Restorative Dentistry in The Primary Dentition

10/13/2020 Restorative Dentistry in the Primary Dentition - Decisions in Dentistry
Latest Features Pediatric Dentistry
Restorative Dentistry in the Primary Dentition

Selecting the right material for the right situation will help ensure optimal function,
longterm performance and esthetics.
By Joel H. Berg, DDS, MS and Zheng Xu, DDS, MDS, PhD On Sep 8, 2016
Selecting the right material for the right situation will help ensure optimal function, long-
term performance and esthetics
The practice of dentistry for children requires extensive knowledge and understanding
of restorative materials and techniques. Restorative procedures should be the last
approach in managing caries; unfortunately, is often the rst step. The progressive
philosophy in today’s caries management continuum (Figure 1) is managing bio lm and
demineralization, and taking a proactive therapeutic approach in the early stages of
caries lesion development. The later stages include minimally invasive restoration,
followed by traditional operative dentistry. This paper will discuss various aspects of
restorative dentistry for children, and some common techniques in caring for primary
teeth.
FIGURE 1. Caries Management Continuum
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While early lesions may be detected clinically or radiographically,

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Cookies newer caries
detection tools, only clinicians can synthesize all the information, and make the decision to
restore the tooth. Prior to the restorative procedure, it is important to distinguish the
diagnosis of caries or other need for restoration. Dental charts commonly contain only
information about what restorations were performed — with the assumption there must
have been a caries lesion, but without speci c delineation and determination of the
diagnostic component prior to engaging in restorative dentistry. Clinicians should carefully
document the method and basis of the diagnosis or other justi cation for restoration, such
as trauma or hypomineralization/hypocalci cation, as well as the extent and depth of the
lesion requiring restoration. Although it may seem routine and mundane, this diagnostic
documentation is essential in order to provide the best quality care, and to ensure treatment
is justi ed based on diagnostic determinations.
ISOLATION TECHNIQUES
Prior to restorative dentistry for children, proper isolation is essential. The surgical
environment should be isolated from potential contaminants. This will also protect the
patient from swallowing or inhaling materials, water or other contaminants during the
procedure. Additionally, all restorative materials have some technique sensitivity, and
contamination with moisture, water, saliva or other debris could affect retention and, thus,
long-term outcomes. This is particularly true for composites resins, but also applies to the
more moisture-tolerant glass ionomer materials.
A rubber dam is the preferred isolation technique. It provides excellent isolation and
visualization during the procedure, and it also serves as a behavior management tool. It is
worth taking the time to train the team to place dental dams. A properly trained staff will
enjoy the opportunity to place dams and be part of the team delivering care in the best
1
possible manner.
Although a dam is recommend for each pediatric restorative procedure, there may be
circumstances, such as partially erupted teeth, in which the patient cannot tolerate a dam. In
situations in which it is believed that contamination will not be a factor (permanent anterior
teeth, for example), alternative isolation techniques can be used — including devices that
provide light, suction and physical isolation from contaminants. These devices are also useful
for shorter procedures, such as sealant placement.
GLASS IONOMER
Glass ionomer is a salt created by a chemical reaction between a polyalkenoic acid and an
aluminum-containing glass powder. The glass powder includes uoride so the latter can be
released — and recharged — after restoration with glass ionomer. This is the only material
2
used in restorative dentistry that chemically bonds to tooth structure. Because the glass
ionomer bonds to calcium ions in dentin and enamel, it bonds independently of the
morphology
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Other materials, such as composites, require a speci c morphological structure

