CASE REPORT

Journal of Research in Dental and Maxillofacial Sciences

DOI: 10.61186/jrdms.9.3.204

Esthetic Reconstruction of Primary Molars with

Direct Composite Crown: One-Year Report of Five
Cases
Roozbeh Sadrimanesh 1, Parissa Aref 2 
, Sara Tavassoli- Hojjati 2, Saman
Haghighat 1
1
Private Dental Practice, Tehran, Abstract
Iran. Background and Aim: Dissatisfaction of parents with the appearance
2
Department of Pediatric Dentistry,
of conventional stainless-steel crowns (SSCs) has led the pedodontists
Faculty of Dentistry, Tehran Medical
Sciences, Islamic Azad University,
to choose alternative esthetic restorations such as zirconia crowns.
Tehran, Iran. Case Presentation: In this report, a new approach for fabrication of
direct composite crowns for primary molars was described using dual-
 Corresponding author: cure core build-up composite material in five patients with one-year
Parissa Aref, Department of Pediatric follow-up.
Dentistry, Faculty of Dentistry, Tehran Conclusion: Direct composite crown appears to be a suitable esthetic
Medical Sciences, Islamic Azad
restoration for pulpotomized primary molars in cooperative patients
University, Tehran, Iran.
with acceptable oral hygiene.
Keywords: Child; Composite Resins; Crowns; Esthetics, Dental; Molar
parissa234@yahoo.com
Cite this article as: Sadrimanesh R, Aref P, Tavassoli-Hojjati S, Haghighat S. Esthetic
Reconstruction of Primary Molars with Direct Composite Crown: One-Year Report of Five
Article History Cases. J Res Dent Maxillofac Sci. 2024; 9(3):204-210.
Received: 13 February 2024
Accepted: 15 May 2024

Introduction esthetic demands of parents [6]. Zirconia crowns

Dissatisfaction of parents with the unesthetic met the esthetic requirements to a great extent;
appearance of stainless-steel crowns (SSCs) is a however, they did not gain increasing popularity
challenge in pediatric dentistry [1-3]. SSCs are due to the need for extensive tooth preparation,
highly durable, and are the most commonly used inability to adjust the crown margins, and high
type of crown for primary posterior teeth. cost [2,3,7]. Pre-veneered metal crowns had
However, unesthetic appearance is their main optimal esthetics; however, inability to adjust
drawback [4]. Dissatisfaction of parents with the the crown margins, and chipping of the
unesthetic appearance of SSCs led dental veneering over time were among their main
clinicians to search for alternative esthetically drawbacks [3,8]. The long-term success of
pleasant restorations [5]. Pre-veneered SSCs, composite resin application along with a strip
resin-bonded strip crowns, and prefabricated crown for full coverage of primary anterior teeth
zirconia crowns are among the alternative has been well documented [9,10]. However, this
crowns introduced to the market to meet the method was not widely accepted by dental

Copyright © 2024 Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license
(https://creativecommons.org/licenses/by-nc/4.0/). Noncommercial uses of the work are permitted, provided the original work is properly cited.
205 Sadrimanesh et al. Direct Composite Crown for Primary Molars

