Stainless steel crowns were introduced to pediatric dentistry by the Rocky Mountain Co. in 1947, and made popular by W. P. Humphrey in 1950. Until then the treatment for grossly decayed primary teeth was extractions. Stainless steel is composed of iron, carbon, chromium, nickel, manganese and other metals. The term stainless steel is used when the chromium contents exceeds 11% (usually a range of 12 to 30%). The chromium oxidizes and forms a protective film of chromium oxide which protects against corrosion. Although, more durable and retentive than amalgam or composite, they are unaesthetic, especially on the anterior teeth. With aesthetics of their child’s smile of extreme importance to parents, many opted for extraction and prosthetic replacement of severely decayed teeth, rather than placement of stainless steel crowns. The advent of composite bonding allowed for a composite facing to be placed on the facial surface of the tooth, thus improving aesthetics. Open-faced stainless steel crowns combine strength, durable and improved aesthetics; however, they are time consuming to place as the composite facing cannot be placed until the stainless steel crown cement sets. Bleeding of the metal margin color surrounding the composite adds a grayish tinge to the tooth that is accentuated next to the white enamel of an adjoining or opposing primary tooth.
The advantages and disadvantages of stainless steel crowns are:
The technique for the fabrication of stainless steel crowns and open-faced crowns is as follows:
Occlusal and buccal views after reduction.