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intertubular dentin in order to create the so-called hybrid layer that allows the composite to
adhere to the tooth substrate.
Additionally, glass ionomer contains water. Combined with its chemical bonding to tooth
structure, this makes it biocompatible and somewhat moisture tolerant. Glass ionomer
cannot be placed in a “fully wet” environment in which there is excess water or saliva. In
situations in which there is humidity, but not a visible “thickness of uid,” glass ionomer is
useful and can easily be bonded to the tooth substrate. By comparison, resin sealants, as well
as resin composites, are not as moisture tolerant.
Because glass ionomer restorations release uoride, they can be bene cial in preventing
recurrent decay around the margins of restorations. They can also prevent adjacent
structures from demineralizing when subject to acidic attack.
Clinicians commonly encounter situations in which the proximal surface of a primary tooth
shows a small caries lesion, but there is also decay on the approximal surface that is not
detected radiographically. In these cases, it is logical to assume that whatever forces allow
the caries lesion to form where it is radiographically visualized also act on the adjacent
approximal surface, causing demineralization not yet perceptible via bitewing radiography.
Placing glass ionomer in the lesion obviously requiring restoration will also provide the
3
possibility of remineralization of the adjacent surface.
It is reasonable to suggest that using glass ionomer as a healing material for adjacent
structures will become more prevalent as newer technologies emerge that allow
visualization of lesions at a very early stage. The ability of glass ionomer to remineralize
4
adjacent lesions is an advantage that no other material possesses.
COMPOSITE RESTORATIONS
Composite materials are commonly used for pediatric restorations. In a scenario in which a
cooperative child, ideal isolation, and adequate time for the procedure all exist, a resin
composite should be used. Composite is the strongest material within the armamentarium
of intracoronal direct restoratives, and is also the most esthetic. In addition, new devices are
available that facilitate composite placement; these includes systems for restoring primary
molars that provide simultaneous wedging and banding during placement in interproximal
situations (Figures 2A through 2C).
FIGURES 2A THROUGH 2C. This series taken during a composite restorative

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wedge placement (A), restoration with a composite material (B), and nal restoration (C).
When a composite’s technique sensitivity and moisture intolerance do not allow it to be

placed properly — perhaps due to issues stemming from cooperation, isolation or time — an
alternative material, such as glass ionomer or resin-modi ed glass ionomer, should be used.
The advantages of glass ionomer and resin-modi ed glass ionomer are many, and the fact
that several materials have emerged (and more will be emerging over the next year or two)
support the discussion that, together with composites, glass ionomer will continue to play
5
an important role in restorative dentistry for children.
Key Takeaways
The continuum of caries management philosophy (Figure 1) dictates that clinicians
manage bio lm and demineralization, and implement other steps to arrest caries
lesions during the early stages of their development.
Lesions that are addressed in the later stages should be treated with minimally invasive
restoration, followed by traditional operative or restorative dentistry.
Early caries lesions may be detected clinically or radiographically, or by newer caries
detection tools — but only clinicians can synthesize all the information and decide to
go forward with a restorative procedure.
Proper isolation (e.g., the use of rubber dams) is essential prior to restorative pediatric
dentistry.
Achieving the best combination of function, esthetics and performance hinges on
choosing the right material for the right situation.
STAINLESS STEEL CROWNS

Stainless steel crowns (SSCs) are another commonly used restorative solution. There is
signi cant literature demonstrating that extracoronal coverage is helpful in primary teeth
with extensive caries.6 Besides protecting the tooth from additional decay and infection,
SSCs prevent lesion progression and leakage, and allow the tooth to remain until natural
exfoliation. Consequently, they are indicated for children with high decay rates, patients with
multiple lesions, and in younger children where longevity is needed before exfoliation. They
can also be used when isolation presents challenges, or when children are being treated
under general anesthesia due to their precooperative or uncooperative presentation.
Conversely, SSCs might be contraindicated when the decay rate is low or only one tooth is
effected, or in cooperative children whose lesions can be restored with intracoronal
restorations.
Multiple steps are involved in placing SSCs. After a local anesthetic is delivered,
Privacy & Cookies Policya dental dam
is placed. Following isolation, the tooth’s occlusal surface is reduced to the extent necessary
(generally, 1.0 to 1.50 mm) to create space for the crown and cement. This reduction should
follow the original contour of the occlusal surface (Figure 3). In creating interproximal
separation, clinicians must take crown thickness into account. This generally requires
reductions of 1 mm or more so an explorer can pass through the proximal space (Figure 4).
When SSCs are placed adjacent to primary molars, the reduction for each crown must be
made as if they were placed independently.
FIGURE 3. When placing stainless

