This document provides an overview of stainless steel crowns for pediatric dentistry. It discusses the history, composition, indications, contraindications, advantages and disadvantages of stainless steel crowns. It describes different types of crowns based on composition and morphology. The document outlines the armamentarium, techniques, adaptations and modifications for stainless steel crowns. It is intended to serve as a reference for using stainless steel crowns in treating pediatric dental patients.
This document discusses stainless steel crowns, which are semi-permanent restorations used in primary and young permanent teeth. It describes the history, types, indications, advantages, disadvantages, composition, placement procedure, modifications, and complications of stainless steel crowns. Stainless steel crowns provide full tooth coverage and are effective for restoring extensively decayed or malformed primary teeth. They are durable, economical restorations that can improve function and aesthetics for young patients.
This document discusses rotary endodontics in primary teeth. It begins with an introduction noting that canal preparation in primary teeth can be challenging but was introduced to pediatric dentistry by Barr in 2000. Rotary files are more convenient and may be better for children with behavior issues. The document then covers the development of rotary systems from the late 1800s to modern developments. It discusses features of rotary instrument design including tip design, helical angle, taper, rake angle, and movements. Common rotary systems for primary teeth like Profile are mentioned. The advantages of rotary files in pediatric cases are debridement and reduced treatment time.
This document discusses different types of full coverage restorations for anterior primary teeth in pediatric dentistry. It begins with an introduction describing the shift from extracting decayed primary teeth to restoring them. It then covers indications for full coverage of anterior teeth and contraindications. The main types discussed are stainless steel/open faced crowns, composite strip crowns, polycarbonate crowns, pre-veneered crowns, and zirconia crowns. For each type, the document describes advantages and disadvantages. It concludes that esthetics are now important in pediatric dentistry and different full coverage options allow restoring decayed anterior primary teeth while considering function, durability and aesthetics.
This document provides information on single file systems for root canal preparation. It discusses the history of reciprocation motion and generations of rotary file systems. Specific single file systems like WaveOne and Reciproc are described in detail, including their design features and advantages. The document emphasizes that recent advances in endodontics have focused on completing root canal shaping with only one or two files to be more efficient and minimize procedural errors.
This document discusses apexification and indirect pulp capping procedures. Apexification is used to induce calcification at the open apex of an immature tooth to allow for root canal treatment. Materials used include calcium hydroxide, tricalcium phosphate, and MTA. Calcium hydroxide is placed in the canal and replaced every 3 months until radiographic evidence of apical barrier formation. MTA can also be used by placing it at the apex. Indirect pulp capping covers the deepest carious dentin with a biocompatible material like calcium hydroxide to prevent pulpal exposure while removing infected dentin, allowing for pulp preservation.
Remineralization is defined as the process whereby calcium and phosphate ions are supplied from an external source to the tooth thereby, causing ion deposition into crystal voids in demineralized enamel, thus producing net mineral gain.
Remineralization Agents - Biomimetic approaches to stabilization of bioavailable calcium, phosphate, and fluoride ions and the localization of these ions to non-cavitated caries lesions for controlled remineralization.
Fermentable carbohydrates provide plaque bacteria with substrate for acid production.
This causes a rapid drop in plaque pH and when pH becomes less than 5.5, hydroxyapatite in enamel breaks down and calcium and phosphate ions diffuse out from the enamel.
5.5 is the “critical pH”, the point where equilibrium exists. There is no mineral dissolution and no mineral precipitation.
The plaque remains acidic for about 30-60 minutes after which normal pH is restored gradually.
The calcium and phosphate ions re-enter enamel when normal pH is restored and thus remineralization occurs.
Recent advances in endodontics include improved methods for diagnosis using tools like pulse oximetry and laser Doppler flowmetry. Cone beam CT and newer apex locators provide more accurate determination of working length. Advances in instrumentation include nickel-titanium rotary files and self-adjusting files. New irrigants and devices improve cleaning and disinfection of the root canal. Regenerative endodontic procedures aim to regenerate damaged tissues through stem cell therapy and tissue engineering.
This document discusses stainless steel crowns, which are semi-permanent restorations used in primary and young permanent teeth. It describes the history, types, indications, advantages, disadvantages, composition, placement procedure, modifications, and complications of stainless steel crowns. Stainless steel crowns provide full tooth coverage and are effective for restoring extensively decayed or malformed primary teeth. They are durable, economical restorations that can improve function and aesthetics for young patients.
This document discusses rotary endodontics in primary teeth. It begins with an introduction noting that canal preparation in primary teeth can be challenging but was introduced to pediatric dentistry by Barr in 2000. Rotary files are more convenient and may be better for children with behavior issues. The document then covers the development of rotary systems from the late 1800s to modern developments. It discusses features of rotary instrument design including tip design, helical angle, taper, rake angle, and movements. Common rotary systems for primary teeth like Profile are mentioned. The advantages of rotary files in pediatric cases are debridement and reduced treatment time.
This document discusses different types of full coverage restorations for anterior primary teeth in pediatric dentistry. It begins with an introduction describing the shift from extracting decayed primary teeth to restoring them. It then covers indications for full coverage of anterior teeth and contraindications. The main types discussed are stainless steel/open faced crowns, composite strip crowns, polycarbonate crowns, pre-veneered crowns, and zirconia crowns. For each type, the document describes advantages and disadvantages. It concludes that esthetics are now important in pediatric dentistry and different full coverage options allow restoring decayed anterior primary teeth while considering function, durability and aesthetics.
This document provides information on single file systems for root canal preparation. It discusses the history of reciprocation motion and generations of rotary file systems. Specific single file systems like WaveOne and Reciproc are described in detail, including their design features and advantages. The document emphasizes that recent advances in endodontics have focused on completing root canal shaping with only one or two files to be more efficient and minimize procedural errors.
This document discusses apexification and indirect pulp capping procedures. Apexification is used to induce calcification at the open apex of an immature tooth to allow for root canal treatment. Materials used include calcium hydroxide, tricalcium phosphate, and MTA. Calcium hydroxide is placed in the canal and replaced every 3 months until radiographic evidence of apical barrier formation. MTA can also be used by placing it at the apex. Indirect pulp capping covers the deepest carious dentin with a biocompatible material like calcium hydroxide to prevent pulpal exposure while removing infected dentin, allowing for pulp preservation.
Remineralization is defined as the process whereby calcium and phosphate ions are supplied from an external source to the tooth thereby, causing ion deposition into crystal voids in demineralized enamel, thus producing net mineral gain.
Remineralization Agents - Biomimetic approaches to stabilization of bioavailable calcium, phosphate, and fluoride ions and the localization of these ions to non-cavitated caries lesions for controlled remineralization.
Fermentable carbohydrates provide plaque bacteria with substrate for acid production.
This causes a rapid drop in plaque pH and when pH becomes less than 5.5, hydroxyapatite in enamel breaks down and calcium and phosphate ions diffuse out from the enamel.
5.5 is the “critical pH”, the point where equilibrium exists. There is no mineral dissolution and no mineral precipitation.
The plaque remains acidic for about 30-60 minutes after which normal pH is restored gradually.
The calcium and phosphate ions re-enter enamel when normal pH is restored and thus remineralization occurs.
Recent advances in endodontics include improved methods for diagnosis using tools like pulse oximetry and laser Doppler flowmetry. Cone beam CT and newer apex locators provide more accurate determination of working length. Advances in instrumentation include nickel-titanium rotary files and self-adjusting files. New irrigants and devices improve cleaning and disinfection of the root canal. Regenerative endodontic procedures aim to regenerate damaged tissues through stem cell therapy and tissue engineering.
As an intracanal medicament
Definition
Clinical application
Mechanism of action
Vehicles
Placement of Calcium hydroxide paste
Dentin and Calcium hydroxide
Effect of Calcium hydroxide on clinical outcome
Calcium hydroxide and Chlorhexidine
Calcium hydroxide and Sodium Hypochlorite
Removal of Calcium hydroxide from the canal
When to replace Calcium hydroxide dressing?
Calcium hydroxide and CO2
Toxicity
As a Root canal Sealer
Clinical significance
Classification
Composition
Properties
Leakage
Solubility
- In tissue fluids
- In chemical solvent
Biocompatibility
Antimicrobial
Toxicity
Conclusion
References
This document discusses space maintainers, which are appliances used to maintain space after premature loss of primary teeth. It defines space maintainers and describes their important functions. The main causes of premature primary tooth loss are caries, trauma, ectopic eruption, and systemic disorders. Premature loss can lead to undesirable tooth movement and malocclusion. The document discusses factors that influence space closure rate and direction, as well as treatment considerations for timely space maintenance. It also outlines types of space maintainers, including fixed and removable, and their advantages and disadvantages.
