Introduction

In order to ensure the success of the restoration placed in the oral cavity. The physico-mechanics of the forces acting on it has to be understood, by restoring the tooth form, we aim at maintaining the integrity and continuity of dental arch which is very important as far as mastication is concerned. Therefore, the basic aim of cavity preparation design should be to establish the best possible shape that can cope with the distribution of stresses in tooth structure and restoration without failure. for this one should understand the nature of forces acting on it and resistance to such forces. Both resistance and retention form is very important as far as success of restoration is concerned. Resistance form is defined as the architectural form given to a tooth preparation which enables both the

restoration and the remaining tooth to resist structural failure from occlusal loading stresses.

Building a restoration is similar to building any mechanical structure, in that the stress patterns of the available foundation and the contemplated structure must be predetermined. Accordingly, the following items should be considered. A STRESS PATTERNS OF TEETH very tooth has its own stress pattern, and every location on a tooth has special stress patterns. Recogni!ing them is vital prior to designing a restoration without failure potential. I. STRESS BEARING & STRESS CONCENTRATION AREAS IN ANTERIOR TEETH a. The function between the clinical crown and the clinical root bears shear components of stress together with tension on the loading side and compression at the non-loading side, during e"cursive mandibular movements. b. The Incisal angles, especially if they are s#uare, are sub$ect to tensile and shear stresses in normal

occlusion massive compressive stresses will be present in edge-to-edge occlusion, and if the incisal angles are these involved stresses in are a disclusive

mechanisms, increased.

substantially

c. The a"ial angles and lingual marginal ridges will bear concentrated shear stresses. In addition on the loading side tensile stresses are present, and on the non-loading side compressive stresses are found. d. The slopes of the cuspid will bear concentrated stresses, especially if the cuspid is a protector for the occlusion or part of a function during mandibular e"cursions. e. The distal surface of a cuspid e"hibits a uni#ue stress pattern as a result of the anterior

components of force concentrating compressive loading at the function of the anterior and posterior segments of the dental arch and

microlateral displacement of the cuspid during e"cursive movements. Both of these factors will &

lead

to

stress

concentration

with

resultant

abrasive activity there. f. The lingual concavity in upper anterior teeth bears substantial compressive stresses during centric occlusion in addition to tensile and shear stresses movements. g. The incisal edges of lower anterior teeth are sub$ected to compressive stresses. In addition tensile and shear stresses are present during protrusive mandibular movement. The incisal ridges of upper anterior teeth will have these same stresses during protrusive and sometimes at the protrusive border location of the mandible. II. STRESS BEARING AREAS AND OF STRESS POSTERIOR during protrusive mandibular

CONCENTRATION TEETH a'

(usp tips, especially on the functional side bear compressive stresses.

b'

*arginal

and

crossing

ridges

bear

tremendous tensile and compressive stresses. c' stresses A"ial on angles the bear tensile and side shear and

non-functional

compressive and shear stresses on the functional side. d' The function between the clinical root and the clinical crown during function +especially lateral e"cursion' bears tremendous shear stresses, in addition to compression on the occluding contacting side and tension on the non-contacting side. e' will Any occlusal, facial or lingual concavity e"hibit compressive stress concentration.

specially if it has an opposing cuspal element in static or functional occlusal contact with it. III. WEAK AREAS IN THE TOOTH SHOULD BE IDENTIFIED AND RECOGNIZED BEFORE ANY RESTORATIVE ATTEMPT, in or !r "o #$oi

