Early Childhood Caries (ECC) Other Names: overall or 0.5 – 1.

25 mm on all planes of the

 Baby Bottle Caries tooth.
 Baby Bottle Tooth Decay  Use a fine thin tapered diamond – create a
 Nursing Caries feather edge margin 1-2 mm subgingivally.
 Nursing Bottle Syndrome  Make sure NO subgingival shoulders or ledges
 Milk Bottle Syndrome remain.
 Infant Tooth Decay  FINGER PRESSURE ONLY!!
 NO “SNAP FIT”
White Spots – Early ECC (check pictures)  Load crowns with high performance luting
Moderate ECC (check pictures) cement (Ceramir), Resin Cement, RMGI or GI and
Advanced ECC (check pictures) passively seat crown.
 Tack cure when applicable and begin final clean-
Zirconia Crowns up.
 All Ceramic Crowns
 Fully “WHITE” or Tooth Colored Posterior Stainless Steel Crown Restoration
 PREFABRICATED  Important Factors to be Considered When
Choosing the Restorative Material for the Child
 Ceramic crowns especially designed for children.
Patient.
 These crowns are made of solid ZIRCONIA, a
o Age
biocompatible material that has only been used
o Caries Risk
in high-end, adult cosmetic dentistry.
o Cooperation of the child
 Composed entirely of one solid tooth-colored
material, they look extremely esthetically
Stainless Steel Crown vs. Amalgam
acceptable, both from the front view and on the
(8-year longitudinal clinical study)
inside of the mouth.
 Survival Rate
 Each crown is glazed with a tint of natural color,
o SSC – after 8 years – 80%
making them very smooth, shiny and
o Amalgam – after 1 year – 80%
impermeable to staining.
-After 4-5 years – 40%
(EZ-Pedo Co.)
 Replacement Rate
o SSC – 4 out of 66 crowns had to be
Anterior Zirconia Crowns (Nu-Smile)
replaced.
 Use a fine thin tapered diamond – create a
o Amalgam – 38 out of 66 amalgam
feather edge margin 1-2mm subgingivally.
restorations had to be re-filled.
 Make sure NO subgingival shoulders or ledges
remain.
 Reasons for replacement
 Check fit and alignment. 1. Defects like fractures or marginal splitting.
 Load crowns with high performance luting 2. Occurrence of new lesions or secondary
cement (Ceramir), Resin Cement, RMGI or GI and caries.
passively seat crown.
 Tack cure when applicable and begin final clean- Stainless Steel Crowns
up.  Indications:
o Primary molars requiring large
Zirconia Primary Posterior Crowns (NuSmile ZR Posterior multisurface restoration.
Crowns) o Children with rampant caries
 Case Selection: o Teeth after pulp therapy
o Utilize anytime a standard SSC would be o Teeth with developmental anomalies like
used. those exhibiting hypoplastic anomalies,
o AVOID cases with severe crowding or malformed teeth.
severe mesial-distal space loss. o Fractured primary molars
o Some clinical crown remaining. o As an abutment for space maintainer
o Single crown placement is best for o In children with bruxism
beginning cases. o Restoration of hypoplastic young
 Carefully PREP tooth SUPRAGINGIVALLY to avoid permanent teeth.
tissue MASCERATION. Reduce the tooth 20%
Types of Stainless Steel Crowns
 Pre-Crimped (cervical is trimmed, see pics)
 Pre-Festooned (occlusal portion is
festooned/polished)
 Pre-Crimped and Festooned

Stainless Steel Crown Restoration

 1.0 – 1.5 mm reduction occlusal (see pic)
 1.0 mm subgingival reduction (see pic)
 Trim cervical portion of SSC if there is blanching
of the gingiva.
 If SSC rocks, check occlusal reduction if it is
adequate. If not, reduce more in the occlusal.
 After occlusal reduction, check if there is
blanching again. If there is, repeat cervical
reduction of SSC.
 Crimp the cervical crown margins.
 Load crowns with high performance luting
cement (Ceramir), Resin Cement, RMGI or GI and
passively seat crown.
 Tack cure when applicable and begin final clean-
up.

 Yung iba na nakalagay dito sa SSC, sa picture ko

lang binase. Dun kasi sa ZIRCONIA crowns range
ang binigay niya sa reduction. Pero same lang ata.
Nagkataon lang iba sa picture 
 Correct niyo na lang if may mali THANKS!
 Manarang <3

END OF LECTURE 