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Stainless Steel Crown

Stainless Steel Crown

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Stainless Steel Crown

  1. 1. PRESENTED BY, Shiji margaret CRRI
  2. 2. CONTENTS •History •Introduction •Types of crown •Types of stainless crown •Classification of stainless steel crown •Indication •Objective of stainless steel crown •Advantage •Disadvantage •Composition
  3. 3. •Factors to be considered in pre – operative evaluation •Clinical procedure •Tooth preparation •Reduction •Method of placing •modification •complication •conclusion •reference
  4. 4. HISTORY Stainless steel crown was first introduced as chrome steel crown by william humphrey  stainless steel crown were introduced to pediatric dentistry by rocky mountain company in 1947 First used in the late 1940s and became commonly used in the 1960s
  5. 5. INTRODUCTION STAINLESS STEEL CROWN IS A SEMI PERMANENT RESTORATION USED IN PRIMARY AND YOUNG PERMANENT TEETH. STAINLESS STEEL CROWN IS USED IN DECIDUOUS DENTITION THAN PERMANENT DENTITION BECAUSE OF 2 REASONS THAT IS DECIDUOUS TEETH CARIES CAN DESTROY THE TOOTH FASTER THAN PERMANENT. AND ALSO IN DECIDIOUS TOOTH PULP IS LARGER THAN PERMANENT AND ENAMEL AND DENTIN THICKNESS IS LESS. STAINLESS STEEL CROWN IS AN EFFICIENT AND RELIABLE METHOD OF RESTORATION OF DECIDUOUS DENTITION.
  6. 6. Types of crowns •Stainless steel •Nickel chromium •Veneered stainless steel crowns •Strip crown •Ceramic crown
  7. 7. Types of stainless crowns Rocky mountain Ormco company Unitek 3M company
  8. 8. Classification of stainless steel crowns Based on shape Untrimmed- crowns are neither trimmed nor contoured Pretrimmed- crowns have stright non-contoured sides but are festooned to line parallel to the gingival crest.they still require contouring and trimming Precontoured – these are festooned and precountoured though a minimal amount of trimming may be necessary
  9. 9. indication  extensive decay in primary and young permanent tooth
  10. 10. Teeth deformed by developemental defects or anomalies Teeth with hyperplastic defects
  11. 11. Following plup therapy
  12. 12. As a preventive restoration As an abutment Temporary restoration of a fractured tooth In severe cases of bruxism
  13. 13. Single tooth cross bite
  14. 14. For replacing prematurely lost anterior teeth
  15. 15. 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.
  16. 16. ADVANTAGES Can be used for badly broken down crown Can be placed with poor isolation Economical Full coverage-prevents recurrent decay Acceptable for both patient and dentist
  17. 17. disadvantages The aesthetics is not fair
  18. 18. composition Stainless steel crown 17-19% chromium 10-13% nickel 67% iron 4% minor elements
  19. 19. Nickel base crown 72% nickel 14% chromium 6-10% iron 0.04% carbon 0.35% manganese 0.2% silicon
  20. 20. Factors to be considered in pre-operative evaluation Dental age of the patient Co-peration of the patient Motivation of the patient Medically compromised/disabled children
  21. 21. 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
  22. 22. 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.
  23. 23. Tooth preparation L.A. should be administrated Isolation by rubber dam or cotton rolls Remove the decay
  24. 24. Reduction Occlusal reduction A 69L or 169L bur is used to reduce the occlusal surface by 1.5-2.0mm .
  25. 25. Proximal slices place the wooden wedges in the inter proximal embrasures, the 69L bur is moved B-L across the proximal surface.
  26. 26. Buccolingual reduction Reduction of buccal and lingual surface is minimal Round off all the line angles It is done by using side of bur
  27. 27. 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.
  28. 28. 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.
  29. 29. 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
  30. 30. 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.
  31. 31. Uncrimped v/s crimped
  32. 32. 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.
  33. 33. 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.
  34. 34. Radiographic confirmation of the gingival fit Before cementation a bitewing is taken to verify proximal marginal integrity
  35. 35. 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.
  36. 36. 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.
  37. 37. Remove the excess cement by an explorer or scaler & for interproximal area can be cleaned by passing dental floss through them.
  38. 38. result
  39. 39. Confirm occlusion
  40. 40. 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 1. Undersize tooth or the oversize crown. 2. Oversize tooth or undersize crown. 3. Deep subgingival caries. 4. Open contact. 5. Open-faced stainless steel crown.
  41. 41.  Interproximal ledge.  Crown tilt.  Poor margins.  Inhalation or ingestion of crown
  42. 42. conclusion The stainless steel crown is in the superior durability and longevity to class II amalgam in primary teeth
  43. 43. reference Dentistry for the child and adolescent 9th edition , McDonald Text book of pediatric dentistry 3rd edition, S.G damle Principles and practice of pedodontics 2nd edition , arathi rao Text book of pediatric dentistry 2nd edition, nikhil marwah Text book of pedodontics 2nd edition shoba tandon
  44. 44. Hand book of pediatric dentistry , 3rd edition, angus c cameron and richard p widmer Clinical pedodontics , 4th edition, finn Fundamentals of pediatric dentistry, 3rd edition, richard j mathewson and robert e primosch Pediatric dentistry principles and practice, MS muthu and N sivakumar

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