Review

TYPES OF FINISH LINES OR GINGIVAL MARGINS INTOOTH PREPARATION

Malini Murali1, Narasimman2, C.J. Venkatakrishnan3.

Abstract:

The placement of finish lines has a directbearing on the ease of fabricating arestoration and on the ultimate
success of therestoration. Improper or inappropriateplacement of finish lines may result in failureof the fixed
prosthesis. This article reviewsthe various finish lines/ gingival margins intooth preparation along with its
evolution andthose preferred in special conditions.

Key words:

1. CRRI, Tagore Dental College & Hospital, Chennai.

2. Reader, Department of Prosthodontics, Tagore Dental College & Hospital, Chennai.
3. Professor & HOD, Department of Prosthodontics, Tagore Dental College & Hospital, Chennai.

Introduction
Achieving close marginal adaptation is crucial Preservation of Tooth Structure
for the long-term clinical success of single- or
multiple-unit fixed-partial dentures (FPD) and Adjacent teeth
for the prognosis of the restored tooth. Luting
Iatrogenic damage to an adjacent tooth is one
agent solubility may, in time, result in gap
of the most common happenings in day to day
formation between the tooth and the
practice. Disturbing or damaging the proximal
restorative material, leading to micro-leakage,
contact area, will render the tooth more
plaque accumulation, caries and subsequent
susceptible to caries. This is presumably
failure of the restoration. Hence choosing the
because of the reason that the surface enamel
appropriate finish line based upon the
contains higher fluoride concentrations and the
restoration’s material and the condition of the
interrupted layer contains no or comparatively
tooth is essential to arrive at a successful fixed
less amount of fluoride. The anti-plaque action
partial prosthesis. of fluoride is washed away and the damaged
Principles of tooth preparation: tooth becomes more prone to plaque retention.
This damage to the adjacent tooth can be
The design of a preparation for a restoration minimized by the use of a metal matrix band.
and the execution of the design are governed The next method of minimizing the damage is
by 5 principles:1,2,3 the use of thin long end tapering diamond bur.
This minimizes excessive tooth reduction and
1. Preservation of tooth structure prevents undesirable angulations.
2. Retention and resistance
3. Structural durability Soft tissues
4. Marginal integrity
5. Preservation of the periodontium Damage to the soft tissues of the tongue and
cheeks can be prevented by careful retraction

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with a mouth mirror, or flanged saliva ejector, the necessary retention and resistance
aspiration tip. Care must be taken while Retention prevents removal of the restoration
protecting the tongue when the lingual along the path of insertion or long axis of the
surfaces of mandibular molars are being tooth preparation. The essential element of
prepared. Injury to the gingiva is also to be retention is two opposing vertical surfaces in
avoided. This can be reduced through gingival the same preparation. These may be external
retraction. surfaces, such as the buccal and lingual walls
of a full veneer crown Resistance prevents
Pulp dislodgment of the restoration by forces
directed in an apical or oblique direction and
Extreme temperatures, chemical irritation, or
prevents any movement of the restoration
microorganisms can cause an irreversible
under occlusal forces.4
pulpitis, particularly when they occur on
freshly sectioned dentinal tubules. Pulpal Taper
damage can be caused due to accidental pulp
exposure, failure to use water coolant causing Taper is defined as the convergence of two
heating up of the burs. Prevention of pulpal opposing external walls of a tooth preparation
damage necessitates selection of techniques as viewed in a given plane. The extension of
and materials that reduce the risk of damage these 2 planes form an angle, the terms angle
while tooth structure is prepared. The location of convergence and angle of divergence can be
of the pulp chamber should be estimated using used to describe the respective relationships
radiographs, so that the perforation can be between the two opposing walls of a
prevented. This is more common in cases of preparation. The relationship of one wall of a
tooth preparation for all ceramic restoration or preparation to the long axis of that preparation
for those that require excessive tooth cutting. is the inclination of that wall.