clinicians for posterior teeth due to high for complete crown coverage of primary
technical sensitivity and difficult application posterior teeth by using a dual-cure core build-
[6,11]. Also, no clinical study is available up composite resin. This restoration has optimal
regarding its true clinical efficacy. Composite durability without the unesthetic appearance of
resin restorations have long been successfully SSCs.
used for reconstruction of permanent posterior
teeth. However, application of composite resin Case Presentation
for multi-surface restoration of primary Five pediatric patients were selected among
posterior teeth has not shown satisfactory those presenting to the Pediatric Dentistry
results due to the occurrence of secondary caries Department of School of Dentistry of Islamic
[12,13]. Also, due to the risk of fracture of Azad University, Tehran who required
undermined tooth wall in multi-surface pulpotomy and complete coverage of their
restorations, particularly after pulp therapy, primary first molars. The patients had no
systemic disease or bruxism. The selected teeth
such teeth should be preferably crowned [14]. A
had to have sound buccal and lingual walls. Thus,
previous study reported successful results of
pulpotomized teeth with mesio-occluso-distal,
indirect composite crown of primary molars
disto-occlusal, and mesio-occlusal cavities were
with multi-surface caries after pulpotomy at the
selected. The gingival floor had to be located
1-year follow-up. They suggested this modality
supra-gingivally, and the residual walls had to be
for cases requiring esthetic restorations.
free from caries, and supported by sound dentin.
However, the need for laboratory fabrication of After caries removal, the walls had to have a
crowns is a limitation of this modality for minimum of 2 mm residual thickness. Also, the
esthetic reconstruction of primary teeth [15]. teeth had no caries in the buccal and lingual
Dual-cure core build-up composite resins are walls. The patients had to be cooperative
used for core build-up after endodontic (Frankl's behavior rating scale 3 or 4) and were
treatment in permanent teeth. Also, evidence between 4-8 years of age. They had good oral
shows that their application for direct hygiene (oral hygiene index < 3) as well. The
restoration increases the fracture resistance of study was approved by the ethics committee of
teeth [16]. This type of composite has increased School of Dentistry of Islamic Azad University,
percentage of fillers, which confers greater Tehran (IR.IAU.DENTAL.REC.1399.035). The
strength and decreases shrinkage. Also, such treatment was started after obtaining written
composites have increased fracture resistance informed consent from the parents.
due to improved flexural modulus [17,18]. These
composite resins are available in flowable Primary restoration:
After pulpotomy, Zonalin (Golchay, Iran) was
consistency, which enhances their application
applied in the pulp chamber with 2 mm
and results in their improved adaptation to
thickness, and a 1-mm glass ionomer lining
surfaces [19]. Their dual-cure polymerization
(Willmann & Pein, Germany) was applied over it
mode is another added advantage, which
to prevent the adverse effect of Zonalin on
eliminates the need for incremental application composite resin [21]. Next, the internal walls of
of composite, and the composite resin can be the cavity were cleaned such that the sound
applied as bulk in one step to save time [20]. Due dentin was visible. A matrix band was applied
to such favorable properties, such composite around the tooth with a matrix holder, and the
resins are optimal for use in pediatric dentistry. internal cavity walls were etched with 37%
This study aimed to introduce a novel approach phosphoric acid gel for 20 seconds. Care was
J Res Dent Maxillofac Sci 2024; 9(2) Sadrimanesh et al. 206

taken not to over-etch the glass-ionomer. The gingival sulcus by the respective gun, and the
tooth was then rinsed with water for 20 seconds patient was asked to bite on the GingiCap
and dried with gentle air spray [22]. Two layers (spongy cap placed on the tooth) for 2 minutes.
of Single Bond (3M ESPE, USA) were then Next, the GingiCap was removed, and the
applied on the tooth, dried with gentle air spray material was rinsed off with water spray. It is a
for 10 seconds, and cured for 20 seconds. Auto- kaolin clay-based material that retracts the
mix dual-cure core build-up composite (Rebilda gingiva. It also contains 15% aluminum chloride
DC, VOCO GmbH, Germany) was injected into the to induce hemostasis [25]. The area was isolated
cavity to the level of the occlusal surface, and by placing cotton rolls in the buccal and lingual
after chemical curing for 5 minutes, light curing sulcus. Also, a subgingival retraction cord size 00
was performed for 20 seconds [23] (Figure 1). (Coltene/Whaledent AG, Switzerland) was
packed in the gingival sulcus [26,27]. To protect
the adjacent teeth during etching, they were
protected with Teflon tape.

