1

Mechanism of Action of NSAIDs

Arachidonic
Acid

COX-1 COX-2
Constitutive Inducible
NSAIDs
Stomach
(-)
Intestine
Inflammatory site
Kidney
Platelet
MLA. Tripathi, K. D. Essentials of Medical Pharmacology. 8th ed., Jaypee Brothers Medical, 2018.
Analgesics ADVERSE Dosage for Dosage for 10
EFFECTS DOSAGE AVAILABILITY 10 kg kg

ADULT CHILDREN Tablets Syrups

mg ml
Ibuprofen Gastric 600-800 mg 5-10mg/kg Motrin- 100mg Ibugesicplus/ 100mg TID 5ml TID
Discomfort tds every 6-8 Ibuprofen100 Children’s
hours Ibuprofen-
t1/2 = 2hrs Nausea
1oomg
vomiting +162mg in 5ml
Paracetamol Nausea 325- 650mg 15mg/kg Paracip-500 Dolopar/ 150mg TID 3ml TID
tds every 4-6 DOLO-650 Dolo250 -
Rashes hours 250mg/5ml
t1/2 = 2-3 hrs
Acute susp
Paracetamol
Posioning
Nimesulide Epigastric 100 mg bd 5 mg/kg Nimulid -100mg P-Nyme – 50mg TID 2.5ml TID
Distress, Every 6-8 Nimodol -100mg 100mg/5ml
Heart burn hours Nimodol –
Nausea
t1/2 = 2-5 hrs Diarrhoea 50mg/5ml

Mephenamic Diarrhoea 250-500 mg tid 20 mg/kg Meftime-KID Mefacid – 200mg TID 10ml TID
acid every 8hours Mefic -100DT 100mg/5ml
Epigastric Meftal -250mg,
distress
t1/2 = 2-4 hrs 500mg
Medol- 250mg
Antimicrobial agent ADVERSE DOSAGE AVAILABILITY Dosage for Dosage for 10 kg
EFFECTS 10 kg
ADULT CHILDREN Tablets Syrups

mg ml

AMOXICILLIN Diarrhoea 500 - 875mg 20-40 mg/kg Amoxylin, 125mg/5ml 400 MG in 16 ML in

tid /day in Novamox, dry syrup divided doses divided doses
t1/2 = 1 hr rash divided Synamox Amoxcilina
doses every 250, 500mg 250mg/5ml (125mg tid) (5ml tid)
8 hours capsule

500-875mg 25-45 Augmentin, Moxikind-CV 450mg in 9.8 ml in

Candida bd mg/kg/day Enhancin, 228mg in divided doses divided doses
clavulanic acid stomatitits divided Amonate , – 5ml
rashes doses every (250mg + (228mg bd) (5ML BD)
t1/2 = 1 hr 12 hours 125mg) Augmentin
acute  (500mg+125mg) DUO
hepatitis is Moxikind CV (125mg+31.5
rare KID(228MG) mg in 5ml)

CEPHALEXIN Diarrhoea 250-1000 mg 25-50 cephaxin cePHaXIN 500 MG in 20 ML in

Nausea qID mg/kg/day sporidex, 125 mg/5 ml divided doses divided doses
t1/2 = 1hr Vomiting divided alcephalin
Upset doses every 250,500 mg cap,
stomach 12 hours
Antimicrobal agent ADVERSE Dosage for Dosage for 10
EFFECTS DOSAGE AVAILABILITY 10 kg kg

ADULT Tablets Syrups mg ml

CHILDREN

AZITHROMYCI Mild gastric upset 500 mg OD 10mg/kg/day AZITECH, AZITROVIN 200MG 100 MG 2.5ML
N Abdominal pain on day 1, azithral-500, 250 IN 5ML on day 1,
Headache , single dose, tab single dose,
t1/2 = 1,5 -2 hrs dizziness followed by 5- Aziwok -100mg AZIvok- 2OOMG IN followed by
6 mg/kg once 5ML 50 mg once
daily
daily 100mg/5ml