Anatomy of root apex and its significance newDilu Davis
The document discusses the anatomy and morphology of the apical third of teeth roots. It notes that this region is the most complex part of teeth and is important prognostically for endodontic procedures. The apical third can display variations like accessory canals, isthmuses, additional root canals and foramen, and curved or ribbon-shaped canal systems. These anatomical variations make cleaning, shaping, filling and surgery in this region challenging for endodontists. Proper instrumentation techniques and materials are required to navigate the complex apical third anatomy.
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses the use of lasers in endodontics. It begins with a brief history of lasers, describing their development from Einstein's work in the early 1900s to their first use in dentistry in the 1970s. It then covers laser physics and components, different types of lasers including wavelengths used in dentistry, and laser tissue interactions. The main body discusses several clinical applications of lasers in endodontics such as pulp testing, pulp capping, pulpotomy, root canal disinfection and shaping, and endosurgery. Lasers can provide benefits like reduced need for anesthesia, hemostasis, and less collateral damage compared to other tools. Training is required and no single laser can perform all
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
This document discusses irrigation in endodontics. It provides an introduction to irrigation solutions and devices used, challenges of irrigation, and recent advances. It describes the ideal characteristics of endodontic irrigants and commonly used solutions such as sodium hypochlorite. Sodium hypochlorite is the current irrigant of choice and its properties, concentrations, effects on dentin, and safety considerations are discussed in detail. The document concludes by emphasizing the importance of irrigation in endodontic treatment.
This document provides information about stainless steel crowns (SSCs), including their history, objectives, indications, contraindications, types, composition, clinical procedure, and references. Some key points:
- SSCs were first described in the 1950s and became commonly used in the 1960s to restore primary and permanent teeth.
- Objectives are to achieve a biologically compatible restoration that maintains tooth form and function.
- Indications include restoring teeth after pulpotomy/pulpectomy, with large/deep caries, or when 3+ surfaces need restoration.
- Clinical procedure involves evaluating occlusion, selecting correct crown size, tooth preparation to provide space and remove caries, and cementing the crown
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
Retentive features of a cavity
Indications and contraindication
Advantages and disadvantages
Types of pins
Cemented pins
Friction locked pins
Self threaded pins –(TMS)
Thread mate system
Regular , minim, manikin, minuta
Standard, self shearing, two in one, link series, link plus
Factors involved
Mechanical aspect
Anatomical aspect
Mechano-anatomical principles
Mechanical aspects of Pin-Retained restoration
Pins and tooth structure
Stressing capabilities of pins
Retention of pins in dentin
Microcracking and crazing
Pins and restorative materials
Effect of pins on strength of restorative materials
Retention of pins to restorative material
The document discusses the history and generations of dentin bonding agents. It describes the challenges of bonding to dentin due to its composition and structure. Early bonding agents bonded weakly to the smear layer rather than dentin. Current bonding agents condition and prime the dentin surface to allow resin infiltration and strong bonding. They are classified based on their treatment of the smear layer and number of clinical steps.
This document summarizes various endodontic irrigants used during root canal treatment. It describes the properties and effectiveness of sodium hypochlorite (NaOCl), chlorhexidine (CHX), iodine, ethylenediaminetetraacetic acid (EDTA), citric acid, a mixture of tetracycline, acid and detergent (MTAD), Tetraclean, maleic acid, bis-dequalinium acetate (BDA), triclosan with Gantrez, and chlorine dioxide. It provides details on how each irrigant aids in disinfection, removal of smear layer and debris, and substantivity within the root canal system. The document emphasizes
The document discusses principles of tooth preparation for cast restorations. It covers topics such as preparation path, apico-occlusal taper, circumferential tie features for intracoronal and extracoronal preparations, and auxiliary means of retention such as grooves, boxes, and pins. The key goals of preparation design are to provide maximum retention, resistance, and a definitive path of insertion and withdrawal for the restoration. Taper, bevels, flares, and other features are used to achieve an ideal relationship between the casting and tooth for a strong, durable restoration.
This document discusses the diagnosis and treatment of Class III malocclusions. It begins with definitions and features of Class III malocclusions, noting they involve a mesial relationship of the mandible to the maxilla. Treatment approaches are described for:
1. Intercepting Class III malocclusions during growth using myofunctional appliances, chin cups, or face masks to redirect growth.
2. Using fixed appliances in mixed dentition to retrocline lower incisors and procline upper incisors.
3. Addressing anterior and posterior crossbites.
4. Considering extractions for mild mandibular prognathism.
5. Surgical-orthodontic treatment
This document discusses endodontic retreatment. It defines retreatment as removing root canal filling materials from a tooth to clean, shape, and re-obturate the canals. Reasons for retreatment include persistent or reinroduced intraradicular microorganisms, extraradicular infection, foreign body reaction, or true cysts. Evaluation involves clinical examination, radiographs, and assessing for symptoms like pain, swelling or sinus tracts. Success is defined as resolution of symptoms and periapical radiolucency, while failure is persistence or worsening of these signs.
This document discusses various types of crowns used in pediatric dentistry to restore primary teeth. It begins by introducing the need for aesthetic full coverage restorations in children. It then describes several types of crowns in detail, including their indications, advantages, disadvantages, and placement techniques. The crowns discussed are stainless steel, open-faced steel, polycarbonate, composite strip, pre-veneered steel, and NuSmile crowns. For each type, the document outlines the specific technique for tooth preparation and crown cementation or bonding. The goal of discussing these various crown options is to help pediatric dentists select the best restoration for primary teeth based on factors like aesthetics, durability, and technique sensitivity.
This document discusses root canal curvatures and methods for determining their degree. It begins with an introduction on the importance of understanding root canal anatomy for successful endodontic treatment. It then covers causes of canal curvatures, various classification systems, and techniques for assessing curvature using periapical radiographs, cone-beam computed tomography, and angular measurement methods. The relationship between curvature degree and ledge formation risk is also addressed, as are canal characteristics often invisible on routine radiographs. The document concludes by emphasizing the challenges of treating severely curved canals and the need for accurate preoperative assessment and proper instrumentation.
dental Monoblock obturation technique or concept in endodonticsAhmed Ali
dental Monoblock obturation technique or concept in endodontics which are classified into primary ,secondary & tertiary based upon resin , now the bioceramics
This document discusses provisional restorations and their requirements. It defines provisional restorations as temporary restorations designed to enhance function and aesthetics until definitive treatment. Provisional restorations must meet biological, mechanical, and aesthetic requirements. Biologically, they must protect the pulp, maintain periodontal health, and provide positional stability. Mechanically, they must resist functional loads and removal forces. Aesthetically, they must match the tooth's color, shape, and texture. The document discusses various materials used for provisional restorations including acrylic resins, bis-acryl composites, and light-cured resins.
This document discusses laminate veneers, including their history, definitions, indications, contraindications, and comparisons of different types of veneers. Laminate veneers originated in the 1930s when Dr. Charles Pincus used thin resin and porcelain facings to create Hollywood smiles for actors. The document compares direct resin veneers, indirect resin veneers, and porcelain indirect veneers in terms of strength, esthetics, longevity, costs, and other factors. Porcelain indirect veneers generally provide the best esthetics and longevity while direct resin veneers are best for covering dark stains and cost less.
This document provides an overview of stainless steel crowns used in pediatric dentistry. It discusses the history and development of stainless steel crowns, their composition, indications and contraindications for use. The document outlines the armamentarium, techniques and modifications for placing stainless steel crowns. It also addresses advantages like longevity and protection of tooth structure, and disadvantages such as appearance. Overall, the document presents stainless steel crowns as an effective treatment for restoring severely decayed primary teeth.
This document provides an overview of stainless steel crowns used in pediatric dentistry. It discusses the history and development of stainless steel crowns, their composition, indications and contraindications for use. The document outlines the armamentarium, techniques and modifications for placing stainless steel crowns. It summarizes that stainless steel crowns provide effective long-term restoration of primary molars and protection of tooth structure, with the advantages of easy placement and low failure rates, though they can appear unsightly.
As an intracanal medicament
Definition
Clinical application
Mechanism of action
Vehicles
Placement of Calcium hydroxide paste
Dentin and Calcium hydroxide
Effect of Calcium hydroxide on clinical outcome
Calcium hydroxide and Chlorhexidine
Calcium hydroxide and Sodium Hypochlorite
Removal of Calcium hydroxide from the canal
When to replace Calcium hydroxide dressing?
Calcium hydroxide and CO2
Toxicity
As a Root canal Sealer
Clinical significance
Classification
Composition
Properties
Leakage
Solubility
- In tissue fluids
- In chemical solvent
Biocompatibility
Antimicrobial
Toxicity
Conclusion
References
This document discusses space maintainers, which are appliances used to maintain space after premature loss of primary teeth. It defines space maintainers and describes their important functions. The main causes of premature primary tooth loss are caries, trauma, ectopic eruption, and systemic disorders. Premature loss can lead to undesirable tooth movement and malocclusion. The document discusses factors that influence space closure rate and direction, as well as treatment considerations for timely space maintenance. It also outlines types of space maintainers, including fixed and removable, and their advantages and disadvantages.
