For filling therapy in pediatric dentistry, materials based on the compomers with color and glitter effects are available, which can be used to treat defects in the first dentition (in the milk teeth). Voco offers the Twinky Star material. The base material is compomer, a plastic material similar to the material used in composite fillings (plastic fillings). However, unlike composites, the fillers here consist of dissolvable glass bodies as in the material group of glass ionomer cements, and the fillers are also much larger than the nanoparticles used in composite fillings. Twinky Star is offered in eight different shades with glitter particles.
Indications (areas of application)
The colored compomers are adapted to the first dentition (milk teeth) in terms of their material properties. They are
- Color-stable
- Biocompatible
- Sufficiently abrasion resistant (abrasion resistant)
- Durable until exfoliation (to the natural loss of milk teeth).
- Radiopaque (radiopaque)
- Show good adhesion to dentin and enamel, provided that an adhesive system is used
- Have high compressive strength
- Have a filler content of about 78% by weight
- Give off fluoride, which makes the development of secondary caries (new caries) more difficult
In terms of their abrasion behavior (their abrasion resistance), the colored compomers are indeed at a disadvantage compared to the composites; however, a deciduous tooth also has a much higher abrasiveness than a permanent tooth, so the use of the colored dental fillings in the deciduous dentition is quite acceptable, taking into account the service life of the tooth and filling. However, the indication for a colored deciduous tooth filling is not based on its aforementioned material properties. Rather, it is one of quite a few artifices used in pediatric dentistry to increase the compliance (ability to cooperate) of young patients and, if necessary, to maintain it over several treatment sessions:
- The color and glitter effects arouse the child’s interest
- The child has a right of co-determination through the choice of colors, which reduces the feeling of being at the mercy of others
- The anticipation of another color from the palette facilitates the next visit to the dentist
- The colorful “jewelry” can have a positive effect on oral hygiene behavior
Contraindications
- Allergy to composite resins
- Circular caries (surrounding the tooth in a band): in this case, a deciduous crown is indicated
- Too large cavity with missing walls oral or buccal (to the tongue or cheek side): here, too, the stabilization of the remaining tooth substance with a deciduous crown is useful.
Before the filling
Before filling, you will accordingly attach great importance to the choice of colors by the child and also try to create anticipation for more colors.
The process
- Usually local anesthesia (local anesthesia).
- Excavation (removal of the carious destroyed tooth structure).
- Preparation of the cavity (shaping, e.g. removal of too thin friable marginal areas).
- If necessary, pulp protection (covering of dentin areas in the immediate vicinity of the pulp) with a calcium hydroxide preparation.
- Dentin adhesion promoter: to improve the adhesion of the compomer filling material to the dentin (dental bone), a self-etch adhesive, for example, is massaged into the dentin for approx. 20 seconds or according to the manufacturer’s instructions
- Light curing (chemical curing is initiated by light).
- Placement of the compomer filling in several layers into the cavity (hole in the tooth), plugging and modeling (fitting to the tooth contours).
- Light curing of the individual layers
- Finishing the hardened filling e.g. with finishing diamonds and polishers.
After filling
After the filling, it can be loaded immediately. However, the patient must wait for the anesthetic effect (anesthesia) to completely wear off before eating, otherwise there is a risk that the still anesthetized lips, cheeks or tongue will be lodged between the teeth when chewing.
Possible complications
Possible complications arise from the individual situation of the tooth to be restored and from the cooperation of the young patient, rather than from the material used, for example:
- Pulpitis (inflammation of the pulp) due to excessive proximity of the cavity floor to the pulp
- Loss of filling due to lack of adhesion, e.g. because of saliva ingress when placing the filling
- Interruption of the procedure by no longer resilient patient, with quality losses as a result (saliva, too little light curing, no more time for filling contouring, etc.).
