TOOTH PREPARATION FOR CAST

RESTORATIONS
Seminar By
Dr. S. HIMAGIRI
Postgraduate Student
DEPARTMENT OF CONSERATIE DENTISTR! " ENDODONTICS
SRI RAMACHANDRA DENTA# CO##EGE AND HOSPITA#
CHENNAI
1
CONTENTS
Page No.
Introdu$tion %
De&inition %
Indi$ations '
Contra indi$ations '
Ad(antages )
Disad(antage *
Prin$i+,es o& $a(ity +re+aration &or $ast restoration *
Pre+aration &eatures o& t-e $ir$um&erentia, tie .
Ty+es and design &eatures o& o$$,usa, gingi(a, /e(e, 0
Cir$um&erentia, tie $onstituents &or e1tra $orona, +re+aration %%
Ty+es and design &eatures o& &a$ia, and ,ingua, &,ares %)
Me$-ani$a, +ro/,ems and +re+aration design so,utions %2
Design o& $a(ity and toot- +re+arations &or $ast restorations '3
Modi&i$ations &or $,ass $ast meta,s '.
Toot- +re+aration &or on,y $ast restorations '0
Modi&i$ations &or $,ass 4 I and $,ass III ))
Modi&i$ation &or $,ass $ast materia,s ))
Toot- +re+aration &or $ast restoration 5it- sur&a$e e1tension )*
Re&eren$es )6
2
INTRODUCTION
Dr. D. Philbrook in 1897 was credited with casting the first
restoration, which was without any evidence.
Taggart in 197 was credited for i!"roving cast restoration with lost
wa# "rocedure, giving details of the casting "rocedure.
DEFINITION (Vimal K. Sikri)
$n inlay is "ri!arily an intra coronal cast restoration that is designed
!ainly to restore occlusal and "ro#i!al surfaces of "osterior teeth
without involving the cus"s and rarely the "ro#i!al surface anterior
teeth.
%nlay is a co!bination of intra coronal and e#tra coronal cast
restoration when one or !ore cus"s are covered.
&ull veneer crown is an e#tra coronal cast restoration where all cus"s
are covered.
ACCORDING TO STURDEVANT
Inlay
'lass (( inlay involves the occlusal and "ro#i!al surface)s* of
"osterior teeth and +ay ca" one or !ore but not all of the cus"s.
Onlay
The class (( onlay involves the "ro#i!al surface)s* of a "osterior
tooth and ca"s all of the cus"s.
,
INDICATIONS:
-#tensive tooth involve!ent. restorations are efficient in re"lacing
lost tooth structure and also for su""orting re!aining tooth surface.
&ractured a!alga! restorations.
$d/unct to "eriodontal thera"y to correct tooth ano!alies, which
"redis"oses to "eriodontal "roble!s.
0estoration of endodontically treated teeth.
0etainers for fi#ed "rosthesis.
1ub gingival lesions2 "ro"erly finishing and "olished gold alloys are
!ore co!"atible with the "eriodontiu!.
Patients with low incidence of "la3ue accu!ulation.
Frac!r" lin"#: fracture lines in the ena!el, es"ecially in teeth having
e#tensive restorations, should be recogni4ed as cleavages "lanes for
"ossible future fracture of the tooth.
E#$"ic#: all !etallic restorations )e#ce"t gold* "ro"erly fitted cast
restorations are !ost "leasant esthetically.
CONTRA INDICATIONS:
Physiologically, young dentition with large "ul" cha!bers and
inco!"letely !inerali4ed dentin are contra indications2
Develo"ing and deciduous teeth
5
6igh "la3ue 7 caries indices "atient with ra!"ant caries and "oor
oral hygiene should not be given cast restoration.
1hould not be used in8"atient with severing occlusal interference or
other defects in the sto!atognathic syste!.
Dissi!ilar !etals2 gold8based castings are avoided in "atients
already having silver restorations.
ADVANTAGES:
9ield strength, co!"ressive strength, tensile strength and shear
strength of alloys used for cast restorations are for greater than those
of any !aterials used intra orally.
'ast alloys are five ti!es the ulti!ate strength of a!alga!.
(n i!"art resistance to the tooth rather than de"ending on tooth
structure to "roduce resistance for! to the restoration.
$re ca"able of re"roducing "recise for! and !inute detail .
$s the cast inlay contains one or !ore noble !etals, they are not
significantly affecting by tarnish and corrosion "rocess.
0estorations can be finished and "olished outside the oral cavity there
by "roducing surface with !a#i!u! biological acce"tance.
:
DISADVANTAGE:
;eing a ce!ented restoration, several inter "hases will be created at
the tooth ce!ent casting /unction, this leakage is "ronounced
gingivally than the other "arts of the restoration.
0estorations necessitate e#tensive tooth involve!ent in the
"re"aration, which creates "ossible ha4ards for the vital dental tissues.