Anatomy of root apex and its significance newDilu Davis
The document discusses the anatomy and morphology of the apical third of teeth roots. It notes that this region is the most complex part of teeth and is important prognostically for endodontic procedures. The apical third can display variations like accessory canals, isthmuses, additional root canals and foramen, and curved or ribbon-shaped canal systems. These anatomical variations make cleaning, shaping, filling and surgery in this region challenging for endodontists. Proper instrumentation techniques and materials are required to navigate the complex apical third anatomy.
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document discusses the use of lasers in endodontics. It begins with a brief history of lasers, describing their development from Einstein's work in the early 1900s to their first use in dentistry in the 1970s. It then covers laser physics and components, different types of lasers including wavelengths used in dentistry, and laser tissue interactions. The main body discusses several clinical applications of lasers in endodontics such as pulp testing, pulp capping, pulpotomy, root canal disinfection and shaping, and endosurgery. Lasers can provide benefits like reduced need for anesthesia, hemostasis, and less collateral damage compared to other tools. Training is required and no single laser can perform all
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
This document discusses irrigation in endodontics. It provides an introduction to irrigation solutions and devices used, challenges of irrigation, and recent advances. It describes the ideal characteristics of endodontic irrigants and commonly used solutions such as sodium hypochlorite. Sodium hypochlorite is the current irrigant of choice and its properties, concentrations, effects on dentin, and safety considerations are discussed in detail. The document concludes by emphasizing the importance of irrigation in endodontic treatment.
This document provides information about stainless steel crowns (SSCs), including their history, objectives, indications, contraindications, types, composition, clinical procedure, and references. Some key points:
- SSCs were first described in the 1950s and became commonly used in the 1960s to restore primary and permanent teeth.
- Objectives are to achieve a biologically compatible restoration that maintains tooth form and function.
- Indications include restoring teeth after pulpotomy/pulpectomy, with large/deep caries, or when 3+ surfaces need restoration.
- Clinical procedure involves evaluating occlusion, selecting correct crown size, tooth preparation to provide space and remove caries, and cementing the crown
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
Retentive features of a cavity
Indications and contraindication
Advantages and disadvantages
Types of pins
Cemented pins
Friction locked pins
Self threaded pins –(TMS)
Thread mate system
Regular , minim, manikin, minuta
Standard, self shearing, two in one, link series, link plus
Factors involved
Mechanical aspect
Anatomical aspect
Mechano-anatomical principles
Mechanical aspects of Pin-Retained restoration
Pins and tooth structure
Stressing capabilities of pins
Retention of pins in dentin
Microcracking and crazing
Pins and restorative materials
Effect of pins on strength of restorative materials
Retention of pins to restorative material
The document discusses the history and generations of dentin bonding agents. It describes the challenges of bonding to dentin due to its composition and structure. Early bonding agents bonded weakly to the smear layer rather than dentin. Current bonding agents condition and prime the dentin surface to allow resin infiltration and strong bonding. They are classified based on their treatment of the smear layer and number of clinical steps.
This document summarizes various endodontic irrigants used during root canal treatment. It describes the properties and effectiveness of sodium hypochlorite (NaOCl), chlorhexidine (CHX), iodine, ethylenediaminetetraacetic acid (EDTA), citric acid, a mixture of tetracycline, acid and detergent (MTAD), Tetraclean, maleic acid, bis-dequalinium acetate (BDA), triclosan with Gantrez, and chlorine dioxide. It provides details on how each irrigant aids in disinfection, removal of smear layer and debris, and substantivity within the root canal system. The document emphasizes
The document discusses principles of tooth preparation for cast restorations. It covers topics such as preparation path, apico-occlusal taper, circumferential tie features for intracoronal and extracoronal preparations, and auxiliary means of retention such as grooves, boxes, and pins. The key goals of preparation design are to provide maximum retention, resistance, and a definitive path of insertion and withdrawal for the restoration. Taper, bevels, flares, and other features are used to achieve an ideal relationship between the casting and tooth for a strong, durable restoration.
This document discusses the diagnosis and treatment of Class III malocclusions. It begins with definitions and features of Class III malocclusions, noting they involve a mesial relationship of the mandible to the maxilla. Treatment approaches are described for:
1. Intercepting Class III malocclusions during growth using myofunctional appliances, chin cups, or face masks to redirect growth.
2. Using fixed appliances in mixed dentition to retrocline lower incisors and procline upper incisors.
3. Addressing anterior and posterior crossbites.
4. Considering extractions for mild mandibular prognathism.
5. Surgical-orthodontic treatment
This document discusses endodontic retreatment. It defines retreatment as removing root canal filling materials from a tooth to clean, shape, and re-obturate the canals. Reasons for retreatment include persistent or reinroduced intraradicular microorganisms, extraradicular infection, foreign body reaction, or true cysts. Evaluation involves clinical examination, radiographs, and assessing for symptoms like pain, swelling or sinus tracts. Success is defined as resolution of symptoms and periapical radiolucency, while failure is persistence or worsening of these signs.
This document discusses various types of crowns used in pediatric dentistry to restore primary teeth. It begins by introducing the need for aesthetic full coverage restorations in children. It then describes several types of crowns in detail, including their indications, advantages, disadvantages, and placement techniques. The crowns discussed are stainless steel, open-faced steel, polycarbonate, composite strip, pre-veneered steel, and NuSmile crowns. For each type, the document outlines the specific technique for tooth preparation and crown cementation or bonding. The goal of discussing these various crown options is to help pediatric dentists select the best restoration for primary teeth based on factors like aesthetics, durability, and technique sensitivity.
This document discusses root canal curvatures and methods for determining their degree. It begins with an introduction on the importance of understanding root canal anatomy for successful endodontic treatment. It then covers causes of canal curvatures, various classification systems, and techniques for assessing curvature using periapical radiographs, cone-beam computed tomography, and angular measurement methods. The relationship between curvature degree and ledge formation risk is also addressed, as are canal characteristics often invisible on routine radiographs. The document concludes by emphasizing the challenges of treating severely curved canals and the need for accurate preoperative assessment and proper instrumentation.
dental Monoblock obturation technique or concept in endodonticsAhmed Ali
dental Monoblock obturation technique or concept in endodontics which are classified into primary ,secondary & tertiary based upon resin , now the bioceramics
This document discusses provisional restorations and their requirements. It defines provisional restorations as temporary restorations designed to enhance function and aesthetics until definitive treatment. Provisional restorations must meet biological, mechanical, and aesthetic requirements. Biologically, they must protect the pulp, maintain periodontal health, and provide positional stability. Mechanically, they must resist functional loads and removal forces. Aesthetically, they must match the tooth's color, shape, and texture. The document discusses various materials used for provisional restorations including acrylic resins, bis-acryl composites, and light-cured resins.
This document discusses laminate veneers, including their history, definitions, indications, contraindications, and comparisons of different types of veneers. Laminate veneers originated in the 1930s when Dr. Charles Pincus used thin resin and porcelain facings to create Hollywood smiles for actors. The document compares direct resin veneers, indirect resin veneers, and porcelain indirect veneers in terms of strength, esthetics, longevity, costs, and other factors. Porcelain indirect veneers generally provide the best esthetics and longevity while direct resin veneers are best for covering dark stains and cost less.
This document provides an overview of stainless steel crowns used in pediatric dentistry. It discusses the history and development of stainless steel crowns, their composition, indications and contraindications for use. The document outlines the armamentarium, techniques and modifications for placing stainless steel crowns. It also addresses advantages like longevity and protection of tooth structure, and disadvantages such as appearance. Overall, the document presents stainless steel crowns as an effective treatment for restoring severely decayed primary teeth.
This document provides an overview of stainless steel crowns used in pediatric dentistry. It discusses the history and development of stainless steel crowns, their composition, indications and contraindications for use. The document outlines the armamentarium, techniques and modifications for placing stainless steel crowns. It summarizes that stainless steel crowns provide effective long-term restoration of primary molars and protection of tooth structure, with the advantages of easy placement and low failure rates, though they can appear unsightly.
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Stainless steel crowns are prefabricated crown forms that are adapted to individual teeth and cemented with a biocompatible luting agent. “The SSC is extremely durable, relatively inexpensive, subject to minimal technique sensitivity during placement, and offers the advantage of full coronal coverage.”
Stainless steel crowns are semi-permanent restorations used for primary and young permanent teeth. They provide superior longevity compared to other restorative materials. Stainless steel crowns require minimal tooth preparation and can be placed in a single appointment, making them efficient. They are indicated for restoring teeth with extensive decay, following pulpotomies, in patients with poor oral hygiene, and as a space maintainer. Proper tooth preparation, crown adaptation, cementation, and follow up are important for success.
