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PRESENTED BY, 
Shiji margaret 
CRRI
CONTENTS 
•History 
•Introduction 
•Types of crown 
•Types of stainless crown 
•Classification of stainless steel 
crown 
•Indication 
•Objective of stainless steel crown 
•Advantage 
•Disadvantage 
•Composition
•Factors to be considered in pre – 
operative evaluation 
•Clinical procedure 
•Tooth preparation 
•Reduction 
•Method of placing 
•modification 
•complication 
•conclusion 
•reference
HISTORY 
Stainless steel crown was first 
introduced as chrome steel crown by 
william humphrey 
 stainless steel crown were 
introduced to pediatric dentistry by 
rocky mountain company in 1947 
First used in the late 1940s and 
became commonly used in the 1960s
INTRODUCTION 
STAINLESS STEEL CROWN IS A SEMI PERMANENT 
RESTORATION USED IN PRIMARY AND YOUNG 
PERMANENT TEETH. 
STAINLESS STEEL CROWN IS USED IN DECIDUOUS 
DENTITION THAN PERMANENT DENTITION BECAUSE OF 
2 REASONS 
THAT IS DECIDUOUS TEETH CARIES CAN DESTROY 
THE TOOTH FASTER THAN PERMANENT. AND ALSO IN 
DECIDIOUS TOOTH PULP IS LARGER THAN PERMANENT 
AND ENAMEL AND DENTIN THICKNESS IS LESS. 
STAINLESS STEEL CROWN IS AN EFFICIENT AND 
RELIABLE METHOD OF RESTORATION OF DECIDUOUS 
DENTITION.
Types of crowns 
•Stainless steel 
•Nickel chromium 
•Veneered stainless steel crowns 
•Strip crown 
•Ceramic crown
Types of stainless crowns 
Rocky mountain 
Ormco company 
Unitek 
3M company
Classification of stainless steel crowns 
Based on shape 
Untrimmed- crowns are neither 
trimmed nor contoured 
Pretrimmed- crowns have stright 
non-contoured sides but are festooned to 
line parallel to the gingival crest.they still 
require contouring and trimming 
Precontoured – these are 
festooned and precountoured though a 
minimal amount of trimming may be 
necessary
indication 
 extensive decay in primary and young 
permanent tooth
Teeth deformed by developemental 
defects or anomalies 
Teeth with hyperplastic defects
Following plup therapy
As a preventive restoration 
As an abutment 
Temporary restoration of 
a fractured tooth 
In severe cases of bruxism
Single tooth cross bite
For replacing prematurely 
lost anterior teeth
Objectives of using 
To achieve biologically 
compatible , competent for 
mastication and clinically 
acceptable restoration. 
To maintain the form and 
function and where possible the 
vitality of the tooth should be 
maintained.
ADVANTAGES 
Can be used for badly broken 
down crown 
Can be placed with poor isolation 
Economical 
Full coverage-prevents recurrent 
decay 
Acceptable for both patient and 
dentist
disadvantages 
The aesthetics is not fair
composition 
Stainless steel 
crown 
17-19% chromium 
10-13% nickel 
67% iron 
4% minor elements
Nickel base crown 
72% nickel 
14% chromium 
6-10% iron 
0.04% carbon 
0.35% manganese 
0.2% silicon
Factors to be considered in pre-operative 
evaluation 
Dental age of the patient 
Co-peration of the patient 
Motivation of the patient 
Medically compromised/disabled 
children
Clinical procedure 
Evaluate the 
preoperative occlusion 
•Take the alginate impression of 
U/L jaws. 
•Pour the cast with dental stone 
•Note the dental midline and the 
cusp fossa relationship bilaterally
Selection of crown 
•The correct size crown is 
selected by the M-D 
dimensions of the tooth to be 
restored using Boley gauge. 
•To produce steel crown 
margins of similar shape 
examine the contour of 
gingiva of the buccal & 
lingual marginal gingiva.
