Survival analysis of metal crowns versus restorations in primary mandibular molars

Zirconia vs. stainless steel pediatric crowns: a literature review

The aim of this review was to assess efficacy and acceptance of aesthetic zirconia crowns (ZCs) compared to the traditionally employed stainless steel crowns (SSCs) for primary teeth restoration. A comprehensive literature search was completed for the relevant keywords in Scopus and Medline databases. Resulting article abstracts and full texts were screened to determine final inclusion. Eighteen articles were included from the initial search. There is still little evidence to support the use of one type of crowns over another for primary teeth, in particularly for ZCs, lately introduced in pediatric restoration. The gold standard for restoring decayed primary teeth is still represented by SSCs, despite the growing importance of the aesthetic issue related to their use. Aesthetic ZCs resulted in having adequate properties to be employed for the treatment of decayed primary teeth, such as mechanical resistance, limited plaque adhesion, wear behavior and natural appearance. There is still a paucity of literature clinically evaluating the efficacy of ZCs for primary teeth restoration, but they can be considered a promising alternative to SSCs. This field of research has to be more deeply explored to improve dental care in children affected by early childhood caries.

Atraumatic restorative treatments reduce the need for dental general anaesthesia: a non-inferiority randomized, controlled trial

BACKGROUND

A dental general anaesthesia (DGA) is commonly undertaken for the management of dental caries in young children. A randomized-controlled trial was undertaken to test the feasibility of using the Atraumatic Restorative Treatment and Hall Technique approaches (ART/HT) to manage the dental treatment of children recommended for a DGA.

METHODS

Consenting children, recommended a DGA for caries management, at the Oral Health Centre of Western Australia were randomized. Test group children were treated using the ART/HT approach and the control group under a DGA. Children were examined after 12 months by two blinded, calibrated examiners. Analysis was on an intention to treat basis; between and within group comparisons were undertaken using appropriate paired and unpaired tests. Logistic regression was used to test restorative success, controlling for clustering of teeth.

RESULTS

Sixty-five children participated, (Test = 32; Control = 33). At study termination, 28 children (88%) in the ART/HT group and 20 children (61%) in the DGA group had been provided with care, P < 0.01. Crown restorations were protective of restorative failure in a multivariate logistic model (OR 0.05, P < 0.01).

CONCLUSION

Use of the ART/HT approach enabled timely dental treatment of young children recommended for a DGA, and should be among the treatment options considered.