Figure 1. Schematic view of the tooth after primary

restoration

Tooth preparation:
In the next step, the tooth received standard Figure 2. Schematic view of the prepared tooth
SSC preparation. The occlusal surface was
prepared such that the respective tooth had 1.5 Final restoration:
mm distance from the opposing tooth in The tooth was etched with 37% phosphoric
occlusion. Also, adequate interproximal distance acid gel for 30 seconds. The etchant was rinsed
was ensured by passing the tip of an explorer with water for 20 seconds, and the tooth was
through the interproximal space. After selecting dried with air spray. Two layers of adhesive
the proper-size SSC, and its correct seating and (Single Bond Universal, 3M ESPE) were applied
adaptation with the tooth, a putty-wash on the tooth, and dried with gentle air pressure
impression was made from the tooth along with for 10 seconds. Light curing was performed for
SSC. Next, the SSC was removed from the tooth. 20 seconds using a curing unit (Woodpecker,
To achieve optimal composite thickness supra- China) with 1000 mW/cm2 light intensity.
gingivally, the sound walls were prepared with Automix dual-cure core build-up composite
fissure bur (#847-010, Jota, Switzerland) by 0.5 (Rebilda DC, VOCO GmbH) was applied into the
mm according to the tooth contour to obtain a tray at the site of the respective tooth, and the
shoulder finish-line at the tooth periphery [24] tray was placed in the oral cavity immediately
(Figure 2). after removing the cotton rolls, and held in place
In case of gingival bleeding, Access Edge for 5 minutes with gentle pressure to allow
(Centrix, USA) was injected into the gingival completion of chemical curing. Next, the tray
sulcus around the tooth for isolation of the area. was removed and composite was cured from the
For this purpose, it was first injected into the buccal, lingual and occlusal surfaces, each for 20
207 Sadrimanesh et al. Direct Composite Crown for Primary Molars

seconds. The subgingival cord was removed, and

the restoration margins were evaluated to
ensure absence of excess composite. Next, the
occlusion was checked by a copying paper. The
contact area was checked by a dental floss, and
the composite restoration was finished and
polished (Figure 3). Finally, one layer of low-
viscosity polishing liquid (Biscover LV, Bisco,
Schaumburg, IL, USA) was applied on the crown.
For this purpose, composite was etched for 15 Figure 5. Bitewing radiograph showing a maxillary primary
seconds and rinsed. Next, a thin layer of liquid first molar with a composite crown
was applied on the composite, and after 15
seconds, it was light-cured for 30 seconds Follow-up:
(Figure 4) [28,29]. To assess the final crown for The patients were followed-up for 3, 6, 9, and
integrity and absence of overhang, a bitewing 12 months for evaluation of the crowns. In the
radiograph was obtained from the tooth recall sessions, the following parameters were
(Figure 5). evaluated according to the modified United
States Public Health criteria [30]:
(I) Assessment of gingival health by
evaluation of bleeding on probing
(II) Assessment of secondary caries by bite-
wing radiography
(III) Assessment of tooth fracture by clinical
inspection and examination with a dental
explorer
(IV) Assessment of fracture, discoloration,
integrity, and marginal adaptation of crown by
visual inspection and clinical examination with a
Figure 3. Schematic view of the tooth after placement of dental explorer [30].
final crown Also, the patients received oral hygiene
instructions, and underwent fluoride therapy at
each recall session. Restoration loss, poor
marginal adaptation, secondary caries,
restoration discoloration, and periodontal
problems did not occur in any patient during the
follow-up period.

Discussion
This study described a new approach for
complete coronal reconstruction of primary
teeth with a dual-cure core build-up composite
resin. According to the guidelines of the
American Association of Pediatric Dentistry,
SSCs are recommended for restoration of
Figure 4. Clinical view of a maxillary first molar primary teeth to increase their fracture
immediately after crowning resistance and success rate of pulp therapy [31].
J Res Dent Maxillofac Sci 2024; 9(2) Sadrimanesh et al. 208

