The Journal
*Dr. Haleen Kaur Soni
Aesthetic Restoration of Grossly Carious Primary
Anterior Teeth
Early childhood caries (ECC) is the most common chronic dental disease which occurs in children
and primarily involves the primary maxillary anterior teeth. Early childhood caries in a majority of
cases, leads to the destruction of almost the entire crown, leaving just the root and minimal crown
portion, hence, only dentine is left for bonding of the restorative materials. Restoring severely
mutilated primary anterior teeth is a challenge to the pedodontist. This a case report describing
restoration of severely damaged primary anterior teeth with omega loops followed by composite resin
restoration.
Introduction
As a Pediatric Dentist, we witness the
dynamic journey of growth and development of
a child and transitional phases which he goes
through, starting from a set of primary teeth
towards a completely new set of permanent
dentition. The primary posterior teeth play an
important role in mastication whereas the
anterior teeth aid in aesthetics and a proper
development of speech and self confidence in a
child.
Early childhood caries (ECC) is the most
common chronic dental disease which occurs in
children and primarily involves the primary
maxillary anterior teeth. According to the
American Academy of Pediatric Dentistry
(2003) ECC may be defined “as the presence of
one or more decayed, missing (due to caries) or
filled tooth surfaces in any primary tooth in a
[1]
child 71 months of age or younger.” The
prevalence is 1-12% in developed countries
and 70%, while in India, a prevalence of 44%
has been reported for caries in 8-48 months old
[2]
children. .In majority of cases, the destruction
of the tooth structure involves almost the entire
crown, leaving just the root and little crown
portion, hence, only dentine left for bonding of
the restorative materials. Thus, the only option
left is to extract these teeth. [3] Extraction of
anterior teeth results in loss of self confidence in
the child making these children shy and
introverts. Thereby, saving such teeth should be
our prime concern. To restore such severely
damaged teeth with pulpal involvement is
always a challenging task for the pediatric
dentist. Treatment of such teeth usually
involves pulp therapy followed by placement of
crown.
Case Report
Chief Complaint & History
A 3 year old male patient reported with fractured
upper anterior teeth to the Department of
Pediatric Dentistry, Manubhai Patel Dental
College, Vadodara. Parent gave history of
fracture of anterior teeth due to fall 15 days
back. The parent noticed the decayed anterior
teeth 1 year back and the patient had a history
of pain 4-5 months back which resolved with
unknown medication from the nearby dentist.
Intra-Oral Examination
On clinical examination, fractured upper
anterior teeth 51, 52, 61 and 62 were noticed.
There was complete loss of the crown with
direct pulpal involvement of 51, 61 and 62. 52
showed fracture involving only enamel and
dentine. There was a dull, lifeless appearance
of 51, 61 and 62 and there was no response to
electric and heat pulp tests.
*Senior Lecturer at Manubhai Patel Dental College, Vadodara, Gujarat.
9
Vol. 14 No. 2
May-August 2018