Purpose: The purpose of this study was to determine which materials were most commonly used by pediatric dentists in California to restore Class II lesions in the primary dentition.

Methods: A questionnaire consisting of 18 multiple-choice questions was mailed to all 440 active members of the California Society of Pediatric Dentistry (CSPD). The questions related to the practitioners' material of choice for restoring Class II lesions in primary molars.

Results: A 66% response rate was received. For 57% of the respondents, amalgam was the material of choice for restoration of Class II lesions in primary molars. Twenty-nine percent selected composite, 5% glass ionomer, 6% compomer, and 1% (1 practitioner) stainless steel crowns. Sixty-eight percent responded that amalgam has historically proven to be a safe, reliable, and affordable material. The main reasons cited for using composite resin were "patient preference" (86%) and "better esthetics" (78%). Most practitioners used either a single-step (fifth-generation) or 2-step (fourth-generation) bonding agent (53% and 35%, respectively). When using a nonamalgam restorative material, 49% of practitioners used a traditional Class II amalgam preparation. The role of dental literature in treatment decision-making was not significantly related to the restorative material used.

Conclusions: While amalgam was the most common material used for Class II restorations, nonamalgam materials were significantly popular among California pediatric dentists.

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