Presentation from Prof Paul A. Tipton, for Smile GB, on anterior bonded crowns

1. Dr. Paul A. Tipton
anterior bonded crowns
Dr. Paul A. Tipton
tooth preparation

2. Dr. Paul A. Tipton
prepare UR1 for P.F.M. crown

3. Dr. Paul A. Tipton take 2 thick putty matrices of the upper arch

4. Dr. Paul A. Tipton
“the facial surface must be reduced in two planes
to allow adequate clearance for porcelain”
h. shillingburg 1981
some authorities say 3 plane reduction.
that is gingival, incisal and mid-facial.

5. Dr. Paul A. Tipton
use 1 - 1.2mm depth cuts in 3 planes and the putty matrix

6. Dr. Paul A. Tipton
reduce the incisal edge by
2mm – using depth cuts
you may wish to use matrix band separators
to avoid preparing the adjacent teeth

7. Dr. Paul A. Tipton
complete reduction of the labial surface with
round ended tapered bur with 1.0 – 1.5 mm cutting
tip. do not break through the contacts yet.
establish your shoulder labially and into the
embrasures. keep the shoulder supra gingival
at this stage.

8. Dr. Paul A. Tipton
break through the contacts with a thin tapered
bur. finish off the margin inter-proximally with a
long chamfer bur or round ended bur 1mm thick
so as to produce a 0.5 mm chamfer margin

9. Dr. Paul A. Tipton
the shoulder preparation should be a
deep chamfer 1.2 – 1.5 mm deep cut
with a 2.4 to 3.0 mm chamfer bur . It
should stop just past or palatal to the
contact points.

10. Dr. Paul A. Tipton
reduce the palatal surface by 1mm for metal or 1.2 mm reduction for porcelain and
metal. use a football-shaped bur for correct depth then a rugby ball-shaped bur for the
correct shape

11. Dr. Paul A. Tipton
prepare a palatal finish line with a
supra gingival chamfer and ensure
it is not undercut relative to the
labial gingival third
for more precision use a speed
increasing hand piece.

12. Dr. Paul A. Tipton
finish the margins with speed
increasing hand piece and shape
the wings
finished preparation showing winged appearance
with a rounded incisal edge

13. Dr. Paul A. Tipton
shoulder runs into chamfer interproximally

14. Dr. Paul A. Tipton
check incisal reduction

15. Dr. Paul A. Tipton
check marginal reduction

16. Dr. Paul A. Tipton
check labial and incisal reduction using the putty matrix

17. Dr. Paul A. Tipton
place 2 Dux Ginginkit soaked in astringent
solution– thinnest (00) first and then finish
your preparation subgingivally to the cord .
Use the correct cord packer .The cord
gives you sulcus depth and protects it
against violation of the biological width
impression techniques

18. Dr. Paul A. Tipton
this second cord - soaked in astringent
solution is half in, half out of the soft tissue.
(n.b. for this preparation on the phantom head
it needs to be subgingival as the tissue reacts
differently).

19. Dr. Paul A. TiptonDr. Paul A. Tipton

20. Dr. Paul A. Tipton
impression techniques
dry the preparation and sulcus
syringe light body ‘provil’ impression over the dried prep
use the 3:1 air syringe to blow (push) the impression material
into the sulcus and onto the tooth
syringe more impression material onto the prep
gently seat the tray and ‘monophase’ tray materialDr. Paul A. Tipton
tooth preparation

21. Dr. Paul A. TiptonDr. Paul A. Tipton

22. Dr. Paul A. TiptonDr. Paul A. Tipton

23. Dr. Paul A. Tipton
anterior bonded crowns
premolar bonded crowns
Dr. Paul A. Tipton
tooth preparation

24. Dr. Paul A. TiptonDr. Paul A. Tipton
prepare ul5 for bonded crown.
tooth preparation

25. Dr. Paul A. Tipton
Use the same matrix

26. Dr. Paul A. TiptonDr. Paul A. Tipton
reduce occlusal surface by 1.5mm use depth cuts of 1.2 mm bur

27. Dr. Paul A. TiptonDr. Paul A. Tipton
eliminate the grooves to provide
even reduction. Make sure occlusal
reduction is completed with the bur
at the correct angle , taken from the
cusp angles of adjacent teeth

28. Dr. Paul A. Tipton
“the functional cusp bevel is a wide bevel on the palatal inclines
of maxillary palatal cusps and the buccal inclines of mandibular
buccal cusps that provides space for an adequate bulk of metal
in an area of heavy occlusal contact”
fundamentals of fixed prosthodontics h. shillingberg
quintessence 1981
Dr. Paul A. Tipton
tooth preparation

