STRIP CROWN

1) L.A.
2) Isolation with cotton rolls and
saliva ejector or rubber dam.

10)

Composite resin is squeezed into

the crown form and hollowed out
in the center to reduce the
amount of excess.
Acid etching:

The teeth are etched for 20

seconds with etchant, washed and
dried. The chalky appearance of
enamel is evident.
11)
Bond application
12) The crown forms, containing
composite resin are firmly seated
on the prepared tooth

3) Size selection

13)

4) Caries removal
Use a tapered diamond bur in
high speed headpiece
the length of the crown is
reduced incisally.
Mesial and distal slices are

made tapered to a knife edge at

the gingival margin.

Excess

removed with a probe

14) Curing composite

15)

Striping the crown

16)

Finishing

5) Shade selection
6) Trimming

The length and cervical length

should
be checked
at this
stage.

7) Vent holes
8) Base
9) Calcium hydroxide
ionomer cement.
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paste or glass

composite

resin

is

POLYCARBONATE CROWN
INDICATION

5) UNDERCUT can be added to the

labial surface with inverted cone
bur.
6) LABIAL AND LINGUAL surfaces are
reduced 0.5 mm. to allow space to
the crown form.
7) Carry the preparation 0.5-1.0 mm.
under the gum margin
8) Crown adaptation. Finish line is

It is used to be as a temporary
esthetic restoration for permanent
anterior teeth
CONTRAINDICATIONS:

preferred to be a chamfer.
9) Finally caries removal is done
CEMENTATION:
Badly destroyed teeth.
Deep overbite
Patients with bruxism.

Crown and bridge cement.

Resin cement.
Zinc oxide eugenol cement ??

TECHNIQUE:

1) Administer local anesthesia

2) Use a thin flame Polycarbonate
crowns shaped diamond bur and
prepare the mesial and distal
portion1 of the tooth, keep the long
axis of the bur parallel to the long
axis of the tooth2, Sweep the bur
through to the embrasure 3 and be
careful
not
to
injure
the
neighboring tooth.
3) Reduction is done proximally to
open
the
contact
with
neighboring tooth.
4) Approximately 1 to 1.5 mm. of
tooth structure is removed at the
INCISAL portion with slight less
removal at the gingival area.
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STAINLESS STEEL CROWNS

 COMPOSITION (Humphrey,
1950)
TYPE 1 UNITEK
Iron

67%

TYPE 2 (3M
CROWN)
Iron
10%

Chromium

17%

Chromium

16%

Nickel

12%

Nickel

72%

Carbon
Manganese
4%
Silicon

A- Straight Side Crowns

B- Pre-Trimmed Crowns (UNITEK)
Straight sides but are festooned to
follow a line parallel to the gingival
crest.
require contouring and some
trimming.
C- Pre-Contoured Crowns(Ion Crowns
3M)
Festooned and are also
precontoured.
They are available in 6 numbers for
each primary tooth
ADVANTAGES AND
DISADVANTAGES

Protect
remainingTooth structure

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1- restoration of primary or young

permanent teeth with caries involving >
2 surfaces.
2- restoration of hypoplastic teeth.
3- after pulpotomy or pulpectomy.

Carbon
Manganese
2%
Silicon

TYPES OF STAINLESS STEEL

CROWNS

ADVANTAGES
Very durable

INDICATIONS:

DISADVANTAGES
Expensive
preparation

Not Aesthetic

4- teeth with hereditary anomalies such

as
dentinogenesis imperfect
amelogenesis imperfecta.

5- as an abutment for space

maintainers .
6- restoration for disabled children or
whom oral hygiene is extremely poor.
7- attachment for a habit breaking
appliance, and space maintainers.
8. Trauma.
9. Bruxsim
INSTRUMENT

A-To protect the adjacent tooth structure.

B-To improve visibility and efficiency.
C-Manage behavior in a better way.
D-To prevent ingestion of s.s. crowns
during preparation.

CROWN SELECTION

Three main considerations in the

selection of s.s. crowns:

1-Adequate mesio-distal diameter.

2-Light resistance to seating.
3-Proper occlusal seating.
Place the points of dividers on the mesial
and distal surface of the tooth at the level
of the lingual margin, select the crown
with the same mesiodistal dimensions as
that indicated by the dividers

3. REMOVE CARIES using excavators or

large round burs at slow speed

If caries is superficial shape of the

resulted cavity is not important as the
cavity is later filled with the material
used to cement the crown. (IRM)

Calcium hydroxide can be applied in

deep cavities to protect the pulp.

PREPARATION OF STAINLESS
STEEL CROWNS
1. Establish deep ANESTHESIA maxillary
teeth by infiltration and lower teeth by
inferior alveolar block.
Before placing rubber dam CHECK THE
CHILD'S OCCLUSION, observe for the
following:
A- The opposing tooth has extruded
because of long standing carious lesion.
B- Mesial drift has resulted because
carious lesions have changed the
occlusion of the adjacent tooth.
-Tooth reduction is needed so that the
restored tooth can be returned to normal
function.
2. PLACE RUBBER DAM, use of rubber
dam in preparing tooth for s.s.crowns
specially if caries is deep and pulp
exposure is possible:

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 CROWN ADAPTATION

TOOTH PREPARATION FOR SSC

Use a high-speed with water coolant:

1- OCCLUSAL REDUCTION:
Penetrate the occlusal fissure with a
straight or pear shaped diamond to a
depth of 1.0 to 1.5 mm.
Extend through the pits and
fissures at this depth passing through
any oblique ridges and extending to
the buccal, lingual and proximal
surface of the occlusal surface.