!%"r&'"i$! (o# in) "*!+ #r!,

a. Bi and trifurcation. b. (ementum should be eliminated as a component of a cavity wall. The $unction between the cementum and the dentin is always irregular so the dentin surface should be smoothed flat after cementum removal. c. Thin dentin bridges in deep cavity preparation. d. -ubpulpal floors in R(T treated teeth. Any stress concentation interceptally. e. (rac.s or cra!ing in enamel, and / or dentin both should be treated passively in any restoration design. They may act as shear lines leading to further spread. SOME TEETH I. Although the following figures are averages, they provide an idea about the principal mechanical properties of tooth structure. It must be understood APPLIED MECHANICAL PROPERTIES OF there may split the tooth

that these figures can differ from one location on a tooth to another, and from one tooth to another. a. (ompressive strength of enamel supported by vital dentin is usually &0-)%,1112-I. b. (ompressive strength of vital dentin is )1,1,1112-I. c. *odulus of resilience of enamel supported by vital dentin is 01-31 inch-lbs / cubic inch. d. *odulus of resilience of vital dentin is 111-1)1 inch-lbs /inch&. e. *odulus of elasticity of enamel supported by vital dentin under compression is 4,111,111 2-I. f. *odulus of elasticity of vital dentin is

1,51,1112-I. II. In general, when enamel loses its support of dentin, it loses more than 3,6 of its strength properties. III. Tensile strength of dentin is about 116 less than its compressive strength.

I7.

Tensile strength and compressive strength of enamel are similar, as long as the enamel is supported by vital dentin.

7.

-hear strength of dentin is almost 016 less than its compressive strength, and this is very critical in restorative design.

7I.

There is minimal shear strength for enamel when it loses its dentin support.

7II. 8hen the dentin loses it vitality, there is a drop of almost )1-016 in its strength properties. To best resist masticatory forces, use floors or planes at right angles to the direction of loading to avoid shearing stresses. If possible walls of preparations should be parallel to the direction of the loading forces, in order to minimi!e or avoid shearing stresses. Intracoronal and intraradicular cavity preparations can be done in bo", cone or inverted truncated cone shapes.

9rom the drawings, it is possible to deduce that the inverted truncated cone shapes will have a higher resistance to loading than the bo" shapes, and the bo" shapes will have a higher resistance than the cone shapes. Therefore if conditions and re#uirements allow, cavity preparations

should be prepared in an inverted truncated cone shape. :efinite floors, walls and surfaces with line and point angles are essential to prevent micromovements of

restorations with concomitant shear stresses on remaining tooth structure. Increasing the bul. of a restorative material or leaving sufficient bul. of tooth structure in critical areas is one of the most practical ways of decreasing stresses per unit volume. :esigning the outline form with minimal e"posure of the restoration surface to occlusal loading will definitely minimi!e stresses and the possibility of mechanical failure in the restoration. A comparative evaluation of the mechanical properties of the restorative material relative to that of the tooth

structure will dictate the preparation and restorative design i.e. if the restorative material is stronger than the tooth structure, the design should be such that the restorative material will support the tooth structure and vice versa if the restorative material is wea.er than tooth structure. ;unction between different parts of the preparation especially those acting as fulcra, should be rounded in order to minimi!e stress concentration in both tooth structure and restorations and to prevent any such sharp components from acting as shear lines for fracture failure. 1. RETENTION FORM Retention form is defined as that form given to the tooth preparation, especially its detailed anatomy and

general shape which enables the restoration, that it will accommodate, to avoid being dislodged by masticatory loading. Prin'i-#( .!#n% o/ r!"!n"ion, 9rictional retention depends on ) factors<

11

a.

The

surface

area

of

contact

between

tooth

structure and restorative material. =reater surface area produces a greater frictional component of retention. It is directly proportional to the length, width and depth of the walls and surface involved in the preparation. b. >pposing walls or surface involved< *ore opposing walls or surfaces in a tooth preparation produce greater frictional components of retention and conse#uently, preparation. c. 2arallelism and non-parallelism A higher degree of parallelism between opposing walls produces greater frictional components of retention. a more stable restoration within the

?igher convergence of the walls in the intracoronal preparation and higher divergence of walls in the

e"tracoronal preparation produce greater loc.ing ability of the tooth preparation to restorative material,

irrespective of frictional retention.

11

d.

