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At least 19 recordsLinked to original sources
PubMed2002

Influence of different convergence angles and tooth preparation heights on the internal adaptation of Cerec crowns.

STATEMENT OF PROBLEM: Because of an imagining principle called active triangulation in the Cerec system, a shadow is cast distal to the illuminated objects. This distal shadow may be enlarged when the occlusal-cervical height of the prepared tooth is increased. Depth data of the shadow are unreliable, so the internal fit of Cerec crowns has been questioned. PURPOSE: This study evaluated the influence of different convergence angles and tooth preparation heights on the internal adaptation of Cerec crowns. MATERIAL AND METHODS: Tooth preparations were made on typodont teeth with different combinations of convergence angles and occlusal-cervical heights: Group I = 20 degrees angle, 6 mm height; Group II = 20 degrees angle, 4 mm height; Group III = 12 degrees angle, 6 mm height; and Group IV = 12 degrees angle, 4 mm height. Ten Cerec crowns were fabricated for each type of tooth preparation. Measurements of the internal fit were performed with the cement space replica technique and an image analysis system. Three-way analysis of variance was used to analyze the differences in cement space with different tooth preparations and the number of times that milling tools were used to prepare the Cerec crowns (P<.05). Multiple comparisons were made to evaluate differences between groups (P<.0083). RESULTS: Cerec crowns with a 12 degrees convergence angle demonstrated the best internal fit (cement space in Groups III and IV = 121 +/- 41 microm and 115 +/- 42 microm, respectively). The difference between the 2 convergence types was within the range of the scanning error (25 microm) produced by the Cerec camera. The number of times that milling tools were used had no significant effect on internal fit (P=.78). Tooth preparation height equal to or shorter than 6 mm occlusal-cervically with both 12 degrees and 20 degrees convergence angles also had no significant effect on internal fit (P>.0083). Cement space at distal walls (185 +/- 28 microm) was the thickest among all axial walls (P=.0001) and was twice as thick as that at the facial (90 +/- 14 microm) and palatal walls (92 +/- 15 microm). CONCLUSION: Within the limitations of this study, there was little difference in the internal fit of Cerec crowns prepared with convergence angles of 12 degrees and 20 degrees. Distal shadows influenced the thickness of the cement spaces, particularly at the distal walls. However, tooth preparations with an occlusal-cervical height not greater than 6 mm did not exaggerate the effect of the distal shadows.

Algorithms↗
PubMed1997

Enamel subsurface damage due to tooth preparation with diamonds.

In clinical tooth preparation with diamond burs, sharp diamond particles indent and scratch the enamel, causing material removal. Such operations may produce subsurface damage in enamel. However, little information is available on the mechanisms and the extent of subsurface damage in enamel produced during clinical tooth preparation. The aim of this study, therefore, was to investigate the mechanisms of subsurface damage produced in enamel during tooth preparation by means of diamond burs, and to examine the dependence of such damage on enamel rod orientation, diamond particle size, and removal rate. Subsurface damage was evaluated by a bonded-interface technique. Tooth preparation was carried out on two enamel rod orientations, with four clinical diamond burs (coarse, medium, fine, and superfine) used in a dental handpiece. The results of this study showed that subsurface damage in enamel took the form of median-type cracks and distributed microcracks, extending preferentially along the boundaries between the enamel rods. Microcracks within individual enamel rods were also observed. The median-type cracks were significantly longer in the direction parallel to the enamel rods than perpendicular to the rods. Preparation with the coarse diamond bur produced cracks as deep as 84 +/- 30 microns in enamel. Finishing with fine diamond burs was effective in crack removal. The crack lengths in enamel were not significantly different when the removal rate was varied. Based on these results, it is concluded that subsurface damage in enamel induced by tooth preparation takes the form of median-type cracks as well as inter- and intra-rod microcracks, and that the lengths of these cracks are sensitive to diamond particle size and enamel rod orientation, but insensitive to removal rate.

Dental Enamel↗
PubMed2004

Training in tooth preparation utilizing a support system.

