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2011-03-14 13:52:02
paedo ssc stainless steel crowns

Paedo SSC
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  1. Advantages of SSCs
    • extremely durable
    • excellent retention
    • inexpensive
    • minimal technique sensitivity
    • offers full advantage of full coronal coverage
  2. Disadvantages of SSCs
    appearance (colour)
  3. Indications of SSCs
    • primary molars that have undergone pulp therapy
    • grossly broken down teeth
    • cervical decalcification (white spot lesions)
    • severe enamel/dental anomalies e.g. AI, DI, ext enamel hypoplasia, vitD resistant rickets
    • children at high risk of caries
    • when predictability is essential - treating intellectually/medically compromised pts
    • young patients with long anticipated service life of tooth
    • failure of other restorative materials likely
    • hypoplastic primary molars
  4. Cost effectiveness of SSCs
    • prevents need for re-treatment
    • no space loss - may prevent need for ortho
    • reduced likelihood future caries in high risk pts
    • under GA use SSCs aggressively to prevent need for future repeat GAs
  5. Restoration Longevity out of SSC, compomer, GIC, composite, amalgam
    • SSC > compomer > GIC > composite > amalgam
    • class II amalgams - 2-7 x failure rate of SSCs
  6. Tooth Preparation Steps for SSC
    • pain control (LA) - both buccal and lingual
    • RD isolation - safety and efficiency
    • occlusal reduction of 1.5mm
    • caries removal
    • pulp therapy if required
    • core placement (RMGIC)
    • axial reduction
  7. Periodontal response to SSC
    • relatively benign despite imperfect margins
    • plaque adherence is low
    • rough margins will enhance subgingival plaque accumulation --> gingival inflammation
  8. Resin Veneered SSCs
    • prone to chipping
    • aesthetic
    • poorer fit due to inability to crimp margins and contour mesiodistally
    • cost issues - need to import
  9. Aim of SSC Preparation Technique
    • eliminate all dental caries
    • re-establish proper occlusal contacts
    • re-establish normal MD coronal dimension for arch length maintenance
    • good periodontal health - emerg. prof., contacts, embrasure form
    • provide durable restoration with service life > expected retention of primary tooth
  10. SSC in Permanent Dentition - indications in a permanent molar
    • highly broken down
    • presence of a developmental defect e.g. amelogenesis imperfecta or MIH (molar incisor hypomineralisation)
    • consider it as an interim restoration until patient has reached ~15yo for definitive prosthetic restorative option