2ro"imity Bringing the restorative material closer to the tooth

structure during insertion will substantially increase the frictional retention. 2. ELASTIC DEFORMATION OF DENTIN (hanging position of dentinal walls and floors

microscopically by using condensation energy within the dentin proportional limit. (an add more gripping action by the tooth on the restorative material. This occurs when the dentin regains its original position while the restorative material remains rigid, thereby completely obliterating any remaining space in the cavity preparation.

CLASS I
All (lass I cavity preparations will have a mortise shape i.e. each wall and floor is in the form of a flat plane meeting each other at definite line and point angles. This form is commonly applied in various mechanical structures, so its application here is understandable.

1%

It is advantageous to have a mortise shape preparation in an inverted cone shape to minimi!e shear stresses that tend to separate the buccal and lingual cuspal elements i.e. to prevent the splitting of the tooth. The bo" shaped mortise is less advantageous and the cone shaped is the least advantageous in this regard. -o, whenever the anatomical and cariological factors allow the cavity preparation should be an inverted cone shape. 8hen a caries cone penetrates deeply into dentin, removing undermined and decayed tooth structures can lead to a conical cavity preparation, mechanically, two problems can occur if restoration is inserted into such a cavity preparation. If the occlusal loading is applied centrically the restoration may act as a wedge, concentrating forces at the pulpal floor and leading to dentin bridge crac.ing and increased tendency for tooth splitting +A'. If the occlusal loading is applied eccentrically the restoration will have tendency to rotate laterally, for there would be no lateral loc.ing walls in definite angulation with a floor. Although these lateral movements are microscopic 1&

they occur fre#uently enough to encourage microlea.age around the restoration, predisposing to a recurrence of decay. These measurements can also lead to fracture of marginal tooth structure and even to splitting of lateral walls. To solve these problems, flatten the pulpal end of the cavity preparation. +?owever if accomplishing this at a deep location incurs increased ris. of involving the pulp chamber, pulp horns, or recessional lines containing remnants of pulp tissues' ma.e the pulpal floor at more than one level +B' one level will be the ideal depth level +1.,mm' and the others will be the caries cone level dictated by the pulpal e"tent of the decay. The shallow level creates the flat portion of the pulpal floor at definite angles to the surrounding walls, ade#uately resisting occlusal forces and laterally loc.ing the restoration, without impinging on pulp tissues. The first level should be as pronounced and

circumferentially continuous as possible. At least it should e"ist at two opposing locations in the cavity preparation in order to fulfill its ob$ectives. This level is sometimes called

1)

@The ledgeA and it can be circumferential, interrupted or opposing.

CLASS II
:uring mandible centric the and e"cursive and movements of the are

both

restoration

tooth structure

periodically loaded both separately and $ointly. This brings about different stress patterns, depending upon the actual morphology of the occluding area of both the tooth in

#uestion and the opposing contacting cuspal elements. 9or the purpose of this discussion, one can classify these loading situations and their induced stress patterns in the following way< A small cusp contacts the fossa away from the restored pro"imal surface, in a pro"imo-occlusal restoration at centric closure. A' As shown in mesio-distal cross

section, due to the elasticity of the dentin, especially in young teeth, a restoration will bend at the a"io-pulpal line angle +provided the pro"imal part of the restoration is self retained'. This creates tensile stresses at the isthmus 1,

portion of the restoration, shear stresses at the $unction of the main bul. of the pro"imal part of the restoration and its self retained parts, and compressive stresses in the underlying dentin. B' A large cusp contacts the fossa

ad$acent to the restored pro"imal surface in a pro"imoocclusal restoration at centric closure, either in the early stages of moving out of centric or at the late stages of moving toward it. As the diagram shows, the large cusps will tend to separate the pro"imal part of the restoration from the occlusal part. This creates tensile stress at the isthmus portion of the restoration even if the pro"imal portion is self retained. This loading situation will deliver compressive forces in the remaining tooth structure, apical to the restorations. (' >ccluding cuspal elements contact facial and lingual tooth structure surrounding a pro"imoocclusal or pro"imo-occluso-pro"imal restoration during centric and e"cursion movements.

