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Tricks and Techniques for Class II Composites in Primary Molars by Fred Margolis

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by Fred Margolis


After more than 40 years as a dentist, I find that the Class II restoration is the most challenging class of restorations.

Numerous factors make this restoration difficult: moisture control, sealing of the dentinal tubules, marginal seal, placement of the restoration, light curing, contacts and occlusion, and finishing and polishing the restoration. We ask ourselves, "Which materials will be best for this patient?”

We must also consider whether the goal is to provide a long-lasting restoration that will be aesthetic with no postoperative sensitivity. We also would like to provide minimally invasive dentistry and not remove more tooth structure than is necessary.

Fortunately, dental manufacturers of adhesive materials can provide our patients and the dentists with all of the above. Various techniques are available for restoring Class II restorations in primary teeth that meet all of the patient's goals and our goals in providing the best restoration with the best materials available.

Case Report
A 5-year-old male had Class II caries on the mesial of the lower right second primary molar. The preparation was made with a hard-tissue laser and a #330 carbide bur. Due to laser analgesia, no local anesthetic was needed. A matrix band and wedge were placed. The matrix I now prefer for excellent contacts and contour is the 3D XR by Garrison Dental Solutions (Fig. 1).

After rinsing and drying the preparation, a one-step bonding agent, BeautiBond, was applied for 10 seconds. The bonding agent was dried for five seconds and then light-cured (Fig. 2).

A flowable composite, Beautifil Flow Plus by Shofu, was placed in the proximal box. The purpose of using this flowable composite is the release and recharge of fluoride, resistance of bacterial colonization, radiopacity, and excellent aesthetics and durability (Fig. 3).

A composite was placed over the flowable composite, completely filling the preparation (Fig. 4). Finishing burs were used to shape the restoration. Shaping and polishing was done using sandpaper discs (Fig. 5). Shofu's Super-Snap OneGloss polishing discs and points were used to obtain a smooth, shiny surface (Fig. 6).

The final restoration is shown in the final image (Fig. 7).

Author's note: The case photos were taken for illustration purposes. A rubber dam or Isolite mouth prop was used to provide a dry field.





Dr. Fred Margolis received his BS and DDS from Ohio State University and his certificate in pediatric dentistry from the University of Illinois, College of Dentistry. He has lectured internationally and is the author of Beautiful Smiles for Special People, a course manual for working with disabled patients. He is co-author of Pediatric Laser Dentistry, A User's Guide, published by Quintessence. Dr. Margolis is in private practice of pediatric dentistry in Highland Park, Illinois.


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