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Pediatric Dentistry Restorative Dentistry

How can you restore teeth with minimal invasive restorations?

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This summary is adapted from the article published in the Dental Clinics of North America: Restorative Dentistry for Children (January 2013)

Indications of dental restorative materials

Glass ionomer cement/Resin-based glass ionomer cement

  • Occlusal restorations: their compressive strengths offer adequate wear properties for posterior primary dentition. Also, when there is a difficulty in isolating the tooth to keep it sufficiently dry to place a resin-based composite restoration.
  • Class II restorations: no need to acid-etch tooth structure before placing the restoration. The glass ionomer chemical reaction will take place with mild saliva contamination. Also beneficial in cases where tooth isolation is difficult and speed is critical.
  • Class III restorations: when a perfect isolation for resin-based composite restoration is not possible.
  • Class IV restorations: successful in primary dentition and when a good isolation of the tooth is difficult/not possible for a resin-based composite restoration.

 Resin-based composite

  • Occlusal restorations: when tooth can be sufficiently isolated. There are also benefits in terms of the wear and strengths of the resin-based composite restorations.
  • Class II restorations: for restorations that do not exceed the line angles of the tooth or approximately one half the intercuspal distance.
  • Class III restorations: good for anterior teeth that are easily isolated.
  • Class IV restorations: good for primary and permanent dentitions. In permanent anterior dentition, these have been considered as esthetic and effective restorations.
  • Class V restorations: good for primary and permanent dentition and when tooth isolation is achieved to avoid the contamination of the acid-etched preparations during the restoration procedure.
  • Strip crown restorations: good for the restorations of multiple-surface carious primary incisors with adequate tooth structure and healthy gingiva.

Stainless-steel crowns

  • Anterior Aesthetic Stainless-Steel Crowns: good in cases of severe caries, minimal tooth structure due to trauma, difficulty isolating the tooth, and high-risk for caries development. Tooth isolation is not necessary and placement is easier than with resin-based composite. They can be adjusted to obtain a well-adapted fit to tooth strucure. 
  • Posterior Stainless-Steel Crowns: good in cases of difficulty isolating the tooth, long-terms use, high-caries risk, and in posterior tooth restorations that require general anesthesia.

 

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