29. Dr. Paul A. TiptonDr. Paul A. Tipton
place the functional cusp bevel at 45
degrees to the occlusal plane
place the functional cusp bevel at 45 degrees to the
occlusal plane and supra-gingival palatal chamfer

30. Dr. Paul A. Tipton
completed functional cusp bevel and palatal surface
reduction. chamfer finish line palatally.Dr. Paul A. Tipton

31. Dr. Paul A. Tipton
use 1 – 1.2mm tapered bur to prepare labial
surface using depth grooves or putty matrix
Dr. Paul A. Tipton

32. Dr. Paul A. Tipton
eliminate the grooves to produce even labial reduction
and prepare 1.2mm labial shoulderDr. Paul A. Tipton

33. Dr. Paul A. Tipton
two plane
reduction
Dr. Paul A. Tipton

34. Dr. Paul A. Tipton
cut through
interdentally
using long thin
diamond bur
Dr. Paul A. Tipton

35. Dr. Paul A. Tipton
prepare to just labial of contact point distallyDr. Paul A. Tipton

36. Dr. Paul A. Tipton prepare half way into the mesial contact areaDr. Paul A. Tipton

37. Dr. Paul A. TiptonDr. Paul A. Tipton
smooth all sharp edges

38. Dr. Paul A. Tipton
final preparation (labial view)Dr. Paul A. Tipton

39. Dr. Paul A. Tipton final view of preparation from the occlusal surfaceDr. Paul A. Tipton

40. Dr. Paul A. Tipton
check the marginal preparation using the putty matrixDr. Paul A. Tipton

41. Dr. Paul A. Tipton
final view from the labial aspect
shoulder – 1.2mm
preparations
wings mesially and
distally
labially – 2 plane
reduction
occlusally – 1.5
mm reductions

42. Dr. Paul A. TiptonDr. Paul A. Tipton
check occlusal reduction

43. Dr. Paul A. TiptonDr. Paul A. Tipton
Impression techniques
place 1st cord place 2nd cord

44. Dr. Paul A. TiptonDr. Paul A. Tipton
ensure there is a definate visable space around all the preparation
edge. If not re pack or place additional cord

45. Dr. Paul A. TiptonDr. Paul A. Tipton st ann’s dental clinic
dry the prep and sulcus and syringe ‘provil’ impression material
blow the impression material into the sulcus and onto the prep
then syringe more on top

46. Dr. Paul A. TiptonDr. Paul A. Tipton

47. Dr. Paul A. Tipton

48. Dr. Paul A. Tipton
anterior bonded crowns
premolar bonded crowns
posterior bonded crowns
tooth preparation
Dr. Paul A. Tipton

49. Dr. Paul A. Tipton
prepare depth cuts 1.2mm on the occlusal surface
all over but keep the bur parallel to the cusp angles
or copy the angulation from the adjacent teeth
Dr. Paul A. Tipton
deeper preparation for thicker posterior restoration
to reduce stresses to the cement lute and metal
framework

50. Dr. Paul A. Tipton
functional cusp reduction of a further
0.5mm (lower buccal – upper palatal)
Dr. Paul A. Tipton
functional cusp bevel.
silver dies produce better
marginal quality.

51. Dr. Paul A. Tipton
labial reduction for posterior teeth in 2 planes and 1.2-1.5 mm
reduction depending upon aesthetic requirementsDr. Paul A. Tipton

52. Dr. Paul A. Tipton
make sure there is a mid buccal groove
that mimics the shape of the shoulder at
the gingival margin
Dr. Paul A. Tipton st ann’s dental clinic
The occlusal reduction should follow the
shape of the original tooth

53. Dr. Paul A. TiptonDr. Paul A. Tipton
mesio - buccal view disto - buccal view lingual view
finished preparation

54. Dr. Paul A. TiptonDr. Paul A. Tipton
the wings where the shoulder turns into a chamfer or shoulder bevel should be buccal to
the disto-buccal contact area and just into the contact area mesio-buccally.
distal wing mesial wing

55. Dr. Paul A. Tipton
distal wing
central groove
finished preparation
mesial wing
1.5mm occlusal
reduction
functional cusp
bevel
lingual chamfer or
shoulder bevel
shoulder
bevel

56. Dr. Paul A. TiptonDr. Paul A. Tipton

57. Dr. Paul A. Tipton