Considering the high prevalence of early composite crown had a larger bonding interface
childhood caries in primary teeth [32], a high with enamel compared with multi-surface
number of primary teeth require complete restorations, which can aid in clinical success
crown coverage after pulp therapy [33]. and durability of restorations.
However, many parents are dissatisfied with the In the present study, the primary first molars
unesthetic appearance of SSCs [34], indicating of 5 patients were restored with direct
the need for a more esthetic replacement for composite crowns after pulpotomy. The teeth
esthetically important zones. A dual-cure core were evaluated according to the modified United
build-up composite resin (Rebilda DC, VOCO States Public Health Service criteria at the 3, 6, 9,
GmbH) was used to fabricate direct composite and 12-month follow-ups. All crowns were intact
crowns in the present study. This composite is at the 1-year follow-up, and showed complete
suitable for the fabrication of composite crowns adaptation. None of the patients had secondary
in children due to optimal properties. Dual-cure caries, and they all had acceptable gingival
core build-up composite resins have higher filler health. Also, none of the crowns showed
content than conventional composites, which discoloration. The present results were similar
increases their fracture resistance [17]. They are to those of Mohammadzadeh et al, [15] who
dual-cure and are chemically cured in hard-to- restored teeth with indirect composite crowns
reach areas for light curing [18]. Thus, when the by using fiber-reinforced composites for
tray containing composite resin is placed over laboratory fabrication of tooth-colored crowns
the prepared tooth, primary setting occurs for primary molars, and reported optimal
without requiring light. Such composite resins success rate at the 1-year follow-up.
are flowable and auto-mix. Auto-mixing The described approach has advantages such
minimizes the risk of void formation while as designing a direct composite model by using
flowability ensures adequate adaptation of the precise anatomy of SSCs, and using the
composite in the tray with the tooth [35]. available composite resins. Also, this approach
Previous studies demonstrated that multi- does not require laboratory procedures, which
saves time and cost. However, further studies on
surface restorations were not successful in
a higher number of patients with longer follow-
primary teeth [36,37]. Pires et al, [38] in a
ups are required to cast a final judgment
systematic review and meta-analysis in 2018
regarding its widespread use.
compared the bond strength of primary and
permanent teeth. They acknowledged the
Conclusion
differences between the primary and permanent
It appears that direct composite crown can
enamel and dentin, which are responsible for the serve as a suitable esthetic restoration for
different bond strength values of composite to pulpotomized primary molars in cooperative
primary and permanent teeth. The enamel in patients with acceptable oral hygiene.
primary teeth is thin, and primary dentin has
lower mineral content. Also, due to high density References
of dentinal tubules in primary teeth, the amount 1. Akhlaghi N, Hajiahmadi M, Golbidi M. Attitudes of Parents
of available inter-tubular dentin for bonding is and Children toward Primary Molars Restoration with
lower. All these factors are responsible for lower Stainless Steel Crown. Contemp Clin Dent. 2017 Jul-
bond strength of composite to primary teeth, Sep;8(3):421-6.
compared with permanent teeth [39]. However, 2. Lopez-Cazaux S, Aiem E, Velly AM, Muller-Bolla M.
the bond strength of composite to primary and Preformed pediatric zirconia crown versus preformed
permanent enamel has been reported to be pediatric metal crown: study protocol for a randomized clinical
comparable [40-42]. In the present study, direct trial. Trials. 2019 Aug 24;20(1):530.
209 Sadrimanesh et al. Direct Composite Crown for Primary Molars

