Errors to avoid with PFM tooth preparation:

➢ Lipping and gouging of the labial shoulder.

o Be sure to think about your bur choice to avoid this mistake.
➢ Uneven labial shoulder.
o Make sure your depth stays consistent while preparing the tooth. It might
result to under contour or over contour.
➢ Over preparation in some areas and under-preparation in other areas.
o Under-reduction –
▪ In margin causes: cervical overhangs; harbors plaque accumulation
which results in gingival irritation/recession, microleakage, and
secondary caries;
▪ In axial surface: bulky restoration;
▪ In occlusal surface: deflective premature contacts that can have
biological and mechanical implications.
o Over-reduction -
▪ Jeopardize the strength and vitality of the underlying tooth and
compromises its long-term prognosis.
▪ Increases the possibility of hypersensitivity, pulpal exposure and/or
abutment tooth fracture.
➢ Lack of interproximal space between preparation margins and adjacent teeth.
o Remember, the technician must be able to section the die, so there must be
enough space between the prepared tooth and other teeth.

1. Index Preparation

➢ Not used
o Reveals inappropriate reduction
2. Occlusal Reduction

➢ Too great / too little reduction occlusally

o Over/under reduction
➢ No functional cusp bevel
o There will be no adequate clearance from the opposing tooth
o To reduce the stress at the line angles
o To prevent the fracture of the tooth structure
o For the structural durability of the restoration
 o To help in retention
o To have an adequate bulk in area of heavy occlusal contact
3. Axial Reduction

➢ Too great / too little axial reduction

➢ Too great / too little taper
➢ Undercut regions present
o There is no path of insertion
4. Margin

➢ Too wide or shoulder or inverted

➢ Too narrow or absent so not continuous
➢ Too far above / below gingival margin
➢ Not cleared contact with adjacent tooth
5. Surface Finish

➢ Rough and pitted

6. Path of Insertion

➢ In conflict with tooth structure of adjacent teeth

➢ Seating groove incorrectly placed / angled
7. Other

➢ Damage to adjacent teeth other than minor grazing

Common Errors in PFM Preparation

1. Insufficient Tooth Reduction:

• Description: Not reducing enough tooth structure can lead to inadequate
space for the metal and porcelain, resulting in a bulky crown or weak porcelain layer.
• why is important to avoid: This can compromise the crown’s aesthetics and
durability.
• how to avoid: Ensure proper occlusal, axial, and gingival reduction as per
guidelines (1.5-2 mm for porcelain).
2. Overtapering the Tooth Preparation:
• Description: Excessive tapering of the tooth preparation can reduce retention
and resistance form.
• why is important to avoid: This can lead to crown dislodgement.
• how to avoid: Aim for a taper of 6-12 degrees to provide adequate retention
while allowing for a passive fit.
3. Improper Margins:
• Description: Margins that are not smooth, well-defined, or of the incorrect type
(e.g., chamfer vs. shoulder) can compromise the fit and finish of the crown.
• why is important to avoid: Poor marginal adaptation can lead to microleakage,
secondary caries, and periodontal issues.
• how to avoid: Use appropriate burs and techniques to create well-defined
margins suitable for the PFM design (e.g., shoulder with a bevel or chamfer).
4. Underpreparing or Overpreparing Specific Areas:
• Description: Uneven reduction, particularly in critical areas like the occlusal or
interproximal surfaces, can affect the crown’s fit and occlusal harmony.
• why is important to avoid: This can cause occlusal discrepancies, discomfort,
and potential damage to opposing teeth.
• how to avoid: Use depth-cutting burs and check reductions with a putty index
or reduction guides.
5. Failure to Account for Porcelain Thickness:
• Description: Not allowing enough space for the porcelain layer can lead to a
compromised aesthetic outcome or a weakened structure.
• why is important to avoid: Poor aesthetics or fracture of the porcelain layer.
• how to avoid: Plan and execute adequate reduction (typically 1.5-2 mm) to
ensure sufficient space for a durable and aesthetic porcelain layer.
6. Subgingival Margins:
• Description: Placing margins too deep subgingivally can complicate
impression taking, increase the risk of periodontal disease, and cause inflammation.
• why is important to avoid: Poor marginal integrity, difficulty in seating the
crown, and potential for periodontal problems.
• how to avoid: Place margins at or just below the gingival margin whenever
possible, ensuring they are accessible for proper finishing and hygiene.
Preparing anterior teeth for PFM crowns
➢ For pleasing aesthetics, an anterior tooth should be reduced by at least 1.2 mm on
its labial surface, although 1.5mm is the preferable size.
➢ Using a rotary instrument, lingual surfaces are reduced by 1 mm and incisally by 2
mm.
➢ To successfully prepare the labial surface, a central cervical groove should be made
parallel to the path of placement along the long axis of the tooth.
➢ Two other secondary grooves are made on either side.
➢ Incisal edge reduction grooves are placed, and these must be approximately 1.8 mm
deep. The depth of these grooves can be verified using a periodontal probe; they then
should extend halfway down the labial surface.
➢ Next, the incisal edge is reduced, and proximal contact is broken while maintaining
a lip of enamel that protects the adjacent tooth from damage. Ideally, the incisal edge
on an anterior tooth should be reduced by 2 mm. This will allow for adequate material
thickness, enabling the ceramist to create a crown with good incisal translucency.
➢ The proximal contacts are reduced, and a 0.5-mm lingual chamfer is created.
➢ The tooth structure between the depth grooves is removed, creating a cervical
shoulder that should be approximately 1 mm wide. It should extend into the proximal
embrasures.
➢ The easiest way to shape the lingual surface of an anterior tooth is using a football-
shaped diamond. Generally, a single guiding groove is placed in the central lingual
surface for anterior teeth.
➢ Preparation is completed with a fine-grit diamond bur. Be sure to consider metal
collars where possible, as this will help reduce the extent of the cervical tooth
preparation. This is especially beneficial for teeth that have exposed root dentine or
gingival recession.

