A new challenge overcome in pediatric dentistry for aesthetic rehabilitation with acetate crown and unichromatic resin in a 4-year-old child.
Authors: Prof. Dr. Sandra Kalil Bussadori, Prof. Dr. Pamella de Barros Motta, Prof. Dr. Ana Paula Taboada Sobral, and Prof. Dr. Carolina Cardoso Guedes
MALE PATIENT, 4 YEARS OLD
The main complaint of the guardians was the darkened teeth of the child.
Initial evaluation
No pathological changes were observed after detailed anamnesis and clinical and radiographic examination. The presence of generalized non-cavitated active carious lesions (white spots) in the upper and lower arches was verified during the clinical examination. Teeth 51 and 52 had caries lesions in dentin without pulp involvement.
Caries is a dynamic and multifactorial disease caused by the imbalance of the oral microbiota due to the high-frequency consumption of fermentable carbohydrates, such as sucrose, which leads to the demineralization of the hard tissues of the tooth. When mineral loss occurs, the caries lesion will manifest clinically, at first as a non-cavitated lesion, which may evolve into a cavity.1
Pediatric Dentistry aims to promote preventive actions in oral health to patients. However, we still find a high rate of caries lesions in deciduous teeth, requiring the rehabilitation of the elements affected by the disease to restore the function and aesthetics of patients.
Treatment performed
The guardians were instructed on the adequacy of diet and oral hygiene. Duofluorid XII application protocol was performed on active white spots (four sessions of one session per week). Condac 37 etching was performed on teeth 51 and 52, washing, drying, applying the Ambar APS adhesive system, and photoactivation for 10 seconds. The darkened dental structure was masked with the Opallis composite resin in OW color.
The acetate crowns were cut for better adaptation to the dental remnant. A hole in the palatal face of the acetate crowns was made to prevent extravasation of excess composite resin. The crowns were filled with Vittra APS Unique resin, and the excesses of composite resin from the proximal regions were removed. Only then was photoactivation performed around the crowns for 20 seconds on each surface.
The unichromatic resin copied the color of the dental substrate that was masked with the Opallis resin in OW color, discarding the failure to select the color and thus reducing the clinical time desired in pediatric dental care.
Step by step
1 | Acid etching with Condac 37.
2 | Application and photoactivation of the Ambar APS adhesive system.
3 | Accommodation of the acetate crown to check the adaptation.
4 | Positioning the acetate crown filled with Vittra APS Unique composite and photoactivation of tooth 52.
5 | Removing the acetate crown after photoactivation of tooth 52.
6 and 7 | Initial and final aspect.
Check out the step-by-step guide to using Opallis composite resin.
References
- ABOPED – Associação Brasileira de Odontopediatria. Diagnóstico da Cárie Dentária. Capítulo 6. Diretrizes para Procedimentos Clínicos em Odontopediatria. 3. ed. Rio de janeiro: Santos, 2020
Products used Pediatric Dentistry