3. Rezvi FB, Mathew MG, Gurunathan D. Crowns in Pediatric Build-Up Materials: An Invitro Study. IOSR-JDMS.
Dentistry-A Review. Annals of RSCB . 2021;25(3):30-9. 2018;17(10):26-9.
4. Abdulhadi BS, Abdullah MM, Alaki SM, Alamoudi NM, Attar 17. Spinhayer L, Bui ATB, Leprince JG, Hardy CMF. Core build-
MH. Clinical Evaluation Between Zirconia Crowns and Stainless up resin composites: an in-vitro comparative study. Biomater
Crowns in Primary Molars Teeth. Journal of Pediatric Dentistry Investig Dent. 2020 Nov 3;7(1):159-66..
2017; 5(1): 21-7. 18. Zarow M, Dominiak M, Szczeklik K, Hardan L, Bourgi R,
5. Möhn M, Frankenberger R, Krämer N. Wear and marginal Cuevas-Suárez CE, et al. Effect of Composite Core Materials on
quality of aesthetic crowns for primary molars. Int J Paediatr Fracture Resistance of Endodontically Treated Teeth: A
Dent. 2022 Mar;32(2):273-83. Systematic Review and Meta-Analysis of In Vitro Studies.
6. Nowak AJ. Pediatric Dentistry: Infancy Through Adolescence. Polymers (Basel). 2021 Jul 9;13(14):2251.
6th ed. USA: ELSEVIER; 2019. 634 P. 19. Bortolotto T, Melian K, Krejci I. Effect of dual-cure
7. Rocha MCM, Inácio GC, Taira TM, Delgado RZR, Maciel SM, composite resin as restorative material on marginal adaptation
Frítola MJPDJ. Zirconia crowns as an esthetic alternative for of class 2 restorations. Quintessence Int. 2013 Oct;44(9):663-
oral rehabilitation in pediatric dentistry: A review. Pediatric 72.
Dental Journal. 2021;31(3):224-34. 20. Mathew MG, Roopa KB, Soni AJ, Khan MM, Kauser A.
8. Guelmann M, Shapira J, Silva DR, Fuks AB. Esthetic Evaluation of Clinical Success, Parental and Child Satisfaction of
restorative options for pulpotomized primary molars: a review Stainless Steel Crowns and Zirconia Crowns in Primary Molars.
of literature. J Clin Pediatr Dent. 2011 Winter;36(2):123-6. J Family Med Prim Care. 2020 Mar 26;9(3):1418-23.
9. Chen X, Zhong J, Yan W, Zhang H, Jiang X, Huang Q, et al. 21. Itskovich R, Lewinstein I, Zilberman U. The Influence of Zinc
Clinical performance of rensin-bonded composite strip crowns Oxide Eugenol (ZOE) and Glass Ionomer (GI) Base Materials on
in primary incisors. Journal of Peking University Health the Microhardness of Various Composite and GI Restorative
Sciences 2020;52(5):907-12. Materials. Open Dent J. 2014 Feb 7;8:13-9.
10. Grewal N, Jha S, Kaur N. Clinical and Radiographic Success 22. Choi SM, Choi YC, Park JH, Choi SC. The effect of etching
of Resin-bonded Strip Crowns in Primary Incisors with Varying time on the pattern of acid etching on the enamel of primary
Extents of Sound Tooth Structure Available for Bonding. Int J teeth. J Korean Acad Pediatr Dent. 2008;35(3):437-45.
Clin Pediatr Dent. 2021 Jul-Aug;14(4):454-61. 23. Tauböck TT, Bortolotto T, Buchalla W, Attin T, Krejci I.
11. Garg V, Panda A, Shah J, Panchal P. Crowns in pediatric Influence of light-curing protocols on polymerization shrinkage
dentistry: A review. J Adv Med Dent Scie Res 2016;4(2):41-6. and shrinkage force of a dual-cured core build-up resin
12. Chen K, Lei Q, Xiong H, Chen Y, Luo W, Liang Y. A 2-year composite. Eur J Oral Sci. 2010 Aug;118(4):423-9.
clinical evaluation of stainless steel crowns and composite 24. Pan CY, Lan TH, Liu PH, Fu WR. Comparison of Different
resin restorations in primary molars under general anaesthesia Cervical Finish Lines of All-Ceramic Crowns on Primary Molars
in China's Guangdong province. Br Dent J. 2018 Jul in Finite Element Analysis. Materials (Basel). 2020 Mar
13;225(1):49-52. 1;13(5):1094.
13. Chisini LA, Collares K, Cademartori MG, de Oliveira LJC,
25. Dederichs M, Fahmy MD, Kuepper H, Guentsch A.
Conde MCM, Demarco FF, Corrêa MB. Restorations in primary
Comparison of Gingival Retraction Materials Using a New
teeth: a systematic review on survival and reasons for failures.
Gingival Sulcus Model. J Prosthodont. 2019 Aug;28(7):784-9.
Int J Paediatr Dent. 2018 Mar;28(2):123-39.
26. Loguercio AD, Luque-Martinez I, Lisboa AH, Higashi C,
14. Mathew MG, Roopa KB, Soni AJ, Khan MM, Kauser A.
Queiroz VA, Rego RO, Reis A. Influence of Isolation Method of
Evaluation of Clinical Success, Parental and Child Satisfaction of
the Operative Field on Gingival Damage, Patients' Preference,
Stainless Steel Crowns and Zirconia Crowns in Primary Molars.
and Restoration Retention in Noncarious Cervical Lesions.
J Family Med Prim Care. 2020 Mar 26;9(3):1418-23.
15. Mohammadzadeh Z, Parisay I, Mehrabkhani M, Madani AS, Oper Dent. 2015 Nov-Dec;40(6):581-93.