Tooth preparation should follow a

two plane reduction in order to
fulfill all the three principles of
tooth preparation.
Single plane reduction can result in either an aesthetic failure (left) or an over-contoured prosthesis
(center) or possible pulpal damage (right).

Preparation Sequence:
1. Labial preparation.
2. Interproximal preparation.
3. Palatal margin preparation.
4. Incisal preparation.
5. Lingual fossa preparation.
6. Finishing of the preparation.

1. LABIAL PREPARATION
Desired Amount of Preparation: Margin: 0.8-1 mm; Axial Surface:
1.2-1.5 mm

Margin Architecture: Deep Chamfer

Bur used: DC 1.4 (Cluster 2)

The labial surface of a maxillary central incisor has two planes; the gingival plane and the incisal plane. It is
imperative to ensure that the final preparation has adequate reduction in both these plane

Using a DC 1.4 bur, a depth groove is made in the gingival

plane (in the center of the tooth) by sinking the bur tip to half
its diameter. Sinking the bur any deeper carries the risk of
developing a lip of unsupported enamel at the margin.

Placing depth grooves before embarking on larger areas of

tooth reduction helps achieve a controlled removal of tooth
structure.

Two additional grooves are then made (in

the gingival plane) along the mesial and
distal line angles of the tooth. Note, how the
depth grooves shallow out (and eventually
fade away) as they approach incisally where
the facial curvature of the surface is the
greatest.
Using the same bur, a depth orientation groove is then made in
the incisal plane. Here again, the bur tip is sunken to only half
it’s diameter.

Two or more depth grooves are placed

in the incisal plane (depending on the
width of the labial surface).

Depth grooves along the two planes

can be clearly distinguished.

Using the same bur, enamel islands

are first removed in the gingival
plane. It is important that the
preparation margin is placed slightly
supra-gingival at this point and that it
follows the gingival contour.

The incisal plane is then reduced,

ensuring all enamel islands between the
depth grooves are reduced completely
 It is important to ensure that the preparation is in
harmony with the labial contours of the adjacent teeth.

