THE BASICS

OF
TOOTH
PRPARATION

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TOOTH PREPARATION

- Mechanical treatment of dental disease or injury to hard tissues that restores a tooth to the original form
By: Tylman

- The mechanical preparation or the chemical treatment of the remaining tooth structure, which enables it to
accommodate a restorative material without incurring mechanical or biological failure
By: Marzouk

- The process of removal of disease and/or healthy enamel and dentin and cementum to shape a tooth to receive a
restoration
By: GPT-9
- The mechanical alteration of a defective, injured or diseased tooth to receive a restorative material that re-
establish the healthy state for the tooth including its esthetics corrections where indicated and normal form and
function
By: Sturdevant

DENTAL BURS

- Or “bur” is applied to all rotary cutting instruments that have bladed cutting heads

- Classification:

a. Cutting Burs

1. Steel burs – earliest burs to be used, dull rapidly while cutting enamel, mainly used for finishing purpose

2. Carbide burs – heads of carbide cemented on steel shank, stiffer and stronger than steel
- possesses blades that shear or cut tooth structure
- they are used for making precise intracoronal preparation features such as placing
grooves and boxes
- they are not use for bulk reduction because they produce undulations on the tooth surface

b. Abrasives

1. Diamond burs – abrasive instruments are based on small, angular particles of hard substance held in
matrix of softer material, works by grinding
- made from diamond chips bonded to blanks
- used for grinding enamel and dentin surfaces
- may be divided according to coarseness and shape

2. Discs – attached to mandrels, rounded in shape with various usage

a. Sandpaper disc – used to finish and polish restorations

- used abrasives like garnet, sand, emery, and cuttlefish

b. Carborandum disc – also called separating disc or Jo-dandy disc

- double sided, green-gray or dark colors
- fast cutting of metal casting, cast gold, porcelains, acrylics and tooth
Structures

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 c. Diamond disc – used to trim porcelain
- diamond particles bonded to metal structure

3. Stones – used for cutting, polishing metal, amalgam, porcelain restorations in laboratory
- its abrasive materials include garnet, aluminum oxide and silicon carbide

4. Rubber Wheels – used for finishing and polishing metal restorations

- its matrix can be phenolic resins or rubber
- abrasive can be sintered or resin bonded

Numbering and coding of burs

- Types of Diamond Burs According to Shapes and its’ Uses in Tooth Preparation:

a. Long Tapered Flat End

- used for bulk axial reduction

- used for occlusal reduction
- used to create shoulder finished line

b. Torpedo
- used for creating chamfer finish line
- also known as Tinker diamond
- creates a chamfer with greater control than round-end tapered diamonds
- for formatting the bevel shoulder finish line

c. Long Tapered Round End

- for axial reduction with 6-degree taper

- chamfer finish line – 0.5 mm

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 d. Long Needle
- for interproximal initial access without causing injury to adjacent tooth and to form
knife-edge finish line

e. Wheel-shaped Bur/Donut

- used for reduction of occlusal surface, reduction of incisal edge, reduction of palatal
surface of anterior teeth

f. Foot-ball Shaped Bur

- used for occlusal reduction and for reduction of palatal fossa of anterior teeth

g. Depth Marking/Cutting Bur/Guide Groove Bur

- used for marking depth grooves before tooth preparation

h. Tapered Oblong Diamond Bur/Flame

- used for bevel placement

i. Barrel Shaped Bur

- used for occlusal reduction of posterior teeth

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 ANTERIOR
TOOTH PREPARATION
FOR
METAL CERAMIC
CROWN

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 I. Placement of depth
orientation grooves
at the labial surface
which is 1.2 to 1.8 mm depth.

II. Incisal reduction – 2mm

Use tapered flat end
diamond bur. Remove the
remaining tooth structure
between depth grooves.

III. The labial grooves cut into two sets:

TO ACHIEVE ADEQUATE REDUCTION WITHOUT
ENCROACHING UPON THE PULP – FACIAL SURFACE
PREPARED IN TWO PLANES THAT CORRESPOND
ROUGHLY TO THE TWO GEOMETRIC PLANES PRESENT
ON THE FACIALSURFACE OF AN UNCUT TOOTH
1. One parallel to the gingival half of the labial surface
2. One parallel to the incisal half of the labial surface

IV. Labial reduction:

Incisal half using
long tapered flat end.
Remove the tooth structure
remaining between the
orientation grooves

V. Labial reduction:
Gingival half using
long tapered flat end:
creating shoulder finish line.

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 Remove the remaining tooth
structure between the depth
grooves creating a shoulder
cervical margin.