METRONIDAZO metallic 500 MG 15-50 Flagyl, metrogyl, 300 MG 7.5ML

LE taste,anorexia TID mg/kg/day In aldezole 200, 400 200mg/5ml susp.,
Abdominal cramps divided doses mg tab,
t1/2 = 8 hrs 3 times daily

peripheral
neuropathy
thrombophlebitis of
the injected vein

American Academy of Pediatric Dentistry, American Academy of Pediatric Dentistry. Useful medications for oral
conditions. Pediat Dent. 2014;37(6):407-14.
Crowns IN Pediatric Dentistry
PresEnted by : DR ASHIMA TYAGI
MDS 2020

Checked by: Dr Tanvi

DR KANISHKA
  INTRODUCTION
C
 CLASSIFICATION OF
O
CROWNS
N
 STAINLESS STEEL CROWNS
T
 STRIP CROWNS
E
 ZIRCONIA CROWNS
N
CONCLUSION
T
 REFERENCES
S
 12

Full Coverage Restoration is a fully extra

coronal restoration.
Destructed tooth structure is preliminarily
replaced directly by restorative materials to
create a fully anatomic tooth, following
which the circumferential tooth structure
is cut off, as in a crown preparation.
Indications of Full Coverage Restoration:

• Multiple surface carious lesions

• Incisal edge involvement

• Extensive cervical calcification

• Restoration of endodontically treated tooth

• High DMFT score 13

Committee O. Guideline on restorative dentistry. Pediatr Dent. 2015;37:232–243.
 • A Primary tooth close to its exfoliation
Limitations of Full
Coverage • Excessive tooth crown loss/Bone loss
Restoration: • Space loss due to tipping of neighboring teeth
Committee O. Guideline on restorative dentistry. Pediatr Dent. 2015;37:232–243. 14
Crowns in pediatric dentistry

15
 FULL-COVERAGE RESTORATIONS IN
PRIMARY AND MIXED DENTITION

CLASSIFICATION OF CROWNS
 BASED ON MATERIAL USED
• ALL METAL CROWNS • PREVENEERED STAINLESS STEEL CROWNS
STAINLESS STEEL CROWN (PVSSC) WITH COMPOSITE, RESINOUS,
ALUMINIUM CROWN HDP, POLYETHYLENE OR EPOXY FACING
 NuSmile CROWN
• SSC WITH FACING  FLEX CROWN
• RESIN/ COMPOSITE CROWNS  PEDOPEARLS
 CHENG CROWN
STRIP CROWN
 HDPE CROWN
COMPOSITE SHELL CROWN  DURA CROWN
NEW MILLENNIUM CROWN • CERAMIC (ZIRCONIA CROWN)
POLYCARBONATE CROWN  ZIRKIZ CROWN
 EZ CROWN
KUDO CROWN  KINDER KROWN
PEDO JACKET CROWN  CEREC CROWN
ART GLASS CROWN • BIOLOGICAL CROWNS
 ACCORDING TO LOCATION:

• Anterior crowns- strip crowns,

polycarbonate crowns, pedo jacket
crowns, SSC with esthetic
modification

• Posterior crowns- conventional

stainless steel crown, Zirconia
Crowns

18
 A. Crowns that are luted to the tooth

Resin Polycarbo Facial cut Pedo Ceramic

veneered nate out crown pearls crowns
stainless crown (Zirconia)
steel
crown

19
 B. Crowns that are bonded to the tooth

New
Strip crowns Pedo Jacket millennium
crowns crowns

Sahana S, Vasa AAK, Sk Ravichandra. Esthetic Crowns for Anterior Teeth: A Review. Annals and Essence of Dentistry. 2010-
2:87-93. 20
STAINLESS STEEL CROWNS
Extensive caries Developmental defect

