NuSmile Signature FAQs

What is the difference between the regular size NuSmile Signature crown and short?

Short crowns are manufactured 1mm shorter.

What area of NuSmile Signature Posterior crowns does the tooth colored coating cover?

The buccal and occlusal surfaces of posterior NuSmile Signature crowns are coated with the esthetic material.

Do your NuSmile Signature Crowns come in left & right?

NuSmile Signature Anterior crowns are a universal shape for left and right. The distal point angle can be rounded after the crown is cemented to shape as a right or left side crown.

Do you offer sample NuSmile Signature crowns for interested doctors?

Yes, we will provide a sample of our NuSmile Signature crown which also includes our Technical Guide/IFU and QuickStart guide explaining the product in more detail. Please call NuSmile Customer Service to request a sample.

How do I sterilize NuSmile Signature crowns?

Cold sterilization according to the sterilant manufacturer’s instructions.

Can I steam autoclave the NuSmile Signature crowns?

While this is acceptable, you will see some color change (darkening) of the esthetic coating. We recommend keeping a separate stock box for autoclaved crowns. Many times these darker crowns are suitable for single crown placement situations. Do not chemiclave NuSmile Signature crowns.

Can I shorten a NuSmile Signature crown? If so, how?

Yes, we recommend using our shortening bur to avoid damage to the facing. A flame shaped fine fluted carbide should be used at a low range speed with a water spray to safely circumferentially shorten and feather the gingival margin of NuSmile Signature crowns. NuSmile offers two burs to use: A fine fluted finishing carbide #H48LF-012, used to shorten circumferentially and the gingival margin of the NuSmile Signature crown. A yellow finishing point, composite polisher is used to restore the luster on the NuSmile Signature crown after adjustments or shortening. Many doctors prefer to order a selection of Short NuSmile Signature Anterior crowns to eliminate the need for crown shortening during operatory procedures.

What ADA Code is recommended for NuSmile Signature crowns? Is it the same for both anterior & posterior crowns?

For NuSmile Signature Anterior and Posterior crowns use: D2934 - Prefabricated esthetic coated stainless steel crown-primary tooth. Stainless steel primary crown with exterior esthetic coating.

Can I use a bite stick to seat a NuSmile Signature crown?

No, NuSmile Signature crowns must be seated with finger pressure only. If the crowns will not seat passively, more reduction of the tooth structure is required.

Do you offer canine/cuspid and lower incisor crowns?

Yes, NuSmile Signature Cuspid crowns are available and are universal in shape for maxillary, mandibular, right or left side use. The smaller sized maxillary lateral crowns may be used for lower incisors.

How is gingival response to NuSmile Signature crowns?

With a properly fitted crown, good gingival response is expected within 7-10 days. With reasonable hygiene, good gingival health should remain long-term.

How do NuSmile Signature crowns compare to strip crowns?

NuSmile Signature crowns are less technique sensitive than strip crowns and they offer the same full coverage protection as a SSC (SSC-8% failure; Tate et al, Pediatric Dentistry 2002; 24:69-71). NuSmile Signature crowns take less time to place and are more durable than strip crowns (strip crowns-51% failure; Tate et al, Pediatric Dentistry 2002; 24: 69-71). Of 226 NuSmile Signature Anterior crowns evaluated, 88% resisted coating fracture, 99% resisted coating crazing, 99% were retained to the tooth, 99% were color stable and 91% maintained a good to excellent appearance overtime (Waggoner et al, Pediatric Dentistry 2007; 29:377-381).

What expectation of success should I have over time with NuSmile Signature anterior crowns, posterior crowns, and canine crowns?

With NuSmile Signature crowns you should expect to have a 95% success rate or greater of the coating on anterior crowns and an 85-95% success rate of the coating on posterior crowns. The coating on NuSmile Signature Cuspid crowns are the most susceptible to fracture and wear.

How can I repair a NuSmile Signature crown that has chipped?

