Biomechanical principles 11-2-2014 Sondos Ahed of teeth wahadneh harbieh preparations

BIOMECHANICAL PRINCIPLES OF TEETH PREPERATIONS

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script number (3) , Title : biomechanical principles of teeth preperations , Date 11-22014

*the doctor began to talk about the last lecture and review some points

# Now let us start talking about the principles of teeth preparation that is needed for fabricating crowns and bridges Why do we need to do teeth preparations ? 1) We need to have a good fit for the crown 2) to have certin geometry for the preparation to reach a good outcome ) to create ade!uate space " if there is not enough space between the opposing tooth and the ceramic this mean that the ceramic thickness will be thin and the ceramic will be fractured ) what do we need from the preparation ? ## we need good integrity between the margin of the tooth structure and the margin of the finish line which will improve the biocompatibility

now these are the biomechanical principles of teeth preperations 1$preservation of tooth structure% 2$retention and resistance form % $structure durability of the restoration % &$'arginal integrity% ($preservation of peridontium%

)et us start discuss them one by one 1 ) preservation of tooth structure ** avoid over reduction * you should direct the hand piece to the tooth structure and not apply over pressure to avoid destruction of the tooth structure because this procedure is irreversible ** e+cessive removal of tooth structure can have many ill effects % if a tooth is overtappered or shortened too much , there will be an unnecessary sacrifice of retention and resistance ** thermal hypersensitivity , pulpul inflammation and necrosis can result from approaching the pulp too closely

2 ) retention and resistance

** clinically they are one term but theoretically they are different a) retention * is the ability to dislodge the crown from force that is directed a long the a+is of the crown " or tooth preparation) $ to do this you need parallel preparation " buccolingually and mesiodistally ) and by this you will have one path of insertion $ if you do taper preparation then you will not have one path of insertion types of forces * 1) tensile force 2) shear force ) compression force hese are the forces that ma' dislod(e the crown so we sho)ld ma*e (ood preparation to pre+ent this dislod(ment

b ) resistance * the dislodgment of the crown or bridge in direction other than the long a+is of the tooth %

parallelism $ 6 degree tapering is the ideal situation for the preparation ,up to 32 degree is acceptable and beyond this is unacceptable

surface area
* the more the surface area the more the retention * if some one do preparation for a tooth and end up with tapered tooth you can correct the mistake by adding grooves so increasing the surface area " increase friction ) and increasing the retention

* the more the filling the less the resistance " if - have enough tooth structure - can do filling with composite or amalgam but if - don.t have enough structure - have to do crowns )

roughness
* it is better to have a rough surface when doing the preparation because cement stick in it and this will give us microretention # the longer the tooth the better the resistance # the wider the tooth the better the resistance

path of insertion
$ for posterior teeth must be parallel to the long a+is of the tooth structure , but for anterior it should be parallel to the incisol two third

** now - did a preparation , - should not have any undercut " you can check this by closing one eye and opening the other and you have to look with the mirror or directly in one direction , if you can see all the finish lines then you don.t have undercuts , if you open both eyes you will see all margins )

3 ) structural durability $ it is the durability of the material of the crown or bridge %/he thickness of the crown is known by you already , so you have to remove the same thickness from the tooth structure not more and not less *not more because we want to avoid over reduction *not less because we need an enough thickness to withstand the forces $ occlusally under fossa and under direct forces we need more reduction so we make bevels "so if the reduction was 1%( mm , with beveling %( mm , it will become 2 mm reduction ) *functional cusp bevel* we have to increase the reduction from the functional cusp of molars because it has too much occlusal force% ** the functional cusps are the lower buccal and the upper lingual cusps%

4 ) marginal integrity - the margin of the crown and the margin of the tooth structure " the finish line ) should have good integrity 0

$ one of the books said that the tip of the hair which is &1 micron shouldn.t be inserted between the margin of the crown and the tooth structure * this is important because if there is space there will be leakage of saliva for e+ample and this will cause disintegration of the cement , less retention , inflammation and at the end failure of your work 2

5 ) preservation of periodontium /he dentist should choice the right finish lines , thickness, type, on the right place to prevent pla!ue accumulation and preserve the periodontium% We have 1) chamfer finish lines " %( mm ) for metal crown 2) shoulder finish lines " 1%( mm ) for ceramo$metal ) deep chamfer finish lines for all ceramic and ceramo$metal "between finish line and a+ial wall and go deeper feather edge " we are not using it now )

Now let us cast the principles of preparation i have to choice the right finish line for the right type of crown

** we can take putty inde+ to check if our preparation is right or not " made from silicone ) 3go back to dental material and read about putty inde+ techni!ue 4

5o for ideal preparation shape we should have 1$rounded margins 2$finish lines% $a+ial, cingulum, palatal reduction &$cingulum$gingival area%

he doctor showed us a picture of three cases and two of them were wrong */he first one because there is not enough reduction of the tooth structure so we does not reach the structural durability * in the second one we have over reduction so we are talking about $ retention and resistance $ preservation of tooth structure $ we are near the pulp so we may e+pose the pulp

** to know that we reach a good occlusal reduction we bring a sheet of wa+ " 2 mm ) and soften it then tell the

patient to bite on it if it perforate then we need to remove more tooth structure

in crown preparation you should change burs according to the area you are preparing *chamfer burs for chamfer finish lines * flame shaped burs for cingulum * shoulder burs for shoulder finish lines *retentive grooves are done by tungsten burs

6or anterior toorth preparation achieve marginal integrity by doing finish lines "choice the right finish lines for your preparation ) you have to reduce the si7e to reach more retention and resistance more reduction if - need more thickness ! structural durability )

** you can choice from where you want to start preparation ** palatally you do reduction by flame shaped or disk bur 6or posterior teeth preparation ** preparation should be in planes ** more retention can be achieved by seating grooves ** cutting grooves , orientation grooves also can be used ** you must be carful when doing pro+imal preparation $ you have an area which is called gingival col area , we shouldn8t hit this area with the bur " you start drilling until you reach this area then go up , keep doing like this until the area become thin and it will open ) " a col area is a depression in the gingival tissue of the interdental papilla apical to the contact## Wikipedia ) ** there is a techni!ue that is called three !uarter preparation techni!ue , it is used for shoulder or chamfer but we don.t use it too much " you can see a picture of this in the handout page &1 figure 1$ 9 5:;;< 6:; =N< '-5/=>? 22 THE HAPPY END Done by : sondos majdi harbieh