10

As

shown

in

this

bucco-lingual

cross

section

concentrated shear stresses will occur at the $unction of the surrounding tooth structure and corresponding floors, with a tendency toward fracture failure there. This loading situation can be unilateral or bilateral, depending on the direction of mandibular movement, occluding surface morphology, stage of movement, and degree of intercuspation. It is most deleterious to tooth structure, especially on the biting side if there is interference during lateral e"cursion. :' >ccluding cuspal elements contact facial and lingual parts of the restoration, surrounded by tooth structure during centric and e"cursive movements. As shown in this bucco-lingual cross section this arrangement will induce tensile and compressive stresses in the restoration which will be transmitted to the surrounding tooth structure. ' >ccluding cuspal elements contact facial or lingual parts of the restoration, completely replacing facial or lingual tooth structure during centric and e"cursive movements.

14

As shown in the bucco-lingual cross section the stress pattern will be similar to Bo. % with tensile stresses induced at the $unction of the occlusal and facial or lingual part of the restoration in both occluding situation. 9' >ccluding cuspal elements contact a restorations marginal ridges or part of a marginal ridge during centric and e"cursive movements. As shown, in this mesio-distal cross section +assuming the restoration is loc.ed occlusally', there will be

concentrated tensile stresses at the $unction of the marginal ridge and the rest of the restoration. =' (uspal elements occlude or disclude via the facial or lingual groove of a restoration. Assuming, that the restoration is loc.ed occlusally, there will be tensile stresses at the $unction of the occlusal and facial or lingual parts of the restoration at full intercuspation +A' and to and from that position +B' ?' (usps and crossing ridges are part of the restoration in centric and e"cursive movement.

13

compressive stresses

Both during

will such

be

sub$ected positions

to and

movements. Besides, tensile stresses could concentrate at their $unction with the main restoration, especially during contacting e"cursive movement. I' during contacts. 8henever these portions are in contact with opposing occlusal surfaces, there will be induced compressive and shear stresses whenever they are not reciprocating, the a"ial surfaces will be stressed in a slight tensile and shear pattern at their $unction with the main bul. of the restoration. ;' Restoration is not in occluding centric A"ial occlusion portions and of the restoration movement

e"cursive

contact or is in premature contact during centric occlusion or e"cursive movement of the mandible. The first situation is not conducive to function, in so far as the restoration will not be involved with direct loading from the opposing occluding teeth. After a period of time however the tooth will supraerupt, rotate or tilt, establishing

15

contact with the opposing cuspal elements. Csually this newly ac#uired location will not be the most favourable position for the restoration, tooth or the remainder of the gnatho-stomatic system either mechanically or biologically. It is safer to build the restoration to predetermined contacting areas with opposing teeth which will lead to predictable physiologic stress patterns in the tooth structure and the restoration. occluding (onversely, prematurely any portion of the

restoration

will

tremendously

e"aggerate the same types of stresses normally induced in that area of the restoration. Besides additional shear

components of stress could be precipitated there. This could lead to locali!ed or generali!ed gnatho-stomatic disturbances with eventual mechanical or biological features. Beedless to say, pre-e"isting premature contacting areas should be eliminated before restorative treatment. This is done primarily because cavity preparation increases the susceptibility of remaining tooth structure to fracture failure, besides, the restoration should be built to the predetermined occlusal position, even if the pree"isting tooth structures were not.

%1

Amalgam is least resistant to tensile stress and more resistant to compressive stress. Tooth structure particularly when interrupted by a cavity preparation, is least resistant to shear stress. Therefore (lass II cavity preparations for amalgam restorations should be designed to resist cyclic loading while minimi!ing tensile loading in the amalgam and shear loading in the remaining tooth structure +9ig. 1&'. :esign features for the protection of the mechanical integrity of the restoration. 1. ISTHMUS: In the Isthmus, i.e. the $unction between the occlusal part of a restoration and the pro"imal potentially deleterious tensile stresses occur under any type of loading. *ost mathematical, mechanical and photoelastic

analyses of these stresses reveal three things< 1. The fulcrum of binding occurs at the a"io-pulpal line angle. %. -tresses increase closer to the surface of a restoration, away from that fulcrum and

