On the other hand, others advocated for none to minimal (0.5 to 1 mm) preparation on the vestibular and lingual aspect of the crown, unless pronounced enamel convexity should only be reduced by a small amount. Some authors suggested preparing the buccal and lingual walls to create a gingivally inclined long bevel to make crown placement easier. The reduction of the buccal and lingual mucosa is optional. Reducing the buccal and lingual surfaces is the third step in the preparation. A smooth taper from occlusal to gingival, free of ledges or shoulders, should be achieved. Following the normal proximal contour, proximal slices should slightly converge toward the occlusal and lingual. The mesial and distal contact points should be cleared such that a probe could pass through them. Proximal surfaces are reduced using a 69 L/ tapered fissure bur at high speed to make room for the crown and establish a feather finish line gingivally while avoiding damaging neighboring teeth. If a sufficient amount of occlusal surface has already been lost due to caries, marginal ridges of neighboring teeth can be used as a reference. Occlusal depth guidance grooves could be given for better reduction. The cusps original contour needs to be preserved. Operators can use 69L or 169L bur to reduce 1.5 to 2.0 mm of the occlusal surface. If proximal reduction were to be performed first, diagnosing possible pulp exposure will become difficult due to the gingival bleeding that can occur when preparing the proximal surfaces. The best strategy is to reduce the occlusal surface first while removing caries and reducing the proximal surfaces. Other authors recommended preparing the proximal slices before reducing the occlusal. įull et al. suggested that preparing the occlusal surface first allows for better access to the proximal areas of the tooth. Despite its many advantages, the use of stainless steel crowns is still unpopular among some professionals that see them as difficult to use, even though they are easier to place than intracoronal restorations and have much better long-term outcomes. Scientific evidence favors stainless steel crowns as restoration of choice in young children with high caries risk. In fact, no restorative material has provided the benefits of low cost, reliability, and durability when interim full-coronal coverage is required. Stainless steel crowns have outperformed other materials, such as amalgam and composite, in terms of durability and longevity for more than a half-century. They were introduced into pediatric dentistry in 1947, first described by Engel, and then popularised by Humphrey in 1950. Stainless steel crowns are the most commonly used restorative option for repairing and preserving the remaining tissue of severely damaged and decayed teeth. The treatment of dental caries in the pediatric population is a long-standing issue that involves various challenges, like behavior management and the need for a perdurable treatment that lasts until tooth exfoliation. The care of decayed primary teeth is crucial due to their role in chewing, speaking, and functioning as natural space maintainers in the dental arch. Dental caries is a highly prevalent disease, especially among young children.
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