Pulp therapy

As an abutment to Disabled individuals with poor

space maintainer Bruxism oral hygiene
22
• Teeth expected to exfoliate
within - brief period (6 to12
months)
• Radiograph - over half the
primary root resorbed
• Clinical and radiographic –
radicular pathology
• Partially erupted teeth.
• Esthetically unappealing.
• Patients with nickel allergies
• Single visit
• Quick and simple
• Good retention rate • Esthetics
• Inexpensive 24
Classification of Stainless
Steel Crown
25
  Untrimmed Crowns
 

26
 Pre-trimmed crowns (pre-festooned)

27
Pre-contoured

28
 • Preveneered SSC (NuSmile Crowns)

- Aesthetic posterior crowns

- Resin based composite bonded to the buccal and occlusal

surfaces

- Allow only minimal crimping

Pinkham; Pediatric dentistry: Infancy through Adolescence; 4 th ed; Saunders; Missouri; 2005 29
30
 Based On Composition
Composition Nickel base crowns
Stainless steel crowns (InConell 600 alloy)
-austenitic type
(Rocky mountain) • 72% nickel
• 14% chromium
• 17-19% chromium
• 6-10% iron
• 10-13% nickel
• 0.04% carbon
• 67% iron
• 0.35% manganese
• 4% minor elements
• 0.2% silicon
Armamentarium

32
 • Pliers/instruments

- No.114 Pliers (Johnson contouring pliers)

- No. 800 -417 crown pliers (Unitek corp,)
- No.112 ball and socket pliers (optional)
- Sharp scaler or instrument
- Crown and bridge scissors.
- No.110 Howe pliers
- No.137 pliers (Gordon contouring pliers)

RJ Mathewson, Primosch; Fundamentals of pediatric dentistry; 3 rd ed.; Quintissence Publ Co.

Inc,Chicago 1995 33
34
Selection of crown

35
Evaluate the preoperative occlusion

36
 Local anesthesia

Isolation

37
 Occlusal Reduction

-Mink and Bennett (1968) 1.5mm

-Troutman (1976) at least 1 mm
-Kennedy (1976) 1.5 to 2 mm.
Proximal Reduction
Mathewson, Pinkham Stewart, Welbury,
and Mink &Bennet Forrester & Brocre
First proximal First occlusal
reduction followed by reduction followed by
occlusal proximal.

40
 Bucco-lingual reduction

But in some cases it is necessary to reduce the

distinct buccal bulge, particularly on the first
primary molar.

All the line angle created by the occlusal and

proximal reduction are rounded

The occluso-buccal and lingual surfaces are beveled

by moving the bur at 45 degrees to the occlusal
preparation.
 Evaluation criteria for tooth preparation

An explorer can be
The proximal slices
passed between the
converge towards
The occlusal prepared tooth and
the occlusal and
clearance is 1 to 1.5 the proximal tooth
lingual, following the
mm at the gingival
normal proximal
margin of the
contour.
preparation.
INITIAL ADAPTATION OF CROWN
Festooning
Crown Contouring Crown crimping

The crimping pliers bends edges inwardly.

 Final Adaptation of the crown
 
  • Snap into place
• Not - removed with finger pressure

• No rocking
• Correspond to the marginal ridge height - adjacent tooth-
not rotated on the tooth

• The crown margin - 1 mm gingival into gingival crest.

• No opening exists between - crown and the tooth - cervical margins
- should not cause gingival irritation – check – blanching of gingiva

46
 Principals for adaptation of
stainless steel crowns
- R H Spedding 1984

- 1. Length of SSC

- 2. Shapes of SSC margins

RH Spedding; Two principals for improving the adaptation of stainless steel crowns in primary molars;
Dent Clin North Am. ; 1984; 28(1);157-175. 47
Principle no. 1 – length of SSC

- Convergence is characteristic of primary molars

- Buccal and lingual marginal gingivae are located at the greatest
diameter of the tooth
- Greatest diameter is found on the contact area of the tooth
- The tooth portion below the greatest diameter is not visible in
the mouth
- The average length of the tooth from the CEJ to the crest of the
gingival margin is 2mm - - the depth of the gingival sulcus

- Somewhere between – the margin of the SSC should lie.

