Restos in Primary & Mixed Dentition

Restos in Primary & Mixed Dentition

1. Primary vs Permanent Teeth Differences

   • Crown smaller, more bulbous
   • Occlusal surface narrow
   • More cervical constriction
   • Thinner enamel & dentine (1/2 thickness)
     • Lighter colour, easier to cut
   • Larger pulp, fine canals, thin pulpal floor
   • Roots long, slender, curved
     • Endo difficult, thus pulptomy is tx of choice
   • Enamel rods at gingival 1/3rd extend occlusally

2. Split Dam

   • Pain on clamp placement
   • Latex allergy
   • Airway obstruction
   • Damage to teeth by clamps
   • Matrix band placement

3. PMC

   • Indications
     • High caries risk
     • After pulpotomy or pulpectomy
     • # primary molars or extensive tooth surface loss
     • Local or generalised developmental problems
     • As abutments for appliances
     • Impaired OH routine
   • Anaesthetise & Isolate
   • Hall's Technique
     • Selection Criteria
       • Minimal caries into enamel & D
       • Pulp status - reversible pulpitis
       • No signs & symptoms of pain & vital tooth
     • Done w/o RD or in uncooperative child
     • In primary molars with minimal caries (Hall's)
   • Risks/Complications
     • Perio concerns with plaque accumulation
     • Nickel allergy
     • Aesthetics

4. Materials

   • PMC
     • Must after pulp tx in primary molars
     • In multisurface cavities
   • Amalgam
     • Class 1 & minimal Class 2
   • GIC
     • Only as temp & caries stabilisation
   • RC
     • Minimal Class 2 (slot cavity)
     • Anterior teeth - Class 3,4 & 5