For anterior NuSmile Signature crowns, it is highly recommended to replace the crown if a portion of the esthetic coating is displaced or lost rather than attempting to repair the defect. There are a couple of repair techniques that provide adequate results intraorally, but, all are time consuming and tedious. It is probably reasonable to cut a window to repair an occlusal chip or wear area on a posterior crown if you wish. NuSmile will replace at no charge the occasional chipped crown if you will return it to NuSmile after replacement. Before returning a NuSmile crown for replacement please contact NuSmile Customer Service.

Is pulpal therapy needed or required when using NuSmile Signature crowns?

Similar to SSC restorations, pulpal therapy should not be needed for NuSmile Signature crown placement unless dictated by the extent of caries.

Are NuSmile Signature crowns crimpable?

You can crimp slightly on the lingual, but it is very important to avoid a "snap fit" and seat the crown with finger pressure only. All NuSmile Signature crown performance and durability testing and studies have been done without any crimping.

How do I properly cement a NuSmile Signature crown?

For NuSmile Signature crowns use NuSmile BioCem® Universal BioActive Cement or a high quality glass ionomer cement. Completely load the crown with cement so there are no voids. The NuSmile Signature crown should have a passive fit and be held in position until the cement self-sets.

Is there something you can send me that will help me better understand the technique for using NuSmile Signature crowns? Do you have training videos available for your crowns?

Yes, we offer a technical video available on our YouTube Channel that demonstrates preparation and placement procedures (on actual patients), used for achieving the highest degree of success and efficiency when using both anterior and posterior NuSmile Signature crowns. You can access this video titled "NuSmile Signature Anterior Clinical Technique 1" from NuSmile’s YouTube channel at: www.youtube.com/channel/UCAsG3apKAwtgCPNikyXjOSQ With your first order, our DVD "NuSmile Signature Technique Essentials, Mastering Cosmetic Pediatric Crowns" will be sent to you. This DVD is also available on our web store.

Can you provide the research that has been done with NuSmile Signature crowns?

Our website contains information regarding research and studies that have been done with NuSmile Signature crowns. Stainless steel crowns have been used effectively for primary tooth restoration for many years. You can expect the same good results with NuSmile Signature crowns.

Is placing NuSmile Signature crowns the same as placing a SSC?

Similar, however NuSmile Signature crowns require more tooth reduction than for SSCs. NuSmile Signature crowns require about 20% more reduction than a SSC around the entire circumference of the tooth. The occlusal reduction is approximately 1.5mm more than for a SSC. When using NuSmile Signature crowns you will use one or two sizes smaller than for a traditional SSC. If you use the same size as you would for a traditional SSC, the restoration will look bulky and unnatural. Also, the gingival response will be poor overtime if the appropriate size is not used. Always prep the tooth to fit the crown and remember that a "snap fit" is contraindicated for NuSmile Signature crowns.

Is the technique different when placing adjacent and opposing posterior NuSmile Signature crowns compared to seating a single crown?

It’s a little different. You are going to remove approximately 2 mm off the buccal and 2 mm off the occlusal, with greater circumferential reduction as well, to get the crowns to passively seat. In all cases you will be using at least one or two crown sizes smaller than if you were using traditional SSCs. If necessary, you can remove some of the esthetic material in the interproximal/buccal and interproximal/occlusal areas on the crown with a rubber point or wheel to help with seating. You can try using a contralateral upper posterior crown for a lower restoration when there has been mesial-distal space loss. Some doctors will reduce the distal of the deciduous canine a little if necessary.

There is often space loss due to decay in the cases I treat. Can I use NuSmile Signature crowns in these cases?

Yes, but you will always need to use a crown size that fits in the space and prepare the tooth accordingly. It will usually be at least one or two crown sizes smaller than if traditional SSCs were being used, maybe more if there is space loss. This always requires preparation of the tooth to fit the crown. With lower posterior crowns, you might find that an upper contralateral crown may work best. NuSmile Signature Posterior crowns are also available in a size 1 (straight wall).