The dental treatment of children is a challenge from behavioral and also esthetic point of view. Extensive carious lesions may lead to premature extraction of deciduous teeth and also to incorrect growth of permanent teeth and jaws.
Children may receive appropriate oral health care with esthetic, reliable, functional and long lasting restorations even in primary dentition.

Fig.1

Initial situation of deciduous mandibular first and second left molar of 6-years-old patient.

Fig.2

Rubber dam isolation. Using a special rubber dam clamp 75 for second left lower deciduous molar. Pre-wedging for opening the interproximal space was useful during cavity preparation on first deciduous molar.

Fig.3

Opening the cavity of the second deciduous molar. A large defect is visible, pre-eruptive intracoronal resorption.

Fig.4

After preparation and caries excavation of tooth 75, a glass-ionomer cement (Ketac™ Universal Aplicap) was applied. In order to restore the interproximal area, special Quickmat Junior sectional matrix was used. The small, child-sized matrix was fixed using the unique myClip Junior (Polydentia).

Fig.5

myClip Junior (Polydentia).

Fig.6

After selective enamel etching, Single Bond Universal Adhesive (3M) was used. Interproximal area was restored by Filtek™ Ultimate Universal Restorative (3M). After light-curing, a layer of bulk material (Filtek™ Bulk Fill Flowable Restorative, 3M) was applied.

Fig.7

A2 Shade, Filtek™Bulk Fill Flowable Restorative.
A1 Body Shade, Filtek™ Ultimate Universal Restorative.

Fig.8

Situation after occlusal modelling, light curing, finishing and polishing of the restoration of the second molar, before starting with tooth 74.

Fig.9

Then we proceeded to the restoration of the the first primary molar. The Quickmat Junior matrix and myClip Junior were placed to build the contact area.

Fig.10

Final situation after finishing and polishing. A natural appearance of the deciduous molars composite restorations using 3M Filtek™ Ultimate Universal Restorative.

Conclusions

Special care should be taken when restoring primary dentition. This article illustrates a simple approach to obtain esthetic and reliable results also in deciduous teeth by using Filtek™ Ultimate Universal Restorative, meanwhile the capability of bulk material Filtek™ Bulk Fill Flowable Restorative to be placed and light cured in the depth of 4 mm prevents prolonged treatment, which is very relevant especially in treating pediatric patients. Also, using the unique matrix system myClip Junior and junior sectional matrices from Polydentia can simplify everyday procedures of posterior restorations in children.

Bibliography

1. Ribeiro JF, Forgerini TV, Pedrotti D, de Oliveira Rocha R, Ardenghi TM, Soares FZ, Lenzi TL. Performance of resin composite restorations in the primary dentition: a retrospective university-based study, International journal of paediatric dentistry, 2018; 28:497-503.
2. Dean Jeffrey A. McDonald’s and Avery’s Dentistry for the child and adolescent, 10th edn., 2016; 54-56.