MOBILE

Restorative Dentistry in Children

Recommendations

Foundational Articles

Frencken JE, Liang S, Zhang Q. Survival estimates of atraumatic restorative treatment versus traditional restorative treatment: a systematic review with meta-analyses. Br Dent J. 2021 Apr 21. Available at: https://www.nature.com/articles/s41415-021-2701-0.pdf. Accessed Sept. 25, 2021.

American Academy of Pediatric Dentistry. Policy on interim therapeutic restorations (ITR). 2017. Available at: https://www.aapd.org/globalassets/media/policies_guidelines/p_itr.pdf. Accessed Oct. 25, 2021.

American Academy of Pediatric Dentistry. Pediatric restorative dentistry. 2019. Available at: https://www. aapd.org/globalassets/media/policies_guidelines/bp_restorativedent.pdf?v=new. Accessed Oct. 25, 2021.

Peric T, Markovic E, Markovic D, Petrovic B. Meta-Analysis of In Vitro Bonding of Glass-Ionomer Restorative Materials to Primary Teeth. Materials 2021;14,3915. https://doi.org/10.3390/ ma14143915.

Ortiz-Ruiz AJ, Pérez-Guzmán, N., Rubio-Aparicio M. et al. Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis. Sci Rep. 2020, 10, 6409 (2020). Available at: https://www.nature.com/artic es/s41598-020-63497-4.pdf. Accessed, Sept. 25, 2021.

Sigal AV, Sigal MJ, Titley KC, Andrews PB. Stainless steel crowns as a restoration for permanent posterior teeth in people with special needs: A retrospective study. J Am Dent Assoc. 2020;151(2):136-144.

Alrashdi M, Ardoin J, Liu JA. Zirconia crowns for children: A systematic review. Int J Paediatr Dent. 2021.
DOI: 10.1111/ipd.12793

Background

Contemporary management of dental caries includes identification of an individual’s risk for caries progression, understanding of the disease process for that individual, and management with appropriate preventive services, supplemented by restorative therapy where indicated. The benefits of restorative therapy include: maintaining tooth vitality, removing cavitation or defects to eliminate areas that are susceptible to caries, restoring the integrity of tooth Background structure, preventing the spread of infection into the dental pulp, and preventing the shifting of teeth due to loss of tooth structure. The risks of restorative therapy include reducing the longevity of teeth by making them more susceptible to fracture, recurrent lesions, pulp exposure during caries excavation, future pulpal complications, and iatrogenic damage to adjacent teeth.

IAPD Recommendations

  1. High viscosity glassionomer cements may beused in atraumatic restorative treatment (ART) or interim therapeutic restorations (ITR), as an option for conventional treatment in primary teeth. ART/ITR may be used for controlling caries in children that are not cooperative for definitive treatment or treating multiple open carious lesions before rendering
    definitive restoration. Consensus-based statement > Global agreement 100%
  2. Glass ionomer and resin modified glass ionomer restorative materials may be used as restorative materials for single surface restorations in primary and permanent posterior teeth. Consensus based recommendation > Global agreement 87%
  3. Where local regulations permit and without any other contraindications to the use of amalgam providers may use dental amalgam for restoration based on clinical judgement and shared decision making. Consensus-based statement > Global agreement 70%
  4. Because of the greater longevity of preformed metal crowns, their use may be recommended on high-risk children having multi-surface or large cavitated lesions on primary molars, especially when children undergo ful  mouth rehabilitation under
    general anaesthesia. Consensus-based statement > Global agreement 95%
  5. In cases of permanent teeth with large carious lesions or severe enamel defects, preformed metal crowns may be used as semi-permanent restorations. Consensus-based statement > Global agreement 95%
  6. Zirconia crowns are an aesthetic alternative to preformed metal crowns and may be used for teeth with similar indications. Consensus-based statement > Global agreement 79%

Other Recommendations