Dental Pediatric Crowns

1. CROWNS
GLO ARBY D. ARGUELLES, DMD

2. I. STAINLESS STEEL CROWNS
II. STRIP-OFF CROWNS
III. PRE-VENEERED STAINLESS STEEL CROWNS
IV. ZIRCONIA CROWNS

3. I. STAINLESS STEEL CROWNS
 PREFORMED METAL CROWNS
 TREATMENT OF CHOICE FOR BADLY BROKENDOWN PRIMARY TEETH
 LARGER CLINICAL LIFE SPAN
 DIFFERENT SIZES
 TRIMMED AND CONTOURED TO PATIENT’S INDIVIDUAL TEETH

4. TYPES OF SSC
1. PRE-TRIMMED
 STRAIGHT, NON-CONTOURED SIDES
 REQUIRES CONTOURING AND TRIMMING
2. PRE-CONTOURED
 ANATOMY CLOSELY RESEMBLES NATURAL TOOTH
 PRE-FESTOONED AND PRE-CONTOURED

5. INDICATIONS
 RESTORATION OF PRIMARY OR YOUNG PERMANENT TEETH WITH EXTENSIVE CARIOUS LESIONS
 RESTORATION OF HYPOPLASTIC PRIMARY OR PERMANENT TEETH
 RESTORATION OF PULPALLY TREATED TOOTH
 RESTORATION OF TEETH WITH HEREDITARY ANOMALIES
 RESTORATION IN PATIENT WITH SPECIAL NEEDS
 AS AN ABUTMENT FOR SPACE MAINTAINER OR PROSTHODONTIC APPLIANCE
 STRONG CONSIDERATION IN CHILDREN WHO REQUIRES GEN. ANES. FOR DENTAL TREATMENT

6. PROCEDURE
1. EVALUATE PRE-OP OCCLUSION
2. ADMINISTER LA AND RUBBER DAM ISOLATION
3. OCCLUSAL REDUCTION USING N0. 169L TAPERING FISSURE BUR OR FOOTBALL DIAMOND BUR
4. CARIES REMOVAL USING ROUND BUR
5. PROXIMAL REDUCTION USNG A TAPERING FISSURE BUR.
GINGIVAL MARGINS SHOULD HAVE A FEATHER-EDGE FINISH LINE.
6. ROUND ALL LINE ANGLES BY 30-45 DEGREES
7. SELECTION AND FITTING OF CROWN
8. CONTOUR AND CRIMP CROWN IF NECESSARY

7. PROCEDURE
1. EVALUATE PRE-OP OCCLUSION
2. ADMINISTER LA AND RUBBER DAM ISOLATION
3. OCCLUSAL REDUCTION USING N0. 169L TAPERING FISSURE BUR OR FOOTBALL DIAMOND BUR
4. CARIES REMOVAL USING ROUND BUR
5. PROXIMAL REDUCTION USNG A TAPERING FISSURE BUR. GINGIVAL MARGINS SHOULD HAVE A FEATHER-EDGE FINISH LINE.
6. ROUND ALL LINE ANGLES BY 30-45 DEGREES
7. SELECTION AND FITTING OF CROWN
8. CONTOUR AND CRIMP CROWN IF NECESSARY
9. REMOVE RUBBER DAM TO CHECK OCCLUSION
10. RINSE AND DRY CROWN
11. USE GIC CEMENT
12. DRY TOOTH WITH AIR AND SEAT CRWON COMPLETELY .

8. II. STRIP-OFF CROWNS
 MOST ESTHETIC OF ALL RESTORATIONS FOR THE TREATMENT OF
SEVERELY DECAYED PRIMARY INCISORS
 MOST TECHNIQUE SENSTIVE
 MAY BE DIFFICULT TO PLACE

9. PROCEDURE
1. ADMINISTER LAAND RUBBER DAM PLACEMENT.
2. SELECT SHADE OF COMPOSITE TO BE USED.
3. SELECT A CELLULOID CROWN WITH A MESIODISTAL WIDTH APPROXIMATELY EQUAL TO THE TOOTH TO BE
RESTORED.
4. CARIES REMOVAL.
6. REDUCE INCISAL EDGE BY 1.5 MM USING A FINE TAPERED DIAMOND BUR OR 169L BUR
7. REDUCE INTERPROXIMAL SURFACE 0.5-1 MM ; SHOULD BE PARALLEL AND GINGIVAL MARGINS SHOUL HAVE
A FEATHER-EDGE FINISH LINE.
8. REDUCE FACIAL SURFACE BY1 MM AND INGUAL SURFACE BY ATLEAST 0.5 MM. ROUND ALL LINE ANGLES.
9. TRIM THE SELECTED CROWN FORM BY CUTTING THE EXCESS GINGIVALLY WITH SCISSORS AND TRIAL FIT THE
CROWN
10. PUNCH A SMALL HOLE IN THE LINGUAL SURFACE WITH AN EXPLORER
11. FILL THE CROWN FORM APPROXIMATELY 2/3 FULL WITH COMPOSITE AND SEAT ON TOOTH.
12. POLYMERIZE MATERIAL.
13. REMOVE CELLULOID, RUBBER DAM.
14. EVALUATE OCCLUSION.
15. FINIFSHING ANF CONTOURING IS DONE IF NECESSARY.

10. III. PRE-VENEERED SSC
 SSC WITH COMPOSITE FACINGS
 PREPARATION F TOOTH IS MORE EXTENSIVE
 REQUIRES INTERPROXIMAL REDUCTION MAY RESULT IN PULP
EXPOSURE
IF INADEQUATE PREP, CROWN MAY APPEAR BULKY

11. DISADVANTAGES
 LONGER CHAIR TIME
 DEEP BITE AND BRUXISM
 EXPENSIVE
 NOT CRIMPABLE
FRACTURE OR STRIPPING F FACINGS

12. PROCEDURE
1. CROWN SELECTION
2. ADMINISTER LA AND RUBBER DAM ISOLATION
3. OCCLUSAL REDUCTION USING 2 MM USING FOOTBALL DIAMOND BUR
4. REDUCE MESIAL, DISTAL, BUCCAL AND LINGUAL WITH FINE TAPERING BUR
5. EXTEND CIRCUMFERENTIAL FEATHER-EDGE MARGIN OF 2MM SUBGINGIVALLY
6. CHECK OCCLUSAL REDUCTION BEFORE TRY IN
7. CLEAN CROWN
8. FILL CROWN WITH GIC
9. SEAT CROWN
10. ASK PATIENT TO BITE ON COTTON ROLL UNTIL CEMENT SETS
11. REMOVE EXCESS
12. CHECK OCCLUSION.

13. IV. ZIRCONIA CROWNS
 PRE-FABRICATED, EXCEPTIONALLY STRONG CERAMIC
 ANATOMICALLY CONTOURED AND METAL FREE
 CERVICAL MARGIN IS KNIFE-EDGE TO PRESERVE GINGIVAL HEALTH
 CANNOT BE CRIMPLED AND ARE NOT FLEXIBLE
FORCING TO SEAT CROWN MAY RESULT IN FRACTURE

14. PROCEDURE
1. CROWN SELECTION AND EVALUATION OF OCCLUSAL RELATIONSHIP
2. PREPARATION SIMILAR TO PRE-VENEERED CROWNS BUT WITH MORE REDUCTION.
3. FOOTBALL DIAMOND BUR FOR 1-2 MM OCCLUSAL REDUCTION
4. A ROUND-END TAPERING DIAMOND BUR FOR CIRCUMFERENTIAL REDUCTION
5. ROUND ALL MESIAL AND DISTAL LINE ANGLES.