1. FUNDAMENTALS IN TOOTH
PREPARATION
By- Priyesh Kharat

2. DEFINITION OF TOOTH PREPARATION

Tooth preparation is the mechanical alteration of a
defective, injured, or diseased tooth to receive a
restorative material that re-establishes a healthy
state for the tooth, including esthetic corrections
where indicated and normal form and function.

3. OBJECTIVES OF TOOTH PREPARATION
Remove all defects and provide necessary
protection to the pulp
 (2) extend the restoration as conservatively as
possible,
 (3) form the tooth preparation so that under the
force of mastication the tooth or the restoration or
both will not fracture and the restoration will not
fracture & the restoration will not displaced, and
 (4) allow for the esthetic and functional placement
of a restorative material.


4. TOOTH PREPARATION TERMINOLOGY
Tooth preparation walls
 Internal wall –An internal wall is prepared surface
that does not extend to external tooth surface.


Axial Wall - An axial wall is an internal wall parallel
with the long axis of the tooth

Pulpal Wall- A pulpal wall is an internal wall that is
perpendicular to the long axis of the tooth and
occlusal of the pulp.

5. 


External Wall- An external wall is a prepared (cut) surface
that extends to the external tooth surface. Such a wall
takes the name of the tooth surface (or aspect) that the
wall is toward
.
Floor (or Seat)- A floor (or seat) is a prepared wall that is
reasonably flat and perpendicular to the occlusal forces
that are directed occlusogingivally (generally parallel to
the long axis of the tooth Examples are the pulpal and
gingival walls.

Enamel Wall- The enamel wall is that portion of a
prepared external wall consisting of enamel

Dentinal Wall- The dentinal wall is that portion of a
prepared external wall consisting of dentin, in which
mechanical retention features may be located.

7. TOOTH PREPARATION ANGLES
Line angle. A line angle is the junction of two planal
surfaces of different orientation along a line
 An internal line angle is a line angle whose apex
points into the tooth
 An external line angle is a line angle whose apex
points away from the tooth


Point angle – a point angle is the junction of three
planal surface of different orietation

8. CLASSIFICATION OF TOOTH PREPARATION
Class I Restoration
 All pit rand-fissure restoration are class I and they are
assigned to three groups.
 Restoration on Occlusal Surface of Premolars &
Molars.
 Restorations on Occlusal Two Thirds of the Facial and
lingual surfaces of Molars.
 Restoration on lingual Surface of Maxillary Incisor



class II Restorations.
Restorations on Proximal surface of posterior teeth
are Class II

9. Class III Restorations
 Restorations on the proximal surface of anterior teeth
that do not involve the incisal angle are Class III.

Class IV Restoration Restorations on the proximal surfaces of anterior teeth
that do involve the incisal edge are class IV

Class V Restorations
 Restoration on the gingival third of the Facial or lingual
surface of all teeth( except pit-and-fissure lesions) are
Class V

Class VI Restorations Restorations on the incisal edge of anterior teeth or the
occlusal cusp height of posterior teeth are class VI


10. INITIAL AND FINAL STAGES OF TOOTH
PREPARATION
Initial tooth preparation stage
 Step 1: Outline form and initial depth
 Step2 Primary resistance form
 Step3 Primary retention form
 Step4 Convenience form

Final tooth preparation stage
 Step 5 Removal of any remaining infected dentin or old
restorative material (or both), if indicated
 Step 6: Pulp protection, if indicated
 Step 7: Secondary resistance and retention forms
 Step 8: Procedures for finishing external walls
 Step 9: Final procedure--cleaning, inspecting sealing


11. INITIAL TOOTH PREPARATION STAGE

Initial tooth preparation is the extension and initial
design of external walls of preparation at a specified
limited depth so as to provide access to the caries or
defect, reach sound tooth Structure, resist fracture of
the tooth restorative material from masticatory forces
principally directed with the long axis of the tooth,and
retain the restorativc material in the tooth .

12. STEP 1: OUTLINE FORM AND INITIAL DEPTH
Def Establishing the outline form means(1) placing the
preparation margins in the positions they will
occupy in the final preparation except for Finishing
enamel walls and margins and (2) preparing an
initial depth of 0.2 to 0.8 mm pulpally of the DEJ
Postion or root-surface position


13. PRINCIPLES:(1) all friable or weakened enamel should be
removed

(2) all faults should be included and

(3) all margins should be in a position to afford
good finishing of the margin of the restoration.

14. FEATURES…
1) Preserving cuspal strength
 2) preserving marginal ridge strength
 3) Minimizing faciolingual extension
 4) using enamelopasty
 5) Connecting two close faults or tooth preparation
 6) Restricting the depth of the preparation into
dentin to a maximum of 0.2mm for pit & fissure
caries and 0.2 to 0.8 mm for axial wall of smooth
surface caries.