The cathode nature of cast dental alloys towards a!alga! !ay lead to
galvanic deterioration of a!alga!. (t these two restorations are
"laced ad/acent to or o""osite to each other.
The "rocedure is lengthy and re3uiring !ore than one visit.
+uch !ore e#"ensive than other restorative !aterials.
1o!e cast alloys have a very high abrasive resistance caused wear of
o""osing natural tooth.
PRINCIP%ES OF CAVIT& PREPARATION FOR CAST
RESTORATION
'ast alloys and cera!ics can restore teeth via intra and e#tra coronal
"re"arations.
(ntra coronal is !ortise sha"ed having definite walls and floors
/oined at line angle and "oint angle.
<
-#tra coronal "re"arations are created by occlusal and a#ial surface
reduction, in !any casts ending gingivally with no definite flat floor.
CAST PREPARATIONS SHOU%D HAVE THE FO%%O'ING
FEATURES:
Pr"(arai)n (a$:
The "re"aration will have a single "ath, an o""osite to the direction of
the occlusal loading.
Path is usually "arallel to the long a#is of the tooth, and it will hel"
restoration between and decreases its !icro !ove!ents during
function.
APICO*OCC%USA% TAPER OF A PREPARATION
Pre"aration should be without any under cuts.
+a#i!u! retention is achieved by "lacing o""osing walls "arallel to
each other.
7
1ince e#act "arallelis! can create technical "roble! in "rocessing and
in getting final !aterials into and out of the "re"aration.
1light divergences of o""osing walls are essential to facilitate cast,
fabrication with !ini!u! errors.
$ ta"er should be an average of 2 to : fro! the "ath of the
"re"aration. it can be decreased or increased according to the
following factors2
+. %ENGTH OF THE PREPARATION
The greater the de"th of "re"aration, the !ore ta"er will be but it
should not e#ceed 1.
,. DI-ENSIONS AND DETAI%S OF SURFACE INVO%VE-ENT
The greater the surface involve!ent is and the !ore detailed that the
internal anato!y is, the greater will be the frictional co!"onent
between the "re"aration and the !aterials contacting it.
To di!inish friction, the ta"er is increased but not e#ceed 1.
.. THE NEED FOR RETENTION
The greater the need for retention is, the !ore will be the need to
a""roach e#act "arallelis!.
8
(f carcinogenic and anato!ical conditions dictate two different ty"es
for o""osing walls, it is "referable to create two "lanes for each
involved wall, i.e., inner "lanes "arallel to each other and outer "lanes,
satisfying the needs co!"elling the different ta"ers. The inner "lane
assures the single insertion of "ath of "re"aration.
PREPARATION FEATURES OF THE CIRCU-FERENTIA% TIE
Peri"heral !arginal anato!y of the "re"aration is called
=circu!ferential tie> and should have the following features,
advocated by ?%92
(t the !argin ends on ena!el
-na!el !ust su""orts by dentin
0ods should be continuous with dentin
0ods should be covered with restorative !aterial
9
'ircu!ferential tie in inlays will be in the for! of bevel. (t@s directed
away for! the cavity "re"aration.
T&PES AND DESIGN FEATURES OF OCC%USA% GINGIVA%
/EVE%:
Parial 0"1"l:
(nvolves "art of the ena!el not e#ceeding 27,
rd
of its di!ension.
Ased to tri! weak ena!el rods fro! !argin "eri"heries.
S$)r 0"1"l
(ncludes the entire ena!el wall e!"loys for class ( alloy.
1
%)n2 0"1"l
(ncludes all of the ena!el and u"to B of the dentinal wall.
Ased for class (, (( and ((( alloys.
(t "reserves the internal bo#ed8u" resistance and retention fracture
of the "re"aration.
F!ll 0"1"l
(ncludes all of the ena!el and dentinal wall
De"rives the "re"aration of its internal resistance and retention.
(ts use should be avoided unless i!"ossible to use any other for!
of bevel.
C)!n"r 0"1"l:
11
Chen ca""ing cus"s to "rotect and su""ort the!, this ty"e of bevel
is used, o""osite to an a#ial wall on the facial or lingual surface of
the tooth and it will have a gingival inclination facially or
lingually.
HO%%O' GROUND /EVE% (CONCAVE /EVE%)
;evel "ortion of circu!ferential tie !ust have a s"ecific angulation
relative to the re!aining "ortion of the wall.
This allows !ore s"ace for cast !aterial bulk, to i!"rove !aterials
castability, retention and better resistance to stresses.
FUNCTION OF OCC%USA% AND GINGIVA% /EVE%:
;evels are the fle#ible e#tension of a cavity "re"aration, allowing the
inclusion of surface defects, su""le!entary grooves, or other areas on
the tooth surface.
12
;evels create obtuse angled !arginal tooth structure, which is the
bulkiest and the strongest configuration of any !arginal tooth
anato!y and "roduce acute angled !arginal cast alloy this
configuration will be the !ost a!enable to burnishing for that alloy.
;evels are !a/or retention for!s for cast restorations.
