The taper of clinical preparations for fixed prosthodontics

Effect of metal type and surface treatment on in vitro tensile strength of copings cemented to minimally retentive preparations

STATEMENT OF PROBLEM

Due to the potential lack of ideal preparation form, the type of alloy and its surface pretreatment may have clinically relevant correlations with the retentive strength of castings to minimally retentive preparations.

PURPOSE

The purpose of this study was to evaluate the effect of alloy type and surface pretreatments of base and noble metal copings on their tensile strength to minimally retentive preparations.

MATERIAL AND METHODS

Minimally retentive, standardized crown preparations were made on recently extracted human third molars (n=68). Noble (IPS d.SIGN 53) and base metal (Rexillium NBF) copings were fabricated. All copings received heat treatment for oxide formation. Three experimental groups were then developed for each metal type (groups ranging from 10 to 12 specimens each): oxide only, airborne-particle abraded, or metal-primed. Copings were cemented using a self-adhesive universal resin cement (RelyX Unicem) and were thermal cycled (500 cycles between 5 and 55 degrees C) and stored (24 hours, 37 degrees C) before debonding using a universal testing machine. Frequency of debond location was compared among specimen groups. A 2-way ANOVA was used to test for interaction between the metal type and surface treatment, and, if no significant interaction was found, to test the main effects for metal type and surface treatment (alpha=.05). A multinomial logit model using the likelihood ratio test was used to describe the effect of metal type and surface treatment on failure site location (alpha=.05).

RESULTS

The 2-way ANOVA indicated no significant influence of any factor on debond load: metal type (P=.885), surface treatment (P=.555), or their interaction (P=.644). The multinomial logit statistical model showed that noble metals and metal primers significantly (P<.05) shifted debond failures to occur more frequently at the resin/tooth interface or within the tooth itself.

CONCLUSIONS

Neither metal type nor surface pretreatment affected bond strength. However, alloy type and surface treatment affected site of debond location. (J Prosthet Dent 2007;98:199-207).

Effect of auxiliary grooves on molar crown preparations lacking resistance form: a laboratory study

PURPOSE

To investigate the effect of auxiliary grooves on resistance to dislodgment of crowns on compromised molar preparations lacking resistance form.

MATERIALS AND METHODS

Thirty human molar teeth were randomly assigned to three groups of ten, and prepared to a height-to-width ratio of 0.3 with a total convergence of 50 degrees , and 1-mm shoulder margin. Base metal alloy copings were constructed with a 45 degrees loading platform and cemented with zinc phosphate cement under a 50 N load. Initially, resistance testing was conducted using a Universal Testing Machine (Instron) at 1 mm/min for all 30 specimens. Following crown dislodgment, Group 1 copings were recemented and retested, Group 2 had one axial groove added, and Group 3 had two axial grooves added. New copings for Groups 2 and 3 were made, cemented, and again tested for resistance. Standardized radiographs were taken prior to initial cementation and scanned into digital images. The percentage of area occupied by the pulpal chamber above the acrylic mounting (PS), and the closest distance to pulp from the preparation surface (CD) were measured.

RESULTS

Recementation or the addition of one groove did not affect the dislodgment values (p > 0.05), but addition of two grooves caused a highly significant increase in resistance (p < 0.001). Regression analysis showed an inverse relationship between initial resistance values and pulpal space area. Lower resistance values were observed when the pulpal space area was large (p= 0.004).

CONCLUSIONS

Crowns can be recemented without affecting resistance to dislodgment. Two grooves should be incorporated into compromised molar crown preparations to increase resistance form. Teeth with large pulps and therefore less coronal dentine have poorer resistance form, and therefore would benefit from placement of auxiliary grooves.

Assessment of convergence angles of tooth preparations for complete crowns among dental students

OBJECTIVES

Convergence angles for complete crown preparations have been recommended at 4-12 degrees . However, practitioners have difficulty meeting these recommendations. This study measured and compared the convergence angles of tooth preparations for complete crowns prepared at three Colleges of Dentistry: the University of Tanta, Egypt, King Abdulaziz University, Saudi Arabia, and The Ohio State University, Columbus, Ohio.

