02 SSC Flashcards by Chris King

What are the indications for SSCs

Large lesions
Rampant Caries
Following Pulp Therapy
Teeth with developmental defects
Fractures teeth
Temporary restoration of young permanent teeth

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Why are SSCs indicated for large multi-surface lesions

Because they historically have a high failure rate

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What teeth have an especially bad track record for multi surface restorations

Mandibular first molars

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Why might behavioral issues be an indication for an SSC instead of a restoration?

Because if they child is so bad that they need to be sedated, you only want to do the procedure once

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What are the numbers as far as comparing SSCs to multi-surface amalgams?

70% of 2-surface amalgams need replacement before the age of 8

Only 12% of SSCs ever need further treatment

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List the order of restorative reliability from best to worst

SSC>Amalgam>Composite>GI

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Which restorative material has the worst survival rate

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What is the armamentarium for SSCs

Assorted crown sized

Crown contouring pliers

Crown crimping pliers

Crown scissors

Heatless stone

Rubber Wheel

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Why might anesthesia be required, even following pulp therapy

comfort due to damage to gingiva

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Why should a rubber dam be used

Controls

Moisture and Contamination

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When should the rubber dam be removed

To check occlusal reduction and occlusion

May be needed to make proximal slice

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What are the four principles of tooth preparation

Remove all evidence of caries
Remove loose and overhanging tooth structure
Place any needed liner or supporting base
Complete any needed pulp therapy

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What should be measured before the SSC preparation

mesio-distal width in order to select the correct sized crown

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What bur should be used to reduce the occlusal surface

Large flat fissure bur

Large Round bur

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What are the three steps to complete the occlusal reduction

reduced groove
cusp tip
cusp slope

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How much should the occlusal be reduced in order to have enough clearance

1-1.5 mm

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What is the most important part of the preparation

the proximal reduction

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What feature will prevent the seating of the crown

a proximal ledge

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What are three keys to the reduction of the proximal surface

Protect adjacent tooth
Beveled buccal surface
Preparation below gingival crest

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What do you need to check for after the proximal reduction

Probe to check that there is no ledge and enough clearance for the crown
Make sure there is the proper amount of proximal clearance

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What must be done in order to avoid leaving a ledge

the proximal slice must extend sub-gingivally

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What are 4 keys of a complete preparation

Contact broken
Material removed
Occlusal reduction
Proximal reduction

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What are the three steps to put finishing touches on the preparation?

Bevel the occlusal-facial and occlusal-lingual line angles
Round the gingival border of the bevel
Round the proximal-facial and proximal-lingual line angles

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What are finishing touches 4-6

Round sharp edges of enamel
check for adequate occlusal and proximal clearance
check for proximal ledges

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What are the three types of ssc crowns that we can choose from

1. 3M ION Pre-fab 2. 3M Unitek 3. Denovo

What are the advantages of the 3M ION Pre-fab crowns

1. Pre-trimmed, belled, and crimped 2. Requires minimal adjustment for fast and easy placement 3. Accurately duplicates anatomy for better fit and performance

What sizes are the preformed SSCs available in

2-7, Pedo and Adult

What are two situations where a UNITEK SSC would be indicated

1. May be needed when significant space loss has occurred secondary to interproximal decay 2. When caries extends further gingivally than the length of the Ion crown

Which crown type has flat axial surfaces and requires axial contouring

Unitek

Which crown requires shortening and marginal adaptation

Unitek

Which crowns have curved axial design

Pre-countoured ION/ESPE

Which crowns have anatomically defined occlusal surfaces

ION/ESPE

Which crowns require less manipulation to accurately fit a prepared tooth

ION/ESPE

What are the 5 steps for fitting a SSC

1. Pick size 2. Length of crown 3. Marginal adaptation 4. Contouring 5. Crimping

What measurement is used to help in crown selection

mesio-distal width

How should the crown be placed?

Set lingually and rotate over the buccal slope

Should you have to use a lot of force to put the crown on?

no, it should go into place with little pressure

What is the problem if the crown easily slides over the tooth with no pressure

It is too big

What is the problem is the crown will not seat entirely over the tooth

it is too small

If a crown is too large or a crown before contouring might cause this

Blanching of the tissue

What should you do if a snug fit cannot be obtained

reduce buccal and lingual surfaces slightly

How do you adjust the crown fit if needed

With the crown in place scribe line along buccal and lingual gingival crest

When trimming the crown how much excess should be trimmed off?

Enough so that the margins are 1.0 mm below the scribed line

What instruments decrease the circumference of the crown while creating a fit that is more snug

Contouring pliers

What should you inspect after fitting in terms of the crown margin

1. Inspect the crown for exposed tooth structure and open margins 2. Crown margin should be 1 mm below gingial crest

What does contouring do to the crown circumference

Reduces

How do you contour the crown

Use contouring pliers to bend inward the gingival third of the crown.....more contouring on buccal and lingual

Why are crown margins crimped

Ensure good cervical marginal adaptation "Snap" seating

What are the two common crown cements used

Polycarboxlyate Glass Ionomer

What can you use to have the child help seating the crown

Band seater or bite stick

Three steps to complete crown cementation

1. check that crown is comletely seated 2. Remove excess cement when tacky 3. Use floss to clean interproximal areas

What are the four bullet items for the final check of the crown restoration

1. check for interproximal and subgingival cement 2. Polish crown surface lightly with pumice 3. Check occlusion 4. Ignore minor occlusal discrepanciees

Which tooth adjusts itself very quickly

primary molars

What is usually the cause of a crown not seating properly?

A proximal ledge which should be removed with a tapered bur

What is usually the solution to a loss of space?

Rotate the crown slightly mesio-buccally Use flat beaked pliers to flatten the contact points, this reduces the mesio-distal width

what are the pliers with the little hook like things on the end

Howe pliers

Do crowns interfere with the exfoliation of primary teeth?

Crowns are significantly better than restorations if the child is under _____ years of age

Crown and alloy are not significantly different if tooth is due to be exfoliated within _____ years

What is the main goal behind using SSCs

To keep primary teeth restored until they are ready to exfoliate

What do you want to avoid when deciding to use a crown?

Re-treatment

Things to consider

Patient behavior v. restorative techniques Longevity/durability of the restoration material Ability to maintain the restored tooth by appropriate diet and OH

What are the 5 indications for strip crown

1. Extensive or multi surface caries 2. Congenitally malformed teeth 3. Discolored teeth 4. Fractured teeth 5. Sufficient crown material remains after caries removal to retain resin

What are the materials needed for a strip crown restoration

1. Anterior restorative materials 2. Celluloid crown forms in various sizes 3. Scissors to trim crown form

During a strip crown prep, how are the caries removed?

With a round bur on slow speed to protect the pulp

What are tapered burs used for during a strip crown prep?

Interproximal and incisor reduction

What are the 3 steps to forming the celluloid crown for the strip crown prep

1. Crown form trimmed so cervical margin extends slightly below gingival crest 2. Height adjusted to match adjacent tooth 3. Vent hole placed

What are the 3 steps to prepare the tooth surface for a strip crown

1. Pulp protection applied 2. Tooth surface etched, washed and dried 3. Bonding agent applied and cured

What do you want to avoid when squeezing material into the crown form

creating voids

When the crown is seated, where should the excess composite come out?

Cervical opening and vent holes

Usually you need to cure to a depth of _____ mm

Why are they called strip crowns?

Because you strip off the crown form after the composite is cured

What are 4 other types of anterior crowns

SSC EZ Pedos SSC w/ Facial cutout and composite (Window) NuSmile

02 SSC Flashcards

(73 cards)