Mustansiriyah University ‫الجامعة المستنصرية‬

College of Dentistry ‫كلية طب االسنان‬

‫الخامسة‬:‫المرحلة‬ ‫ ي‬:‫الرباع‬
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D:‫الشعبة‬ alkaraguliali@gmail.com:‫ون للطالب‬ ‫ر‬
‫البيد االلكب ي‬
‫ر‬
pediatric dentistry:‫اسم المادة‬ ‫اولية‬:‫نوع الدراسة‬

Ceramic crown for children

pediatric dental crown?

Pediatric crowns are nothing but dental
crowns manufactured for kids to get them
back their attractive and confident smile . A
positive smile can take your life to different
level as it brings with it high level of
confidence and self-esteem. Especially,
kids look extremely attractive when smiling.
As, most often losing a tooth or two is
part of kid’s growth, regenerating the lost
smile by fixing the teeth
lost becomes critical. Pediatric dental
crowns are the best options to accomplish that.There are different types of pediatric
dental crowns out there in the dental space for serving patients withdental complications.
Some of them include: stainless steel, metals, veneer, strip, porcelain-based metal,all
resin, all ceramic, temporary, permanent
-listed dental crown types in detail to realize the benefits and select the onebest suited for
dental needs.
The need of pediatric dental crowns for kids:
Well, it is a must for kids for two reasons and for children four reasons. For kids who have
only primary teeth, dental crowns are widely used for preventing from tooth decay and
damaged tooth. For children who already have adult teeth coming in, dental crowns can
cover dental implant, damaged tooth, decay, large filling.
Are pediatric dental crowns so expensive?
costs of dental crowns all over the globe is still a cause of concern, yet the advancement of
technology has enabled the dentistry to offer the dental crown treatments cost effectively.
As far as the United States is considered, dental treatments are covered under insurance
and opting for crown implant tswithout insurance could cost on the higher side. But, there
are affordable dental care centers available all everywhere today and finding the best ones
nearby to your home town could save your time and money.

‫توقيع الطالب‬ 1
 Mustansiriyah University ‫الجامعة المستنصرية‬
College of Dentistry ‫كلية طب االسنان‬

pediatric dentistry :‫اسم المادة‬ ‫ ي‬:‫الرباع‬

‫عل صادق جعفر محمد‬ ‫ي‬ ‫اسم الطالب‬

Procedure and placing of pediatric dental crowns:

A common procedure adopted by most dentists include assessing and numbering the kid
’s affected teeth,
preparing the right kind of alternative for that, and replacing the decayed or missing tooth
with atemporary crown. Usually it takes at least 30 minutes to complete these steps. Post
the first visit, the kidshave to revisit the dental clinic within a span of 2 weeks. Meanwhile
the dental assistants will startfabricating the permanent dental crowns which will be placed
to the client during the final visit. This isreferred to as cementing. This process may involve
approximately 20
25 minutes.The dentists have to consider multiple factors when planning for replacing the
decayed tooth with a newone. Starting right from the size of the crown to its durability, type
of crown that best suits the kid(s), theyhave to take into account the most critical factors that
would help the patient win back the bright andpositive smile lost.I have compiled below some
of the most utilized dental crowns by top dentists all over the globe
Pediatric zirconia crowns: Changing pediatric restorative dentistry
Dentists can use primary zirconia crowns for esthetic, durable restorations in children. These
can be used in place of stainless steel crowns or other bonded restorative options. This
option is becoming more popular, with demand for esthetic dental solutions for children and
pediatric dentistry increasing.
Use of zirconia
Zirconia has a long history as a proven biocompatible material in the human body. It has
been used as a prosthesis in hip replacements since the 1970s,2 and for crowns, endodontic
posts, implant abutments, and other crown and bridge applications in adult patients for at
least 15 years. However, zirconia has only been used for pediatric crowns since 2010, when
the first primary zirconia crown came on the market.
When restoring badly broken-down primary incisors and molars, pediatric dentists have
several options that have been in use much longer than zirconia crowns, including stainless
steel, preveneered stainless steel, and bonded resin strip crowns.
Pediatric zirconia crowns, like stainless steel crowns, come premade in six or seven different
sizes for each tooth and are supplied in kits. To place the crowns, the caries is removed and
the tooth prepared with occlusal and circumferential reduction to a gingival featheredge. An
appropriately sized crown is then tried onto the preparation. If the crown does not fit, either
‫توقيع الطالب‬ 2
Mustansiriyah University ‫الجامعة المستنصرية‬
College of Dentistry ‫كلية طب االسنان‬

