European Archives of Paediatric Dentistry

, Volume 16, Issue 5, pp 425–429 | Cite as

A novel approach for building up infraoccluded ankylosed primary molars in cases of missing premolars: A case report

  • N. A. LygidakisEmail author
  • K. Chatzidimitriou
  • N. N. Lygidakis
Case Report



In cases of infraoccluded primary molars associated with agenesis of premolars, any treatment plan occasionally includes retention of the primary teeth for space preservation and future implant placement if needed. In these cases, building up the crowns to the occlusal line is necessary to prevent various clinical problems. The present case report describes in detail a novel but simple clinical approach for retention and building up of the crown of infraoccluded primary molars.

Case report/technique presentation

The technique is presented in a 14-year-old girl with nine missing permanent teeth. Orthodontic evaluation indicated space closure for five teeth and space maintenance in the remaining four second primary molars, three of them being infraoccluded. The technique included the following clinical steps: (a) elastic separators were placed proximally to the primary molars for few days to create space; (b) proximal minimal reduction of the crown width was performed; a direct hand composite resin core was made to increase crown height facilitating the selection of a preformed metal crown (PMC). The selected PMC was filled with self-curing composite resin and placed on the primary tooth following an acid etch and adhesive procedure; excess cervical material was removed; (c) after polymerisation, the PMC was carefully removed using cutting and hand instruments, revealing the composite resin fabricated crown which was adjusted for occlusion and polished. Radiographic evaluation confirmed the result.


This simple method for infraoccluded primary molars crown building up to occlusion using conventional instruments and materials, appears to be a valuable clinical tool for paediatric dentists who frequently find themselves dealing with primary teeth that need to be retained and which can produce serious clinical problems if left untreated.


Infraocclusion Ankylosis Primary molars Built-up Treatment 



Dr. K. Chatzidimitriou is a Scholar of the Hellenic State Scholarships Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© European Academy of Paediatric Dentistry 2015

Authors and Affiliations

  • N. A. Lygidakis
    • 1
    Email author
  • K. Chatzidimitriou
    • 1
  • N. N. Lygidakis
    • 1
  1. 1.Private Paediatric Dental ClinicAthensGreece

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