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Finish lines (3) final

This document discusses different types of finish lines used in fixed prosthodontic restorations. It defines finish lines and describes their principles and configurations for both extracoronal and intracoronal restorations. For extracoronal restorations, finish line types for full veneer crowns, partial veneer crowns, and laminate veneers are explained. For intracoronal restorations, finish line designs and bevels for direct restorations using amalgam, composites, and direct gold are outlined. Guidelines for finish line placement and exposure techniques are also provided.

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1 MOHD.SIBGHATULLAH KHATIB 1ST PG STUDENT GOOD MORNING SUCCESS is not just a measure of how big you can DREAM… It is also a measure of how much you can DO
2 FINISH LINE
Contents • Introduction • Definition • Principles of tooth preparation • Finish lines for Extracoronal restorations Full veneer crown Complete cast crown Metal - ceramic crown All-ceramic crown – Porcelain veneer crown  Partial veneer crown  Onlays • Finish lines for Intracoronal restorations Inlays Amalgam Direct filling gold Composites Glass ionomer cement • Conclusion 3
• One of the basic tenets of restorative dentistry is to conserve as much tooth structure as possible consistent with the mechanical and esthetic principles of tooth preparation. 4 Introduction Contemporary Fixed Prosthodontics 3rd edition
Introduction • Restoration can survive in the biologic environment of the oral cavity only if the margins are closely adapted to the finish line of the preparation 5 Contemporary Fixed Prosthodontics 3rd edition
According to Schwartz • Refers to the border of the preparation where the prepared tooth structure meets the unprepared surface of the tooth. According to Rosenstiel 1. A line of demarcation 2. The peripheral extension of a tooth preparation 3. The planned junction of different materials 4. The terminal portion of the prepared tooth. 6 Definition
Principles of tooth preparation 1. Preservation of tooth structure 2. Retention and resistance 3. Structural durability – Marginal geometry 4. Marginal integrity – Marginal adaptation 5. Preservation of the periodontium – Margin placement 7 Herbert T. Shillingburg 3rd edition
Preservation of tooth structure • Avoide excessive destruction • Design restoration to reinforce and protect remaining enamel and dentin 8 Herbert T. Shillingburg 3rd edition
Retention & Resistance • Retention prevents removal of the restoration along the path of insertion or long axis . • Resistance prevents dislodgement of the restoration by an apical/oblique forces 9 Herbert T. Shillingburg 3rd edition
10 Taper Freedom of displacement Herbert T. Shillingburg 3rd edition
11 Length Substitution of internal feature Path of insertion Herbert T. Shillingburg 3rd edition
Structural durability • Adequate space created by tooth preparation 12 Occlusal reduction Axial reduction
Marginal integrity • Margins of restoration must be closely adapted to finish line of preparation • Configuration of the preparation finish line dictates the shape of restorative material in the margin of the restoration 13 To bevel….. ….Not to bevel Herbert T. Shillingburg 3rd edition
Finish line in extracoronal restoration Chamfer Heavy chamfer Shoulder Sloping shoulder Radial shoulder Shoulder with bevel Knife edge/ Feather edge Chisel edge 14 Contemporary Fixed Prosthodontics 3rd edition
Extracoronal restorations - Finish line configurations • Finish line classification according to width Marginal width less than 0.3mm - Knife-edge/ feather edge Marginal width upto 0.3mm – Chamfer Marginal width greater than 0.3mm - Shoulder 15 A.J. Hunter JPD 1990;64
Chamfer • GPT- A Finish line design for tooth preparation in which the gingival aspect meets the external axial surface at an obtuse angle. • TYLMANN (1965): Concave extra coronal finish line that provides greater angulation than a knife-edge and less width than a shoulder. 16
17 Advantage Disadvantage Indication •Distinct margin •Adequate bulk •Easier control •Care needed to avoid unsupported lip of enamel •Cast metal restoration •Lingual margin of metal ceramic Bur Round end taper Round end taper
Heavy chamfer  Provides 90 degrees cavosurface angle with a large radius rounded internal angle.  A bevel can be added to the heavy chamfer for use with metal restoation. 18 Herbert T. Shillingburg 3rd edition
19 Round end taper Bur Advantage Disadvantage Indication •Better support for a ceramic crown •Unskilled operator can create an undesirable fragile “lip” of enamel at cavosurface •Ceramic crown •With bevel metal crown
 Finish line of choice for all-ceramic crown  Wide ledge provides resistance to occlusal forces  Produce the space for healthy restoration contours and maximum esthtetic 20 Shoulder Herbert T. Shillingburg 3rd edition
21 •Advantage •Disadvantage •Indication •Bulk of restorative material •Less conservative of tooth structure •Stress concentration at 90 degree internal angle of the finish line, hence conducive to coronal fracture •Facial magin of metal ceramic crowns •Complete ceramic crown Flat end taper Bur
 Modification of shoulder finish line  Support for ceramic restoration is good 22 Herbert T. Shillingburg 3rd edition Radial shoulder •Advantage •Disadvantage •Indication •Stress concentration lesser than the classic shoulder •Less conservative of tooth structure •Facial magin of metal ceramic crowns •Complete ceramic crown
23 Flat end taper End cutting carbide finishing bur Modified bine-angle chisel Bur
24 Herbert T. Shillingburg 3rd edition Shoulder with bevel •Advantage •Disadvantage •Indication •Bulk of material •Less conservative, extend peraparation apically •Facial magin of posterior metal ceramic crowns with supragingival margin  Uses – • Gingival finish line on the proximal box of inlays and onlays • Occlusal shoulder of onlays and mandibular three-quarter crowns • Finish line for extremely short walls • More destruction of tooth - NOT USED routinely for full veneer restorations
