Restorative materials in the primary dentition of poli-caries patients

Despite an overall caries decline in children, still 50-60% of carious primary teeth of 6-year-olds remain untreated, in 3-year-olds 13%. There are an increasing number of poli-caries patients with insufficiently treated primary teeth. Therefore, early treatment is fundamental.

The assessment and indication for the use of restorative materials can be summarized as follows: Glass ionomer cements (GIC) are associated with easy handling and high fluoride release. This makes them attractive especially for Class I cavities in uncooperative children. However, low flexural strength causes high fracture rates in Class II cavities. Further developments (viscous and resin-modified GIC) have improved handling characteristics, but conventional non-resin-modified GIC are still prone to fracture. Compomers exhibit a clear potential as an alternative to amalgam. Long-term results are good even in stress-bearing areas. The compliance of the child should at least last long enough for adhesive application. Resin composites are still the most time-consuming alternative. Under a correct application protocol, resin composites behave in a similar manner to compomers. Therefore, the effort has to be judged individually. Finally, especially in severely decayed teeth and after endodontic treatment, preformed metal crowns should be taken into account as a last and appropriate alternative to direct restorations.

Based on the high clinical success rates, compomers with self-etch adhesives can be recommended for restorative therapy in anterior and posterior primary teeth.