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Advantages of SSCs
- extremely durable
- excellent retention
- inexpensive
- minimal technique sensitivity
- offers full advantage of full coronal coverage
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Disadvantages of SSCs
appearance (colour)
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Indications of SSCs
- primary molars that have undergone pulp therapy
- grossly broken down teeth
- cervical decalcification (white spot lesions)
- severe enamel/dental anomalies e.g. AI, DI, ext enamel hypoplasia, vitD resistant rickets
- children at high risk of caries
- when predictability is essential - treating intellectually/medically compromised pts
- young patients with long anticipated service life of tooth
- failure of other restorative materials likely
- hypoplastic primary molars
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Cost effectiveness of SSCs
- prevents need for re-treatment
- no space loss - may prevent need for ortho
- reduced likelihood future caries in high risk pts
- under GA use SSCs aggressively to prevent need for future repeat GAs
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Restoration Longevity out of SSC, compomer, GIC, composite, amalgam
- SSC > compomer > GIC > composite > amalgam
- class II amalgams - 2-7 x failure rate of SSCs
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Tooth Preparation Steps for SSC
- pain control (LA) - both buccal and lingual
- RD isolation - safety and efficiency
- occlusal reduction of 1.5mm
- caries removal
- pulp therapy if required
- core placement (RMGIC)
- axial reduction
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Periodontal response to SSC
- relatively benign despite imperfect margins
- plaque adherence is low
- rough margins will enhance subgingival plaque accumulation --> gingival inflammation
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Resin Veneered SSCs
- prone to chipping
- aesthetic
- poorer fit due to inability to crimp margins and contour mesiodistally
- cost issues - need to import
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Aim of SSC Preparation Technique
- eliminate all dental caries
- re-establish proper occlusal contacts
- re-establish normal MD coronal dimension for arch length maintenance
- good periodontal health - emerg. prof., contacts, embrasure form
- provide durable restoration with service life > expected retention of primary tooth
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SSC in Permanent Dentition - indications in a permanent molar
- highly broken down
- presence 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
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