Stainless steel crowns in pediatric dentistry pptdrvinodini
This document provides an overview of stainless steel crowns (SSCs), including their history, composition, indications, contraindications, placement procedure, and modifications. SSCs were first described in 1950 as a semi-permanent restoration option for primary and young permanent teeth. They are made of stainless steel or nickel-chromium alloys. SSCs are indicated for restoring teeth with extensive decay, fractures, pulpotomies, or as a space maintainer. Placement involves tooth preparation, selection and fitting of the crown, contouring, crimping, cementation, and finishing. Modifications include altering crown size or adding material to accommodate deep caries or spacing issues. Studies have found SSCs to have low microleakage and
This document discusses semi-permanent crowns used in pediatric dentistry. It begins by introducing the author and defining semi-permanent crowns. It then covers the indications and contraindications for full coverage restorations. Five different types of crowns are described in detail: 1) preformed metal crowns, 2) stainless steel crowns with composite facings, 3) composite crowns, 4) preveneered stainless steel crowns, and 5) zirconia crowns. The conclusion reiterates that various crown options exist for restoring carious primary teeth, each with their own advantages and disadvantages.
The document discusses the use of stainless steel crowns in restorative pediatric dentistry, including their history, indications and contraindications, comparison to other restoration methods, and the Hall technique involving placement of stainless steel crowns. Stainless steel crowns provide durable restorations for primary teeth with extensive decay and have survival times over 40 months, making them an economical option despite initial higher costs compared to other materials like glass ionomer cement. Case examples are presented to illustrate when stainless steel crowns are suitable or not suitable for carious primary molars.
Stainless steel crowns are indicated for restoring primary teeth with extensive decay, fractures, or other defects. They provide a durable and cost-effective restoration. Contraindications include situations where esthetics is a primary concern. Crowns can be modified as needed for individual clinical situations, such as space loss, deep lesions, or bruxism. Proper tooth preparation and crown adaptation are essential for optimal fit and function.
This document provides information on tooth preparation for full veneer crowns. It begins with an introduction stating that tooth preparation is an important phase that everything following, like vitality, health, esthetics, and longevity depend on. It then discusses the history of crowns dating back to 300-400 BC and developments over time. Principles of tooth preparation according to Rosenstiel and Shillingburg are outlined focusing on biologic factors, mechanical retention and resistance form, esthetics, and the periodontium. Terminologies are defined. The different crowns types - complete cast metal, anterior/posterior metal-ceramic, porcelain jacket, and all-ceramic crowns are described along with their indications, advantages, disadvantages
Stainless Steel Crown (Department of pedodontics)shebin_1992
This document discusses stainless steel crowns, including different types, their objectives and uses, composition, indications, clinical procedure, modifications, and complications. There are three main types of stainless steel crowns - untrimmed, pretrimmed, and precontoured. Stainless steel crowns are used to restore primary and young permanent teeth with extensive decay or other defects. The clinical procedure involves tooth preparation, initial crown adaptation, contouring, crimping, and cementation. Complications can include ledges, crown tilt, or poor margins.
The document discusses the progression of early childhood caries (ECC) leading to poor quality of life. It then summarizes the use of stainless steel crowns in pediatric dentistry, including their introduction, classification based on morphology and composition, indications, advantages, disadvantages, modifications, and complications. Prefabricated stainless steel crowns provide a superior restoration to multi-surface fillings and can help prevent further dental problems if used for extensive decay, following pulp therapy, or as a preventive restoration in primary teeth.
This document discusses stainless steel crowns. It begins with an introduction and history of stainless steel crowns. It then discusses definitions, classifications, indications, contraindications and armamentarium. The main body describes the clinical procedure for stainless steel crowns in detail, including tooth preparation, crown selection, adaptation, contouring, crimping and cementation. It concludes with modifications for special clinical situations and causes of failure.
Stainless steel crowns have been used since the 1940s to restore primary teeth. They provide full coverage of badly broken down teeth and can be placed quickly and economically compared to other restorative materials. SSCs are durable and help prevent further decay by fully covering the tooth. They are indicated for restoring teeth with large or multi-surface cavities, following pulpal therapy, or for high-risk patients. Placement involves preparing the tooth with rounded line angles and occlusal reduction before selecting the correct sized preformed crown and adapting it over the tooth margins.
Stainless steel crowns in paediatric dentistryDr Ravneet Kour
Stainless steel crowns are commonly used in pediatric dentistry to restore heavily decayed primary molars. They have a long history of use dating back to the 1940s. There are different types based on composition and morphology. Indications include restoring teeth with extensive decay involving multiple surfaces. Contraindications include teeth with advanced root resorption. Placement involves tooth preparation, crown selection, adaptation and cementation. Potential complications include aspiration during placement and nickel allergy in some patients.
This document discusses stainless steel crowns which are preformed metal crowns used to restore primary teeth. It provides background on their history, classification based on material and form, composition, indications and contraindications. The key advantages are their longevity, protection of tooth structure and low failure rate. The main disadvantage is their metallic appearance.
This document discusses stainless steel crowns which are preformed metal crowns used to restore primary teeth. It provides background on their history, classification based on material and form, composition, indications and contraindications. The key advantages are their longevity, protection of tooth structure and low failure rate. The main disadvantage is their metallic appearance.
Restoration of endodontically treated teeth.Anish Amin
provides an overview of restoring endodontically treated teeth using posts and cores. It discusses the historical background of posts and describes characteristics of teeth that have undergone endodontic treatment. Key points include that these teeth often have reduced strength and require special considerations for retention and resistance. The document outlines indications for posts and cores, principles of preservation of tooth structure and providing retention and resistance. It also describes methodologies for various steps of the post and core procedure.
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4. INTRODUCTION
Maintenance of the primary dentition in a healthy condition is important for the
overall well being of the child.
Treatment of the severely destructed teeth poses a challenge for the pediatric
dentist as 3 important FACTORS have to be kept in mind,
1. Patient’s behavioural management,
2. Preservation of the tooth structure and
3. Parental satisfaction.
5. The technological advances in dental materials in children make constant re
evaluation of our treatment philosophies and techniques a necessity because
what was an acceptable treatment approach in the past may not necessarily
be the best treatment option for our young patients today.
Dental decay in children’s teeth is a significant public health problem, affecting
60% to 90% of school children in industrialized countries (WHO Report 2003)
INTRODUCTION…
6. Many options exist to repair carious teeth in paediatric patients, from
stainless steel crowns to its various modifications to other esthetic crowns like
strip crowns and zirconium crowns which are rising in their popularity.
INTRODUCTION…
7. STAINLESS STEEL CROWNS (SSCS)
A crown is a tooth shaped covering which is cemented to the tooth structure & its main
function is to protect the tooth structure & retain the function
7
8. STAINLESS STEEL CROWNS
The preformed metal crown (PMC), more commonly known as the stainless
steel crown (SSC), has been used for approximately 50 years.
Preformed metal crowns (PMCs) for primary molar teeth were first described
in 1950 by Engel, followed by Humphrey.
9. THE SSC STORY…!!
Dr. William Humphrey of Denver,
Colorado.
Relation with Rocky Mountain
Orthodontic company.
10. It began as a fairly crude metal tube closed on one end with a prestamped
facsimile of a molar occlusal surface.
It required a significant amount of time and skill to trim, festoon, crimp and
harden the margins to custom fit the tooth.
Today’s crown is much easier to place and often requires minimal
modifications from its manufactured form.
THE SSC STORY…!!
11. CLASSIFICATION: BASED ON COMPOSITION
1. Stainless Steel crown ( Unitek and Rocky Mountain crowns)
2. Nickel-Base crowns (Ion Ni-chro from 3M)
3. Tin –base crowns
4. Aluminum -base crowns
12. COMPOSITION
Iron (67%), carbon, chromium (17-19%), nickel (10-13%), manganese and
other metals (4%).
Chromium oxidizes - “passivating film”
The term “stainless steel” is used when the chromium content exceeds 11%
and is generally in the range of 12 to 30%.
SSC contain about 18% chromium and 8% nickel as well as small amounts of
other elements and are considered as 18-8 stainless steel.
