An in vitro evaluation of the integrity of stainless steel crown margins cemented with different luting agents

Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements

The most common pathological condition, dental caries when remain untreated which shows pulpal involvement and may lead to invasive treatment, such as crown placement followed by pulp therapy. Larger carious lesions on primary molars stainless steel crowns (SSCs) placement by means of conventional tooth preparation. The modern approach to managing carious lesions concentrates on using less invasive treatment techniques, with the focus being on biofilm change. One among such alternative method of managing the primary molars is the Hall's technique. Another most important factor for the survival of a crown is its sealing ability, in which luting cements, such as adhesive cements, have a crucial role as they help in providing a suitable marginal seal and thereby cause a reduction in the microleakage. Silver diamine fluoride (SDF) has proven anticariogenic activity in arresting carious lesions. Hence the aim was to evaluate and compare the microleakage of SSCs placed by Hall's technique, Hall's technique with SDF, and the conventional crown technique using different luting cements. A total of 60 primary first and second molars with occlusoproximal caries, which were initial and moderate in nature. The blocks were randomly divided into three groups, in which precontoured SSCs were applied by using either the Hall's technique or the conventional technique. After subjecting tothermocycling, the samples were examined under stereomicroscopic for microleakage evaluation. A few samples were randomly selected from each subgroup, and a scanning electron microscopic (SEM) examination was done. Highest values of microleakage were noted with Hall's technique resin-modified glass ionomer cements (RMGIC) luting cement group. It can be concluded from the present study that the conventional technique was found to be superior over the Hall's technique with SDF and then by the Hall's group alone. SDF application beneath the Hall's crown appears to be promising approach for the reduction of microleakage.

How to cite this article

Thakur NS, Tyagi P, Tiwari S, et al. Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements. Int J Clin Pediatr Dent 2023;16(1):16-21.

Stainless steel crowns as a restoration for permanent posterior teeth in people with special needs: A retrospective study

BACKGROUND

Limited information exists regarding the use of stainless steel crowns (SSCs) in permanent teeth. The objective of this retrospective cohort study was to present the long-term clinical outcomes of the SSC compared with those of amalgam and composite resin restorations and the SSC radiographic outcomes in a special-needs population.

METHODS

This study included 271 patients with at least 1 SSC restoration from the Mount Sinai Hospital Dentistry Clinic for Persons with Special Needs in Toronto, Ontario, Canada. A total of 2,621 posterior permanent tooth restorations were documented: 766 SSCs, 1,651 amalgam restorations, and 204 composite resin restorations. Clinical analysis included patient demographics, treatment parameters, and outcome assessments for each restoration recorded. Radiographic analysis of SSC restorations included 127 bite-wing radiographs and 118 periapical radiographs, measurement of interproximal bone loss, and assessment of periapical status using the Periapical Index Scale.

RESULTS

The 10-year survival rates for new SSC and amalgam restorations were 79.2% and 63.5%, respectively. The 91 SSC failures included 2 recementations, 33 replacements, and 56 extractions. Primary diagnoses at the time of failure included chronic periodontal disease (25) and loose or lost SSCs (24). Of the 528 failed conventional restorations that were replaced, 60% were replaced with SSCs. The mean alveolar bone loss from mesial and distal sites was 1.36 millimeters and 1.40 mm, respectively. Therefore, 93% of the sites recorded were less than 2 mm and classified as healthy. All pre-SCC and post-SSC periapical radiographs had healthy Periapical Index Scale scores (1 or 2) recorded over an average duration of 8.4 years (1-29.1 years).

CONCLUSIONS

SSCs are a durable treatment option for the restoration of the posterior permanent dentition.

PRACTICAL IMPLICATIONS

Posterior permanent teeth restored with stainless steel crowns can be expected to last for 10 years and represent a viable treatment choice for severely carious or fractured posterior permanent teeth.

