Restorative Materials for Primary Teeth Flashcards
What are some considerations to take into consideration when treatment planning for deciduous teeth?
- Different morphology
- Relationship to permanent teeth–>space maintenance, can damage permanent teeth if traumatised
- Shorter progression of caries to pulp
- Caries risk
- Size and type of lesion
- Pulp status
- Age
- Stage of root development/extent of resorption
- Tooth anomalies
- Level of cooperation
- Attendance
- Oral hygiene
- Material properties
What are some differences in morphology of deciduous teeth vs permanent?
- Greater convexity in cervical third of crown–>narrower neck–>not as much structure to support slot preps for deep restorations
- Mesiodistal length: crown height ratio is larger
- Enamel is only 1mm thick (vs 2mm in permanent)
- Dentine is also thinner
- Larger pulp with more prominent pulp horns, especially mesial horn in molar teeth
- Broader contact areas
- Molar roots more slender and flared
What should you aim for when restoring primary teeth and why?
Restore the tooth once only before exfoliation and no more
-Better for child, cost, time
What are the materials available for use in paeds?
SS crown CR RMGIC GIC Amalgam Compomers
What are the advantages and disadvantages of SS crowns?
- Durability + longevity
- Relatively inexpensive
- Minimal technique sensitivity
- Full coronal coverage
- MOre conservative of tooth structure in long run
- Poorer aesthetics
- Can impact erupting 6’s
What are the advantages/disadvantages of white stainless steel crowns?
- Durability + longevity
- Better initial aesthetics
- More expensive
- 1 or 2 shades only available
- Cant’ modify shape for fit (e.g. crimping) as white facing quite solid
- Over time white facing debonds bit by bit resulting in poorer aesthetics
What are some adv + disadv of using zirconia crowns in children?
adv:
-More aesthetic
Disad:
- Need to prep as in permanent tooth (as can’t leave undercuts since can’t stretch like SS)
- Less conservative prep since not as thin as SS
- Can’t rely on undercuts on teeth to hold crown in–>relying purely on cement
- Large amount of tooth structure cut away means a pulpotomy will be needed whther or not pulp was affected
- Limited studies on longevity
What are the indications of SS crowns?
- After pulpotomy
- Multi surface restoration
- Any other restoration likley to fail
- Developmental defects
- Early wear + loss of occlusal height
- Previous restoration failure
- Fractured teeth
- High caries risk
- Infrequent attender with caires
Should you do occlusal reduction first or remove caries first?
-Occlusal reduction first: gives better caries access after
What should you do first: ss crown or fissure sealant?
- Fissure sealant: gingival bleeding caused by SS crown prep can compromise moisture control for F/S
- Same for small occlusals and other restorations
If doing side by side crowns, should you do the D or E first in general?
E, as it is easier
What should you consider when fitting a crown on the E?
Do not make it overly big if 6 not erupted else risk impaction
What size SS crown is most common for E’s?
4
What size SS crown is most common for D’s?
5+
What are the advantages/ disadvantages of amalgam?
Adv:
- Easy to manipulate
- Good durability
- Lower cost
- decreased Microleakage with time
- Low technique sensitive
Disad:
Not aesthetic
-Mercuary issues (requires consent!)
-Not conservative
*Not generally advised to be used in children, but not based on evidence on toxicity, based on impact on environment
What are advantages/disad of resin cr?
Adv:
- More aesthetic
- Micromechanical bond
- Bond to dentine via hybrid layer
- conservative
Disad:
- shrinkage
- Microleakage
- Secondary caries
- Technique sensitive
What is the filler content of flowable resin?
37-53%
What happens to resin properties as filler decreases?
- Increased wear
- Higher shrinkage
What are the adv + disad of GIC?
Adv:
- Chemical bond
- conservative
- thermal expanasion similar to tooth
- Bicompatabile
- Uptake and release of fluoride
- Decreased moisture sensitivity
Disad:
- Wear
- Poor Strength (unsuitable for stress bearing areas)
- Chemical cure
What are the adv + disad of RMGIC?
Adv:
- Fluoride release
- Dual cure
- conservative
- Aesthetic
- Easy to use
Disad:
- Mechanical properties
- Strength/aesthetic < CR
What is the issue with sandwich technique in deciduous?
-Not enough bulk to do GIC and resin
What are the adv and disad of compomers?
Adv:
- Easy to use
- MOre moisture tolerant than CR
- Superior physical properties to GIC/RMGIC
- Similar aesthetics to CR
- Possible fluoride release
- Similar short term success as CR
Disad:
- Wear
- Lack of long term longevity studies
What is the issue with plugging a small hole with CR in anterior teeth?
-Tend to fall out as kid is biting/chewing
What is an alternative, longer lasting restoration for anterior teeth than just filling the hole? What are some +’s and -‘s?
CR Strip crowns
Adv:
- Excellent aesthetics and colour match
- Good strength + longer longevity vs small resto
- Reasonable wear resistance
- Ease of repair
Dis:
- Require adequate tooth structure
- Technique sensitive