13. Composition
Stainless steel crowns (18-
8) Austenitic type (Rocky
mountain)
• 17-19%chromium
• 10-13% nickel
• 67% iron
• 4% minor elements
Nickel base crowns
(InConell 600 alloy)
• 72% nickel
• 14% chromium
• 6-10% iron
• 0.04% carbon
• 0.35% manganese
• 0.2% silicon
13
14. Manufacturer Iron Chromium Nickel Carbon,
Manganese,
Silicon
Unitek 67 17 12 4
3M 10 16 72 2
Chemical Composition of Two types of Crowns Expressed as Percentages
Brook & King. Dent Update 9:25, 1985. 14
15. CLASSIFICATION: BASED ON MORPHOLOGY
According to form and contour:
1. Uncontoured/ untrimmed crowns
(Rocky mountain, Unitek)
2. Pretrimmed crowns
(Unitek stainless steel crowns,3M,De novo crowns)
3. Precontoured crowns
( Ni-chro ion crowns 3m Crowns and Unitek)
16. Classification
16
Untrimmed crowns (e.g. Rocky
Mountain)
• neither trimmed nor contoured
• longer
• lot of adaptation
• time consuming
Pre trimmed crowns (e.g. Unitek
stainless steel crowns, 3M and
Denovo crowns)
• straight, non-contoured sides
• but shorter
• festooned
• require contouring
17. Pre contoured crowns (e.g.
Ni-Cr Ion crowns , Unitek
stainless steel crowns,3M)
• Festooned, Pre Contoured & Pre
trimmed
• minimal amount of adjustment
necessary
• more difficulty in adaptation since
trimming will result in removal of
manufacturers gingival crimp
Preveneered SSC
• Aesthetic posterior crowns
• Resin based composite bonded
to the buccal and occlusal
surfaces
• Allow only minimal crimping
17
18. AUSTENITIC V/S FERRITIC
Increased ductility and ability to be cold worked without fracturing
Strengthening during cold working
Greater ease of welding
Ability to overcome sensitization (> 6500C)
18
19. INDICATIONS FOR USE IN PRIMARY MOLAR TEETH
1. After pulp therapy;
2. Multisurface caries
3. Pt’s at high caries risk;
4. Where a restoration is likely to fail (eg, proximal box Extended beyond the
anatomic line angles;
5. Fractured teeth;
6. Teeth with extensive wear (bruxism);
7. Abutment for space maintainer.
20. INDICATIONS FOR PERMANENT MOLAR TEETH
1.Interim restoration of a broken-down or traumatized tooth
2. When financial considerations are a concern,
3. Teeth with developmental defects (dentin dysplasia, sensitivity).
4. Restoration of a permanent molar which requires full Coverage but is
only partially erupted.
21. INDICATIONS
1.Restoration of carious primary molars where more than two surfaces are
affected, or where one or two surface carious lesions are extensive.
2.If restoration is needed to last >2 yrs
21
22. 3. Child < 6yrs SS crown preferable to restorations
4. Following pulpotomy or pulpectomy procedures. (Kindelan 2008)
22
INDICATIONS
23. 23
5.Localized or generalized developmental problems,
e.g.:Enamel hypoplasia,
Amelogenesis imperfecta,
Dentinogenesis imperfecta
6. Restoration of fractured primary molars.
INDICATIONS
24. 24
7. Extensive tooth surface loss due to
Eg : Attrition
: Abrasion/erosion
: Bruxism
8. In patients with a
high caries susceptibility
9. As an abutment for certain
appliances, such as
space maintainers.
INDICATIONS
25. 25
10. In patients where routine oral hygiene measures are
impaired.
11.In patients undergoing restorative care under general
anaesthesia if two or more surfaces are involved
12. In patients with infra-occluded primary molars
13. Single tooth cross bite
INDICATIONS…
26. 26
14. As an “emergency” measure to reduce the sensitivity of these
teeth
15. For :temporary restoration of permanent teeth
:fractured permanent anterior teeth and
:young permanent molars following endodontic treatment.
16. Recurrent caries around existing restorations
INDICATIONS…
27. CONTRAINDICATIONS
1. Non restorable and severely broken down teeth
2. As a permanent restoration in a permanent teeth
3. Primary teeth exhibiting more than ½ of root resorption
4. If the primary molar is close to exfoliation with more than half the roots resorbed or exfoliation within 6-
12 months
5. Clinical or radiographical evidence of radicular pathology
6. Tooth exhibits excessive mobility
27
28. CONTRAINDICATIONS
6. Primary posterior teeth - conservative restorations can be placed
7. Partially erupted teeth
8. Esthetically unappealing
9. Where conservative restorations can be placed
10. In a patient with a known nickel allergy or sensitivity
-ESPE SSC consists of a chromium-nickel
steel of surgical quality.
- Incidence of Ni allergy due to orthodontic
treatment 1 in 100 (Hensten& Petersen 1992)
-Conventional SS crowns do not aggravate hypersensitivity (Janson 1998) 28
29. ADVANTAGES
1. Their lifespan is the same as that of an intact primary tooth.
2. They provide protection to the residual tooth structure that may have been
weakened after excessive caries removal.
3. The technique sensitivity or the risk of making errors during their application
is low.
4. Their long-term cost effectiveness is good.
5. They have a low failure rate.
31. SIZE FOR SSC TOOTH SIZES AVAILABLE WIDTH RANGE
(MM)
Upper 1st primary molar 2- 7 7.2 to 9.2
Upper 2nd primary molar 2-7 9.2 to 11.2
Lower 1st primary molar 2-7 7.4 to 9.4
Lower 2nd primary molar 2-7 9.4 to 11.4
Upper 1st permanent molar 2-7 10.7 to 12.8
Lower 1st permanent molar 2-7 10.8 to 12.8
Sizes 4 & 5 are most often
used
Supplied in kit form with
user
needing to reorder only
those
sizes frequently used.
39. PLIER NAME NO. OF
PLIER
USE
Gordon plier no 137 Contouring gingival third of crown
Ball & socket plier no 112 Exaggerating interproximal contour in
open contacts, for bell shaped contouring
Howe plier no 110 Flattening interproximal contour of crown
Howe Plier
40. OTHERS:
•Rough or whitening polish wheels.
•Sharp scalers or instruments
•Cement medium
-Glass slab
- Spatula/ Agate spatula
- Luting cement
•Dental floss
•Rubber dam armamentarium
•Sharp explorer- for marking gingival extension of crown margin
41. TECHNIQUE
1. Evaluate the preoperative occlusion:
2. Selection of crown
3. Tooth preparation
1. Anterior
2. Posterior
4. Final adaptation of the crown
5. Finishing
6. Polishing
7. Crown fit
8. Cementation
42. Crown selection
Determine the mesiodistal width of the crown from premeasured chart or measure it using boley
gauge or vernier calipers.
STEPS FOR CLINICAL PROCEDURE
43. STEPS
Pre-operative occlusion evaluation
By visual examination and transfer this relation on
the wax-sheet by asking the patient to bite.
Local anaesthesia administration.
As minimal amount of gingival tissue is
manipulated during crown cutting.
Caries removal
Occlusal reduction -1.5 -2mm (Keneddy)
44. Rubberdam application.
Placement of wedges.
They are placed in interproximal space
which act as tooth seprators and also
protects the underlying soft tissues.
45. Tooth preparation.
Occlusal reduction
Uniform occlusal reduction of 1.0- 1.5 mm which
follows the anatomy of occlusal surface.
46. FOR TOOTH REDUCTION:
Occlusal reduction
Uniform occlusal reduction of 1 to 1.5mm using a 1mm bur to make grooves in the occlusal surface
to guide the reduction.
Proximal reduction
Tapered fissure bur is used to reduce the trauma to soft tissues.
Bur is moved buccolingual direction starting at the occlusal surface 1-2 mm away from occlusal
surface.
Mesial and distal clearance and a smooth taper obtained free of ledges and shoulders.
Buccal and lingual reduction
Minimal reduction is necessary.
Line angles rounded
47. Trial fitting, trimming and contouring the crown.
To leave the crown margins in the gingival sulcus.
To reproduce tooth morphology.
Finishing the crown.
It is done with stone and rubber wheel to remove scratches.
48. EVALUATION CRITERIA FOR TOOTH PREPARATION:
1. The occlusal clearance should be 1.5 to 2mm.
2. Proximal slices converge toward the occlusal and lingual, following the
normal proximal contour. (Mathewson)
3. An explorer can be passed between the prepared tooth and the proximal
tooth at the gingival margin of preparation.
4. The buccal and lingual surface if required
are reduced at least 0.5 mm which the reduction ending in a feather edge 0.5
to 1mm into the gingival sulcus.
49. 5. The buccal and lingual surfaces converge slightly towards the occlusal.
6. All the line angles in the preparation are rounded and smoothened.
7. The occlusal third of buccal and lingual surfaces are gently rounded.
50. ADAPTATION OF CROWN
Initial adaptation of crown
Two principles of Spedding (1984)
Correct occluso-gingival crown length
Crown margins should follow tooth’s marginal gingiva
51. A. Gingival contour of 2nd molar- ‘smile’
B. Gingival contour of 1st molar –
‘stretched s’
C.Proximal gingival contour of molars –
‘frown’
52. Seat the lingual side first
Friction should be felt
Gingival blanching- long crown
Crown does not seat-
- Inadequate occlusal reduction
- Proximal ledge
- Contact not broken
SEATING THE CROWN
53. CONTOURING THE CROWN
Johnson 114 plier (ball and socket pliers)
Middle 1/3rd of crown-belling effect.