METHODS

The convergence angles of 499 tooth preparations for complete crowns were evaluated. These comprised of a random sample of 262 teeth prepared by third-year dental students at the University of Tanta on extracted molars under normal preclinical conditions, 37 preparations on molar teeth on typodonts done by first-year dental students. The Ohio State University and 200 molar typodont complete crown preparations done by fourth-year dental students at King Abdulaziz University, Saudi Arabia. The bucco-lingual and mesio-distal convergence angles of each preparation were measured with a goniometer microscope. Mean convergence angles were calculated, and differences between groups were tested for statistical significance with analysis of variance (ANOVA) at 5% level of confidence.

RESULTS

Convergence angle measurements were significantly different between the groups and the dimensions (P<0.001). The greatest convergence value (19.8+/-10.0) was for bucco-lingual measurements prepared by Egyptian dental students. The smallest convergence value (14.1+/-3.8) was for mesio-distal measurements prepared by Saudi dental students.

CONCLUSIONS

This study emphasized the difference between what is taught at dental schools (what is theoretically possible) and the school results of actual practice. There was a considerable disparity between the convergent angles recorded in this study and the ideal configurations recommended in fixed prosthodontic textbooks and the dental literature.

Effect of preparation convergence on retention and seating discrepancy of complete veneer crowns

The purpose of this study was to evaluate the retention and marginal seating discrepancy of complete veneer crown cemented with zinc phosphate cement using various preparation convergence designs. The method employed was that of cementing cast metal crowns onto 46 metal dies fabricated as complete veneer crown preparations with various convergence angles ranging from 0 degrees to 70 degrees and a shoulder finish line. The marginal discrepancy was calculated by measuring the change in crown height before and after cementation using an optical measuring microscope. The force required to remove the crowns from the dies in a vertical direction was determined using an Instron universal testing machine and recorded as retention. The increase in preparation convergence exhibited a wide variation of seating discrepancy between specimens, ranging from 4.58 +/- 1.13 to 73.13 +/- 78.32 microm. Significant tilting of crown was observed as the convergence angle of preparation increased. The retention values ranged from 4.03 +/- 0.61 to 12.12 +/- 0.33 MPa. The Pearson analysis revealed statistically significant correlations between preparation convergence and marginal discrepancy (r = +0.62), and retention (r = -0.91). Crown retention and marginal discrepancy were influenced by the preparation convergence design.

Quantitative evaluation of axial wall taper in prepared artificial teeth

The purpose of this study was to quantitatively evaluate the axial wall taper of prepared artificial teeth using a non-contact three-dimensional shape measuring system. A total of 54 artificial teeth prepared by pre-clinical dental students for complete cast restorations were evaluated. For quantitative analysis, five cross sections were computer-graphically placed perpendicularly to the z-axis. The surface coordinate values (x, y, z) of each cross section were converted into polar coordinate values (r, theta), which were then graphically rendered to a two-dimensional plane. At four points, each 90 degrees from the distal center point of the cross section, the axial wall taper was quantitatively calculated using a formula based on the differences in radius between the highest and lowest positions of the cross sections of the prepared tooth. The average calculated taper was 5.8 degrees in the distal region, 21.7 degrees in the buccal region, 14.9 degrees in the mesial region and 12.5 degrees in the lingual region. These results suggest that the axial wall taper of prepared teeth can be quantitatively evaluated using this measuring system.

Designing tooth preparations for optimal success

The form of prepared teeth and the amount of tooth structure remove dare important contributors to the mechanical, biologic,and esthetic success of the overlying crown or fixed partial denture.Therefore, it is important to develop clinical guidelines that can be used to optimize success in fixed prosthodontics.

Resistance form in tooth preparation

Theoretical and clinical studies of resistance form are reviewed, supporting the basic prosthodontic principle that resistance form is an essential element in preparation design. Concepts of the"on-off" nature of resistance form, its application in guidelines for minimally acceptable preparation taper, and the controversy over whether there is a relationship with clinical success or failure are discussed. It is more challenging to obtain resistive molar preparations than resistive anterior preparations, and uneven preparation margins can make parallel 0 degree taper preparations lack resistance form. The usefulness of grooves, especially in molar preparations with uneven margins, is illustrated. The Lewis and Zuckerman techniques for evaluating resistive areas of a preparation are shown to be consistent with each other but not with the Weed method.