Tooth preparation is an essential technique for dental treatment, but it is a skill not easily learned by a dental student. To facilitate this leaning process, a new tooth preparation support system with a parallel link mechanism was developed. This study reports the educational efficiency of this system for dental students. Dental students with no experience in clinical practice were selected and divided into two groups; one trained with this support system; and the other, with freehand preparation. They prepared axial walls in right maxillary second premolars and molars mounted in a phantom manikin with an air-turbine handpiece. Convergence angles of the axial walls and parallelisms between axes of prepared teeth were evaluated. Training with the support system led to significantly smaller convergence angles and parallelisms as compared with freehand preparation training. With the freehand preparation after training, the convergence angles and parallelisms became smaller in the group trained with the support system than those trained with freehand. The above findings suggest that training in tooth preparation utilizing the newly developed support system can be one of practical programs that are useful for dental students to achieve greater competency in tooth preparation.

Bicuspid↗
PubMed1999

Assessment of tooth preparation designs for posterior resin-bonded porcelain restorations.

Tooth preparation designs advocated for posterior resin-bonded porcelain restorations were evaluated for clinical application. This study examined the design of tooth preparations from stone dies for individual posterior resin-bonded porcelain onlays and complete porcelain crowns placed in a specialist practice, and compared features that provided retentive and porcelain fracture-resistance with those in the dental literature. Stone dies of tooth preparations for 57 onlay and 46 crown preparations were provided. Measurements were recorded for the tooth preparations with the aid of interocclusal silicone impressions. Proximal boxes, grooves and occlusal steps resulting from removal of amalgam restorations were common. These retentive features were more evident with onlays, and appeared larger on the distal than the mesial surfaces. Internal tooth preparation tapers or convergence angles were frequently greater than 20 degrees, leading to relatively-wide occlusal isthmus widths, especially for onlays. There were wide variations in occlusal surface reductions for the central fossae and supporting cusps. Tapers for tooth preparations were frequently more extensive, and occlusal surface reductions were often less than recommended. The implications of these differences for long-term clinical success should be resolved.

Adult↗
PubMed2004

PREPassistant: a system for evaluating tooth preparations.

Learning the widely differing forms of tooth preparation, especially in restorative dentistry, places high demands on both trainees and instructors with regard to precision, reproducibility, assessment, evaluation and three-dimensional conceptualization. In the past, evaluation of such preparations has been against subjective parameters and their interpretation by the assessor (usually the instructor). The use of CAD systems in teaching seminars and courses allows an objective assessment of tooth preparations and offers the trainee the possibility of measuring him/herself against a standard, of detecting errors, and of achieving perfection in the required tasks. The PREPassistant system described in this article is one such CAD-assisted learning system. It is recommended both for students in dental schools and for the continuing education of established dentists. Its strengths are that it produces a design for a tooth preparation, enables exact comparison with an ideal preparation, detects errors, and promotes improvements and perfection.

Computer Systems↗
PubMed2004

[Clinical evaluation of two tooth preparation methods of metal-porcelain restoration].

OBJECTIVE: To evaluate the clinical performance of the two configurations of gingival margin preparation of tooth. METHODS: The cases in this study were divided into two groups according to different tooth defects. Each group consisted of 40 cases. One group's gingival margin configuration was 90 degree shoulder, the other was under-gingival non-shoulder. The clinical performance of these restorations was followed up for 1 year and 2 years. The evaluators examined the restorations for plaque index, gingival index, marginal discolor and marginal fit. RESULTS: There was no significant difference in the evaluators between the two groups. CONCLUSION: The under-gingival non-shoulder margin configuration of porcelain fused to metal should be used for clinical application compared with the 90 degree shoulder one in certain circumstance.

Dental Porcelain↗
PubMed1980

Periodontal considerations in tooth preparation for crowns and bridges.

