2016-10-01

Class 2016/ 2017

Preparations for Partial

coverage Restorations
For the level 4 DELTA UNIVERSITY students

By Dr.
Mohamed H. Ghazy
September 24, 2016

Tooth
preparation

extracoronal

Full
coverage

Partial
coverage

intracoronal

Inlays
onlays

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THE PARTIAL COVERAGE CROWN

(PARTIAL COVERAGE RESTORATION)

An extra-coronal metal restoration

that covers only part of the clinical
crown.
It generally includes all tooth surfaces
except the buccal or the labial wall in
the preparation.
Bucco-ligual
displacement
of
the
restoration is prevented by internal
features (e.g. proximal boxes and
grooves).

TYPES OF PARTIAL COVERAGE

CROWNS:
For

posterior teeth:

Three-quarter,
modified
threequarter, seven-eights, and half
crowns.

For

anterior teeth:

Three-quarter,
pinledges.

MacBoyle,

and

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THE PARTIAL COVERAGE CROWN

Indications:
For posterior teeth:
1. Restore posterior teeth if the buccal wall is intact
and well supported by sound tooth structure.

2. When restoration or alteration of the occlusal

surface is needed.

3. They can be used as a retainers for an FDP.

THE PARTIAL COVERAGE CROWN

Indications:
For anterior teeth:
1- Rarely suitable for restoring damage teeth but they can be used as a retainers for
FDP, to reestablish anterior guidance and to splint teeth.

2- They are suitable for teeth with sufficient bulk because they can accommodate
the necessary retentive features.

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THE PARTIAL COVERAGE CROWN

Contraindications:
1. Short clinical crown because retention may not
be adequate.
2. As a retainer for long-span FDP
3. Rarely suitable for endodontically treated
anterior teeth because insufficient supporting tooth
structure remain for the retentive features.
4. Shouldn't be used for endodontically treated
posterior teeth if the buccal cusps are weakened
by the access cavity or on teeth with extensively
damage crowns.

THE PARTIAL COVERAGE CROWN

Contraindications:
5. They are contraindicated in dentitions with
active caries or periodontal disease.
6. Proximally bulbous teeth because making of
the necessary proximal grooves is likely to leave
unsupported enamel .
7. Shouldn't be used on thin teeth with restricted
facio-palatal dimensions because it is impossible
to place adequate retentive proximal grooves.
8. They can't be used with poorly aligned teeth as
problems with unsupported enamel often result.

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THE PARTIAL COVERAGE CROWN

Advantages:
1. Conservative than the full coverage preparation because it
requires less reduction of sound tooth structure.
2. Reduced
preparation.

pulpal

and

periodontal

insult

during

tooth

3. Access to the supragingival margins is rather easy and allows

the operator to perform selected finishing procedures that are
more difficult or impossible with complete coverage
restorations and also allow the patient for easy cleaning of the
mouth.

THE PARTIAL COVERAGE CROWN

Advantages:

4. Access is also better for oral hygiene because less of

the margin approximates the soft tissues subgingivally.
There is less gingival involvement than the complete
coverage restorations.
5. Luting agent can escape more easily during
cementation which produce relatively good seating of the
restoration.
6. Because of direct visibility verification of seating and
cement removal are simple.
7. The remaining intact facial or buccal tooth structure
permits electric vitality testing

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THE PARTIAL COVERAGE CROWN

Disadvantages:
1. They have less retention and resistance than
do complete cast crowns.
2. Preparation is more difficult.

3. Some metal is displayed in the completed

restoration which may be unacceptable to
patients with high cosmetic expectations.

POSTERIOR PARTIAL COVERAGE CROWN PREPARATION

Criteria:

4 mm long axial walls

Chamfer finish line
0.5 mm axial depth
0.5 mm supragingival
6-10 taper between opposing axial walls
Armamentarium

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POSTERIOR PARTIAL COVERAGE CROWN

PREPARATION

Armamentarium

1. Narrow (approximately 0.8 mm), round tipped, tapered

diamond (regular or coarse grit): used for bulk reduction.
2. Regular size (approximately 1.2 mm), round tipped,
tapered diamond (fine grit) or carbide: used for finishing.

POSTERIOR PARTIAL COVERAGE CROWN PREPARATION:

Armamentarium

3. Football shaped or wheel shaped diamond (regular

grit): used for occlusal reduction.
4. Tapered carbide fissure burs: used for preparing
grooves.
5. Inverted cone carbide bur: used for preparing incisal
offset.

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POSTERIOR PARTIAL COVERAGE CROWN PREPARATION

Armamentarium

6. Finishing stones.
7. Mirror.
8. Explorer and periodontal prop: used for assessing various
steps.

9. Chisels: used for finishing proximal flares and bevels.

MAXILLARY PREMOLAR THREE-QUARTER

Its name is derived from the number of the

axial walls involved.
Except for a slight bevel or chamfer placed
along the bucco-occlusal line angle the
buccal tooth surface remains intact.

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MAXILLARY PREMOLAR THREE-QUARTER

Occlusal reduction:
1- Mark the proposed location of the margin of the
completed restoration on the tooth with a pencil.

