Fundamentals of

Tooth Preparation
PART 1
Introduction:
• In the past, most restorative treatment was for caries and
the cutting or preparation of the remaining tooth structure
to receive a restorative material was referred to as cavity
preparation.
• Currently, many indications for treatment are not related
to caries, and the preparation of the tooth is termed tooth
preparation.
Definition of Tooth Preparation:

• Tooth preparation is the mechanical alteration of a

defective, injured , or diseased tooth to best receive a
restorative material that will re-establish normal form ,
function and esthetic
Need for Restorations:

1. Dental caries lesion.

2. Replacement or repair of restoration.
3. Fractured teeth.
4. Congenital malformation.
5. Esthetic consideration.
Objectives of Tooth Preparation:
1- Remove all defects and provide necessary protection to
the pulp.
2- Extend the restoration as conservatively as possible.
3- Form the tooth preparation so that under masticatory
force, the tooth or the restoration or both will not fracture,
and the restoration will not be displaced.
4- Allow for the esthetic and functional placement of a
restorative material.
 Factor affecting tooth
preparation:

1-General 2-Conservation of 3-Restorative

factors tooth structure material factors

iii.Patient
i.Diagnosis ii.Knowledge of factors
dental anatomy
Factors Affecting Tooth Preparation:
1- General factors:

i. Diagnosis:

• Before any restorative procedure, a complete and thorough

examination must be done.
• There must be a reason to place a restoration in the tooth.
• The reasons may include caries, fractured teeth, esthetic
needs, or needs for improved form or function.
Factors Affecting Tooth Preparation:
1- General factors:

i. Diagnosis:
• Proper assessment of both pulpal and periodontal status.
• Assessment of occlusion.
• Esthetic consideration.
• Relationship with other ttt plan i.e tooth being an
abutment in a fixed or removable partial denture.
• Assess the patient caries risk.
Factors Affecting Tooth Preparation:
1- General factors:
ii. Knowledge of dental anatomy:

Knowledge of the anatomy of each tooth and it’s related

parts is a prerequisite for understanding of tooth preparation.
• The thickness of the enamel and dentin.
• The size and position of the pulp.
• The relationship of the tooth to supporting tissues.
Factors Affecting Tooth Preparation:
1- General factors:
iii. Patient factors:

Play an important role in determining the appropriate

restorative treatment.
• Patient knowledge and appreciation of good dental health.
• Economic status.
• Age.
Factors Affecting Tooth Preparation:
2- Conservation of tooth structure:

Every effort should be made to make restorations as small as

possible.
i- The less tooth structure removed, the less potential damage
that may occur to the pulp.
ii- The smaller the tooth preparation, the easier it is to retain
the restorative material in the tooth.
Factors Affecting Tooth Preparation:
2- Conservation of tooth structure:

Every effort should be made to make restorations as small as

possible.
iii- The smaller the tooth preparation, the stronger will be the
remaining tooth structure (resist fracture).
Factors Affecting Tooth Preparation:
3- Restorative material factors:
Type of restorative material used affects the tooth
preparation.

Selection of restorative material depends upon:

i. Economic and esthetic consideration of the patient.
ii. Ability to isolate the operating area.
iii. Extend of the lesion/defect.
Terminology of Tooth Preparation:

• Simple tooth prep. (involves 1 surface).

• Compound tooth prep. ( involves 2 surfaces).
• Complex tooth prep.( involves 3 or more surfaces).
Tooth preparation in surface is abbreviated by
using the first letter of the surface involved.
• For example:
• Preparation involves the occlusal surface is an
O.
• Preparation involving the mesial and occlusal
surfaces is an MO.
• Preparation involving the mesial, occlusal, and
distal surfaces is an MOD.
 Tooth Preparation Walls:
There are internal walls and external walls.
External wall:
• Is the prepared surface that extends
to the external tooth surface.
• The external wall take the name of
the tooth surface that the wall is
adjacent to.
• For example: buccal, lingual,
mesial, distal.
Tooth Preparation Walls:
Internal wall:
• Is the prepared surface that doesn’t
extend to the external tooth surface.
Pulpal wall: Is the internal wall that is Pulpal
perpendicular to the long axis of the wall

tooth and occlusal to the pulp.

Axial wall: Is the internal wall
parallel to the long axis of the tooth.
Axial
wall
Tooth Preparation Walls:

Enamel wall: Is the portion of a

prepared external wall consisting of
enamel.
Dentinal wall: Is the portion of a
prepared external wall consisting of
dentine.
Tooth Preparation Walls: Occlusal force

Floor/ Seat:
• Is the prepared wall that is
horizontal and perpendicular to the
occlusal force.
• Examples: pulpal floor, gingival
Pulpal

floor. wall

Axial
wall

Gingival
floor
Tooth Preparation Walls:
Line angle:
The junction of two surfaces.
• Internal line angle: The line angle
whose apex points into the tooth.
• External line angle: The line
angle whose apex points away
from the tooth.
Point angle:
The junction of three surfaces.
Tooth Preparation Walls:
Cavosurface angle: The junction of a
prepared wall and external surface of
the tooth.
• The cavosurface angle varies
according to:
i. Location on the tooth.
ii. Direction of the enamel rods in the
prepared wall.
iii. Type of the restorative material to be
used.
Classification of Tooth Preparation:
• As presented by G.V. Black, based on the diseased anatomic
area.
• Divided into 5 classes, a 6th class was added later on.
 Class I Preparations:
• All pit-and-fissure preparations are Class I, and they are assigned to
three groups, as follows:
1. Preparations on Occlusal Surface of Premolars and Molars.
Class I Preparations:
• All pit-and-fissure preparations are, and they are assigned to
three groups, as follows:
2. Preparations on Occlusal Two Thirds of the Facial and Lingual
Surfaces of Molars.
 Class I Preparations:
• All pit-and-fissure preparations are, and they are assigned to
three groups, as follows:
3. Preparations on Palatal Surface of Maxillary Incisors.
Class II Preparations:

• Preparations on the proximal

surfaces of posterior teeth.
Class III Preparations:
• Preparations on the proximal surfaces
of anterior teeth that do not involve
the incisal angle.
 Class IV Preparations:
• Preparations on the proximal surfaces
of anterior teeth that involve the
incisal edge.
Class V Preparations:

• Preparations on the gingival/cervical third of the facial or

lingual surfaces of all teeth
 Class VI Preparations:
• Preparations on the incisal edge of anterior teeth or the
cusp tips of posterior teeth.
To be continued