SSC


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