Comparison of microleakage from stainless steel crowns margins used with different restorative materials: An in vitro study

Is the Metallic Color of Stainless Steel Crown Satisfying for Cooperative Children and their Parents? a Preliminary Study

STATEMENT OF THE PROBLEM

Currently, the demand for tooth-colored restorations in children and young adults is increasing. Stainless steel crown (SSC) is the most common restoration for decayed primary molars. Given the dark metallic color of SSC, the esthetic appearance of this restoration is poor and subsequently their acceptance is still a matter of debate.

PURPOSE

This study was conducted to evaluate the effect of restoration's color on children's daily living conditions and compare the clinical and radiographic success rates of composite resins with SSC in primary molars.

MATERIALS AND METHOD

This clinical trial study was performed on 70 primary molars in 44 healthy 4- to 7-year-old children. The children were randomly divided into two groups restored with SSC and restored with composite resin. Two researcher-made questionnaires were used to assess the children's satisfaction concerning the appearance and color of restoration. The data were analyzed with SPSS 20 using chi-squared, Fisher's, and Mann-Whitney U tests. The significance level was set at p< 0.05.

RESULTS

Children's satisfaction with restoration color in the treatment session was 75% in the SSC group and 85% in the composite resin group. However, the difference was not statistically significant (p= 0.246). After one year of follow-up, the satisfaction rate decreased to 69% in the SSC group and increased to 90.6% in the composite resin group, with a significant difference (p< 0.001). Moreover, the frequency of clinical success was 95% in the SSC group and 96.7% in the composite resin group, with no statistically significant difference (p= 0.749). The frequency of radiographic success was 87.5% in the SSC group and 100% in the composite resin group; this difference was not significant (p= 0.061).

CONCLUSION

The results verified that restoration color was not important for cooperative children in the treatment session. However, after one year, children who received composite resin restorations were pointedly more satisfied than those who were treated with SSC restorations.

Evaluation of Immediate and Delayed Microleakage of Class V Cavities Restored with Chitosan-incorporated Composite Resins: An In Vitro Study

Aim and objective

To evaluate and compare the microleakage of unmodified microhybrid composite and 0.2% chitosan-incorporated composite in class V cavities restored immediately and after 3 months of storage in artificial saliva.

Materials and methods

Sixty human permanent maxillary premolars were collected and standardized class V cavity prepared on the buccal surface of each tooth with dimensions: mesiodistally 3 mm, occluso cervically 2 mm, and depth of 1.5 mm and restored with microhybrid composite and chitosan-incorporated composite resins respectively and randomly divided: Group I: control-microhybrid composite (n = 30): (a) 15 teeth tested immediately (b) 15 teeth tested after 3 months. Group II–restored with chitosan + composite (n = 30): (a) 15 teeth tested immediately (b) 15 teeth tested after 3 months. Specimens were stored in artificial saliva following which a dye extraction test was carried out using a spectrophotometer.

Results

There was no statistically significant difference in microleakage score between the chitosan-composite group and unmodified composite group when evaluated immediately after placing the restoration. Microleakage values of the unmodified composite group increased significantly after 3 months of storage in artificial saliva and values of the chitosan-composite group did not differ significantly even after 3 months of storage. Microleakage was seen significantly less in the chitosan-composite group compared to the unmodified composite group after 3 months of storage in artificial saliva.

Conclusion

It can be concluded that chitosan-incorporated composite seems to have improved mechanical properties and forms a more stable bond when compared with unmodified microhybrid composite in addition to being antibacterial.

Clinical significance

Considering the advantageous properties of this material, it may be clinically useful in restoring class V cavities in patients with high caries risk. However, further in vitro and in vivo studies need to be carried out.

How to cite this article

Deb A, Pai V, Nadig RR. Evaluation of Immediate and Delayed Microleakage of Class V Cavities Restored with Chitosan-incorporated Composite Resins: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(5):621–627.

Fracture resistance of pulpotomized and composite-restored primary molars: Incremental versus bulk-fill techniques

BACKGROUND

The aim of this study was to assess the fracture resistance of pulpotomized primary molars restored with incremental and bulk-fill composite application techniques.

MATERIALS AND METHODS

In this in-vitro experimental study, 36 extracted primary molars were nonrandomly (selectively) divided into three groups of 12 each. All teeth underwent conventional pulpotomy treatment, and mesio-occluso-distal cavities were prepared in such a way that the buccolingual width of the preparation was two-thirds of the intercuspal distance, and the depth of the buccal and lingual walls was 4 mm. The teeth were then restored as follows: Group 1 (control) was restored with amalgam, Group 2 was restored with Tetric N-Ceram composite using the incremental technique, and Group 3 was restored with Tetric N-Ceram composite using the bulk-fill technique. The restored teeth were subjected to thermocycling and then underwent fracture resistance testing in a universal testing machine at a crosshead speed of 1 mm/min. Fracture resistance of groups was compared using the one-way ANOVA and Tukey's honestly significant difference test.

RESULTS

The mean fracture resistance was 1291.47 ± 603.88 N in the amalgam, 1283.08 ± 594.57 N in the Tetric N-Ceram incremental, and 1939.06 ± 134.47 N in the Tetric N-Ceram bulk-fill group. The difference in this regard between Group 3 and Groups 1 and 2 was statistically significant (P = 0.019 and P= 0.035, respectively).

CONCLUSION

Bulk-fill composite is recommended for reinforcing the remaining tooth structure after the primary molar pulpotomy procedure. Time-saving characteristics of this material are clinically important for reducing appointment time for children.

In vitro analysis of the marginal adaptation and discrepancy of stainless steel crowns

Aim: The purpose of the study was to assess the marginal adaptation and discrepancy of SSC's. Differences in adaptation and discrepancy between the four surfaces (mesial, lingual, distal, and buccal) were evaluated. Methods: The placement of stainless steel crowns were completed on a phantom head in accordance with the clinical technique. The ideal tooth preparation was made and this 'master tooth' duplicated to achieve a sample size of 15. The stainless steel crowns were placed, trimmed, and cemented as per the clinical technique. The cemented stainless crowns were analyzed under 100× stereomicroscope magnification. The marginal adaptation and discrepancy of each specimen was measured every 2 µm. Results: All the specimens showed marginal adaptation and discrepancy. The lingual margin had a significantly better adaptation (p < .0001) over the other surfaces. The buccal surface was the only surface that had an appropriate supra-CEJ level with a significance of p < .0001. Conclusion: The marginal discrepancies occur during the trimming procedure and assessment of the gingival approximation of the SSC margin. The inspection of stainless steel crown adaptation and discrepancy is an essential clinical step.

Prosthetics in Paediatric Dentistry

Premature loss of teeth in children may lead to both functional and esthetic problems. Missing teeth in both anterior and posterior regions may cause malfunctions in mastication and proper pronunciation. If the missing teeth are not replaced, further complications may occur, including adjacent tooth migration, loss of alveolar bone, and irregular occlusion. Considering the sensitive nature of children, loss of teeth may cause the development of insecurities and low self esteem problems. Due to dynamic nature of growth in children and adolescents, prosthetic appliances must not hinder development of orofacial system, and must meet adequate esthetic and functional standards. Dental prosthetic appliances in paediatrics must be planned with respect to the special conditions that led to tooth loss or damage. Multi-disciplinary approach is needed, under constant supervision of paediatric dentist and orthodontist, as well as regular checkups with clinical and radiographical examinations.