Placement of Pre-formed Metal Crowns

Question 1

When may you apply a stainless steel crown? (8)

Answer 1

• 2 or more carious surfaces
• Following pulp therapy of primary molar teeth
• Developmental problems (ie hypoplasia, AI)
• Fractured primary molars
• Excess tooth surface loss
• High caries risk patient
• Special needs patient
• As an abutment for certain appliances

Question 2

When may you choose not to apply a stainless steel crown? (2)

Answer 2

• If primary molar close to exfoliation with more than half the roots resorbed (radiograph)
• In patients with known nickel allergy or sensitivity

Question 3

Describe the Prep technique for SSC placement (8)

Answer 3

1. Put patient under LA
2. Caries removal and pulp treatment
3. Place distal and mesial wedges to protect tissue and prevent contamination
4. Remove mesial and distal surfaces with bur. Cut through contact points
5. Reduce occlusal surface by 1.5-2mm
6. Place crown to see if it fits
7. Wash and dry tooth
8. Cement crown

Question 4

Describe the halls technique for SSC placement (6)

Answer 4

1. Assess the tooth shape, contact points (use separators if tight contacts)
2. Sit child slightly upright
3. Protect the airway
4. Size the crown
5. Load the crown with cement
6. Fit the crown