%1

&. Tensile stresses predominate at the marginal ridge area of a (lass II restoration. *aterials tend to fail, therefore, starting from the surface, near the marginal ridge, and proceeding internally, toward the a"io-pulpal line angle. These problems may be solved by applying common engineering principles. 1' A theoretical solution might be to increase amalgam bul. at the a"io-pulpal line angle. Thereby placing the surface stresses away from the fulcrum +fig'. ?owever this actually results in increased stresses within the restorative material and a deepened cavity preparation, dangerously lose to pulp anatomy. Therefore such a solution, in and of itself is actually unacceptable. %' Another solution might be to bring the a"io-pulpal line angle closer to the surface, in an effort to reduce tensile stresses occurring near the marginal ridge. ?owever, this too is unacceptable in that conse#uent diminished bul. of amalgam would no longer ade#uately resist compressive forces. &' A combination of the two solutions i.e. increasing amalgam bul. near the marginal ridge, while bringing %%

the

a"io-pulpal line

angle

away from

the

stress

concentration area and closer to the surface, can be achieved simply by slanting the axial wall towards the pulpal floor . 1. The obtuse-pulpal line angle thereby created not only provides greater amalgam bul. in the marginal ridge area of the restoration but also reduces tensile stresses per unit area by bringing this critical area of the preparation closer to the surface of the restoration. %. If the a"io-pulpal line angle is rounded, structural pro$ections or sharp $unctions that may concentrate stresses at the isthmus would be avoided as well as increase the amalgam bul. at the fulcrum. &. By slanting the a"ial wall, bul. is improved by increased depth rather than increased width.

Increasing the width at the isthmus portion only increases the surface area receiving deleterious

occluding stresses.

%&

). The pulpal and gingival floors at the isthmus should be perfectly flat in order to resist forces at the most advantageous angulation. ,. The fifth design feature is that every part of the preparation +occlusal, facial, lingual or pro"imal' should be self retentive. If every part of the

restoration is loc.ed in both structure-independently from other parts, there will be minimum stresses at the $unction of one part with another i.e. the isthmi. This can be achieved in amalgam preparation by retentive grooves internal bo"es, and undercuts. 0. >ne should avoid, as much as possible placing or leaving any surface discontinues such as carved developmental grooves, scratches etc. at these critical areas in the restoration. These can precipitate and accentuate stresses leading to fatigue failure. 9inally by chec.ing occlusion to eliminate

prematurities in the restoration, immediate overloading and failure can be avoided.

%)

MARGINS 9rail, feather-edged margins of amalgam, which will occur when the cavo-surface angles of preparations are beveled, will fracture easily. >ccluding forces will cause amalgam at the bevel to bend with ma"imum tensile stress, occurring as a result of elastic deformation of the tooth structure beneath the bevel. *arginal e"cess of amalgam will similarly fracture, leaving a ditch around the restoration that will enhance recurrence of decay. -o, for the margins of these preparations, four design features should be observed< 1. (reate butt $oint amalgam tooth structure at the margins. %. Deave no frail enamel at the cavo-surface margins. &. Remove flashes of amalgam on tooth surface ad$acent to amalgam margins. ). The interface between amalgam and tooth structure should not be at an occluding contact area with opposing teeth either in centric or e"cursive

mandibular movements.

%,

Cus s !nd !"i!# !n$#%s: The following are the design features for these parts of a restoration< a. Amalgam bul. in all three dimensions should be atleast 1-,mm. b. ach portion of the amalgam should be completely immobili!ed with retention modes. c. Amalgam should be seated on a flat floor or table in these areas. d. Amalgam replacing cusps or a"ial angles should have a bul.y connection to the main part of the restoration with similar design features as for the isthmus areas. RETENTION FORM In order to design a cavity preparation that will hold a restorative material, it is necessary to .now the possible displacements that can happen to such a restoration, the forces that can cause them, and the fulcrum of these movements. There are such displacements for a (lass II pro"imo-occlusal restoration.