A 120-degree sloped shoulder margin used as an alternative to the 90-degree shoulder for the facial margin of a metal-ceramic crown.  Reduces the possibility of leaving unsupported enamel Provides sufficient bulk to allow thinning of the metal framework to a knife-edge for acceptable esthetics. 25 Sloping shoulder •Advantage •Disadvantage •Indication •Bulk of material •Less conservative of tooth sturcture •Facial magin of metal ceramic crowns Contemporary Fixed Prosthodontics 3rd edition
 The ultimate finish line that permit an acute margin of metal  Uses – • Lingual surface of mandibular posteroior teeth • Very convex axial surfaces • Surface towards which tooth is tilted  Disadvantage – • Axial reduction may fade out • Thin margins difficult to wax and cast • Overcontoured restorations 26 Herbert T. Shillingburg 3rd edition Knife edge/ Feather edge
Chisel edge • A variation of the featheredge, • Formed when there is a larger angle between the axial surfaces and the unprepared tooth structure. • Associated with an excessively tapered preparation 27 Contemporary Fixed Prosthodontics 3rd edition
28 A. Featheredge, B. Chisel, C. Chamfer, D. Bevel, E. Shoulder, F. Sloped Shoulder, G. Beveled shoulder Contemporary Fixed Prosthodontics 3rd edition
• Shoulder margins provide good seat but a comparatively wider marginal seal • Chamfer, long chamfer and feather edge margin provide superior sealing of the margins despite poor seat. 30 Journal of Clinical and Diagnostic Research. 2015 Aug, Vol-9(8 )
• Both ZZ and E copings presented better marginal fit on shoulder preparations than chamfer preparations. 31 European Journal of Dentistry April 2012 - Vol.6
Preservation of the periodontium • Margins as smooth as possible • Kept clean by the patient • Supragingival placement of finish lines whenever possible! • Subgingival finish lines 2.0 mm from alveolar crest 32 Herbert T. Shillingburg 3rd edition
• The biologic width is defined as the dimension of the soft tissue, which is attached to the portion of the tooth coronal to the crest of the alveolar bone • Biologic width (EA + CTA) dimensions - – Anterior teeth 1.75mm – Premolars 1.97mm – Molars 2.08mm 33 Biologic width J Clin Periodontol 2003; 30: 379–385
35 Margin placement Supragingival margin Equigingival margins Subgingival margin Placed in non-esthetic area At the crest of the marginal gingiva Below the gingiva Least impact on periodontium More impact on the periodontium Greatest biologic risk More plaque retentive May violate gingival attachment apparatus
Margin placement guidelines 36 If the sulcus probes 1.5mm or less, place the margin 0.5mm below the gingival crest If probing depth more than 1.5mm – place the margin half the depth of the sulcus below the crest If probing depth more than 2.0 mm – Gingivectomy is advocated Indian Journal of Clinical Practice, Vol. 23, No. 11, April 2013
37 Orkin et al Silness Indian Journal of Clinical Practice, Vol. 23, No. 11, April 2013 Subgingival restorations Bleeding Gingival recession Supragingival position of the crown margin Margins below the gingival margin
Finish line exposure • Mechanical – Copper tube/band – Rubber dam • Chemomechanical (retraction cord) – Caustic chemicals – sulfuric acid, trichloracetic acid, negatol, zinc chloride – Racemic epinephrine – Aluminium chloride, alum, aluminium sulfate, ferric sulfate • Rotary curettage/ gingettage • Electrosurgery 38
39 MOHD.SIBGHATULLAH KHATIB 1ST PG STUDENT GOOD MORNING Beginning well is a momentary thing; finishing well is a life long thing.
Extracoronal restoration - Full veneer crowns 40 All ceramic crown Full metal crown Metal ceramic crown
Full veneer crowns 41 Full metal
Metal ceramic crown Full veneer crown 42
Metal ceramic crown Full veneer crown 43
Full veneer crown 44 ALL CERAMIC CROWN
Partial veneer crowns 45
Porcelain laminate veneers 46
47 A conservative method of restoring the - Discolored Pitted Fractured anterior teeth.
According to sturdavent – PLV can be classified into 1. Partial veneers 2. Full veneers a) Window preparation b) Incisal lapping 48
Windows Feather Bevel Incisal overlap Four basic preparation designs for the incisal edge reduction......... Incisal edge reduction Walls et al. Crowns and other extra-coronal restorations: Porcelain laminate veneers :British dental journal 2002;193 : 2:73-81
Cervical finish line Long chamfer with about a 0.4 mm maximum depth. • Proximal finish line – Incisal third of the tooth - not to extend beyond the contact point 50Walls et al. Crowns and other extra-coronal restorations: Porcelain laminate veneers :British dental journal 2002;193 : 2:73-81
Finish lines for intracoronal restorations 51
Enamel pattern Occlusal surface Axial surface 52 Clincal significance Cavity wall angulation Convergent Depending upon the buccolingual width Divergent Parallel Cavity prepared Amalgam BevelsCast gold
Noy’s criteria 53 1. Enamel must be supported by sound dentin 2. The enamel rod which form the cavosurface angle must have their inner end resting on sound dentin 3. Enamel rods forming cavosurface angle should be covered with restorative material 4. Angular cavosurface angles should be trimmed M.A Marzouk
54 Cavosurface margin Cavosurface angle Cirumferential tie Terminologies
Bevels Plane of a cavity wall/ floor directed away from the cavity preparation Any angle other than 90o between a tooth cut and a cavity wall in the preparation of the tooth cavity 55
Classification 1. Partial bevel 2. Short bevel 3. Long bevel 4. Full bevel 5. Counter bevel 6. Hollow ground (concave) bevel 56
Partial bevel • Not more than two third the thickness of enamel • Used to trim weak enamel rods at the margins Short bevel • Entire enamel wall but not dentin • Used for class I alloys – type I and II alloys Long bevel • Entire enamel+1/2 of dentinal wall • Used for first three classes of cast alloys • Preserves internal box form of resistance and retention feature Full bevel • Entire enamel and dentin • Resistance and retention form hampered • All classes of cast alloys 57
