- Anesthetize
area.
- Take preliminary
impression.
- Remove all
defective amalgams and caries.
- Select gingival,
body and incisal shades of teeth to be restored (NOTE: Best accomplished
after old dark alloy is gone).
- Prepare teeth
as follows:
- reduce
facial, lingual and proximal surfaces a minimum of 1.2 mm
(1.5 mm is the minimum necessary for esthetic areas, i.e.,
the buccal aspect of the preparation).
- allow
for no more than 2.5 mm of occlusal reduction.
- all line
angles should be smooth and rounded.
- sharp
transitions, inner angles, undercuts or feather edges should
be avoided.
- insure
there is an adequate path of insertion.
- all gingival
margins should be butt shoulder with rounded axio-cervical
line angle. A chamfer preparation is possible as long as
a
mechanical support is guaranteed, particularly when used
with reduced tooth structure (e.g., after repeated crowning).
- flat
chamfers, shoulder preparations with angles greater than
100º,
tangential preparations and bevels of the preparation limit
are contraindicated.
- It is necessary
to place a proximal box in the preparations adjacent to the edentulous
space, to allow bulking of the framework at the axio/occlusal
line angle.
- Use the preliminary
impression to fabricate a well-fitting custom temporary restoration.
- Take final
impression with Panasil vinyl polysiloxane or similar impression
material.
- Secure an
adequate interocclusal record.
- Cement temporary
restoration.
- Prepare detailed
lab prescription with details of nature of opposing teeth, age
of patient, surface occlusal stain required, etc.
|
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Ideal
3-Unit Bridge Preparation |
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Ideal
Posterior Preparation (Full Circumferential
Shoulder 90° - 120°) |
|
RECOMMENDED
PREPARATION LIMITS:
 |
 |
Chamfer
preparation (with reduced mechanical
support of the crown). Particularly used with
reduced substance (e.g. after repeated crowning) |
Contraindicated:
flat chamfers, shoulder preparations with angles >100°, tangential
preparations and bevels of the preparation limit
Common Preparation
Errors:
1. Insufficiently
defined and finished preparation margins.
- uneven preparation
limit (so-called gutter preparation, vertical unevenness)
- irregular marginal
reduction of layers (horizontal unevenness)
- wrong shape of
preparation limit
- unnecessarily deep
subgingival preparation
- preparation in
the root dentin
2. Poorly controlled
tooth reduction
- not following proper
reduction guidelines, therefore not allowing sufficient porcelain for
ceramic vitality.
- insufficient reduction
at the palatal side of the upper anterior teeth (malfunctional occlusion)
- excessive taper
Reprinted with
permission of Vident. In-Ceram is a registered trademark of Vita Zahnfabrik.
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