2. PROXIMAL PREPARATION
Desired Amount of Preparation: Margin: 0.8-1.0 mm; Axial Surface:
1.2-1.5 mm

Margin Architecture: Deep Chamfer

Bur used: MI 0.5 (Cluster 3)

Following labial reduction, the proximal contacts are to be opened. In order to prevent damage to the
adjacent teeth, the same technique as described previously is used.
The MI 0.5 bur is placed slightly
above the interdental papilla and
used in a sawing motion to slice
through the interproximal
surface, ensuring that a fine
sliver of enamel remains
between the tooth being
prepared and the adjacent tooth.

The same procedure is then

repeated along the other
proximal surface. Labial view

Palatal view.

The proximal contacts are then

opened by breaking the sliver of
enamel. This is done with the
help of a straight probe.
3. PALATAL MARGIN PREPARATION
Desired Amount of Preparation: Margin: 0.5-0.8 mm; Axial Surface: 0.5-0.8 mm

Margin Architecture: Deep Chamfer

Bur used: DC 1.4 (Cluster 2)

Following reduction of the proximal surfaces, attention is paid towards preparing the palatal axial margin.

The DC 1.4 bur is used to score one

depth groove in the center of the
palatal surface by sinking the bur tip
slightly less than half its width. It is
advisable to place this groove slightly
supra-gingival in order to conserve
tooth structure.

This portion of the tooth is responsible

for providing the necessary resistance to displacement of anterior prosthesis. Thus, when reducing this
critical area, care needs to be taken to ensure the bur is oriented at the correct angle.
Image depicts the correct angle of the bur, which is
relatively parallel to the gingival plane of the labial
surface. This helps in achieving maximum resistance
from the palatal axial wall.

Using uni-directional motion, the

preparation is then extended from the
palatal groove into the mesial and
distal interproximal margin.
4. INCISAL PREPARATION
Desired Amount of Preparation: 2 mm

Burs used: IR 2.0 (Cluster 6) followed by any long bur

Following preparation of all axial surfaces, the incisal edge is reduced.

The IR 2.0 bur is a self-limiting bur

and thus, ideally suited to create
depth grooves of 2 mm. It is placed
such that the non-cutting shaft sits
flush with the incisal edge, allowing
only the working tip to be in contact
with the tooth.

This bur is then run across facio-

palatally along the mid-incisal edge
(in one stroke), thereby leaving a 2
mm deep grove.

Two additional grooves are made,

to the mesial and distal of the mid-
incisal groove
 Next, any long bur is used to
connect these grooves.
Maxillary incisal edge reduction
should be done with the bur
angled slightly palatally.

This ensures that the reduction is performed parallel to the original

incisal edge angle and (more importantly) perpendicular to the forces
of mastication.

It is advisable to reduce the last 0.5 mm of the incisal edge

with a coarse Sof-Lex disc from 3M. This prevents the grooves
from deepening further, thereby preventing inadvertent over-
reduction of the incisal edge beyond 2 mm.
5. LINGUAL FOSSA PREPARATION
Desired Amount of Preparation: 0.5-0.8 mm

Bur used: CR 2.3 or CR 2.8 (Cluster 5)

Here, adequate clearance during all functional movements is paramount. This is to ensure that, the desired
anterior guidance can be re-established in the final prosthesis.

In order to achieve adequate reduction, the

CR bur is held such that it’s widest portion
sits into the deepest aspect of the palatal
concavity. This ensures that desired
reduction is achieved in the middle third of
the lingual fossa.
 Too steep an angle. This would reduce the
height of the palatal axial wall, thereby
compromising the resistance form and can
also cause over-thining of the incisal edge.

Too shallow an angle. This would result in

under-reduction of the tooth, thereby
causing premature contact in MIP and
interferences in excursion.

To reduce this surface, the CR bur is moved mesio-distally across the fossa and as the bur approaches
incisally, it is straightened out. This ensures uniform reduction and maintenance of the palatal curvature.
6. FINISHING OF THE PREPARATION
Burs used: DC 1.8F, DC 1.2F (Cluster 1 and 2)

Once basic preparation is completed, finishing of the preparation is undertaken.