Correct tooth preparation and adequate reconstruction of the anatomy of the crown are essential to the maintenance and preservation of a healthy periodontium. Adequate tooth preparation requires careful attention to many details and clear knowledge of the features of the finished product. The anatomic reconstruction of the crown with a perfect marginal adaptation will provide an adequate environment for maintaining the health of surrounding periodontal tissues.

Crowns↗
PubMed2001

Variations in tooth preparations for resin-bonded all-ceramic crowns in general dental practice.

OBJECTIVE: To investigate variations in tooth preparations for resin-bonded all-ceramic crowns (RBCs) in general dental practice (GDP). DESIGN: Laboratory-based retrospective analysis of dies for RBCs. SETTING: General dental practices in the UK and Ireland (2000). METHODS: A sample (n = 132) of laboratory models containing 180 tooth preparations for RBCs, featuring work from different general dental practitioners was obtained from four commercial dental laboratories. Aspects of the preparations were quantified and compared with accepted criteria defined following a review of the literature. RESULTS: The teeth found to be most frequently prepared for RBCs were maxillary incisors (41%). Margin positions were variably positioned with 29% of the preparations on the buccal aspect having subgingival margins. There were many tooth preparation dies for low fusing RBCs (47%) and Chameleon Fortress RBCs (62%) demonstrating overpreparation in the mesiodistal plane. The majority of the margins (84% buccally and 79% lingually) of the dies examined exhibited appropriate shoulder or chamfer finishes. Of the Chameleon Fortress preparations analysed, 86% had been underprepared occlusally. 42% of the teeth had been prepared with no regard to tooth morphology and demonstrated just one plane of reduction. The majority (93%) of the clinicians failed to provide any information regarding the shade of the prepared tooth stump. CONCLUSIONS: On the evidence of this survey of this sample of general dental practitioners' work, it was found that relevant guidelines for the preparations of RBCs are not being fully adhered to.

Crowns↗
PubMed2001

Tooth preparations for complete crowns: an art form based on scientific principles.

STATEMENT OF THE PROBLEM: No recent literature has reviewed the current scientific knowledge on complete coverage tooth preparations. PURPOSE: This article traces the historic evolution of complete coverage tooth preparations and identifies guidelines for scientific tooth preparations. MATERIAL AND METHODS: Literature covering 250 years of clinical practice was reviewed with emphasis on scientific data acquired during the last 50 years. Both a MEDLINE search and an extensive manual search were used to locate relevant articles written in English in the last 50 years. RESULTS: Teeth should be prepared so that they exhibit the following characteristics: 10 to 20 degrees of total occlusal convergence, a minimal occlusocervical dimension of 4 mm for molars and 3 mm for other teeth, and an occlusocervical-to-faciolingual dimension ratio of 0.4 or greater. Facioproximal and linguoproximal line angles should be preserved whenever possible. When the above features are missing, the teeth should be modified with auxiliary resistance features such as axial grooves or boxes, preferably on proximal surfaces. Finish line selection should be based on the type of crown/retainer, esthetic requirements, ease of formation, and personal experience. Expectations of enhanced marginal fit with certain finish lines could not be validated by recent research. Esthetic requirements and tooth conditions determine finish line locations relative to the gingiva, with a supragingival location being more acceptable. Line angles should be rounded, and a reasonable degree of surface smoothness is desired. CONCLUSIONS: Nine scientific principles have been developed that ensure mechanical, biologic, and esthetic success for tooth preparation of complete coverage restorations.

Bicuspid↗
PubMed1998

Temperature response in the pulpal chamber during ultrahigh-speed tooth preparation with diamond burs of different grit.

