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CONTENTS
 Types of crown
 Different type of Stainless Steel Crown
 Objective of Using
 Advantage
 Disadvantage
 Composition
 Indication
 Factor s to be considered in Pre-Operative Evaluation
 Clinical Procedure
 Tooth Preparation
 Steps in Reduction
 Initial Adaptation of Crown
 Seating the Crown
 Crown Contouring
 Crown Crimmping
 Checking Final Adaptation of Crown
 Finishing and Polishing
 Radiographic Confirmation of Gingival Pit
 Cementation
 Result
 Confirm Occlusion
 Stainless Steel Crown Modifications
 Complications
 Reference
INTRODUCTION
Stainless steel crown is a semi permanent restoration
used in primary and young permanent teeth.
It was introduced as chrome-steel crown by
‘Humphrey’ in 1950.
Stainless steel crown is more frequently used in
deciduous dentition than permanent dentition .
Stainless steel crown is an efficient and reliable
method of restoration of deciduous dentition.
TYPES OF CROWN
•Stainless steel
•Nickel chromium
•Veneered stainless steel crowns
•Strip crown (ZIRCONIA)
•Ceramic crown
DIFFERENT TYPES OF
STAINLESS STEEL CROWN
1) Untrimmed - These crowns are neither trimmed nor contoured
thus require lot of adaptation and are time consuming.
Eg :- Rocky Mountain.
2) Pretrimmed - These crowns have straight non-contoured
sides but are festooned to line parallel to the gingival crest. They
still require contouring and trimming.
Eg : - Unitek Stainless steel Crowns and 3M Co.
3) Precontoured - These crowns are festooned and are also
precontoured though a minimal amount of festooning and trimming
may be necessary. Eg : - Unitek Stainless steel Crowns and 3M Co.
 Untrimmed : Neither trimmed nor
contoured
 Pretrimmed : Crowns have straight
non-contoured sides.
 Precontoured : Crowns are festooned
DIFFERENT TYPES OF STAINLESS
STEEL CROWN
OBJECTIVES OF USING
To achieve biologically compatible , competent
for mastication and clinically acceptable
restoration.
To maintain the form and function and where
possible the vitality of the tooth should be
maintained.
ADVANTAGES
These crowns are more superior to multisurface amalgam
restoration with respect to life span, replacement , retention and
resistance.
They are acceptable to both patient and dentist
They are more cost effective because of comparatively simple
procedure involved in restoring even severely affected primary
molars
DISADVANTAGE
The aesthetics is not fair
COMPOSITION
STAINLESS STEEL CROWN
•17-19% - chromium
•10-13% - nickel
•67% - iron
•4% - minor elements
NICKEL-BASE CROWN
•72% - nickel
•14% - chromium
•6-10% - iron
•0.04% - carbon
•0.35% - manganese
•0.2% - silicon
INDICATIONS
Extensive decay in primary and young permanent tooth
Teeth deformed by developemental defects or anomalies
Teeth with hyperplastic defects
Following plup therapy
As a preventive restoration
As an abutment
Temporary restoration of
a fractured tooth
In severe cases of bruxism
Single tooth cross bite
For replacing prematurely lost anterior teeth
FACTORS TO BE CONSIDERED
IN PRE-OPERATIVE
EVALUATION
Dental age of the patient
Co-operation of the patient
Motivation of the patient
Medically compromised/disabled children
CLINICAL PROCEDURE
EVALUATE THE PREOPERATIVE OCCLUSION
•Take the alginate impression of U/L jaws.
•Pour the cast with dental stone
•Note the dental midline and the cusp fossa
relationship bilaterally
SELECTION OF CROWN
•The correct size crown is selected by the M-D
dimensions of the tooth to be restored using Boley
gauge.
•To produce steel crown margins of similar shape
examine the contour of gingiva of the buccal & lingual
marginal gingiva.
TOOTH PREPARATION
•L.A. should be administrated
•Isolation by rubber dam or cotton rolls
•Remove the decay
STEPS IN REDUCTION
OCCLUSAL REDUCTION
A 69L or 169L bur is used to reduce the occlusal surface by
1.5-2.0mm .
PROXIMAL SLICES
Place the wooden wedges in the inter proximal embrasures, the 69L bur
is moved B-L across the proximal surface.
BUCCOLINGUAL REDUCTION
Reduction of buccal and lingual surface is minimal
ROUND OFF ALL THE LINE ANGLES
It is done by using side of bur
INITIAL ADAPTATION OF
CROWN
•The crown should be of a correct length and its margins
should be adapted closely to the tooth.
•For shaping the crown margins mark 3 light points on the
metal at the (mesiolingual, lingual and distolingual)and at
(mesiobuccal, buccal, distobuccal) surfaces at the crest of
respective marginal gingiva without compressing the
marginal gingiva.
•Final finished margins are placed approximately 1mm
below these marks.
