Fundamentals of extracoronal tooth preparation. Part I.
Retention and resistance form
Dennis B. Gilboe, D.D.S.,* and Walter R. Teteruck, D.D.S., M.S.D.**
College of Dentistry, University of Saskatchewan, Saskatoon, Sask., Canada
lhe differential selection and application of retention and resistance form in tooth
preparation depend upon the individual clinical situation. Since the “textbook ideal”
is not often encountered clinically, knowledge of basic principles and factors is
mandatory for the successful preparation of extracoronal restorations.
Black1 astutely recognized and stressed the importance of these two basic char-
acteristics. He stated : “Resistance form is that shape given to a cavity intended to
afford such a seat for the filling as will best enable it to withstand the stress brought
upon it in mastication. Retention form is the provision for preventing it from being
dislodged.”
More recent concepts tend to emphasize the duplication of a preconceived design
of a preparation rather than the assessment of biomechanical requirements of indi-
vidual retainers. The modification of an ideal design for a preparation entails judg-
ment in the application of the basic principles of retention and resistance (Table I).
An analysis of these principles and factors should enable the dentist to effectively
apply them during the design of any preparation. The ability to cope with atypical
clinical situations is markedly enhanced by such organized application.
All preparations require the incorporation of factors to prevent the dislodgment
of the restoration by functional stresses. Retention form counteracts tensile stress, and
resistance form counteracts shearing stress (Fig. 1) .? A preparation with good re-
sistance form will be retentive; the opposite is not necessarily true.” The same
method is often used when incorporating the factors of both retention and resistance
form. Thus, for practical purposes, these factors can be considered together (Fig. 2).
PRIMARY FACTOR-AXIAL SURFACES
Parallelism. As the axial walls approach parallelism, the restoration can withstand
greater displacement from tensile and shearing stresses (Fig. 3) .4-‘i Axial surface re-
*Assistant Professor.
**Associate Professor and Chairman, Division of Fixed Prosthodontics, Department of
Restorative Dentistry, University of Western Ontario, London, Ont., Canada.
651
652 Gilboe and Teteruck .I. l’rosthet. Dcnf.
Dec:~mher. 1974
TENSILE SKfSS
Fig. 1. Retention and resistance form.
Table 1. Principles and factors in retention and resistance form
I. Principles
1. Parallelism
2. I,ength
3. Surface area
II. Factors
1. Primary factor--axial surfaces
2. Secondary factors
a. Groove
b. Box
c. Pinhole
d. Combinations of a, b, and c
ductions, within 2 to 5 degrees of parallelism with the path of withdrawal of the
preparation. provide optimal resistance and retention. This convergence facilitates
technical procedures and eliminates inadvertent undercuts. Axial surface reduction
approaching parallelism produces opposition to displacement that is substantially
more effective than any other factor.’ Thus, in rlinical situations (i.e., short teeth).
the need for maximal resistance and retention form is obvious. The prepared axial
surfaces must be as close to parallel as is clinically feasible (Fig. 3).
Length. As the length of the axial walls of the preparation increases, the resist-
ance and retention form increase (Fig. 4) .(; The maximum length of the axial walls
is maintained during preparation by removing minimal occlusal or incisal tooth
structure to provide adequate bulk of restorative material for occlusion. Preservation
of the inclined planes of the occlusal surfaces and the incisal angles of anterior teeth
is the primary factor affectin g this objective. The sur@cal repositioning of the mar-
ginal gingiva apically becomes unnecessary when the retention and resistance form
can be achieved throu<gh the effective application of the primary factors alone or in
conjunction with any or all of the secondary factors.
Surface area. A direct relationship exists between surface area and the retentive-
resistance potential of the retainer.” The larger the cervical diameter of the tooth,
the greater the surface area available tc br included in the preparation. Thus, the
greater the circumference of the tooth, the greater the potential resistance of the
retainer to dislodgment. Also, by increasing circumferential involvement through the
addition of axial walls, retention and resistance are increased (Fig. 5).
Extracoronal tooth preparation. Part I 653
Fig. 2. The stress range of retention and resistance form.
03 GREATER R
0 4 GREATER 99 LESSER m
Fig. 3. Retention and resistance increase as the length of the axial walls increases.
Fig. 4. Resistance and retention increase as the length of the axial walls increases.
SECONDARY FACTORS
If the primary factor and its utilization are insufficient, secondary factors should
be incorporated. The principles of parallelism, length, and surface area, already
considered for the primary factor, also influence the secondary factors’ effectiveness.
Secondary factors should be placed within 2 to 5 degrees of parallelism with a pri-
mary or another secondary factor for maximum effectiveness. Normally, this position
is perpendicular to the direction of shear stress.
The secondary factor should be located (1) with the line of withdrawal, (2) as
far as possible from its reciprocal retentive feature, and (3) at a point which permits
the maximum length. The appropriate factor to be incorporated is the one which
resists the displacing forces while conserving the greatest amount of structure.
Groove. The groove is the secondary factor which best achieves resistance form
while conserving maximum tooth structure. It is, thus, the most commonly incor-
porated secondary factor.
BOX. The box may be regarded as a wide groove with an increased surface area.
Pinhole. The pinhole may have tapered or parallel walls. Both types contribute
more toward retention than resistance. The amount of retention is directly related to
the area of the pin contacting the tooth and to the intimacy of the contact.? Reten-
tion is a function of the length and diameter of the pin. The pin is most vulnerable
when subjected to shearing stress. Therefore, bulk is always necessary adjacent to
the body of the casting. Pins alone should not be depended upon for resistance form.*
Secondary factors must have sufficient axial depth for adequate breadth of the
lateral retentive wall. A definite gingival seat will also provide greater surface area
654 Gilboe and Teteruck J. Prosthet.
December,
Dent.
