FULL COVERAGE RESTORATION

FOR PRIMARY TEETH

.
FULL COVERAGE RESTORATION FOR PRIMARY TEETH

• Stainless steel crowns

• Is a metal shell with preformed anatomy that can be adapted to the tooth.
Stainless steel crowns (SSCs) are the restoration of choice for primary molars of
children with high-caries risk, after pulp therapy, for large, multisurface caries
and interproximal preparation that extends beyond the line angle .
INDICATIONS FOR USING A SSC

• Early childhood caries

• High caries incidence
• After endodontic treatment
• Space maintainer
• Bruxism
CONTRAINDICATIONS FOR SSC

• Esthetics.
• Allergy to nickel
• Extensive dental caries:
a. there is not enough crown structure left.
b. the caries (gingival) extent does not allow for adaptation.
• excessive mesial drift.
CLINICAL PROCEDURES FOR SSC

•Tooth preparation.

• Crown selection
• Crown adaptation.

• Complications.
• Cementation.
RATIONALE FOR SSC TOOTH PREPARATION AND ADAPTATION

• The tooth preparation and crown adaptation of SSC in primary molars is based on the crown’s
a. Flexibility : easily bent or shaped
b. Elasticity: the tendency of a body to return to its original shape after it has been stretched
• Preformed metal crowns are flexible and elastic.
• The tooth cervical bulge is “surrounded” by the crown.
RATIONALE FOR SSC TOOTH PREPARATION AND ADAPTATION

• do not require the retention features that are incorporated in cavity design of
cast crowns.
• obtain their retention from the flexibility and elasticity of the thin, contoured
and crimped crown margins, and cementation.
 TOOTH PREPARATION FOR SSC
Occlusal surface 1-1.5mm reduction
Occlusal preparation :
Create a “channel” 1.25 mm deep between the cusps.
Reduce the cusps to the depth of the channel.
• Buccal and lingual reduction.
Prepare a slight bevel, at the occlusal 1/3 portion of the surface.
• Proximal surfaces :
) tapered fissure or thin tapered diamond bur.
b) Break proximal contacts at appropriate depth gradually.
c) Vertical proximal walls with slight convergence in an occlusal and lingual/palatal direction.
d) Feather-edge finish line
COMPLICATIONS

• Aspiration

• Gingival and periodontal diseases

• Allergy
.

• SSCs represent a long term, easy one appointment full coverage restorations
of primary molars.
• The tooth preparation and adaptation are relatively easy, in most cases.
• Durable and cost effective
AESTHETIC FULL COVERAGE RESTORATIONS FOR
PRIMARY TEETH

• Indications :
• Tooth with large interproximal lesions
• Unaesthetic tooth due to discoloration
• Tooth with small carious lesions and with large areas of cervical
discoloration
CLASSIFICATION OF CROWNS

• According to material used :

a. Stainless steel crowns with facing
b. Resin crowns/composite crowns
c. Pre-veneered SSC
d. Ceramic (zirconia) crown
CLASSIFICATION OF CROWNS

• According to bonding or luting of full coronal restoration

a. Luted
-SSC
-SSC with facing
-Ceramic crowns
b. Bonded
-Resin based
-Composite based
-Natural tooth
 STAINLESS STEEL CROWNS WITH FACING

Advantages Disadvantages

The aesthetics are fair. The time for placement is long.

Placement of the composite facing
may be compromised when gingival
They are very durable, wear well and
hemorrhage or moisture is present or
retentive.
when the patient exhibits less than
ideal cooperation.

The materials are fairly inexpensive.

COMPOSITE STRIP CROWNS

• • These are composite filled celluloid crowns forms.

