PRINCIPLES OF TOOTH

REDUCTION
 II- MECHANICAL PRINCIPLES

 There are mainly three types of forces

acting on the prostheses and tend to displace
the restoration away from the related teeth.

 The studying of these forces is essential so that

the design of the prostheses provide
adequate retention and resistance against
fracture of the related teeth or the restoration.
Types of forces :
1. Tipping forces: these forces occur in bucco-
lingual or mesio-distal directions depending on the
direction of the force application ,it tend to displace
the restoration along what is called tipping path.
2-Twisting or rotational forces; forces tend to move
the restoration circumferentially around the prepared
teeth . This situation is met when the final prepared tooth is

rounded in cross section, in these cases, a groove is

added to prevent rotation of the restoration.

Occlusal view of lower molar Anti rotational groove

3-Forces along the path of insertion:
These are forces tend to displace the
restoration in apical or occlusal
direction , when the mandible is
closing (chewing) a food bolus or
when suddenly opened against sticky
food.
 Mechanical considerations can be
divided into these categories:
1. Path of insertion

2. Providing retention form

3. Providing resistance form

4. Preventing deformation of the

restoration
Path of insertion:
Is the path along which the restoration can be
seated on the preparation.

Path of insertion of a single restoration:

 Single line of insertion
 Range of insertion
Single line of insertion

➢ Is the single path or line along which the

restoration can be seated or removed.
➢ It is obtained when opposing walls of the
preparation are absolutely parallel to each
other.
➢ any deviation from the path of insertion
make the seating of the crown impossible
Range of insertion:
Range of angles along which the restoration
can be positioned. It is obtained when the
opposing walls of the preparation are
converging to each other
Path of insertion (removal) for FPD
two or more retainers

Common line of insertion:

Common range of insertion:
Common line of insertion: is the
single direction along
➢ Which all retainers of a bridge could be seated
on the corresponding abutments.

➢ Strict parallelism between axial walls of all

abutments is indicated.

➢ Any deviation from the common line of insertion

make the seating of the bridge impossible.
Common range of insertion:
➢ Range of angles along which the
restoration can be positioned. It is
denoted by the sum of converging
angles of the axial walls of the
preparation.
Factors affecting path of insertion
1-Reduction of axial surface.
2-Roundation of axial line angles.
3-Ledges and/or indentations.
4-Proximal grooves.
5-Pinholes.
1- Reduction of the axial walls:
This may be;

Parallel to each other to give a line of insertion

with Slight occlusal convergence to give a
range of insertion.

➢ All undercuts should be removed:

➢ Buccal and lingual infra-bulge areas in buccal

and lingual surfaces should be reduced.

➢ Removal of occlusal divergence. in mesial and

distal surfaces
2- Rounding of line angles:
Preparing each surface of the tooth
individually create four cervical triangular
undercut area at their meeting (line angles).
These areas should be removed by rounding
the line angles to help in establishing the
proper path of insertion
3- Alignment of the axial grooves
(mesial, distal ,buccal and lingual)
1. In ½ crown: grooves are in lingual and buccal surfaces.

2. In ¾ crown: grooves are in mesial and distal surfaces.

3. Each groove has –buccal wall-lingual wall-axial wall-

gingival wall.
 Buccal wall Axial wall

Gingival wall
(seat)
Lingual wall
Buccal & Lingual Walls Of The Groove In Relation
To Each Other

should be parallel or with slight occlusal divergence

 Buccal & lingual walls of the groove in
relation to the lingual surface of the prepared
Lingual tooth
Buccal wall
wall

