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Advanced management techniques for carious and hypomineralised molars in children

Despite advances in preventive dentistry, dental caries is increasing in children. In addition, the prevalence of developmental defects of tooth structure (enamel hypomineralisation and hypoplasia) in young children is increasing in general dental practice. Management of the pulpally involved or severely compromised primary tooth poses considerable challenges for clinicians providing care of the child patient. Vital pulp therapy and stainless steel crowns are proven, dependable and efficient treatment options in the primary dentition as a means of maintaining the tooth and space for the permanent successor, whilst minimising the need for re-treatment. Case selection through appropriate diagnosis is essential to the long-term success of the procedures. In some cases, it may be appropriate to extract a primary tooth. We will discuss the reasons it may be preferable to extract a tooth and the options for space management. These options will include practical demonstrations and hands-on experience with the construction of a chairside space maintainer. 

Stainless steel crowns may be indicated in permanent molars when there has been enamel hypomineralisation, significant breakdown of the crown and pulpal sensitivity. The procedure is more complex than for primary crowns but the results are again reliable and predictable. Restoration with stainless steel crowns can provide an effective interim restoration with a view to considering planned extractions at the appropriate developmental stage. 

Topics include

  • Introduction to dental caries and development defects of dentition in children treatment planning for the paediatric dentition. Vital Pulp therapy for primary and immature permanent molars

  • Stainless steel crowns for primary and permanent molars. The concept of “minimal preparation” stainless steel crown techniques

  • Chairside construction of space maintainers

  • Behaviour management options for these procedures, including local anaesthesia techniques and placement of rubber dam

These procedures will be discussed in detail and participants will have the opportunity to complete the procedures on replica teeth.

Completion of this course will give attendees the confidence to provide predictable restorative options for young patients in a variety of settings. 

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The Paediatric Dentition

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