pediatric dentistry:‫اسم المادة‬ ‫ ي‬:‫الرباع‬

‫عل صادق جعفر محمد‬ ‫ي‬ ‫اسم الطالب‬

another size is tried or more tooth reduction is done until a crown is passively seated onto
the preparation.
This article will attempt to shed some light on why and when zirconia crowns might be the
preferred choice for restoring these teeth.
Advantages of zirconia
The most obvious advantage of zirconia crowns is
their excellent esthetics, which is far superior to other
pediatric crown options and rivals custom-fabricated
crowns (see figures 1-3). In adult dentistry, zirconia
crowns have been shown to be exceptionally
durable. While zirconia crowns have not been used
long enough in pediatric dentistry to build up an
extensive history, I believe that time will show them
to be the most durable of all esthetic pediatric crown
options available. Moreover, zirconia crowns will not chip as the preveneered stainless steel
crowns do on occasion, nor will they discolor and break down over time like resin strip
crowns often do.
Potential disadvantages of zirconia
One potential disadvantage of zirconia crowns is the fact that exposing the zirconia to saliva
and blood during the try-in stage can impair the strength of the bond between the crown and
the cement. Phosphate groups found in the saliva will bond with the zirconia surfaces,
thereby making the zirconia surface less reactive to bonding with phosphate groups found
in the most effective cements indicated for use with zirconia. NuSmile ZR zirconia
crowns offer an interesting solution to the contamination problem. A pink try-in crown is used
to verify the fit first (figure 4). Upon selecting the correct size, cement is loaded into the size-
matched, tooth-colored NuSmile ZR zirconia crown. The first time the NuSmile ZR crown
enters the patient's mouth is during cementation, which ensures maximum bond strength of
the luting cement to the zirconia. Meanwhile, the pink try-in crown can be cleaned,
autoclaved, and reused.
Zirconia crowns also might not be appropriate for cases involving severe crowding or space
loss. The ability to manipulate the size, shape, and fit of the zirconia crown is very limited,
so in areas of crowding, the use of a crown whose shape and size can be adjusted easily is
recommended.

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Mustansiriyah University ‫الجامعة المستنصرية‬
College of Dentistry ‫كلية طب االسنان‬

pediatric dentistry:‫اسم المادة‬ ‫ ي‬:‫الرباع‬

‫عل صادق جعفر محمد‬ ‫ي‬ ‫اسم الطالب‬

When to use zirconia crowns

You can use zirconia crowns in most cases for which
other pediatric crowns can be used. The main
exceptions are when the patient has significantly
crowded teeth, or when there is very little sound tooth
structure remaining. Also, as many insurance
companies do not yet cover these crowns, the cost
may be a deterrent to some parents.In my practice,

I use zirconia crowns for many of my anterior restorations. The advantages in esthetics
and durability are simply too significant to ignore. Since posterior crowns are less visible,
I usually allow the parents to decide if they prefer the esthetic zirconia or the lower-cost
stainless steel crown option. While nearly all would certainly prefer zirconia, many feel
they cannot afford or justify the price premium for posterior teeth, and I certainly respect
their point of view.

The best cements for zirconia crowns

Based on my experience, I recommend cementing zirconia crowns with either resin-
modified glass ionomer (RMGI) cements, resin cements, or bioactive RMGI cements
(e.g., NuSmile BioCem, Doxa Ceramir). Laboratory tests have found the bond strength to
zirconia of these cements to be superior to glass ionomer cements.

Summary
As recently as the early 1990s, children requiring crowns to restore chipped or severely
carious teeth had no option other than stainless steel or resin-based composites. Often
the esthetics or durability were somewhat disappointing to both the dentist and parents.
Fortunately, today's dentists have several esthetically appealing options they can offer,
with zirconia crowns at the head of the class. The esthetic superiority, coupled with
unmatched durability, biocompatibility, and many other advantages, make zirconia
crowns an excellent option for nearly all primary anterior crown restorations and for many
posterior crown restorations as well.

‫توقيع الطالب‬ 4
Mustansiriyah University ‫الجامعة المستنصرية‬
College of Dentistry ‫كلية طب االسنان‬

pediatric dentistry:‫اسم المادة‬ ‫ ي‬:‫الرباع‬

‫عل صادق جعفر محمد‬ ‫ي‬ ‫اسم الطالب‬

References
1. American Academy of Cosmetic Dentistry. Cosmetic Dentistry

2. Sandhu HS, Middleton RG. Controversial topics in orthopaedics: ceramic-on-ceramic

3. Pediatric Dental Crowns, academia.edu.

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