-// to each -No problem

other or either
with slight converging
occlusal or diverging
convergence occlusally.
4- Alignment of the ledges and indentations:
Pinledge crown preparation includes
ledges and indentation.
Indentations create a space for thick
metal to withstand occlusal forces
,into which ,the pinholes will be
drilled.
The prepared surfaces are lingual
,incisal ,and one or both proximal
surfaces.
 4-Ledges & Indentations
NO problem regarding

to the path of insertion in

case of cutting ledges and

indentations on the lingual

surface of anterior teeth

 5-Pinholes

Should be // to the incisal 2/3 of the labial

surface of the anterior teeth.
▪Parallelism between the pinholes and the sagittal
plane is indicated.
▪Incisal convergence or divergence will make the
seating impossible.
Pin ledge
preparation
PINLEDGE PREPARATION
2-RETENTION AND RESISTANCE
Retention form:
It is the features given to the preparation
to prevent removal of the
restoration along the path of
insertion or long axis of the tooth
preparation.
Resistance form
It is the features given to the preparation to prevent
dislodgement of the restoration by forces directed in
an apical or oblique direction and prevents any
movement of the restoration under occlusal
forces.(during eccentric contact between posterior teeth).

➢ Retention and resistance

are interrelated and often
inseparable qualities.
➢ The tipping path : the path along which the restoration
could be displaced under the displacing occlusal forces.

➢ Tooth structure which is lying outside the tipping path

will resist the displacing forces .

➢ Therefore , when prepare a tooth to receive a crown we

must preserve a considerable amount of tooth structure
outside the tipping path , otherwise the crown will tend to
be displaced easily under occlusal forces.
Factors affecting retention
1-Magnitude of the Dislodging Forces.

2-Geometry of the Tooth Preparation

- Taper
- Surface area
-Preparation features.
3-Roughness of the restoration’s fitting surface.

4- Type of luting agent.

5-Materials being cemented
 1-Magnitude of the Dislodging Forces

➢ It depends on:
-Stickiness of food.
- Surface area and
texture of restoration
being pulled.
2-Geometry of the Tooth Preparation

Taper

Surface area

Preparation
features
 A-Taper
▪ Theoretically, the more nearly parallel
the opposing walls of a preparation, the
greater is the retention.
➢ A parallel preparation is impractical

Since , cement cannot be extruded from

the crown during cementation → excessive

thickness of cement occlusally and at the

margin → prevent the crown from

complete seating
➢ Tooth preparation
taper should be kept
minimum because of
its adverse effect on
retention.
B- Surface area

▪A full crown preparation is more retentive on

a molar than on a premolar because the molar
preparation has greater surface area
➢Surface microscopic irregularities
Improves retention with sand paper disc
finishing.

➢Reduction of occlusal surface

Should follow the anatomical cusps shape, flat
reduction decreases the axial wall height
▪Inadequate space easily perforated by finishing
procedures or by wear in the mouth.
C-Preparation features
➢ The retention of full coverage crowns is
double that of partial-coverage
restorations.

▪Adding grooves or boxes to a preparation

will increase the retention through limiting its
path of insertion.
▪Adding grooves or boxes to a preparation will increase
the retention through limiting its path of insertion.
 4- Type Of Luting Agent.

➢ The type of the luting agent chosen affects the

retention of a cemented restoration
➢ Film thickness should not increased
otherwise dissolution will results.
➢ Data suggests that adhesive resin cements are
the most retentive.
NEVER depend the
retention of
restoration on the
type of the luting
agent
5-Materials Being Cemented
▪Base metal alloys are better retained than gold
content alloys

WHAT are the Retentive Features that

should be given to the preparation to resist
displacing forces acting on the restoration?
Retentive Features that should be given to the
preparation to resist displacing forces acting
on the restoration

1- Frictional retention
between opposing
axial surface in case of
Full coverage
2-Axial grooves
3-Pin holes
4-Ledges and indentations
5-Post hole in the
prepared root
canal
Retention gained by axial grooves:
Types of grooves
1. V-shaped groove. it tend to cause easily
displacement of the restoration under the
horizontal component of occlusal forces.
2. U-shaped groove. it characterized by thick rib
of metal, it provide more retention
3. Box shaped groove. used in case of proximal
caries and beside a solder joint .
 U-shaped Box-shaped
V-shaped
Generally, the retention gained from the
grooves depends on:
1- The length of the groove; the longer the groove the
more retention.
2-The position of the groove: more buccally placed
groove will give enough tooth structure lingual to the
groove which will resist the displacing forces.
3- the depth of the groove: u-shaped and box shaped
grooves give more retention than v-shaped grooves.

