An Alternative Approach to the Transitional Rehabilitation of Infra‐Occluded Primary Second Molars

Different approaches have been proposed for the treatment of retained infra‐occluded primary molars with agenesis of permanent successors including extraction with orthodontic space closure, prosthetic replacement, or retention of the primary tooth in situ for space maintenance. The retention of primary second molars in situ represents a conservative treatment option to preserve alveolar bone at the future implant site, and it is especially indicated for young patients who have not completed skeletal growth until later reassessment can determine definitive treatment. The orthodontist and the restorative dentist must work together in the comprehensive treatment planning of these patients for optimal results. The present report describes the transitional rehabilitation of infra‐occluded primary second molars for a 13‐year‐old patient with direct resin composite restorations. Furthermore, the report illustrates the use of an alternative technique with a clear vinyl‐(poly‐siloxane) matrix to facilitate the direct restorative procedures and minimize the finishing procedures involved in the placement of large composite restorations. CLINICAL SIGNIFICANCE A conservative approach for the transitional rehabilitation of infra‐occluded primary molars is possible with direct composite restorations. Alternative techniques such as the use of a clear vinyl‐(poly‐siloxane) matrix that can be cured‐through allow considerable simplification of the direct restorative techniques. ( J Esthet Restor Dent 22:354–362, 2010)