Dentarum 112 plier (Abell plier)-proximal surface.
137 Gordan pliers- gingival 1/3rd of crown.
54. Unitek 800-412 pliers
Groper crimper #230-750
Tight marginal fit aids in
- Mechanical retention of the crown
- Protection of the cement from exposure to oral fluids
- Maintenance of gingival health
CROWN CRIMPING
55. Final Adaptation Of The Crown:
Crown must snap into place, should not be able to be removed with finger
pressure.
The crown should fit so that there is no rocking on the tooth.
Moderate occlusal displacement forces at the margin should not displace the
crown.
The properly seated crown will correspond to the marginal height of the
adjacent tooth and is not rotated on the tooth.
56. Crown is in proper occlusion and should not interface with the eruption of teeth.
There should be no high points when checked with an articulating paper.
The crown margin extends about 1mm gingiva to gingival crest.
57. No opening exists between the crown and the tooth at the cervical
margins.
Crown margins closely adapted to the tooth and should not cause
gingival irritation.
The crown seats without cutting or blanching the gingiva.
58. TITLE Comparison of Marginal Circumference of Two Different Pre-crimped Stainless Steel
Crowns for Primary Molars After Re-crimping
AUTHORS
JOURNAL
Hossein Afshar, Mehdi Ghandehari, Banafsheh Soleimani
Journal of Dentistry, Iran 2015. LEVEL: 4
AIM To assess the changes in the circumference of 3M ESPE and MIB pre-crimped stainless
steel crowns (SSCs) for primary maxillary and mandibular first and second molars following
re-crimping
METHOD Initial photographs were obtained from the margins of 3M and MIB SSCs for the upper and
lower primary molars using a digital camera. Crown margins were crimped by applying 0.2N
force using 114 and
137 pliers. Post-crimping photographs were also obtained and the changes in crown
circumference after crimping were calculated using AutoCad software. The percentage of
reduction in the circumference of crowns for each tooth was statistically analyzed. The effect
of crown design and the associated teeth on the decreased circumference percentage was
statistically analyzed.
59. CONCLUSION Considering the significant reduction in the marginal circumference of precrimped
SSCs following re-crimping, it appears that this manipulation must be necessarily
performed for MIB and 3M pre-crimped SSCs. By using 3M SSCs, higher marginal
adaptation can be achieved following crimping.
RESULT The percentage of reduction in lower E SSC circumference was 3.71±0.39% in MIB and
6.29±0.62% in 3M crowns. These values were 3.55±0.55% and 7.15±1.13% for the lower
Ds, and 3.95±0.43 and 6.24±0.85% for the upper Ds, respectively. For the upper Es,
these values were found to be 3.12±0.65% and 5.14±0.94%, respectively. For each
tooth, a significant difference was found between MIB and 3M SSCs in terms of the
percentage of reduction in crown circumference following crimping. The magnitude of
this reduction was smaller in MIB compared to 3M SSCs (P<0.001).
60. Finishing and Polishing :
While polishing the crown, margins should be blunt since knife edge finish
produces sharp ends which act as areas of plaque retention.
A broad stone wheel should run slowly, in light brushing strokes, across the
margins, towards the center of the crown. This will draw the metal closer to
the tooth without reducing the crown height and thus improves the adaptation
of the crown.
61. Radiographic Confirmation of Gingival Fit
Crown too long-reduce the length.
Crown short- orthodontic band or adaptation of another crown.
62. CEMENTATION
Rinse and dry the crown.
Cements used are ZnOE, ZnPO4,
Polycarboxylate, glassionomer
cement, self curing resin-RMGI
preferable
When the cement is half set , the
occlusion is rechecked
Excess cement should be removed
using explorer tip, dental floss.
63. POST CEMENTATION INSTRUCTION
Avoid heavy chewing with the crown for 24 hours.
Maintain oral hygiene.
Recalled after 6 months.
64. Interproximal ledge.
Crown tilt.
Poor margins.
Inhalation or ingestion of crown.
Under extension of crown.
Over extension of crown.
COMPLICATIONS
65. The gingival finishing line should be a feather edge.
A taper mesially and distally will help to achieve this.
The Buccal and Lingual surfaces if required are reduced 0.5mm, with the
reduction ending in a featheredge, 0.5 to 1mm into the gingival sulcus
68. ADJACENT CROWNS (DAVID NASH, 1981)
When restoring multiple primary molars in the same quadrant, it is advisable to
reduce the adjacent proximal surface of the teeth being restored more than
when only one tooth is restored.
The greater reduction will ease the placement of crowns and the interproximal
approximation.
The more severe tooth reduction is necessitated by the loss of arch
circumference, which occurs when the proximal surfaces of two adjacent teeth
are affected. 7/9/2019 68
MATHEWSON.: FUNDAMENTAL OF PEDIATRIC DENTISTRY. 3RD ED. QUINTESSENCE PUBLISHING CO. SHICAGO, 1995
69. ADJACENT TO CLASS II AMALGAM (MC EVOY, 1985)
First crown reduction is completed and crown is adapted.
Cementation of crown.
Next do amalgam restoration with matrix band in place.
Remove the matrix band.
Final carving of amalgam.
7/9/2019
MATHEWSON.: FUNDAMENTAL OF PEDIATRIC DENTISTRY. 3RD ED. QUINTESSENCE PUBLISHING CO. SHICAGO, 1995
69
70. INAPPROPRIATE SIZE OF CROWN AVAILABLE
In 1971 Mink and Hill reported several ways of modification of stainless steel crown when the crowns
are either too large or too short.
7/9/2019
MATHEWSON.: FUNDAMENTAL OF PEDIATRIC DENTISTRY. 3RD ED. QUINTESSENCE PUBLISHING CO. SHICAGO, 1995
70
71. OVERSIZED
CROWN
7/9/2019 71
MATHEWSON.: FUNDAMENTAL OF PEDIATRIC DENTISTRY. 3RD ED. QUINTESSENCE PUBLISHING CO.
SHICAGO, 1995
Check the crown for marginal adaptation, contour,
crimp and the cement the crown
Polish the soldered area
The cut edges can then be repositioned and spot-
welded
Again try the crown on the tooth
Pinch the crown together in effect reducing the
crown size
Use a pair of scissors to cut the crown from the
gingival to the occlusal surface, either buccally or
lingually
Try the crown on the tooth
72. UNDERSIZED
CROWN
7/9/2019 72
MATHEWSON.: FUNDAMENTAL OF PEDIATRIC DENTISTRY. 3RD
ED. QUINTESSENCE PUBLISHING CO. SHICAGO, 1995Polish the soldered area and cement the crown
solder, adapt, contour and crimp the crown
Retry the crown on the tooth
Spot weld a strip of orthodontic band material over
the v shaped groove in the crown
Try the crown on the tooth for fit
Cut a v shaped groove in the crown on the buccal
or lingual side
Check the crown on the tooth
73. DEEP PROXIMAL LESIONS
Solder and polish the area and cement the crown
Spot weld the piece to crown and check the
adaptation and extent
Cut a piece of orthodontics band conforming to the
lesion
Prepare the crown for the tooth
7/9/2019
MATHEWSON.: FUNDAMENTAL OF PEDIATRIC DENTISTRY. 3RD
ED. QUINTESSENCE PUBLISHING CO. SHICAGO, 1995
73
74. CROLL MODIFICATION
Patients with tooth grinding habits may tend to wear through the occlusal
surfaces of stainless steel crowns.
A technique is described which prevents this problem by increasing metal
occlusal surface thickness of the crown.
7/9/2019 74
75. HALLS TECHNIQUE
It is a novel method of managing carious primary molars by cementing
preformed metal crowns over them.
The technique does not require local anesthesia, caries removal or any tooth
preparation.
It requires careful case selection, a high level of clinical skill, and excellent
patient management
7/9/2019
INNES, N.P.T., STIRRUPS, D.R., EVANS, D.J.P., HALL, N. AND LEGGATE, M., 2006. A NOVEL
TECHNIQUE USING PREFORMED METAL CROWNS FOR MANAGING CARIOUS PRIMARY
MOLARS IN GENERAL PRACTICE – A RETROSPECTIVE ANALYSIS. BRITISH DENTAL JOURNAL,
200(8), PP. 451-454.
75
76. The technique is named after Dr Norna Hall, a general dental practitioner
from Scotland, who developed and used the technique for over 15 years
until she retired in 2006.
With the Hall Technique, the process of fitting the crown is quick and
non-invasive.