RH Spedding; Two principals for improving the adaptation of stainless steel crowns in primary molars; Dent Clin
North Am. ; 1984; 28(1);157-175. 48
 Principle no. 2

- When margins of the SSC are adapted to lie just below

the gingival margins they would be more closely
adapted if they are located at the correct anatomical
positions at all points on the tooth

Buccal & lingual marginal gingiva –

- 2nd primary molars – Smile
-1st primary molars – Stretched out S – shape

Proximal marginal gingiva - Frown

RH Spedding; Two principals for improving the adaptation of stainless steel crowns in primary molars;
Dent Clin North Am. ; 1984; 28(1);157-175. 49
 Luting Cements for SSC

Zinc Phosphate Type 1GIC RMGIC Pure resin

cement cement
 Resin cement was found to exhibit the best
retentive force and least microleakage while
glass ionomer cement was found to be the
best in inhibiting demineralization.

Nikhil Srivastava., et al. “How Efficacious are Stainless Steel Crown Luting Cements: An Ex Vivo Comparative Study”. EC Dental
Science 17.11 (2018): 1887-1898.
GLASS IONOMER CEMENT
TYPE 1: LUTING

Based on the reaction of silicate

glass- powder and polyacrylic acid,
an monomer.
The use of polyacrylic acid makes
GIC capable of bonding to tooth
structure.
52
 RESIN MODIFIED GLASS
IONOMER CEMENT

Hybrid cement that sets via an acid base

reaction and partly by photo- chemical

polymerization reaction.

Eg: Fuzi II LC, Vitrebond, Photac- fil,

53
Vitremer , FuziV
54
55
HALL TECHNIQUE

Dr. Norna Hall in the

1980s
• No caries removal
• No crown preparation
• No administration of
local anesthetic

56
 Modified HALL TECHNIQUE

About 1mm proximal

Use of Local
slice and minimal
Anaesthetic
occlusal reduction

Midani R, Splieth CH, Mustafa Ali M, Schmoeckel J, Mourad SM, Santamaria RM. Success rates of preformed metal
crowns placed with the modified and standard hall technique in a paediatric dentistry setting. International journal of
paediatric dentistry. 2019 Sep;29(5):550-6.
 HT is successful option for the management of caries in
primary teeth, particularly for proximal or multi-surface
dentine lesions. It is well-tolerated by children and
acceptable to parent, with mild adverse effects reported.

Hu S, BaniHani A, Nevitt S, Maden M, Santamaria RM, Albadri S. Hall technique for primary teeth: A systematic review
and meta-analysis. Japanese Dental Science Review. 2022 Nov 1;58:286-97.
Modification of stainless steel crown
i) Facial cut out Stainless steel crowns:

ii) Resin Veneered Stainless steel crowns:

59
Facial cut out Stainless steel crowns:

• Placement of composite material in a labial

fenestration of Stainless steel crowns.
• The esthetics is fair
• Economical, most durable, easy to use

60
 Roberts C et al conducted the first study on resin-
faced stainless steel crowns used for restoring
primary anterior teeth and described the clinical
performance of these crowns.
Stainless steel crowns have high rate of retention
and there was high prevalence of one third of the
facing failure which occurred most commonly at
resin-resin and resin-metal interface.

Robert C, Lee JY, Wright JT. Clinical Evaluation Of and Parental Satisfaction With Resin-Faced
63
Stainless Steel Crown. Pediatr Dent. 2001;23:28-31
Resin Veneered Stainless steel crowns

• Developed to serve as a convenient, durable, reliable, and esthetic

solution
• The resistance to fracture and attrition is good in pre veneered
stainless steel crowns.
• Disadvantage - resin shades give an artificial look.
• Placement of PVSSC is also technique sensitive as they rely on luting
of the cement and crimping of gingival margins.