First, the DC 1.8F bur is used to half its

depth on the labial aspect of the
preparation. The large head of this bur
helps remove any lip of enamel that may
have formed earlier. At this phase, the
preparation margin can be taken closer to
the gingival crest (if necessary).

Proximal surface may not have enough

clearance to allow the wide DC 1.8F bur to
pass through. Thus, a thinner DC 1.2F is
used to finish the mesial and distal
proximal margins. Here, it is important to
follow the pre-existing gingival
architecture (interdental col) of the tooth.
 The same DC 1.2F is used to finish the
palatal axial margin as well.

A Sof-Lex Spiral from 3M can be used to finish the lingual fossa area of the preparation.

It is important to ensure that clearance is achieved not just in maximum intercuspation, but throughout
the entire path of incisal guidance. This can be confirmed with the use of PrepGauge from MIK Dental.
FINAL LOOK OF THE PREPARATION
The final preparation should look smooth and be free of undercuts. All 360° of the margin should be
continuous and visible when seen from the incisal view.

Final Preparation: Labial View.

Final Preparation: Palatal View.

Final Preparation: Incisal View.

Final Preparation: Lateral View.

Pre-treatment index can be used to evaluate the uniformity and adequacy of reduction.
Preparing posterior teeth for PFM crowns

➢ When preparing posterior teeth for PFM crowns, depth holes are created in the
occlusal surface to facilitate the creation of occlusal depth cuts.
➢ Once these depth cuts have been completed, the occlusion can be reduced, and a
lingual chamfer and a buccal shoulder are created. The buccal shoulder preparation
should extend at least 1mm lingually to the proximal contact.
➢ The preparation should extend slightly further mesially than distally, as it is more
visible.
➢ The occlusal surfaces of posterior teeth generally require 1.5 to 2 mm of clearance.
Occlusal reduction may be less if the crown is fabricated with a metal occlusal
surface or a metal bite stop.
➢ All margins should be distinct and continuous circumferentially.
➢ All other angles must be rounded, and the finished preparation should not have any
noticeable bur marks.
➢ Areas frequently missed during finishing include the incisal edges of anterior
preparations and the transition from axial wall to occlusal in posterior preparations.
➢ Margins should be finished with diamonds or with hand instruments.
➢ The design of the shoulder does depend on the chosen margin. For example, a
porcelain margin requires proper support, and a 90° angle is preferable. This
shoulder is also suitable for crowns with conventional metal collars, allowing the
collar to the kept narrow and unobtrusive. However, beveling the margin or sloping it
will enable the porcelain to be better supported.
Preparation Sequence:

1. Buccal preparation.
2. Interproximal preparation.
3. Lingual preparation.
4. Occlusal preparation.
5. Functional cusp bevel preparation.
6. Finishing of the preparation.

1. BUCCAL PREPARATION

Desired amount of preparation: Margin 1-1.2 mm; Axial Surface:

1.2-1.5 mm
Margin Architecture: Modified Shoulder
Bur used: MS 1.0 (Cluster 1)
Fig. 4.73: The MS 1.0 bur helps to create the modified shoulder margin on the buccal aspect of a PFM
preparation.

The buccal surface has two planes; a gingival plane and an occlusal plane. However, when working on the
buccal aspect of posterior teeth, only the gingival plane is prepared. It is not advisable to work on the
occlusal plane at

this time, as occlusal reduction (Step 4) and functional cusp bevel preparation (Step 5) would offset all
efforts made.

The first step in buccal preparation is the placement of depth orientation grooves (also called as depth cuts).
Grooves placed before embarking on larger areas of tooth reduction help ensure easy and controlled
removal of tooth structure. A rotary instrument of known diameter is used so that the depth of reduction
achieved can be measured against the unprepared tooth structure.

As the ideal preparation margin width is 1-1.2 mm, the MS 1.0 bur is used to place these depth grooves.

Fig. 4.74: The MS 1.0 bur is held parallel to the long axis of the tooth (or along the intended path of
insertion) and the tip of the bur is sunken full depth, around the mesio-distal center of the tooth. This
creates a 1.0 mm deep groove. The groove should ideally be placed on enamel, slightly above the gingival
margin.
Fig. 4.75: Three such depth grooves are made on the buccal aspect. One around the mesio-proximal
surface, one around the mesio-distal center and one around the disto-proximal surface of the tooth.