Hollow ground (concave) bevel • Concave form • For base metal alloys and castable ceramics • Improves castability • Provides bulk Counter bevel • Cusp capping • Opposite to axial cavity wall on facial or lingual surfaces 58
Bevel with different restoration • Amalgam ……….. • Composite ….. 59
Amalgam 60 Cavosurface angle Gingival margin Cavosurface Margins in Direct restorations
Margins in Direct tooth coloured restorations • General concepts 1. Minimal extension 2. Pulpal and/or axial walls of varying depth 3. Enamel bevel 4. Butt joint on root surfaces 5. Tooth preparation walls must be rough 61
Direct tooth coloured restoration • Five designs of tooth preparations for composite restorations are.......... 1. Conventional • Similar to amalgam cavity preparation designs 2. Beveled conventional • Similar to conventional but bevels given 3. Modified • Scooped out design 4. Box only • Proximal caries 5. Slot preparation designs. 62
Anterior composite restoration 63 Class III composite Beveled conventional class III design
64 Anterior composite restoration Bevelled conventionalClass IV restoration
Anterior composite restorations According to Albers • Class IV cavity preparations – Chamfer design – Bevelled margins 1. Chamfer design – 1mm long or half the length of fracture – Most durable restorative margins – Stair stepping – better esthetics 65
Anterior composite restorations • Bevelled margins – Alternative to stair step chamfer – 2-3mm bevel – Better esthetics – Bevels in a curve better than scalloped margins – Drawback • Margins not as durable as chamfer • Chipping 66
Anterior composite restorations 67
Anterior composite restorations 68 Class V restoration Conventional Bevelled conventional
Posterior composite restoration 69 Enamel margin design 90 degree exit 45 degree bevel Concave bevel (chamfer)
• Internal bevel at the cervical cavosurface of class 2 composite restoration reduced marginal microleakge as compared to conventional butt joint 70 JIOH, October 2010, Volume 2 (Issue 3)
Margins in direct gold restoration 71 • Cavosurface margin bevel – Partial bevel Width – not more than 0.2mm 30-40 degrees metal margin Gingival margin bevelled if on enamel Should include atleast 1/4th enamel wall Wedelstaedt chisel used • Allows coverage of the enamel margin with the restorative material
72 MOHD.SIBGHATULLAH KHATIB 1ST PG STUDENT GOOD MORNING Don’t stop when you are tired. STOP when you are DONE……
Margins in Indirect restorations 73
74 AdvantageIndication •Large restoration •Endodontically treated teeth •Teeth at risk for fracture •Removable prosthodontic abutment •Strength •Biocompatibility •Low wear •Control of contour and contact Contraindication •High caries rate •Young patient •Esthetics •Small restoration Disadvantage •Number of appointment •Temoprary •Cost •Technquie sensitive •Splitting force
Cast metal inlay • It is as intracoronal cast restoration replacing one or more, but not all of the cusps fabricated extrorally using direct or indirect wax pattern. 75
76
Cast metal inlay 77 Bevel
• Basic part of circumferential tie • Similar to long bevel • Angulations of 45 degrees to inner dentinal wall Flare 78 Primary
• Function - Same as bevels Brings facial and lingual margins to self – cleansable areas • Indication - Normal contacts Minimum extension of caries in the buccolingual dimension 79
• Flat plane superimposed peripherally to a primary flare • Prepared solely in enamel, sometimes includes dentin • No definite angulation – depends on involvement and extent • 40 degrees marginal metal and 140 degrees marginal enamel desirable 80 Flare Secondary
Indications Indirect wax pattern Broad contact areas Wide extension of caries buccolingually Overcome undercuts in the cervical aspect of facial and lingual proximal walls in ovoid teeth Extends margins into embrasures Stronger enamel margin produced 40 degree marginal metal 81 Function
• Secondary flare omitted in mesiofacial proximal wall of – Maxillary premolars Maxillary molars • Burs No. 8862/ 169 L / paper discs 82
Tooth coloured inlays • Ceramic and Composite inlays – Facial, lingual, and gingival margins of the proximal boxes - clear the adjacent tooth by at least 0.5 mm – 90-degree cavosurface margin desired – Minimal gingival margin extension - margins in enamel preferred for bonding and impression 84
Margins for onlay 85
Onlay • According to sturdavent – The cast metal onlay by definition caps all of the cusps of a posterior tooth and can be designed to help strengthen a tooth that has been weakened by caries or previous restorative experiences. 86
Onlay 87 Counter bevel
Onlay 88 Collar Skirt
Summary 89 Extracoronal restoration Intracoronal restoration
90 Restoration Finish line design Finish Line dimension Purpose Full metal Chamfer, knife- edge, shoulder with bevel 0-1mm Marginal integrity, structural durability
Restoration Finish line design Finish Line dimension Purpose Metal ceramic Labially shoulder, shoulder with bevel, sloping shoulder Lingually Chamfer Labially 1.2mm Lingually 0.5mm Removes unsupported enamel, structural durability, marginal integrity 91
92 Restoration Finish line design Finish Line dimension Purpose All ceramic Shoulder, heavy chamfer, rounded shoulder 0.7 - 1mm Marginal integrity Structural durability Esthetic
93 Restoration Finish line design Finish Line dimension Purpose Partial veneer crown Chamfer 0-1mm Marginal integrity, Structural durability Proximal flare Marginal integrity Occlusal/incisal offset Structural durability Buccal/incisal bevel Marginal integrity, Remove unsupported enamel Occlusal shoulder 1mm Structural durability
94 Restoration Finish line design Finish Line dimension Purpose Porcelain laminate veneer Long chamfer 0.3-0.5mm Marginal integrity, conserves tooth structure, better etching
95 Restoration Cavosurface margin design Margin features purpose Amalgam Butt joint 90 degrees Strongest margin for amalgam Gingival finish line At Gingival third- beveled At Middle third/root surface – no bevel 15-20 degrees Remove unsupported enamel