Training in tooth preparation utilizing a support system

Tooth preparation is an essential technique for dental treatment, but it is a skill not easily learned by a dental student. To facilitate this leaning process, a new tooth preparation support system with a parallel link mechanism was developed. This study reports the educational efficiency of this system for dental students. Dental students with no experience in clinical practice were selected and divided into two groups; one trained with this support system; and the other, with freehand preparation. They prepared axial walls in right maxillary second premolars and molars mounted in a phantom manikin with an air-turbine handpiece. Convergence angles of the axial walls and parallelisms between axes of prepared teeth were evaluated. Training with the support system led to significantly smaller convergence angles and parallelisms as compared with freehand preparation training. With the freehand preparation after training, the convergence angles and parallelisms became smaller in the group trained with the support system than those trained with freehand. The above findings suggest that training in tooth preparation utilizing the newly developed support system can be one of practical programs that are useful for dental students to achieve greater competency in tooth preparation.

The effectiveness of auxiliary features on a tooth preparation with inadequate resistance form

STATEMENT OF PROBLEM

No study has evaluated the efficacy of auxiliary tooth preparation elements for crowns with originally reduced resistance form.

PURPOSE

This study evaluated the effects of different auxiliary preparation features on the resistance form of crowns with reduced axial wall and total occlusal convergence.

MATERIAL AND METHODS

An Ivorine tooth was prepared on a milling machine with 20-degree total occlusal convergence (TOC), 2.5 mm of occlusocervical dimension, and a shoulder finish line. This design lacked geometric resistance form. The crown preparation was subsequently modified to include mesiodistal grooves, mesiodistal boxes, buccolingual grooves, occlusal inclined planes, an occlusal isthmus, and reduced TOC in the axial wall from 20 to 8 degrees TOC in the cervical 1.5 mm of the axial wall. The grooves and boxes were placed into the tooth with the same 20-degree TOC as the initial axial walls. Ten standardized metal dies were used for each preparation design. Standardized complete metal crowns were fabricated for all specimens. The metal crowns were cemented on metal dies with resin-modified glass ionomer cement. A strain gauge was placed at the mid-lingual cervical area of each crown preparation margin. The resistance of each specimen was evaluated when force was applied at a 45-degree angulation to the long axis of the die in a lingual to buccal direction. The peak loads during crown dislodgment, as well as the tensile stress at the mid-lingual cervical area, were measured using a universal testing machine (Kgs) for each specimen. The control group consisted of 10 dies, with the original crown preparation having no geometric resistance form and no auxiliary preparation features. Strain gauges provided the force (Kgs) that resulted in electric currency disrupt at the crown/die interface, thus providing data regarding the force required for slight crown micromovement (2 microm). Data between control and experimental groups were compared using the Mann-Whitney U test (alpha=.05).

RESULTS

Proximal grooves, proximal boxes, buccolingual grooves, occlusal inclined planes, and occlusal isthmuses were not effective at increasing a crown's resistance to dislodgement when the tooth preparation lacked resistance. The only crown modification that offered enhanced resistance form when compared with the control group was the reduced TOC in the cervical half of the axial wall.

CONCLUSION

Within the limitations of this in vitro study the crown preparation modification that significantly enhanced the resistance form of a compromised tooth preparation was reducing the TOC at the cervical aspect of the axial wall. Placing auxiliary retentive features such as grooves and boxes into a compromised tooth preparation (2.5 mm occlusocervical dimension and 20-degree TOC) was not effective when these retentive features possessed the same 20-degree TOC as the prepared axial walls.

A technique to determine a desired preparation axial inclination

The guidelines recommended in the literature for the convergence angle of a crown preparation vary from 3 to 24 degrees. There is a lack of guidelines on techniques to achieve a specific axial inclination. The purpose of this article was to present a practical technique, with a diamond rotary cutting instrument of known axial inclination, to determine the diamond rotary cutting instrument angulations required to achieve the desired axial inclination of a preparation.

The retention of complete crowns prepared with three different tapers and luted with four different cements

STATEMENT OF PROBLEM

The role of adhesive properties of cements on the retentive strength of crowns with different degrees of taper is not clear.

PURPOSE

This study evaluated the retention of full crowns prepared with 3 different tapers and cemented with 2 conventional and 2 adhesive resin cements.

