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SHAN LAL
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Director, Pre-clinical Programs |
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Pediatric Dentistry |
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Full coverage, metallic, definative restorations |
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Available as: pretrimmed (Unitek), precontoured
and festooned (Ni-Chro ION crowns) |
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Durable and cost effective |
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Restoration of primary and young permanent teeth
with multiple carious surfaces. |
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Class 2 lesions where the caries extend beyond
the anatomic line angles. |
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Restoration of primary teeth after pulpotomy or
pulpectomy procedures. |
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Hypoplastic teeth. |
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Hereditary anomalies (D.I., A.I.) |
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Pts. with special needs. |
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As an abutment for space maintainers or
prosthetic appliances. |
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Evaluate pre-operative occlusion |
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Administer appropriate local anesthesia* |
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Place rubber dam (clamp adjacent tooth) |
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Removal of caries (if present) |
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Crown preparation |
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Selection and trial placement of SSC |
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Contour and crimp (if necessary) |
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Evaluate post-operative occlusion |
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Cementation |
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Occlusal reduction |
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Inter-proximal |
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Buccal and Lingual (limited to occl 1/3) |
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169L tapered fissure bur |
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Place depth cuts and uniformly reduce occlusal
surface by 1-1.5mm. |
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169L tapered fissure or thin tapered diamond
bur. |
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Break proximal contacts at appropriate depth in
single sweeping motion. |
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Vertical proximal walls with slight convergence
in an occlusal direction. |
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Feather-edge finish line. |
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Common error - ledge formation. |
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169L or diamond bur |
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Limited to occlusal 1/3 as a 45º bevel. |
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Round off all line angles. |
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Occasionally, an exagerrated mesio-buccal or
cervical bulge may warrant more buccal and lingual reduction. |
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SELECT smallest crown that restores pre-existing
proximal contacts. |
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Occlusal dimensions of SSC should be same as
pre-op. tooth. |
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Most commonly used molar SSC is size 4. |
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PLACE or seat crown from lingual to buccal. |
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Push crown over the buccal bulge for a snap fit. |
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Check margins for close cervical adaptation
extending 1mm subgingivally. |
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‘Blanching effect’ |
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Remove dam and check occlusion. |
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Linguo-buccal seating of crown. |
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Snap fit. |
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Crimping and Contouring involves bending the
gingival 1/3 of the crown’s margins
inward to establish a tight marginal fit and adaptation. |
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Pliers - #114, 417 |
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ION crowns require least adjustments. |
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Rinse and dry crown |
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Prepare glass ionomer cement and fill crown to
2/3 with all inner surfaces covered. |
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Seat crown completely |
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Remove excess cement from margins |
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Rinse and floss inter-proximal areas |
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Check occlusion |
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Notes