96 Restoration Cavosurface margin design Margin features Purpose Anterior Direct Composite Restoration Conventional – no bevel 90 degrees margin Lesion on root- no enamel to bevel Bevelled conventional (partial , long) 45 degrees 0.25-0.5mm Increased surface area for etching and bonding According to Sturdavent
97 Restoration Cavosurface margin design Margin features Purpose Anterior direct composite restoration Chamfer 1mm or half the length of defect Half the depth of enamel Durability Bevelled (scalloped) 2-3mm Esthetics According to Albers
Restoration Cavosurface margin design Margin features purpose Occlusal Butt joint Bevel (partial, long) 90 degrees 45-70 degrees 0.25 – 0.5mm Enamel rod ends exposed Conserves tooth structure Better sealing Proximal Long bevel 0.5mm wide 45 degrees 1. Increased surface area for etching and bonding 2. Margins placed in accessible areas 3. Reduced marginal leakage 98 Posterior direct composite restoration
99 Restoration Cavosurface margin design Margin features purpose Gingival Partial bevel Butt joint .... close to CEJ 1/3rd – ½ the enamel wall 90 degrees Better sealing Exposes enamel rod ends internally Better sealing than butt joint Direct gold restoration Partial bevel <0.2mm 30-40 degrees metal margin Posterior direct composite restoration
100 Cast metal inlay Bevel Occlusally Gingivally Flare Primary Secondary Partial bevel
101 Restoration Cavosurface margin design Margin features Purpose Cast metal inlay Occlusally – • partial bevel • Steep cusp – no bevel Width – 1/4th the depth of respective wall 140-150 degrees cavosurface margin • 30-40 degrees marginal metal – burnishible, lap joint • Strongest cavosurface margin INDIRECT RESTORATION
102 Restoration Cavosurface margin design Margin features purpose Cast metal inlay Gingivally – • Partial bevel • Reverse bevel – sufficient gingival floor width Width - 0.5-1mm 150 degrees cavosurface margin • 30-40 degrees marginal metal – burnishable •Minimizes cement line • Strongest cavosurface margin • Removes unsupported enamel •Resistance to dislodgement against occlusal forces INDIRECT RESTORATION
103 Restoration Cavosurface margin design Margin features Purpose Cast metal inlay Primary flare 45 degrees to inner dentinal wall similar to long bevel 30-40 degrees marginal metal •Increases retention •Self-cleansable areas Secondary flare Placed entirely in enamel sometimes dentin No particular angulation • Acute marginal metal • Strong enamel margins •Extends margins to embrasures INDIRECT RESTORATION
105 Restoration Cavosurface margin design Margin features Purpose Tooth coloured inlay Bevels and flares – hollow ground 90 degrees butt joint • Material bulk • Better Resistance to stresses Gingival margin - hollow ground Or no bevel – middle third/cementum 90 degrees butt joint • Removes unsupported enamel • Material bulk • Better Resistance to stresses INDIRECT RESTORATION
Restoration Margin design Margin features purpose Cast metal onlay Counter bevel Facial and lingual margin of reduced cusp Structural durability, marginal integrity, retention, stress distribution 30-40 degrees marginal metal Just gingival to tip and ridge crests Flat sometimes partial bevel given if unsupported enamel remains Increased resistance and retention Conservation of tooth structure Gingival bevel and secondary flares similar to inlay 106 INDIRECT RESTORATION
Restoration Margin design Margin features purpose Tooth coloured onlays Cusp protection – capping Exaggerated hollowground counterbevel – occlusal table to facial termination of the preparation Shoulder – 1mm Increased retention Structural durability Gingival margins and proximal margins – same as tooth coloured inlays 107 INDIRECT RESTORATION
Conclusion... • While choosing a configuration of finish line for extracoronal restoration one must consider the advantages and disadvantages of various finish lines • While deciding about the placement of the finish line , periodontal health and esthetics have to be equally weighed • For the intracoronal restoration, type of restorative material being used and the enamel pattern play an important role 108
Conclusion... • For the restorative materials with low tensile strength like amalgam and ceramics, butt joint is preferred • Bevels and flares are used for metals because of their property of burnishability • Angle and width of bevels and flares also require careful placement 109
Conclusion... “We shall neither fail nor falter , we shall not weaken or tire, give us the tools and we will finish the job” - Winston Churchill • Hence every effort should be made to design and prepare the marginal peripheries to create the most favourable relationship with the restoring casting and luting cement..... 110
References • Contemporary Fixed Prosthodontics 3rd edition • Herbert T. Shillingburg 3rd edition • A.J. Hunter JPD 1990;64 • Journal of Clinical and Diagnostic Research. 2015 Aug, Vol- 9(8 ) • European Journal of Dentistry April 2012 - Vol.6 • Indian Journal of Clinical Practice, Vol. 23, No. 11, April 2013 • Walls et al. Crowns and other extra-coronal restorations: Porcelain laminate veneers :British dental journal 2002;193 : 2:73-81 • Sturdavent 4th edition • JIOH, October 2010, Volume 2 (Issue 3) • J Appl Oral Sci. 2012;20(2):174-9 111
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Finish lines (3) final

  • 1.
    1 MOHD.SIBGHATULLAH KHATIB 1ST PGSTUDENT GOOD MORNING SUCCESS is not just a measure of how big you can DREAM… It is also a measure of how much you can DO
  • 2.
  • 3.
    Contents • Introduction • Definition •Principles of tooth preparation • Finish lines for Extracoronal restorations Full veneer crown Complete cast crown Metal - ceramic crown All-ceramic crown – Porcelain veneer crown  Partial veneer crown  Onlays • Finish lines for Intracoronal restorations Inlays Amalgam Direct filling gold Composites Glass ionomer cement • Conclusion 3
  • 4.