15. STEP 2. PRIMARY RESISTANCE FORM
Def: Primary Resistance form may be defined as the
shape and placement of preparation walls that best
enable the restoration and the tooth to withstand,
without Fracture, masticatory forces delivered
principally in the long axis of the tooth.


16. PRINCIPLE__
1) to use the box shape with a relativity flat floor
which helps the tooth resist occlusal loading by
virtue of being at right angles to the forces of
mastication that are directed in the long axis of the
tooth
 2) to restrict the extension of the external walls to
allow strong cusp and ridge areas to remain with
sufficient dentin support
 3) to have a slight rounding of internal line angles
to reduces stress concentration in tooth structure


17. 
4) to cap weak cusps and envelope

5) to provide enough thickness of restorative
material to prevent its Fracture under load and

6) to bond the material to tooth structure when
appropriate.

18. FEATURES:
1) Relatively flat floors

2) Box shape

3) Inclusion of weakened tooth structure

4) Preservation of cusps & marginal ridges

5) Rounded internal line angles

6) Adequate thickness of restorative material

7) Reduction of cusps for capping when indicated

20. STEP3: PRIMARY RETENTION FORM

Def:-

Primary Retention form is the shape or form of the
conventional preparation that resists displacement
or removal of restoration by tipping or lifting forces.

22. STEP4: CONVENIENCE FORM.

Convenience form is the shape or form of
preparation that provide for adequate observation,
accessibility and ease of operation in preparing &
restorating the tooth.

23. STEP 5: REMOVAL OF ANY REMAINING ENAMEL PIT
OR FISSURE, INFECTED DENTIN, OR OLD
RESTORATIVE, IF INDICATED.

Removal of any remaining enamel pit or fissure
infected dentin, or old Restorative material is the
elimination of any infected carious tooth Structure
or faulty restorative material left in the tooth after
initial tooth preparation .

24. ANY REMAINING OLD RESTORATIVE MATERIAL SHOULD
BE REMOVED IF ANY OF THE FOLLOWING CONDITIONS
ARE PRESENT_- _
1) The old material may affect negatively the esthetic
result of the new restoration.
 2) the old material may compromise the amount of
anticipated needed retention.
 3) Radiographic evidence indicates caries is Under the
old material.
 4) The tooth pulp was symptomatic preoperatively or
 5) The periphery of the remaining old restorative
material is not intact.


25. STEP 6: PULP PROTECTION, IF INDICATED

The reason for using traditional liner or bases is to
protect the pulp or to aid pulpal recovery or both.
Other pulpal irritants that affect operative procedure
are: 1) Some ingredients of various materials
 2) thermal changes conducted through restorative
materials,
 3) force transmitted through materiel to the dentin
 a) Galvanic shock and most importantly
 5) The ingress of noxious products & bacteria through
microleakage.


26. Liners also may provide
 1) A barrier that protects the dentin from noxious
agents from restorative material oral fluids
 2) Initial electrical insulation
 3) Some thermal protection

Ex- of bases include zinc phosphate, zinc oxide
eugenol calcium hydroxide, polycarboxylate &
glass ionomer

27. STEP 7… SECONDARY RESISTANCE &
RETENTION FORMS
The secondary retention and resistance form are of
two types…
 1) Mechanical preparation feature
 Retention locks, Grooves & Coves.
 Groove Extensions, Skirts
 Beveled Enamel Margins.
 Pins, Slots, Steps, Amalgampins..
 2) treatments of preparation walls with etching,
priming &adhesive materials.
 Enamel Wall Etching
 Dentin Treatment .


28. STEP 8: PROCEDURE FOR FINISHING THE
EXTERNAL WALLS
Finishing the preparation wall is the further
development, when indicated, of a specific Cavo
surface design & degree of smoothness or
roughness that produces the maximum
effectiveness of he restorative material being used.
 Objectives:  1) create the best marginal seal possible between
the restorative material and the tooth strcture.
 2)afford a smooth marginal junction and
 3) provide maximal strength of the tooth & the
restorative material at & near the margin


29. FEATURES1) the design of the cavosurface angle &
 2) The degree of smoothness or roughness of wall.

. Cavosurface angle of 90° produces maximal.
Strength for the amalgam & the tooth. No bevels an
placed at the cavosurface margin.
 Beveling can serve useful purpose in tooth
preparation
 1) It produces a strong enamel margin
 2) If permits a marginal seal in slightly undersized.
Casings.


30. STEP. 9: FINAL PROCEDURE: CLEANING,
INSPECTING. & SEALING

The usual procedure in cleaning is to free the.
Preparation of visible debris with warm water from
the syringe & then to remove the visible moisture
with a few light surges of air from the air syringe .

31. THANK YOU