%0

A0

PRO1IMAL DISPLACEMENT OF THE ENTIRE RESTORATION In analy!ing the obli#uely applied force EAF into a vertical

component EvF and a hori!ontal component E?F it can be seen that E7F will try to seat the restoration further into the tooth, but E?F will tend to rotate the restoration pro"imally around a"is EGF at the gingival cavosurface margin. To prevent such displacement self-retaining facial and lingual grooves pro"imally are necessary, in addition to an occlusal dovetail. B0 PRO1IMAL DISPLACEMENT OF THE

PRO1IMAL PORTION If one were to consider the restoration as being Dshaped with the long arm of the D occlusally and short arm pro"imally. 8hen the long arm is loaded by vertical force E7F, E?F will seat the restoration more into the tooth. This is due to elasticity of the dentin, especially in young teeth wherein the pulpal floor will change location from position 1 to position %. ?owever, since the metallic restorations are more rigid than the dentin, the short arm of the D will more pro"imally, the fulcrum of this restoration is the a"io-pulpal line angle. In order to prevent such a displacement, pro"imal %4

self-retention in the form of facial and lingual grooves are re#uired. C0 LATERAL ROTATION OF THE RESTORATION AROUND HEMISPHERICAL FLOORS 2PULPAL AND GINGIVAL0 A0 OCCLUSAL DISPLACEMENT This can be prevented by directing occlusal loading to seat the restoration and by inverted truncated cone shaping of .ey parts of the preparation. Although the magnitude of these four displacements is minute, they are repeated thousands of times per day. This can definitely increase microlea.age and initiate mechanical and biological failure of the restoration and surrounding tooth structure. Therefore, proper loc.ing of the restoration into the tooth should be e"ercised to minimi!e these ha!ards. To repeat, every part of the cavity preparation should be self retaining, if possible i.e. independent in its retention from the rest of the cavity. This minimi!es shear

concentration areas at the $unctions of different parts of the restorations with less failure to be e"pected as a result. %3

CLASS &
(lass 7 restorations confined to one surface and not sub$ected to direct loading may be thought of as free of any mechanical problems. ?owever, as the mandible moves in lateral e"cursion, the lingual slopes of the buccal and lingual cusps of ma"illary teeth lead to the buccal slopes of the buccal and lingual cusp of mandibular teeth. Assume that we have a facial (lass 7 restoration in the lower molar tooth. As the tooth is firmly seated in bone, the tooth structure of the crown can move from position 1 to position %, ma.ing a 7-shape opening at the margin, together with a facial component of force during the restoration facially. Although this opening and the facial component of the force are very minute and may not displace the restoration completely, their repetition, thousands of times per day can create marginal failure and eventually, facial protrusion of the restoration. The same thin can happen for a lingual restoration in lower teeth and a facial or lingual one in upper teeth.

%5

To minimi!e the effects of these displacing forces, grooved occlusal and gingival walls are essential for any (lass 7 cavity preparation for amalgam, in addition to definite surrounding walls, line and point angles. FORCES ACTING ON CAVITY PREPARATION FOR

DIRECT TOOTH COLOURED MATERIALS 9or any pro"imal restoration in anterior teeth there are two possible displacing forces. The first E?F is a hori!ontal displacing or rotating the restoration in a labio-pro"imo-lingual or linguo-pro"imolateral direction. It has its fulcrum almost parallel to long a"is of the tooth being loaded. The second is a vertical forces displacing or rotating the restoration pro"imally and having a fulcrum at the gingival margin of the preparation. The mechanical picture can be summari!ed as follows< 1. 8ith normal overbite and over$et during centric

closure of the mandible, mainly the hori!ontal forces will be in action, these forces would try to move it

