Advances in paediatric restorative dentistry

Abstract

Dental caries has been a highly prevalent and costly disease in the world, representing the most common infectious disease in the paediatric population. Caries lesions are also increasingly isolated in specific teeth and tooth morphology types, and there is growing controversy about the most appropriate restorative material for these lesions in deciduous teeth. In fact, restorative materials continuously improved in durability, strength, aesthetics, and anti-cariogenic properties. Moreover, the increasing demand for aesthetic restorative treatment has totally transformed the practice of paediatric dentistry in the last decade. Traditionally, the use of amalgam was a standard procedure in the restoration of carious primary teeth. Because of the introduction of adhesive restorative materials, the treatment of proximal caries has changed. The principal advantage of these new materials is that they require less retention form and this is particularly important in primary teeth to conserve the relatively thin enamel that could help prevent subsequent carious invasion of dentin. When planning dental treatment for paediatric patients, each subject and restorative material to be used should be evaluated on an individual basis, in order to provide appropriate care within each material's limitations. This chapter reviews the evolution of restorative materials used in paediatric dentistry, from the amalgam to bonding materials. The current trends and future directions in material research are also discussed. The chemical composition and the physico-chemical properties of the following materials are reported: Amalgam; Stainless steel crown restorations; Pit and fissure sealants; Dentin/enamel adhesives (from the first to the seventh generation); Glass-ionomer cements; Resin-based composites; Compomers. In order to assist the practitioner in the restorative dental care of children and adolescents, the clinical use and the cost-effectiveness of the various materials currently used in paediatric restorative dentistry are also discussed, with a special focus on the dentin/enamel adhesives.