• Lack of tooth structure, & the presence of moisture or hemorrhage contributes
to compromised retention.
COMPOSITE STRIP CROWNS
Advantages
It provides superior aesthetics & the cost
of materials are reasonable
The time for placement is reasonable.
Simple to fit and trim.
Leaves smooth shiny surface.
Disadvantages
It is extremely technique sensitive.
Adequate moisture control might be
difficult on an uncooperative patient.
Not recommended on patients with a
bruxism habit or a deep bite.
NEW MILLENIUM CROWNS

Advantages Disadvantages
Very expensive compared to
Esthetics
strip crown .
Can be trimmed and
reshaped with high speed Brittle
finishing bur
Adequate moisture control
POLYCARBONATE CROWNS

• These are heat-molded acrylic resin shells that are adapted to teeth with self
cured acrylic resin.
• hey were more aesthetic than stainless steel crowns the polycarbonate
material was:
a. Brittle
b. did not resist strong abrasive forces, exhibiting frequent fracture and
dislodgement
PRE-VENEERED STAINLESS STEEL CROWNS

• They were introduced in the mid 1990’s.

• • Aesthetic
• • Placement & cementation are not significantly affected by hemorrhage and
saliva and can be placed in a single appointment.
PRE-VENEERED STAINLESS STEEL CROWNS
Advantages
They are aesthetically pleasing.
They have the durability of a steel
crown.
Disadvantages
They are 3 times more expensive than
stainless steel, strip and polycarbonate
crowns
they are relatively inflexible as the resin
facing is brittle and tends
to fracture when subjected to heavy
forces
ZIRCONIA PEDIATRIC CROWNS

• Ceramic/ Zirconia crowns

• EZ crown
• Kinder krown
• ZIRKIZ crown
 REFERENCES
• • Stewart R. Pediatric dentistry. St. Louis: Mosby; 1982.

• • Babaji P. Crowns in pediatric dentistry.

• • Holsinger D M, Wells M H, Scarbecz M, Donaldson. Clinical Evaluation and Parental Satisfaction with Pediatric Zirconia Anterior Crowns. Pediatr Dent
2016;38(3):192-7

• • Ram D & Fuks A. B. Clinical performance of resin-bonded composite strip crowns in primary incisors: a retrospective study, Int J Paeditr Dent. 2006;16:49-
54.

• • Shah P V, Lee J Y, Wright J T.Clinical Success and Parental Satisfaction With Anterior Preveneered Primary Stainless Steel Crowns. Paeditr Dent. 2004;26:391-
95.

• • Salami A, Walia T, Bashiri R. Comparison of Parental Satisfaction with Three Tooth- Colored Full- Coronal Restorations in Primary Maxillary Incisors. J Clin
Pediatr Dent. 2015; 39(5): 423-28

• American Academy of Pediatric Dentistry. Guideline on pedi- atric restorative dentistry. Pediatric Dentistry, 2014; 36 (special issue), 230–241.

• Erdemci, Z.Y., Cehreli, S.B. & Tirali, R.E. (2014) Hall versus con- ventional stainless steel crown techniques: In vitro investiga- tion of marginal fit and
microleakage using three different luting agents. Pediatric Dentistry, 36, 286–290.

• Innes, N.P., Evans, D.J. & Stirrups, D.R. (2011) Sealing caries in primary molars: randomized control trial, 5-year results. Journal of Dental Research, 90, 1405–
1410.

• Mahoney, E., Kilpatrick, N. & Johnston, T. (2008) Restorative paediatric dentistry. In: Cameron, A.C. & Widmer, R.P. (eds), Handbook of Pediatric Dentistry, 3rd
edn. Mosby, London, pp. 341 – 377.

• Ohlimoba, H.O. & Nelson, L.P. (2013) A performance mea- surement plan for pediatric dentists: using accuracy of caries diagnosis from intraoral radiographs.
Pediatric Dentistry, 35, 27–32.
• Ram, D., Fuks, A.B. & Eidelman, E. (2003) Long-term clinical performance of esthetic primary molar crowns. Pediatric Den- tistry, 25, 582–584.
FULL COVERAGE RESTORATION FOR PRIMARY
TEETH
Presented by
Mohamed Faik Elkafrawy 201500602
Bassem Nabil Mohamed 201500638
Mohamed elsayed Mohamed Ismaeel 201500716
Amr Ahmed Wahba 201500693
Alsayed Ismail Ahmed Aboelmaaaty 201500622
Ismael moustafa ismael elsaed 201500617
.