The Influence of Home Position(H.P.) and Random Position(R.P.) on the Shape of Prepared Tooth Surfaces -Upper Left 1st Molar for Full Cast Crown-

시술자세가 치관 삭제면 형태에 미치는 영향 -상악 좌측 제 1 대구치의 전부 주조관-

To properly prepare teeth, dentists require a direct view of the working area and are often placed in a difficult position, moreover, a high proportion of dentists suffer from headache and back pain. Dentists who make use of the dental mirror and position their patients carefully to gain a proper view report less headache, pain and discomfort in the shoulders. It is recommended that dentists learn the "Home Position(H.P.)" which among the various "Random Position(R.P.)" methods, enables dentists to approach their patients in a stable posture. The purpose of this study was to compare tooth preparation in the H.P. and the R.P., and evaluate the clinical efficacy of the H.P.. Tooth preparation for a full cast crown was performed on the maxillary left 1st molar using the H.P. and the R.P., and the shapes of the prepared tooth surfaces at the two different operating positions were compared. The amount of occlusal reduction, marginal width, height, and axial taper were measured and analyzed. A T-test was performed separately to compare the results of the H.P. and the R.P. with respect to the accuracy of the corresponding tooth reduction. The results were as follows. ; 1. The amount of occlusal reduction was excessive on the mesiobuccal cusp(P<0.05), and deficient on the lingual cusp in the H.P.(P<0.01). In the R.P., this was excessive on the buccal cusp and deficient on the fossa and distolingual cusp(P<0.01). 2. The amounts of marginal width were excessive in all areas except on the lingual and mesial surfaces in the H.P. and lingual surface in the R.P.(P<0.01). 3. The marginal heights were achieved more accurately in the R.P. than the H.P.(P<0.01). 4. Axial surface taper was excessive in all areas in the H.P.(P<0.01). But the axial taper of measured areas was even, and tooth is more like to retain its original axis after reduction. In the R.P., axial surface taper was excessive on the mesial and buccal area, and deficient on the distolingual area(P<0.01), and therefore, the axis of the prepared teeth was tipped in the distolingual direction. 5. The times needed for preparation were 12 minutes and 49 seconds in the H.P., and 11 minutes and 35 seconds in the R.P., and the R.P. was statistically faster(P<0.01). The tooth preparation in the H.P. achieved its goal, in that it enabled the operator to make even tooth reduction. In conclusion, the H.P. system offers an improved method that can be used in clinic after specific training.