3.6 Restorative Materials

Amalgam is a safe and effective restorative material. With the current generation of low-expansion amalgam, this material has a definite role to play in restoring small pit lesions on posterior teeth that cannot be isolated well.

Unlike class I amalgams, class II amalgams have a technique sensitivity that renders their value very limited for restoring the primary teeth of young children. Because of this, stainless steel crowns may be a better alternative. Finally, amalgam has limitations. Extremely wide occlusal restorations are subject to both fracture and recurrent decay. Reserve amalgam for those circumstances that maximize its benefits and take advantage of its strengths.

Composites provide an esthetic result that is important to some parents, because the filling is the same color or nearly the same color as the tooth. If a composite is chosen, only two shades are needed—light and very light. In most cases, matching exact tooth colors is unnecessary for young children.

Composites have limitations, including a high degree of technique sensitivity and limited proven life span in primary teeth. The same strength considerations that apply to large amalgam restorations apply to composites. Experience and research suggest that composites are not well-retained in anterior primary teeth. Strip crowns using clear celluloid crown forms filed with composite etched to the entire crown work better than composites over the life span of the tooth.

There are two main challenges to applying composites. The first challenge is fluid control with materials that require a dry field to be successful. Failed restorations in primary teeth often hinge on fluid contamination and leakage. The second challenge is ensuring that the child remains still during critical phases of the procedure.

BACK

NEXT