Pre-Clinical Fixed Prosthodontics I

DR. Wassim Karzoun

DDS, MSc
Master of fixed Prosthodontics

The metal ceramic crown preparation
One of the most widely used fixed restorations.
The restoration consists of a complete-coverage cast metal crown (or
substructure) that is veneered with a layer of fused porcelain to mimic the
appearance of a natural tooth. The extent of the veneer can vary.
INDICATIONS
Anterior teeth that require complete coverage.
Typical indications are similar to those for all metal complete crowns.
CONTRAINDICAIONS
Patients with active caries or untreated periodontal disease.

In young patients with large pulp chambers.

More conservative restorative option such as a composite resin or porcelain
laminate veneer can be used.
ADVANTAGES
combines, to a large degree, the strength of cast metal with the esthetics of an
all-ceramic crown.

Criteria for preparation
Criteria for preparation
Preparation
The clinical procedure to prepare a tooth for a complete cast crown consists of
the following steps:

Occlusal guiding grooves.
Occlusal reduction.
Axial alignment grooves.
Axial reduction.
Guiding grooves
Occlusal reduction
The occlusal reduction and functional cusp bevel are planed smooth with a no.
171L bur or when the bur is used to instrument the seating groove


Axial preparation
A uniform reduction of approximately 1.2 mm is needed over
the entire facial surface. To achieve adequate reduction
without encroaching upon the pulp, the facial surface must
be prepared in two planes that correspond roughly to the two
geometric planes present on the facial surface of an uncut
tooth.

If the facial surface is reduced in one plane that is an extension of the gingival
plane, the incisal edge will protrude, resulting in a bad shade match or an
overcontoured "block." If the facial surface is prepared in one plane that has
adequate facial reduction in the incisal aspect, the facial surface will be
overtapered and too close to the pulp.

Axial preparation
The buccal wall are reduced with a flat end diamond bur, whose sides will produce
the desired axial reduction while its tip forms a shoulder finish line.

Over-tappered Undercut
Proximal preparation
The initial proximal cuts are made
with a needle diamond. The thin
diamond is worked through the
proximal area in an occlusogingival or
buccolingual "sawing" motion,
carefully avoiding the adjacent teeth.
Once sufficient room has been
obtained, the tapered round end
diamond is introduced to plane the
walls while simultaneously forming a
chamfer as the interproximal gingival
finish line.
Finishing
All of the axial surfaces are smoothed with a round carbide
finishing bur or fin grit diamond bur whose size and shape
enable it to finish the chamfer finish line as well.

Wing type
preparation
Wingless
preparation
Metal ceramic restorations
After casting
and finishing
Degazing
Opaquing Dentine Enamel
Finishing
and Glazing