Fig. 4.76, 4.77: With the same bur placed in any one of the three grooves, the hand piece is moved using
uni-directional sweeping movements (either push or pull) to amputate the islands between them. The full
diameter of the bur is used to reduce the tooth. The tip of the diamond bur should be slightly supra-
gingival at this point, even if the final intended position of the finish line is flush with or slightly beneath
the gingival margin.

NOTE: It is important to avoid back and forth (continuous) movement of the bur, as this results in
undesirable deepening of the depth grooves, thereby resulting in non-uniform reduction.
Fig. 4.78, 4.79: The buccal preparation is then extended as far into the proximal embrasures as possible,
without opening the contact or nicking the adjacent teeth. Top: Buccal view; Bottom: Buccal-occlusal view.

2. PROXIMAL PREPARATION

Desired amount of preparation: Margin: 1-1.2 mm; Axial Surface: 1.2-1.5 mm

Margin Architecture: Modified Shoulder
Bur used: MI 0.8 (Cluster 3)

Following buccal reduction, the proximal contacts are to be opened. This is one of the trickiest areas to
prepare and good hand piece skills are important. At this point, no attempt is made at establishing an
interproximal gingival margin. The goal is only to open the interproximal contact without inflicting any
iatrogenic damage to the adjacent tooth.

Fig. 4.80: The MI 0.8 bur is placed parallel to the long axis of the tooth and slightly above the interdental
papilla. This is important to avoid damage to the ‘col’.
Fig. 4.81: This bur is used to saw through the interproximal surface ensuring a fine sliver of enamel
remains between the tooth being prepared and the adjacent tooth. Fig.

Fig. 4.82, 4.83: The procedure is repeated on the other proximal surface. Note, the supra-gingival nature
of the margin along the entire interproximal surface. The buccal view (top) and lingual view (bottom)
clearly show the constant plane of reduction followed from the buccal through to the lingual and a
definite margin formation. This is possible owing to the non-cutting tip of the MI bur.

Fig. 4.84, 4.85: The thin sliver of enamel is then easily flicked away using a straight probe. This opens up
the proximal contact, as shown here for the distal surface.
Fig. 4.86, 4.87: The same procedure is then repeated for the mesial contact.

Fig. 4.88: The proximal finish line may be quite irregular at this point, but that can be very easily remedied
at the finishing stage of the preparation. The yellow rings outline the separated pieces of proximal tooth
enamel (lip).

3. LINGUAL PREPARATION

Desired amount of preparation: Margin: 0.5 mm; Axial Surface: 1.2 - 1.5 mm
Margin Architecture: Deep Chamfer for a lingual metal collar.
Bur used: DC 1.0 (Cluster 1)
Following the proximal surface, attention is paid towards reduction of the lingual aspect, which is the last
axial surface to be prepared.

Fig. 4.89: On the lingual surface, just one depth groove is made using the DC 1.0 bur. This bur is sunken to
only half its width, in order to avoid formation of a lip of unsupported enamel. This margin should
preferably be kept supra-gingival in an attempt to conserve tooth structure.
Fig. 4.90: Using a pull or a push (uni-directional) stroke, a definite margin is created. This is first performed
mesially where the lingual margin is merged into the proximal margin.

Fig. 4.91: The same is then repeated to create a definite distal-lingual margin. Here again, careful
attention needs to be paid to ensure correct bur orientation along the proposed path of placement.

Fig. 4.92: Lingual reduction as seen from the lingual view. Note, the supra-gingival nature of the prepared
margin.
4. OCCLUSAL PREPARATION
Desired amount of preparation: Functional Cusp: about 2mm; Non- Functional Cusp: about 1.5 mm

Burs used: OR 1.6 and OR 1.2 (Cluster 4)

It is often said, a preparation should look like a miniature of the original and this mainly holds true for the
occlusal aspect.

