Composite Resin Strip CrownMethodLocal anesthesia, and rubber damSelect the correct celluloid crown (mesio distal width)Remove the caries using slowspeed roundburReduced the incisal height by around 2 mm, prepare

interproximal slicesProtect the exposed dentin with GICTrim the crown form and make two holes in insical cornerEcth the enamel for 20 secondApply bondingFill the crown with apropiate shade of composite and seat

with gentle, even pressure , allowin the excess to exit freelyLight cure from all direction

Stainless steel CrownThe lifespan of multisurface amalgam

restoration is markedy shorter in primary tooth

Replacement are often necessary within a short period

Need alternative SSCPaired study between multisurface amalgam

and SSC clinical longitudinal study (8 years) SSC are more acceptable, cost efevtive

Indication A tooth has receive Pulpotomy and

pulpectomyTooth has severe malformations, e.g enamel

hypoplasiaHigh caries susceptibilityAn abutment for certain appliancesSeverely decayed tooth/ Extensive multi-

surface caries and/or fracturesFailed alloy or resin restoration

Caries Progression and restoration

ContraindicationExtensive loss of tooth structureOcclusion is a critical factorPatient compliance during multiple crown

fitting can be a problem

Anterior and Posterior SSC

TechniqueCheck the proper occlusionGive local anesthesiaPlace rubber dama and wedgesReduce occlusal surface 1,0- 1,5 mmReduce proximal surfacesBevel occlusal-buccal and occlusal-lingual line angleRound off the proximo buccalRemove caries do pulpotomy or pulpectomySelect the crownSeat the crown into occlusion, contour itCrimping, established contact, polish the crownCementing, remove excess

Armamentarium

• Child behavior• Number of decayed surfaces• Length of time restoration will be in place (i.e. age of child)• Which tooth is in need of a restoration• Caries rate• Probability child’s family will continue with dental care• Severity of decay• Is there a parental preference

Pediatric Considerations in Choosing Restorative Material

Restorative Tx Planning Example Cases:Age?- 1-18- when will exfoliation occur?Behavior?- ability to tolerate treatment (gag reflex, anxious, limited opening, etc)- special needs- pre-cooperative or can comply with directionsCaries Risk?- high (plaque accumulation, white spot lesions, dental hx, missed appointments, SES,diet, frequency of brushing, hx of caries, etc.)What Type of Physical Restoration is Needed?- how many surfaces involved, will the prep pass the line angles, is there hypocalcifiedenamel present, etc.)- does the child have known allergies to any of the substances you would choose?Has the information been communicated to the parent?- does the parent have a preference of white or silver?- has the parent been informed of your tx decisions and why you are choosing thematerials you are?- is cost a factor? Is the family going to be responsible for costs above what an amalgamcosts?