0educe the error factor to three or !ore folds at the !argins.
1o!e bevels like hallow ground and counter bevel, are used for the
resistance for! of the tooth8restoration co!"le# by enco!"assing
cus"s.
CIRCU-FERENTIA% TIE CONSTITUENTS FOR E3TRCORONA%
PREPARATION:
a). T$" c$am4"r 4ini#$in2 lin". it is the !ost universal design for class (,
(( and ((( cast !etals. (t involves bulk and definite ter!ination for
"re"aration !arginally, with little tooth involve!ent ).:!! !a#i!al
de"th*.
Di#a51ana2": (ts only disadvantage is the li!ited burnishability of the
!arginal cast alloy and liability of transitional continuation of a
circu!ferential tie and ad/acent bevel tie. (t is !ost "ractical ty"e of
1,
finishing line for sub gingival e#tra coronal "re"aration. (t is
contraindicated for class (D, D cast !aterial due to "oor castability.
0). T$" kni4"*"52" 4ini#$in2 lin": (s circu!ferential tie with least tooth
structure involve!ent. (t should only be used to acco!!odate a very
castable8burnish$ble ty"e of alloy )Eold alloy*. (t should be located on
assessable areas of the tooth surfaces for "ro"er finishing. (t is !ost
indicated when !ini!al a#ial de"th is re3uired.
Di#a51ana2": "ossibility of indefinite ter!ination for casting.
There is a chance of the !argin not being covered with a casting
!ade of certain alloys due to lack of bulk s"ace to acco!!odate less
wetting alloy. There is "ossibility of fracturing the alloy "art of the
circu!ferential tie during burnishing finishing "olishing. (t is
contraindicated for class (((, (D, D cast !aterial
c). T$" 0"1"l"5 #$)!l5"r 4ini#$in2 lin": (t is involve with !ost of tooth.
(t is e#actly a gingival floor of an intra coronal "re"aration but on a
s!aller scale
1. (t is indicated when a definite gingival floor, with all its
co!"onents is needed for resistance F retention "ur"oses.
15
2. $lso when !a#i!u! bulk of the cast is needed !arginally for
!aterial that are li!ited in their castability or are difficult to
burnish. (t is ideal design for sub gingivally located !argin
because !a#i!u! "redictability of the casting ter!ination
gingivally.
(t can be used for any cast !aterial its bevel "ortion could be
hollow ground, as this is !ost suitable for class (D and D cast
!aterial.
5). T$" $)ll)6 2r)!n5 (c)nca1") 0"1"l: (s actually an e#aggerated
cha!fer of a concave beveled shoulder. (ts tooth involve!ent is greater
than a cha!fer and less than a beveled shoulder. (t is !echanically
co!"arable to beveled shoulder and su"erior to a cha!fer care !ust be
taken to ensure there is no residual friable ena!el or thinned tooth
structure at the "eri"hery of this finishing design. (t is ideal finishing line
for class (D and D cast !aterial.
+echanical "roble!s for cast restoration and "re"aration design
solution in general cast restoration is used for co!"ound and co!"le#
tooth involve!ent. (n addition to the "rinci"al retention for! "revious
described )"arallelis!, dovetail, surface area frictional retention,
1:
circu!ferential tie, !asticatory load, directed to seat the restoration*,
there are nu!erous a#illary@s !ean for cast restoration.
T&PES AND DESIGN FEATURES OF FACIA% AND %INGUA%
F%ARES:
&lares are the flat or concave "eri"heral "ortions of the facial and
lingual walls.
There are two ty"es of flares2
1. Pri!ary flare
2. 1econdary flare
PRI-AR& F%ARE:
(t is the conventional and basic "art of circu!ferential tie facially and
lingually for an intra coronal "re"aration. (t is very si!ilar to long
bevel for!ed of ena!el and dentin on the facial or lingual wall,
"ri!ary flares always have a s"ecific angulation, i.e., 5: to the inner
dentinal wall "ro"er.
1<
+ain function of flare is to bring the facial and lingual !argins of the
cavity "re"arations to cleansable F finishable areas.
SECONDAR& F%ARE:
&lat F "lane su"er i!"osed "eri"herally to a "ri!ary flare
1o!eti!es it is "re"ared in a hollow ground for! to acco!!odate
!aterials with low castability.
1econdary flares !ay have different angulations. involve!ent and
e#tent de"end on their function.
(ndicated in very widely e#tended lesions bucco8lingually, results in
"ri!ary flare ends with an acute angle !arginal tooth structure.
$ secondary flare with correct angulation can create the needs obtuse
angulation of !arginal tooth structure.
(n very broad contact areas or !al"osed contact area.
17
-ECHANICA% PRO/%E-S AND PREPARATION DESIGN
SO%UTIONS:
There are nu!erous au#illary !eans of retension for cast
restorations are "resent.
a. %!in2 c"m"n#
$ction is "ri!arily !echanical, locking the cast to tooth structure
by filling the s"ace between the!, wetting the details of both the casting
and tooth "re"aration and filling in the vacancies or irregularities.