MATERIAL AND METHODS

One hundred twenty sound human molar teeth were assigned randomly to 1 of 12 groups, (n=10). The groups represented the 4 cements: zinc phosphate (Fleck's), a conventional glass ionomer (Ketac-Cem); 2 adhesive resin cements (C&B Metabond and Panavia); and 3 tapers of 6-degrees, 12-degrees, and 24-degrees within each cement. Crowns were cast with a high noble alloy. The 6-degree taper was considered the control within each cement group. Retention was measured (MPa) by separating the metal crowns from the prepared teeth under tension on a universal testing machine. Analysis of variance was used to test the main effects on the retentive strength of full crowns, namely cements, tapers, and failure modes. The Fisher's multiple comparison test was used to evaluate the source of the differences. The chi(2) analyses were used to examine the relationships between failure types, cements, and tapers. All statistical tests were conducted at alpha=.05.

RESULTS

There was a significant difference in the main effect cement (P<.0001) and taper (P=.0002). The mean retentive strength values of both Fleck's and Ketac-Cem were significantly lower than the mean retentive strength values of both C&B Metabond and Panavia (P<.0001). The retention of crowns prepared with 6-degree taper was not significant from the 12-degree taper (P=.0666). The difference in retention was significant between the 6-degree taper and the 24-degree taper (P<.0001) and between 12-degree taper and 24-degree taper (P=.0178). The types of failure were adhesive in the cement (65%), cohesive in the tooth (31%), and assembly failure (fracture of embedding resin) (4%). The type of failure was dependent on the degree of taper (P<.0001) and on the type of cement (P<.0042).

CONCLUSION

Within the limitations of this study, the retentive values of the adhesive resins at 24-degree taper were 20% higher than the retentive values of the conventional cements at 6-degree taper. The use of resin luting agents yielded retention values that were double the values of zinc phosphate or conventional glass ionomer cement.

Retentive properties of five different luting cements on base and noble metal copings

STATEMENT OF PROBLEM

The retention of indirectly fabricated restorations can be compromised by short or over-tapered tooth preparations.

PURPOSE

The aim of this study was to evaluate the retentive properties of 5 different luting cements on base and noble metal copings to short and over-tapered preparations.

MATERIAL AND METHODS

Eighty extracted mandibular premolars were prepared to receive full cast copings with a flat occlusal surface, 33 degrees taper, and 3-mm axial length. Half of the standardized metal copings were cast in an AuAgPd alloy, whereas the other half were cast in an NiCr alloy. Cementation was performed with 5 different luting cements through use of 5 kg of pressure in 90% relative humidity. Specimens were stored in distilled water at 37 degrees C for 24 hours and thermocycled between 5 degrees C and 55 degrees C for 5000 cycles, with a dwell time of 30 seconds. After thermocycling, vertical tensile force was applied in a Zwick universal testing machine with a constant speed of 1 mm/min until separation was noted. A 2-factor analysis of variance was used to analyze the data, with a significance level of alpha =.05.

RESULTS

Mean dislodgement forces for AuAgPd crowns and NiCr crowns were 120.88 N and 143.09 N, respectively, for zinc phosphate cement; 135.45 N and 150.38 N for Principle; 145.88 N and 220.71 N for Meron; 276.85 N and 225.61 N for Avanto; and 300.92 N and 381.02 N for Fuji Plus.

CONCLUSION

Within the limitations of this study, Fuji Plus and Avanto showed significantly higher retentive strengths for AuAgPd copings in comparison to the other cements tested (P <.05). The retentive strength of Fuji Plus was significantly higher than those of the other cements tested with NiCr copings (P <.05).

Crowns and other extra-coronal restorations: preparations for full veneer crowns

Preparations for full veneer crowns is the eighth in the series on crowns and other extra-coronal restorations. Whilst handpiece skills are important, many other factors combine to ensure provision of a satisfactory full veneer crown (also termed 'full coverage crown'). Our aim in writing this article is to consider the principles which influence crown preparation, seasoned with clinical advice our undergraduate and postgraduate students have found useful.

Influence of different convergence angles and tooth preparation heights on the internal adaptation of Cerec crowns

STATEMENT OF PROBLEM

Because of an imagining principle called active triangulation in the Cerec system, a shadow is cast distal to the illuminated objects. This distal shadow may be enlarged when the occlusal-cervical height of the prepared tooth is increased. Depth data of the shadow are unreliable, so the internal fit of Cerec crowns has been questioned.

PURPOSE

This study evaluated the influence of different convergence angles and tooth preparation heights on the internal adaptation of Cerec crowns.

