Semi – Permanent

Restorations of anterior
teeth.

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 POLYCARBONATE CROWNS
in Pedodontic practice the most common lesion in
anterior teeth is likely to be the result of nursing bottle
caries.
Poly carbonate crowns are temporary crowns which
can be given as fixed prosthesis to decidious anterior
teeth which will get exfoliated in future.

CONTRAINDICATION:-
Severe bruxism
deep bite
Excessive abrasion
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 Advantage
- They save time
- Are easy to trim and
- Can be easily adjusted with pliers.
Steps in preparation :
a) Shoulderless preparation

Caries removal, Pulp protection

Reduce the mesial and distal proximal surface below the

gingival tissue, wit care being taken to avoid ledge

formation. www.FourthMolar.com
 After carries excavation if a ledge if formed,
then this ledge is modified to achieve a shoulder.
Adaption of the crown it probably will be
necessary to trim the cervical area of the crown
especially on the mesial and distal aspect to fit the
crown properly on the tooth. It may be necessary to
shorten the entire crown at cervical region, occasinaly.
Roughening of the interior surface of the crown
should be done before cementation.
Cementation of the crown:-
Polycarbonate crown can be cemented with the
phosphate or glass ionomer cements.
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Disadvantage :
Difficult to place
Poor retention
Prone to excessive wear
Brittle and have high incidence of fracutre.
Anterior strip crown also known as full coverage composite
resin restoration.

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 ANTERIOR STRIP CROWN
(Also Known as full coverage Composite
Resin Restoration).

Indications :
1. Primary incisors with loss of mesial and distal incisors
corners, as well as circumferential class 5 lesions
such as may occur in nursing bottle mouth.
2. Malformed primary incisors.
3. Dental hypoplasia.
4. Fractured primary incisors due to trauma.
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MATERIALS :
- Hand piece
- A tapered high speed bur
- Calcium hydrooxide or GIC.
- A light cure composite with etchant.
- Bonding agent.
- Visible curing light and scissors.
- The celluloid crown.

TECHNIQUE : CROWN SELECTION :

1. Select the appropriate celluloid crown
size from the mesial and distal dimension
at the tooth’s incisial edge.
2. Trim of excess material www.FourthMolar.com
with scissors.
TOOTH PREPARATION
The teeth should be
anaesthetized, and then
isolated cotton wool roll
isolation is usually sufficient,
rubber bam or dry dam may
be preferred.

 All caries is removed using

a small round bur in a slow
speed hand piece.

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The teeth are prepared for the strip crown using a tapered diamond or
tungsten carbide bur in a high speed hand piece, the length of the crown
reduced the incisally mesial and distal slice or made tapered to a knief
edge at the gingival margin.

Round all the line angle.

Place a small cervical under cut at the gingival margin of the labial
surface this serve as mechanical lock and aids in retention.

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The mesial and distal
walls of the incisors
prepared for strip
crowns the carries have
been removed.
The shade of composite
resin is chosen when the
tooth is discoloured, an
adjustecent tooth or the
lower incisors can be
used for shade
matching. www.FourthMolar.com
The celluloid crown are
trimmed using fine curved
scissors, care should be
taken at this stage to avoid
splitting or distorting the
crown form.
The trimmed celluloid
crown are fitted on to the
prepared incisors. The
length and cervical fit
should be checked at this
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Vent holes are made in the
mesial and distal corners of
the incisal edge of each crown
from to allow air and excess
composite resin to escape.
 A proprietry calcium
hydroxide paste or GIC is
applied to the pulpal wall of
any exposed dentin.
 The teeth are etched for 1
minute with a 37%
phasphoric acid washed and
dried. The opaque frosty
apperance of the enamel.
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The bonding agent is applied, and then
cured for 15 second.

The crown forms, containing composite

resin, are firmly on the prepared tooth, again
case should be taken at this stage, since
excess pressure can resulting in spilting.

Excess composite resin is removed with a

probe of ward’s carver. It will make final
finishing easier and quicker.

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 The composite resin is cured for
one minute, labialy and palataly.
 An Excavator or probes inserted
beneath the edge of the
celluloid, in the crown form is
stripped off after the composite
resin has been cured.
 The last step is to smooth and
polish the crowns, although
finishing is usually minimal.
Flexible carberundum disc are
ideal for this, although fine
diamond or baker Curzon high
speed burs may be preferred.
.

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 A labial view of the finished strip
crown restoration
 A palatal view of the finished strip
crown restoration clearly demonstrating
the full coverage provided by this
restoration technique.
 Pre-operative photographs of extensive
caries of primary maxillary incisors.
 Post-operative photographs.
 Pre-operative photographs of extensive
caries of primary
 maxillary incisors.
 Post-operative photographs showing
restored maxillary incisors.

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Advantage :
- More esthetic crown.
- Improved retention.
- Better wear resistance.
Dis Advantage :
- More technique sensitive.
- Fractured or debond when traumatized.