steel crowns, the occlusal surface is
reduced to allow space for the
crown and cement. This reduction
should follow the surface’s original
contour.
FIGURE 4. Following preparation of

the occlusal surface, clinicians must
take crown thickness into account
when creating interproximal
separation. This generally requires
reductions of 1 mm or more so an
explorer can pass through the
proximal space.
FIGURE 5. As is the case here, glass

ionomer is commonly used to
cement stainless steel crowns.
FIGURES
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LIN, DDS, MS
Finally, buccal and lingual bevels are placed, extending from the&occlusal
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Policy onto the
respective buccal and lingual surfaces. These long bevels, generally at a 45-degree angle, will
allow reduction of the buccal and lingual surfaces without removing the important buccal
and lingual bulges present in primary molars. These bulges are essential for the retention of
the crown as its “snaps” over these surfaces during placement. After smoothing the
preparation, a crown is selected based on the mesio-distal size of the tooth. Once the crown
is tted, contoured and crimped, it can be cemented, generally with glass ionomer cement
(Figure 5).
ESTHETIC CROWNS FOR PRIMARY TEETH

Restoring the esthetic form and function of caries-affected primary anterior teeth presents
unique challenges. While it is unclear whether less esthetic restorations in primary anterior
teeth have negative psychosocial impact on children, an increased demand is evident
7,8
among parents and caregivers for esthetic pediatric restorations. Though many options
have been proposed to address this concern, strong evidence of ef cacy or superiority of any
particular technique or option is still lacking. Intracoronal tooth-colored restorations,
9
including glass ionomer, resin-modi ed glass ionomer, or composite, can be considered. In
addition, full-coverage restorations — such as composite resin strip crowns, preveneered
SSCs, and the newly introduced prefabricated primary zirconia crowns — may be used to
9
achieve optimal esthetics and retention. Each of these techniques has its advantages and
limitations.
Both Class V and Class III restorations can be placed on primary anterior teeth. While Class V
restorations are relatively easy to place and usually provide good retention, Class III
restorations in primary anterior teeth are among the most technique-sensitive procedures a
pediatric dentist performs. A conservative preparation may be indicated due to small crown
size and close proximity of the pulp horns to the interproximal surfaces. Clinicians must also
take into account that slot preparations could result in less than ideal retention because of
10
the small area for etching and bonding, Studies comparing Class III slot preparations with
dovetail preparations have demonstrated no clinically signi cant differences between two
11,12
designs. Besides preparation, the material placement can be also challenging in terms of
isolation, and moisture and hemorrhage control.
9
According to guidelines from the American Academy of Pediatric Dentistry, full coverage
coronal restorations are indicated when:
Decay is present on multiple surfaces

An incisal edge is involved
There is extensive cervical decalci cation
Pulpal therapy is indicated
The caries lesion is small, but oral hygiene is poor
Patient behavior makes moisture control or precision preparations dif cult to achieve
COMPOSITE STRIP CROWNS
Among esthetic full-coverage restorations in primary anterior teeth,

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composite “strip crowns” (CSCs) has the longest history. A survey among pediatric dentists
showed that 46% of respondents chose CSCs as their rst choice for full-coverage
13
restorations of primary anterior teeth. Retrospective studies indicate that overall retention
14–17
of CSCs ranges from 49% to 80%. Lower retention rates were noted in children following
dental rehabilitation under general anesthesia, possibly due to the greater propensity for
17
developing new and recurrent caries in this high-risk population. In spite of high parental
satisfaction with CSCs, durability is most likely to cause concerns among
18,19 14,18
parents/caregivers. Parental dissatisfaction was also noted regarding color changes.
Instead of composite, some practitioners have suggested using resin-modi ed glass
20
ionomer as an interim restorative material for CSCs when ideal isolation is not possible.
Occlusion and the extent of the lesion should likewise be considered when placing CSCs.
Leaving adequate tooth structure during preparation will ensure suf cient surface area for
16
bonding. Low retention rates have been seen in teeth with decay in three or more surfaces.
In addition, due to high probability of resin fracture, CSCs should be avoided in patients with
anterior crossbites or severe bruxism.
PREVENEERED STAINLESS STEEL CROWNS