    • One ofthe basic tenets of restorative dentistry is to conserve as much tooth structure as possible consistent with the mechanical and esthetic principles of tooth preparation. 4 Introduction Contemporary Fixed Prosthodontics 3rd edition
  • 5.
    Introduction • Restoration cansurvive in the biologic environment of the oral cavity only if the margins are closely adapted to the finish line of the preparation 5 Contemporary Fixed Prosthodontics 3rd edition
  • 6.
    According to Schwartz •Refers to the border of the preparation where the prepared tooth structure meets the unprepared surface of the tooth. According to Rosenstiel 1. A line of demarcation 2. The peripheral extension of a tooth preparation 3. The planned junction of different materials 4. The terminal portion of the prepared tooth. 6 Definition
  • 7.
    Principles of toothpreparation 1. Preservation of tooth structure 2. Retention and resistance 3. Structural durability – Marginal geometry 4. Marginal integrity – Marginal adaptation 5. Preservation of the periodontium – Margin placement 7 Herbert T. Shillingburg 3rd edition
  • 8.
    Preservation of toothstructure • Avoide excessive destruction • Design restoration to reinforce and protect remaining enamel and dentin 8 Herbert T. Shillingburg 3rd edition
  • 9.
    Retention & Resistance •Retention prevents removal of the restoration along the path of insertion or long axis . • Resistance prevents dislodgement of the restoration by an apical/oblique forces 9 Herbert T. Shillingburg 3rd edition
  • 10.
    10 Taper Freedom of displacement HerbertT. Shillingburg 3rd edition
  • 11.
    11 Length Substitution of internalfeature Path of insertion Herbert T. Shillingburg 3rd edition
  • 12.
    Structural durability • Adequatespace created by tooth preparation 12 Occlusal reduction Axial reduction
  • 13.
    Marginal integrity • Marginsof restoration must be closely adapted to finish line of preparation • Configuration of the preparation finish line dictates the shape of restorative material in the margin of the restoration 13 To bevel….. ….Not to bevel Herbert T. Shillingburg 3rd edition
  • 14.
    Finish line inextracoronal restoration Chamfer Heavy chamfer Shoulder Sloping shoulder Radial shoulder Shoulder with bevel Knife edge/ Feather edge Chisel edge 14 Contemporary Fixed Prosthodontics 3rd edition
  • 15.
    Extracoronal restorations -Finish line configurations • Finish line classification according to width Marginal width less than 0.3mm - Knife-edge/ feather edge Marginal width upto 0.3mm – Chamfer Marginal width greater than 0.3mm - Shoulder 15 A.J. Hunter JPD 1990;64
  • 16.
    Chamfer • GPT- AFinish line design for tooth preparation in which the gingival aspect meets the external axial surface at an obtuse angle. • TYLMANN (1965): Concave extra coronal finish line that provides greater angulation than a knife-edge and less width than a shoulder. 16
  • 17.
    17 Advantage Disadvantage Indication •Distinctmargin •Adequate bulk •Easier control •Care needed to avoid unsupported lip of enamel •Cast metal restoration •Lingual margin of metal ceramic Bur Round end taper Round end taper
  • 18.
    Heavy chamfer  Provides90 degrees cavosurface angle with a large radius rounded internal angle.  A bevel can be added to the heavy chamfer for use with metal restoation. 18 Herbert T. Shillingburg 3rd edition
  • 19.
    19 Round end taper Bur AdvantageDisadvantage Indication •Better support for a ceramic crown •Unskilled operator can create an undesirable fragile “lip” of enamel at cavosurface •Ceramic crown •With bevel metal crown
  • 20.
     Finish lineof choice for all-ceramic crown  Wide ledge provides resistance to occlusal forces  Produce the space for healthy restoration contours and maximum esthtetic 20 Shoulder Herbert T. Shillingburg 3rd edition
  • 21.
    21 •Advantage •Disadvantage •Indication •Bulkof restorative material •Less conservative of tooth structure •Stress concentration at 90 degree internal angle of the finish line, hence conducive to coronal fracture •Facial magin of metal ceramic crowns •Complete ceramic crown Flat end taper Bur
  • 22.
     Modification ofshoulder finish line  Support for ceramic restoration is good 22 Herbert T. Shillingburg 3rd edition Radial shoulder •Advantage •Disadvantage •Indication •Stress concentration lesser than the classic shoulder •Less conservative of tooth structure •Facial magin of metal ceramic crowns •Complete ceramic crown
  • 23.
    23 Flat end taperEnd cutting carbide finishing bur Modified bine-angle chisel Bur
  • 24.
    24 Herbert T. Shillingburg3rd edition Shoulder with bevel •Advantage •Disadvantage •Indication •Bulk of material •Less conservative, extend peraparation apically •Facial magin of posterior metal ceramic crowns with supragingival margin  Uses – • Gingival finish line on the proximal box of inlays and onlays • Occlusal shoulder of onlays and mandibular three-quarter crowns • Finish line for extremely short walls • More destruction of tooth - NOT USED routinely for full veneer restorations
  • 25.
    A 120-degree slopedshoulder margin used as an alternative to the 90-degree shoulder for the facial margin of a metal-ceramic crown.  Reduces the possibility of leaving unsupported enamel Provides sufficient bulk to allow thinning of the metal framework to a knife-edge for acceptable esthetics. 25 Sloping shoulder •Advantage •Disadvantage •Indication •Bulk of material •Less conservative of tooth sturcture •Facial magin of metal ceramic crowns Contemporary Fixed Prosthodontics 3rd edition
  • 26.
     The ultimatefinish line that permit an acute margin of metal  Uses – • Lingual surface of mandibular posteroior teeth • Very convex axial surfaces • Surface towards which tooth is tilted  Disadvantage – • Axial reduction may fade out • Thin margins difficult to wax and cast • Overcontoured restorations 26 Herbert T. Shillingburg 3rd edition Knife edge/ Feather edge
  • 27.
