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D2: 622 Pediatric Dentistry > 02 SSC > Flashcards

Flashcards in 02 SSC Deck (73):
1

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

2

Why are SSCs indicated for large multi-surface lesions

Because they historically have a high failure rate

3

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

Mandibular first molars

4

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

5

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

6

List the order of restorative reliability from best to worst

SSC>Amalgam>Composite>GI

7

Which restorative material has the worst survival rate

GI

8

What is the armamentarium for SSCs

Assorted crown sized

Crown contouring pliers

Crown crimping pliers

Crown scissors

Heatless stone

Rubber Wheel

9

Why might anesthesia be required, even following pulp therapy

comfort due to damage to gingiva

10

Why should a rubber dam be used

Controls

Moisture and Contamination

11

When should the rubber dam be removed

To check occlusal reduction and occlusion

May be needed to make proximal slice

12

What are the four principles of tooth preparation

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

13

What should be measured before the SSC preparation

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

14

What bur should be used to reduce the occlusal surface

Large flat fissure bur

Large Round bur

15

What are the three steps to complete the occlusal reduction

1. reduced groove
2. cusp tip
3. cusp slope

16

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

1-1.5 mm

17

What is the most important part of the preparation

the proximal reduction

18

What feature will prevent the seating of the crown

a proximal ledge

19

What are three keys to the reduction of the proximal surface

1. Protect adjacent tooth
2. Beveled buccal surface
3. Preparation below gingival crest

20

What do you need to check for after the proximal reduction

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

21

What must be done in order to avoid leaving a ledge

the proximal slice must extend sub-gingivally

22

What are 4 keys of a complete preparation

1. Contact broken
2. Material removed
3. Occlusal reduction
4. Proximal reduction

23

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

1. Bevel the occlusal-facial and occlusal-lingual line angles
2. Round the gingival border of the bevel
3. Round the proximal-facial and proximal-lingual line angles

24

What are finishing touches 4-6

4. Round sharp edges of enamel
5. check for adequate occlusal and proximal clearance
6. check for proximal ledges

25

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

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

26

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

27

What sizes are the preformed SSCs available in

2-7, Pedo and Adult

28

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

29

Which crown type has flat axial surfaces and requires axial contouring

Unitek

30

Which crown requires shortening and marginal adaptation

Unitek

31

Which crowns have curved axial design

Pre-countoured ION/ESPE

32

Which crowns have anatomically defined occlusal surfaces

ION/ESPE

33

Which crowns require less manipulation to accurately fit a prepared tooth

ION/ESPE

34

What are the 5 steps for fitting a SSC

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

35

What measurement is used to help in crown selection

mesio-distal width

36

How should the crown be placed?

Set lingually and rotate over the buccal slope

37

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

no, it should go into place with little pressure

38

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

It is too big

39

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

it is too small

40

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

Blanching of the tissue

41

What should you do if a snug fit cannot be obtained

reduce buccal and lingual surfaces slightly

42

How do you adjust the crown fit if needed

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

43

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

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

44

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

Contouring pliers

45

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

46

What does contouring do to the crown circumference

Reduces

47

How do you contour the crown

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

48

Why are crown margins crimped

Ensure good cervical marginal adaptation

"Snap" seating

49

What are the two common crown cements used

Polycarboxlyate

Glass Ionomer

50

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

Band seater or bite stick

51

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

52

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

53

Which tooth adjusts itself very quickly

primary molars

54

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

A proximal ledge which should be removed with a tapered bur

55

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

56

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

Howe pliers

57

Do crowns interfere with the exfoliation of primary teeth?

No

58

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

5

59

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

3

60

What is the main goal behind using SSCs

To keep primary teeth restored until they are ready to exfoliate

61

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

Re-treatment

62

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

63

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

64

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

65

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

With a round bur on slow speed to protect the pulp

66

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

Interproximal and incisor reduction

67

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

68

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

69

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

creating voids

70

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

Cervical opening and vent holes

71

Usually you need to cure to a depth of _____ mm

4

72

Why are they called strip crowns?

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

73

What are 4 other types of anterior crowns

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