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STRIP CROWNS FOR LEIGH
By Eyal Simchi, D.M.D.
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Figure 1: Child presents with failed composite restorations and rampant caries.
Figure 2: Strip crowns are trimmed and pre-fitted. (Taken from a different case.)
Figure 3: Shows prepared Figure 4: Finished case. No maxillary anteriors. (Taken from anesthesia, no tears
a different case.)
The AAPD recommends establishing a dental home by age one so that children get accustomed to seeing a dentist and their parents can be educated about hygiene and prevention.
Leigh was 3 years old when he first came to my office with failed restorations and rampant caries (Figure 1). Both he and his mother had developed severe dental-phobia due to bad experiences in the past.
Leigh needed significant dental work completed quickly and without trauma. My goal was to relieve discomfort, reduce dental disease and secondary decay, and restore function and esthetics, all in one visit.
We have seen the disadvantages of conventional composite strip crowns: degradation of the bond, recurrent decay that may lead to pulpal involvement, and fracture and chipping. A strip crown technique using ACTIVA BioACTIVE-RESTORATIVE requires fewer steps, takes less time, provides a better seal against secondary caries, and provides a more durable and fracture-resistant restoration.
First I trim the strip crowns so they are even with the sulcus (Figure 2). I prep the teeth with a #4 or #6 round bur, slowly removing decay with short light touches. The minimal prep usually does not require anesthetia. I avoid incisal reduction whenever possible and use a very fine diamond to shape and open contacts, if needed. I only work 2-3 seconds at a time and keep a 2×2 gauze under the teeth for children who are uncomfortable with the water spray and suction. Figure 3 shows the prepped teeth.
After applying a self-etching bonding agent, I fill the strip crowns with ACTIVA BioACTIVE-RESTORATIVE, seat the central incisor crowns, light cure, and then the laterals. The strip crowns are easily removed with an explorer, and there is very little finishing required.
This case took less than 20 minutes and looks great (Figure 4). No anesthesia, no tears, and a happy child looking forward to his next visit to the dentist.
PULPDENT Corporation / 800-343-4342 / 617-926-6666 / www.pulpdent.com
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