The fate and survival of amalgam and preformed crown molar restorations placed in a specialist paediatric dental practice

Abstract

The fate of 1688 amalgam restorations and 716 preformed crowns placed in permanent and primary molars in a specialist paediatric dental practice over a 10-year period by one operator is reported. For primary molar amalgams, the replacement rate, true failure rate and 5-year survival estimates were, for Class 1 restorations, 16.1%, 3.9%, 73.3%, respectively, with an estimated median survival time greater than 8.5 years, and for Class 2 cavities 14.7%, 11.6%, 66.6%, with an estimated median survival time greater than 7.5 years. For permanent molar amalgams, the replacement rate, true failure rate and 5-year survival estimates were for Class 1 restorations 11.5%, 6.5%, 76.8%, respectively, with an estimated median survival time greater than 9.3 years, and for Class 2 restorations 9.8%, 8.0%, 82.2%, with a median survival time greater than 8.5 years. For all preformed crowns, the replacement rate, true failure rate and 5-year survival estimates were 2.8%, 1.9%, 92.0%, and the estimated median survival time greater than 7.64 years. No relationship was observed between the age of the patient and the age of replaced restorations. No significant difference was found between the survival rates of Class 1 and 2 amalgam restorations in primary or permanent molars, nor between first and second primary molars.

The survival of resin modified glass ionomer and stainless steel crown restorations in primary molars, placed in a specialist paediatric dental practice

“…No extension of outline form was made into sound but caries-susceptible pits and fissures as would have been necessary for amalgam restorations. 2 Instead, having satisfied the criteria of caries removal, caries prevention was accomplished by applying fissure sealant over both the occlusal RMGIC and the remaining pits and fissures. For Class II caries, a minimal proximal box was cut to give access to the caries, with cavo-surface margins that approximated 90 degrees, and with clearance of contact at the gingival floor.…”

“…In the past, stainless steel crowns (SSCs) have been shown to provide the most durable restorative material for primary molars. 2,3 However, they have been mainly recommended where pulp therapy has been performed, or in teeth with multi-surface restorations due to developmental defects or caries, or where other restorative materials are likely to fail. 4 Traditionally, amalgam has been the main restorative material for small Class I and Class II cavities in primary dentition.…”

Clinical evaluation of paired compomer and glass ionomer restorations in primary molars: final results after 42 months

“…Stainless steel or nickel chrome preformed crowns provide the most durable restoration, often surviving until the tooth exfoliates. 1 The durability of other restorative materials are usually compared with dental amalgam. Composite resins in the short term are as durable as amalgam but after 6 years have a failure rate of 62% compared with 20% for amalgam after 5 years.…”

Success rate of calcium hydroxide pulpotomy in primary molars restored with amalgam and stainless steel crowns

“…Previous studies have demonstrated SSCs to be more durable than other restorations used for primary dentition. 52,53 In a review, Randall 54 reported that the failure rate of Class II amalgams ranged from 2-7 times that of SSCs in primary teeth, making the SSC an outstanding alternative to other restorative materials for use in restoration of primary teeth. 15 Moreover, SSCs have been found to be more durable for restoring teeth with large caries lesions involving multiple surfaces where an amalgam is likely to fail.…”