7/9/2019
INNES, N.P.T., STIRRUPS, D.R., EVANS, D.J.P., HALL, N. AND LEGGATE, M., 2006. A NOVEL TECHNIQUE USING
PREFORMED METAL CROWNS FOR MANAGING CARIOUS PRIMARY MOLARS IN GENERAL PRACTICE – A
RETROSPECTIVE ANALYSIS. BRITISH DENTAL JOURNAL, 200(8), PP. 451-454.
76
77.
78. INDICATIONS OF HALLS TECHNIQUE :
Class I lesions, non-cavitated
if patient unable to accept fissure sealant, or conventional restoration
Class I lesions, cavitated
if patient unable to accept partial caries removal technique, or conventional
restoration
Class II lesions, cavitated or non-cavitated
79. CONTRAINDICATIONS FOR FITTING HALL CROWNS
Irreversible pulpal involvement
Insufficient sound tissue left to retain the crown
Patient co-operation where the clinician cannot be confident that the crown
can be fitted without endangering the patient’s airway
A patient at risk from bacterial endocarditis.
Parent or child unhappy with aesthetics.
80. TITLE The success of stainless steel crowns placed with the Hall technique: a retrospective
study.
AUTHOR
LEVEL OF EVIDENCE
J Am Dent Assoc. 2014 Dec;145(12):1248-53.
Ludwig KH, Fontana M, Vinson LA, Platt JA, Dean JA
Ic
AIM In this retrospective study, the authors evaluated the clinical and radiographic success of stainless steel
crowns (SSCs) used to restore primary molars with caries lesions, placed by means of both the
traditional technique (involving complete caries removal and tooth reduction before placement of the
SSC) and the Hall technique (involving no caries removal, no crown preparation and no use of local
anesthetic before placement of the SSC).
MATERIALS AND METHOD The authors conducted a retrospective chart review by using the patient records at a
private pediatric dental practice at which the Hall technique had been introduced in June 2010 as an
alternative treatment to traditional SSC placement. The inclusion criteria were caries lesions on a primary
molar with no clinical or radiographic evidence of pulpitis, necrosis or abscess, as well as follow-up of at
least six months or until failure, whichever came first. They graded restoration success by using a four-
point scale based on presence or loss of the SSC, and whether or not the patient needed further
treatment associated with pulpal pathology or secondary caries. They collected and summarized patient
demographic information. They used a Kaplan-Meier survival curve along with 95 percent confidence
intervals to evaluate clinical success.
81. RESULT The authors found that 65 (97 percent) of 67 SSCs placed with
the Hall technique (mean observation time, 15 months; range, four-37 months) and
110 (94 percent) of 117 SSCs placed with the traditional technique (mean observation
time, 53 months; range, four-119 months) were successful.
CONCLUSION Findings of this study show a similar success rate for SSCs placed with the
traditional technique or the Hall technique.
82. TITLE The use of stainless steel crowns: a systematic literature review.
AUTHORS
LEVEL OF EVIDENCE
Pediatr Dent. 2015 Mar-Apr;37(2):145-60
Seale NS, Randall R
Ia
AIM The purpose was to review the published literature on stainless steel crowns (SSCs) from 2002 to the
present as an update to an earlier review published in 2002
METHOD Included were published papers on clinical studies, case series, and laboratory testing on SSCs
(including esthetic SSCs and the Hall technique) in peer-reviewed journals. Study quality and strength of
evidence presented were assessed for papers reporting clinical results for SSCs as a primary study
outcome using a list of weighting criteria.
RESULT Sixty-one papers fulfilled the inclusion criteria (24 papers on 22 clinical studies, three case reports, 21
reviews and surveys, and 13 laboratory testing reports on SSCs and esthetic preformed
metal crowns for primary and permanent molar teeth). Ten clinical studies achieved weighting scores
ranging from 68 percent to 26 percent, with the two highest scoring studies (68 percent and 63 percent)
considered good quality.
CONCLUSION Within the confines of the studies reviewed, primary molar esthetic crowns and SSCs had superior
clinical performance as restoratives for posterior primary teeth, and the Hall technique was shown to
have validity. No clinical studies were available on zirconia crowns. Further well-designed prospective
studies on primary molar esthetic crowns and the Hall technique are needed.
83. B
TITLE A randomized clinical trial investigating the performance of two commercially available posterior pediatric
preveneered stainless steel crowns: a continuation study.
AUTHOR
LEVEL OF EVIDENCE
Kratunova E1, O'Connell AC2
Pediatr Dent. 2014 Nov-Dec;36(7):494-8
Ib
AIM This study aimed to compare the clinical and radiographic success of preveneered posterior NuSmile® and Kinder
Krowns® over one year and to assess the level of parental satisfaction with their esthetics.
METHOD Three trained operators placed 120 crowns in a split-mouth design with a random allocation for 36 participants
(mean age: 5.8 years) who received two, four, six, or eight crowns. Blind assessment of the clinical and
radiographic performance of the restorations was performed by four calibrated examiners after one year. Results
were analyzed by Fisher's exact test and McNemar test. Examiner reliability was determined by Cohen's kappa
score. Visual analogue scale (VAS) was used to assess the level of parental satisfaction.
RESULT All crowns but one were retained, and the majority (83 percent) had no facing fractures. Parental satisfaction was
high (9.4/10 on the VAS). Primary maxillary first molar crowns had more occlusal facing fractures than their
mandibular counterparts (P=.02). Primary mandibular second molar crowns showed more facing fractures than
their maxillary counterparts (P=.008). Both types showed no statistical difference in most categories, but Kinder
Krowns had more facing fractures (P<.02).
CONCLUSION Posterior preveneered crowns have predictable durability at 12 months while offering natural appearance to
restored teeth.
84. TITLE Assessment of oral hygiene and periodontal health around posterior primary molars after their
restoration with various crown types.
AUTHOR
LEVEL OF EVIDENCE
Beldüz Kara N1, Yilmaz Y
Int J Paediatr Dent. 2014 Jul;24(4):303-13. doi: 10.1111/ipd.12074. Epub 2013 Oct 28
IIc
AIM To compare the time-dependent changes in oral hygiene and periodontal health after restoring
primary posterior molars with a traditional stainless steel crown (SSC) or an aesthetic crown using
various measures of periodontal health and oral hygiene.
METHOD This investigation was a randomized, non-blinded prospective controlled clinical trial in which
264 crowns of different types were fitted onto the first and/or second primary molars of 76 children. The
oral hygiene and the gingival health of the restored teeth and the antagonistic teeth were evaluated
clinically and radiographically at 3- and 6-month intervals for 18 months after fitting the crowns.
RESULT The periodontal health of the control teeth was better than that of the remaining 215 restored teeth. The
oral hygiene, as measured by the simplified oral hygiene index, and gingival health, as measured by the
gingival index and the volume of gingival crevicular fluid, of the restored teeth, irrespective of crown type,
progressively increased during the 18-month study period.
CONCLUSION Oral hygiene and gingival health around a restored primary tooth deteriorate with time. Our results
suggest that SSC, an open-faced SSC, or a NuSmile(®) pediatric crown should be the
preferred crown type for restoring posterior primary teeth.
85. PRE-VENEERED STAINLESS STEEL CROWNS
These combine the durability of a stainless steel crown with the esthetics of a
resin facing.
The primary issues with these crowns are the need to reduce additional
coronal tooth structure, limitations in the ability to crimp the margins prior to
cementation, and loss of the esthetic acrylic facing, among others.
These crowns are available from various manufacturers: Cheng Crowns,
NuSmile, and Kinder Krowns.
86. Lopez-Loverich et al.(2015):- evaluated the retention of SSC vs. preveneered
crowns on primary anterior teeth & concluded that there was “good crown
retention rates for both crown types with no statistically significant difference
between them.”
O’Connell et al.(2014):- the clinical performance of two brands of stainless steel
veneered molar crowns after three years (NuSmile crowns and Kinder Krowns).
The study found that the primary problem with resin-veneered crowns used in
posterior primary molars was facing fracture.
In addition, when the adjacent tooth was missing, fracture was more likely to
occur, possibly due to the increased force of occlusion on the veneered crown.
87. TITLE SHEAR BOND STRENGTH OF PREVENEERED POSTERIOR SSC
AUTHORS
LEVEL OF EVIDENCE
Nihal BELDÜZ, 2006
AIM To evaluate the shear bond strength of veneer material of posterior preveneered
stainless steel crowns (SSCs).
METHOD 32 preveneered SSCs (lower first primary molar=8, upper first primary molar=8, lower
second primary molar=8 and upper second primary
molar=8) were used for this study. Specimens were kept in humid environment at 370C
for thirty days and exposed to thermocycling. Then, each veneered crown was cemented
on one of the cast dies. After twenty-four hours, force was applied on the occlusal
surfaces of the crowns according to primary molar occlusal relationship. The fractured
specimens were photographed under X10 magnification with a stereomicroscope.
