Part
3: Alternative
Restorative Therapy
RGMI materials are excellent choices for controlling carious lesions in infants and toddlers by using them in band-aid restorations. Not only do they have good adhesion and clinical retention, but they release fluoride into the surrounding tooth structure and they are aesthetically pleasing. They are relatively easy to handle, are easily mixed, and can be placed in cavity preparations with minimal excavation if necessary, or in very difficult cases with no excavation at all. They also adhere well to dentin and enamel.
In extreme cases, ionomers can be placed with no conditioning of the tooth at all. Of course, better conditions during placement will result in improved adhesion and durability of the restoration.
A product used by the Department of Pediatric Dentistry at the University of Washington is Vitrebond (3M Dental Products) as the RMGI band-aid restorative material. This material can be light cured, which expedites the speed of placement and helps with managing infants and toddlers. Most RMGI systems, including Vitrebond, also have the benefit of being self-cure systems, so layering the material during placement is not necessary. However, the light cure reaction results in improved physical properties in the case of Vitrebond.
It is recommended that a calcium hydroxide base be placed in areas of preparations that are in very close proximity to the pulp (less than 1.0 mm).