Tuesday, March 13, 2018

Retrospective study of retention of stainless steel crowns and pre-veneered crowns on primary anterior teeth

Article Title: Retrospective study of retention of stainless steel crowns and pre-veneered crowns on primary anterior teeth
Author(s): Lopez-Loverich AM
Journal: Pediatric Dentistry
Date: 2015; 37: 530-4
Major Topic: Primary anterior crowns
Type of Article: Longitudinal study
Main Purpose: This article aimed to compare the retention of anterior PVSSCs and conventional SSCs.
Key Points: Similar retention rates were found in PVSSCs and SSCs.  
Indications for full-coverage anterior restorations in primary teeth:
1.     Caries on multiple surfaces
2.     Incisal edge involvement
3.     Extensive cervical decalcification
4.     Pulpal therapy indicated
5.     Minor caries but very poor OH (high caries risk)
6.     Poor moisture control, making class III very difficult
7.     Children requiring GA should be given strong consideration for use of SSCs

·      Strip crowns are esthetic but retention depends on amount of enamel present and are very technique sensitive.
·      Open-faced SSCs are the most time consuming and lack esthetics
·      PVSSCs: inflexible, esthetic, allow for limited crimping, must fit passively, require more removal of tooth structure
·      Records of children treated with either SSCs or PVSSCs were reviewed. Of 483 PVSSCs,  9% failed. Of 154 SSCs, 7% failed.
o   Did NOT review chipping or debonding if facial veneer
o   Failure = crown fell off
·      PVSSCs and SSCs demonstrate similar retention rates, 91% vs. 93%
·      SSCs were retained longer in the mouth than PVSCCs by about 10 months
·      The worse the patient behavior, the more likely the clinician placed SSC rather than PVSSC

Remarks:
1- I am not sure if PVSSCs are relevant anymore because of advent of Figaro and Zirconia crowns. I think strip crowns may always be applicable in certain scenarios but the use of other crowns may change significantly over time.
Assessment of Article:  Level of Evidence/Comments: II-2

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