PAEDIATRIC DENTISTRY - 3rd Ed. (2005)

(John Hannent) #1

  1. Remove any carious dentine and enamel.

  2. Replace tooth bulk with glass ionomer.

  3. Reduce the occlusion minimally.

  4. Reduce the mesial and distal surfaces, slicing with a fine tapered bur. Depending on
    the natural anatomy of the tooth it may be necessary to create a peripheral chamfer on
    the buccal and lingual surfaces.

  5. Try the selected crown; adjust the shape cervically, such that the margins extend ~1
    mm below the gingival crest evenly around the whole of the perimeter of the crown.
    Sharp Bee Bee scissors usually achieve this most easily, followed by crimping pliers
    to contour the edge to give spring and grip. Permanent molar preformed metal crowns
    need this because they are not shaped accurately cervically. This is because there is
    such a variation in crown length of the first permanent molars.

  6. After the contouring, smooth and polish the crown to ensure that it does not attract
    excessive amounts of plaque.

  7. After test fitting of the crown remove the rubber dam to check the occlusion then
    re-apply for cementation.

  8. Cement the crown usually with a glass ionomer based cement.

  9. Remove excess cement carefully with an explorer and knotted floss. Finally
    recheck the occlusion.(See 497HFigs. 9.42, 498H9.43, 499H9.44, 500H9.45, and 501H9.46.)


502H


Fig. 9.42 Stainless-steel crown
preparation. The occlusal surface is
reduced minimally just enough to allow
room to place the crown without
disrupting the occlusion.
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