CSL 9 Restoration (medium)

Pediatric Dental Restorations

• Stage 1: Acute Treatment involves excavating open cavities using temporary cement and performing necessary extractions or emergency endodontic procedures.

• Stage 2: Caries Disease Management includes taking a detailed diet history, providing dietary counseling, performing salivary and bacteriological tests, instructing patients on oral hygiene and plaque control, and applying topical fluoride treatments and fissure sealing.

• Stage 3: Restorative Treatment focuses on restoring damaged tooth structures.

• Stage 4: Risk Assessment and Follow-up involves evaluating risk factors and establishing a follow-up program.

Choice of Restoration

• The restoration approach for a primary tooth hinges on the specific tooth, its past caries history, and the child's cooperation.

Restorative Techniques

• Conventional G.V. Black technique relies on extension for prevention, drilling and filling, and anesthesia.

• Microdentistry approaches prioritize minimizing tooth substance removal through pit and fissure preparations, preventive extension, box-only preparations, filling without drilling (laser/air abrasion/chemomechanical), and no or less anesthesia.

Caries Excavation

• Non-selective removal aims at complete removal of all carious tissue. Selective removal, as per the ICCC (International Caries Consensus Collaboration), involves varying degrees of tissue removal tailored to peripheral and pulpal areas, ensuring sufficient depth for the restoration without pulp exposure.

• Caries excavation methods include hand instruments and rotary instruments.

Handpieces

• Low-speed handpieces (500 to 15,000 rpm) are frequently used for caries removal and polishing. Light pressure and brushing strokes help prevent excessive heat generation.

• High-speed handpieces (100,000 to 300,000 rpm) need to be combined with coolants. Intermittent cutting helps prevent excessive heat generation.

Instruments

• Spoon Excavators are used to remove carious dentin and temporary/permanent crowns. They're characterized by concave designs, spoon shapes, and cutting edges, available in different sizes (large, small-round blade, single or double ended).

• Burs are used to achieve a variety of dental tasks in high- or low-speed handpieces. Burs have heads, necks, and shanks, their shapes and sizes varying according to their purpose. Some burs are designed for surgical use.

• Specific burs are detailed in terms of size and function: - 5.0 mm bur - 2.5 mm bur

Restorative Materials

• Various restorative materials are used like composites, compomers, resin-modified glass ionomers, glass ionomers or SSC (Stainless Steel Crowns).

Restoration Types

• One surface restorations and two surface restorations are two types detailed in the notes.

Interim Restorations

• Interim restorations are a temporary way to seal and help protect a tooth.

Clinical Considerations

• Adhesive restorations are sensitive to technique and operator skill, crucial for good case selection. Proper application in posterior teeth requires understanding of composite, polymerization, and adhesive principles to apply to the patient's treatment. Adhesive materials, compared to amalgam, are less forgiving to poor handling and placement.