Characterizations of the failure modes and fracture extents of the veneer material were
scored. Data were analyzed statistically.
88. RESULT For bond strength, there was a statistically difference between crown groups
(P<0.05). However, there were no significant differences between both failure
modes and fracture extents of the crown groups (P>0.05).
CONCLUSION Both lower and upper second molar crown groups showed higher shear bond strengths
than first primary molar crown groups. Veneer material was observed to fracture
commonly.
89. TITLE A clinical and radiographic evaluation of stainless steel crowns for primary molars
AUTHORS Aly A. Sharaf, Najat M. Farsi
Journal of Dentistry (2004), LEVEL OF EVIDENCE: 2b
AIM To evaluate clinically and radiographically the effect of stainless steel crowns placed on
primary molars on gingival and bone Structures
METHOD 254 crowns were evaluated in a sample of 177 children aged 3.5–12 years old with a mean
age of 7 years. The crown marginal extension, crown marginal adaptation, intact proximal
contact, gingival index and the duration of presence of the crowns, together with the oral
hygiene index of the child. Bitewing radiographs were used for evaluation.
RESULT Interproximal bone resorption was not significantly affected by either crown marginal
extension or adaptation, preserving tight proximal contact between molars, oral hygiene level
or duration of presence of the crown. On the other hand, there was significant bone
resorption when the crown was judged radiographically as non-satisfactory. While oral
hygiene level had a significant effect on the gingival index, presence or absence of proper
proximal contact did not have an effect on the gingival index.
CONCLUSION SSC are still a valuable procedure that has no harmful effect on the gingiva and bone
provided that good oral hygiene level was maintained.
90. AIM Multi-surface composite vs stainless steel crown restorations after mineral trioxide aggregate
pulpotomy: a randomized controlled trial.
AUTHORS
LEVEL OF EVIDENCE
Hutcheson C1, Seale NS, McWhorter A, Kerins C, Wright J.
Pediatr Dent. 2012 Nov-Dec;34(7):460-7.
1a
AIM Parents increasingly request esthetic restorations for their children's teeth. This split mouth,
randomized controlled trial compared primary molars treated with white MTA pulpotomies and restored
with either multi-surface composites (MSC) or stainless steel crowns (SSC).
METHOD Forty matched, contra-lateral pairs of molars received MTA pulpotomies and were randomly assigned
to MSC or SSC restorations and evaluated clinically and radiographically at 6 and 12 months. Two
calibrated, blinded examiners evaluated and scored radiographs.
RESULT Thirty-seven matched pairs were evaluated at 6 months, and 31 were available at 12 months. All teeth
in both groups were radiographically and clinically successful at 6 and 12 months. Dentin bridge
formation was noted in 20% of the primary molars by 12 months. Although not significant, the
composite group exhibited fewer intact clinical margins than the SSC group. The vast majority (94%) of
teeth restored with composite displayed gray discoloration at follow-up exams, which did not appear to
affect the quality of the restoration and is believed to be associated with the white MTA.
91. CONCLUSION The white MTA pulpotomies succeeded over 12 months regardless of the
restoration; however, the teeth restored with composite were not as durable
nor considered an esthetic alternative to the SSC.
92. TITLE The survival of resin modified glass ionomer and stainless steel crown restorations in
primary molars, placed in a specialist paediatric dental practice.
AUTHOR
LEVEL OF EVIDENCE
Roberts JF1, Attari N, Sherriff M.
Br Dent J. 2005 Apr 9;198(7):427-31.
IIb
AIM To prospectively report on the survival of resin-modified glass ionomer cement (RMGIC), photac-fil
and pre-formed stainless steel crown (SSC) restorations in primary molar teeth placed over a
seven-year period in a specialist paediatric dental practice under private contract of remuneration.
METHOD All primary molar restorations placed by a specialist paediatric dentist over a seven-year period
were reviewed and the outcome results recorded. Data were recorded at review visits until June 30,
2003. Data recorded included Class I restorations, Class II restorations and SSC. The Class II
cavities were either mesial or distal, with or without buccal/palatal extensions. If both proximal
surfaces were decayed or if after cavity preparation the resultant outline form was significantly larger
than the minimal classical form, RMGIC was not used; an SSC was placed instead. Stainless steel
crown preparation followed conventional guidelines. The crowns were cemented with reinforced zinc
oxide and eugenol (Kalzinol). The status was recorded as satisfactory restoration, tooth exfoliated,
tooth extracted for orthodontic reasons with the date of extraction, or needing replacement. If
replaced then the reason for replacement was also recorded.
93. RESULT
A total of 544 Class I RMGICs, 962 Class II RMGICs, and 1,010 SSCs were placed.
At the last review of each restoration, 98.3% of Class I, 97.3% of Class II RMGICs
and 97.0% of SSCs were either satisfactory or withdrawn intact.
CONCLUSION Under the conditions of private specialist practice-based study SSCs continued to prove
very successful for the restoration of larger cavities and for pulp-treated primary molar
teeth. For the smaller cavities RMGIC were also very successful.
94. REFERENCES
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dentistry: An illustrated guide to the restoration of extensively carious primary teeth, London, Martin Dunitz; 8,
72, 1995.
Finn S.B.: Clinical pedodontics. 3rd Ed, Philadelphia, W.B. Saunders, 184-186, 1967.
Mathewson.: Fundamental of pediatric dentistry. 3rd ED. Quintessence Publishing Co. Shicago, 1995
Mc Donald.: Dentistry for child and adolescent, 5th ED,1996; The C.V. Mosby Co
Pinkam: Pediatric Dentistry, Infancy Through Adolescence. 3rd ED (1999) W.B. Saunders Company.
Shobha Tandon: Text Book of Pedodontics. Ist ED, 2001, Paras Publishing Co
Stewart: Scientific foundations and clinical practice in pediatric dentistry. C.V. Mosby Co., 1982
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Croll T.P and Helpin M.L.: Preformed resin-veneered stainless steel crown for restoration of primary incisors.
Quintessence Int. 27(5): 309-313, 1996
95. Einwag J. and Dunninger: Stainless and crown versus multispace amalgam restorations, an 8 year
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Humphrey W.P.: Use of chrome steel in children’s dentistry. Dent. Surv. 26: 945-953, July 1950.
Rapp R.: A simplified, yet precise technique for the placement of stainless steel crowns on primary teeth. J.
Dent. Child. 33: 101-112, 1966
Mink J.R and Bennett I.C.: The stainless steel crown. J. Dent. Child, 35: 186-196, 1968.
Kennedy D.B.: The stainless steel crown. Pediatr. Oper. Dent. Bristol 1976, J. Wright and Sons Ltd
Hartman C.R.: The open face stainless steel crown: An esthetic technique. J. Dent. Child, 31-33, Jan-Feb,
1983.
Lee JK. Restoration of primary anterior teeth: review of the literature. Pediatr Dent 2002;24:506-10
Guelmann M, Gehring DF, Turner C. Retention of veneered stainless steel crowns on replicated typodont
primary incisors: an in vitro study. Pediatr Dent 2003;25:275-8
Unitek-california, , 3M-minneapolis, rocky mountain-denver//NICKEL BASE –already work hardened while AUSTENTIC soft and malleable & harden when adapted with pliers… Ni base fit easily& require least adjustment(stephen wei)
Untrimmed -THESE ARE CROWNS WITH STRAIGHT SIDES & MARGINS THAT FOLLOW THE GINGIVAL CONTOUR. THE GINGIVAL MARGINS CAN BE TRIMMED WHERE NECESSARY & ALSO NEED CONTOURING & CRIMPING TO ENSURE GINGIVAL ADAPTATION TO THE PREPARED TOOTH. Pre trimmed -Parallel crown walls saves chair time, minimizing the need for buccal, lingual, and mesial tooth reduction.
Consistent wall thickness helps prevent bite through and minimizes trial fitting distortion.
The Molar Crowns have shallow occlusal anatomy which reduces rocking during mastication, with minimal occlusal interference.
Pre contoured –more rounded..POSSESSS MORE DIFFICULTY IN ADAPTATION SINCE TRIMMING WILL RESULT IN REMOVAL OF MANUFACTURERS GINGIVAL CRIMP & inc dimensiond os cervical margin
Chromium oxidizes and forms a thin surface film of chromium oxide (Cr2O3), known as “passivating film” which protects against corrosion.
Austenitic stainless steel is used extensively for the fabrication of dental appliances and is composed of chromium (11.5-27%), nickel (72.2%.),and carbon (0.25%). Nickel-Base Crowns Inconel 600 alloy 72% nickel 14% chromium 6-10% Fe 0.04% carbon 0.35% manganese 0.2% silicon