The choice which groove to be used depends on the tooth

size and amount of occlusal forces.
Retention by pinholes:
pinledge crown in maxillary incisor will be subjected to :
1- forces in inciso-gingival direction when the patient
bits on the retainer during occlusion
2- forces in bucco-lingual direction when biting on the
pontic.
Amount of tooth structure contacting the pins will resist
these forces, avoidance of over drilling of the pinholes is
a must.
Retention by ledges and indentation
Cutting lingual ledges as in case of pinledge crown will
resist tissue ward displacement.
Resistance form
Qualities or features given to the preparation to resist
,,.deformation or fracture of the restoration

Rigidity is the property of the material which make it more

resistance to deformation without fracture.
➢ cast gold alloys, minimum required space is 0.5mm
➢ base metal alloys, minimum required space is 0.3-0.5mm.
➢ Reduction of occlusal surface should follow the anatomical shape
of the cusps.
➢ Reduction of occlusal surface should give enough space to the
material to resist deformation

➢ Occlusal surface must be reduced up to 1-1.5mm to provide

sufficient rigidity of the restoration.
➢ Additional space should be given in functional cusps
by beveling to give more thickness of the crown.

➢ In upper posterior teeth, palatal cusps are the

functional cusps

➢ In lower posterior teeth, the buccal cusps are the

functional cusps.

More reduction is needed in full veneered crowns to

accommodate for the metal substructure and the
ceramic.
FUNCTIONAL CUSP BEVEL

Porcelain+metal
Prevention of tooth fracture:
In all cases of weakened tooth structure either
due to caries or previous failed restoration , it is
recommended to prepare the tooth for complete
coverage restoration, as it provide maximum
protection against fracture and tends to hold
cusps together.
Extension for protection
• The outline of the preparation should protect
the tooth structure from further destruction The
followings are required:-

➢Removal of all undermined enamel.

➢Onlay restoration rather than inlay in case of

weak cusps (height more than width ).
➢ Extensionof the out line into a self
cleaning area

➢ Tooth reduction should provide

sufficient room for bulk of metal at
the margin to prevent distortion.

➢ Supragingival margins &subgingival

margins.
 II-Biological Principles

Prevention Considerations
of Damage Conservation affecting
during of Tooth Future Dental
Tooth Structure Health
Preparation
1-Prevention of Damage during
Tooth Preparation

1- Adjacent teeth
2- Soft tissues
3- Pulp
 1- Adjacent teeth
Two techniques may be used to prevent the
damage to adjacent teeth during crown
preparation:
•The use of a metal matrix band around the
adjacent tooth for protection.
•The use of the proximal enamel of the tooth being
prepared for protection of the adjacent tooth.
Protect the adjacent tooth by matrix band and cut
inter-proximally by fine tapered diamond stone.
2- Soft tissues

Careful retraction to the tongue & cheeks must

be done with an aspirator tip, mouth mirror.
 3- Pulp
Causes of pulp injury:
1-Temperature
2- Chemical action
3- Bacterial action
4- Amount of dentine removed.
5- Morphology of pulp chamber & size
1-Temperature

▪Considerable heat is generated by friction

between a rotary instrument and the surface
being prepared.