0. Gr))1"#
1hould be located co!"letely in dentin
Pre"are at the e#"ense of the dentinal "ortion of the facial or
lingual walls or gingival floors "ro#i!ally.
(t hel"s to "revent lateral dis"lace!ent of !esial 7 distal, facial and
lingual "arts of restorations.
(t also i!"roves seating of the restoration and !ini!i4e !arginal
discre"ancies.
Erooves are Pre"ared with ta"ered fissure bur and they should not
e#ceed 2!! in de"th.
18
R"1"r#" 0"1"l
Placed at the e#"ense of the gingival floor, creating an internal
dentinal "lane inclining gingivally F a#ially.
(t "rovides locking the restoration and "reventing "ro#i!al dis"lace!ent
of restoration.
In"rnal 0)7
Pre"ared in dentin with four vertical surrounding walls /oining a floor
at definite line and "oint angles, it can i!"art four to twelve ti!es the
retention of an e#ternal bo# of sa!e di!ension.
(t is advisable to "lace internal bo#ed at the very "eri"heries of a
cavity "re"aration.
1hould have !ini!u! 2!! in three di!ensions.
19
Sl)
(nternal cavity within a floor of the "re"aration having a
continuous surrounding wall and floor, /unction between the floor and the
surrounding walls is very rounded.
Pin#
Pins can be ce!ented and threaded, "arallel and non8"arallel,
vertical and hori4ontal.
C)ll)r
This is a surface e#tension co!"letely surrounding a cus" or a
surface of a tooth.
Skir
(t involves a "art of the a#ial angles of tooth.

2
P)#
They are used as retention !ode for as core foundation to be
covered with cast restoration.
R"ci(r)cal r""ni)n
(n a cavity or tooth "re"aration to acco!!odate a ce!ented ty"e of
restoration, every retention !ode !ust have an o""osite retention !ode
to co!"letely i!!obili4e the restoration "lacing retention !odes at every
end of the "re"aration or "arts of the "re"aration is called reci"rocal
retention, a basic and design "re"aration for cast restoration.
Ca((in2 $" )ccl!#)*(r)7imal 4acial )r lin2!al c)rn"r )4 $"
(r"(arai)n:
This is done for dual "ur"ose of "rotecting thinned corners, due to
over "re"aration or wide "re"aration in an ovoid tooth, and adding to the
restoration retention by locking it, over a facial or lingual corner, a bevel
e#tension facially or lingually a knife edge or cha!fer finishing line.
This "rocedure is not indicated for class (D and D !aterial.
Pr"*c"m"nai)n 2r))1in2 )4 $" ca#in2 an5 $" a58ac"n ))$ #!r4ac"
)r 6all#
21
To add to the retaining ca"ability of the luting agent, after the
casting is ready for ce!entation an inverted truncated cone groove is cut
on one or !ore of the sides of casting and o""osite it on the "re"aration a
si!ilar groove is cut. (f they are not o""osite one another, the retaining
effect will be !ini!i4ed. $ sufficient a!ount of ce!ent should be !i#ed
and flown into the grooves when ce!enting the casting. (t has been
"roven that this techni3ue will enhance the retaining effect of the ce!ent
several fold, and it is !ost effective for class D.
El"cr)lyic "c$in2 )4 ))$ #!r4ac" )4 $" ca#in2
The internal surface of class (D cast !aterial restoration can be
sub/ected to electrolytic etching. The !argins and e#ternal surface of the
restoration are covered with sticky way, and the restoration is used as an
anodic electrode in an electrolytic cell co!"osed of .:? nitric acid and a
cathode of another non noble alloy higher in the electro!otive force table
a voltage current is "assed into cell, leading selective etching of non
noble alloy. -tching "rocess takes 181: !inutes, to create irregularities.
The other "re"aration feature that will hel" solve !echanical
"roble!s of cast restoration.
$ll line and "oint angle should be definite, but not angular.
0oundness for class D !aterial.
22
$#ial wall should slant toward "ul"al floor, together with rounding
a#io "ul"al line angle can reduce stress.
+a#i!u! reduction should be at the occluding surface, es"ecially
the "arts of tooth surface that are in contact during static and dyna!ic
relation of the !andible average of 1!! should be cleared for !etallic
casting in inclined "lace of cus". This reduction is 1.: !! for cera!ic
restorations.
DESIGN OF CAVIT& AND TOOTH PREPARATIONS FOR CAST
RESTORATIONS
G"n"ral S$a(":
The outline of the occlusal "ortion of the "re"aration is the dove8
tailed. The "ro#i!al "ortion is usually bo#ed in sha"e.