MATERIAL AND METHODS

Tooth preparations were made on typodont teeth with different combinations of convergence angles and occlusal-cervical heights: Group I = 20 degrees angle, 6 mm height; Group II = 20 degrees angle, 4 mm height; Group III = 12 degrees angle, 6 mm height; and Group IV = 12 degrees angle, 4 mm height. Ten Cerec crowns were fabricated for each type of tooth preparation. Measurements of the internal fit were performed with the cement space replica technique and an image analysis system. Three-way analysis of variance was used to analyze the differences in cement space with different tooth preparations and the number of times that milling tools were used to prepare the Cerec crowns (P<.05). Multiple comparisons were made to evaluate differences between groups (P<.0083).

RESULTS

Cerec crowns with a 12 degrees convergence angle demonstrated the best internal fit (cement space in Groups III and IV = 121 +/- 41 microm and 115 +/- 42 microm, respectively). The difference between the 2 convergence types was within the range of the scanning error (25 microm) produced by the Cerec camera. The number of times that milling tools were used had no significant effect on internal fit (P=.78). Tooth preparation height equal to or shorter than 6 mm occlusal-cervically with both 12 degrees and 20 degrees convergence angles also had no significant effect on internal fit (P>.0083). Cement space at distal walls (185 +/- 28 microm) was the thickest among all axial walls (P=.0001) and was twice as thick as that at the facial (90 +/- 14 microm) and palatal walls (92 +/- 15 microm).

CONCLUSION

Within the limitations of this study, there was little difference in the internal fit of Cerec crowns prepared with convergence angles of 12 degrees and 20 degrees. Distal shadows influenced the thickness of the cement spaces, particularly at the distal walls. However, tooth preparations with an occlusal-cervical height not greater than 6 mm did not exaggerate the effect of the distal shadows.

Tooth preparations for complete crowns: an art form based on scientific principles

STATEMENT OF THE PROBLEM

No recent literature has reviewed the current scientific knowledge on complete coverage tooth preparations.

PURPOSE

This article traces the historic evolution of complete coverage tooth preparations and identifies guidelines for scientific tooth preparations.

MATERIAL AND METHODS

Literature covering 250 years of clinical practice was reviewed with emphasis on scientific data acquired during the last 50 years. Both a MEDLINE search and an extensive manual search were used to locate relevant articles written in English in the last 50 years.

RESULTS

Teeth should be prepared so that they exhibit the following characteristics: 10 to 20 degrees of total occlusal convergence, a minimal occlusocervical dimension of 4 mm for molars and 3 mm for other teeth, and an occlusocervical-to-faciolingual dimension ratio of 0.4 or greater. Facioproximal and linguoproximal line angles should be preserved whenever possible. When the above features are missing, the teeth should be modified with auxiliary resistance features such as axial grooves or boxes, preferably on proximal surfaces. Finish line selection should be based on the type of crown/retainer, esthetic requirements, ease of formation, and personal experience. Expectations of enhanced marginal fit with certain finish lines could not be validated by recent research. Esthetic requirements and tooth conditions determine finish line locations relative to the gingiva, with a supragingival location being more acceptable. Line angles should be rounded, and a reasonable degree of surface smoothness is desired.

CONCLUSIONS

Nine scientific principles have been developed that ensure mechanical, biologic, and esthetic success for tooth preparation of complete coverage restorations.

Effective taper criterion for the full veneer crown preparation in preclinical prosthodontics

PURPOSE

Effective taper criteria must define a realistic, measurable goal that the student can visualize and achieve. Six degrees is widely accepted as the taper criterion for the full veneer crown preparation. However, studies show the actual taper of most preparations to be greater than 12 degrees. The purpose of this study was to determine whether 12 degrees is an effective taper criterion for the full veneer crown preparation in preclinical prosthodontics instruction.

MATERIALS AND METHODS

A group of 191 full veneer crown preparations with 6 degrees as the taper criterion, and a group of 130 full veneer crown preparations with 12 degrees as the taper criterion were evaluated. All preparations were accomplished by preclinical dental students working on typodonts under examination conditions.

RESULTS

The overall mean taper for each group exceeded the targeted criterion. The overall mean taper for the 6 degrees group was 14,490. When 12 degrees was the criterion, the overall mean taper was 15,580. The t test results indicate significant differences (p < .0001) between the targeted criterion and the actual preparation mean taper in all samples except one: the faciolingual measurements in the 12 degrees group. The faciolingual measurement of 12,920 was not statistically significantly different (.0542) from the targeted criterion of 12 degrees.

