Full Metal Crown Restoration

By
Dr. Mohamed Mostafa
 FULL METAL CROWN:
A cast metallic extracoronal
restoration covering the
entire prepared clinical
crown.

It may be made from

precious, non-precious or
semiprecious alloy, and is
cemented to the prepared
abutment tooth to restore
anatomy and function.
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Indications

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 1.Single restoration in
posterior teeth where
esthetics is not needed.

2.Posterior fixed partial retainer

especial in long edentulous
spans.

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3. Small
abutment teeth as it provides
maximum resistance & retention. E.g.
Short length occlusogingivally. Severe
attrition.
5. Allows correction and alteration of tooth
form, alignment and contour Rotated,
tilted and malformed teeth.
6. Protection of endodontically treated
teeth.
7. To support partial denture clasp or
precision attachment component.
8. Patient with high caries index and
poor hygiene.
9. Correction of occlusal plane.
10. Patients with Parafunctional habits. 5
Contraindications

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1.Anterior teeth for esthetic reasons.
2.When other more conservative
preparations can be made
e.g. Partial coverage.
3. Young patients with large pulp and
high level of epithelial attachment.

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Advantages

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1. Maximum resistance and
retention offered by any
extracoronal coverage.

2. Hard enough to withstand

masticatory forces.

3. Restoration of high strength

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Disadvantages

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1. Bad esthetics.

2. Pulp vitality cannot be tested.

3. Recurrent caries under the

restoration cannot be detected
as it is radiograpically opaque.

4. Full coverage reduction may

result in pulpal and periodontal
effects.

5. Not conservative when compared

to partial coverage.
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Aims of the preparation/
Criteria of preparation

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 Aims of the preparation:
Biologic/ Mechanical
1) Preservation of pulp vitality by
avoiding unnecessary over
reduction.

2) Preservation of periodontium and

marginal integrity:
Proper shape and position of
finish line.

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3.Anatomic occlusal reduction:
Minimal clearance should be provided of at least 1.5 mm in
functional cusps and 1mm in non-functional cusps.
This provides enough occlusal thickness of metal to avoid its
perforation or deformation during function.

Should never exceed 1/3 occlusogingival height, otherwise,

retention is reduced.
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Axially:

1. Remove height of contour and establish slight convergence.

2. No undercuts should remain between two opposing axial walls.
3. Taper should be 6°-10°.
4. Reduction should be 0.3 - 0.5 apically increasing to 1- 1.5 mm
occlusally.
5. Insufficient axial reduction results in overcontoured restorations.

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4) Resistance and Retention form:
Opposing axial walls should be prepared with a slight taper of 5°-
10° to establish proper path of insertion and adequate resistance
and retention.
Minimum taper of 6° is required to eliminate undercuts.

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 5) To restore function, anatomy & ensure Structural
Durability:

Adequate bulk of restoration material is required to withstand

forces of mastication without distortion.

Amount of reduction is proportional to the desired bulk needed.

It should provide enough rigidity to the restoration to avoid its

distortion (perforation) under forces.

Insufficient clearance leads to

perforation during use (wear) or
during finishing while excessive
reduction leads to decreased
retention due to insufficient height.
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1) Preservation of pulp vitality by avoiding
unnecessary over reduction.

2) Preservation of periodontium and

marginal integrity:
Proper shape and position of finish line.

3)natomic occlusal reduction:

4) Resistance and Retention form:

5) To restore function, anatomy & ensure

Structural Durability:
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Materials:
Noble e.g. Au alloys type III or IV, Ag pd .
Base metal e.g .Cr Ni alloy.
In case of gold alloys thickness of chamfer F.L. is 0.5mm
In case of base metal alloys thickness may be reduced to 0.3mm.

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Steps of Reduction / Preparation

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Amount of reduction
Instrument
How to check
Special feature

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Steps of Reduction

Occlusal Axial Roundation

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 Advantages of starting with the
occlusal reduction:
1.Determination of occlusogingival height.
2.Less reduction is required in the 4 remaining axial
surfaces.
3.Easier interproximal access thus less risk of injury
to the neighboring teeth.
4.Allows better visual access especially distally.

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 1. Occlusal Reduction:
Vital teeth:
Reduction is uniform and follows anatomy of cusp inclines.
Decrease steepness between cusp tip and fossa to counteract
horizontal forces.
Non vital teeth
occlusal surface is reduced in two planes buccal and lingual.

