Use of Bulk-Fill giomer in primary molars with pulp therapy: Case report

Abstract

Introduction: Preformed metal crowns are the standard treatment for the rehabilitation of primary molars undergoing pulp therapy. However, esthetic or anatomical limitations may hinder their use, prompting the search for alternatives. In this context, giomers have emerged as hybrid materials that combine the mechanical, esthetic, and adhesive properties of composite resins with fluoride release and a bioactive effect. Their glass filler allows for the sustained release of ions (fluoride, strontium, sodium, aluminum, silicate, and borate), promoting remineralization, antibacterial action, and the prevention of secondary caries. Clinical studies have shown success rates close to 94% in primary molars. Case report: A 7-year-old female patient presented with an acute abscess in tooth 7.5. A two-session mechanized pulpectomy was performed. During restoration, mesiodistal misfit of the preformed metal crown was detected, attributed to interproximal space loss caused by caries.
Given this situation, a posterior celluloid crown (TDV) filled with giomer (Beautifil Bulk, Shofu Inc.) was selected. Once proper fit was confirmed, a selective adhesive protocol was applied, followed by bulk-fill resin insertion. Each surface was individually light-cured, and occlusion was adjusted and polished. Clinical and radiographic follow-ups up to 10 months showed an aesthetic, functional, and stable restoration. Conclusions: Bulk-fill giomer crowns are an aesthetic, functional, and bioactive option when metal crowns cannot be properly adapted.