64
Zirconia crowns
in Pediatric
dentistry

68
EZ -Pedo

69
 PREFABRICATED ZIRCONIA
CROWNS:

First introduced in 2008,

Prefabricated zirconia crowns

were commonly

manufactured by two

companies, namely, Tuff Kid

70
Waggoner WF. Zirconia primary crowns. Critiques in Pediatric dentistry. July 2013 .
 Made of yttrium-stabilized zirconium and are either milled or

injection molded.

 Offers many benefits: far greater flexural strength than that of a

natural tooth.

Waggoner WF. Zirconia primary crowns. Critiques in Pediatric dentistry. July 2013 . 71
 Suits the
Biocompatible esthetic
needs of the
patient.

Benefits
Patients
Reduces allergic to
hypersensitivity metal
Resemble
natural tooth
enamel
"Zirconia in Dentistry", [Online] Available from: https://www.ddslab.com/zirconia-in-dentistry/, 2020. 72
 Has
High cost Abrasive
effect

Demerits
Less potential Limited
to alter the translucency
shape of the
crown Increased
tooth
reduction
"Zirconia in Dentistry", [Online] Available from: https://www.ddslab.com/zirconia-in-dentistry/, 2020. 73
 Indications of Prefabricated Crowns:
Aesthetics

Masking of discoloration of underlying tooth structure.

Nickel sensitive patients

Restoration of grossly mutilated primary tooth

Following endodontic treatment

Restoration of teeth with Developmental defects

Curzon MEJ; Roberts JF; Kennedy DB. Kennedy's paediatric operative dentistry. 4th edition. Oxford; Boston : Wright,74 1996.
Contraindications/ Limitations of Prefabricated Crowns :

Primary tooth close to exfoliation / Non Restorable tooth

Uncooperative Children

Patients with severe bruxism

Crowding of anterior teeth

Curzon MEJ; Roberts JF; Kennedy DB. Kennedy's paediatric operative dentistry. 4th edition. Oxford; Boston : Wright,75 1996.
 Zirconia crowns - gingiva friendly?

Biocompatibility and reduced plaque accumulation due to the

polished surface of zirconia crowns are considered to be the
reason behind lesser gingival inflammation, when compared to
veneered stainless-steel crowns 76

Holsinger, D.M. et al., Clinical Evaluation and Parental Satisfaction with Pediatric Zirconia Anterior Crowns. Pediatric Dentistry,
2016. 38 (3): p. 192-7
 Zirconia crowns as compared to SSCs
performed better regarding gingival
response to the material of restoration and
plaque retention despite of its cost.

Abdulhadi BS, Abdullah MM, Alaki SM, Alamoudi NM, Attar MH. Clinical evaluation between zirconia crowns and stainless
77
steel crowns in primary molars teeth. J Pediatr Dent 2017;5:21-7
 Zirconia crowns have been proved with
better results than other crowns in terms of
gingival and periodontal health, esthetics,
and crown fractures.

78
: Ajayakumar LP, Chowdhary N, Reddy VR, et al. Use of Restorative Full Crowns Made with Zirconia in Children: A Systematic Review. Int J Clin Pediatr Dent 2020;13(5):551–558.
ARMAMENTARIUM

79
 Armamentarium for tooth preparation:

 Rubber dam kit

 Coarse grit wheel diamond bur

 Football-shaped diamond(#379/HS-23/ HL-4.2)

 Flame shaped diamond bur

NuSmile. Product Profile: NuSmile ZR Zirconia Pediatric Crown System. The journal of multidisciplinary care. Decisions in dentistry.
80
Sept 2016.
  Narrow, thin, tapered diamonds bur

 Finishing stones and carbides

81
NuSmile. Product Profile: NuSmile ZR Zirconia Pediatric Crown System. The journal of multidisciplinary care. Decisions in dentistry. Sept 2016.
 Armamentarium for cementation of the crown and finishing:

• Luting cement

• Sodium hypochlorite

• Ultrafine diamond burs

• Diamond-impregnated silicone cups and points.

