S S Crowns in Pediatric Dentistry

Dr.Tharian B Emmatty
Prof.&Head
Dept.Of Pedodontics
Annoor Dental College ,Muvattupuzha
• Humphrey & Engel (1950)
• Suggested Chrome steel crowns for Primary
teeth restorations
• First -Rocky mountain Co.
• Stainless steel crowns, Preformed SS Crowns,
Semi permanent Restorations
 Content
Why, When , & How
• The need for SS crowns
• Classification
• Indications /Contra indications
• Crown selection
• Armamentarium
• Clinical steps
• Modifications
 Failure rate of SS Crowns less

• Amalgam v/SS crown : 34% failure in 3 years

• 64% in 4.5 years v/s 10 % SS Crowns

• Conventional Restorations v/s SS Crowns

(Amalgam,GIC,RMGIC,Compomers,Composites)
• 11% -88% v/s 1%-11% Failure
Reasons for multi surface restoration failure in Primary
molars

• Narrow occlusal table

• Less tooth material covering pulp

• . Wide proximal contact areas

 Reasons for multi surface restoration failure in
Primary molars

. Marked cervical constriction

. Prismless enamel
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 Classification -Based on Composition
• Stainless steel crown (Unitec , Rockymountain )
• Nickel based crowns ( Ion Ni chromium eg: 3M )
• Tin Based Crowns
• Aluminium based crowns
 Classification -Based on Composition
• Open faced SS crowns

• Pre veneered crowns

• Nu smile, Cheng, Dura ,Kinder crowns

• Zirconia crowns
Classification based on site
Anterior Posterior
 Classification-Based on Shape
• Non Contoured ,Non trimed, Un crimped
Eg.Rocky mountain

• Pre trimmed ,Pre contoured

Eg.Unitek crown

Pre trimmed ,Pre crimped ,Pre contoured

Eg. 3M ESPE
 Choice of Crown
• Pre trimmed

• Pre contoured

• Pre crimped

• Festooned
• Eg.3M ESPE Crowns, Hu friedy crowns
 Indication for SS crowns
• Multi surface decay

• Following pulp therapy

• Localized / Generalized
Developmental anomalies
• Restoration of fractured tooth /cusp

• Anterior single tooth cross bite

• Differentialy abled children

• Recurrent decay /Secondary decay in existing

restored cases
( poor oral hygiene)
• Tooth to be retained minimum 2 years
 Contra indications
• Conservative restorations can be given

• Partially erupted tooth

• Esthetically not appealing

• Patient with Nickel allergy

Crown availability and selection
Permanent Molar crowns available
 Objectives of tooth preparation
• Provide sufficient space for SS crown

• Caries removal

• Sufficient tooth for crown retention

/ Isolation
RTooth Rotation
Uneven oclusal reduction Crown will be rocking
 Crown selection
• Prior to preparation: measure mesial- distal diameter

• After preparation :Trial & Error

Choose respective size/Number
• Smallest crown to be selected,
• Snap fit while placing over prepared tooth
• Crown size larger to tooth while placing
• Too large crown will rotate
 Crown placement
Lingual /Palatal side to Buccal
Snap fit
Gingival margin with crown
 Crown adaptation
• Vertical excess = Blanching
• Crown contouring

• 114# Johnson Contouring plier

• Crown crimping
 Crown finishing & Polishing
Large green stone for
cervical margin finish

Rubber wheel to smoothen

margin

Rouge wheel for lusture and

shine
 Final Trial
• Snap fit
• Resistance in seating
• No Blanching
• No Rocking /Rotation
• Pre treatment occlusion established

• The best retention is by Cementation

Radiographic verification
 Post cementation Instructions

• Avoid eating /chewing for ½ -1 hour

• Avoid sticky /hard food for 1 hour
• Analgesics (Once)?
• Post anesthesia numbness present
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Halls technique Dr. Norna Hall-2006