Esthetic and Cost-Effective Restoration of Carious Primary Teeth with Extra-Coronal Restoration(s) Fabricated Using a Novel Composite Based Material



Neeraj Gugnani, Inder Kumar Pandit, Monika Gupta, Shalini Gugnani, Bhavika Sandhu, Ritika Chhiber
Department of Pediatric and Preventive Dentistry, Yamunanagar, Haryana, India

Background: Primary teeth affected by ECC are restored with intra-/extra-coronal restorations. Teeth with single-surface caries are restored with intra-coronal restorations while endodontically-treated/teeth with multi-surface caries/carious broken are restored with extra-coronal restorations. Strip-crowns with composites are used to restore such teeth but moisture-control and dependency on remaining tooth surface for bonding offers challenge for these restorations. Prefabricated zirconia/Pre-veneered crowns are being propagated owing to better esthetics and retention but higher cost and difficult adaptation are their limitations.

An alternative solution can be; to fabricate full-coronal restoration, which is esthetic, durable and cheap and serves till primary tooth exfoliates. Recently, a composite-based material is launched; indicated to fabricate chair-side esthetic crowns that can serve for 5-6 years. This case-series depicts use of this novel-material (Luxacrown, DMG-Germany) for restoring primary teeth.

Methods: Patients with ECC involving anterior/posterior teeth requiring full-coronal restoration were selected and informed consent was sought.

For crown fabrication, following caries removal/pulpal therapy, tooth preparation was done, reducing the tooth ~1.5mm from all surfaces. For broken teeth post-and-core build-up was done before crown fabrication.

Further, either strip-crown was selected (anterior teeth) or wax mock-up was done on cast following which sectional-putty-index (SPI) was taken (posterior/anterior). Subsequently, strip-crown/SPI was loaded with Luxacrown material which was placed on prepared tooth. This was removed while material was still elastic and then material was allowed to set extra-orally. Finally, crowns were finished and cemented using RMGIC cement. Patients were recalled after 1-week, 1 and 3-months respectively to evaluate retention, color-match and patient-satisfaction.

Results: All patients exhibited good immediate-esthetics and good retention, color-match and marginal-adaptation at all recalls. Patient satisfaction was also scored high in all cases.

Conclusion: Full-coronal restorations fabricated using composite-based material can be indicated as esthetic/cost-effective solution for restoring teeth affected by ECC. Long term clinical trials are required to validate the results.

Neeraj Gugnani