Depth:
Uniform clearance of 1.5 mm should be provided at the
functional cusps and 1 mm at the non-functional cusps.

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Depth grooves:
Depth grooves are placed to quantify reduction and ensure even
thickness.
1. Grooves are placed on the ridges and grooves.
2. Depth holes 1 mm depth are deeper on the functional cusps.
3. Tooth structure in between the grooves is removed from half the
surface maintaining the other half as reference.
4. Complete the remaining reduction.

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 Ways of evaluating amount of Reduction :

Occlusal clearance is verified by asking the patient to bite on

1. Two layers of utility wax.
2. Clearance guide
3. Putty index
4. Vacuuform before reduction
5. Bite indication material

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1. Two layers of utility wax.

2. Clearance guide

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 3. Putty index

4. Vacuuform before reduction

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5. Bite indication material

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 2.Axial Reduction

A. Adequate Reduction= strong bulk

of metal

B. Inadequate Reduction= thin ,weak

walls

C. Overcontoured crown=bulky,
plaque accumulation
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Instruments:
1. Tapered with round end diamond stone.
2. Wheel diamond stone.
3. Tapered carbide fissure.
4. Fine or needle

Steps of axial reduction

1. Buccal reduction
2. Lingual reduction
3. Open contact
4.Proximal reduction
5.Roundation of line angle
6.Finishing and finish line accentuation
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1.Buccal & Lingual Reduction
Depth of cutting:
0.3 mm to 0.5 mm cervically increasing gradually to attain 1-1.5mm
occlusally.
Initially:
Three depth cuts are made.
Reduction is completed by connecting them.

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Direction:
Sweeping motion mesiodistally. Shank of the instrument should
be parallel to the long axis of the tooth. This produces a
convergence between the walls identical to the taper of the
instrument. (6°).

Instrument:
Tapered with round end stone  chamfer finish line.
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Axial Reduction parallel to the
long axis of the tooth

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Buccal and lingual walls are reduced
with the round-end tapered
diamond or torpedo stone

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The sidesof the diamond will produce the desired axial
reduction while the tip forms the chamfer.

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 Functional cusp bevel
. Additional reduction is needed for the functional cusps to give a minimum of 1.5 mm
occlusal clearance.
.The bevel is placed at 45° to the long axis.
. Functional cusp bevel is placed with round-end tapered diamond.
Failure to place this bevel can produce :
• thin casting
• poor morphology. Structure durability

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Buccal reduction 2 plane reduction
Lingual reduction 1 plane,minimal due to its inclination
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Half the stone More than half
the stone

Enamel lip

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 MARGIN PLACEMENT
• Whenever possible the finish line
should be placed in an area where
the margins can be finished by the
dentist easily and kept clean by the
patient.

• In addition,finish lines must be

placed so that they can be
duplicated by the impression
without tearing or deformation.

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Finish line of choice should be distinct, smooth and continuous
• Metallic finish lines:
• 1. Feather edge ex in swaged crowns
• 2. Chisel
• 3. Chamfer
• 4. Bevel
a) Chamfer F.L. of adequate width preferably placed supragingivally.

b)Bevel F.L. maybe used in case of initial cervical caries.

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c) Chisel edge F.L.
used in inaccessible surfaces
such as proximal and
lingual surfaces of tilted mandibular
molars.

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3. Proximal Reduction (opening the
contact ) :
Direction:
Initial access is made with short thin tapered stone (needle) moved
in a buccolingual direction and held parallel to the long axis of the
tooth
(path of insertion).

Initial proximal axial reduction with short

needle diamond followed by the
round-end tapered diamond.

The adjacent tooth should be protected with a metal matrix band to

avoid injuring it.

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4) Roundation and Finishing:
Preparation of each wall separately results
in the production of four cervical undercuts
at the axial line angles.

All lines angles between the axial and occlusal

surface should be rounded.

All line angles between the four axial surfaces

should be rounded to remove cervical
triangular undercuts.

Finish line should be continuous and distinct

around the whole circumference of the
preparation.

Prevents stress concentration in sharp areas.

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Smoothening of the preparation :
is done with

1. Finishing diamonds of fine grit.

2. Carbide finishing burs.
3. Sand paper discs.
4. Low speed contra-angle maybe used for roundation.

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Finished Full Metal Reduction

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