White crowns (Zirconia) vs Stainless steel crowns in Pediatric Patients

Sep 4, 2021

Lots of advances in the restoration of primary teeth and important to consider as parents are keen for alternative, aesthetic options. We also know the importance of maintaining primary teeth for function, aesthetics and space maintenance. Crowns provide a full coronal coverage restoration to help preserve form and function. 

 

Reasons and indications for placement of crowns 

 

• following a pulpotomy/pulpectomy
• for teeth with developmental defects (enamel hypomineralisation) or large carious lesions involving multiple surfaces where a normal restoration is likely to fail
• high caries risks patients 
• where longevity of restoration is required 

Types of crowns available and What are zirconia crowns made of

 

 

• Stainless steel crowns, composite crowns, Porcelain fused to metal crowns and Zirconia crowns (Pre-fabricated)
• Zirconia crowns are made from zirconium dioxide, a very durable type of metal that’s related to titanium. They are still classified under ceramic crowns 

 

Pros and cons of zirconia crowns 

 

• Pros- strength and aesthetics. Research shows similar durability and strength as SSC. Can be used in patients with nickel allergy or who require MRIs (where SSC may cast artefacts in the scan).  Ferrule Effect.What colour choices do prefabricated have?
• Cons- extensive prep, technique sensitive, more time consuming, cost. Good colour match but are opaque. Areas of severe crowding? Cannot adjust shape easily. Bond strength where isolation poor?
• contraindications- severe bruxism, 

Cementation:

• RMGIC or GIC? 

 

Some tips for dentists interested in trying:

 

• take a course 
• practice, practice, practice 
• choose your first case carefully 
• Be careful of back-to-back crowns
• Ensure excellent haemostasis