%)cai)n )4 mar2in#
2,
(n the occlusal "ortion the facial, lingual, and, so!eti!es, "ro#i!al
!argins are located on the inclined "lanes of the corres"onding cus"s,
triangular ridges or the !arginal ridges )crossing ridges*. This is
designed so that the bucco8lingual width of the cavity "re"aration
)distance !easured between the buccal and lingual wall "ro"er*,
es"ecially at the isth!us "ortion, does not e#ceed one8third the
intercus"al distance. The !ost "eri"heral !argins of the "re"aration are
located away for! contact with the o""osing tooth surfaces during centric
closure and e#cursive !ove!ents of the !andible. $ll ad/acent wear
facet, su""le!entary grooves and areas of decalcifications, or any defect
in the ad/acent "arts of the occlusal surface, should be included in the
beveled "ortion of the cavity "re"aration only.
(n the "ro#i!al "ortion the facial and lingual !argins are each in
the corres"onding e!brasure. This is designed so that the full length of
an e#"lorer can be "assed freely in the occluso8gingival direction, and so
that all under!ined ena!el, surface defects, and "eri"heral !arginal
undercuts are eli!inated.
The wall "ro"er, constituting about the "ul"al two8thirds of the
facial or lingual )"ro#i!al* walls, is for!ed co!"letely of dentin. These
walls should ta"er fro! each other on the average of 28:, or be "arallel
25
to each other, if necessary. -ach wall should !ake a right angle or
slightly obtuse angle with the "ul"al floor.
The occlusal bevel, which is a long bevel, constituting al!ost one8
third of the facial and lingual )"ro#i!al* walls, this beveled outer "ane of
the walls will have an average angulation of ,85: to the long a#is of the
crown.
This angulation should increase as the width of the cavity
"re"aration increases, in order to acco!!odate !ore bulk of cast alloy,
and to be able to resist increased stresses near the cus"s on the inclined
"lanes. $lso, this increased angulation is necessary to bevel ena!el rods,
which are inclined toward the cus"s.
The angulation of the bevel should decrease with increased
stee"ness of the cus"s. 1o!eti!es, bevels are not needed at all in very
stee" cus"s.
The =bevel> "art of the facial and lingual, and, so!eti!es, the
"ro#i!al walls of the inlay cavity "re"aration will usually be half that of
the cavity =wall "ro"er>. This bevel is e#tended to include wear facets
and occlusal defects or decalcifications, if they are confined to the
2:
occlusal surface. They are also e#tended to include su""le!entary
groves and to !ove the !argin away fro! occlusal contacts.
(n the inlay cavity "re"aration, the "ul"al floor should be flat over
!ost of its e#tent. (f this is not "ossible, at least the "eri"heral "ortions
should be flat.
The conventional "ul"al de"th of the inlay cavity "re"aration is a
little !ore than that for a!alga! in order to create !ore length for
surrounding walls. Eenerally s"eaking, this de"th should be 181. : !!
fro! the dentinoena!el /unction. The "ul"al floor should !eet all
surrounding walls in a definite line angle. e#"ect its /unction with the
a#ial wall, where the /oint should be very rounded.
(n the "ro#i!al "ortion of the inlay cavity "re"aration, the a#ial
wall should be either flat or slightly rounded in the bucco8lingual
direction, and either vertical or slightly divergent ):81* towards the
"ul"al floor in the gingivo8occlusal direction. Divergence here is
i!"ortant only insofar as it i!"arts so!e ta"er on the "re"aration,
facilitating the "rocedural ste"s for the restoration.
2<
The a#ial wall should, !eet the "ul"al floor in an e#tre!ely
rounded /unction as in a!alga!. This "revents stress concentration in
the tooth and the casting. &urther!ore, the de"th, a#ially, should ideally
be 181.:!! fro! the dentinoena!el /unction. 6owever, different de"ths
!ay be necessary according to the cariogenic "attern of the dentinal
lesion "ro#i!ally.
Pro#i!ally, facial and lingual walls are co!"rised of two "lanes.
(n the a#ial half )i.e., the facial or lingual =wall "ro"er>* it is for!ed
co!"letely of dentin ad !eets the a#ial wall at a right angle relationshi".

This is the !ain resistance and retention feature of that "art of the
cavity "re"aration. The "ro#i!al half of the facial and lingual walls is
for!ed of a "ri!ary flare, co!"rised of ena!el and dentin with an
unchanged 5: angle to the =wall "ro"er.
1o!eti!es it is necessary to i!"ose a third "lane in the for! of a
secondary flare, "laced on ena!el "eri"herally. This serves to si!"lify
i!"ressions and wa# "atter !ani"ulations ad for the other reasons
"reviously !entioned. 1econdary flares should not be used if a direct
27
wa# "attern techni3ue is to be used. The secondary flare can have
variable angulation and e#tent to achieve its ob/ectives.
The gingival floor, "ro#i!ally should be flat in the bucco8lingual
direction, !aking a slightly obtuse angle with the buccal and lingual
walls.
