presentation about different crowns used in pediatric dentistry

1. Anterior Crowns
Dr. Abhishek Kumar
Pediatric Dentist

2. Open faced stainless steel crown
Restoring primary anterior teeth can be difficult.
Often, once all the caries are removed, there remains
little tooth structure to bond a conventional composite
restoration and have adequate durability over time.
This same problem arises with large fractures to
primary incisors.
In these situations the best restoration is an open faced
stainless steel crown.

3. Advantages
The aesthetics are fair. (The metal shows
through the composite facing).
They are very durable, wear well and retentive.
The materials are fairly inexpensive.

4. Disadvantages
The time for placement is long as it involves
two-step process (crown cementation /
composite facing placement.
Placement of the composite facing may be
compromised when gingival hemorrhage or
moisture is present or when the patient exhibits
less than ideal cooperation.

5. check the child’s occlusion prior to preparation.
Slice mesial and distal surfaces and reduce incisal
edge 1-1.5mm, round all line angles and reduce lin-
gual and facial surfaces about 0.5 mm.
Remove all caries with round burs on slow speed
hand piece.
Choose crown of correct size.
Adapt margins and crimp appropriately.
Cement crown and remove excess cement.

6. After cement has completely set, use a 245 bur to
cut out a “window” on the facial surface of the
crown.
One can use a white stone to smooth edges of
metal on collar.
Also it is imperative that the cement around the
edges of the “window” is re- moved to create an
undercut for better composite retention.

8. Anterior Crowns
Polycarbonate crowns
Strip crowns
Pre-veneered crowns
Cheng Crowns
Kinder Crown
Nu Smile
Pedo pearls

9. Veneered steel crown
Tooth coloured materials are bonded to the
labial surface of the stainless steel crowns.
These come as pre-veneered stainless steel
crowns.
Examples are NuSmile Primary Crown, Cheng
Crowns, Kinder Crowns, Whiter Biter Crown.

10. Polycarbonate crowns
Indications:
• Short-term or long-term provisional coverage
• Centrals, laterals, cuspids and bicuspids.

11. Crown Selection
• Prepare tooth and determine crown size needed.
• Select appropriate crown and trial fit.

12. Crown Preparation
Seat crown on preparation.
Mark gingival contour using a pencil.
Remove crown and trim 1.0 mm below line using
Crown Scissors, bur or stone.
Cervical margins can be crimped, if needed,
using a Crimping Pliers.
Reseat and check fit.

13. Roughen inner crown surface with diamond or
bur to enhance adhesion of an acrylic or resin
lining material to crown.
Line crown with acrylic or resin material to
enhance fit and extend wear.
Seat crown on moistened preparation.
Allow provisional material to set according to
manufacturer’s directions.

14. Remove from mouth and trim to finish line using a
carbide bur.
Smooth and polish as required, using Finishing and
Polishing Discs and rubber wheel.
Mix cement and fill crown, assuring voids are not
present in cement.
Seat crown and allow cement to set.
Remove excess cement with scaler or explorer.
Floss interproximal areas

15. Strip crowns
Indications:
- Extensive or multi-surface caries in primary
incisors
- Congenitally malformed
- Discolored
- Fractured
- Amelogenesis imperfecta

16. Technique
1. After carious dentin is removed and based,
prepared the tooth with undercuts to receive a strip
crown.
2. Once size is obtained, select corresponding STRIP
CROWN and trim margins with scissors. Crown
should fit close to cervical margin but not to touch
tissue.
3. Prepare the tooth as needed. (i.e. enamel etch,
dentin bonding agent etc.)

17. 5. Once a crown is selected, margins adjusted
and tooth is in proper occlusion, vent lingual
surface of the crown if necessary with a #2 bur.
6. Follow manufacturer’s directions for applying
adhesive.
Next, fill crown with a restorative material. Avoid
trapping air bubbles, allowing material to flow out
the lingual vent of the crown.

18. Immediately place filed crown on prep, using finger
pressure to seat crown.
Remove excess material and allow restorative
material to cure
After material has cured, trim off incisal edge of
crown with disk or fine bur.
Next, with an scaler or explorer “slit ” lingual of
crown. Then lift and peel off strip crown material
from restoration.

20. Paedo jacket crown
This is like a strip crown. It is made of tooth
coloured polyester material which can be filled
with resin and left on the tooth after
polymerisation.
It comes only in a single shade which makes
matching to adjacent non-restored tooth difficult

21. Paedo Pearls
This is a metal crown form similar to the
stainless steel crown but it is completely coated
with a tooth coloured epoxy paint.
The crowns are made from aluminum instead of
stainless steel because the epoxy coating adapt
better to aluminum.

22. Artglass crowns
They are made of bifunctional and new
multifunctional methacrylates.
The fillers are microglass and silica which gives it
greater durability and aesthetics than composite
strip crowns.
They contain 75% fillers compared to composite
that contains 85% fillers.
Crown failure is usually as a result of bond failure.

23. Have
a nice
day!