Full Coronal Restorations in the Oral Rehabilitation of Patients with Severe ECC: 2 Case Reports

Background: Stainless steel crowns have proved success for the restoration of primary molars, however the esthetic management of extensively decayed primary maxillary anterior teeth requires an esthetic and also reliable material. Zirconia crowns have provided a treatment alternative to address the esthetic concerns in the recent years. Two cases who applied to Yeditepe University, Faculty of Dentistry, Department of Paediatric Dentistry with severe ECC will be presented.

Methods:

Case 1: A 27 months old girl referred with esthetic concerns and her history revealed 22 months ad-libitum breast feeding and no fluoride exposure. Fluoride varnish was applied and after 6 months screening, she was treated under general anesthesia. 2 primary incisors had pulpotomies whereas pulpectomy was performed in the others. The four maxillary incisors were restored with zirconia crowns. Maxillary first primary molars were restored with compomer and the oral rehabilitation was completed with sealants and fluoride varnish application. 3rd, 6th and 12th month control examinations revealed that the patient was free of new caries, had good oral hygiene and the zirconia crowns have demonstrated good retention and esthetic results.

Case 2: A 4 year old boy referred for treatment of his severeley destructed primary teeth due to long-term nocturnal feeding with baby bottle. The oral rehabilitation was performed under general anesthesia, including 10 pulpotomies, 1 pulpectomy, 6 SSC’s, 2 posterior, 5 anterior composite resin restorations, extraction of maxillary right canine and nance appliance. Oral hygiene instructions and dietary counseling was provided. 3rd and 6th month control examinations showed that the patient was healthy with optimum oral hygiene, despite the plaque accumulation potential of SSC’s and nance appliance.

Conclusions: Although application of preformed coronal restorations require advanced operational skills and patient cooperation, they are successful and practical tools for the oral rehabilitation of young patients with severe ECC.