SEATING THE CROWN
Now the crown is tried on the preparation by
seating the lingual first and applying pressure in a
buccal direction so that the crown slides over the
buccal surface into the gingival sulcus.
Resistance should be felt as the crown slips over
the buccal bulge.
CROWN CONTOURING
•Initial crown contouring is performed with a114 plier (ball and
socket plier) in the middle 1/3rd of the crown to produce belling
effect
•This will give the crown more even curvature
CROWN CRIMPING
•This is very important to the gingival Health of the
supporting tissue.
•Using the no.417 crimping pliers the crown is crimped
in the gingival third.
•After completion of crimping there
will be gradual bend in the gingival
third of crown.
•The use of crimping is for the
protection of soft Tissues.
CHECKING THE FINAL
ADAPTATION OF THE CROWN
The crown should be replaced on the preparation after
the contouring procedure to see that it snaps securely into
place.
The occlusion should be checked at this stage to make
sure that the crown is not opening the bite or causing a
shifting of mandible into an undesirable relationship with
opposing teeth.
FINISHING AND POLISHING
Accumulation of plaque and inflammation of
gingiva is commonly seen in practice of restorative
dentistry due to rough and unpolished restoration.
To avoid these complications crown should be
polished prior t o cementation with rubber wheel to
remove all scratches.
RADIOGRAPHIC CONFIRMATION
OF THE GINGIVAL FIT
Before cementation a bitewing is taken to
verify proximal marginal integrity
CEMENTATION
SSC should be cemented
only on clean dry mouth, isolation of teeth with cotton roll
is recommended.
Rinse and dry the crown inside & out side and prepare to
cement it.
A zinc phosphate, polycarboxylate or GIC is preferred.
Before the cements set ask the patient to close into
centric occlusion by applying pressure through a
cotton roll and confirm that the occlusion has not been
altered.
Remove the excess cement by an explorer or scaler & for
interproximal area can be cleaned by passing dental floss
through them.
RESULT
CONFIRM OCCLUSION
STAINLESS STEEL CROWN
MODIFICATIONS
In 1971, Mink & Hill report several way of
modifying the stainless steel crown when they
are either too large or too small
• Undersize tooth or the oversize crown.
• Oversize tooth or undersize crown.
• Deep subgingival caries.
• Open contact.
• Open-faced stainless steel crown.
COMPLICATIONS
• Interproximal ledge.
• Crown tilt.
• Poor margins.
• Inhalation or ingestion of crown
REFERENCE
•Shobha Tondon
Stainless Steel Crown (Department of pedodontics)

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Stainless Steel Crown (Department of pedodontics)

  • 1.
  • 2. CONTENTS  Types of crown  Different type of Stainless Steel Crown  Objective of Using  Advantage  Disadvantage  Composition  Indication  Factor s to be considered in Pre-Operative Evaluation  Clinical Procedure  Tooth Preparation  Steps in Reduction
  • 3.  Initial Adaptation of Crown  Seating the Crown  Crown Contouring  Crown Crimmping  Checking Final Adaptation of Crown  Finishing and Polishing  Radiographic Confirmation of Gingival Pit  Cementation  Result  Confirm Occlusion  Stainless Steel Crown Modifications  Complications  Reference
  • 4. INTRODUCTION Stainless steel crown is a semi permanent restoration used in primary and young permanent teeth. It was introduced as chrome-steel crown by ‘Humphrey’ in 1950. Stainless steel crown is more frequently used in deciduous dentition than permanent dentition . Stainless steel crown is an efficient and reliable method of restoration of deciduous dentition.
  • 5. TYPES OF CROWN •Stainless steel •Nickel chromium •Veneered stainless steel crowns •Strip crown (ZIRCONIA) •Ceramic crown
  • 6. DIFFERENT TYPES OF STAINLESS STEEL CROWN 1) Untrimmed - These crowns are neither trimmed nor contoured thus require lot of adaptation and are time consuming. Eg :- Rocky Mountain. 2) Pretrimmed - These crowns have straight non-contoured sides but are festooned to line parallel to the gingival crest. They still require contouring and trimming. Eg : - Unitek Stainless steel Crowns and 3M Co. 3) Precontoured - These crowns are festooned and are also precontoured though a minimal amount of festooning and trimming may be necessary. Eg : - Unitek Stainless steel Crowns and 3M Co.
  • 7.  Untrimmed : Neither trimmed nor contoured  Pretrimmed : Crowns have straight non-contoured sides.  Precontoured : Crowns are festooned DIFFERENT TYPES OF STAINLESS STEEL CROWN
  • 8. OBJECTIVES OF USING To achieve biologically compatible , competent for mastication and clinically acceptable restoration. To maintain the form and function and where possible the vitality of the tooth should be maintained.
