Transitional anterior esthetic restorations for patients with enamel defects.

The past decade has witnessed significant advances in the diagnosis and treatment of children with enamel defects. However, the emphasis in pediatric restorative care for this population has been focused largely in managing the primary dentition with treatment recommendations, ranging from resin strip crowns to stainless steel crowns with resin facings. Limited reports exist in the dental literature that address those patients in late childhood with the need for transitional care prior to complete eruption of the permanent dentition. It is during this preadolescent period that patients with developmental dental defects can present with an array of problems, including rapid dental deterioration, severe esthetic concerns, hypersensitivity to thermal, chemical, and mechanical stimuli, and alterations in vertical dimension of occlusion. Ideally, many of these issues are addressed best by using definitive restorations, but substantial challenges arise when the child is in the mixed dentition and teeth are still undergoing active eruption (e.g. the cuspids are not present and the central and lateral incisors are not fully erupted). Nevertheless, clinicians are faced with children and parents that desire treatment to ameliorate the functional and esthetic problems presented by a defective dentition. The two most common restorative approaches for young permanent incisors include composite resin restorations and stainless steel crowns with resin facings. The following report presents an alternative transitional treatment approach not previously described for the esthetic management of children in the mixed dentition with severe enamel defects.