Discussion on anterior strip crown used in paediatric dentistry.

2. CONTENT
• INTRODUCTION
• DEFINITION
• PURPOSE
• INDICATIONS
• CONTRAINDICATIONS
• TECHNIQUE
• ADVANTAGES
• DISADVANTAGES
• CONCLUSION

3. INTRODUCTION
•ALTHOUGH ADVANCES IN THE APPLICATION OF PREVIOUS
DENTISTRY TECHNIQUES, INCREASED DENTAL
EDUCATION IN PARENTS HAVE REDUCED THE INCIDENCE
OF CARIES IN CHILDREN, THERE IS STILL A HIGH
PREVALENCE OF EARLY CHILDHOOD CARIES ESPECIALLY
IN THE LOWER SOCIOECONOMIC POPULATION.

4. •AESTHETIC TREATMENT OF SEVERELY DECAYED PRIMARY TEETH IS
ONE OF THE GREATEST CHALLENGES TO PEDIATRIC DENTISTS. IN
THE LAST HALF CENTURY THE EMPHASIS ON THE TREATMENT OF
EXTENSIVELY DECAYED PRIMARY TEETH SHIFTED FROM
EXTRACTION TO RESTORATION.
•A HIGHER ESTHETIC STANDARD IS EXPECTED BY PARENTS FOR
RESTORATION OF THEIR CHILDREN’S CARIOUS TEETH. THUS,
THE CHOICE OF FULL COVERAGE RESTORATION FOR PRIMARY
TEETH MUST PROVIDE AN AESTHETIC APPEARANCE IN
ADDITION TO RESTORING FUNCTION & DURABILITY.

5. •THIS PRESENTATION WILL CONCENTRATE ON AESTHETIC FULL
COVERAGE RESTORATION FOR ANTERIOR PRIMARY TEETH.

6. DEFINITION
•ANTERIOR STRIP CROWNS ARE THE RESTORATION OF
CHOICE FOR UPPER OR LOWER ANTERIOR TEETH THAT
HAVE MULTIPLE SURFACE OR LARGE CAVITIES. IT IS A
CLEAR PLASTIC TOOTH FORM THAT IS TRIMMED AND
FILLED WITH COMPOSITE RESIN (TOOTH COLORED
FILLING MATERIAL) TO PROVIDE FULL TOOTH
COVERAGE AFTER CAVITY REMOVAL.

7. PURPOSE
•THE CROWN PROTECTS THE TOOTH OR FILLING WHILE A
PERMANENT CROWN IS MADE FROM ANOTHER MATERIAL.
FOR CHILDREN, A STAINLESS STEEL CROWN IS
COMMONLY USED TO FIT OVER A PRIMARY TOOTH THAT'S
BEEN PREPARED TO FIT IT. THE CROWN COVERS THE
ENTIRE TOOTH AND PROTECTS IT FROM FURTHER DECAY.

9. INDICATIONS
EARLY RESTORATIONS CONSISTED OF PLACEMENT OF STAINLESS
STEEL BANDS OR CROWNS ON SEVERELY DECAYED TEETH.
THE INDICATIONS FOR STRIP CROWNS INCLUDE -
•EXTENSIVE DECAY OF THE PRIMARY ANTERIOR TEETH WHERE
ONLY CONSERVATIVE TREATMENT IS NOT SUFFICIENT
•MULTISURFACE CARIES OF THE PRIMARY ANTERIOR TEETH
•RAMPANT CARIES
•NURSING BOTTLE SYNDROME
• FRACTURED TEETH

10. •TEETH THAT EXHIBIT DISCOLORATION
•MALFORMED TEETH
•AS COVERAGE FOR TEETH THAT HAVE RECEIVED PULP THERAPY .
• DENTAL HYPERPLASIA
•AMELOGENESIS IMPERFECTA
•AESTHETICS

11. Some conditions requiring anterior strip crown

12. CONTRAINDICATIONS
• EXTENSIVE CARIOUS EXPOSURE
• IF THE PRIMARY MOLAR IS CLOSE TO EXFOLIATION WITH MORE THAN
HALF THE ROOT RESORBED OR EXFOLIATION WITHIN 6-12 MONTHS.
• CLINICAL OR RADIOGRAPHICAL EVIDENCE OF RADICULAR PATHOLOGY.
• MORE THAN 2 WEEKS AFTER TRAUMA
• TOOTH EXHIBITS EXCESSIVE MOBILITY.
• PRIMARY POSTERIOR TOOTH

