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

September 5th, 2021 Andrew Chang

With advances in the restoration of primary teeth, pediatric dentist Dr Diane Tay and orthodontist Dr Andrew Chang talk about white crowns Vrs stainless steel crowns in pediatric patients. This is to also meet parent demand for alternative aesthetic options. Maintaining primary teeth is important 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)
  • 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
  • Pediatric Zirconia crowns are 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).  Colour choices for prefabricated crowns
  • Cons- extensive prep, technique sensitive, more time consuming, cost. Good colour match but are opaque. Areas of severe crowding are not suitable due to more extensive preparations. Cannot adjust shape easily. Less optimal bond strength where isolation is poor.
  • contraindications- severe bruxism 

Cementation:

RMGIC or GIC? 

Tips for dentists interested in trying:

  • take a course 
  • practice, practice, practice 
  • Case Selection Criteria are covered on how to choose your first case 
  • Be careful of back-to-back crowns
  • Ensure excellent haemostasis