Pediatric trauma is one of those clinical scenarios that induces the most angst. The sub-10 year old maxillary central incisor reconstruction is fraught with patient anxiety, emotional/stamina-based difficulty, with partially-erupted/emerged centrals with the cingulum often still a few millimeters subgingival. This makes the placement of ligatures nearly impossible. Both these freehand direct cases were isolated with relative isolation/split dam, which allowed access for simultaneous gingival recontouring as required and featured gingival retraction using different materials.
Remember if you use retraction cord and impregnate it with aluminum chloride that you need to neutralize its presence on dentin either with micro air abrasion (29 micron aluminum oxide) or with 15% EDTA (aq) via a 30 second scrub to remove the insoluble precipitate, lest your bond strengths be negatively impacted relative to control. PTFE tape is convenient to place and convenient to remove.
Both cases were restored using various combinations of Majesty ES-2 Premium shades.
#KurarayNoritake #ClearfilMajestyES2Premium #DirectResin #PediatricDentalTrauma
