A 7-year-old boy reported to our clinic with the chief complaint of decayed teeth. Clinical and radiographic examination revealed multiple carious lesions in all teeth with retained roots of 61, 62. Complete preventive care was provided, retained roots were extracted and all carious teeth were restored. Primary mandibular first molar (84) was grossly carious [] and a decision to place biologic shell crown was made.\nThe operative procedure is described below:\nStep 1: Biologic shell crown preparation: Primary mandibular right first molar (possibly extracted for serial extraction) was selected based on mesiodistal dimensions of the tooth to be restored. The selected tooth was sectioned approximately 1 mm occlusal to cemento-enamel junction. Any remaining pulp tissue was removed using sharp spoon excavator. All undercuts were removed and dentinal surfaces were prepared to diverge cervically. The cervical margin was prepared flat with rounded internal line angles so that it can be seated on prepared margin of primary mandibular first molar. Sterilization was performed as described previously.\nStep 2: Complete caries excavation was performed under local anesthesia with area isolated using rubber dam. After caries removal, a layer of GIC (GC Fuji II, Glass Ionomer Restorative, GC, USA) was placed. Circumferential shoulder margin with rounded internal line angles was placed using round end tapered diamond parallel to long axis of tooth []. Withdrawal form was established by rounding of all line and point angles and removing all undercuts.\nStep 3: Rubber dam was removed and occlusal clearance was checked using modeling wax sheet.\nStep 4: Trial fit of biologic shell crown was done and adjustments were done if needed [].\nStep 5: Etching of dentinal surfaces of prepared biologic shell crown and prepared tooth surfaces was done with 35% phosphoric acid (3M™/ESPE™ Dental Products, USA) for 15 s. Final cementation was performed using dual cure resin cement (RelyX™ U100 Self-Adhesive Resin Cement, 3M™/ESPE™ Dental Products, USA) following manufacturer's instructions.\nStep 6: Final check for occlusion in centric as well as eccentric positions to check for any functional interferences. Thin carbon paper was used and pre-maturities, if any were removed.\nStep 7: Finishing and polishing of margins was done with composite finishing and polishing tips (CompoSite™ Finishing Kit, CompoSite™ Polishing Kit, Shofu, USA).\nClinical examination [] at 1, 6, and 9 months showed the cemented biologic crown to be functioning well in the oral cavity.
A 17-year-old male patient presented with a complaint of yellow discoloration of his teeth since 8 to 9 years. Patient was giving positive history of discolored anterior deciduous teeth; however, medical history and family history was unremarkable. Patient had permanent dentition with no missing teeth. All the anterior and posterior teeth were affected with brownish discoloration; while attrition present with posterior teeth. Height of the clinical crowns of upper and lower posterior teeth were reduced. In 11, 14, 21, 22, 24, 34, 42, pitting were present. Consistency of enamel was hard. Chipping of enamel was not present in any teeth []. Panoramic radiograph was taken which showed presence of a thin layer of enamel with radiodensity of enamel more than dentin []. On the basis of clinical and radiographic features, final diagnosis of hypoplastic AI was made.