Seminar on Stainless Steel Crown

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

10. DISADVANTAGE
The aesthetics is not fair

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

14. Following plup therapy

15. As a preventive restoration
As an abutment
Temporary restoration of
a fractured tooth
In severe cases of bruxism

16. Single tooth cross bite

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.

35. RESULT

36. CONFIRM OCCLUSION

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

39. REFERENCE
•Shobha Tondon