(n the a#io8"ro#i!al direction, it is for!ed of two "lanes. The
a#ial half consists of gingival wall )floor* "ro"er, being "erfectly flat,
for!ed of dentin, and !aking either a right angle or a slightly obtuse
angle with the a#ial wall. The "ro#i!al half should be beveled in the
for! of a long bevel inclining gingivally. This bevel is usually angulated
on the average of ,85: to the wall "ro"er. 6owever, this angulation
can be increased by an increase in the gingival e#tent and length of the
surrounding walls. This will serve to !ini!i4e !arginal discre"ancy.
$lthough this bevel is usually e3ual in e#tent to the =wall "ro"er>,
it can be increased to include notches or surface defects, or decreased if
the !argin ends on ce!entu! rather than ena!el.
The e#tent of the bevel !ay also be decreased if the cavity is
increased in length occluso8a"ically. This creates !ore roo! for the flat
=wall "ro"er>.
28
Te /unction between the occlusal bevel and the secondary or
"ri!ary flares "ro#i!ally, and also, the /unction between the "ri!ary or
secondary flares "ro#i!ally and the gingival bevel should be very
rounded and s!ooth.
-)5i4icai)n# 4)r Cla## IV an5 #)m" Cla## III ma"rial#
$lthough the general sha"e, location of !argins, and !ost of the
internal anato!y of "re"arations for cast alloys in the 'lass (D )and
so!eti!es 'lass (((* category are si!ilar to those to be described for
'lass ( and (( alloys, certain s"ecific !odifications !ust be enu!erated.
$lthough the "re"aration will still contain internal bo#ed "ortions
)buccal, lingual, and "ro#i!al =wall "ro"er>* occlusally and "ro#i!ally,
the internal line and "oint angles should be !ore rounded.
1urrounding walls should be !ore "arallel to one another. $ll
circu!ferential tie constituents )"ri!ary or secondary flares, occlusal or
29
gingival bevels* should be hollow8ground to i!"rove the ca"ability of
these alloys to re"licate !arginal details during casting.
Tooth "re"aration should be dee"er a#ially and "ul"ally to
co!"ensate for the loss of retention that results fro! the relatively "oor
castability of these alloys.
-)5i4icai)n# F)r Cla## V Ca# -"al#
The internal anato!y of cavity "re"arations for these alloys will
include the following additional changes.
Definitely flat "ul"al and a#ial walls !eet surrounding walls in a very
rounded line angles.
To i!"rove retention, the "re"aration should be relatively dee"er and
with !ini!al or no ta"er.
The gingival floor, if its !argins end on ce!entu! )dentin* or at the
occlusal or !iddle third of the anato!ical crown !ay be !ade a flat,
one8"laned floor co!"letely for!ed of dentin )after ce!entu!
,
re!oval*, or ena!el and dentin ter!inating in a 9 cavosurface
!argin. $lthough this !ight reduce the negating effect of bevels on
internal discre"ancies shown !arginally, e#actness of the fit of cast
cera!ics would counteract this "roble!. This could si!"ly be done
by "re"aring these surrounding walls in a "urely wall "ro"er
configuration with no bevel or flare co!"onents. This si!"lified
cavity "re"aration could be done "rovided that.
?o under!ined ena!el is left !arginally.
The !argins are "laced in finish able, cleansable areas
Goint angles are "re"ared e#tre!ely rounded and the
cavosurface ones are !ade right angles.
T))$ (r"(arai)n 4)r )nly ca# r"#)rai)n#2
%nlays are the !ost and universally used cast restoration for
individual teeth. (t is "artly intra coronal and "artly e#tra8coronal ty"e of
a restoration, which has cus"al "rotection as the !ain feature.
In5icai)n#:
1. 'us"al "rotection is to be considered if the width of the lesion is
17, to B of inter cus"al distance.
,1
2. (n the cast restoration cus"al "rotection is !andatory, if the width
of the lesion is e#ceeds B of inter cus"al distance.
,. (n tooth "re"aration the length width ratio of cus"al is !ore than
121, but not e#ceeding 221, cus"al "rotection is to be considered.
5. (f length. width ratio is !ore than 221 cus"al "rotection is
!andated.
:. Chen need to change the di!ension, sha"e and interrelationshi" of
the occluding tooth surface the onlay cast restoration are ideal.
<. %nlay is ideal restoration for abut!ent teeth for a 0.P.D )or* fi#ed
"rosthesis.
7. They are ideal su""orting restorations for re!aining tooth
structure.
8. %nlays are necessary to include wear facets that e#ceeded the cus"
ti"s and triangular ridge crests.
G"n"ral #$a(":
1. %nlays are dovetailed internally and follow cus"al anato!y
e#ternally.
2. Pro#i!ally they a""ear as bo# )or* cone sha"ed.
,. The !ain feature is to ca""ing of the functional and the shoeing f
non8functional cus"s.
,2
%)cai)n )4 mar2in:
Occluso-facio-lingual portion.
1. %n the functional side cus"s are ca""ed for the additional retention
and "rotection.
2. They !ust be located for enough gingivally away fro! contact
with the o""osing tooth surface.