When reducing the occlusal aspect, it is imperative to follow the pre-existing cuspal inclines and contours.

The occlusal surface of a mandibular first molar has a small distal cusp. This cusp often gets reduced as
part of the proximal preparation and no special efforts are made at recreating this cusp during the
preparation.

For those who find working this aspect of the preparation difficult, it would help to visualize (or even mark)
the occlusal ridges and desired reduction contours on the tooth.
Fig. 4.93: Two dots are marked on the buccal aspect which represent the future cusp tips.

Fig. 4.94: These two dots are joined together in the form of a valley. This represents the outline of the
desired reduction in this area.

Fig. 4.95: The marks then are extended towards the proximal surface to develop a two mountain pattern
that roughly represents the architecture of the final occlusal reduction desired.
Fig. 4.96: Three marks are made on the occlusal aspect along the mesiobuccal cusp ridge, the buccal
developmental groove and the distobuccal cusp ridge. We shall be using these three marks to make
depth grooves by sinking the bur along their length.

Fig. 4.97: All markings made as seen from an angular view. Once all the marks are made, it is time to use
these to help anatomically reduce the occlusal aspect.

Fig. 4.98: The occlusal reduction bur should be oriented along the preexisting incline of the tooth.

Fig. 4.99: In case the bur orientation flattens out, the occlusal reduction begins to resemble a table-top
with greater reduction over the cusp tips and barely any reduction along the central groove. This often
culminates into metal exposure or porcelain fracture along this under-reduced area.
Fig. 4.100: As the functional cusp requires 2 mm reduction, the OR 1.6 bur is used to create a depth
orientation groove extending from the cusp tip to the base/central developmental groove. This bur needs
to be sunken full depth.

Fig. 4.101: This creates a groove that is 1.6 mm in depth. For descriptive purposes, we shall label this
groove as “B”.

Fig. 4.102: The same step is repeated on the mesiobuccal and distobuccal cusp ridges. For descriptive
purposes, we shall label the mesial groove as “A” and distal groove as “C”.
Fig. 4.103: All three grooves as seen from the buccal view.

Fig. 4.104: Following the anatomic contour of the occlusal surface and without changing its angle or
depth, the bur is moved from “A” downward and inward to connect into “B” and from “C” downwards and
inwards to also connect into “B” (as depicted by the yellow arrows). This produces a valley in the mid-
buccal region.

Fig. 4.105: Keeping the same angle and depth, the bur is next moved from “A” downward and mesially to
exit into the proximal area and from “C” downward and distally to exit into the proximal area (without
nicking the adjacent teeth). This results in the creation of two mountain peaks with uniform reduction.
These peaks would eventually become the mesio-buccal and the disto-buccal cusp tips of the final
prosthesis.
Fig. 4.106: The overall buccal-occlusal reduction as seen from an angular view. The reduction should
reproduce the general occlusal morphology.

Fig. 4.107: The overall buccal-occlusal reduction as seen from the lingual view. Note, the reduction follows
the general occlusal morphology.

Once the gross buccal reduction is completed, the lingualocclusal surface is reduced following similar
principles.

Fig. 4.108: Three marks are made on the lingual-occlusal aspect along the mesiolingual cusp ridge, the
lingual developmental groove and disto-lingual cusp ridge.
Fig. 4.109: As the amount of desired reduction is 1.5 mm, the OR 1.2 bur is sunken full depth along the
three markings made. These again can be labeled in one’s head as “A” “B” and “C”. By following the arrows
as depicted in the image, uniform occlusal reduction can be achieved along the lingual occlusal surface.

Fig. 4.110: Occlusal reduction can be done one cusp at a time, allowing the other cusp to help gauge the
amount of reduction achieved. As shown here, first the disto-lingual cusp is reduced.

Fig. 4.111: The mesio-lingual cusp is reduced next. This completes the gross lingual occlusal preparation.