&1

linguo-pro"imo-laterally +for the upper restoration' and labio-pro"imo-lingually +for lower'. In protrusive and lateral protrusive movements of the mandible, directly loaded pro"imal restorations in anterior teeth will be sub$ected to substantial hori!ontal as well as vertical displacing forces especially in restorations replacing the incisal angle. The results of this loading are rotational forces as well as forces rotating the restoration laterally and pro"imally +for upper' or lingually and pro"imally +for the lower'. %. If anterior teeth meet in edge to edge fashion i.e. there will be vertical displacing forces with very limited hori!ontal components. &. If the upper and lower anterior teeth meeth such that the lowers are labial to the uppers in centric occlusion +AngleFs (lass III', the hori!ontal loading will tend to rotate or displace restorations labio-pro"imo-lingually +for uppers' and linguo-pro"imo-labially +lowers'. ). In occlusions, with deep anterior overbite and normal or no over$et, the hori!ontal type of loading will be

&1

greatly

e"aggerated.

The

vertical

displacement

although present will be minimal in comparison. ,. In occlusions with anterior open bite or severe over$et or any other condition that creates a no contact situation between upper and lower anterior teeth during centric occlusion and e"cursive movements of the mandible, pro"imal restorations will not be loaded directly either vertically or hori!ontally. It should be understood that none of these loading forces wor. separately. It should They be wor. together here and a

simultaneously.

mentioned

that

restoration replacing part or all of the incisal ridges of an anterior tooth will have the same pattern of loading as mentioned in +1'-+0' but with increased intensity. Doss of incisal angle of a tooth i.e. conversion from a (lass III to a (lass I7 represents a ma$or complication in the mechanical problems of anterior tooth restoration. This loss will lead to definite direct loading of the restoration, definite vertical loading with its se#uelae, and the placement of margins on the incisal ridge. This further e"poses the restoration to the ma"imal loading possible in anterior teeth.

&%

0. In cases when the pro"imal restoration of an anterior tooth is a part of a mutually protective occlusion i.e. an incisor and the ad$acent cuspid are involved in an anterior lateral disocclusion mechanism, the teeth and the restoration will be part of that disocclusion mechanism with e"cessive hori!ontal and vertical loading forces. Ideally, a restoration made of tooth colored materials should not be loaded directly i.e. there should be intervening tooth structure between the occluding tooth and the

restoration. This situation can only be achieved by force intact walls surrounding the restoration, unfortunately, this is usually not the case that is why the clinical performance of tooth colored materials diffuses from one situation to another, sometimes dramatically. CAST PREPARATIONS (ast restorations are usually used for compound or comple" displacing tooth involvement. their The possible and their loading effects and on

forces,

fulcra,

restorations, together with their effect on remaining tooth structure, have been fully described in the discussions of the &&

different cavity preparations for amalgam and in the general principles of preparation design. The formability of casting materials enables us to use myriad retention and resistance means that are impossible to use with any other materials. INLA' RESTORATIONS ?ere are & illustrations representing the different design of a pro"imal bo" cavity

+A'

+B'

+('

9ig.+A' shows walls parallel to each other where rotational force is applied by means of a bar in a counter cloc.wise direction. The tendency for E"F to use occlusally on area "y is resisted by dentin lying withing the area "y!. In 9ig. +B' same rotational force finds no resistance to point E"F rotating might out of the cavity because of too great divergence of buccal and lingual walls. In 9ig. +(' shows gingivo-occlusal divergence of ,H from vertical plane where the rotational force finds

&)

resistance to point " by the bul. of dentin contained in area "y!. Therefore, while parallelism of the walls offers

ma"imum rotational resistance from clinical standpoint, a slight divergence of %H to ,H from parallelism will furnish necessary resistance to bucco-lingual tor#ue displacement. This figure shows a pro"imal view of a *>: inlay not #uite seated in the cavity. The width of inlay is EBF at about its vertical center. (ontact is assumed to have been made between the inlay and the walls of the cavity. After the contact, the inlay is further forced downwards I an amount EdhF. The walls of the cavity ma.e an angle with the vertical wall of the restoration. Assuming that the tooth structure is prevented from deformation, the total shortening per unit width of gold is<

