FIXED

PROSTHODONTICS
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CROWN ROOT RATIO
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PRIMARY AND SECONDARY RETAINER

Dr Hemant Jivanani
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PIER ABUTMENT
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CANTILEVER FPD
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 Principles of tooth preparation
Preservation of
tooth structure

Dr Hemant Jivanani
Luting Dislodging Geometry
Preservation of agent used forces -taper
periodontium -freedom of
Retention & displacement
Materials
resistance form -path of insertion
cemented
Marginal -length
integrity Roughness of -stress
fitting surfaces -preparation type

Structural
durability
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Occlusal Axial
reduction reduction
 Tooth preparation

Dr Hemant Jivanani
The process of removal of diseased and/or healthy
enamel, dentin and cementum to shape a tooth to
receive a restoration

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REQUIREMENTS OF TOOTH PREPARATION
 Biological -maintenance of pulp vitality,

Dr Hemant Jivanani
adjacent teeth & soft tissues
-conservation of tooth structure

 Mechanical - retention & resistance

 Esthetic - minimal display of metal

- adequate thickness of porcelain
- proper shade matching
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 PRINCIPLES OF TOOTH PREPARATION

 Preservation of tooth structure

Dr Hemant Jivanani
 Retention & Resistance

 Structural durability

 Marginal integrity

 Preservation of the periodontium

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PRESERVATION OF TOOTH STRUCTURE

Dr Hemant Jivanani
 Preserve the remaining tooth structure

 Conservation guidelines-

 Coverage: Partial v/s complete

 Margin: Supragingival v/s subgingival

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 Preparation of teeth with the minimum practical
convergence angle between axial walls

Dr Hemant Jivanani
 Occlusal surface reduction: follow anatomic planes

 Axial surfaces : if necessary, teeth should be

orthodontically repositioned.

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 RETENTION & RESISTANCE FORM

 Retention prevents removal of the

restoration along the path of insertion

Dr Hemant Jivanani
or long axis of the tooth preparation.

 Resistance prevents dislodgment of the

restoration by forces directed in an
apical or oblique direction and prevents
any movement of the restoration under
occlusal forces.

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 RETENTION FORM
 Dislodging forces

Dr Hemant Jivanani
 Geometry of the tooth preparation

 Roughness of the fitting surface of the

restoration

 Materials being cemented

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 Luting agent being used
 Dislodging forces

 Forces that tend to remove a cemented restoration along

Dr Hemant Jivanani
its path of withdrawal

 FPD subject to dislodging forces-

 Flossing under the connectors
 Sticky food

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Geometry of the tooth preparation

 Restrained movement (eg. Nut and bolt )

Dr Hemant Jivanani
 Sliding pair – two cylindrical surfaces constrained to
slide along one another

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Geometry of the tooth preparation

 Taper / Total Occlusal Convergence (TOC)

Dr Hemant Jivanani
 Substitution of internal features

 Path of insertion

 Freedom of displacement

 Length and Surface area

 Stress concentration
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 Type of preparation
 Taper
 Inclination - relationship of one wall of a preparation to

Dr Hemant Jivanani
the long axis of that preparation

 Tapered diamond bur: 2-3° inclination

 Opposing surfaces with 3° inclination= 6° taper

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External walls Internal walls
(converge) (diverge)
 Angle of Occlusal Convergence

Dr Hemant Jivanani
 Angle of Occlusal Divergence

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 Parallel walls – maximum retention

Dr Hemant Jivanani
 Taper
 visualize preparation walls
 prevent undercuts
 permit more nearly complete seating of
restorations during cementation

 Ideal taper: 6°

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 Retention

 More the taper, lesser the retention

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Jorgenson KD. The relationship between retention and convergence angle in
cemented veneer crowns. Acta Odontol Scand 1955 Feb;59(2):94-8.
 Total occlusal convergence

 Angle between two opposing prepared axial surfaces

Dr Hemant Jivanani
 Historically TOC : 2°-6°
 Clinical goal : 10°-22°

 TOC beyond 10-22° – auxilliary features needed

 Resistance testing was found to be more sensitive to

changes in the TOC than retention testing

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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
 Dr Hemant Jivanani
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Esteves HJ, Costa N, Esteves IS, Clinical determination of angle convergence in a
tooth preparation for a complete crown. Int J Prosthodont. 2014 Sep-Oct;27(5):472-4.
 Substitution of internal features
 Basic unit of retention-opposing walls with minimal taper