Causes of injury
1. Temperature – inadequate water coolant,
excessive pressure, high rotational speed,
poor condition of the cutting instrument.
2. Chemical action – harsh chemicals that are
introduced as luting agents, restorative
resins, bases, degreasing purpose.
3. Bacterial action - left over infected
dentine, microleakage.
Fig 1: 2-3 degree of taper
Retention and Resistance
A tapered diamond or bur will impart an
No cements that are compatible with living
inclination of 2 to 3degrees to any surface it
tooth structure and the biologic environment of
cuts if the shank of the instrument is held
the oral cavity possess adequate adhesive
parallel to the intended path of insertion of the
properties to hold a restoration in place solely
preparation. (Fig 1) Two opposing surfaces,
through adhesive ion. The geometric
each with a 3-degreeinclination, would give
configuration of the tooth preparation must
the preparation a 6-degree taper. Theoretically,
place the cement in compression to provide
the more nearly parallel the opposing walls of
a preparation, the greater should be the
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retention. Some early authors advocated the on a preparation for a metal-ceramic crown
use of parallel walls. However, it is not will leave the facio-occlusal angle too
practically possible to create perfectly parallel prominent, resulting in over contouring of the
walls and even the slightest undercuts created restoration, "opaque show through," or both.
will prevent the restoration from being well
seated.5 Structural Durability

Freedom of Displacement A restoration must contain a bulk of material

that is adequate to withstand the forces of
Retention is improved by geometrically occlusion. This bulk must be confined to the
limiting the numbers of paths along which a space created by the tooth preparation. Only in
restoration can be removed from the tooth this way can the occlusion on the restoration
preparation. Maximum retention is achieved be harmonious and the axial contours normal,
when there is only one path. A full veneer preventing periodontal problems around the
preparation with long, parallel axial walls and restoration. It is the ability of the restoration to
grooves would produce such retention. On the last long without damage, under occlusal
opposite extreme, a short, overtapered forces.
preparation would be without retention
because the restoration could be removed Occlusal Reduction
along an infinite number of paths. Grooves and
One of the most important features for
proximal boxes can be used in this case. There
providing adequate bulk of metal and strength
must be a definite wall perpendicular to the
to the restoration is occlusal clearance. For
direction of the force to sufficiently limit the
gold alloys- 1.5mm of clearance on the
freedom of displacement and provide adequate
functional cusps (lingual of maxillary molars
resistance.10,11
and premolars and buccal of mandibular
Path of Insertion molars and premolars) Not quite as much is
required on the nonfunctional cusp – 1mm.
The path of insertion is the specific direction Metal-ceramic crowns- 1.5 to 2.0 mm on
in which the prosthesis is placed on the functional cusps1.0 to 1.5 mm on
abutment. It is determined mentally by the nonfunctional cusps to receive ceramic
dentist before the preparation is begun, and all coverage. All-ceramic crowns- 2mm clearance
features of the preparation are cut to coincide
with that line. It is of special importance when Functional Cusp Bevel
preparing teeth to be fixed partial denture
An integral part of the occlusal reduction is the
abutments, since the paths of all the abutment
functional cusp bevel. A wide bevel on the
preparations must parallel each other. The
lingual inclines of the maxillary lingual cusps
correct technique must be used to survey a
and the buccal inclines of mandibular buccal
preparation visually, since this is the primary
cusps provides space for an adequate bulk of
means of insuring that the preparation is
metal in an area of heavy occlusal contact. If a
neither undercut nor overtapered. The path of
wide bevel is not placed on the functional
insertion must be considered in two
cusp, several problems may occur. If the
dimensions: faciolingualy and mesiodistally.
crown is waxed and cast to normal contour,
The faciolingual orientation of the path can
the casting will be extremely thin in the area
affect the esthetics of metal ceramicor partial
overlying the junction between the occlusal
veneer crowns. For metal ceramic crowns, the
and axial reduction.
path is roughly parallel with the long axis of
the teeth. A facially inclined path of insertion
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Axial Reduction a potential site for caries and periodontal