Although SSCs may be the most durable restoration for primary anterior teeth with large
lesions, they are not esthetically acceptable to many parents. Open-face SSCs were
introduced to improve the appearance of SSCs by removing the metal facing after
21
cementation and replacing it with a tooth-colored material. Placement of these crowns is
technically challenging and time consuming, however.
Preveneered SSCs (PVSSCs) were introduced approximately 20 years ago. In a survey by

Oueis et al, 41% of respondents selected PVSSCs as their rst choice for restoring primary
13 22–24
anterior teeth. Esthetically pleasing, the crowns earn high levels of parental satisfaction.
Unlike SSCs, the tting of PVSSCs should be passive, as any forceful placement or excessive
7
pressure could cause the white facing to break, crack or chip. Only slight crimping of the
lingual surface should be used for margin adaption and retention, but minimal adjustment
25
of the lingual margin does not seem to decrease facial veneer facture resistance. Several
22,23,26,27
retrospective studies have demonstrated the high retention rates of PVSSCs. The
biggest issues with these crowns are fracture and loss of some, or all, of the veneer — which
22,23,24
is challenging to repair. Consequently, PVSSCs should also be avoided in patients with
anterior crossbites or where occlusion precludes their use.
ZIRCONIA CROWNS
Recently, prefabricated zirconia crowns have become available in various sizes to t every
primary tooth. Some brands also offer a narrower version of canines and rst primary molars
for patients with space loss or crowding. These monolithic crowns are made of solid zirconia,
28,29
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exposure) while still leaving enough tooth structure for
retention. Other considerations include cost and the learning
curve in placing zirconia. Currently, there is little information
on their long-term clinical performance. Yet these crowns
19
show high parental satisfaction and are likely to become
30–32
more popular. The single prospective study available has
a six-month follow-up period. In this short trial, zirconia
crowns demonstrated a 100% success rate, while 22% of CSCs
experienced either fracture or complete loss, and 5% of the
29
PVSSCs lost a portion of the veneer. In evaluations of
gingival health, zirconia crowns showed improved health,
while the other crowns showed increased gingival
29 FIGURES 6A THROUGH 6C.
in ammation. This may possibly be attributed to the highly
32 Here are three examples of
polished surfaces and biocompatibility of zirconia crowns. esthetic restorations for
primary anterior dentition:
Opposing tooth wear was noted in four out of 38 zirconia composite strip crowns (A),
29
crowns studied. preveneered stainless steel
crowns (B), and zirconia crowns
(C).
FUTURE DIRECTIONS
While many options exist for esthetic restorations in primary anterior teeth (Figures 6A
through 6C), to date, very little controlled clinical data are available to suggest that one type
is superior to the others. Clinical decisions regarding the choice of restoration and the
ultimate outcome are dictated by the extent of decay, moisture and hemorrhage control,
and the child’s level of cooperation, as well as caries risk, parental desires, and the clinician’s
32,33
experience and preferences.
Many new materials and techniques are available to dentists who treat children. Ultimately,
clinicians can ensure the optimal combination of function, long-term performance and
esthetics by selecting the right material for the right situation. Doing so will help set
pediatric patients on a lifetime course of improved oral and systemic health.
References
1. Dhar V, Hsu KL, Coll JA, et al. Evidence-based update of pediatric dental restorative
procedures: Dental materials. J Clin Pediatr Dent. 2015;39:303–310.
2. Uribe S. Which lling material is best in the primary dentition? Evid Based Dent.
2010;11:4–5.
3. Rodrigues E, Delbem AC, Pedrini D, Cavassan L. Enamel remineralization by uoride-
releasing materials: proposal of a pH-cycling model. Braz Dent J. 2010;21:446–451.
4. Donly KJ, Henson T. Glass ionomer cement restorations for contemporary pediatric
dentistry. Alpha Omegan. 2005;98(4):21–25.
5. Aykut-Yetkiner A, Simşek D, Eronat C, Ciftçioğlu M. Comparison of the remineralisation
effect of a glass ionomer cement versus a resin composite on dentin of primary teeth.
can2014;15:119–121.
Eur J Paediatr Dent. opt-out if you wish. Accept Read More
6. American Academy of Pediatric Dentistry. GuidelinePrivacy