Dr Hemant Jivanani
 Opposing walls not available for use-
 Destroyed previously (severe attrition)
 Partial veneer restorations
 Greater than desirable inclination

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Groove Box Pinhole
 Path of insertion

 Imaginary line along which the restoration will be placed

Dr Hemant Jivanani
onto and removed from the preparation

 Paths of all FPD abutments must parallel each other

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 Visual survey - ensures preparation is
neither undercut or overtapered

Dr Hemant Jivanani
 Center of the occlusal surface of the
preparation is viewed with one eye
from a distance of 30 cm (12”)

 Binocular vision avoided- undercut

preparation can appear to have an
acceptable taper
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 In patient’s mouth – mouth mirror is held at an angle
approximately ½ inch above the preparation

Dr Hemant Jivanani
 Image viewed with one eye

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 FPD abutments– common path of insertion
 Firm finger rest established – mirror maneuvered until

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one preparation is centered– mirror moved by pivoting on
the finger rest without change in angulation till the 2nd
preparation is centered

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 Path of insertion considered in 2 dimensions-
mesiodistally and faciolingually.

Dr Hemant Jivanani
 Mesiodistal inclination - parallel to contact areas of
adjacent teeth

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 Freedom of displacement

 Numbers of paths along which a restoration can be

removed from the tooth preparation

Dr Hemant Jivanani
 Only one path – maximum retention

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 LENGTH AND SURFACE AREA

 Longer preparation – more surface area – more retentive

 Length must be great enough to interfere with the arc of

Dr Hemant Jivanani
the casting pivoting about a point on margin on opposite
side of restoration
 Short preparations – inclination critical

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 Smaller tooth - short rotation
radius

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 Grooves in the axial walls-
reduce the rotation radius

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 Stress concentration

 Retentive failure occurs - cohesive failure in cement

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 Stress concentration- around the junction of axial and
occlusal surfaces

 Rounding the internal line angles

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 Type of preparation
 Complete crown> partial coverage crowns

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 Adding groove/ boxes increases retention

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Potts RG, Shillingburg HT Jr, Duncanson MG Jr,Retention and resistance of

preparations for cast restorations. J Prosthet Dent. 1980 Mar;43(3):303-8
Roughness of the fitting surface of restoration

 Roughening/grooving the restoration - retention

increased

Dr Hemant Jivanani
 Prepared by air-abrading the fitting surface with 50
µm of alumina
 Airborne particle abrasion - increase in vitro retention
by 64%

 Roughening the tooth preparation- not recommended

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 Luting agent being used

 Adhesive cements- most retentive

Dr Hemant Jivanani
 Film thickness of luting agent- effect not certain

 Adhesive resin> Glass ionomer> Zinc Phosphate=

Polycarboxylate> ZnO-E

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Factors influencing retention of cemented restorations

Dr Hemant Jivanani
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RESISTANCE FORM
 Dislodging forces

Dr Hemant Jivanani
 Luting agent being used

 Geometry of the tooth preparation

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 Dislodging forces
 Mastication and parafunctional activity - substantial
horizontal or oblique forces

Dr Hemant Jivanani
 Lateral forces displace the restoration by causing rotation
around the gingival margin

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 Luting agent being used
 Resistance to deformation affected by compressive
strength and modulus of elasticity

Dr Hemant Jivanani
 Adhesive resin> Glass ionomer> Zinc Phosphate>
Polycarboxylate> ZnO-E

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 Geometry of the tooth preparation

 Type of preparation

Dr Hemant Jivanani
 Freedom of displacement

 Occlusocervical/incisocervical dimension

 Ratio of OC and FL dimension

 Circumferential form of the prepared tooth

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 Type of preparation
 Partial
coverage restoration< complete
crown (no buccal resistance areas in partial

Dr Hemant Jivanani
coverage)

 Adding groove/ boxes increases resistance

(greatest if walls are perpendicular to
direction of force)

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 FREEDOM OF DISPLACEMENT

Groove Proximal box

Dr Hemant Jivanani
 Lingual wall perpendicular  Buccal and lingual walls
to the direction of force must meet the pulpal wall
Oblique angle at 90°
V-shaped groove Oblique angle

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 Occlusocervical / incisocervical dimension

