Preformed pedodontic caps
Introduction
Preformed pedodontic caps are fixed unit prosthetic devices that recreate the shape and function of young temporary and permanent teeth.
1- preformed pedodontic cap (CPP) in stainless steel
A-definition
It is an anatomical crown made of nickel-chromium alloy. It is prefabricated in numerous dimensions corresponding to the mesio-distal diameters of each tooth.
B- Indications
- Carious lesions responsible for very significant coronal deterioration
- Polycaries and high caries risk
- Coronary structural abnormalities
- Coronal fracture
- Bruxism
- As a space maintainer support
- After pulpotomy or pulpectomy of temporary teeth
C- Contraindications
- Close to its fall date
- Whose presence on the arch hinders the development of the underlying germ
- Painful, impossible to cure
- When there are periapical changes
- When the carious lesion destroys the inter-radicular space
D- Principles of implementation
-Only one session is necessary to create and seal a preformed pedodontic cap.
-Before the crown is made, the caries treatment must be carried out and any pulp or endodontic treatment completed.
-The tooth is reconstituted with a permanent stable material, such as amalgam or glass-ionomer, especially if the limits of the cavity are located near, or even under, the gum.
E- Operating protocol
-Initial stage:
Preoperative X-ray;
Checking the occlusion height. Take reference points;
Anesthesia of the tooth and/or mucous membranes;
Measurement of the mesiodistal diameter of the tooth using a caliper.
The tooth is previously restored either with amalgam or with other materials if the limits are supragingival;
-Tooth preparation: “minimal”.
Proximal faces : Slice cut with relief. No cervical shoulder.
Occlusal face Reduction of 1 to 1.5mm.
The vestibular and buccal bulges of the temporary molars will be preserved.
A little beveling may be necessary on the peripheral corners.
-Choice of headdress
It is done according to the space to be reconstructed . This space will be measured between the distal face of the anterior tooth and the mesial face of the posterior tooth.
-Adjusting the headdress
It will be juxtagingival all around and the edges will be carefully rounded with a rubberized grinder.
The riveting of the cervical walls of the cuff is often essential to ensure better retention of the cuff.
-Occlusion: is determined based on the opposing tooth.
-Installation: will be done by tilting from inside to outside. The cap must act as a snap button.
– Sealing: is done with a CVI or zinc orthophosphate for endodontically treated teeth.
– Pulped teeth should receive a protective base over the entire exposed dentin surface.
-Take a control X-ray.
2- composite peripheral caps (strip crowns): Restorations of anterior teeth using transparent molds:
These are crowns with thin transparent walls, serving as a mold for a microhybrid composite restoration. Indicated in cases of baby bottle syndrome or structural anomalies.
The operating protocol is as follows:
3- Steel cap with vestibular facet
These are CPPm on which a porcelain or composite veneer is chemically or mechanically attached. Indicated for temporary anterior teeth
Preparation of the teeth the caps are inserted and sealed
Conclusion
Thanks to the advancement of techniques and materials, it is interesting to look into non-invasive restorative treatments when they are possible, with the aim of tissue preservation and pulp integrity.
Preformed pedodontic caps
Untreated cavities can cause painful abscesses.
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A soft-bristled toothbrush protects enamel and sensitive gums.