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Fundamentals of Tooth Preparation 2

The document outlines the 9 steps of tooth preparation: 1. Outlining the margins and initial depth removal 2. Establishing primary resistance form with a box shape 3. Creating primary retention form through wall convergence 4. Providing convenience form for visibility and access 5. Removing infected dentin or old restorations 6. Applying pulp protection if needed 7. Adding secondary resistance and retention features 8. Finishing external walls for the material being used 9. Final cleaning, inspection, and desensitization

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samar yousif mohamed
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180 views

Fundamentals of Tooth Preparation 2

The document outlines the 9 steps of tooth preparation: 1. Outlining the margins and initial depth removal 2. Establishing primary resistance form with a box shape 3. Creating primary retention form through wall convergence 4. Providing convenience form for visibility and access 5. Removing infected dentin or old restorations 6. Applying pulp protection if needed 7. Adding secondary resistance and retention features 8. Finishing external walls for the material being used 9. Final cleaning, inspection, and desensitization

Uploaded by

samar yousif mohamed
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Fundamentals of

Tooth Preparation
PART 2
Steps of Tooth Preparation:
Initial tooth Final tooth
preparation stage preparation stage
Step 1: outline form and initial Step 5: removal of any remaining
depth. infected dentin or old restoration.
Step 2: primary resistance form. Step 6: pulp protection.
Step 3: primary retention form. Step 7: secondary resistance and
Step 4: convenience form. retention form.
Step 8: finishing external walls.
Step 9: cleaning, inspecting,
desensitization.
Step 1 : Outline Form and Initial Depth
Definition:
• Placing the preparation margins in the positions they will
occupy in the final preparation and preparing an initial depth
of 0.2-0.5 mm pulpally to the DEJ.
Principles:
i- All weakened or unsupported enamel should be removed.
ii- All faults should be included.
iii- All margins should be placed in positions that allow
finishing.
Step 1 : Outline Form and Initial Depth

Factors affecting the outline form:


i. The extent of the carious lesion, defect, or faulty old
restoration.
ii. Esthetic considerations.
iii. Occlusal relationship.
iv. Adjacent tooth contour.
Step 1 : Outline Form and Initial Depth
Features:
To establish a proper outline
form and initial depth:
i. Preserve cusp strength
(minimize faciolingual
extension).
ii. Preserve marginal ridge
strength (mesiodistal
extension).
i. Connect too close defects or preparations (< 0.5
mm apart).
ii. Restrict the depth of preparation into dentin.
Step 2: Primary Resistance Form:

Definition:
• Resistance form is the shape of the preparation that enable
the remaining tooth structure and the restoration to
withstand masticatory forces ( directed with the long axis of
the tooth) without fracture.
Step 2: Primary Resistance Form:
Principles:
• Use box shape with a relatively horizontal floor.
• Restrict the extension of the external walls to maintain sufficient
dentin support to cusps and ridge areas.
• Rounding of line angles to reduce stress concentration.
• Provide enough thickness of the restorative material to prevent it’s
fracture.
• Bond the material to tooth structure when possible.
• Capping or covering weak cusps.
ROUNDING OF LINE ANGLE
Step 2: Primary Resistance Form:
Minimum thickness of different
restorative materials to resist fracture

Composite Ceramic Cast metal amalgam Type of


restoration

Non mm 2 1-2mm 1.5mm Minimum


specific thickness
Step 2: Primary Resistance Form:

Factors affecting resistance:


i- The occlusal contact:
• On both the restoration and the remaining tooth structure.
• The greater the contact the greater will be the risk of fracture.
ii- The amount of the remaining tooth structure.
iii- The type of the restorative material.
iv- Bonding of the restoration to the tooth.
Step 3: primary retention form:
Definition:
• Primary retention form is the form of the preparation that
prevent displacement or removal of the restoration by
tipping or lifting forces.
Step 3: primary retention form:
Principles of retention:
Retention depends on the type of the restorative
material.
• For composite restorations:
Micromechanical retention.
• For conventional amalgam:
Mechanical retention obtained through:
i. Convergence of buccal and lingual walls in class I
and II.
ii. Occlusal dovetail in class II.
Convergence to occusal surface
Step 4: Convenience Form

Definition:
• It is the form of the preparation that provides observation,
accessibility and ease of operation.

It may necessitate extension of facial, mesial, lingual or


distal walls.
Steps of Tooth Preparation:
Initial tooth Final tooth
preparation stage preparation stage
Step 1: outline form and initial Step 5: removal of any remaining
depth. infected dentin or old restoration.
Step 2: primary resistance form. Step 6: pulp protection.
Step 3: primary retention form. Step 7: secondary resistance and
Step 4: convenience form. retention form.
Step 8: finishing external walls.
Step 9: cleaning, inspecting,
desensitization.
Step 5: Removal Of Any Infected Dentine or Old
Restoration

i- Removal of infected dentine:


• Removal of infected dentin while retain the affected dentin.
• Using spoon excavator or round carbide bur in slow speed
hand piece.
Step 5: Removal Of Any Infected Dentine
or Old Restoration:
ii- Removal of old restorative material:
Old restorative material is indicated to be removed when:
1. The old material may negatively affect esthetic.
2. The old material may decrease the retention.
3. Radiographic evidence indicate caries beneath the
restoration.
4. The periphery of the restoration are not intact.
5. The tooth was symptomatic preoperatively.
Step 6: Pulp Protection If Indicated:

• Reason for using liners or bases is to either protect


the pulp or to aid pulpal recovery or both.
Step 7: Secondary Resistance And Retention
Forms:

• These could be considered together, they are divided


into 2 types:
i. Mechanical preparation features.
ii. Treatment of cavity walls by etching, priming, &
adhesive material.
Step 7: Secondary Resistance And Retention
Forms:

Mechanical features:
• Retention locks, grooves
• Beveled enamel margin: used in composite + cast metal.
• Pins, slots , steps and amalgam pins.
Step 8: Finishing The External Walls Of
The Tooth Preparation:
Definition:
• Is the further development(when indicated) of :
i. a specific cavosurface design and
ii. degree of smoothness or roughness
that produce the maximum effectiveness of the restorative
material being used.
Step 9: Final Procedure: Cleaning, Inspecting,
And Desensitizing

• Washing the cavity and drying .


• Visualize any debris or defect.
• Use of desensitizers( for non bonded restorations) or
dentin bonding agents (for bonded restorations) to limit
post operative sensitivity.
Thanks

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