2- PROXIMAL REDUCTION:
Place tapered diamond bur in contact
with tooth at buccal or lingual
embrasures angled about 20 degree
with its tip at the gingival margin, keep
the instrument in their position while
slicing through the tooth, this angling
reduces the risk of injuring the
adjacent tooth.
It is better to slice from buccal to
lingual or vice versa rather than
from occlusal to gingival (produces a
shoulder which prevent the proper
seating of the crown).

It may be necessary to remove rubber

dam at this stage.
Try the selected crown on the tooth,
place the crown on the lingual
side and rotate it on the labial
(buccally) surface
The crown should fit loosely with 23 mm. excess gingivally
The Crowns that is pre-festooned and
contoured needs little or no trimming.
With a probe check that the edge of
the crown is within the gingival
crevice.

If the length of the crown is too long

scratch the gingival margin
around the crown with a hand
scaler, this scratch line indicates the
portion of the crown to be
removed.
Remove the crown from the prepared
tooth exposing the scratch line with
crown and bridge scissors cut the
crown 1 mm. below the scratch

3- BUCCAL AND LINGUAL SURFACES:

No reduction, only roundation1 of the

line angles and reverse bevel2 at the
occlusal surface.

line.

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Retry the crown on the tooth.

If there is blanching of the gingiva it
may be necessary to retrim the crown
Adapt and contour the crown
(crimping) with pliers, adaptation is

very important to the gingival health

of the supporting tissues

A poorly adapted crown will serve as:

1) Collection point of bacteria.

2) Contribution to recurrent caries.
3) Increased periodontal disease.
-If the crown has a loose fit on the tooth
crimp the cervical margins.

Fill the crown with cement, seat the

crown on the tooth from lingual to
buccal and press it firmly into place
first with finger pressure and then by
inserting band seater and ask the child
to bite firmly on it
When the cement is set remove all
excess particularly from the gingival
contact and from interdentally areas
using a probe and dental floss.

A well fitted crown will make a

POPPING OR SNAP NOISE when
it removed from the tooth.

CROWN FINISHING

Use a large green stone to finish the

cervical margin.

Smooth and polish the margins with a

rubber wheel.
Polish the entire crown with polishing
material to give the crown fine luster.
Try on the crown and check occlusion,
evaluate the opposite side for proper
cuspal and occlusal interdigitation.

CROWN CEMENTATION

Wash and dry the tooth and the crown.

Isolate the tooth with cotton rolls and
saliva ejectors.
The tooth and the crown must be clean
and dry for good adhesion of cement.
Use an adhesive cement1,
polycarboxylate cement2 or glass
ionomer cement3, mixed to creamy
consistency.

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CAUSES OF STAINLESS
STEEL CROWN FAILURE
1-Poor tooth preparation.
2-Poor crown adaptation.
3-Improper cementation technique.
4-Recurrent caries.
5-Crown perforation occlusally.

 MODIFICATIONS OF
STAINLESS STEEL CROWNS
1- Over sized crown:
a. Try the crown on the tooth.
b. Use a pair of scissors to cut the
crown from the gingival to the
occlusal surface either bucally or
lingually as needed.
c. Pinch the crown together and again
try the crown on the tooth.
d. Spot weld the overlapped edges
together use solder and flux, polish
and smooth. Check the crown for
marginal adaptation, contour,
crimp and cement the crown.

RECENT ADVANCES
1- Stainless steel crowns may be
esthetically improved by placement of
composite resin in a buccal window cut
into the labial face of The crown.
2- Crowns with prefabricated tooth colored
buccal facings are available. Crown forms
with bonded resin veneers for primary
incisors were developed to serve as a
convenient, durable, reliable and esthetic
solution for restoring severely destructed
primary incisors.
3-Pre-veneered stainless steel crowns
resolve some of the problems associated
with stainless steel crowns, open faced
stainless steel crowns, and composite strip

2- UNDERSIZED CROWN:
a. Check the crown on the tooth
b. Cut a V shape in the crown on the
buccal or lingual side or both, as
needed then try the crown on the
tooth.
c. Use a strip of orthodontic band and
spot welded over the V cut in the
crown
d. Use #114 pliers to adapt the band
material to the crown contour cut
off the excess approximating the
gingival contour of the crown.

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crowns.
4-They were introduced in the mid 1990s.
They are aesthetic, placement and
cementation are not significantly affected
by hemorrhage and saliva and can be
placed in a single appointment. The
stainless steel crown is covered on its
buccal or facial surface with a tooth
colored coating of polyester/epoxy hybrid
composite.