CONCLUSION

The use of a 12 degrees taper criterion did not result in preclinical students achieving the goal of a 12 degrees taper. However, a 12 degrees criterion is more realistic than a 6 degrees criterion for full veneer crown preparations.

Compressive and tensile zones in the cement interface of full crowns: a technical note on the concept of resistance

PURPOSE

The objectives of the study were: 1) to map the stresses acting on the cement interface of crown and abutment analogs during loading; and 2) to provide a theoretical basis for the hypothesis that resistance to lateral dislodgment is a function of the distribution of compressive force vectors acting on the cement lute.

MATERIALS AND METHODS

Three-dimensional finite element (FE) meshes of crown and abutment analogs were constructed and loaded in a direction perpendicular to the axes of symmetry of the abutments. Three parameters were investigated: taper (10 degrees and 20 degrees of convergence), abutment substrate (Ni-Cr alloy and dentin), and type of cement (zinc oxide eugenol, zinc phosphate, glass ionomer, and composite resin). The tensile and compressive components of the resulting force systems were plotted along two axes (z: parallel to the axis of symmetry of the crown/abutment complex; and y: perpendicular to z, i.e., parallel to the direction of loading). Von Mises stresses were also generated.

RESULTS

First, it was shown that the restoration's axis of rotation was located inside the abutment cone and was perpendicular to and intersected the axis of symmetry of the crown/abutment complex. Second, stress distribution was dependent on the three parameters investigated. Varying taper led to shifts due mainly to alterations in specimen geometry, whereas the abutment substrate and the cement type had a bearing on the level of the axis of rotation. The smaller the modulus of elasticity of the abutment substrate or the cement lute, the farther apical the location of the axis of rotation.

CONCLUSIONS

Conventional schemes for explaining crown dislodgment in which the restoration rotates around an axis located at the preparation margin should be reassessed. The results of the FE analysis are compatible with the hypothesis that resistance to lateral dislodgment is a function of the distribution of compressive force vectors acting on the cement interface.

Dental luting agents: A review of the current literature

STATEMENT OF PROBLEM

The practice of fixed prosthodontic has changed dramatically with the introduction of innovative techniques and materials. Adhesive resin systems are examples of these changes that have led to the popularity of bonded ceramics and resin-retained fixed partial dentures. Today's dentist has the choice of a water-based luting agent (zinc phosphate, zinc polycarboxylate, glass ionomer, or reinforced zinc oxide-eugenol) or a resin system with or without an adhesive. Recent formulations of glass ionomer luting agents include resin components (resin-modified glass ionomers), which are increasingly popular in clinical practice.

PURPOSE

This review summarizes the research on these systems with the goal of providing information that will help the reader choose the most suitable material.

MATERIAL

The scientific studies have been evaluated in relation to the following categories: (1) biocompatibility, (2) caries or plaque inhibition, (3) microleakage, (4) strength and other mechanical properties, (5) solubility, (6) water sorption, (7) adhesion, (8) setting stresses, (9) wear resistance, (10) color stability, (11) radiopacity, (12) film thickness or viscosity, and (13) working and setting times. In addition, guidelines on luting-agent manipulation are related to available literature and include: (1) temporary cement removal, (2) smear layer removal, (3) powder/liquid ratio, (4) mixing temperature and speed, (5) seating force and vibration, and (6) moisture control. Tables of available products and their properties are also presented together with current recommendations by the authors with a rationale.

Retention of metal ceramic crowns cemented with resin cements: effects of preparation taper and height

This study investigated the effect of varying crown preparation taper and height on the retention of metal ceramic crowns cemented with resin cements. In part 1, 32 extracted molars were divided into four groups. All groups received complete-veneer crown preparations, two with a 12-degree wall angle and two with a 35-degree wall angle. Crowns were cemented with zinc phosphate and dentin-bonded resin cements. After 24 hour water storage at 37 degrees C, the crowns were separated in tension. Crowns cemented with zinc phosphate were cleaned and recemented with another dentin-bonded resin cement and after similar storage, the crowns were separated. Mean separation forces of resin-cemented crowns were higher than those of crowns cemented with zinc phosphate cement. Mean separation force of 35-degree crowns cemented with one dentin-bonded resin cement was found to be significantly higher than for the 12-degree crowns cemented with zinc phosphate cement. In part II, 32 extracted molars were divided into two groups of complete-veneer crown preparations (group I preparations were 3 mm high and group II were 5 mm high). Crowns for all teeth were cast and cemented with zinc phosphate. After 48 hours' water storage at 37 degrees C, the crowns were separated in tension. Crowns and teeth were then cleaned and each group was subdivided into 2 equal subgroups. In one subgroup of teeth with 3 mm and in one with 5 mm high preparations, the crowns were recemented with one of the two resin cement systems and the other two subgroups were recemented with the other resin cement. After 48-hour water storage, the crowns were separated. Mean separation forces of the resin-cemented crowns were greater than those of crowns cemented with zinc phosphate. Also, mean separation force of 3 mm crowns cemented with one resin cement was significantly greater than the 5 mm crowns cemented with zinc phosphate. Cohesive dentin fracture on separation was observed with some resin-cemented crowns but never with crowns cemented with zinc phosphate.