disease because of the dissolution of the
Axial reduction also plays an important role in luting agent.
securing space for an adequate thickness of
restorative material. If restorations are made The restoration can survive in the biological
with normal contours over preparations with environment of the oral cavity only if the
inadequate axial reduction, it will result in thin margins are closely adapted to the cavosurface
walls that will be subject to distortion. Hence finish line of the preparation. The
over-contouring the axial surfaces are done to configuration of the preparation finish line
compensate for this. While this "solution" to dictates the shape and bulk of restorative
the problem strengthens the restoration, it has material in the margin of the restoration It also
a damaging effect on the periodontium. There can affect both marginal adaptation and the
are other features that serve to provide space degree of seating of the restoration.
for metal that will improve the rigidity and
durability of the restoration: the offset, the Preservation of the Periodontium
occlusal shoulder, the isthmus, the proximal
The margins should as smooth as possible and
groove, and the box. The isthmus connects the
be exposed to a cleansing action. The
boxes, and the offset ties the grooves together
placement of the finish line should be kept in
to enhance the reinforcing "truss effect."6 an area where the margins of the restoration
Marginal Integrity can be finished by the dentist and kept clean
by the patient. In addition, the placement
The integrity of the margin is determined by should be such that the dentist finds it easy to
finish and visualize the finish line easily.
I. Margin placement
Supra gingival margins are placed at or
above the gingival crest. When the same is
placed exactly at the level of the gingival
crest, it is termed as equigingival. Easy to
place, visualize, evaluate and can be
maintained by the patient. Sub-gingival
margins are employed when there is root
caries, sensitivity, in anterior region for
esthetics and in case of short clinical
crowns.7
II. Margin Geometry
It is the shape or configuration of the
prepared finish line. The various Fig 2: Supra Gingival Finish line
finishlines are discussed in detailed in the
upcoming pages.8,9 In the earlier days, finish lines were placed as
sub-gingivally as possible. This was to ensure
III. Margin adaptation
A marginal gap of 10 microns for that the cervical root portion and the tooth
castmetal and upto 50 microns for ceramic portion that lies within the gingival sulcus
restorations in clinically accepted. The remains caries free. But overtime, it was
space between the tooth and the restoration reported that when sub-gingival margins were
should be smooth and even as it is always placed, it lead to periodontitis and indeed was
a major etiological factor.6

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The reason for periodontitis with subgingival However, a tooth that has been endodontically
margin could be due to improper finishing treated and is asymptomatic, with radiographic
leading to gingival inflammation, loss of evidence of a good seal and complete
attachment, bone loss and pocket obturation of the canal, can be used as an
formation.12,13 abutment. However, the tooth must have some
sound, surviving coronal tooth structure to
Biological width insure longevity. Even then, some
compensation must be made for the coronal
The dimension of the softtissue, which is
tooth structure that has been lost. This can be
attached to the portion of the tooth coronal to
accomplished through the use of a dowel core,
the crest of the alveolar bone."Crown
or a pin-retained amalgam or composite resin
lengthening" may be required to surgically
core.
move the alveolar crest 3.0 mm apical to the
placed finish line to maintain the biologic The supporting tissues surrounding the
width and prevent periodontal pathology. abutment teeth must be healthy and free from
inflammation before any prosthesis can be
Evaluation of fixed prosthodontics
contemplated. Normally, abutment teeth
If a tooth adjacent to an edentulous space should not exhibit mobility, since they will be
needs a crown because of damage to the tooth, carrying an extra load. The roots and their
the restoration usually can double as an FPD supporting tissues should be evaluated for
retainer. If several abutments in one arch three factors:
require crowns, there is a strong argument for
1. Crown-root ratio
the selection of a fixed partial denture rather
than a removable partial denture. Whenever 2. Root configuration
possible, an abutment should be a vital tooth.
3. Periodontal ligament area

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Address of correspondence
Malini Murali, CRRI, Tagore Dental College & Hospital, Chennai.
Email Id: [email protected]

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