BACKGROUND:
Caries decline in the western world is accompanied by strong polarization among children; 8% of Finnish 5-year-olds having 76% of untreated caries. This high caries risk group needs preventive and restorative strategies.

AIM:
To explore survival of extensive restorations in primary molars.

DESIGN:
This study was based on health records from 2002 to 2016 of children under 18 years.

RESULTS:
Of severely affected primary molars (n = 1061), 41% were restored with preformed metal crowns (PMCs), 38% with glass-ionomer cement (GIC)/polyacid-modified resin composite (PAMRC)/resin-modified GIC (RMGIC), and 21% with resin composites (RC). Younger children (3-8) received 97% of the PMCs and 86% of GIC/PAMRC/RMGIC; older ones (≥9) 91% of the RC restorations. Neither amalgam nor indirect restorations were registered. General dentists (GDs) engaged in primary care restored with GIC/PAMRC/RMGIC (52%) or RC (48%). GDs in general anesthesia care service placed 66% and specializing/specialized dentists 31% of PMCs. PMCs had lower failure rate (1.4% vs 3.0%) than GIC/PAMRC/RMGIC (P = 0.001). Choosing PMCs reduced patient visits compared to other restorations (P < 0.001).

CONCLUSIONS:
Severely affected primary molars of children at high caries risk are better managed, using PMCs to optimize the resources in public oral health services.

Reference
Survival of extensive restorations in primary molars: 15-year practice-based study.
Tseveenjav B, Furuholm J, Mulic A, Valen H, Maisala T, Turunen S, Varsio S, Auero M, Tjäderhane L.
Int J Paediatr Dent. 2017 Dec 3. doi: 10.1111/ipd.12348. [Epub ahead of print]