Anteriors

 
 Treatment  Op/ons  for  Anterior  Caries  
  ART  
  Intra  Coronal  Restora/ons  
  Full  Coverage  –    SSC,  open  face  SSC,  strip  
crown,  pre-­‐veneered  SSC  
  Extrac/on  –  with  or  without  prosthe/c  
replacement  
  Cavity  Design  for  Intra  Coronal  Restora/ons    
OR  
   “Why  Intra  Coronal  Restora/ons  Don’t  Work”  

•  Reten/on  is  almost  en/rely  from  etch  and  

bond  
•  Thickness  of  enamel  of  a  primary  tooth  is  
approximately  ½  that  of  a  permanent  tooth  
•  Most  children  are  bruxers  
•  Flexure  is  a  problem  
 Why  Full  Coverage  
•  Pa/ent  age,  behaviour,  coopera/on  
•  Moisture  and  hemorrhage  control  
•  High  caries  risk  -­‐  remember  anterior  caries  is  
SECC  
•  Cost  
•  Ease  of  placement  
 Advantages  of  Pre  Veneered  SSC  
•  Good  esthe/cs  
•  Good  reten/on  
•  Moisture  /  hemorrhage  control  is  not  cri/cal  
•  Minimal  chair  /me  
•  Full  coverage  protec/on  of  SSC  
Disadvantages  of  Pre  Veneered  SSC  
•  Increased  cost  
•  More  aggressive  tooth  reduc/on  
•  Metal  visible  from  lingual  
•  Chipping  or  fracture  
•  Color  match  may  be  difficult  
 Case  Selec/on  
•  No  anterior  cross  bites  
•  No  severe  crowding  
•  Some  clinical  crown  must  remain  
•  Best  esthe/cs  when  mul/ple  crowns  are  
placed  
Sizing  of  Crown  
Feather  Edge  Prepara/on  
Feather  Edge  Prepara/on  
Interproximal  Reduc/on  
Shaping  of  Crown  
 Study  of  Pediatric  den/sts  and  what  they  use  for  full  coverage  of  
anterior  teeth  

•  Strip  crowns  46%  

•  Pre  veneered  crowns  41%  

•  University  of  Detroit  Mercy  School  of  Den/stry  2008  

Premature  Loss  of  Anterior  Primary  Teeth  

•  Space  loss  is  unlikely,  so  long  as  the  

primary  canines  are  erupted  into  
occlusion  
•  Replacement  if  primary  incisors  is  
elec/ve  only  and  is  only  recommended  
for  cosme/cs  –  not  space  maintenance