Composite Resin Strip Crown

Method

Local anesthesia, and rubber dam Select the correct celluloid crown (mesio distal width) Remove the caries using slowspeed roundbur Reduced the incisal height by around 2 mm, prepare interproximal slices Protect the exposed dentin with GIC Trim the crown form and make two holes in insical corner Ecth the enamel for 20 second Apply bonding Fill the crown with apropiate shade of composite and seat with gentle, even pressure , allowin the excess to exit freely Light cure from all direction

Stainless steel Crown

The lifespan of multisurface amalgam restoration is

markedy shorter in primary tooth Replacement are often necessary within a short period Need alternative SSC Paired study between multisurface amalgam and SSC clinical longitudinal study (8 years) SSC are more acceptable, cost efevtive

Indication
A tooth has receive Pulpotomy and pulpectomy
Tooth has severe malformations, e.g enamel hypoplasia High caries susceptibility An abutment for certain appliances Severely decayed tooth/ Extensive multi-surface

caries and/or fractures Failed alloy or resin restoration

Caries Progression and restoration

Contraindication
Extensive loss of tooth structure
Occlusion is a critical factor Patient compliance during multiple crown fitting can

be a problem

Anterior and Posterior SSC

Technique
Check the proper occlusion Give local anesthesia Place rubber dama and wedges Reduce occlusal surface 1,0- 1,5 mm Reduce proximal surfaces Bevel occlusal-buccal and occlusal-lingual line angle Round off the proximo buccal Remove caries do pulpotomy or pulpectomy Select the crown Seat the crown into occlusion, contour it Crimping, established contact, polish the crown Cementing, remove excess

Armamentarium

Pediatric Considerations in Choosing Restorative Material

Child behavior Number of decayed surfaces Length of time restoration will be in place (i.e. age of child) Which tooth is in need of a restoration Caries rate Probability childs family will continue with dental care Severity of decay Is there a parental preference

Restorative Tx Planning Example Cases: Age? - 1-18 - when will exfoliation occur? Behavior? - ability to tolerate treatment (gag reflex, anxious, limited opening, etc) - special needs - pre-cooperative or can comply with directions Caries Risk? - high (plaque accumulation, white spot lesions, dental hx, missed appointments, SES, diet, frequency of brushing, hx of caries, etc.) What Type of Physical Restoration is Needed? - how many surfaces involved, will the prep pass the line angles, is there hypocalcified enamel present, etc.) - does the child have known allergies to any of the substances you would choose? Has the information been communicated to the parent? - does the parent have a preference of white or silver? - has the parent been informed of your tx decisions and why you are choosing the materials you are? - is cost a factor? Is the family going to be responsible for costs above what an amalgam costs?