▪The heat must be dissipated before it can cause

discomfort to the patient or damage to the pulp,
How?
1- Use of high-speed hand piece
2- Using light and intermittent pressure
touches during prep.
3- Prevention of the use of dull rotary
instruments.
4- Using water spray coolant during prep.
5- For grooves use low speed.
2- Bacterial action
➢ Either due to bacteria left behind or due to
micro-leakage
➢ Removal of all carious tooth structure is a
must before placing a restoration

3- Chemical action
➢ Certain dental materials e.g. (bases, luting
agents, solvents) may cause pulpal damage.
use (varnish)
➢ Using chemical cleaning agents is contra-
indicated → irreversible pulp damage.
 4- Amount of Dentine Removed.
The more closely the preparation approaches
the pulp, the greater is the degree of pulp
damage.

5- Morphology of Pulp Chamber & Size

The thickness of this layer of dentin will depend
upon the age of the patient and the type of the
preparation.
 Pulp size
decreases by
age.
 III-Biological Principles

Prevention of
Considerations
Damage during Conservation of
affecting Future
Tooth Tooth Structure
Dental Health
Preparation
 2-Conservation of Tooth Structure

As much as possible through the following

guidelines:
1-The use of Partial Coverage than Full
Coverage.
[Link]. with minimal degree of taper
[Link]. Reduction should follow the anatomic
planes to give uniform thickness
[Link] surface prep. should be uniform as

much as possible

[Link] uprighting of tilting abutment

[Link] unnecessary apical extension of prep.

[Link] of proper margin design.

The use of Partial than Full Coverage.
Minimal degree of taper
Avoid unnecessary apical extension of prep.
 III-Biological Principles

Prevention of
Considerations
Damage during Conservation of
affecting Future
Tooth Tooth Structure
Dental Health
Preparation
3-Considerations affecting Future Dental
Health
Improperly prepared tooth may have adverse effect
on long term dental health
➢ Insufficient axial reduction→ overcontoured
restoration→ plaque accumulation,
periodontal disease or dental caries.

➢ Inadequate occlusal reduction→ occlusal

dysfunction

➢ Poor margin placement→ chipped enamel

or cusp fracture
Considerations affecting Future Dental Health

1-Axial reduction

[Link] placement

[Link] adaptation

[Link] geometry

[Link] considerations
1- Axial reduction
Undercut

Over-convergence
 Adequate axial reduction will insure
adequate production of emergence profile
Emergence profile
The part of the axial contour that
extends from the base of the gingival
sulcus past the free margin of the
gingiva to the height of contour.
 2- Margin placement
As a rule the margin of the preparation should be
supra-gingivally whenever possible
Advantages
- located on hard enamel.
- Easy to prep. & to finish.
- Easy in taking impression.
- Easy to kept clean.
- Easy checking of the restoration at follow up.
- No trauma of the soft tissue.
Indications of subgingival finish line:

1- Cervical caries or cervical erosions

2- Subgingival restoration
3- Short clinical crown
4- Proximal contact extended to the gingival crest
5- Additional retention needed
6- For esthetics in anterior region
7- Root sensitivity
 3- Margin adaptation

Finish line must be

smooth , well defined,
continuous and
regular ( not stepped)
➢ The more accurately the margin of
restoration is adapted to the finish line.
: Lesser the chance for dissolution of luting
cement.
: Lesser possibility of recurrent caries and
periodontal diseases.
 4-Margin geometry
➢ The recommended finish line
should be not wider than
half the stone used to form
it.
➢ Gutter finish line (lip of
unsupported enamel)
Not recommended for indefinite
finish line

1- Not sufficiently distinct.

2- Minimal cervical tooth reduction results in
over contouring to provide adequate rigidity.
3- Inaccurate fit.
4-Not enough bulk for strength and esthetics of
restoration.
Not recommended for finish line at
gingival crest

➢ Margins are not usually placed at the

crest of. the gingiva.