STATEMENT OF PROBLEM: Ultrahigh-speed tooth preparation can traumatize the hard dental tissues and the dental pulp. PURPOSE: This in vitro study examined the relationship between different grits of diamond burs on the temperature response within a pulpal chamber during tooth preparation with a turbine. MATERIAL AND METHODS: Newly extracted, undamaged third molars were secured by a rapid-tensioning device mounted on an air-supported slide. NiCrNi thermocouples were inserted apically and used to determine the temperature within a pulpal chamber. The grinding tests used cylindrical fine, coarse, and ultracoarse diamond burs. RESULTS: The maximal temperature elevation within the pulp was 3.2 degrees C, and the most pronounced rise in temperature occurred with ultracoarse burs. Temperature increases in the pulpal chambers and grinding times or temperatures of the cooling water were approximately proportional. Residual dentinal thickness was inversely proportional to temperature elevation within the pulpal chamber. CONCLUSIONS: This study demonstrated that coarse diamond burs resulted in more pronounced temperature increases within the pulpal chamber during tooth preparation. In addition, the benefit of short intervals between grinding steps and a cooling water temperature between 30 degrees C and 32 degrees C was confirmed. A cooling temperature of 38 degrees C to 43 degrees C did not afford actual cooling.

Body Temperature Regulation↗
PubMed2003

[The effect of tooth preparation design on the CAD/CAM all-ceramic coping crown's fitness].

OBJECTIVE: To study the effect of tooth preparation design on fitness of CAD/CAM all-ceramic coping crown. METHODS: The tooth preparation comprised 2 types of occlusal convergence (10 degrees, 20 degrees), 2 margin forms (shoulder, chamfer). The MC coping were milled by Cerec 2 CAD/CAM system, cemented, embedded, sectioned, and measured at 10 sites to obtain the data of margin, shoulder, axial surface, occlusal surface fitness. RESULTS: The coping's fitness was influenced by convergence angle and margin form. The coping's fitness was very nice (101.7 approximately 127.9) microm when the coping with 20 degrees occlusal convergence angle. Those coping with 20 degrees occlusal convergence and chamfer margin in tooth preparation provided the best fitness, its cement film thickness in margin was (40.1 +/- 11.8) microm. CONCLUSIONS: The 20 degrees occlusal convergence and chamfer margin can be used for CAD/CAM all-ceramic crown in clinical application.

Computer-Aided Design↗
PubMedDate not supplied

The effects of tooth preparation on pressure measured in the pulp chamber: a laboratory study.

PURPOSE: The purpose of this study was to determine pressure changes in the pulp space during tooth preparation with either diamond or tungsten carbide burs in a high-speed dental handpiece in the laboratory. MATERIALS AND METHODS: Twenty premolar teeth were collected and randomly assigned to two groups: group 1 received preparation with diamond burs and group 2 with tungsten carbide burs. The teeth were mounted on a pressure transducer and the pulp chambers were filled with saline. A 0.1-mm thickness of tooth tissue was removed from the proximal surface of each tooth, alternating dry and wet cutting, until the pulp chamber was exposed. Pressure and temperature changes were recorded during tooth preparation. RESULTS: At 0 to 1 mm of remaining dentin depth dry cutting with diamond and tungsten carbide burs generated a mean positive pulpal pressure of 12 kPa and 6 kPa, respectively. Wet cutting under the same conditions produced 0.6 kPa and 0.15 kPa, respectively. The difference between wet and dry cutting was highly significant (P < 0.001). Diamond burs produced significantly higher pressure increases than carbide burs at all levels for both wet and dry techniques (P < 0.05). When cutting farther than 2 mm from the pulp, tooth preparation created a mean 0.09-kPa pressure increase, which was not influenced by either coolant use or bur type. The temperature change was minimal during wet cutting and only minor temperature increases were recorded during dry cutting. CONCLUSION: From this laboratory study it is concluded that significant pressure changes occur in the pulp chamber during tooth preparation of extracted teeth when the remaining dentin thickness is less than 2 mm.

Body Temperature↗
PubMed2007

Sequential expression of endothelial nitric oxide synthase, inducible nitric oxide synthase, and nitrotyrosine in odontoblasts and pulp cells during dentin repair after tooth preparation in rat molars.

