Pedodontics seminar….

TITLE: RESTORATION OF
PRIMARY AND YOUNG
PERMANENT TEETH
Introduction :

Pediatric operative dentistry aims to maintain the

tooth in the dental arch in a healthy state, to prevent
its loss and the development of subsequent problems.
It is important to understand the difference in
the structure between the deciduous and permanent teeth
before planning any procedure

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1Shorter crown: The total height of the clinical crown
of the deciduous tooth is less and hence the depth of
the cavity should be similarly less. The mesial pulp
horns extend higher occlusal than on permanent
teeth, and thus the risk of accidental exposure increases
during cavity preparation.

2. Narrow occlusal table: The occlusal table

width of deciduous molars is very narrow compared
to the permanent molar as presented in the figure.
Accordingly, the width of the cavity should also be
less in a deciduous tooth.
 3. Constricted cervical portion): The
deciduous teeth are characterized by a prominent
cervical ridge more pronounced on the buccal aspect and a steep
cervical constriction cervical to the ridge.
Care must be taken while preparing the proximal
box, as there is a risk of pulp exposure at the site of
constriction. Class II cavity should be restored with
proper placement of wedges at the constricted area so
that the matrix band is adapted well to the tooth surface.
4. Thinner enamel and dentin layers: Enamel and dentin is
much thinner, thus dental caries penetrates deeper to
reach the pulp earlier in primary teeth. Care must be
taken during cavity preparation, not to extend very
deep as there is increased chance of pulp exposure.
5. Enamel rods extend in a slightly occlusal direction from the
DEJ in the gingival third So enamel beveling
at the gingivocavo surface line angle is not required,
as no enamel rods remain unsupported.

6. Broad and flat contact areas: Caries may

remain undetected. The proximal box preparation
may have to be extended widely to break the contact
free. Cl II cavity.
7. Wider mesiodistally than cervico-occlusal height: This is
important during the selection of the stainless steel
crown.
8. Lighter color: Deciduous teeth are generally lighter
or whiter in color compared to the permanent teeth.
This has to be kept in mind during shade selection
for composite restoration or crown restorations.
Amalgam restoration for primary
teeth (class l ) :

1. Outline form should include all fissures, areas of

caries, pits and developmental grooves and should
be dovetailed.

2. The extension of the occlusal portion of the cavity

preparation depends on the primary molar involved:
a. The occlusal portion usually is extended about one
half the way across on the primary maxillary and
mandibular first molars.
b. For the primary mandibular second molar, extend
the step completely across the occlusal surface.
c. The primary maxillary second molar preparation
includes only the nearest occlusal pit. The oblique
ridge is not included unless undermined with
carious lesions

3. The walls converge slightly with the greatest width

at the pulpal floor.
4. Cavosurface margins should be sharp

5. Angles of walls and floors should be slightly rounded

6. Isthumus width should be one-third the width of the

occlusal table

7. Depth of the cavity—0.2-0.8 mm into the dentin