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At least 19 recordsLinked to original sources

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

Effect of tooth preparation design on bond strengths of resin-bonded prostheses: a pilot study.

STATEMENT OF PROBLEM: The success rate of resin-bonded fixed partial dentures is directly related to the adhesive system and the tooth preparation design for good retention. PURPOSE OF STUDY: This in vitro study evaluated the effect of various tooth preparation designs on the bond strength of retainers for adhesive fixed partial dentures. MATERIAL AND METHODS: Molar teeth were prepared in the conventional form or with occlusal coverage and opposing grooves and retainers were silicoated and bonded to etched enamel by a bis-glycerol methacrylate adhesive. Bond strengths were determined after water storage and thermocycling. RESULTS: The least mean bond strength was recorded for the conventional form of tooth preparation (p < 0.05). CONCLUSION: A combination of 180-degree opposing groove placement at line angles "wraparound" and occlusal coverage resulted in the greatest bonding values.

Analysis of Variance↗

Effects of the temperature of cooling water during high-speed and ultrahigh-speed tooth preparation.

In vitro measurements of heat production in the pulp chamber during tooth preparation were performed on intact third molars. The experiments were designed to simulate physiologic temperature conditions in the tooth and oral cavity and to standardize parameters of tooth preparation. Two drive systems, the turbine and the high-speed angle, were compared by using two ranges of cooling water temperature. The critical temperature of 41 degrees C to 42 degrees C that is irreversibly harmful to pulpal tissue was not reached with a cooling water temperature of 30 degrees C to 34 degrees C. Because the temperature elevation during turbine preparation was dependent on the diminishing thickness of remaining dentin, in preparing teeth close to the pulp, a high-speed angle was advantageous.

Dental Cavity Preparation↗

Comparison of resin-bonded prosthesis groove parallelism with the use of four tooth preparation methods.

STATEMENT OF PROBLEM: A precise preparation is required to develop resistance form resulting in mechanical stability of the framework for resin-bonded prostheses (RBPs). PURPOSE: The effects of 4 methods of tooth preparation (freehand, guiding pin, extraoral parallelometer, and intraoral parallelometer) on the deviation of proximal grooves from a preestablished path of insertion (guide planes) were investigated under clinical conditions. MATERIAL AND METHODS: Tooth preparation of proximal grooves was performed by 32 dentists on resin substitutes of posterior segments intraorally with a single test patient. A Latin-square randomized cross-over design was selected as the experimental design. RESULTS: The significant least angular deviation of proximal grooves from path of insertion was achieved with an intraoral parallelometer (mean +/- SD 3.15 +/- 1.67 degrees). Compared with freehand tooth preparations (4.37 +/- 2. 11 degrees), neither use of a guiding pin (4.10 +/- 1.62 degrees) nor an extraoral parallelometer (5.06 +/- 2.33 degrees) improved the results. CONCLUSION: Divergence of guiding grooves from path of insertion was reduced with the use of an intra-oral parallelometer. This should improve mechanical stability of posterior RBPs.

Acrylic Resins↗

[Guided impression in tooth preparation for the application of full veneer crowns].

In this study the authors emphasize the importance of the guiding impression for checking the depth of the tooth preparation for full veer crowns. For this purpose they took two impressions in heavy-body silicone before any tooth preparation was made. One of these impressions was cut from the buccal to the lingual aspect across the middle of the imprint of the tooth to be prepared. The other one was cut horizontally in a cervical and an occlusal half. We kept and repositioned from time to time over the preparation in order the distal half of the first impression and the cervical half of the second one to check for the adequate tooth reduction. This method of checking the tooth reduction is useful especially for undergraduates and young practitioners and has better results than the articulation paper.

Crowns↗

[A study on tooth preparation by means of the newly developed parallelometer and its educational effect, with primary regard to convergence angles of abutment tooth].

Proper tooth preparation is one of the fundamental requirements in crown & bridge prosthodontics. However, it is difficult for students in particular to prepare adequate convergence angles of abutment tooth in the limited environment of patient's mouth. Therefore, the parallelometer was developed to improve the preparations as a supplementary device which informs the person by a signal of alarming simultaneously when a bur is not properly installed to convergence angles of abutment tooth. Sixty subjects were selected from students of Kanagawa Dental College and they were divided into two groups (A and B) to prepare abutment tooth of lower right 1st molar for full cast crown on typodont mounted into the manikin. A preliminary training was performed for once without the parallelometer for group A and with it for group B prior to a comparative experiment. The following results were obtained with primary regard to convergence angles of abutment tooth. 1. Related to each of four convergence angles, group B is superior to group A in all mean values with a statistical significance (P less than 0.01). 2. Related to a total of four convergence angles by the maximum number of subjects, group B is also superior to group A in a mean value by about ten degrees. 3. A newly developed parallelometer proved to be an efficient supplementary device for training of students to master a technique of preparation for adequate abutment tooth.

Crowns↗