1974
GREATER ljtj LESSER firg
Fig. 5. Retention and resistance increase as the circumferential involvement increases
TAFERED PIN HOE CWNDRIC.Al FIN I-NE
Fig. 6. Secondary factors increase retention and resistance,
for the lateral retentive wall and enable the axial wall to have minimal divergence
from parallelism. Reciprocal parallelism should exist among lateral retentive walls,
axial walls, and axial surfaces.
Secondary factors should be located as far as possible from their reciprocal re-
tentive features and positioned so as to achieve maximal length (Fig. 6).
DlFFERENTIAL INCORPORATION OF THE PRINCIPLES OF
RESISTANCE AND RETENTION
Parallelism of primary and/or secondary factors produces significantly greater
opposition to displacement than is produced by any other principle. Thus, it is the
optimal means to effective retention and resistance form unless it seriously violates
conservation of tooth structure. Taper of the preparation may exceed 5 degrees only
if inordinate length is present. Otherwise, secondary factors should be employed to
achieve the necessary retention and resistance.
All teeth possess inherent length which can be preserved by controlled occlusal
reduction. The principle of increasing the length of axial surfaces augments resist-
ance and retention. Effective substitution or addition of a secondary factor fre-
quently enables the preparation to terminate supragingivally. With the exception of
the proximal surfaces, subgingival extension should be avoided to maintain both
accuracy in marginal finishing and periodontal integrity.“-”
Increasing the surface area increases retention and resistance. A lack of surface
area can only be compensated for through addition of the same. Increasing surface
area by a primary factor will automatically involve a greater inclusion of axial sur-
Volume 32 Extracoronal tooth preparation. Part I 655
Number6
Table II. The application of principles and factors
Problem* Correction
Inadequate retention Compensatory principle Compensatory factor
and resistance form (increase) (add)
Parallelism Length GKXIW
Box
Pin
Length Parallelism Pin
Surface area
Surface area Surface area Groove
Box
Pin
*Inadequate retention and resistance form.
faces, either apically or circumferentially. Therefore, conservation of tooth structure
and the avoidance of subgingival margins limit the potential of this principle unless
it can be achieved intracoronally by secondary means.
Secondary factors should be placed within 2 to 5 degrees of parallelism. They
also should be located the greatest distance possible from another factor and posi-
tioned to achieve greatest length. Modification within esthetic limits may be necessary
to fulfill these objectives. All secondary factors can partially compensate for inade-
quate parallelism, length, and surface area. Only pins can augment length.
The correction of inadequate retention and resistance form should always be
attempted first through the application of compensatory measures (principles) to the
primary factor (axial walls) and then, if necessary, through the addition of second-
ary factors (Table II).
SUMMARY
1. The principles and factors of retention and resistance form have been classified
and discussed.
2. A basis for the selection and application of these principles and factors to ful-
fill the biomechanical requirements of individual retainers has been presented.
3. Adequate resistance and retention can be achieved during tooth preparation
if a systematic approach, as outlined, is applied.
References
1. Black, G. V.: Operative Dentistry, vol. 2, Chicago, 1908, Medico-Dental Publishing
Company.
2. Guyer, S. E.: Multiple Preparations for Fixed Prosthodontics, J. PROSTHET. DENT. 23:
529-553, 1970.
3. Rosentiel, E.: The Retention of Inlays and Crowns as a Function of Geometrical Form,
Br. Dent. J. 103: 388-394, 1957.
4. Jones, W. E.: The Scientifically Designed Partial Veneer Crown, J. Am. Dent. Assoc. 86:
1337-1343, 1973.
5. Jorgensen, K. D.: The Relationship Between Retention and Convergence Angle in
Cemented Veneer Crowns, Acta Odontol. Stand. 13: 35-40, 1956.
6. Kaufman, E. G., Coelho, A. B., and Colin, L.: Factors Influencing the Retention of
Cemented Gold Castings, J. PROSTHET. DENT. 11: 486-502, 1961.
J. l’rosthet. DC-IO.
656 Gilboe and Teteruck Drcember. 1874
7. Courtade, G. I,., and ‘I‘immermans, J. J.: Pins in Restorative Dentistry, St. I,ouis, 1961.
‘l‘he C. V. Mosby Company.
8. Baum, I.., and Contino, R. M.: Ten Years of Experience With Cast Pin Restorations.
Dent. Clin. North ilm. 14: 81-91, 1970.
9. Christensen, G. J.: Marginal Fit of Gold Inlay Castings, J. PROSTHET. DENT. 16: 297-
305, 1966.
IO. Marcum, J. S.: The Effrct of Crown Marginal Depth Upon Gingival Tissue, J. PROSTHEr.
DENT. 17: 479-487, 1967.
11. Pcrel, M. I,.: Axial Crown Contours, J. PROSTHET. DENT. 25: 642-649, 197 I.
DR. GILBOE
USIVERSITV 0~ SASKATCHEWAN
COLLEGE OF DENTISTRY
SASKATOON, SASK., CANADA S7N OWO
DR. ‘TETERUCK
UNIVERSITY OF WESTERN ONTARIO
FACULTY OF DENTISTRY
LONDON, ONT., CANADA N6A 3K7