Tooth preparation 
L.A. should be 
administrated 
Isolation by 
rubber dam or 
cotton rolls 
Remove the 
decay
Reduction 
Occlusal reduction 
A 69L or 169L bur is used to reduce the occlusal 
surface by 1.5-2.0mm .
Stainless Steel Crown
Proximal slices 
place the wooden wedges in the 
inter proximal embrasures, the 69L 
bur is moved B-L across the 
proximal surface.
Buccolingual reduction 
Reduction of buccal and lingual surface 
is minimal 
Round off all the line angles 
It is done by using side of bur
Initial adaptation of crown 
The crown should be of a correct length and its 
margins should be adapted closely to the tooth. 
For shaping the crown margins mark 3 light 
points on the metal at the (mesiolingual, lingual 
and distolingual)and at (mesiobuccal, buccal, 
distobuccal) surfaces at the crest of respective 
marginal gingiva without compressing the 
marginal gingiva. 
Final finished margins are placed 
approximately 1mm below these marks.
Seating the crown 
Now the crown is tried on the 
preparation by seating the lingual 
first and applying pressure in a 
buccal direction so that the crown 
slides over the buccal surface into 
the gingival sulcus. 
Resistance should be felt as the 
crown slips over the buccal bulge.
Crown contouring 
Initial crown 
contouring is 
performed with a114 
plier (ball and socket 
plier) in the middle 
1/3rd of the crown to 
produce belling 
effect 
This will give the 
crown more even 
curvature
This is very important to the 
gingival Health of the 
supporting tissue. 
Using the no.417 crimping 
pliers the crown is crimped in 
the gingival third. 
After completion of crimping 
there will be gradual bend in 
the gingival third of crown. 
The use of crimping is for the 
protection of soft tissues.
Uncrimped v/s crimped
Checking the final adaptation 
of the crown 
The crown should be replaced on the 
preparation after the contouring procedure 
to see that it snaps securely into place. 
The occlusion should be checked at this 
stage to make sure that the crown is not 
opening the bite or causing a shifting of 
mandible into an undesirable relationship 
with opposing teeth.
Finishing and 
polishing 
Accumulation of plaque and 
inflammation of gingiva is 
commonly seen in practice of 
restorative dentistry due to rough 
and unpolished restoration. 
To avoid these complications 
crown should be polished prior t o 
cementation with rubber wheel to 
remove all scratches.
Stainless Steel Crown
Radiographic confirmation of 
the gingival fit 
Before cementation 
a bitewing is taken to 
verify proximal 
marginal integrity
Cementation 
SSC should be cemented 
only on clean dry mouth, 
isolation of teeth with cotton 
roll is recommended. 
Rinse and dry the crown 
inside & out side and prepare 
to cement it. 
A zinc phosphate, 
polycarboxylate or GIC is 
preferred.
Before the cements set ask the 
patient to close into centric occlusion 
by applying pressure through a cotton 
roll and confirm that the occlusion has 
not been altered.
Remove the excess 
cement by an explorer or 
scaler & for interproximal 
area can be cleaned by 
passing dental floss 
through them.
result
Confirm occlusion
Stainless steel crown modifications 
In 1971, Mink & Hill report several way 
of modifying the stainless steel crown 
when they are either too large or too 
small 
1. Undersize tooth or the oversize 
crown. 
2. Oversize tooth or undersize crown. 
3. Deep subgingival caries. 
4. Open contact. 
5. Open-faced stainless steel crown.
 Interproximal 
ledge. 
 Crown tilt. 
 Poor margins. 