,. ?or!ally this will involve H to 17, the facial )or* lingual surfaces.
5. Eingivally, !argins include all facial )or* lingual grooves and
should be "arallel to the contour of cus" ti"s and crests of ad/acent
ridges.
:. %n non8functional side, the facial )or* lingual !argins located /ust
gingival to the ti" and ridge crests of the cus"s and away fro!
occlusal contact.
Pr)7imal ()ri)n:
1. 1econdary flares are used in all situations
In"rnal ana)my:
In o$$,uso7&a$io7,ingu,a, 4 +ortion8
1. The "ul"al floor is dee"er, and the facial )or* lingual wall will be
for!ed by four "lanes.
,,
a. 'all (r)("r 2 is an a intra coronal "ortion of the wall which
constitutes atleast half of the vertical height of the total wall.
(t is co!"letely in dentin and slightly ta"ered fro! the
o""osing wall "ro"er by 2 to :, !aking a definite angle
with the "ul"al floor.
2. The table is the transitional area between the intra8coronal and
e#tra8coronal "arts of the "re"aration. (t is "artly in dentin and in
ena!el. (t is relived for! o""osing cus"s by at least 1.:!! in
both static and functional contacts. $t any location the table
should be flat, following cus"al direction in !esio8distal direction.
The table is one of the !a/or resistance for!s of the entire
structure.
C)!n"r /"1"l
The counter bevel is for!ed in ena!el and Dentin, and it should be
relieved fro! o""osing cus"al ele!ent at least 1!! in both static and
functional occlusal contact.
The hollow ground bevels are on the ca""ed side will have four
different hollow ground bevels corres"onding inclined "lanes of the cus".
,5
The angulation is fro! ,87 between the bevel and long a#is of
the teeth.
The angle varies according to2
The a!ount indicated for facial or lingual surface
The a!ount of needed retention.
The ty"e of cast alloy, the less the castability of the alloy the greater
will be the angle.
T$" #$)"
(t "erfor!s sa!e functions as table. (n so!e situations it end in
facially or lingually with acute angle leaving frail ena!el. This should
incline away facially or lingually Fgingivally and follows cus"al
anato!y. The "eri"heral "artial bevel is indicated with difficult
continuation between a shoe and a "ri!ary )or* secondary flare
"ro#i!ally.
,:
Pr)7imal ()ri)n
The internal anato!y of tooth "re"aration for on lay "ro#i!ally is
very si!ilar to "ro#i!al "art in cavity "re"aration for inlays. &or onlays,
however the secondary flare with its fle#ible angulation is feature of
cavity "re"aration.
-)5i4icai)n# 4)r cla## 9 IV an5 cla## III
1. The occlusal reduction !ust be greater, in order to acco!!odate
bulkier cast !aterial.
2. $ll circu!ferential tie constituents !ust be hollow ground
,. $ll cus"s !ust be ca""ed rather than shoed, as a !eans of cus"al
"rotection.
5. The "re"arations should not feature any s!all8co!"licated internal
)or* e#ternal details.
:. The concavity of hollow8ground bevels should include ena!el and
dentin.
-)5i4icai)n 4)r cla## 1 ca# ma"rial#:
1. 'us"al "rotection !ust take the for! of ca""ing rather than
shoeing.
2. (n !ost cases, ca""ed cus"s consist of , distinct "lanes an hollow
ground bevel e#tending to "ul"al floor to the table.
,<
The counter bevel should be !ore acute than that described for
class ( and class (( alloys.
,. There is !ore occlusal reduction for the table and counter bevel to
acco!!odate sufficient bulk of cast cera!ic.
5. The gingival, buccal, and lingual walls "ro#i!ally should be
si!ilar to inlays.
:. The "re"aration should be dee"er than that for class F ( and (( cast
alloys due to absence of =bo#ed u"> internal "ortions of
restorations.
<. ?o ta"ering should be e#hibited by any wall
7. (n cases of e#tre!e occlusal involve!ent bucco8lingually this
!odification !ay be acco!"lished.
8. The /unctions between the walls and "ul"al floor and table are
very rounded.
9. The facial )or* lingual !argins ends in the !iddle or occlusal 17,
of that surface.
T))$ (r"(arai)n 4)r ca# R"#)rai)n 6i$ #!r4ac" "7"n#i)n.
These are !odification for basic onlay and inlay tooth "re"arations
and restoration involving "art )or* all the a#ial surfaces.
,7
There are three ty"es of surface e#tensions that !ay be i!"osed on
any ty"e of tooth.
R"1"r#" #"c)n5ary 4lar":
This is a surface e#tension of the basic intra coronal inlay )or*
onlay.
In5icai)n#:
1urface e#tensions are re3uired to include facial )or* lingual defects
beyond the a#ial angle of tooth.
They are used to eradicate "eri"heral undercuts.
To add retentive ca"ability of the restoration "ro#i!ally.
This ty"e is contraindicated in class F (D and D restoration.
