Treatment Modalities for Rehabilitation of Mutilated Primary Anterior Teeth

Abstract

Early childhood caries commonly affects the primary maxillary anterior teeth, in which extensive post- endodontic rehabilitation has always been a challenge. This is due to the small size of the crown, relatively large pulp chambers, and the age of the child. The remaining inadequate sound tooth structure renders restorations more prone to fractures. Among the available treatment modalities which include extraction of the grossly destructed tooth structure, use of semipermanent crowns and intracanal posts, the posts can be used effectively, to restore the lost function and anatomy. They also enhance the quality of the final coronal restoration by providing additional support for retention. The available methods for intracanal reinforcement for anterior teeth include the metal posts fabricated using orthodontic wires, short composite posts fabricated directed in the primary root canal, prefabricated glass fiber posts and posts utilising polyethylene fibers (Ribbond). Recently certain advanced techniques such as the biologic dentin and zirconia have also come into use. The various advantages and disadvantages for these have been summarised in this review along with the standardised clinical protocol for their placement in the primary root canals. Various in-vivo and in-vitro studies have concluded that the glass-fiber short intracanal posts provide the most suitable esthetics, strength, elastic modulus, and resilience. However, further qualitative research is required to certify it as a standard treatment modality.