Basic set up: Acero molar kit, Ketac cement, mixing pad, spatula, howe plier, crimpers.

Basic set up: Acero molar kit, Ketac cement, mixing pad, spatula, howe plier, crimpers.

Howe plier used to flatten interproximal surface (if necessary).

Howe plier used to flatten interproximal surface (if necessary).

Crimpers to modify crown margins for snugger fit (if necessary).

Crimpers to modify crown margins for snugger fit (if necessary).

Ketac filled crown ready to be cemented.  

Ketac filled crown ready to be cemented.
 

Optional Steps and Tips

The crown will need trimming if it causes too much gingival blanching. Use curved crown and bridge scissors or an abrasive stone to trim. After trimming, crimp the margins with crimping pliers. The margins can be finished smooth with a heatless stone and rubber wheel.

When restoring a primary second molar in a patient whose permanent first molar hasn’t erupted, ensure that the distal crown margin does not overhang excessively and thus impede the eruption path of the permanent first molar. Use the smallest possible crown with good distal margin adaptation. A post-op bitewing will verify a clear eruption path.

Due to likely interproximal space loss, it can be challenging to fit two crowns side by side when restoring two adjacent molar teeth with significant interproximal caries. More tooth preparation is needed on the mesial and distal surfaces to accommodate for the space loss and allow placement of a smaller crown. After the teeth are prepared, flatten the mesial and distal sides of the crowns with a Howe plier. This way two crowns can be seated in the diminished mesial-distal space.