Stainless Steel Crowns

Question 1

What are the indications for SSC?

Answer 1

1. Severely broken down tooth (primary/ young permanent teeth)
2. Following pulpotomy/ pulpectomy
3. Severe enamel hypoplasia
4. Abutment for space maintainer (crown with loop/ crowned distal shoe)
5. Fractured teeth

Question 2

What instruments and materials are needed for placement of SSC?

Answer 2

• Fine tapered diamond separating bur
• Crown crimping pliers
• Crown scissors
• Selection of crowns
• GIC

Question 3

How are SSC selected?

Answer 3

1. Measure

2. Trial and error

Question 4

What is the procedure for SSC?

Answer 4

1. LA
2. Caries removal (if pulp involvement –> pulp therapy)
3. Preparation of tooth (knife edge mesial and distal- NO ledges, reduce occlusal by 1mm, buccal/ lingual prep only if accessory cusp and/or smoothing occlusal line angles)
4. Adaptation of crown with crimping pliers and/or scissors (if nes)- do not establish contact point if not present in dentition, ensure 1mm below cervical margin
5. Cement crown with GIC (clean and dry tooth AND crown, ask pt bite down gauze to secure and check occlusion)
6. Remove excess GIC with probe/ floss

Question 5

What are the common problems of SSC when seating?

Answer 5

1. Rocking (too far from maximum curvature; >1mm)
2. Canting (uneven reduction of occlusal surface)
3. Loss of space due to extensive caries (shape of prep not adequate for crown- SQUARE required for uppers, RECTANGLE required for lower)