➢ The margin is rough and harbors

bacteria which encourage recurrent
decay and periodontal disease.
 5- Occlusal considerations

-Insufficient clearance → leads to perforation

by wear or during finishing.
-Excessive reduction→ leads to impaired
retention due to reduced occluso-gingival
length.
Sometimes, violating the principle of
Conservation of tooth structure is
preferable
1-Prevention of tooth fracture
2 -Supra-erupted teeth or tilted teeth
Super Erupted Tooth
According to the amount of over eruption :
➢ Enamel only ► Enameloplasty + fluoride application.

➢ Enamel + Dentin ► Crown or Onlay .

➢ Enamel + Dentin + Pulp ►endo ttt + Crown

➢ Sever over eruption ►extraction.

 3-Tilted teeth
Correction of tilted teeth alignment during reduction
may require reduction of areas more than others as
path of insertion is determined perpendicular to the
occlusal plane.
Normal tooth alignment can
achieve common path of
insertion without over
reduction & endangering its
pulp.

Tilted tooth can't

achieve common path
of insertion without
over reduction
III- ESTHETIC CONSIDERATIONS
ESTHETIC CONSIDERATIONS
➢ The selected type of restoration should
meet the esthetic requirements of the
patient.
➢ Whenever possible those requirements
should be fulfilled with conservative
restorations. However this is not always
possible.
The esthetic restorations are:

1. Partial coverage restorations

2. All ceramic restorations

3. Metal ceramic restorations.

METAL-CERAMIC RESTORATIONS

➢ The poor appearance of some metal-ceramic

restorations is due to insufficient porcelain
thickness.
➢ Adequate porcelain thickness is sometimes
obtained at the expense of proper axial
contour.
➢ The labial margin of a metal-
ceramic crown is not always
accurately placed.
➢ Failure to record the proper color of
the adjacent tooth.

To correct all these deficiencies, certain

principles are recommended during
tooth preparation
 Over contoured ,
apparent metallic rim
at gingival finish line

Bad color
Esthetic principles in ceramo-metallic
preparation
Facial reduction:
➢ Insufficient tooth preparation that will lead to
insufficient room for porcelain thickness

A minimum reduction of 1.5 mm typically is

required for optimal appearance. Adequate
thickness of porcelain is needed to create a
sense of color depth and translucency.
Adequate porcelain thickness
Labial surface should be prepared in two distinct
planes.
Incisal Reduction:
➢ The incisal edge of a metal-ceramic restoration has no
metal backing and can be made with a translucency
similar to that of natural tooth structure.

➢ An incisal reduction of 2 mm is recommended for good

esthetics.

➢ Excessive incisal reduction must be avoided because it

reduces the resistance and retention form of the
preparation.
Labial Margin (finish line) Placement:
➢ Subgingival margins is indicated for esthetic reasons
➢ Metal collars can be hidden below the gingival crest,
although there will be some discoloration if the
gingival tissue is thin
➢ Margins should not be placed so far apically that
they encroach on the attachment.
➢ The margin should follow the contour
of the free gingiva
Partial coverage restorations:

➢ These are an esthetic restoration if properly

designed.
➢ The superior esthetic qualities depend on the
exact location of the facial and proximal
margins.
➢ The mesial margin is more critical esthetically
than the distal margin.
All ceramic restoration
Optimum esthetics is obtained through the following:

1- Sufficient amount of tooth reduction:

adequate thickness of ceramic to create a sense of color depth

and translucency.

➢ Incisal reduction of at least 2 mm:

-Excessive reduction will compromise length of preparation.

-Under reduction will compromise esthetics

AXIAL REDUCTION

➢ Plays an important role in securing space for an adequate

thickness of the restorative material.
➢ Inadequate axial reduction will have thin walls subject to
distortion or result in over contouring the axial surface which
could lead to periodontal problems.
INADEQUATE OCCLUSAL REDUCTION

➢ Makes the restoration weaker.

➢ will not provide adequate space to allow good
functional morphology under the anatomical
grooves.
➢ The restoration easily perforated by finishing
procedures or by wear in the mouth.
Thanks a lot