VI. Initial Proximal Reduction:

Removal of the contact
area using long needle bur.

VII. The finishing line should be smooth

and continuous with other surfaces.

VIII. Rounding of any sharp angles

on the incisal edges and all
around the prepared tooth

IX. Lingual reduction:

Reduce the lingual concavity of the
lingual surface with wheel-shaped
or football-shaped diamond to provide
adequate clearance for the restorative
material.
Typically, 1 mm is required if the centric
contacts in the completed restoration
are to be located on metal.
When contact is on porcelain, additional
reduction will be necessary.

X. Lingual axial reduction:

Use round end tapered or torpedo bur to
obtain chamfer finish line in the lingual
surface.

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 XI. Smoothening of the sharp angles

FACIAL/LABIAL SURFACE LABIAL and PROXIMAL SURFACE

LINGUAL SURFACE INCISAL SURFACE

• RED = METAL COPING

TOOTH PREPARATION PROCEDURE:

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 A. GUIDING GROOVES
B. INCISAL/OCCLUSAL REDUCTION
C. LABIAL/BUCCAL REDUCTION
D. AXIAL REDUCTION – PROXIMAL and LINGUAL SURFACES
E. FINISHING

POSTERIOR
TOOTH PREPARATION
FOR
METAL CERAMIC
CROWN

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 I. PLANAR OCCLUSAL REDUCTION
Done using No, 171 or torpedo bur.
Depth orientation grooves are made
On the triangular ridges and primary
developmental groove.
The depth orientation grooves should
be 1.5 to 2.0 mm in occlusal areas
where porcelain coverage is required.
The tooth structures between the
orientation grooves are removed following
cuspal contours.

II. FUNCTIONAL CUSP BEVEL

Done using round end tapered bur.
A wide bevel is placed on the functional
cusp, depth grooves are also helpful in
this reduction.
The bevel should parallel the inward facing
Inclines of the cusp of the opposing tooth,
at a depth of 1.5 mm forming a 45-degree
angle with the axial wall.
Functional cusp bevel is integral part of
occlusal reduction.
Failure to place this bevel can produce
thin casting or poor morphology.

III. DEPTH ORIENTATION GROOVE

A flat end tapered diamond bur is first aligned
with the occlusal portion of the facial surface
and three vertical cuts are made to the full diameter
of the diamond, fading out at the “break” where
the curvature of the facial surface is the greatest.
two similar grooves are made maintaining the same
instrument parallel to the gingival segment of the
facial surface. A single depth orientation groove
may also be used.

IV. FACIAL REDUCTION: OCCLUSAL HALF

A flat end tapered diamond bur is used to remove
the tooth structure remaining between the
orientation groove in the occlusal portion of the
facial surface.

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 V. FACIAL REDUCTION: GINGIVAL HALF
A flat end tapered diamond bur is
used to reduce the gingival segment
and extend well into the proximal
surface. 1.2 mm to 1.4 mm is the
accepted reduction for porcelain
fused to metal restoration.

VI. PROXIMAL AXIAL REDUCTION

Short needle diamond bur facilitates
interproximal reduction without damaging
adjacent tooth. Once separation between
the teeth are achieved the needle diamond
bur is used to plane the proximal axial wall

VII. LINGUAL AXIAL REDUCTION

A torpedo diamond bur is used for lingual
axial reduction and to round over the corner
created at the line angle with the proximal
surfaces.

VIII. AXIAL FINISHING

All axial surfaces to be veneered with metal
are finished using a torpedo finishing bur
producing the chamfer finish line. The facial
surface and those areas to be veneered with
porcelain is smoothened with the no. 171 bur.
Lingual to the proximal contact, the transition
from the deeper facial reduction to the relatively
shallower lingual axial reduction result in a
vertical wall or wing of tooth structure.

IX. SHOULDER FINISH LINE AND GINGIVAL BEVEL:

Using no. 957 bur is used for preparing a smoothly

cut shoulder perpendicular to the line of force or
to the long axis of the tooth.

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 Gingival bevel using flame diamond bur and finishing
bur.

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 FINISH LINES

POSTERIOR

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 ANTERIOR

References:

1
Fundamentals of Fixed Prosthodontics 4th Edition by Herbert T. Shillingburg and etal, Quintessence Publishing (IL);
4 edition (July 29, 2020)

2
Contemporary Fixed Prosthodontics 5th Edition by Stephen Rosenstiel Martin Land, Elsevier, 18th September 2015,

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