Total crown replacement technique A biological treatment option for grossly destructed primary molars

Background: Restoration of severely damaged primary molars with very short clinical crowns is a big challenge and often extracted due to the lack of restorative options. Total crown replacement (TCR) is a novel treatment alternative for the restoration of such teeth through bonding of the biological restorations which are the sterile decoronated crowns of the extracted human teeth, obtained from a tooth bank. Case Report: Presented here is a report of two cases restored with the TCR technique. A 9-month follow-up showed satisfactory results in terms of function, esthetics, gingival health, and morphology including occlusal wear. TCR can be a viable and economical alternative for restoration of severely decayed/damaged primary teeth, otherwise indicated for extraction.

Biological restorations as a treatment option for primary molars with extensive coronal destruction: report of two cases

This article reports the cases of two young children aged 4 and 5 years, in whom biological restorations using tooth fragments were placed in primary molars with severely damaged crowns due to extensive carious lesions. After radiographic and clinical evaluation, tooth fragments obtained from extracted teeth in stock were autoclaved, adjusted to the prepared cavity and bonded to the remaining tooth structure with either adhesive system (Case 1) or dual-cure resin-based cement (Case 2) over a calcium hydroxide layer and a glass ionomer cement base. Occlusal adjustment was performed and topical sodium fluoride was applied to tooth surface. Periodical clinical and radiographic controls were carried out and the restored teeth were followed up for 4 and 3 years, respectively, until exfoliation. In these two reports, the technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed primary molars are discussed.

Este artigo descreve dois casos clínicos de reconstrução de molares decíduos com extensa destruição coronária por meio de restaurações biológicas, em crianças de 4 e 5 anos. Após avaliação clínica e radiográfica, os fragmentos dentais heterógenos foram submetidos à colagem ao remanescente dental preparado usando sistema adesivo (Caso 1) ou cimento resinoso de presa dual (Caso 2) sobre uma camada de hidróxido de cálcio e uma base de ionômero de vidro. Foi realizado ajuste oclusal e aplicação tópica de flúor sobre a superfície dentária. Controles clínico e radiográfico foram realizados periodicamente e os dentes restaurados foram acompanhados por 4 e 3 anos respectivamente, até a exfoliação. Por meio destes dois relatos, os autores discutem os aspectos técnicos, além das vantagens e desvantagens das restaurações biológicas como tratamento alternativo para restauração de molares decíduos.