grooves.
• It should have a uniform clearance from the incisal edge.
• It should form a 'V' in canines and a straight line in incisors.
• The metal that occupies the offset helps to strengthen the
linguoincisal margin.
 Incisal Bevel
• It is done using a No. 170L bur.It can also be
done using a flame diamond bur.
• A 0.5 mm wide bevel is placed on the labioincisal
finish line.
• The bevel is perpendicular to the path of
insertion along the mesial incline.
 Pin-Modified Three-Quarter Crown
• This is an aesthetic modification of the classic

three-quarter39 crown.
• It is used as a retainer on sound abutments for

short span fixed partial dentures in aesthetically

critical areas.
• This restoration extends over the lingual and a

single proximal surfaces.

Contraindications
• On teeth with caries or restorations
• In mouth with extensive caries
• Malpositioned teeth
• Small teeth with thin enamel and dentine, but
large pulp
 Lingual Reduction
• It is similar to conventional

anterior three-quarter crown

preparation
• A lingual incisal bevel is

prepared with a wheel

diamond.
• The bevel should be

approximately 1.5 mm in
width. It should be parallel
to the uncut incisal edge.
• It should end lingual to the
labioincisal line angle to
avoid the display of metal
 Proximal Reduction
• As mentioned before, only one
proximal surface is prepared.
The proximal surface,which is
adjacent to the edentulous
ridge, is alone prepared.
• It is done using long needle
diamond and torpedo diamond
points
 The axial reduction should be

extended as far labially as

possible, closer to the
labioproximal line angle.
Inadequate facial extension will
lead to an undersized, weak
connector and poor access to
the margins of restoration.
 Preparation of Additional
Features
A. Proximal grooves
• A proximal box may be
given if there is proximal
caries or restoration.
• Placement of two grooves
is more retentive than a box
form in anterior teeth
because the two grooves
have two lingual walls. The
wall of the facially
positioned groove will be
longer and more retentive
than the short lingual wall of
a box
Facial proximal groove
• It is prepared using a No: 170L bur
• Shallow pilot grooves are made to determine the
location and direction
• The bur is then moved along the track of the trial
grooves to deepen it.
Lingual proximal groove
• It is placed parallel to the facial groove
• It is made with a No. 170L bur
Cingulum proximal groove
• A third, short groove is made on the opposite
side on the cingulum near the vertical finish
line of that surface
• This groove enhances the resistance and
reinforces the tooth margin
Counter-sink
• It is a flat ledge prepared in the
incisal corner opposite to the
site of the proximal grooves • It
is prepared using with No. 170L
bur.
• It must be placed in dentin
• It is placed lingual to the finish
line and gingival to the incisal
edge of the restoration. • A
ledge is also placed in the
middle of the cingulum
• These flat areas on the sloping
lingual surface act as starting
point.
Preparation of pinholes
• A shallow depression is prepared on the center of
each flat ledge (countersink) with a No. 1/2 round
bur as described before.
• A low-speed contra-angle 0.6 mm (0.024-inch) drill is
carefully aligned over the depression.
BEVEL
 The angle formed between the facial wall of
the offset and the incisal edge of the uncut
tooth structure should be bevelled.
 This bevel should not be over-extended

facially as it may lead to metal display An

incisal bevel (finishing bevel) is placed on
the functional area of the incisal edge with
a flame diamond.
REFERENCES:
 Deepak Nallaswamy Veeraiyan (2nd edition)
 V Rangarajan/TV Padmanabhan (2nd edition)