NOTE: Occlusal reduction should follow the pre-existing contours of the tooth. Thus, in case of an attrited
tooth the cuspal preparation would also have to be relatively flat.
5. FUNCTIONAL CUSP BEVEL PREPARATION
The functional cusps withstand the bulk of occlusal forces and thus, need to be reinforced with greater
thickness. To achieve this, a functional cusp bevel is incorporated into the preparation. This step helps in
avoiding the creation ofan occlusal interference in excursion and/or porcelain fracture . The average
functional cusp bevel is at a 45° angle and is approximately 1.5 mm wide. However, there are considerable
variations around these values. Fortunately, all teeth in one quadrant present with the same functional
inclines and this can be used to our advantage.
Fig. 4.112: Any long bur is held along plane 2 of the adjacent tooth to help determine the angle of the
functional cusp bevel.

Fig. 4.113: This angle is simply carried to the tooth being prepared in order to achieve the desired amount
of functional bevel reduction.

Fig. 4.114: The functional cusp bevel in itself helps accomplish the buccal reduction in two planes.

Mandibular posterior teeth have an inbuilt lingual inclination and thus, plane 2 reduction for the lingual
axial wall is a mere rounding of the preparation along the occluso-lingual junction.

At this time, it is important to ensure the desired amount of occlusal reduction has been achieved in MIP
as well as all excursive movements. PrepGauge from MIK Dental can be used to check if this has been
achieved or not.

6. FINISHING OF THE PREPARATION

Burs used: EC 1.4F, MS 1.3F and DC 1.2F (Cluster 6 and 1)

Fig. 4.115: First, the EC 1.4F bur is used to plane the proximal margins that have considerable
unsupported enamel at this time. As this bur has diamonds only at the tip, there is no fear of iatrogenic
damage to the adjacent tooth. It is important that this bur be used with pull strokes only, as a push stroke
carries the risk of inadvertent ploughing of the bur into the margin.

Fig. 4.116: Next, the MS 1.3F bur is used to finish the buccal margin, the buccal axial wall and the
functional cusp bevel. The buccal margin can be lowered from a supragingival to an equi-gingival margin
using this finishing bur (if needed). As this bur provides greater control during reduction, it decreases the
possibility of traumatizing the marginal gingiva owing to overzealous preparation. The same bur is also
used to finish both the proximal margins, giving them a modified shoulder design.

NOTE: When finishing the proximal margins, it is important to follow the contours of the interdental col
(which is saddle shaped). Unnecessary extension into proximal gingival tissue leads to bleeding and
inflammation. This is one of the leading causes for food lodgement between teeth post cementation.

Fig. 4.117: Next, the DC 1.2F bur is used to finish the lingual margin of the preparation extending it into
the proximal margin, thereby blending the two margins together. A slight step/wing would be present
here as the wide modified shoulder margin merges with the narrower deep chamfer margin. This wing
guides the technician towards the mesio-distal extension of the proposed lingual metal collar.
Fig. 4.118: The same bur is then used to round off the plane 2 on the lingual-axial surface.

Fig. 4.119: The same bur is also used to finish the entire occlusal preparation, ensuring that the cuspal
architecture is maintained.

When finishing a preparation, care should be taken to ensure no sharp line or point angles remain in the
final preparation. These areas could cause stress concentration and failure of the restoration.

FINAL LOOK of the preparation

Fig. 4.120: The final preparation should look smooth and should be free of undercuts. All 360° of the
margin should be continuous and visible when seen occlusally. This should be done with one eye closed,
because an undercut can be perceived as near parallel surface when seen with both eyes open.
Fig. 4.121: Final preparation: Lingual angular view. Special care should be taken to check the junction
between the proximal and the buccal/lingual reductions, as these are common sites for undercut
formation.

Fig. 4.122: Final preparation: Lingual view.

Fig. 4.123: Final preparation: Buccal angular view.

Fig. 4.124: Molar reduction in accordance with the principles of tooth preparation.

Fig. 4.125: Molar reduction in accordance with the principles of tooth preparation.

Fig. 4.126: Molar reduction in accordance with the principles of tooth preparation.

Fig. 4.127: Molar reduction in accordance with the principles of tooth preparation.
Fig. 4.128: Overall reduction can be checked with the pre-treatment sagittal index. Producing consistent
preparations is a matter of mental discipline.