Nitric oxide (NO) stimulates osteoblast differentiation, but whether NO contributes to odontoblast differentiation during dentin repair is unknown. By using reverse transcription/polymerase chain reaction and immunostaining, we investigated the gene expression and/or immunolocalization of endothelial NO synthase (eNOS), inducible NOS (iNOS), and nitrotyrosine (a biomarker for NO-derived peroxinitrite), and alkaline phosphatase (ALP) and osteocalcin (early and terminal differentiation markers of odontoblasts, respectively) in dental pulp tissue after rat tooth preparation. At the early stage (1-3 days) post-preparation, markedly increased expression of iNOS and nitrotyrosine was found in odontoblasts and pulp cells beneath the cavity, whereas eNOS expression was significantly decreased. ALP mRNA expression was significantly increased after 1 day but decreased after 3 days, whereas ALP activity was weak in the dentin-pulp interface under the cavity after 1 day but strong after 3 days. Osteocalcin mRNA expression was significantly increased at this stage. At 7 days post-preparation, tertiary dentin was formed under the cavity. All the molecules studied were expressed at control levels in odontoblasts/pulp cells beneath the cavity. These findings show that abundant NO is released from odontoblasts and pulp cells at an early stage after tooth preparation and indicate that, after tooth preparation, the up-regulation of iNOS and nitrotyrosine in odontoblasts is synchronized with increased cellular expression of ALP and osteocalcin. Therefore, the NO synthesized by iNOS after tooth preparation probably participates in regulating odontoblast differentiation during tertiary dentinogenesis.

Alkaline Phosphatase↗
PubMed2004

The effectiveness of auxiliary features on a tooth preparation with inadequate resistance form.

STATEMENT OF PROBLEM: No study has evaluated the efficacy of auxiliary tooth preparation elements for crowns with originally reduced resistance form. PURPOSE: This study evaluated the effects of different auxiliary preparation features on the resistance form of crowns with reduced axial wall and total occlusal convergence. MATERIAL AND METHODS: An Ivorine tooth was prepared on a milling machine with 20-degree total occlusal convergence (TOC), 2.5 mm of occlusocervical dimension, and a shoulder finish line. This design lacked geometric resistance form. The crown preparation was subsequently modified to include mesiodistal grooves, mesiodistal boxes, buccolingual grooves, occlusal inclined planes, an occlusal isthmus, and reduced TOC in the axial wall from 20 to 8 degrees TOC in the cervical 1.5 mm of the axial wall. The grooves and boxes were placed into the tooth with the same 20-degree TOC as the initial axial walls. Ten standardized metal dies were used for each preparation design. Standardized complete metal crowns were fabricated for all specimens. The metal crowns were cemented on metal dies with resin-modified glass ionomer cement. A strain gauge was placed at the mid-lingual cervical area of each crown preparation margin. The resistance of each specimen was evaluated when force was applied at a 45-degree angulation to the long axis of the die in a lingual to buccal direction. The peak loads during crown dislodgment, as well as the tensile stress at the mid-lingual cervical area, were measured using a universal testing machine (Kgs) for each specimen. The control group consisted of 10 dies, with the original crown preparation having no geometric resistance form and no auxiliary preparation features. Strain gauges provided the force (Kgs) that resulted in electric currency disrupt at the crown/die interface, thus providing data regarding the force required for slight crown micromovement (2 microm). Data between control and experimental groups were compared using the Mann-Whitney U test (alpha=.05). RESULTS: Proximal grooves, proximal boxes, buccolingual grooves, occlusal inclined planes, and occlusal isthmuses were not effective at increasing a crown's resistance to dislodgement when the tooth preparation lacked resistance. The only crown modification that offered enhanced resistance form when compared with the control group was the reduced TOC in the cervical half of the axial wall. CONCLUSION: Within the limitations of this in vitro study the crown preparation modification that significantly enhanced the resistance form of a compromised tooth preparation was reducing the TOC at the cervical aspect of the axial wall. Placing auxiliary retentive features such as grooves and boxes into a compromised tooth preparation (2.5 mm occlusocervical dimension and 20-degree TOC) was not effective when these retentive features possessed the same 20-degree TOC as the prepared axial walls.

Cementation↗