3.
This is followed by initial outline form and removal of caries, undermined
enamel, weakened tooth structure and old restorations (Protective liners and bases are placed wherever required). 4.
The tooth is then re-evaluated for its reconstructability. If it can be restored, a
final preparation design is decided upon. If it is felt that an intra-radicular retention will help, then an intentional RCT is done to be followed later via a post and core. If this also is not possible, then an extraction is the only alternative.
EVALUATION OF THE REMAINING TOOTH STRUCTURE: Now, once a decision is made that the tooth can be vitaly restored, the next critical step is to evaluate the remaining tooth structure. It is important to form a mental image of the restorative design, material and technique before starting any procedure. Certain points to be kept in mind during this are: 1. Stress patterns on the tooth: The stress concentration areas of the posterior tooth are: o the ridges (including marginal, transverse and oblique) o the cusps with their inclines o the clinical crown root junction For an anterior tooth it is the o lingual ridges and concavity o incisal angle o cervical areas. Every effort should be made to leave these undisturbed if uninvolved. Also remember that: ďƒ˜ stresses are maximum at the IInd premolar and Ist molar region ďƒ˜ upper teeth resist stresses better than the lowers ďƒ˜ stresses are the least in teeth opposing a bridge pontic, denture, inclined tooth / space. 2. Cariogenic evaluation: Is basically done to decide which areas of remaining tooth structure needs to be further involved. Defects / decalcifications can be restored separately rather than