Minimal OC dimension:
 Anteriors - 3mm

Dr Hemant Jivanani
 Premolars - 3mm
 Molars - 4mm

Occlusocervical Total occlusal

dimension convergence
1mm <6°
2mm <12°
3mm <17°
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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
Ratio of occlusocervical to faciolingual dimension

Dr Hemant Jivanani
 Should be 0.4 or higher for all teeth
OC/FL ratio Total occlusal
convergence
0.1 <6°
0.2 <12°
0.3 <18°
0.4 <24°

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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
 Circumference form of prepared tooth

 Should possess circumferential irregularity

 Maxillary molars – rhomboidal form

Dr Hemant Jivanani
 Mandibular molars – rectangular form
 Premolars and anteriors – oval form

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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
 Preserve corners of a tooth preparation
 No axial grooves, boxes should be provided in corners

Dr Hemant Jivanani
Chewing and parafunctional habits

Dislodging forces largely faciolingual

So, grooves and boxes on the proximal surfaces

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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
STRUCTURAL DURABILITY

 To provide adequate bulk:

Dr Hemant Jivanani
 Occlusal reduction
 Functional cusp bevel
 Axial reduction

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 OCCLUSAL REDUCTION
 Full metal restoration:
 1.5 mm – functional cusp

Dr Hemant Jivanani
 1mm – non functional cusp

 Metal-ceramic crowns :
 1.5 to 2mm – functional cusp
 1 to 1.5mm – non functional cusp

 All ceramic crowns :

 2mm over all
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 Dr Hemant Jivanani
Adequate reduction Inadequate clearance Overpreparation
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 FUNCTIONAL CUSP BEVEL
 Wide bevel on-
 Lingual inclines of the maxillary lingual cusps

Dr Hemant Jivanani
 Buccal inclines of mandibular buccal cusps

 Adequate bulk of metal in area of heavy occlusal

contact

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 Lack of functional cusp bevel:

Dr Hemant Jivanani
Thin area in casting Overcontouring Overinclination

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AXIAL REDUCTION

 Thin walls of casting– subject to distortion

Dr Hemant Jivanani
 Overcontouring- disastrous effect on the
periodontium

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 MARGINAL INTEGRITY
 Closely adapted margins to finish lines of
preparation- survival of restoration in the oral

Dr Hemant Jivanani
environment

 Configuration of finish line-

 dictates the shape and bulk of metal at the
margins
 affects the marginal adaptation
 affects degree of seating

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 FINISH LINE CONFIGURATIONS
 Chamfer
 Heavy chamfer

Dr Hemant Jivanani
 Shoulder

 Sloped shoulder

 Radial shoulder

 Shoulder with a bevel

 Knife edge

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 CHAMFER
 Indications-
 Cast metal crowns

Dr Hemant Jivanani
 Metal-only portion of PFM crowns

 Distinct, easily identified

 Least stress

 Round end tapered diamond

 Half the tip of the diamond

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 HEAVY CHAMFER
 Indicated for all-ceramic crowns
 90 degree cavosurface angle with a large radius

Dr Hemant Jivanani
rounded internal angle
 Round end tapered diamond

 Better than conventional chamfer but not shoulder

 Bevel added - to use with metal restoration

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 SHOULDER

 Facial margin of PFM crowns

Dr Hemant Jivanani
 Wide ledge-
 resistance to occlusal forces
 minimizes stresses which leads to fracture of porcelain

 Flat-end tapered bur

 Healthy contours
 Maximum esthetics
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 Destruction of more tooth structure

Dr Hemant Jivanani
Sharp 90° internal line angle

concentrates stress on tooth

Coronal fracture

 Not used for cast metal restorations

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 SLOPED SHOULDER

 120° sloped shoulder margin

 Facial margin of a metal-ceramic crown

Dr Hemant Jivanani
 No unsupported enamel, yet sufficient bulk to allow
thinning of the metal framework to a knife-edge for
acceptable esthetics

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 RADIAL SHOULDER

 Modified shoulder

Dr Hemant Jivanani
 Cavosurface 90°

 Shoulder width lessened with rounded internal

angles

 Lesser stress concentration

 Good support for porcelain

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 SHOULDER WITH A BEVEL

Dr Hemant Jivanani
 Indications:
 Proximal box of inlays, onlays
 Occlusal shoulder of onlays and mandibular ¾ crowns
 Facial finish line of metal-ceramic restorations (gingival
esthetics not critical)
 Situations where a shoulder is already present 75
(destruction by caries, previous restorations)
 Bevel:
 allows the cast metal margin to be bent or burnished against
the prepared tooth structure