  • 9. ADVANTAGES These crowns are more superior to multisurface amalgam restoration with respect to life span, replacement , retention and resistance. They are acceptable to both patient and dentist They are more cost effective because of comparatively simple procedure involved in restoring even severely affected primary molars
  • 11. COMPOSITION STAINLESS STEEL CROWN •17-19% - chromium •10-13% - nickel •67% - iron •4% - minor elements NICKEL-BASE CROWN •72% - nickel •14% - chromium •6-10% - iron •0.04% - carbon •0.35% - manganese •0.2% - silicon
  • 12. INDICATIONS Extensive decay in primary and young permanent tooth
  • 13. Teeth deformed by developemental defects or anomalies Teeth with hyperplastic defects
  • 15. As a preventive restoration As an abutment Temporary restoration of a fractured tooth In severe cases of bruxism
  • 17. For replacing prematurely lost anterior teeth
  • 18. FACTORS TO BE CONSIDERED IN PRE-OPERATIVE EVALUATION Dental age of the patient Co-operation of the patient Motivation of the patient Medically compromised/disabled children
  • 19. CLINICAL PROCEDURE EVALUATE THE PREOPERATIVE OCCLUSION •Take the alginate impression of U/L jaws. •Pour the cast with dental stone •Note the dental midline and the cusp fossa relationship bilaterally
  • 20. SELECTION OF CROWN •The correct size crown is selected by the M-D dimensions of the tooth to be restored using Boley gauge. •To produce steel crown margins of similar shape examine the contour of gingiva of the buccal & lingual marginal gingiva.
  • 21. TOOTH PREPARATION •L.A. should be administrated •Isolation by rubber dam or cotton rolls •Remove the decay
  • 22. STEPS IN REDUCTION OCCLUSAL REDUCTION A 69L or 169L bur is used to reduce the occlusal surface by 1.5-2.0mm .
  • 23. PROXIMAL SLICES Place the wooden wedges in the inter proximal embrasures, the 69L bur is moved B-L across the proximal surface.
  • 24. BUCCOLINGUAL REDUCTION Reduction of buccal and lingual surface is minimal ROUND OFF ALL THE LINE ANGLES It is done by using side of bur
  • 25. INITIAL ADAPTATION OF CROWN •The crown should be of a correct length and its margins should be adapted closely to the tooth. •For shaping the crown margins mark 3 light points on the metal at the (mesiolingual, lingual and distolingual)and at (mesiobuccal, buccal, distobuccal) surfaces at the crest of respective marginal gingiva without compressing the marginal gingiva. •Final finished margins are placed approximately 1mm below these marks.
  • 26. SEATING THE CROWN Now the crown is tried on the preparation by seating the lingual first and applying pressure in a buccal direction so that the crown slides over the buccal surface into the gingival sulcus. Resistance should be felt as the crown slips over the buccal bulge.
  • 27. CROWN CONTOURING •Initial crown contouring is performed with a114 plier (ball and socket plier) in the middle 1/3rd of the crown to produce belling effect •This will give the crown more even curvature
  • 28. CROWN CRIMPING •This is very important to the gingival Health of the supporting tissue. •Using the no.417 crimping pliers the crown is crimped in the gingival third. •After completion of crimping there will be gradual bend in the gingival third of crown. •The use of crimping is for the protection of soft Tissues.
  • 29. CHECKING THE FINAL ADAPTATION OF THE CROWN The crown should be replaced on the preparation after the contouring procedure to see that it snaps securely into place. The occlusion should be checked at this stage to make sure that the crown is not opening the bite or causing a shifting of mandible into an undesirable relationship with opposing teeth.
  • 30. FINISHING AND POLISHING Accumulation of plaque and inflammation of gingiva is commonly seen in practice of restorative dentistry due to rough and unpolished restoration. To avoid these complications crown should be polished prior t o cementation with rubber wheel to remove all scratches.
  • 31. RADIOGRAPHIC CONFIRMATION OF THE GINGIVAL FIT Before cementation a bitewing is taken to verify proximal marginal integrity
  • 32. CEMENTATION SSC should be cemented only on clean dry mouth, isolation of teeth with cotton roll is recommended. Rinse and dry the crown inside & out side and prepare to cement it. A zinc phosphate, polycarboxylate or GIC is preferred.
  • 33. Before the cements set ask the patient to close into centric occlusion by applying pressure through a cotton roll and confirm that the occlusion has not been altered.
  • 34. Remove the excess cement by an explorer or scaler & for interproximal area can be cleaned by passing dental floss through them.
  • 37. STAINLESS STEEL CROWN MODIFICATIONS In 1971, Mink & Hill report several way of modifying the stainless steel crown when they are either too large or too small • Undersize tooth or the oversize crown. • Oversize tooth or undersize crown. • Deep subgingival caries. • Open contact. • Open-faced stainless steel crown.
  • 38. COMPLICATIONS • Interproximal ledge. • Crown tilt. • Poor margins. • Inhalation or ingestion of crown