early childhood caries ( ecc ) is one of the most common chronic diseases of the childhood . according to the american academy of pediatric dentistry ( 2003 ) ecc
may be defined  as the presence of one or more decayed , missing ( due to caries ) or filled tooth surfaces in any primary tooth in a child 71 months of age or younger . 
the prevalence is 1 - 12% in developed countries and 70% , while in india , a prevalence of 44% has been reported for caries in 8 - 48 months old children .
the early loss of primary anterior teeth may result in reduced loss of vertical dimension , masticatory efficiency , development of parafunctional habits ( tongue thrusting , speech problems ) , esthetic functional problems such as malocclusion , psychological problems that can interfere in the personality and behavioral development of the child .
this case report describes the challenging task of treating a 3-year - old child with severely decayed maxillary anterior teeth that were restored using modified omega loop post followed by strip crown .
a 3-year - old child reported to the department of pedodontics and preventive dentistry , with a complaint of severely decayed upper front teeth .
the child was shy , and behavior of the child was definitely negative according to frankl behavior rating scale .
intraoral examination revealed a complete set of deciduous and caries involving with 61 ( maxillary left primary central incisor ) .
coronal portions of 61 were severely damaged , and most of the tooth structure was lost with pulpal involvement .
61 . after taking parents , consent diet analysis , counseling , and oral prophylaxes were performed .
61 using metapex , followed by custom - made half omega - shaped post with 0.9 mm stainless steel orthodontic wire using no.130 to make omega loop , and serrations were done to increase the stability of the esthetic restoration and the mechanical retention of the core .
about 5 mm of the metapex was removed from the coronal end of the root canal , and 1 mm of glass ionomer cement ( gic ) was placed .
the incisal end of the wire projected 3 - 4 mm above the remaining root structure .
after gic set , the canal was prepared to get a space of about 3 mm [ figure 1 ] .
( a - f ) pulpectomy procedure with modified omega loop post followed by strip crown i.r.t .
61 the root canal was etched with 35% phosphoric acid for 20 s , followed by bonding agent was placed and cured for 20 s. the flowable composite was injected into the root canal along with the loop .
the composite was light - cured for 40 s. crown was reconstructed using strip crown . finishing and polishing
treatment of preschool children and restoration of primary anterior teeth with the severe loss of coronal structure is a challenging task for the pediatric dentists .
the main aim is to preserve teeth and restore them so that child is able to perform normal like mastication , speech , and esthetics .
the failure rate is high in such type of cases due to the absence of tooth structure , poor adhesion of bonding agent of primary teeth , limited availability of material and technique .
after the successful endodontic treatment and placement of intracanal retainers , the remaining coronal structure can be restored with indirect or direct technique or single tooth prostheses , such as strip crown , stainless steel crown , metal plastic crown , porcelain veneers , polycarbonate crowns , and acrylic resin crown . nowadays , esthetic crowns are introduced in pediatric dentistry like pedo jacket crowns , fuks crowns , new millennium crowns , preveneered crowns , cheng crowns , dura crowns , pedo pearl crowns and kinder crowns to overcome the disadvantages of strip crown like low retention and poor adhesive of bonding agent .
many studies advocate the use of nonmetallic posts such as ceramic post , polyethylene glass fibers , carbon fibers , etc . , but in such kind of cases , it has some disadvantages like technique sensitive , time - consuming , multiple steps , and expensive .
a simpler and effective method is to use an omega loop that was introduced by mortada and king . in this technique ,
omega loops wire extensions are placed at the depth of around 3 - 4 mm inside pulp chamber and the projected portion of the loop is used for retention of the coronal restoration .
the biggest advantage is that the wire does not cause any internal stresses in the root canal as it is incorporated in the restorative material mainly , and it can be done with minimal chair side time . in the present case report , a simple and effective method for reconstruction of severely destroyed primary anterior teeth has been used .
this technique can be done directly in the oral cavity without involving any laboratory procedures .
the complete procedure can be completed in one appointment , easy for the pediatric patient and less cooperation required from the child .
as the core length of the omega loop , which is placed intracanal , is around 3 mm thus occupies only the cervical one - third of the canal and does not interfere with deciduous tooth root resorption and permanent tooth eruption .
omega loop technique can be an easier , simpler , and inexpensive treatment of choice for severely damaged primary anterior teeth .
the modified omega loop with serration used in this case report demonstrated good retention , good esthetics , and masticatory function to the child .
however , it is a long time success , and its durability in children having parafunctional habits like bruxism , deep bite , etc .
 the esthetic concern of severely mutilated primary anterior teeth in the case of early childhood caries has been a challenge to pediatric dentist . 
 early childhood caries is the most common chronic disease of the preschool child . 
 the case report presented here is of a three year old boy with severely decayed maxillary anterior teeth . 
 after root canal treatment , the primary maxillary central incisors were reinforced using modified omega post and followed by using celluloid strip crowns . 
 the technique described here offers a simple and effective method for restoring severely decayed primary anterior teeth that reestablishes shape , function , and esthetics . 