Restorative Materials in Pediatric Dentistry S.Lal, DDS

Restorative Materials in Pediatric Dentistry S.Lal, DDS Course Director

Preventive Materials 1. Fluoride gels, foam and varnish: Used for remineralisation of decalcified enamel and incipient caries. 2. Sealants: Indicated for preventing and arresting incipient lesions. Available as clear or white, filled or unfilled, containing Fluoride or not.

Resin based composites(RBC) Resin matrix (Bis-GMA) with inorganic filler particles. 1. Filler contentFilled vs Unfilled Flowable vs packable Anterior vs posterior composite 2. Particle size3. macro, microfilled and hybrids

Resin Restorations Steps: Etch, wash, dry or dessicate? Enamel and Dentin adhesives Composite selection and placement Curing tools and techniques

Resin Restorations Disadvantages: 1. Polymerization shrinkage 2. Technique sensitive 3. Performance of posterior composites in large, stress bearing preparations is questionable

Dentin/Enamel adhesives in Pediatric Dentistry Dentin bonding agents or Primers: Smear layer Etch Hydrophillic and hydrophobic component (HEMA) Enamel adhesives or bonding agents: Hydrophobic resin such as Bis-GMA Hybrid layercopolymerized layer of primer, bonding resin and collagen

Dentin/Enamel adhesives in Pediatric Dentistry 1. 2. 3. 4. 3-step total etch Total etch using prime and bond Self etch primers with bonding agent All-in-one adhesives e.g.- prompt L-pops

Glass Ionomer cements Fluorosilicate glass powder(base) combined with a water soluble polymer(acid) e.g. - Ketac cement Resin-modified glass ionomer cements: are glass ionomers with a light polymerised resin component. e.g.- Vitrebond and Vitremer

Resin-modified glass ionomers Advantages: 1. Increased mechanical properties 2. Physiochemically bonds to tooth structure 3. Biocompatible, moisture forgiving 4. Similar coefficient of thermal expansion as dentin therefore a good dentin replacement material. (sandwich technique) 5. Ion lechability - Fluoride release(anticariogenic action) 6. Minimal polymerization shrinkage

Compomers Polyacid-modified, resin based composite with fluoride releasing glass fillers. e.g.- compoglass, dyract Better results after etch and bond Good mechanical properties and polishability

Amalgam No polymerization shrinkage Moisture forgiving Excellent mechanical properties Mercury toxicity Esthetics

SSC- Primary and Permanent Full coverage, metallic, definative restorations Available as: pretrimmed (Unitek), precontoured and festooned (Ni-Chro ION crowns) Durable and cost effective

Research trends Polymerization shrinkage Mechanical properties More ‘forgiving’ materials

In summary . “ Primary teeth are a temporary dentition with known life expectancies of each tooth. By matching the ‘right’ restoration with the expected lifespan of the tooth, we can succeed in providing a ‘permanent’ restoration that will never have to be replaced.”