82
RESTORATION OF THE INVOLVED TOOTH /
GROSSLY MUTILATED TOOTH

83
More than 1/2 of the tooth Less than ½ of the tooth
structure is available structure is available

84
• Occlusal Evaluation and Crown selection

85
Administration of local anaesthesia and isolation

86
Prefabricated Crowns tooth preparation
87
 Incisal reduction: 1.5-2mm

Occlusal reduction: 1-1.5mm

88
“Kids-e-dental crowns” [Online] Available from: http://kids-e-dental.com/Content/downloads/Kids-e-Crown%20Brochure.pdf
89
90
 Greater amount of circumferential
tooth reduction than for traditional
SSC’s.

Proximal reduction: adequate to allow

the selected crown to fit passively

Circumferential reduction:
approximately 20-30%, or 0.5-
1.25mm as necessary

91
92
Feather-edge so that no undercuts
or subgingival ledges remain

Subgingival reduction:
1-2mm

All surfaces of the prepared tooth

are slightly rounded.

Sufficient occlusal clearance with

the opposing teeth 93
94
95
 Preoperative

Postoperative

PREFABRICATED 51,52, 61,62

96
Preoperative Postoperative

PREFABRICATED 74,
84
97
Cementation of
Zirconia
Crowns
A dry field is extremely difficult to maintain.

Zirconia crowns must fit passively, as opposed to

stainless-steel crowns, which have a more retentive fit

When preparing teeth to fit these prefabricated

crowns, clinicians may encounter varying degrees of
thickness

99
 Packable glass ionomer was far more retentive than the bio-active cement

when used for cementation of zirconia pediatric crowns, while the choice of

luting cement had no significant effect on the gingival condition around the

crowns.
Azab MM, Moheb DM, El Shahawy OI, Rashed MA. Influence of luting cement on the clinical outcomes of Zirconia pediatric
crowns: A 3-year split-mouth randomized controlled trial. Int J Paediatr Dent. 2020 May;30(3):314-322.  100
 Bio Cem
A two-paste system with auto-mix tip option.
BioCem’s hydrophilic nature allows cementation without 
having to achieve perfect isolation
Enables the formation of hydroxyapatite within 24 hours
while releasing beneficial calcium, phosphate and fluoride
ions into the oral environment. 
Provides Unique Dual Cure – Flash/Self set Technology.

101
Clean saliva, blood or debris
and achieve hemostasis

102
Seat centrals first followed by laterals
and hold crowns firmly in place until
cement self-sets or is light cured.
Clean up.

103
 NuSmile ZR Crowns Kinder Crowns

Manufacturing Orthodontic technologies, Mayclin Dental

company USA Studios;
Minneapolis, USA
Shades available 2 shades 2Shades (Pedo 1 &
(Light/A1 & Extra light Pedo2)
/A2)
Sizes available 7 sizes (0-6) 6 sizes for Ant.
(1-6)
12 sizes for post.
(1.5,2,2.5,3,3.5,4,4.5,
5,5.5,6,6.5,7)

Retentive Dependent on choice of Mechanical retention

features cement and tooth threads or bands on
preparation intaglio

Availability of Yes No
Try - in crows

Cost per crown INR 2200/- INR 1400-1500/-

104
 Signature Kids-e-Dental
Crowns Crowns
Manufacturing Peacock Dental Kids-e-denal Ll;
company Studios;Gujarat Mumbai, India
India
Shades available 1 shades 1shade (A1)
(B2)

Sizes available 4 sizes for Ant. 6 sizes for Ant.

(1-4) (0-5
6 sizes for Post. 8 sizes for post.
(1-6) (2,3n,3,4n,4,5n,5,6)

Retentive Mechanical Retentive micromechanical

features interlocking Boxes and sandblasted
inner surface of crowns

Availability of No No
Try - in crows

Cost per crown INR 1350/- INR 1500/-

105
 Zirconia crowns showed the highest fracture resistance with NuSmile

zirconia crowns to being able to resist fracture even under intense

pressure of load compared to other commercially available zirconia

crowns.