The relationship between preparation convergence and retention of extracoronal retainers

PURPOSE

Although traditional ideal convergence (the sum of taper of the opposite sides) for crown preparation has been arbitrarily set at 4 degrees to 10 degrees, some believe absolute parallelism yields the highest retention. This study examined the relationship between the degree of convergence of a machined metal die and the retention of its casting.

MATERIALS AND METHODS

The method used was that of cementing cast metal crowns onto full crown preparations on brass dies with varying convergence angles, and then recording the force required to remove the crowns from the dies in a vertical direction using a Tate-Emery Testing Machine and Load Indicator.

RESULTS

It was found that retention (i.e., the force needed to remove the cemented castings from the die in their common long axis) increases from 0 degree convergence to peak between 6 degrees to 12 degrees convergence. It also seems that a critical film thickness does exist for optimum retention, and that film thicknesses smaller than the critical thickness may be responsible for the phenomenon that we have observed and directly related to the convergence angle itself.

CONCLUSIONS

There seems to be experimental data supporting the use of traditionally taught convergence. Our study found that convergence angles between 6 degrees and 12 degrees seem to be optimum for tooth crown preparation when one plans to use zinc phosphate cement. Convergence angles of less than 6 degrees may not be desirable even if they can be clinically achieved. The results of our study indicate that a relationship exists between the convergence angle and the critical cement thickness that is necessary to realize the maximum strength properties of zinc phosphate cement.

New guidelines for preparation taper

The purpose of this article is to provide new guidelines for minimally acceptable preparation taper by developing a theoretical mathematical foundation based on principles of resistance form. Yes and no are the possible answers to the question, "Does a preparation have resistance form?" This dual nature is useful because in graphing resistance form as a function of taper, potential tapers on the x axis are divided into two groups with an exact dividing point. Tapers less than this dividing point provide resistance form; tapers larger or equal do not provide resistance form. This dividing point makes a reasonable standard for minimally acceptable taper. Average tapers are defined as the limiting average taper and are mathematically determined to equal 1/2 arcsin (H/B), where H is the height of the preparation and B is the base. From this equation, the taper required to provide resistance form for an individual preparation can be calculated by using the preparation's height to base ratio. The equation can also be used to provide guidelines by tooth group. Dies of a prosthodontist were saved and sorted by group (incisors, canines, premolars, and molars). Measurements of 30 dies from each of these groups were used to calculate the average (H/B) ratios and standard deviations. Calculating the limiting average taper by using the average height-to-base ratio minus two standard deviations provides the dividing point taper that is acceptable for over 97% of the preparations. The values calculated are: 29 degrees for incisors, 33 degrees for canines, 10 degrees for premolars, and 8.4 degrees for molars.(ABSTRACT TRUNCATED AT 250 WORDS)

Convergence of the axial walls of full veneer crown preparations in a dental school environment

This research report used a simple and accurate method of measuring the convergence of full veneer crown preparations. A random sample of 909 dies was selected from all dies of full veneer crown preparations done at the University of Colorado, School of Dentistry student clinic over a 6-year period. All preparations were accomplished by third- and fourth-year dental students under either normal clinic conditions or under special (proficiency) testing conditions. The mean convergence angles were 19 degrees (S.D. +/- 9.8 degrees) for nonexamination conditions and 15.7 degrees (S.D. +/- 5.5 degrees) for examination procedures. These angles are far in excess of those normally recommended in the fixed prosthodontic textbooks. The values obtained in this investigation agree with the findings of most of the current published studies on the subject.