on Restorative
& CookiesDentistry,
Policy revised
2014. Available at: aapd.org/media/Policies_Guidelines/ G_Restorative.pdf. Accessed
August 15, 2016.
7. Waggoner WF. Restoring primary anterior teeth: Updated for 2014. Pediatr Dent.
2015;37:163–170.
8. Woo D, Sheller B, Williams B, Mancl L, Grembowski D. Dentists’ and parents’
perceptions of health, esthetics, and treatment of maxillary primary incisors. Pediatr
Dent. 2005;27:19–23.
9. Committee O. Guideline on restorative dentistry. Pediatr Dent. 2015;37:232–243.
10. Piyapinyo S, White G. Class III cavity preparation in primary anterior teeth: In vitro
retention comparison of conventional and modi ed forms. J Clin Pediatr Dent.
1998;22:107–112.
11. Trairatvorakul C, Piwat S. Comparative clinical evaluation of slot versus dovetail Class III
composite restorations in primary anterior teeth. J Clin Pediatr Dent. 2004;28:125–129.
12. Rathnam A, Nidhi M, Shigli AL, Indushekar K. Comparative evaluation of slot versus
dovetail design in class III composite restoations in primary anterior teeth. Contemp
Clin Dent. 2010;1:6–9.
13. Oueis H, Atwan S, Pajtas B, Casamassimo PS. Use of anterior veneered stainless steel
crowns by pediatric dentists. Pediatr Dent. 2010;32:413–416.
14. Kupietzky A, Waggoner WF, Galea J. The clinical and radiographic success of bonded
resin composite strip crowns for primary incisors. Pediatr Dent. 2003;25:577–581.
15. Kupietzky A, Waggoner WF, Galea J. Long-term photographic and radiographic
assessment of bonded resin composite strip crowns for primary incisors: results after 3
years. Pediatr Dent. 2005;27:221–225.
16. Ram D, Fuks AB. Clinical performance of resin-bonded composite strip crowns in
primary incisors: A retrospective study. Int J Paediatr Dent. 2006;16:49–54.
17. Tate AR, Ng MW, Needleman HL, Acs G. Failure rates of restorative procedures following
dental rehabilitation under general anesthesia. Pediatr Dent. 2002;24:69–71.
18. Kupietzky A, Waggoner WF. Parentral satisfaction with bonded resin composite strip
crowns for primary incisors. Pediatr Dent. 2004;26:337–340.
19. Salami A, Walia T, Bashiri R. Comparison of parental satisfaction with three tooth-
colored full-coronal restorations in primary maxillary incisors. J Clin Pediatr Dent.
2015;39:423–428.
20. Nelson T. An improved interim therapeutic restoration technique for management of
anterior early childhood caries: report of two cases. Pediatr Dent. 2013;35:124–128.
21. Wiedenfeld KR, Draughn RA, Welford JB. An esthetic technique for veneering anterior
stainless steel crowns with composite resin. ASDC J Dent Child. 1994;61:321–326.
22. Shah PV, Lee JY, Wright JT. Clinical success and parental satisfaction with anterior
preveneered primary stainless steel crowns. Pediatr Dent. 2004;26:391–395.
23. Roberts C, Lee JY, Wright JT. Clinical evaluation of and parental satisfaction with resin-
faced stainless steel crowns. Pediatr Dent. 2001;23:28–31.
24.
ThisChampagne
website usesC, Waggoner
cookies W, Ditmyer
to improve M, Casamassimo
your experience. PS, MacLean
We'll assume you're ok J. Parental
with this, but you
satisfaction with preveneered
can opt-out ifstainless
you wish.steelAccept
crowns forRead
primary
Moreanterior teeth. Pediatr
Dent. 2007;29:465–469. Privacy & Cookies Policy

