Tooth preparation for Metal ceramic crowns.

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Metal Ceramic Crown Preparation

Transcript of Tooth preparation for Metal ceramic crowns.

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Metal Ceramic Crown Preparation

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• Most widely used.• Improvement in:

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Technology.Skills.Growing cosmetic demands.

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• Complete coverage by metal.• Veneer porcelain

mimics

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Extention varies natural teethnatural teeth

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Major requirement:

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More amount of tooth reduction

areas Metal veneered with ceramic.

Place for - Metal- Porcelain

Sufficient bulk.

- Mask metal.- Esthetics.

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Least conservative preparation.

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Other problems

• Alloy’s compatibility with ceramics.

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- Physical properties.- Adequate bond strength.

High fusing range.Low thermal expansion.

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Indications

• Esthetic demands.

• Durability More ( than all ceramic ).

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Marginal fit

better in all ceramics.

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• Crown and bridges metal substrate.

• Allows placement of rests, if RPD is a part of treatment.

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connectors

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• Extensive tooth destruction:

• Correction of malocclusion.• Correction of occlusal plane.

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- Caries.- Trauma- Existing restoration- Endodontically treated

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Contra indications

• Patient with active caries.• Untreated periodontal diseases.• Young patients with large pulp chambers.

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Risk of pulp exposure

- Porcelain laminates.- Composite laminates.

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• If more conservative restoration is possible.• Long Spans.• If facial walls are intact.

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Partial veneer is possible and favorable.

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Advantages

• Strength Good, compared to all ceramics

• Mimic natural appearance Characterization

• Good retention All axial walls are included.

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Reinforcement and support to brittle ceramic.

stains IntrinsicExternal.

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Disadvantages• More amount of tooth removal.• Facial margins often Subgingivally

• Inferior esthetics compared to all ceramics.

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PDL diseaseMargins supra gingivally esthetics not a problem

Indicated:

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• Brittle fracture Poor design.• Difficulty design / shaping and shade

matching.• Many procedural steps.

• Expensive.

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- Casting.- Porcelain adaptation.

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Preparation

• Guiding groves.• Incisal / Occlusal reduction.• Labial / buccal reduction.• Axial reduction

• Final finishing.

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Proximal .Lingual surfaces.

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Anterior tooth preparation

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PUTTY INDEX

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Incisal bevel

• Palatally directed Maxillary anteriors.• Buccaly directed Mandibular

anteriors.

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Incisal Preparation

• Incisal edge 2mm reduction.

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Adequate thickness

Translucency

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• Cervical plane of reduction determines

• Incisal plane Provides space for porcelain veneer.

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Path of withdrawal.

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Lingually• Concavity

• Use foot ball shaped bur / doughnut or any other suitable bur.

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Adequate clearance

Centric contacts

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Wing preparation

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Variants

• Wing less preparation.

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No definite Trancession from chamfer to shoulder

Shoulder gradually narrows lingually.

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Prevention of trauma to pulp

• Adequate coolant while preparing ( copious irrigation ).

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• Intermittent strokes Preparation.

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• Care while preparation of Subgingival margins

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• Permanent gingival recession.

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Finishing

• Smooth glass like / satin like finish.• Rounden all line angles.• No scratches marks.• Use gingival retraction.

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POSTERIOR TOOTH PREPARATION

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POSTERIOR METAL-CERAMIC CROWN

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POSTERIOR METAL-CERAMIC CROWNS

STEP NO : 1OCCLUSAL REDUCTION FOLLOWED BY FUNCTIONAL CUSP BEVEL.barell

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POSTERIOR METAL-CERAMIC CROWNS

STEP NO : 2DEPTH ORIENTATIONGROOVES

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POSTERIOR METAL-CERAMIC CROWNS

STEP NO :3FACIAL REDUCTION-OCCLUSAL HALF

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POSTERIOR METAL-CERAMIC CROWN

STEP NO :4

FACIAL REDUCTIONGINGIVAL HALF

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POSTERIOR METAL-CERAMIC CROWN

STEP NO: 5

PROXIMAL AXIAL REDUCTION

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POSTERIOR METAL-CERAMIC CROWN

STEP NO :6

LINGUAL AXIAL REDUCTION

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POSTERIOR METAL-CERAMIC CROWN

STEP NO : 7

AXIAL FINISHING

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POSTERIOR METAL-CERAMIC CROWN

STEP NO :8

GINGIVAL BEVEL

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POSTERIOR METAL-CERAMIC CROWN