1. Stainless steel crown

2. Contents : Introduction. Indication of stainless steel crown (s.s.c.).
Risk of s.s.c.
Technique.
Errors.

3. Introduction:
Chrome steel crown introduced in 1947 by the Rocky Mountain Company and popularized by Humphrey in 1950.
Stainless steel is composed of iron, chromium, nickel, manganese and other metals.
The ‘stainless steel’ is used when the chromium content exceeds 11%.

4. Indication of s.s.c. : Following pulpotomy/ pulpectomy.
For teeth with developmental defects. Eg. Amelogenesis imperfecta.
Large carious lesions involving multiple surfaces.
Teeth with extensive wear.
Temporary restoration for permanent teeth.
Abutment for space maintainer.
For patients with high caries susceptibility.

5. Risk of S.S.Crown : 1-Aesthetically Unpleasing :
-The recently introduced post. S.S.C. with a tooth colored veneer applied over the metal has been showed to fracture and chip within days of cementation.
2-Periodontal Problems :
-In primary molars and incisors gingival inflammation may arise with improperly adapted crowns.
-In permanent molars periodontal pocket depth may increase and bone loss can occur on improperly adapted crowns.

6. 3- Patients with Nickel Allergies: -Placement of S. S
3- Patients with Nickel Allergies: -Placement of S.S.C on these patients cause a localized or systemic allergic reaction. 4- Teeth are close to exfoliation time.

7. Advantages of S.S.C. over amalgam restoration:
1-Less chair time.
2-Protection of tooth from further decay.
3-Resistance to tarnish.
4- Absence of mercury.
5-Most durable.
6-Maintenance of morphologic form to preserve the health of gingival tissues.
7-The ability to regain vertical dimension and retain occlusion.
8-The ability to preserve arch length.

8. Technique : Clinical procedures for 1ry and permanent molars.
1- Crown Selection:
-Select the smallest crown that completely covers the preparation. Adequate mesio-distal width and proper occlusal height, best done by divider.
2-Tooth Preparation:
-anesthetize place rubber dam.
- Reduce occlusion 1-2 mm. select a tapered fissure bur.
- Slice mesial and distal surfaces of molars just below the contact area using tapered diamond stone.

9. Contouring and Adapting Crown:
- Round line angles and remove large buccal bulges on 1st 1ry. molars.
Contouring and Adapting Crown:
-After a proper crown is selected, place on prepared tooth from lingual to buccal and seat completely.
-Use pliers to contour buccal and lingual surfaces of the crown.
-Again try crown on by seating in lingual to buccal direction. Crown should snap into the correct position.

10. - Check occlusion.
- In order to remove the crown, a large spoon excavator can be used to dislodge the crown off the tooth.
3-Cementation:
S.S.C. are not a tight fit except at the margin.
Cement volume should be seen to flow out from the margins. Excess cement is removed with a scaler and dental floss interproximal.
Several types of cement may be used to cement S.S.C.
Eg, Zinc phosphate cement or Glass ionomer cement.

11. Most common errors in using S.S.C. :
1-Unnecessary destruction of hard tissue in preparation.
2-Failure to round all lines angles which may prevent correct seating of the crown.
3-Over seat due to excessive reduction of the tooth.
4-Ledges on the preparation which prevent crown seating crown rotate.
5-Crown may tend to rotate when wrong size is selected.
6-Over reduced tooth S.S.C. tipping.

12. Causes of S.S.C. failure : 1.Open margin. 2.Excess cement.
3.Plaque accumulation.
4.Crown tilting.
5.Perforation.
6.Pulp necrosis.
7.Inproper contact space loss gingivitis around the crown.
8.Insufficient retention loss of crown excessive occlusal wear.

19. Thank you for your attention