Al Shobber MZ, Alkhadra TA. Fracture resistance of different primary anterior esthetic crowns. Saudi Dent J. 2017;29(4):179-
184. 106
Advantage of zirconia crowns:
• High strength and toughness
• Can withstand wear and tear
• Translucent sufficient to be
comparable to natural teeth
• No metal fuse
• Modifiable size, shape and color
• Biocompatible

107
Disadvantages-
• Abrasive effect
on tooth
• High cost

108
Accidental ingestion
of prefabricated
zirconia crowns

Fracture of
prefabricated zirconia
crowns
 Two major preventive measures to minimize the
occurrence of swallowed foreign objects are the proper
use of rubber dam and oral packing.

Srivastava N, Pandit I, Nikhil V, Gugnani, N. (2009). Accidental Swallowing of a Hypodermic Needle. International journal of
clinical pediatric dentistry. 110
Trendelenburg position

111
 DISINFECTION OF CROWNS

 Cold sterilization/Chemical disinfection

 Autoclave

 Steam sterilization

112
 • Holsinger DM et al did a study to evaluate
the clinical success and parental satisfaction
with anterior pediatric zirconia crowns.
• Zirconia crowns are clinically acceptable
restorations in the primary maxillary
anterior dentition. Parental satisfaction with
zirconia crowns is high.

Holsinger DM, Wells MH, Scarbecz M, Donaldson M. Clinical Evaluation and Parental
Satisfaction with Pediatric Zirconia Anterior Crowns. Pediatr Dent. 2016;38(3):192-7.
113
Mathew, M.G., Samuel, S.R., Soni, A.J. et al. Evaluation of adhesion of Streptococcus mutans, plaque accumulation on zirconia and stainless steel
crowns, and surrounding gingival inflammation in primary molars: randomized controlled trial. Clin Oral Invest (2020).
 Aim :to evaluate and compare the
clinical success, parental satisfaction,
and child satisfaction of stainless steel
and zirconia crowns in primary molars.

Results: Clinical success for stainless steel crowns and zirconia crowns were similar with no statistical
difference between them. Zirconia accumulated less plaque than stainless steel crowns (P = 0.047). The
parental satisfaction was high with both crowns. A highly significant statistical difference existed between
the 2 groups in relation to the acceptance of color (P < 0.001) and child's satisfaction (P < 0.001).

Conclusion :Zirconia can be

considered as an esthetic
alternative in the future.

Mathew MG, Roopa KB, Soni AJ, Khan MM, Kauser A. Evaluation of Clinical Success, Parental and Child Satisfaction of Stainless
Steel Crowns and Zirconia Crowns in Primary Molars. J Family Med Prim Care. 2020;9(3):1418-1423. Published 2020 Mar 26.
doi:10.4103/jfmpc.jfmpc_1006_19
 To compare the opinions of children aged 5-8 years to
have an opinion regarding the changes in appearance of
their teeth due to dental caries and the materials used to
restore those teeth.
It was concluded that children in their sixth year of life
are capable of appreciating the esthetics of the
restorations for their anterior teeth.
Zirconia crowns appeared to be the most acceptable full
coverage restoration for primary anterior teeth among
both children and their parents.

Pani SC, Saffan AA, AlHobail S, Bin Salem F, AlFuraih A, AlTamimi M. Esthetic Concerns and
Acceptability of Treatment Modalities in Primary Teeth: A Comparison between Children and
116
Their Parents. Int J Dent. 2016.
 Strip Crowns
Acid etch resin crowns or Celluloid crowns serve as
one of the most esthetic restorations for the pediatric
dentist to restore decayed primary anterior teeth.

Introduced in 1979 by Webber et al.

 The crown automatically Leaves a smooth
contours the restorative
material.
and polished
surface.

 Crowns are esthetically better.