MAXILLARY PREMOLAR THREE-QUARTER

Occlusal reduction:
2. Initial depth holes are placed in the mesial
and distal fossa approximately 0.8 mm
deep. They are connected by the guiding
grooves.

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MAXILLARY PREMOLAR THREE-QUARTER

Occlusal reduction:
First, depth grooves are cut on the
anatomical ridges and grooves of occlusal
surface.
The amount of occlusal reduction needed :

1.5 mm on functional cusp (palatal)

1.0 mm on non-functional cusp (buccal)

MAXILLARY PREMOLAR THREE-QUARTER

Assess the amount of the occlusal clearance in maximum

intercuspation and in all excursive movements of the mandible.
A clearance of at least 1.5 mm should exist on the functional cusp and at
least 1 mm on the nonfunctional cusp and in the central groove .

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Maxillary premolar three-quarter

MAXILLARY PREMOLAR THREE-QUARTER

Axial reduction:
Reduction

is done to eliminate
cervical to the height of contour.

-Mesio-distally-------------

normal contour of the tooth.

undercut

reduction follows

-Occluso-gingivally--------

reduction should
be parallel to the long axis of the tooth (path of
withdrawal) with slight occlusal convergence.

-Finish

line --------------- chamfer 0.3 to 0.5

mm width.

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AXIAL REDUCTION
1- Palatal Reduction
- Done using tapered stone with round end to eliminate undercut
cervical to the height of contour.
- Reduced palatal surface should be :
a- Mesiodistally follow normal contour of tooth
b- Occlusocervically in 2 planes cervical 23 should be parallel to long
axis, occlusal13 with slight occlusal convergence.

-Finish line chamfer 0.3 to 0.5 mm width.

MAXILLARY PREMOLAR THREE-QUARTER

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Axial Reduction
2- Proximal Reduction
- Initial reduction with tapered stone with
pointed end ,followed with tapered stone with
round end
- Proximal reduction should extended:
a- The mesial margin just before
the proximal contact area to be hidden by
the distal line of the neighboring tooth.
b- The distal margin extend
buccally Just beyond the contact area
-The reduced proximal surfaces should be
parallel to each other and to the path of
insertion
-FINISH LINE: Chamfer 0.3 to 0.5mm wide.
Smoothen the transition from palatal to
proximal surface

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Axial Reduction
3- Proximal grooves

a- Location:
- Placed on the buccal half of the proximal surfaces
at the line between the buccal and middle thirds of the
proximal surface

b- Shape:
1. U shaped groove: The most used?
-Because the palatal wall is prepared at right
angle to the prepared proximal surface
prevent palatal displacement of restoration.
2. Box shaped: Destructive, so used only in:
- Proximal caries or previous restoration

- Solder joint is required

- Precision attachment is required
3. V shaped: The least retentive so mainly
used in anterior teeth.

c-Depth
The groove need not be deeper than 1 mm at its
cervical end but may be deeper near its occlusal end

Axial Reduction
3- Proximal grooves

d- Preparation of grooves:
- Using tapered fissure bur.
- Palatal walls definite
( perpendicular to proximal surface) to
provide resistance to palatal displacement of
the restoration
- Not deeper than 1mm axial depth at the cervical end
- Gingival ends 0.5 mm occlusal to finish line

- Flared buccal wall

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MAXILLARY PREMOLAR THREE-QUARTER

BUCCOCCLUSAL CONTRABEVEL:

Connect the mesial and distal flares

with a narrow contrabevel that follows
the buccal cusp ridges.

Placed with a diamond, a carbide, or

even a hand instrument.

Buccal aspect of the cusp is beveled

at 45 degree to buccal surface to:

1. Protect cusp against fracture.

2. Make proper margin finishing.

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BUCCOCCLUSAL CONTRABEVEL:
Its

is:

primary purpose

To remove any
unsupported
enamel and thereby
protect the buccal
cusp tip from
chipping during
function.

BUCCOCCLUSAL CONTRABEVEL:

The bevel should remain

within the curvature of
the cusp tip rather than
extend
onto
the
buccal wall.

This will result in a

convex shape of the
restoration.

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OCCLUSAL OFFSET.

If additional bulk is needed to ensure rigidity of the

restoration, it can be provided with an occlusal
offset.
This V-shaped groove extends from the proximal
grooves along the buccal cusp.
It is not usually necessary for posterior partial
coverage crowns but is essential for the structural
durability of anterior partial coverage crowns.

Occlusal Offset:
1- Prepared by inverted cone bur .
2- Location:
On the palatal incline of the buccal cusp to join the
two grooves.
3- Shape:
It is in the form of definite step taking the shape of
V.

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light will be prevented from reflecting back to the

observer.
Thus the restoration will be less obvious, and the outline
form of remaining buccal enamel will be perceived.

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FINISHING:
Round

all sharp internal line angles to facilitate

subsequent procedures. A fine-grit diamond or
carbide can be used to blend the surfaces.

Reevaluate

the flares, paying particular attention to

any remaining undercuts, which must be removed.

The

flares should be straight and smooth, with

sufficient clearance between them and the adjacent
tooth.

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