Factors Influencing the Survival of Preformed Zirconia Crowns in Children Treated under General Anesthesia

Abstract

Aim. This study aimed to retrospectively evaluate the success of zirconia crowns placed in the anterior teeth of children and evaluate the impact of pulp therapy of the tooth on the rate of failure. Materials and Methods. A total of 70 anterior teeth of 20 children aged between 3 and 5 years who had undergone the placement of zirconia crowns under general anesthesia were followed up for 24 months. Kaplan–Meier Survival curves were plotted for the estimation of two-year survival time. The outcomes for teeth that had received pulp therapy were compared to those that had not received pulp therapy. Results. Kaplan–Meier survival analysis of 70 crowns observed over a two-year period showed that mean survival time for the crowns was 38.7 months with a confidence interval ranging from 38.1 months to 39.3 months. When the survival of the crowns was observed based on the presence or absence of symptoms, it was observed that only 4 out of the 70 crowns were symptomatic (with or without crown loss) at the end of two years, giving a success rate of 94.3%. The mean survival time was also increased to 39.5 months (confidence interval 39.15–39.98 months). Conclusion. Zirconia crowns provide an acceptable level of success and longevity. Crowns placed on teeth after pulp therapy are more likely to fail than those placed on teeth without pulp therapy.

The Effect of Pulp Treatments on the Survival of Zirconia Crowns in Primary Teeth

“…It can be thought that crown retention may be less than the group without pulp treatment, since teeth requiring pulp treatment have more material loss due to deep caries. As a matter of fact, in a previous study 27 , they revealed that crown loss was higher in teeth that had pulpal treatment. However, there was no difference in our study; It can be attributed to increasing the retention of the crowns by compensating the tissue losses in pulpal treated teeth with filling materials with high adhesion strength before the ZCs is placed.…”

Reasons for Crown Failures in Primary Teeth: A Systematic Review and Meta-Analysis (Preprint)

“…Most, if not all available studies on crowns for primary teeth have recruited children aged < 10 years [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. However, the age distribution of the included participants is not commonly reported.…”

“…A total of 13 RCTs and 5 clinical studies (prospective and retrospective) were included in this systematic review [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Figure 1 presents the PRISMA flow diagram illustrating the study selection process.…”

“…Figure 3 illustrates various retentive complications reported in the RCTs for different materials. Regarding clinical studies, debonding and loss of crown were reported for zirconia crowns, while crown fractures were reported for composite resins (Table 4) [25][26][27][28][29]. In the prospective and retrospective clinical studies, 8.3% of children receiving compomer crowns and 8.8% receiving composite resins reported secondary caries [25][26][27][28][29].…”

“…Regarding clinical studies, debonding and loss of crown were reported for zirconia crowns, while crown fractures were reported for composite resins (Table 4) [25][26][27][28][29]. In the prospective and retrospective clinical studies, 8.3% of children receiving compomer crowns and 8.8% receiving composite resins reported secondary caries [25][26][27][28][29]. Additionally, 3.3% and 21.83% of children with stainless steel crowns and zirconia crowns, respectively, in these studies exhibited gingival inflammation [25][26][27][28][29].…”