Kupietzky A, Waggoner WF, Galea J. The clinical and radiographic success of bonded resin composite strip crowns for primary incisors. Pediatr
 Available in 16 different sizes.
The crown forms are made only for primary upper left
and right central and lateral incisors and for each of
these teeth, they come in four different sizes.
 Kupietzky A et al stated following advantages of strip crowns:

i. They are simple to fit and trim.

ii. The removal is fast and easy.
iii. Easily matches natural dentition.
iv. They leave smooth shiny surface.
v. They have easy shade control with composite.
vi. They are superior esthetically, functionally and
economically.
vii. They are crystal clear and thin.
viii. They are easy to repair.

Kupietzky A Bonded Resin Composite Strip Crowns For Primary Incisors: Clinical Tips For
Successful Outcome. Pediatr Dent. 2002;24:145-8. 121
Disadvantage

• Technique sensitive option

• Moisture contamination with blood or saliva
interferes with the bond
• Haemorrhage can alter the shade or colour of the
material.

Ram D, Fuks AB, Eidelman E, et al. Long-Term Clinical Performance of Esthetic Primary Molar
Crowns. Pediatr Dent. 2003;25:582-4. 122
 3M ESPE

KIT COST – 18966

120 crowns in a kit
• Strip Crowns performed well for restoring primary incisors with
large or multisurface caries for periods of over 3 years.
• Strip Crowns are indicated as an excellent treatment choice for
carious primary incisors with adequate tooth structure after
caries removal, especially if esthetic concerns predominate.

Kupietzky A, Waggoner WF, Galea J. Long-term photographic and radiographic assessment of bonded resin composite
strip crowns for primary incisors: results after 3 years. Pediatric dentistry. 2005 May 1;27(3):221-5.
 Zirconia crowns were found more successful than strip
crowns for the rehabilitation of caries affected primary 
incisors.

Sharma M, Khatri A, Kalra N, Tyagi R. Evaluation and comparison of strip crowns and primary anterior
zirconia crowns in 3–5 years old children at one year. Pediatric Dental Journal. 2021 Aug 1;31(2):136-
44.
Many restorative options exist for treating primary anterior
teeth. The choice of restorative technique depends upon
the operator preferences, esthetic demands by the parents
and child’s behaviour that affect the ultimate outcome of
which ever restorative material chosen.
CONCLUSIO
N
 Conclusion
Many options exist to repair carious teeth in pediatric
patients, from stainless steel crowns to its various
modifications to other esthetic crowns like strip crowns and
zirconia crowns which are rising in their popularity.
Esthetics has become a respectable concept in
dentistry today.

Impact of esthetics should always be considered in

treatment plan as it has vital role in child's overall
general health and psychological well being.

129
• Pani SC, Saffan AA, AlHobail S, Bin Salem F, AlFuraih A, AlTamimi M. Esthetic Concerns and Acceptability of
Treatment Modalities in Primary Teeth: A Comparison between Children and Their Parents. Int J Dent. 2016.
• Sahana S, Vasa AAK, Sk Ravichandra. Esthetic Crowns For Anterior Teeth: A Review. Annals and Essence of
Dentistry. 2010-2:87-93.
• Holsinger DM, Wells MH, Scarbecz M, Donaldson M. Clinical Evaluation and Parental Satisfaction with
Pediatric Zirconia Anterior Crowns. Pediatr Dent. 2016;38(3):192-7
• Clark L, Martha H, Harris EF, Lou J. Pediatr Dent 2016;38(l):42-6.
• Ram et al. Esthetic primary molar crowns. Pediatric Dentistry – 25:6, 2003
• Robert C, Lee JY, Wright JT. Clinical Evaluation Of and Parental Satisfaction With Resin-Faced Stainless
Steel Crown. Pediatr Dent. 2001;23:28-31
• Guelmann M, Gehring DF, Turner C. Retention of veneered stainless steel crowns on replicated typodont
primary incisors: an in vitro study. Pediatr Dent 2003;25:275-8.