Dr Hemant Jivanani
 minimizes the marginal discrepancy
 removes unsupported enamel

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 KNIFE EDGE

 Permit acute margin of metal

 Axial reduction may fade out

Dr Hemant Jivanani
 Thin margin - difficult to wax and cast

 Susceptible to distortion

 Indications:

 Mandibular posterior teeth with very convex axial

surfaces
 Lingually tilted lower molars

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 Reduction uniformity

 Uniformly reduced :
 normal crown form

Dr Hemant Jivanani
 improved aesthetic

 Makes easier for laboratory technician to create

esthetic restorations

 Best achieved by placing depth grooves

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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
 Line angle form

 Should be rounded (increases crown strength)

Dr Hemant Jivanani
 Sharp line angles – stress concentration

 Facilitates laboratory fabrication and fit

 Ease to pour impressions

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Goodacre C J. Designing tooth preparations for optimal
success. Dent Clin N Am 2004; 48: 359-85.
PRESERVATION OF THE PERIODONTIUM
Margin placement

Dr Hemant Jivanani
 Direct effect on ultimate success of restoration
 Margins should be as smooth as possible
 Placed in area that can be finished well by the dentist
and kept clean by the patient
 Placed in enamel whenever possible
 Should be supragingival whenever possible 80
 Supragingival margins

Dr Hemant Jivanani
 Less potential for soft tissue damage
 Easily prepared and finished
 More easily kept clean
 Impressions are more easily made
 Restorations easily evaluated at recall appointments

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 Subgingival margins:
 Esthetics

Dr Hemant Jivanani
 Existing caries, cervical erosion, or restorations extend
subgingivally, and crown-lengthening is not indicated
 Proximal contact area extends to the gingival crest
 Additional retention is needed
 Margin of a metal-ceramic crown is to be hidden behind
the labiogingival crest
 Root sensitivity cannot be controlled by more
conservative procedures, such as the application of
dentin bonding agents
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 Finish line should not be closer than 2mm to the alveolar
crest

Dr Hemant Jivanani
 Placement in this area –
 gingival inflammation
 loss of alveolar crest height
 pocket formation

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 MARGIN ADAPTATION
 Junctionbetween a cemented restoration and

Dr Hemant Jivanani
the tooth - potential site for recurrent caries

 Casting- fits within 10 µm

 Porcelain margin- 50 µm

 Stepped irregular margin- poor adaptation

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 PREVENTION OF DAMAGE DURING TOOTH
PREPARATION

 Adjacent teeth :
 Iatrogenic damage
 Metal matrix band

Dr Hemant Jivanani
 Leave a slight lip or fin of proximal enamel

 Soft tissues:
 Careful retraction of lips, cheeks
 Care to protect tongue when lingual surfaces of mandibular
molars prepared

 Pulp
 Temperature
 Chemical action of cements
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 Bacterial action (microleakage)
  Different preparation depths
 With/without coolants

Dr Hemant Jivanani
 Rise in temperature was noted without coolants
 1mm depth – 0.540 C
 2mm depth – 10 C
 3 mm depth - 1.840 C
 Drop in temperature was noted with coolants
 1mm depth – 0.400 C
 2mm depth – 0.820 C
 3mm depth – 1.130 C

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Chhatwal N. Effect of tooth preparation and coolants on temperature
within the pulp chamber. TPDI 2010;1(2):45-48.
TYPES OF FPD
 Conventional FPD

Dr Hemant Jivanani
 Cantilever FPD

 Spring FPD

 Fixed Fixed

 Fixed Movable 87
 Fixed Removable

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MODIFIED FIXED REMOVABLE

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PONTIC
 Pontic Space
 Orthdontics

Dr Hemant Jivanani
 Residual Ridge Contour
 Blck triangles
 Siebert’s classification of ridge defects

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 Seibert’s class 1- palatal roll tech, pouch

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 Seibert’s class 2 – pouch technique

 Seibert’s class 3 – onlay graft

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 Mucosal Contact

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 Non Mucosal Contact

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 Most biocompatible pontic material??

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CONNECTOR DESIGN

Conne
ctor

Dr Hemant Jivanani
Non-
Rigid Rigid

Cast
Tenon-
Soldered
Mortise
Loop 102
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 Size of connector: 9 sq mm (all metal)
• 16 sq mm (all ceramic)

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