0everse secondary flares can be added to cavity "re"aration in lieu of
a secondary flare, directly over "ri!ary flare.
(t can also be "laced in a cavity "re"aration u"on a secondary flare.
The reverse secondary flare can fulfill the for! of "artial bevel. (t
involves ena!el only, with the !ain cavity "re"aration.
(t ends on the facial )or* lingual surface with a knife8edge finishing
line and its e#tent should not e#ceed the height of contour of facial
,8
)or* lingual surface in !esio8distal direction nor should it included the
ti" of cu"s.
Skir
This is !ore e#tensive surface e#tension than reverse secondary
flare, also su"er i!"osed on the basic intra8coronal inlay or onlay cavity
"re"aration facially )or* lingually.
In5icai)n#
1kirting is to involve defects with !ore di!ensions than those that can
be involved in a reverse secondary flare.
(t is re3uired to i!"art resistance and retention on a cast restoration.
(t is necessary when contact areas and contour of "ro#i!al surfaces
are to be changed in the conte!"lated restorations.
1kirts are essential facially and lingually for tilted Teeth in order to
restore the occlusal "lane and are "re"ared at the side forwards, which
the tooth is tilted.
F"a!r"#:
,9
1kirts include facial and lingual surfaces at a#ial angles to a de"th .:8
1 !! in class F( and (( alloys, and a de"th of 1.: F 2 !! for class (((,
(D and D cast !aterials.
The !a#i!u! de"th of skirts should be at the /unction of the surface
e#tension with the cavity "re"aration.
&or class F (, (( and ((( skirt ends at !esially )or* distally in a cha!fer
line. &or class (D and D the skirt ends in a hollow ground bevel.
(t is so!eti!es "referable to ter!inate the skirt !esially or distally in
a vertical groove, and is used to acco!!odate bulky !aterial.
The de"ths should be 182!! for classes ( and (( and 2!! for cast
cera!ics.
The groove should be co!"letely rounded in !esio8distal direction for
cast cera!ics and surrounding walls for cast alloys.
-very effort should be !ade to !ake a#ial reduction of the skirt
"arallel to the rest of cavity "re"aration and so!e ti!es it is even
ta"ered to re!ainder of "re"aration.
&or class (, ((, ((( and (D cast alloys, intervening facial or lingual wall
"ro#i!ally between cavity "re"aration "ro"er and the skirt e#tension.
1hould have bo#ed "ortion and a "ri!ary flare.
5
(f the skirt to be used to change the contact and contour of the tooth, it
should be e#tended far enough on the facial and lingual surface of a
tooth create sufficient retention for the cast !aterial.
C)llar
This ty"e of surface e#tension is the !ost involving surfacewise and
de"thwise. $nd it !ay be one of two ty"es.
'us"al collars involve facial )or* lingual surfaces of one cus" only in
!ulti8cus"al tooth.
Tooth collars, which involve the entire facial or lingual surface of the
tooth.
-ither ty"e can surround the cus"al ele!ents or a"ical to an already
lost cus"al ele!ent.
In5icai)n#:
They hel" in retention and resistance when an entire cus" is lost "rior
to tooth "re"aration.
They hel" retention in shortened teeth.
They hel" resistance and to enhance su""ort for the tooth that is
endodontically treated.
They are used in situations where "ins are contra indicated.
51
They are used in teeth with large foundations re"lacing cus"al
ele!ents.
They are used in a cast alloy rest to be veneered by fused "orcelain.
F"a!r"#:
Cith a#ial de"th of 1.: !!8 2!! collar e#tensions and gingivally in
a beveled shoulder finishing line.
&or class (D cast !aterial the beveled "ortion of the shoulder should
be hollow ground.
&or cast cera!ic !aterials the bevel is rounded and no bevel re3uired.
(n cast alloy there should be definite line angle gingivally.
'ollars should have less ta"ering toward the cavity "re"aration and
this i!"roves retention in these shortened teeth.
The shoulder "ortion of collar should be "er"endicular to the long a#is
of the crown.
REFERENCES
1. Eerald T. 'harbeneau. Princi"les and "ractice of o"erative
dentistry. ,
rd
-dition. Darghese Publishing. ,:18,:<.
2. Cillia! 6. Eil!ore. %"erative Dentistry. 5
th
-dition. ;.(.
Publication Pvt. Itd. 2<82<8.
52
,. Iioyd ;au!. Te#tbook of %"erative Dentistry. ,
rd
-dition. C.;.
1aunders 'o!"any. 578585.
5. T-eodore M. Ro/ertson. Hera,d O. Heyman. 1turdevants art
and science of o"erative dentistry. (D -dition. +osby 'o!"any.
81882<.
:. ima, 9.Si:ri. Te#tbook of o"erative dentistry. ';1 Publishers.
25,82:<.
<. M.$. +ar4ouk., $.I. 1i!onton., 0.D. Eross. %"erative dentistry
!odern theory and "ractice. $ll (ndia Publishers and Distributors.
5,