 Inhalation or 
ingestion of crown
conclusion 
The stainless steel crown is in 
the superior durability and 
longevity to class II amalgam 
in primary teeth
reference 
Dentistry for the child and adolescent 9th 
edition , McDonald 
Text book of pediatric dentistry 3rd edition, S.G 
damle 
Principles and practice of pedodontics 2nd 
edition , arathi rao 
Text book of pediatric dentistry 2nd edition, 
nikhil marwah 
Text book of pedodontics 2nd edition 
shoba tandon
Hand book of pediatric dentistry , 3rd 
edition, angus c cameron and richard p 
widmer 
Clinical pedodontics , 4th edition, finn 
Fundamentals of pediatric dentistry, 3rd 
edition, richard j mathewson and robert e 
primosch 
Pediatric dentistry principles and practice, 
MS muthu and N sivakumar

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Stainless Steel Crown

  • 1. PRESENTED BY, Shiji margaret CRRI
  • 2. CONTENTS •History •Introduction •Types of crown •Types of stainless crown •Classification of stainless steel crown •Indication •Objective of stainless steel crown •Advantage •Disadvantage •Composition
  • 3. •Factors to be considered in pre – operative evaluation •Clinical procedure •Tooth preparation •Reduction •Method of placing •modification •complication •conclusion •reference
  • 4. HISTORY Stainless steel crown was first introduced as chrome steel crown by william humphrey  stainless steel crown were introduced to pediatric dentistry by rocky mountain company in 1947 First used in the late 1940s and became commonly used in the 1960s
  • 5. INTRODUCTION STAINLESS STEEL CROWN IS A SEMI PERMANENT RESTORATION USED IN PRIMARY AND YOUNG PERMANENT TEETH. STAINLESS STEEL CROWN IS USED IN DECIDUOUS DENTITION THAN PERMANENT DENTITION BECAUSE OF 2 REASONS THAT IS DECIDUOUS TEETH CARIES CAN DESTROY THE TOOTH FASTER THAN PERMANENT. AND ALSO IN DECIDIOUS TOOTH PULP IS LARGER THAN PERMANENT AND ENAMEL AND DENTIN THICKNESS IS LESS. STAINLESS STEEL CROWN IS AN EFFICIENT AND RELIABLE METHOD OF RESTORATION OF DECIDUOUS DENTITION.
  • 6. Types of crowns •Stainless steel •Nickel chromium •Veneered stainless steel crowns •Strip crown •Ceramic crown
  • 7. Types of stainless crowns Rocky mountain Ormco company Unitek 3M company
  • 8. Classification of stainless steel crowns Based on shape Untrimmed- crowns are neither trimmed nor contoured Pretrimmed- crowns have stright non-contoured sides but are festooned to line parallel to the gingival crest.they still require contouring and trimming Precontoured – these are festooned and precountoured though a minimal amount of trimming may be necessary
  • 9. indication  extensive decay in primary and young permanent tooth
  • 10. Teeth deformed by developemental defects or anomalies Teeth with hyperplastic defects
  • 12. As a preventive restoration As an abutment Temporary restoration of a fractured tooth In severe cases of bruxism
  • 14. For replacing prematurely lost anterior teeth
  • 15. Objectives of using To achieve biologically compatible , competent for mastication and clinically acceptable restoration. To maintain the form and function and where possible the vitality of the tooth should be maintained.
  • 16. ADVANTAGES Can be used for badly broken down crown Can be placed with poor isolation Economical Full coverage-prevents recurrent decay Acceptable for both patient and dentist
  • 18. composition Stainless steel crown 17-19% chromium 10-13% nickel 67% iron 4% minor elements
  • 19. Nickel base crown 72% nickel 14% chromium 6-10% iron 0.04% carbon 0.35% manganese 0.2% silicon
  • 20. Factors to be considered in pre-operative evaluation Dental age of the patient Co-peration of the patient Motivation of the patient Medically compromised/disabled children
  • 21. Clinical procedure Evaluate the preoperative occlusion •Take the alginate impression of U/L jaws. •Pour the cast with dental stone •Note the dental midline and the cusp fossa relationship bilaterally
  • 22. Selection of crown •The correct size crown is selected by the M-D dimensions of the tooth to be restored using Boley gauge. •To produce steel crown margins of similar shape examine the contour of gingiva of the buccal & lingual marginal gingiva.
