Indications for use

• Class 3 and 4 caries where amalgam and composite fillings would likely fail due to primary tooth morphology and large pulp chamber.
• Large, multisurface caries compromising overall tooth structure.
• Following pulpotomy/pulpectomy procedures.
• Developmental defects that cause sensitivity and predispose the teeth to damage from caries such as amelogenesis and dentinogenesis imperfect, and hypocalcification.

Intended Use

Acero ES Stainless Steel Crowns are designed to provide long-term coverage of primary anterior teeth.

• Local anesthesia

  Local anesthesia is generally required and the use of a rubber dam strongly recommended.

• Reduce The Incisal Edge

  Using a tapered fissure bur create a uniform incisal reduction of 1.5 mm. This should reflect the shape of the original tooth

• Reduce mesial and distal proximal surfaces

  • Slice directly through the proximal surface. Starting from the buccal surface, reduce or eliminate the contact without creating a ledge in the proximal space and/or damaging the approximating tooth. Switch to the distal surface and perform the same procedure
  • The margin should be knife edge with no ledges and approximately 1.0 mm subgingival. Little reduction is required for the buccal and lingual surfaces

• Remove all existing caries

• Smooth all line angles

  • When multiple adjacent teeth are being prepared, greater interproximal reduction is required for easier crown placement
  • Through a perio probe or other explorer, slide through the proximal surface to ensure there is no contact

• Round off sharp edges

  Make a final check of the preparation

• Select crown

  • Select the smallest ES/ESL crown that will restore pre-existing proximal contacts
  • Place or seat crown from buccal to lingual
  • Push crown passively over tooth and do not exert force as this may damage the facial resin veneer
  • For added retention, user can crimp the lingual metal margin slightly
  • Check margins for close cervical adaptation extending 1 mm subgingivally

• Crimp and contour

  • Crimping and contouring involves bending the gingival one-third of only the crown’s lingual metal margins inward to establish a tight marginal fit and adaptation
  • DO NOT crimp or contour any portion of the resin veneer as this will cause fracture of the resin from the steel crown

• Cement crown

  • Dry the tooth and crown. Fill the crown approximately two-thirds full with glass ionomer so that excess cement will flow out from the margins preventing any voids. Spray off excess cement with air and water. An explorer can be used to check for and remove any residual cement along with a knotted floss for interproximal areas
  • Seat crown completely

• Remove excess cement

• Rinse and floss interproximal areas

• Check occlusion