Mazhari F. Clinical evaluation of fiber-reinforced composite 27. Raskin A, Setcos JC, Vreven J, Wilson NH. Influence of the
crowns in pulp-treated primary molars: 12-month results. Eur J isolation method on the 10-year clinical behaviour of posterior
Dent. 2016 Oct-Dec;10(4):522-8. resin composite restorations. Clin Oral Investig. 2000
16. Rai D, Bondarde P, Patil S, Mujawar S, Vishwakarma A, Sep;4(3):148-52.
Gakhare R. Comparative Evaluation Of Fracture Resistance Of 28. Dede DÖ, Şahin O, Koroglu A, Yilmaz B. Effect of sealant
Endodontically Treated Teeth Restored With Different Core agents on the color stability and surface roughness of
J Res Dent Maxillofac Sci 2024; 9(2) Sadrimanesh et al. 210

nanohybrid composite resins. J Prosthet Dent. 2016 36. Liberman J, Franzon R, Guimarães LF, Casagrande L, Haas
Jul;116(1):119-28. AN, Araujo FB. Survival of composite restorations after
29. Yikilgan İ, Kamak H, Akgul S, Ozcan S, Bala O. Effects of selective or total caries removal in primary teeth and
three different bleaching agents on microhardness and predictors of failures: A 36-months randomized controlled
roughness of composite sample surfaces finished with different trial. J Dent. 2020 Feb;93:103268.
polishing techniques. J Clin Exp Dent. 2017 Mar 1;9(3):e460-5. 37. Pummer A, Cieplik F, Nikolić M, Buchalla W, Hiller KA,
30. Samer MS, Faraz Q, Al-Dubai SAR, Vohra F, Abdullah H, Schmalz G. Longevity of posterior composite and compomer
Taiyeb-Ali TB, Saub R. Clinical Outcomes and Predictors of restorations in children placed under different types of
Satisfaction in Patients with Improved Lithium Disilicate All- anesthesia: a retrospective 5-year study. Clin Oral Investig.
Ceramic Crowns. Med Princ Pract. 2017;26(5):470-9. 2020 Jan;24(1):141-50.
31. American Academy of Pediatric Dentistry. Pulp therapy for 38. Pires CW, Soldera EB, Bonzanini LIL, Lenzi TL, Soares FZM,
primary and immature ermanent teeth. The Reference Manual Montagner AF, Rocha RO. Is Adhesive Bond Strength Similar in
of Pediatric Dentistry. Chicago, Ill.: American Academy of Primary and Permanent Teeth? A Systematic Review and Meta-
Pediatric Dentistry; 2021:399-407. analysis. J Adhes Dent. 2018;20(2):87-97.
32. Jullien S. Prophylaxis of caries with fluoride for children
39. Martínez-Carrasco CA, Nevárez-Rascón A, Soto-Barreras U.
under five years. BMC Pediatr. 2021;21(1):1-11.
Comparative Evaluation of Bond Strength of Self-Etching and
33. Bargale S, Davangere Padmanabh SK, Kariya PB, Shah S,
Total Etch Dental Adhesive Systems to Dentin of Deciduous and
Dave B. Knowledge, attitude, and practice regarding
Permanent Teeth. Int. J. Odontostomat. 2020;14(1):55-9.
standardized treatment protocol for pulp therapy in deciduous
40. Ilie N, Schöner C, Bücher K, Hickel R. An in-vitro assessment
dentition among general dental practitioners of Vadodara,
of the shear bond strength of bulk-fill resin composites to
Gujarat, India. J Indian Soc Pedod Prev Dent. 2019 Oct-
permanent and deciduous teeth. J Dent. 2014 Jul;42(7):850-5.
Dec;37(4):327-2.
41. Nemati Anaraki S, Kazemi H, GHafari Z, Naser Z, Bitaraf T.
34. Karpagam N, Mathew MG. Knowledge awareness and
In-Vitro Comparative Study of the Effect of Four Finishing and
practice among parents regarding the usage of crowns in
Polishing Tools on Surface Roughness of a Microhybrid Resin
pediatric dentistry. Drug Invention Today. 2020;13(5):695-8.
Composite. Journal of Research in Dental and Maxillofacial
35. Almohareb T, Alayed AA, Alzahrani KM, Maawadh AM,
Sciences. 2019;4 (2):26-31.
Almutairi B, Alhamdan RS, Bahkali A, Abduljabbar T, Vohra F.
42. Tedesco TK, Soares FZ, Grande RH, Filho LE, Rocha Rde O.
Influence of curing duration and mixing techniques of bulk fill
resin composites on bi-axial flexural strength and degree of Effect of cariogenic challenge on bond strength of adhesive

conversion. J Appl Biomater Funct Mater. 2020 Jan- systems to sound and demineralized primary and permanent

Dec;18:2280800020975721. enamel. J Adhes Dent. 2014 Oct;16(5):421-8.