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ESTD. 2015 · CNDL CLINICAL PROTOCOLS

Clinical Tooth Preparation & Margin Protocols for CAD/CAM Restorations

Essential biological reduction depths, margin geometries, and chairside protocols engineered to guarantee sub-micron marginal adaptation, zero remakes, and predictable seating with Japanese Roland 5-axis milling.

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Standardized Guidelines

1. Core Reduction Matrix by Material

Calibrated specifically for Roland DGSHAPE 5-axis milling burs and Aidite monolithic sintering parameters.

Material & RestorationOcclusal / IncisalAxial ReductionMargin GeometryTaper & Line Angles
Monolithic & Multilayer Zirconia (Aidite 3D Pro)
High-Strength Ceramic · Roland 5-Axis

Posterior crowns, multi-unit bridges, bruxers, minimal clearance

1.0mm – 1.2mm (Anterior Incisal: 1.2mm)0.8mm – 1.0mmDeep Chamfer (0.5mm – 0.8mm) with rounded internal line angles6° – 8° Total Convergence
Porcelain-Fused-to-Metal (PFM / Co-Cr)
Ceramic-Metal Hybrid

High functional masticatory load, long-span bridges, economical tiers

1.5mm – 2.0mm (0.5mm metal substructure + 1.0mm–1.5mm porcelain)1.2mm – 1.5mm90° Shoulder or Heavy Chamfer (1.0mm – 1.2mm)6° – 10° Total Convergence
IPS E-Max / Lithium Disilicate & Veneers
High Aesthetics · Translucent

Anterior cosmetic smile designs, single units, inlays/onlays

Veneers: 1.0mm Incisal Overlap / Butt Joint | Full Crowns: 1.5mmVeneers: 0.5mm – 0.7mm Facial | Full Crowns: 1.0mmLight Chamfer / Rounded Shoulder (0.3mm – 0.5mm)6° – 8° Total Convergence
Zero-Remake Protocol

2. Five Critical Remake Prevention Rules

Avoid the most frequent causes of restoration rocking, marginal discrepancies, and chairside delays.

RULE 01

Round All Sharp Angles & Line Transitions

The Mechanical Science: Diamond milling tools on Japanese Roland 5-axis machines have a physical tip radius (smallest CNDL bur is 0.6mm). Sharp incisal angles or pointed transitions force the CAM software to "over-mill" the internal fitting surface to achieve seating, creating excessive cement gap and ceramic weakness.

✓ Recommended Clinical Action:Smooth all transition line angles and incisal edges with a fine football or torpedo finishing bur.

Ensure no razor-sharp line angles exist under 10x magnification or loupes.
RULE 02

Zero Undercuts & 6°–8° Axial Taper

The Mechanical Science: Rigid CAD/CAM sintered zirconia has zero flexure. Any undercut along the preparation walls creates an impossible path of insertion, forcing virtual software blockout that compromises retention and marginal fit.

✓ Recommended Clinical Action:Maintain a single, unambiguous path of draw with 6°–8° total occlusal taper (3°–4° per axial wall).

Verify visibility of all margin perimeters from direct occlusal viewing.
RULE 03

Avoid Feather / Knife-Edge Margins

The Mechanical Science: Knife-edge or indistinct bevels prevent milling tools from establishing a defined ceramic boundary, causing micro-chipping during pre-sintered green-state milling and leading to over-contoured margins in the mouth.

✓ Recommended Clinical Action:Always cut a crisp, continuous Deep Chamfer with at least 0.5mm–0.8mm distinct horizontal ledge.

Ensure the margin is clearly palpable with an explorer probe 360° around the tooth.
RULE 04

Clear Occlusal Clearance (Centric & Excursive)

The Mechanical Science: Inadequate reduction (< 1.0mm) forces our digital technicians to thin the zirconia disc during nesting, risking crown fracture under heavy masticatory load or necessitating chairside adjustments that strip glaze.

✓ Recommended Clinical Action:Verify 1.0mm–1.2mm clearance in centric occlusion AND during lateral/protrusive excursions.

Use a flexible 1.0mm clearance gauge or folded 200μm articulating foil to confirm space.
RULE 05

Gingival Retraction Protocol (Double-Cord Technique)

The Mechanical Science: 85% of remake requests across Bangladesh stem from indistinct subgingival margins caused by sulcular fluid or collapsed gingival tissue. Intraoral scanners and PVS silicone cannot read through blood or saliva.

✓ Recommended Clinical Action:Place size #00 cord first into sulcus floor, followed by size #1 or #2 soaked in aluminum chloride.

Remove top cord immediately before scanning/impression; verify 0.5mm exposed tooth structure apical to margin.

Impression & Intraoral Scan (IOS) Best Practices

Whether sending digital STL/OBJ scans or physical PVS rubber base impressions.

1. Digital Scanners (STL/OBJ):

Disable AI teeth-cleaner before margin capture. Verify there are zero mesh holes along the finish line before patient dismissal.

2. Conventional PVS / Polyether:

Always use a rigid metal or custom tray. Use double-mix one-step technique; inspect margins for zero drags, bubbles or tray impingement.

3. Stump / Prep Shade Photography:

For anterior E-max or multilayer zirconia, photograph the prepared stump with a shade tab (ND1–ND9) in the same focal plane under 5500K daylight.

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