13. • PARTIALLY ERUPTRD TOOTH
• BADLY BROKEN DOWN CROWN
• ESTHETICALLY UNAPPEALING
• WHERE CONSERVATIVE RESTORATION CAN BE PLACED.
• INSUFFICIENT TOOTH STRUCTURE FOR RETENTION
• NEGLECTED MOUTH
• UNCOOPERATIVE PATIENT
• PERIODONTAL DISEASE
• PATIENTS WITH BRUXISM

14. CONDITIONS WHERE WE CAN NOT PLACE ANTERIOR STRIP CROWN

15. TECHNIQUE
•STEP 1. REMOVE DECAY
START BY REMOVING ANY DECAY . PROXIMAL TOOTH REDUCTION
IS NOT NECESSARY UNLESS THERE IS DECAY.

16. •STEP 2: SELECT STRIP CROWN TO MATCH
SIZE OF TOOTH
SELECT THE STRIP CROWN AND PLACE INCISAL
EDGE AGAINST THE TOOTH TO CONFIRM IT IS
THE CORRECT SIZE.

17. • STEP 3: FILL STRIP CROWN WITH RESTORATIVE
MATERIAL
PREPARE TOOTH SURFACE USING YOUR USUAL
ETCHING AND BONDING PROCEDURE. ALLOW
MATERIAL TO BACK FILL THE CAVITY. ALWAYS KEEP
THE TIP SUBMERGED IN THE MATERIAL TO
ELIMINATE VOIDS. SHEERING ACTION OF THE MIX
TIP ELIMINATES AIR BUBBLES.

18. • STEP 4: PLACE A SMALL VENT HOLE
BEFORE SEATING THE STRIP
CROWN
IT IS NECESSARY TO PUT A RELIEF
HOLE IN THE LINGUAL AREA OF THE
STRIP CROWN FOR THE ESCAPE OF
TRAPPED AIR & EXCESS RESTORATIVE
MATERIAL .

19. •STEP 5: CURE AND CLEAN UP
CURE THE MATERIAL ON FACIAL AND LINGUAL SIDES AND REMOVE
THE SEMI-SET EXCESS. THEN CURE FOR 20 SECONDS. REMOVE THE
CROWN FORM FROM THE LINGUAL SIDE WITH AN EXPLORER. TRIM
AND FINISH.

20. PROCEDURE OF PLACING ANTERIOR STRIP CROWN

21. RADIOGRAPH SHOWING ANTERIOR STRIP CROWN

22. ADVANTAGES
• ALLOW THE CONTINUATION OF NORMAL DEVELOPMENT OF TOOTH.
• RETAIN THE NATURAL COLOUR OF TOOTH & TRANSLUCENCY.
•IT PROVIDES SUPERIOR AESTHETICS.
•REQUIRE REMOVAL OF SMALL AMOUNT OF TOOTH STRUCTURE.
•BETTER RETENTION THAN POLYCARBONATE CROWN.
•LEAVES SMOOTH SHINY SURFACE.

24. DISADVANTAGES
•FRACTURE OR DEBONDING.
•TECHNIQUE SENSITIVE .
•ADEQUATE MOISTURE CONTROL MIGHT BE DIFFICULT ON AN
UNCOOPERATIVE PATIENT.
•TIME CONSUMING.
•COSTLY.

25. CONCLUSION
THE BONDED RESIN COMPOSITE STRIP CROWN IS PERHAPS THE MOST
ESTHETIC OF ALL THE RESTORATIONS AVAILABLE TO THE CLINICIAN
FOR THE TREATMENT OF SEVERELY DECAYED PRIMARY INCISORS.IT
WAS EASY TO PERFORM AND BENEFITED THE CHILD IMMEDIATELY.
ALSO PARENTAL SATISFACTION WITH BONDED RESIN COMPOSITE
STRIP CROWNS FOR THE TREATMENT OF PRIMARY INCISORS WITH
LARGE OR MULTI-SURFACE CARIES WERE EXCELLENT.

26. WITH ALL FULL COVERAGE RESTORATIONS PARENTS MUST BE
ADVISED TO INSTITUTE APPROPRIATE PREVENTIVE HEALTH
PRACTICES ( ELIMINATION OF SUGAR CONTAINING DRINKS,
REGULAR TOOTH BRUSHING & TOPICAL FLUORIDE APPLICATION) TO
MAXIMIZE GINGIVAL HEALTH & MINIMIZE THE RECURRENCE OF
CARIES UNDER THE RESTORATIONS.

28. THANK YOU