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 Problem and solutions that may be
encountered when using strip crowns.
Problem Solution

Tearing of celluloid crown from when
trimming Splitting of filled crown form
when seating it
Difficulty is stripping off crown form
Keep scissors exclusively for strip crown
preparation Hollow out composite to
reduce excess and use gentle pressure. A
slow ‘rocking’ motion while seating the
form helps excess composite to escape.
Remove excess composite from gingival
margin before curing.

Calcium hydroxide showing through

If this is anticipated, a glass ionomer
composite cement should be used for lining. Extra
thickness of composite can be added
buccally if this is a problem with the
finished restoration.
Time consuming trimming of crowns at Take sectional impression and trim crowns
preparation prior to appointment, thus reducing
chairside time
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 Stainless steel crown
Stainless steel crown
1. Veneered crown.
2. Non veneered crown.
Chair side veneered stainless steel crown.
Advantage : Retention that is similar to traditional
stainless steel crown.
Disadvantage :
1. Problem with contouring and crimping of crown
could cause fracture or loss of veneer.
2- Substantially more expensive.
3- Can’t be heat sterilized due to damage to the
veneer. www.FourthMolar.com
• Stainless steel crown are not frequently used in max.
primary incisors because of poor esthetic.
• PREPARATION:
• Non-Veneered crown.
• The preparation of steel crown is identical to that of a
resin crown, except no facial under cut is made for steel
crown.
• After the preparation is completed select a crown and try
on the tooth.
• Anterior steel crown often need to have their cervical
shaped changed before placement.
- When manufactured the crown have an avoid shaped with
a small faciolingual dimension.

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♣ This must often be changed to allow the crown to slip
on to the tooth. This is done by simply squeezing the
crown slightly mesio-distally with a pair of howe no.
11 utility pliers, thereby increasing the faciolingual
dimension.

♣ The fit of the crown should be snug, and difficulty

may be encountered seating the crown with finger
pressureonly.
♣ An orthodontic band pusher or tongue blade may be
used to aid in seating, but care should be used not to
apply too much pressure.

♣ Contouring and crimping are necessary to ensure a

good marginal fit no. 137 gordon pliers is used.
Check the marginalwww.FourthMolar.com
adaptation with an explorer.
* These procedure complete the non veneered stainless steel crown placement.

For placement of open face or veneered steel crown.

* The cement must be allowed to set completely, then a labial window is cut in
the crown using a no. 330 or no. 35 bur.
* The windows extends just short of the incisal edge- gingivally, to the height of
the gingival crest, and mesiodistally, to the line angles.
* With a no. 35 inverted cone bur remove the cement to a depth of 1mm.
Under cut must be placed at each margin.
Mechanical retention is necessary because there is usually little enamel to
etch.
Smooth cut margins of the crown with a fine green or white finishing stone.
* A thin layer of dentin bonding agent and then composite is placed into the cut
window, engaging the undercuts.
* Resin added with a plastic instrument.
* Polymerize the resin, and finish with abrasive disks.
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 Indication of stainless steel crown :
• A restoration for a primary or young permanent
tooth with extensive carious lesion.
• A restoration for a hyperplasic primary or
permanent tooth that can’t be adequately
restored with silver amalgam or a composite
resin interior restoration.
• A restoration of fractured tooth.
• A tooth in dentin genesis imperfecta.

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 Preformed stainless Steel band:
Indications :
• Restoration of choice in very young child with nursing
carries.
Procedure :
• The restoration of anterior primary teeth with deep
mesial or distal caries involving the incisal angle.
• After caries removal with a bur or excavators an
appropriate base is place in the deep portion of the
cavity.
• The cavity and the band are fitted with a creamy mix of
cement.
• After the cement is hardened, the excess cement is
removed.
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 Direct Resin Crown
Advantage :
• 1 Use an undercut area around the gingival
shoulder.
• 2 Retain as much enamel as possible for
etching.
• 3 Preserve the mid portion of natural
incisal edge, when ever possible to help
retard incisal abrasion and improve
rotational.
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Procedure :
• Excavating the caries protecting the exposed
dentin and etching the enamel.
• The dentist restores the prepared incisor with a
preformed acrylic jacket crown lined with self
curing resin.
• After polymerization the cervical margin and
incisial edge of the restoration are finished and
polished. So that there is no cervicaly over
extend restorative material and so that the
tooth’s preserved natural incisal edge is
exposed.
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 Resin jacket, all ceramic
metal ceramic crown
ADVANTAGE:
• Restoration of single, mal formed, discolored or
fractured teeth.
DISADVANTAGE:
• Poor long term color stability.
• Decreased resistance to wear.
• Greater loss of surface form.

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Porcelain Jacket Crown All
Ceramic Crown:-
Indication :
• Full coverage esthetic restoration.
• Missing because of trauma.
• Caries.
• Previous restoration that were dislodged
during tooth reduction.
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