&,

 g J dh tan
8 And the unit stress becomes - J g dh tan 8 g J modulus of elasticity of gold. The unit stress is not perpendicular to the cavity wall but is parallel to E8F and may be resolved into two components. 9 (os - perpendicular to cavity wall. And 9 -in - parallel to the wall. Assuming the coefficient of friction is EKF between gold of the inlay and tooth structure than K9 (os becomes the frictional force between gold and tooth structure which prevents the movement of the two with respect to each other. The component 9-in parallel to the cavity wall tends to push the inlay bac. to the cavity wall. Thus the total force of frictional retention tending to hold the inlay in its cavity is< 2 J K 9(os - 9 -in &0

This shows that as the value of increases greatly, the inlay will bounce out of the cavity and this angle is .nown as the @(ritical AngleA c. In a pro"imo-occlusal restoration one of the pro"imal wall is absent and opposite retentive stresses are developed only on the buccal and the lingual surfaces whereas the gripping power has been lost in pro"imal direction, due to which there is a force tending to push the restoration out through the absent wall. This displacing force can be counteracted by the retaining stresses present in the buccal and lingual walls and can be supplemented clinically by placing a gingival groove in the gingival wall. The occlusal dovetail loc. also resists lateral displacement of the .ey by the additional tensile stresses developed within the loc.. 8ith the help of the diagram it is seen that by increasing the angulation to &,H-),H of the gingival bevel the resistance to displacement is offered by that portion of dentin which comes in the path of the arc formed by radius 9 and 9 9 with 2 as the rotation center. Leeping the gingival bevel at 1,H wonFt serve any purpose as the filling may be

&4

rotated

out

of

the

cavity

because

no

resistance

to

displacement is offered by either the a"ial wall (= or :=. 8here the buccal and the lingual walls instead of flaring from the a"ial line angle to the cavo-surface margin in a continuous plane are changed into two narrow-and two smaller diverging planes even with such a modification of the buccal and lingual pro"imal walls, it is possible to retain the retentive stresses of a preparation since the

supplementary diverging planes are mostly line angles leaving the balance of the wall in the elastic dentin. If the pro"imal walls diverge e"cessively occlusally from the gingival wall. The reacting stresses in the dentin since all forces react as displacing stresses. ?ence, such a divergence is not acceptable and every effort should be made to approach parallelism not e"ceeding %H-,H gingivo-

occlusally. (E&ELLING Bevelling plays a very important role in reducing the stresses on the remaining tooth structure, thus maintaining the integrity of both the tooth and the restoration.

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The lower surface bevel helps to seal and protect the margin resulting in a strong enamel margin with an 1)1H1,1H angulation. This leaves &1H-)1H marginal metal on the inlay. The marginal gold alloy is too thin and wea. if its angle is less than &1H, conversely the metal at the margins is too bul.y and difficult to burnish, if its angle is greater than )1H. In small teeth such as premolar, the $oining of mesial and distal cavity across the occlusal surface results in a considerable wea.ening of the tooth and an occlusal stress is liable to produce a vertical fracture. 8hen it is thought that there is ris. of this occurring the occlusal bevel should be increased so as to e"tend beyond the summit of the cusps. >cclusal stresses will then be ta.en entirely by the inlay and transmitted to the flat floor, splitting strains thus being much reduced.

CONCLUSION
Tooth is a engineering marvel, which can withstand forces because of resiliency of dentin.

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Increased amount of dentin increases the retention of a restoration and better resistance to forces. An intact tooth can best withstand forces but when lost due to caries, has to be replaced by a restorative material. There are various forces that can act on these restorations hence based on sound principles these restorations should be placed so as to prevent their dislodgement and increase the resistance of tooth as well as restoration to forces.

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FORCES ACTING ON RESTORATIONS

CONTENTS

Introduction Retention and Resistance forms in general 9orces acting on (lass I, (lass II, (lass 7 :irect tooth colored restorations (ast restorations i.e. Inlay (onclusion

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