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Updated: Dec 18, 2025
Potentiodynamic Corrosion Testing
Published on: September 4, 2016
Biological responses to pediatric stainless steel crowns
Sobia Zafar1, Allauddin Siddiqi2
1Discipline Lead Paediatric Dentistry, School of Dentistry, The University of Queensland.
Insights
Allergic reactions to pediatric stainless steel crowns (SSCs) are rare, with limited evidence from low-quality studies. Nickel (Ni) release varies, raising concerns for high-caries-risk children, necessitating further research.
Area of Science:
- Pediatric Dentistry
- Biomaterials Science
- Toxicology
Background:
- Stainless steel crowns (SSCs) are widely used for primary and permanent teeth in patients under 20.
- Concerns exist regarding biological responses, including allergic reactions, toxicity, and ion release from SSCs.
- A comprehensive understanding of these effects is crucial for pediatric dental care.
Purpose of the Study:
- To systematically review biological responses, allergic reactions, hypersensitivity, toxicity, and ion release profiles of pediatric SSCs.
- To synthesize existing literature on adverse effects and ion leaching associated with SSCs in children.
- To identify gaps in current research and guide future investigations.
Main Methods:
- Systematic literature search conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
- Inclusion criteria: patients <20 years, SSC placement, in vivo/in vitro exposure.
- Outcome measures: adverse effects, SSC failure, allergic reactions, ion levels (e.g., Nickel), and genotoxic/cytotoxic effects.
Main Results:
- Analysis of 17 articles revealed limited evidence of allergic reactions to pediatric SSCs, primarily from low-quality studies.
- Nickel (Ni) detection varied; some studies found levels below daily dietary intake, while others reported significant Ni release in acidic environments.
- Concerns were noted regarding metal ion leaching (e.g., Ni) from SSCs in children with high caries risk.
Conclusions:
- Evidence for allergic reactions to pediatric SSCs is limited and derived from low-quality research.
- Nickel ion release from SSCs can be influenced by environmental factors like acidity.
- Further long-term studies are essential to fully understand the implications of metal ion leaching from SSCs in pediatric patients, especially those at high risk for caries.
Abstract:
A systematic review was conducted to identify the biological responses, allergic reaction, hypersensitivity, toxicity, and ion release profile associated with pediatric stainless steel crowns (SSCs) in the existing literature. A systematic search was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The inclusion criteria consisted of patients younger than 20 years of age with SSC placement on primary or permanent teeth and in vivo and in vitro exposure to SSCs. Outcomes measures included adverse oral/mucosal effects; removal/failure/replacement of the SSC; type of allergic reaction; nickel (Ni) or other ion levels in bodily fluids, cellular, genotoxic, cytotoxic, mutagenic or carcinogenic effects related to the SSC. After an initial search of 764 studies in the database, 17 articles were included in the analysis. Evidence of allergic reactions to SSCs in children is limited and obtained from mostly low-quality research. Some studies showed that the amount of Ni detected was less than the amount ingested in the daily diet. In contrast, other studies reported a significantly higher release of Ni occurred into the saliva in acidic environments. There is some concern about the leaching of metal ions such as Ni from SSCs in children at high risk for caries. Further long-term studies are required to investigate this phenomenon.