  • 23. Tooth preparation L.A. should be administrated Isolation by rubber dam or cotton rolls Remove the decay
  • 24. Reduction Occlusal reduction A 69L or 169L bur is used to reduce the occlusal surface by 1.5-2.0mm .
  • 26. Proximal slices place the wooden wedges in the inter proximal embrasures, the 69L bur is moved B-L across the proximal surface.
  • 27. Buccolingual reduction Reduction of buccal and lingual surface is minimal Round off all the line angles It is done by using side of bur
  • 28. Initial adaptation of crown The crown should be of a correct length and its margins should be adapted closely to the tooth. For shaping the crown margins mark 3 light points on the metal at the (mesiolingual, lingual and distolingual)and at (mesiobuccal, buccal, distobuccal) surfaces at the crest of respective marginal gingiva without compressing the marginal gingiva. Final finished margins are placed approximately 1mm below these marks.
  • 29. Seating the crown Now the crown is tried on the preparation by seating the lingual first and applying pressure in a buccal direction so that the crown slides over the buccal surface into the gingival sulcus. Resistance should be felt as the crown slips over the buccal bulge.
  • 30. Crown contouring Initial crown contouring is performed with a114 plier (ball and socket plier) in the middle 1/3rd of the crown to produce belling effect This will give the crown more even curvature
  • 31. This is very important to the gingival Health of the supporting tissue. Using the no.417 crimping pliers the crown is crimped in the gingival third. After completion of crimping there will be gradual bend in the gingival third of crown. The use of crimping is for the protection of soft tissues.
  • 33. Checking the final adaptation of the crown The crown should be replaced on the preparation after the contouring procedure to see that it snaps securely into place. The occlusion should be checked at this stage to make sure that the crown is not opening the bite or causing a shifting of mandible into an undesirable relationship with opposing teeth.
  • 34. Finishing and polishing Accumulation of plaque and inflammation of gingiva is commonly seen in practice of restorative dentistry due to rough and unpolished restoration. To avoid these complications crown should be polished prior t o cementation with rubber wheel to remove all scratches.
  • 36. Radiographic confirmation of the gingival fit Before cementation a bitewing is taken to verify proximal marginal integrity
  • 37. Cementation SSC should be cemented only on clean dry mouth, isolation of teeth with cotton roll is recommended. Rinse and dry the crown inside & out side and prepare to cement it. A zinc phosphate, polycarboxylate or GIC is preferred.
  • 38. Before the cements set ask the patient to close into centric occlusion by applying pressure through a cotton roll and confirm that the occlusion has not been altered.
  • 39. Remove the excess cement by an explorer or scaler & for interproximal area can be cleaned by passing dental floss through them.
  • 42. Stainless steel crown modifications In 1971, Mink & Hill report several way of modifying the stainless steel crown when they are either too large or too small 1. Undersize tooth or the oversize crown. 2. Oversize tooth or undersize crown. 3. Deep subgingival caries. 4. Open contact. 5. Open-faced stainless steel crown.
  • 43.  Interproximal ledge.  Crown tilt.  Poor margins.  Inhalation or ingestion of crown
  • 44. conclusion The stainless steel crown is in the superior durability and longevity to class II amalgam in primary teeth
  • 45. reference Dentistry for the child and adolescent 9th edition , McDonald Text book of pediatric dentistry 3rd edition, S.G damle Principles and practice of pedodontics 2nd edition , arathi rao Text book of pediatric dentistry 2nd edition, nikhil marwah Text book of pedodontics 2nd edition shoba tandon
  • 46. Hand book of pediatric dentistry , 3rd edition, angus c cameron and richard p widmer Clinical pedodontics , 4th edition, finn Fundamentals of pediatric dentistry, 3rd edition, richard j mathewson and robert e primosch Pediatric dentistry principles and practice, MS muthu and N sivakumar