    Chisel edge • Avariation of the featheredge, • Formed when there is a larger angle between the axial surfaces and the unprepared tooth structure. • Associated with an excessively tapered preparation 27 Contemporary Fixed Prosthodontics 3rd edition
  • 28.
    28 A. Featheredge, B.Chisel, C. Chamfer, D. Bevel, E. Shoulder, F. Sloped Shoulder, G. Beveled shoulder Contemporary Fixed Prosthodontics 3rd edition
  • 29.
    • Shoulder marginsprovide good seat but a comparatively wider marginal seal • Chamfer, long chamfer and feather edge margin provide superior sealing of the margins despite poor seat. 30 Journal of Clinical and Diagnostic Research. 2015 Aug, Vol-9(8 )
  • 30.
    • Both ZZand E copings presented better marginal fit on shoulder preparations than chamfer preparations. 31 European Journal of Dentistry April 2012 - Vol.6
  • 31.
    Preservation of theperiodontium • Margins as smooth as possible • Kept clean by the patient • Supragingival placement of finish lines whenever possible! • Subgingival finish lines 2.0 mm from alveolar crest 32 Herbert T. Shillingburg 3rd edition
  • 32.
    • The biologicwidth is defined as the dimension of the soft tissue, which is attached to the portion of the tooth coronal to the crest of the alveolar bone • Biologic width (EA + CTA) dimensions - – Anterior teeth 1.75mm – Premolars 1.97mm – Molars 2.08mm 33 Biologic width J Clin Periodontol 2003; 30: 379–385
  • 33.
    35 Margin placement Supragingival marginEquigingival margins Subgingival margin Placed in non-esthetic area At the crest of the marginal gingiva Below the gingiva Least impact on periodontium More impact on the periodontium Greatest biologic risk More plaque retentive May violate gingival attachment apparatus
  • 34.
    Margin placement guidelines 36 Ifthe sulcus probes 1.5mm or less, place the margin 0.5mm below the gingival crest If probing depth more than 1.5mm – place the margin half the depth of the sulcus below the crest If probing depth more than 2.0 mm – Gingivectomy is advocated Indian Journal of Clinical Practice, Vol. 23, No. 11, April 2013
  • 35.
    37 Orkin et al Silness IndianJournal of Clinical Practice, Vol. 23, No. 11, April 2013 Subgingival restorations Bleeding Gingival recession Supragingival position of the crown margin Margins below the gingival margin
  • 36.
    Finish line exposure •Mechanical – Copper tube/band – Rubber dam • Chemomechanical (retraction cord) – Caustic chemicals – sulfuric acid, trichloracetic acid, negatol, zinc chloride – Racemic epinephrine – Aluminium chloride, alum, aluminium sulfate, ferric sulfate • Rotary curettage/ gingettage • Electrosurgery 38
  • 37.
    39 MOHD.SIBGHATULLAH KHATIB 1ST PGSTUDENT GOOD MORNING Beginning well is a momentary thing; finishing well is a life long thing.
  • 38.
    Extracoronal restoration -Full veneer crowns 40 All ceramic crown Full metal crown Metal ceramic crown
  • 39.
  • 40.
    Metal ceramic crown Fullveneer crown 42
  • 41.
    Metal ceramic crown Fullveneer crown 43
  • 42.
  • 43.
  • 44.
  • 45.
    47 A conservative methodof restoring the - Discolored Pitted Fractured anterior teeth.
  • 46.
    According to sturdavent –PLV can be classified into 1. Partial veneers 2. Full veneers a) Window preparation b) Incisal lapping 48
  • 47.
    Windows Feather BevelIncisal overlap Four basic preparation designs for the incisal edge reduction......... Incisal edge reduction Walls et al. Crowns and other extra-coronal restorations: Porcelain laminate veneers :British dental journal 2002;193 : 2:73-81
  • 48.
    Cervical finish line Longchamfer with about a 0.4 mm maximum depth. • Proximal finish line – Incisal third of the tooth - not to extend beyond the contact point 50Walls et al. Crowns and other extra-coronal restorations: Porcelain laminate veneers :British dental journal 2002;193 : 2:73-81
  • 49.
    Finish lines forintracoronal restorations 51
  • 50.
    Enamel pattern Occlusal surfaceAxial surface 52 Clincal significance Cavity wall angulation Convergent Depending upon the buccolingual width Divergent Parallel Cavity prepared Amalgam BevelsCast gold
  • 51.
    Noy’s criteria 53 1. Enamelmust be supported by sound dentin 2. The enamel rod which form the cavosurface angle must have their inner end resting on sound dentin 3. Enamel rods forming cavosurface angle should be covered with restorative material 4. Angular cavosurface angles should be trimmed M.A Marzouk
  • 52.
    54 Cavosurface margin Cavosurfaceangle Cirumferential tie Terminologies
  • 53.
    Bevels Plane of acavity wall/ floor directed away from the cavity preparation Any angle other than 90o between a tooth cut and a cavity wall in the preparation of the tooth cavity 55
  • 54.
    Classification 1. Partial bevel 2.Short bevel 3. Long bevel 4. Full bevel 5. Counter bevel 6. Hollow ground (concave) bevel 56
  • 55.
    Partial bevel • Notmore than two third the thickness of enamel • Used to trim weak enamel rods at the margins Short bevel • Entire enamel wall but not dentin • Used for class I alloys – type I and II alloys Long bevel • Entire enamel+1/2 of dentinal wall • Used for first three classes of cast alloys • Preserves internal box form of resistance and retention feature Full bevel • Entire enamel and dentin • Resistance and retention form hampered • All classes of cast alloys 57
  • 56.
    Hollow ground (concave)bevel • Concave form • For base metal alloys and castable ceramics • Improves castability • Provides bulk Counter bevel • Cusp capping • Opposite to axial cavity wall on facial or lingual surfaces 58
  • 57.