25. Gupta M, Chen J-W, Ontiveros JC. Veneer retention of preveneered primary stainless
steel crowns after crimping. J Dent Child (Chic). 2008;75:44–47.
26. MacLean JK, Champagne CE, Waggoner WF, Ditmyer MM, Casamassimo P. Clinical
outcomes for primary anterior teeth treated with preveneered stainless steel crowns.
Pediatr Dent. 2007;29:377–381.
27. Lopez-Loverich A, Garcia M, Donly KJ. Retrospective study of retention of stainless steel
crowns and preveneered crowns on primary anterior teeth. Pediatr Dent. 2015;37:530–
534.
28. Manicone PF, Rossi Iommetti P, Raffaelli L. An overview of zirconia ceramics: basic
properties and clinical applications. J Dent. 2007;35:819–826.
29. Walia T, Salami AA, Bashiri R, Hamoodi OM, Rashid F. A randomised controlled trial of
three aesthetic full-coronal restorations in primary maxillary teeth. Eur J Paediatr Dent.
2014;15:113–118.
30. Planells del Pozo P, Fuks AB. Zirconia crowns — an esthetic and resistant restorative
alternative for ECC affected primary teeth. J Clin Pediatr Dent. 2014;38:193–195.
31. Croll T, Donly KJ. Contralateral/Opposite-arch zirconia crown restoration of two
mandibular primary rst molars. Insid Dent. 2015;11:78–81.
32. Ashima G, Sarabjot KB, Gauba K, Mittal HC. Zirconia crowns for rehabilitation of
decayed primary incisors: an esthetic alternative. J Clin Pediatr Dent. 2014;39:18–22.
33. Waggoner WF. Anterior crowns for primary anterior teeth: an evidence based
assessment of the literature. Eur Arch Paediatr Dent. 2006;7:53–57.
The authors have no commercial con icts of interest to disclose.
From Decisions in Dentistry. September 2016;2(09):28–32.
Joel H. Berg, DDS, MS

Joel H. Berg, DDS, MS, is professor emeritus of pediatric dentistry at the University of
Washington School of Dentistry in Seattle. President of the American Academy of Esthetic
Dentistry and a former president of the American Academy of Pediatric Dentistry, he is
coeditor of the textbook Early Childhood Oral Health. Berg is also an industry consultant, as
well as a Decisions in Dentistry editorial advisory board member. He can be reached at
execudent@msn.com.
Zheng Xu, DDS, MDS, PhD

Zheng Xu, DDS, MDS, PhD, is a clinical associate professor of pediatric dentistry at UW School of Dentistry.
She is also a consultant for the American Board of Pediatric Dentistry and a member of the editorial board of
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Pediatric Dentistry, the journal if you wish.
of the American Accept
Academy of Read More
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10/13/2020 Restorative Dentistry in the Primary Dentition - Decisions in Dentistry

Latest Features Pediatric Dentistry

FIGURE 1. Caries Management Continuum

While early lesions may be detected clinically or radiographically,

Other materials, such as composites, require a speci c morphological structure

FIGURES 2A THROUGH 2C. This series taken during a composite restorative

When a composite’s technique sensitivity and moisture intolerance do not allow it to be

STAINLESS STEEL CROWNS

FIGURE 3. When placing stainless

FIGURE 4. Following preparation of

FIGURE 5. As is the case here, glass

ESTHETIC CROWNS FOR PRIMARY TEETH

Decay is present on multiple surfaces

Among esthetic full-coverage restorations in primary anterior teeth,

PREVENEERED STAINLESS STEEL CROWNS

Preveneered SSCs (PVSSCs) were introduced approximately 20 years ago. In a survey by

6. American Academy of Pediatric Dentistry. GuidelinePrivacy

Dent. 2007;29:465–469. Privacy & Cookies Policy

The authors have no commercial con icts of interest to disclose.

From Decisions in Dentistry. September 2016;2(09):28–32.

Joel H. Berg, DDS, MS

Zheng Xu, DDS, MDS, PhD

Privacy & Cookies Policy

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© 2020 - Decisions in Dentistry • All Rights Reserved.

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