A 7-year-old has deep caries on tooth L involving three surfaces (mesial, occlusal, lingual). What is the BEST definitive restoration?

Correct answer: D. A stainless steel crown

• A. Extraction sacrifices a restorable tooth and forfeits natural space maintenance — the tooth should be saved if restorable.
• B. Composite in a three-surface primary molar preparation is technique sensitive, hard to isolate in a young child, and has poorer longevity in this indication.
• C. Multi-surface amalgams in primary molars have high failure rates from recurrent caries at the margins and fracture of the remaining tooth structure.
• D. CORRECT. A STAINLESS STEEL CROWN is indicated for primary molars with multi-surface caries, extensive caries, following pulp therapy, in high-caries-risk children, and in developmental defects. SSCs show markedly higher longevity and lower failure and re-treatment rates than multi-surface intracoronal restorations in primary molars, and they protect the remaining tooth structure that must survive until natural exfoliation.

Note: AAPD guidance: SSC for multi-surface lesions in primary molars, especially in high-risk children and after pulpotomy.