In vitro evaluation of the marginal integrity of CAD/CAM interim crowns

STATEMENT OF PROBLEM

The accuracy of interim crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems has not been well investigated.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal integrity of interim crowns made by CAD/CAM compared with that of conventional polymethylmethacrylate (PMMA) crowns.

MATERIAL AND METHODS

A dentoform mandibular left second premolar was prepared for a ceramic crown and scanned for the fabrication of 60 stereolithical resin dies, half of which were scanned to fabricate 15 Telio CAD-CEREC and 15 Paradigm MZ100-E4D-E4D crowns. Fifteen Caulk and 15 Jet interim crowns were made on the remaining resin dies. All crowns were cemented with Tempgrip under a 17.8-N load, thermocycled for 1000 cycles, placed in 0.5% acid fuschin for 24 hours, and embedded in epoxy resin before sectioning from the mid-buccal to mid-lingual surface. The marginal discrepancy was measured using a traveling microscope, and dye penetration was measured as a percentage of the overall length under the crown.

RESULTS

The mean vertical marginal discrepancy of the conventionally made interim crowns was greater than for the CAD/CAM crowns (P=.006), while no difference was found for the horizontal component (P=.276). The mean vertical marginal discrepancy at the facial surface of the Caulk crowns was significantly greater than that of the other 3 types of interim crowns (P<.001). At the facial margin, the mean horizontal component of the Telio crowns was significantly larger than that of the other 3 types, with no difference at the lingual margins (P=.150). The mean percentage dye penetration for the Paradigm MZ100-E4D crowns was significantly greater and for Jet crowns significantly smaller than for the other 3 crowns (P<.001). However, the mean percentage dye penetration was significantly correlated with the vertical and horizontal marginal discrepancies of the Jet interim crowns at the facial surface and with the horizontal marginal discrepancies of the Caulk interim crowns at the lingual surface (P<.01 in each instance).

CONCLUSIONS

A significantly smaller vertical marginal discrepancy was found with the interim crowns fabricated by CAD/CAM as compared with PMMA crowns; however, this difference was not observed for the horizontal component. The percentage dye penetration was correlated with vertical and horizontal discrepancies at the facial surface for the Jet interim crowns and with horizontal discrepancies at the lingual surface for the Caulk interim crowns.

Calcium Hydroxide vs. Mineral Trioxide Aggregates for Partial Pulpotomy of Permanent Molars with Deep Caries

AIM

To prospectively compare the clinical success rate of partial pulpotomy treatment in permanent molars using calcium hydroxide (CH) and mineral trioxide aggregates (MTA) as pulp dressing agents.

METHODS

Restorable permanent first molars (64) with carious pulp exposures were randomly assigned to two groups; CH and MTA. A standardized operative procedure was followed in both groups. Following isolation and caries removal, the exposed superficial pulp tissue layers were removed with a sterile flame shape diamond bur to a depth of 2-4 mm. Bleeding was controlled and pulp dressed with either a paste of non-setting Ca(OH)2 followed by a setting layer of Ca(OH)2, or with grey MTA. The dressing materials in both groups were then covered with a layer of light cured glass ionomer cement. The teeth were either restored using amalgam, or where grossly carious with preformed metal crowns. Patients were scheduled for follow-up at 3, 6, 12 months and annually thereafter.

RESULTS

There were 34 patients (17 males and 17 females) with 51 teeth available for evaluation. The age of patients at the time of restoration ranged between 6.8 to 13.3 years (mean of 10.3 +/- 1.8 years). The follow-up period ranged from 25.4 to 45.6 months with an average of 34.8 +/- 4.4 months. There was no statistically significant difference in the success rate of teeth treated with CH (91%) in comparison to teeth treated with MTA (93%). Radiographically, a hard tissue barrier under CH was noticed in 12 (55%) teeth compared with 18 (64%) teeth under MTA (p=0.4).

CONCLUSIONS

MTA has clinical success rate comparable to CH as a pulp dressing material for partial pulpotomy in permanent molars with carious exposures.