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  • 1 April, 2022

Stainless Steel Crowns in Pediatric Dentistry 

They are prefabricated crown forms that are adapted to individual teeth and cemented with a biocompatible luting agent. 

History

  • Introduced in 1947, by Rocky mountain company. 
  • Familiarized by Humphrey and Engel in 1950s.
  • Crown preparation was suggested by Mink and Bennet. 

Classification 

According to composition: 

  • 18/8 austenitic stainless steel 
  • Nickel- chromium crown 

According to position:

  • Crown for posterior teeth 
  • Crown for anterior teeth 

According to trimming: 

  • Untrimmed crowns
  • Pretrimmed crowns 

Objectives

  • To achieve biologically compatible, masticatorily competent and clinically acceptable restoration. 
  • To maintain the form and function where possible. 

Indications

  • Extensive caries. 
  • Rampant caries. 
  • Recurrent caries. 
  • Post pulp therapy. 
  • Inherited or acquired enamel defects.
  • Intermediate restorations.
  • Severe bruxism.
  • Abutment teeth to prosthesis.
  • As a part of Space maintainer. 

Contraindications

  • Primary molars close to exfoliation 
  • Primary molars with more than half the roots resorbed 
  • Teeth that exhibit mobility 
  • Teeth which are not restorable 
  • Patients with known nickel allergy 

Armamentarium

  • Crown cutting burs – pear shaped, tapering fissure, needle shaped, smoothening burs. 
  • Pliers – Hoe pliers, No 114 Johnson contouring pliers, No 417 crimping plier, No 112 Ball and socket plier. 
  • Scaler or any sharp instrument 
  • Crown and bridge scissors
  • Crown seater and remover
  • Stone and finishing bur
  • For cementation – luting cement, glass slab, spatula
  • Miscellaneous – Articulating paper, wax sheet, marking pencil 

Procedure 

  • Select the crown according to mesio distal diameter, proper occlusal height
  • Pick the crown with sterile tweezer 
  • Evaluate the occlusion 
  • Administer local anesthesia 
  • Occlusal reduction of 1.0 to 1.5mm with pear shaped head
  • Proximal reduction with needle shaped bur to beak contact and establish taper
  • Reduce and round off all line angles with finishing burs
  • Verify occlusion and proximal contacts
  • Try the crown on the tooth
  • Check the gingival margin, any excess needs to be trimmed
  • Smoothen the edges with finishing burs
  • Contour the crown
  • Crimping of the crown in gingival third
  • Finish the margins of crown
  • Mix and load luting cement on the crown
  • Seat the crown and ask the patient to bite firmly
  • Remove excess cement 

 

 

Article by Dr. Siri P. B. 

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