This document discusses factors to consider when selecting restorative materials for pediatric dental patients. It describes various material options including amalgam, composite resin, glass ionomer, and stainless steel crowns. Key considerations for material selection include the child's age, esthetic demands, cooperation level, remaining life span of the tooth, degree of decay, and cost. The document provides guidelines for choosing between materials based on the restoration situation and outlines common reasons for restoration failure in primary teeth.

1. How to Select
Restorative
Materials
Prepared By :
Saeed Bajafar
Muhammsd Raffat
Fadi Emad
Nouran Waleed

2. Successful results in operative dentistry cannot be
achieved without using proper restorative materials.
The final restoration will never be better than the
properties of the material selected for its fabrication.
Many changes have occurred in the development
and availability of dental restorative materials for
pediatric patients over the last 60 years.
Indrouction :

3. Why ?
Repair or Limit the
damage
Reestablish Adequate
Function
Maintaining Good
Oral Hygiene
Restore Esthetics
Maintain Pulp Vitality
Preserve the Tooth
Structure

4. The restoration is expected to perform certain
FUNCTIONS :
To stop further progress of lesions in hard tissue or loss of
these tissues
.1To prevent future recurrence of caries
.1To restore and maintain normal interproximal
embrasures and contact areas
.1To sustain functional forces
.1To restore and maintain esthetics

5. 1. Adaptability to cavity walls and margins
2. Great strength properties
3. Dimensional stability in the cavity
4. Biologic compatibility with the adjacent structures and pulp
5. Insolubility in the fluids of the mouth
6. Harmonious color
7. Low thermal conductivity and thermal changes
8. Convenience of manipulation
To achieve these objectives the restorative material used is
required to possess DEFINITE PROPERTIES.

6. 1. Adaptability To Cavity Walls And Margins
This refers to the degree of proximity to cavity walls
and margins that the restorative material will be able
to attain and maintain under oral conditions.

7. The restorative material must have adequate strength
against all the types of functional stresses including tensile,
compressive, shear and impact, whether these be static or
dynamic.
2-Great Strength Properties

8. The restoration must exhibit no dimensional changes in the
form of EXPANSION or CONTRACTION after being placed
in the cavity whether during setting or due to thermal changes
in the mouth.
3-Dimensional Stability In The Cavity

9. 4-Biologic Compatibilty With The Adjacent Structure
And Pulp
Restorative material must be free from noxious
effects on the gingival tissues and the pulp
5-Insolubility In The Fluids Of The Mouth
The restorative material must be perfectly insoluble in
the fluids of the mouth irrespective of its type and pH
fluctuations

10. To stimulate the color of the tooth,
the restorative material is required to
have the combined color of enamel
and dentin.
6-Harmonious Color
The restoration may be subjected, even
temporarily, to wide ranges of
temperature changes. Therefore, it
should be nonconductor of heat
7-No Conductivity To Thermal Changes

11. The restorative material must be
easy to fabricate without detailed
procedures or expensive special
equipment.
8-Convenience Of Manipulation

12. The Available Restorative Material
Amalgam
.1Composite Resin
.1Glass Ionomer
.2-Conventional Glass Ionomer
•-Resin Modified Glass
Ionomer
.1Stainless steel crown

13. Amalgam
Because of concerns about toxicity and environmental pollution, plus the
availability of alternative materials, amalgam is less frequently used.
However, it still remains an acceptable and durable material for class I and
II restorations in primary molars.
Advantages :
- Simple
- Quick
- Cheap
- Technique insensitive
- Durable
Disadvantages :
- Not adhesive
- Bad esthetics
- Requires mechanical
retention in the cavity
- Environmental and
occupational hazards

14. Composite Resin
Early studies suggested poor performance in primary teeth, but modern materials
placed with good isolation (i.e. rubber dam) perform as well, or better than
amalgam, but take longer to place.
Advantages :
- Adhesive
- Aesthetic
- Reasonable wear
properties
- Command set
Disadvantages :
- Technique sensitive
- Rubber dam
required
- Expensive

15. Glass Ionomer cement
Has advantages of adhesion and fluoride release, but is more technique sensitive
and less wear resistant than amalgam.
Useful in non-load bearing class III and V cavities, temporization of primary teeth
in young, pre-cooperative children, or teeth near to exfoliation.
Advantages :
- Adhesive
- Aesthetic
- Fluoride leaching
Disadvantages :
- Brittle
- Susceptible to
erosion and wear

16. Resin Modified Glass Ionomer
Advantages :
- Adhesive
- Aesthetic
- Command set
- Simple to handle
- Fluoride release
Disadvantages :
- Water absorption
- Significant wear

17. Stainless Steel Crown
Advantages :
- Durable
- Protect and support
remaining tooth
structure
Disadvantages :
- Extensive tooth
preparation
- Patient cooperation
required
- Unaesthetic

18. Age
Esthetic
Demands
Child’s
Co-operation
Life span of
primary teeth
Degree of
caries
Cost
Restorative
Situation
Colleague
appraisal
Research
reports
Factor
Affecting
The Choice
Of Dental
Material

19. Selecting Restorative Material according to AAPD

20. Selecting Criteria for Full Coverage of Primary Incisor :

21. Various Hypothetical Clinical Scenarios

22. Various Hypothetical Clinical Scenarios

23. Various Hypothetical Clinical Scenarios

24.  Recurrent caries, often due to failure to adequately complete caries
removal because of flagging patient cooperation or failure to use
adequate LA. If unable to finish cavity it is better to place a temporary
dressing (GIC often best) and try again at another visit.
 Cavity preparation does not satisfy the mechanical requirements of
the
filling material.
 Inadequate moisture control, especially true of GI cements,
compomers, and composites.
 Presence of occlusal high spot.
Reasons For Failure Of Restorations In Primary Teeth :