Advantages of SSCs
extremely durableexcellent retentioninexpensiveminimal technique sensitivityoffers full advantage of full coronal coverage
Disadvantages of SSCs
appearance (colour)
Indications of SSCs
primary molars that have undergone pulp therapygrossly broken down teethcervical decalcification (white spot lesions)severe enamel/dental anomalies e.g. AI, DI, ext enamel hypoplasia, vitD resistant ricketschildren at high risk of carieswhen predictability is essential - treating intellectually/medically compromised ptsyoung patients with long anticipated service life of toothfailure of other restorative materials likelyhypoplastic primary molars
Cost effectiveness of SSCs
prevents need for re-treatmentno space loss - may prevent need for orthoreduced likelihood future caries in high risk ptsunder GA use SSCs aggressively to prevent need for future repeat GAs
Restoration Longevity out of SSC, compomer, GIC, composite, amalgam
SSC > compomer > GIC > composite > amalgamclass II amalgams - 2-7 x failure rate of SSCs
Tooth Preparation Steps for SSC
pain control (LA) - both buccal and lingualRD isolation - safety and efficiencyocclusal reduction of 1.5mmcaries removalpulp therapy if requiredcore placement (RMGIC)axial reduction
Periodontal response to SSC
relatively benign despite imperfect marginsplaque adherence is lowrough margins will enhance subgingival plaque accumulation --> gingival inflammation
Resin Veneered SSCs
prone to chippingaestheticpoorer fit due to inability to crimp margins and contour mesiodistallycost issues - need to import
Aim of SSC Preparation Technique
eliminate all dental cariesre-establish proper occlusal contactsre-establish normal MD coronal dimension for arch length maintenancegood periodontal health - emerg. prof., contacts, embrasure formprovide durable restoration with service life > expected retention of primary tooth
SSC in Permanent Dentition - indications in a permanent molar
highly broken downpresence of a developmental defect e.g. amelogenesis imperfecta or MIH (molar incisor hypomineralisation)consider it as an interim restoration until patient has reached ~15yo for definitive prosthetic restorative option