Composite Crown

Composite strip crowns, resin dental crowns or peel off crowns are a clear tooth crown-former  that can be used as an aesthetic full coverage tooth restoration in children. Strip crowns are used to facilitate the placement of a direct composite resin restoration. 

Restorations made using strip crowns have excellent aesthetic appearance and high parental satisfaction. They are used to provide a seal against secondary dental caries. They may also be used to restore fractured primary front incisors. 

Strip crowns are thin and transparent. They serve as support for the restorative material during the procedure of tooth restoration in children. The dentist first selects the appropriate size of the crown and fills it with resin composite and bonds it to the prepared tooth.

“The term strip crown” comes from the clinical manipulation of the crown mold. When the crown is light cured, the form (or mold) is peeled off or stripped from the surface of the tooth which leaves behind the new composite restoration of the tooth.

Dental caries is the most prevalent chronic disease that mostly affects upper front teeth in children. This problem is predominantly caused by bottle feeding without oral hygiene. Early childhood caries can affect very young children shortly after the eruption of the first teeth and it can progress and affect other teeth in their order of eruption.

If dental caries are very deep affecting the nerve of the tooth, pulpotomy or pulpectomy will need to be performed prior to placing the strip crown.

Early childhood caries (also known as bottle mouth caries) which is often found in pre-schoolers affect a lot of children in Brisbane. Bottle mouth caries caused by drinking sweet liquids from bottles are the main reason Brisbane parents seek tooth restoration for their children. Because baby tooth structure is relatively small, by the time the dentist finds these caries in the child’s mouth, most of the coronal structure of the tooth is damaged or lost.

Severe decay in a child front teeth usually requires an aesthetic restoration. Paediatric dentists use composite resin strip crowns for the esthetic treatment of carious primary teeth. Strip crowns by 3M can be used for natural-looking restoration of teeth in children. Strip crowns are usually effective, simple and quick.

Compared to stainless steel crowns, composite crowns are more susceptible to fracture. The durability of composite strip crowns over an extended period of time is usually of concern. Based on a research done on children who completed dental treatment under general anaesthesia, the resin composite strip crowns had a failure rate of approximately 50%. On the other hand, some other studies have shown a retention rate of 80% over 2 to 3 years. Alternatives to strip crowns are: zirconia dental crowns which is an aesthetic restoration or stainless which is very durable but not an aesthetic solution (stainless steel dental crowns are made out of metal and are not natural-looking. They have low parental satisfaction but they are durable restorations for primary teeth).

Strip crowns are used as a mold to build highly aesthetic tooth restorations. Generally they also have a high parental satisfaction. The procedure is half-automatic and allows for life-like contouring of the anterior buildup which would otherwise be very time-consuming and tedious for a young impatient child. They are relatively cost-effective and easy to repair. They can also be placed in crowded dentitions. 

With strip crowns a crown form is filled with resin material and bonded to the prepared tooth. An alternative to strip crowns are zirconium dental crowns for children in Brisbane which are rising in popularity between paediatric dentists and parents.

In short, the size of the composite crown-former (the mold) is selected by the dentist. The dentist uses a curved scissor to shape the crown-former. It is then filled with the desired shade of composite and placed gently and positioned accurately onto the prepared tooth and light cured. The former is removed and the margins are polished and the bite is checked. 

The application of the strip crowns are indicated in:

• Teeth with or without pulp therapy that have multi surface carious lesions
• Teeth with developmental defects or trauma that have loss of tooth structure

The application of the strip crowns are contraindicated in:

• In situations where isolation is a challenge due to the age of the child 
• In situations where isolation is challenging due to the behaviour of the child
• In situations where isolation is challenging due to gingival hemorrhage
• They are not suitable for teeth where inadequate tooth structure remains (retention challenge)

The most common reason for a child requiring strip crowns is early childhood caries (ECC). The cause of this condition is multifactorial, but mostly due to prolonged breast/ bottle feeding especially at night. Children with ECC usually present with multiple carious lesions in the upper anterior teeth.

Children are usually active and move around a lot which unfortunately can end up in traumatic dental injuries. Unaesthetic front teeth can produce a negative self-perception for the child. The most common dental injury is a fracture to the front teeth because they are exposed to the environment. Strip crowns may be an option for the aesthetic restoration of the tooth.  Transparent strip crowns may be used as a mold.

Dental caries in children can progress from mild to severe. It starts with a form of white spot lesion which is noticeable on the smooth surfaces of teeth. The enamel, in this stage, is intact but demineralised and if left untreated, the lesion can progress into dentine and then cavitation will appear in the tooth. The crown of the tooth will be damaged and it can lead to inflammation in the dental pulp and subsequently necrosis and sepsis which can be quite painful for the child.

White spots are present when the tooth enamel is demineralised. Enamel demineralisation is the initial stage of caries and treatment at this stage includes:

• Topical application of fluoride
• Change in diet  
• Instructions for proper oral hygiene

Dental crowns can be used for the restoration of teeth in children. Dental crowns can be:

• Stainless Steel Dental Crowns for Kids
• Resin or Composite Strip Dental Crowns for Children
• Pre-veneered Steel Crowns
• Zirconia Dental Crowns for Kids

Stip crowns are entirely made of composite materials and they resemble natural teeth, however, over time, they tend to absorb stains and discolor. These crowns should be maintained properly and kept clean otherwise they can attract plaque on their surface. Resin crowns are, in general, weaker in strength compared to stainless steel crowns and in general they have a higher risk of experiencing fracture or chipping.

Young patients who have had a traumatic dental injury to their front teeth  may need a composite crown to restore the primary or a young permanent incisor.  Placement of composite crowns on these young patient usually requires more time. Therefore putting a dental crown on uncooperative young children is not easy in a normal dental practice and hospital dentistry by a pediatric dentist is often required. 

When cooperation of the child in the dental chair is a challenge, dental treatment for kids under general anaesthesia (GA) can be a beneficial treatment option for the child and it may be recommended by your kids dentist because this procedure requires exceptional cooperation from the child in the dental chair. Cooperation is sometimes challenging for young children.

When left untreated, dental caries can progress from enamel into dentine of the tooth. Dental caries, at this stage, require tooth restoration and options include: dental filling or dental crown.

But if the entire crown of the tooth is damaged by the caries, then tooth extraction is required.