    Bevel with differentrestoration • Amalgam ……….. • Composite ….. 59
  • 58.
    Amalgam 60 Cavosurface angle Gingivalmargin Cavosurface Margins in Direct restorations
  • 59.
    Margins in Directtooth coloured restorations • General concepts 1. Minimal extension 2. Pulpal and/or axial walls of varying depth 3. Enamel bevel 4. Butt joint on root surfaces 5. Tooth preparation walls must be rough 61
  • 60.
    Direct tooth colouredrestoration • Five designs of tooth preparations for composite restorations are.......... 1. Conventional • Similar to amalgam cavity preparation designs 2. Beveled conventional • Similar to conventional but bevels given 3. Modified • Scooped out design 4. Box only • Proximal caries 5. Slot preparation designs. 62
  • 61.
    Anterior composite restoration 63 ClassIII composite Beveled conventional class III design
  • 62.
    64 Anterior composite restoration BevelledconventionalClass IV restoration
  • 63.
    Anterior composite restorations Accordingto Albers • Class IV cavity preparations – Chamfer design – Bevelled margins 1. Chamfer design – 1mm long or half the length of fracture – Most durable restorative margins – Stair stepping – better esthetics 65
  • 64.
    Anterior composite restorations •Bevelled margins – Alternative to stair step chamfer – 2-3mm bevel – Better esthetics – Bevels in a curve better than scalloped margins – Drawback • Margins not as durable as chamfer • Chipping 66
  • 65.
  • 66.
    Anterior composite restorations 68 ClassV restoration Conventional Bevelled conventional
  • 67.
    Posterior composite restoration 69 Enamelmargin design 90 degree exit 45 degree bevel Concave bevel (chamfer)
  • 68.
    • Internal bevelat the cervical cavosurface of class 2 composite restoration reduced marginal microleakge as compared to conventional butt joint 70 JIOH, October 2010, Volume 2 (Issue 3)
  • 69.
    Margins in directgold restoration 71 • Cavosurface margin bevel – Partial bevel Width – not more than 0.2mm 30-40 degrees metal margin Gingival margin bevelled if on enamel Should include atleast 1/4th enamel wall Wedelstaedt chisel used • Allows coverage of the enamel margin with the restorative material
  • 70.
    72 MOHD.SIBGHATULLAH KHATIB 1ST PGSTUDENT GOOD MORNING Don’t stop when you are tired. STOP when you are DONE……
  • 71.
    Margins in Indirectrestorations 73
  • 72.
    74 AdvantageIndication •Large restoration •Endodontically treated teeth •Teethat risk for fracture •Removable prosthodontic abutment •Strength •Biocompatibility •Low wear •Control of contour and contact Contraindication •High caries rate •Young patient •Esthetics •Small restoration Disadvantage •Number of appointment •Temoprary •Cost •Technquie sensitive •Splitting force
  • 73.
    Cast metal inlay •It is as intracoronal cast restoration replacing one or more, but not all of the cusps fabricated extrorally using direct or indirect wax pattern. 75
  • 74.
  • 75.
  • 76.
    • Basic partof circumferential tie • Similar to long bevel • Angulations of 45 degrees to inner dentinal wall Flare 78 Primary
  • 77.
    • Function - Sameas bevels Brings facial and lingual margins to self – cleansable areas • Indication - Normal contacts Minimum extension of caries in the buccolingual dimension 79
  • 78.
    • Flat planesuperimposed peripherally to a primary flare • Prepared solely in enamel, sometimes includes dentin • No definite angulation – depends on involvement and extent • 40 degrees marginal metal and 140 degrees marginal enamel desirable 80 Flare Secondary
  • 79.
    Indications Indirect wax pattern Broadcontact areas Wide extension of caries buccolingually Overcome undercuts in the cervical aspect of facial and lingual proximal walls in ovoid teeth Extends margins into embrasures Stronger enamel margin produced 40 degree marginal metal 81 Function
  • 80.
    • Secondary flareomitted in mesiofacial proximal wall of – Maxillary premolars Maxillary molars • Burs No. 8862/ 169 L / paper discs 82
  • 81.
    Tooth coloured inlays •Ceramic and Composite inlays – Facial, lingual, and gingival margins of the proximal boxes - clear the adjacent tooth by at least 0.5 mm – 90-degree cavosurface margin desired – Minimal gingival margin extension - margins in enamel preferred for bonding and impression 84
  • 82.
  • 83.
    Onlay • According tosturdavent – The cast metal onlay by definition caps all of the cusps of a posterior tooth and can be designed to help strengthen a tooth that has been weakened by caries or previous restorative experiences. 86
  • 84.
  • 85.
  • 86.
  • 87.
    90 Restoration Finish line design FinishLine dimension Purpose Full metal Chamfer, knife- edge, shoulder with bevel 0-1mm Marginal integrity, structural durability
  • 88.
    Restoration Finish line design FinishLine dimension Purpose Metal ceramic Labially shoulder, shoulder with bevel, sloping shoulder Lingually Chamfer Labially 1.2mm Lingually 0.5mm Removes unsupported enamel, structural durability, marginal integrity 91
  • 89.
    92 Restoration Finish line design FinishLine dimension Purpose All ceramic Shoulder, heavy chamfer, rounded shoulder 0.7 - 1mm Marginal integrity Structural durability Esthetic
  • 90.
    93 Restoration Finish linedesign Finish Line dimension Purpose Partial veneer crown Chamfer 0-1mm Marginal integrity, Structural durability Proximal flare Marginal integrity Occlusal/incisal offset Structural durability Buccal/incisal bevel Marginal integrity, Remove unsupported enamel Occlusal shoulder 1mm Structural durability
  • 91.
    94 Restoration Finish line design FinishLine dimension Purpose Porcelain laminate veneer Long chamfer 0.3-0.5mm Marginal integrity, conserves tooth structure, better etching
  • 92.
