Indications and Contraindications for Stainless Steel Crowns

1) Indications
a) Extensive carious involvement e) Mesial lesions on primary 1 st molars
b) Pulpectomy/pulpotomy
f) Ankylosed primary molars
c) Malformed teeth
g) Young permt molars as semi-permt restoration
d) Rampant caries
h) Fractured teeth
2) Contraindications
a) If esthetics are concern
d) Space loss
b) Teeth nearing exfoliation
e) Caries extends cervically so coverage of defect is issue
c) Lack of mechanical retention
f) As permt restoration in permt dentition
from extensive crown loss
Preparation of Tooth For Stainless Steel Crown
1) Reduce cusps 1-1.5mm
2) Reduce proximal surfaces so that contact w/ adjacent tooth is broken
3) Remove all sharp line angles
4) Usually not necessary to reduce buccal or lingual surfaces as they aid in retention
-may need to reduce buccal ridge on primary 1 st molars
5) When fitting SSC, greater length needed in region of MF bulge on primary 1 st molar
Restoration of Primary Incisors
1) Small class III lesions can be restored w/ composite similar to permt incisors
2) Compromised or involved incisal edge (class IV)
-w/ significant incisal edge loss, composite crown is good choice
-prep includes caries removal, mesial/distal interproximal reduction, and placing undercut 1m incisal to and
following free gingival margin
-celluloid crown former is trimmed and adapted to margins
-at least one vent hole is created on incisal edge to allow escape of excess composite
-crown former filled w/ composite and seated
3) Primary incisors w/ extensive loss of tooth structure
-may require stainless steel crowns w/ facial aspect removed and replaced by composite
Restoration of Primary Canines
-distal surface of primary canines is common place for caries in caries-prone pts
-it is often necessary to place lingual or labial dovetails to aid in retention
Part 5: Pulp Treatment for Primary Teeth
Four Options for Treating Pulpal Involvement in Primary Teeth
1) Pulp Capping
2) Pulpotomy
3) Pulpectomy
4) Extraction
Pulp Therapy Indications and Contraindications
1) Indications
a) Mobility: indicates loss of vitality if mobility due to bone destruction, root destruction, or both
2) Contraindications
a) children who have serious illnesses, b/c serious complications can result secondary to acute infxn if
pulpal therapy fails
-ex. Infective endocarditis, leukemia, nephritis, cancer, decreased PMN count