Indirect restorations in primary dentition: current clinical review

Abstract

Introduction: Indirect restorations in primary teeth have gained importance as an effective option in cases of extensive coronal destruction, where direct techniques are insufficient. Their main goal is to restore function, aesthetics, and durability in pediatric oral rehabilitation, leveraging recent technological advances. Objective: To evaluate current clinical evidence regarding the indication, performance, materials used, and future perspectives of indirect restorations in pediatric dentistry.  Literature review: Articles indexed in databases such as PubMed, Scopus, and ScienceDirect were reviewed, prioritizing systematic reviews, controlled clinical studies, and randomized trials from the past five years. Stainless steel crowns report a success rate of 94–96%, while indirect restorations in composite and ceramic using CAD/CAM techniques show survival rates between 85–91% in follow-ups of up to five years. Improvements in marginal adaptation, aesthetics, and tissue preservation have been reported. Digital techniques such as milling and 3D printing have enabled minimally invasive and reproducible restorations. Conclusions: Indirect restorations are a reliable and aesthetic treatment option for pediatric patients with extensive structural loss, particularly when appropriate technology and trained personnel are available. Recommendations: Promote the clinical application of indirect restorations in pediatric dentistry. Train professionals in advanced digital techniques. Strengthen longitudinal research in pediatric populations to optimize protocols and clinical outcomes.