    95 Restoration Cavosurface margin design Margin features purpose Amalgam Buttjoint 90 degrees Strongest margin for amalgam Gingival finish line At Gingival third- beveled At Middle third/root surface – no bevel 15-20 degrees Remove unsupported enamel
  • 93.
    96 Restoration Cavosurface margin design Marginfeatures Purpose Anterior Direct Composite Restoration Conventional – no bevel 90 degrees margin Lesion on root- no enamel to bevel Bevelled conventional (partial , long) 45 degrees 0.25-0.5mm Increased surface area for etching and bonding According to Sturdavent
  • 94.
    97 Restoration Cavosurface margin design Marginfeatures Purpose Anterior direct composite restoration Chamfer 1mm or half the length of defect Half the depth of enamel Durability Bevelled (scalloped) 2-3mm Esthetics According to Albers
  • 95.
    Restoration Cavosurface margin design Margin features purpose Occlusal Buttjoint Bevel (partial, long) 90 degrees 45-70 degrees 0.25 – 0.5mm Enamel rod ends exposed Conserves tooth structure Better sealing Proximal Long bevel 0.5mm wide 45 degrees 1. Increased surface area for etching and bonding 2. Margins placed in accessible areas 3. Reduced marginal leakage 98 Posterior direct composite restoration
  • 96.
    99 Restoration Cavosurface margin design Margin features purpose Gingival Partialbevel Butt joint .... close to CEJ 1/3rd – ½ the enamel wall 90 degrees Better sealing Exposes enamel rod ends internally Better sealing than butt joint Direct gold restoration Partial bevel <0.2mm 30-40 degrees metal margin Posterior direct composite restoration
  • 97.
  • 98.
    101 Restoration Cavosurface margin design Marginfeatures Purpose Cast metal inlay Occlusally – • partial bevel • Steep cusp – no bevel Width – 1/4th the depth of respective wall 140-150 degrees cavosurface margin • 30-40 degrees marginal metal – burnishible, lap joint • Strongest cavosurface margin INDIRECT RESTORATION
  • 99.
    102 Restoration Cavosurface margin design Marginfeatures purpose Cast metal inlay Gingivally – • Partial bevel • Reverse bevel – sufficient gingival floor width Width - 0.5-1mm 150 degrees cavosurface margin • 30-40 degrees marginal metal – burnishable •Minimizes cement line • Strongest cavosurface margin • Removes unsupported enamel •Resistance to dislodgement against occlusal forces INDIRECT RESTORATION
  • 100.
    103 Restoration Cavosurface margin design Marginfeatures Purpose Cast metal inlay Primary flare 45 degrees to inner dentinal wall similar to long bevel 30-40 degrees marginal metal •Increases retention •Self-cleansable areas Secondary flare Placed entirely in enamel sometimes dentin No particular angulation • Acute marginal metal • Strong enamel margins •Extends margins to embrasures INDIRECT RESTORATION
  • 101.
    105 Restoration Cavosurface margin design Marginfeatures Purpose Tooth coloured inlay Bevels and flares – hollow ground 90 degrees butt joint • Material bulk • Better Resistance to stresses Gingival margin - hollow ground Or no bevel – middle third/cementum 90 degrees butt joint • Removes unsupported enamel • Material bulk • Better Resistance to stresses INDIRECT RESTORATION
  • 102.
    Restoration Margin designMargin features purpose Cast metal onlay Counter bevel Facial and lingual margin of reduced cusp Structural durability, marginal integrity, retention, stress distribution 30-40 degrees marginal metal Just gingival to tip and ridge crests Flat sometimes partial bevel given if unsupported enamel remains Increased resistance and retention Conservation of tooth structure Gingival bevel and secondary flares similar to inlay 106 INDIRECT RESTORATION
  • 103.
    Restoration Margin designMargin features purpose Tooth coloured onlays Cusp protection – capping Exaggerated hollowground counterbevel – occlusal table to facial termination of the preparation Shoulder – 1mm Increased retention Structural durability Gingival margins and proximal margins – same as tooth coloured inlays 107 INDIRECT RESTORATION
  • 104.
    Conclusion... • While choosinga configuration of finish line for extracoronal restoration one must consider the advantages and disadvantages of various finish lines • While deciding about the placement of the finish line , periodontal health and esthetics have to be equally weighed • For the intracoronal restoration, type of restorative material being used and the enamel pattern play an important role 108
  • 105.
    Conclusion... • For therestorative materials with low tensile strength like amalgam and ceramics, butt joint is preferred • Bevels and flares are used for metals because of their property of burnishability • Angle and width of bevels and flares also require careful placement 109
  • 106.
    Conclusion... “We shall neitherfail nor falter , we shall not weaken or tire, give us the tools and we will finish the job” - Winston Churchill • Hence every effort should be made to design and prepare the marginal peripheries to create the most favourable relationship with the restoring casting and luting cement..... 110
  • 107.
    References • Contemporary FixedProsthodontics 3rd edition • Herbert T. Shillingburg 3rd edition • A.J. Hunter JPD 1990;64 • Journal of Clinical and Diagnostic Research. 2015 Aug, Vol- 9(8 ) • European Journal of Dentistry April 2012 - Vol.6 • Indian Journal of Clinical Practice, Vol. 23, No. 11, April 2013 • Walls et al. Crowns and other extra-coronal restorations: Porcelain laminate veneers :British dental journal 2002;193 : 2:73-81 • Sturdavent 4th edition • JIOH, October 2010, Volume 2 (Issue 3) • J Appl Oral Sci. 2012;20(2):174-9 111
  • 108.

Editor's Notes

  • #39 Negatol – 45% condensation of meta cresol, sulfonic acid and formaldehyde
  • #54 When enamel loses its support of dentin, it loses more than 85% of its strength properties
  • #85 composite and ceramic inlays are fragile in thin cross-section.