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Dental caries is a localized post eruptive pathological process of external origin involving softening of the hard tooth tissue and proceeding to the formation of cavity as defined by WHO. It is the most prevalent disease in the humans and manifests with an extremely high caries index in several countries. Early Childhood Caries (ECC) is an infectious disease of the primary teeth in children which leads to severe destruction of the teeth and results in damage to their permanent successors teeth if not treated at an early stage. If the grossly carious primary molar is left untreated may lead to functional disharmony, development of deleterious habit and can affect the permanent tooth buds. In an attempt to widen as biologically and conservatively as possible, several authors have suggested the use of tooth fragments or extracted human teeth as a restorative material to rehabilitate severely destroyed tooth crowns. The technique is simple, allows the preservation of sound tooth structure and provides excellent aesthetics. This paper aims to review the evolution, methods and effects of these biological restorations.