Stainless steel crowns are widely used in pediatric dentistry for the restoration of extensively damaged primary teeth, particularly after pulpotomies or pulpectomies.
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Video 🔽 Stainless Steel Crowns: Adaptation and installation - Step by step ... The video that we share teaches us everything related to steel crowns, advantages, disadvantages, and how to select the appropriate crown.One of the most important determinants of their longevity is the quality of the marginal adaptation. A poor fit can result in microleakage, plaque accumulation, and secondary caries. Therefore, understanding proper techniques for crown selection, adjustment, and cementation is essential.
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✅ Crown Selection
Proper sizing is the foundation for good adaptation. The crown should cover the entire tooth without overextending subgingivally. Undersized crowns can cause open margins, while oversized ones may irritate gingival tissues.
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PDF 🔽 Modified Hall technique in hypomineralized molar ... We share the management of severely hypomineralized molars using the modified Hall technique, indicating its advantages, objectives and the step-by-step process.✅ Tooth Preparation
Minimal tooth reduction is recommended: occlusal reduction of 1–1.5 mm and interproximal slicing to ensure passive crown seating. The feather-edge finish line helps avoid overextension and improves marginal fit.
✅ Crown Trimming and Contouring
After selection, the crown’s cervical margin may require trimming with crown scissors. Following trimming, contouring pliers are used to replicate the natural tooth anatomy. Proper contouring improves mechanical retention and ensures marginal adaptation.
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PDF 🔽 Hall technique: Complete information for the treatment of carious primary molars ... The objective of the article is to provide adequate information on the Hall technique, indications, contraindications, disadvantages, and the cost-effectiveness of this procedure.✅ Crimping
Crimping is one of the most critical steps. Using crimping pliers, the cervical third of the crown is adapted to provide a tight seal against the tooth. Correct crimping prevents leakage and enhances retention.
✅ Cementation Technique
Glass ionomer cement is the material of choice due to its fluoride release and biocompatibility. Excess cement must be removed to prevent plaque retention and gingival irritation.
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PDF 🔽 Preformed crowns for decayed primary molar teeth (Review) ... Teeth undergo a constant process of demineralisation (caused by the acids and enzymes produced by cariogenic bacteria in the dental biofilm (plaque)) and remineralisation (from protective factors such as fluoride and salivary components).💬 Discussion
Recent studies emphasize that the marginal adaptation of SSCs directly affects clinical outcomes. Poorly adapted margins increase the risk of gingival inflammation, caries recurrence, and premature failure of the restoration. Conversely, crowns with precise marginal adaptation show excellent long-term survival rates, often lasting until natural exfoliation of the tooth. Advances in pediatric restorative techniques suggest that proper training in trimming, contouring, and crimping is indispensable. Additionally, digital tools for measuring marginal gaps may play a role in future clinical protocols, although conventional methods remain the gold standard.
✍️ Conclusion
Achieving correct marginal adaptation of stainless steel crowns in pediatric dentistry requires attention to detail in every clinical step: proper tooth preparation, careful crown selection, precise trimming and contouring, and effective crimping. When performed correctly, these procedures ensure long-term success, reduced complications, and improved oral health outcomes in children.
📊 Table 1: Clinical Tips for Correct Marginal Adaptation of Stainless Steel Crowns
| Step | Common Errors | Practical Tip |
|---|---|---|
| Crown selection | Oversized or undersized crown | Choose crown that covers the tooth snugly without gingival impingement |
| Tooth preparation | Excessive or insufficient reduction | Perform 1–1.5 mm occlusal reduction with feather-edge finish |
| Trimming and contouring | Sharp, uneven, or rough margins | Trim smoothly and use contouring pliers to replicate natural anatomy |
| Crimping | Loose cervical adaptation | Crimp cervical third firmly for a tight marginal seal |
| Cementation | Excess cement left in sulcus | Use glass ionomer and remove all excess cement before setting |
📚 References
✔ Randall, R. C. (2002). Preformed metal crowns for primary and permanent molar teeth: Review of the literature. Pediatric Dentistry, 24(5), 489–500.
✔ Seale, N. S., & Randall, R. (2015). The use of stainless steel crowns: A systematic literature review. Pediatric Dentistry, 37(2), 145–160.
✔ Chadwick, B. L., & Evans, D. J. (2010). Restoration of primary molars with preformed metal crowns: A literature review. Journal of Dentistry, 38(1), 2–11. https://doi.org/10.1016/j.jdent.2009.09.005
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