26 June 2025

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Restorative Dentistry for the Primary Dentition

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Pediatric restorative dentistry is a dynamic combination of ever-improving materials and tried-and-true techniques. Many aspects of primary teeth restoration have not changed for decades. In 1924, G.V. Black outlined several steps for the preparation of carious permanent teeth to receive an amalgam restoration.

These steps have been adopted, with slight modification, for the restoration of primary teeth. Restorative techniques for the primary dentition using amalgam and stainless steel crowns (SSCs) have remained relatively consistent for decades. However, with an increased use of adhesive restorative materials and bonding systems, there has been a shift to more conservative preparations and restorations. Materials such as glass ionomers, resin ionomer products, and improved resin-based composite systems have been developed, which are having a profound impact on the restoration of primary teeth.

Additionally, premilled zirconia crowns now offer an esthetic alternative to SSCs. Unfortunately, long-term clinical data (i.e., >3 years) regarding many of these newer materials are limited; but even so, many clinicians are successfully using these materials with increasing frequency.

The clinician can stay with the proven, successful materials of the past, such as amalgam and stainless steel, or move to newer, more esthetic materials that offer advantages such as bonding to tooth structure, fluoride release, improved esthetics, reduction of mercury exposure, and conservation of tooth structure.

None of the esthetic materials have the track record and proven durability of amalgam or stainless steel, but when they are placed appropriately, they can provide useful restorations for the life span of the primary tooth.

Authors: William F. Waggoner, Travis Nelson

Source: https://www.sciencedirect.com/