FIXED PROSTHODONTICS

DR. ERWAN SUGIATNO

DR HARYO M.DIPOYONO

PUSAT PENGAJIAN SAINS PERGIGIAN

UNIVERSITI SAINS MALAYSIA
 PREPARATION FOR FULL
VENEER CROWN
 Full veneer crown exhibits superior
retention and resistance
 This does not mean that a full veneer
designed must be used on every tooth
 It should be used on those teeth whose
restoration demands maximum retention
Full Metal Crown Preparation

 When all of the axial surfaces of a posterior

tooth have been attacked by decalcification
or caries, or when those surfaces have been
previously restored, the tooth is candidate
for a full veneer crown
Armamentarium
 1. Handpiece
 2. No. 171L bur
 3. Round-end tapered diamond
 4. Short needle diamond
 5. Torpedo diamond
 6. Torpedo bur
 7. Red utility wax
Step 1.
Occlusal reduction
 The preparation for a full veneer crown is
begun with occlusal reduction, creating
about 1.5 mm of clearance on the functional
cusps and 1.0 mm on the nonfunctional
cusps.
 The tooth structure remaining between the
orientation grooves is removed to
accomplish the occlusal reduction by a
round-end tapered diamond.
 Any roughness left by the grooves should
be removed, keeping the occlusal surface in
the configuration of the geometric inclines
that make up the occlusal surface of any
posterior tooth.
•Occlusal reduction : Round-end tapered diamond and no. 171L bur
•Functional cusp bevel : Round-end tapered diamond and no. 171L bur
 Step 2.
Buccal/lingual surface reduction:
 The buccal and lingual walls are reduced with
a cylindris fissure bur (torpedo diamond).
 The axial reduction while its tapered tip forms
a chamfer finish line or knife edge.
 •Buccal and lingual axial reduction : Torpedo diamond
•Proximal axial reduction : Short needle and torpedo diamonds
Step 3.
Proximal surface reduction:
 The initial proximal cuts are made with a flat-disc
wheel bur (short needle diamond).
 The tin diamond is worked through the proximal
area in an occlusogingival or buccolingual
“sawing” motion, carefully avoiding the adjacent
teeth
 Once sufficient maneuvering room has been
obtained, the torpedo diamond is introduced to
plane the walls while simultaneously forming a
chamfer as the interproximal gingival finish line.
Step 4.
Axial surface reduction
 All of the axial surfaces are smoothed with
a torpedo carbide finishing bur whose size
and shape enable it to finish the chamfer
finish line as well.
 Special care should be taken in rounding the
corners from the buccal or lingual surfaces
to the proximal surfaces to insure that the
finish line will be smooth and continuous.
 The final step in the full veneer preparation is the
placement of a seating groove.
 It will prevent any rotational tendencies during
cementation, and it will help guide the casting to
place. The groove is formed with a cylindris fissure
bur (no. 171L bur) and placed in the axial surface
with the greatest bulk.
 This usually will be on the buccal surface of
mandibular preparations and on the lingual surface
of maxillary preparations.
  Chamfer and axial finishing : Torpedo bur.
  Seating groove : No.171L bur
•Features of a mandibular full metal crown preparation
and the function served by each
 PREPARATION FOR PARTIAL
VENEER CROWNS
 The partial veneer crown is conservative
restoration that requires less destruction of
tooth structure than does a full veneer
crown.
 To achieve maximum effectiveness,
grooves must have definite lingual walls.
The advantages of partial veneer crown :
1. Tooth structure is spared.
2. The margin is accessible to cleaning.
3. Lowering the possibility of periodontal
irritation.
4. Easily seated completely during
cementation.
Armamentarium
 1. Handpiece
 2. Round-end tapered diamond
 3. Short needle diamond
 4. Torpedo diamond
 5. Torpedo bur
 6. No. 169L bur
 7. No. 171L bur
 8. Flame diamond
 9. Flame bur
 10. Enamel hatchet
Step 1.
Occlusal surface reduction

 Occlusal reduction is the first step in

preparing a tooth for a three-quarter crown.
 Depth orientation grooves are cut on the
anatomic ridges and grooves of the occlusal
surface with a round-end tapered diamond,
1.5 mm on the functional cusp and 1.0 on
the non functional cusp.
 The grooves do extend through the
occlusobuccal line angle (0.5 mm only)
 Functional cusp reduction :
- Holding a round-end tapered diamond (round-
edge whell bur/cylindris bur) at a 45 degree
angle to the long axis of the preparation
- The functional cusp bevel is completed by
removing the tooth structure with the same
bur
•Occlusal reduction : Round-end tapered diamond and no. 171L bur.
•Functional cusp bevel : Round-end tapered diamond and no. 171L bur
Step 2.
Lingual/palatal surface reduction
 Axial reduction is begun by reducing the
lingual surface with a torpedo diamond,
extended interproximally.
 The cut is extended interproximally on each
side as far as possible without nicking the
adjacent teeth
 As the axial reduction is done, a chamfer
finish line is form
Step 3.
Proximal surface reduction
 Proximal access is gained by using a short needle
diamond (flat-disc wheel bur)
 This is continued facially until contact with the
adjacent tooth is broken and maneuvering space is
produced for larger instruments
 Final extension to the buccal is aachieved with the
short needle diamond
 It is followed by the torpedo bur (cylindris fissure
bur) to complete the axial reduction and form a
chamfer
• Lingual axial reduction : Torpedo diamond.
• Proximal axial reduction : Short needle and torpedo diamonds
Step 4.
Proximal grooves
 Proximal grooves are approximately the size of a
no. 171L bur/ no. 169L bur/ cylindris fissure bur
 A groove must be cut into the tooth to the full
diameter of the bur to create a definite lingual wall
 The outline form of the finished groove is drawn
on the occlusal surface with a sharp pencil
 The pencil outline is followed to cut a
template approximately 1.0 mm deep, it is
used as aguide to extend the groove to half
its length, keeping the bur aligned with the
path of insertion.
• Proximal flares : Flame diamond and bur
Step 5.
Occlusal offset
 The occlusal offset is made with a no. 171L bur
(cylindris fissure bur)
 It is a 1.0 mm wide ledge on the lingual incline of
the facial cusp
 It forms an inverted “V” that lies a uniform distance
from the finish line
 A flame diamond and a no. 170 bur (cylindris
fissure bur) are used to place a 0.5 mm bevel along
the bucco-occlusal finish line, perpendicular to the
path of insertion
• Occlusal offset : No. 171L bur
• Buccal bevel : Flame diamond and no. 171L bur
 PROBLEMS WITH FVC PREPARATIONS
A Problem What to Do

   

further reduction of
Wall

undercut
within
one
surface block out
undercut
B
Problem What to Do

opposing walls diverge taper walls more

C.
Problem What to Do

overtapered prep; drop finish line to parallel

loss of retention walls;
and/or add retentive
groove
and/or create a shoulder
& bevel
D
Problem What to Do

finish line too light; increase axial reduction

walls are under-reduced
E.
Problem What to Do

finish line too heavy - drop finish line

walls are over-reduced to lighten it OR
bevel finish
line
F.
Problem What to Do

under- further occlusal

reduced reduction
occlusal
surface -
crown will be
too thin
G. Problem What to Do

over-reduced drop finish line to

occlusal parallel walls or
surface - create a shoulder &
lost retention, bevel to parallel walls
walls too short or create retentive
grooves or buildup
occlusal surface with
pin amalgam