Restorations Versus Stainless Steel Crowns in Primary Molars: A Retrospective Split-Mouth Study

Area of Science:

• Pediatric Dentistry
• Restorative Dentistry
• Dental Public Health

Background:

• Multisurface caries in primary molars present a significant restorative challenge.
• Treatment decisions impact long-term tooth survival and retreatment needs.
• Comparing intracoronal restorations and stainless steel crowns (SSCs) is crucial for optimal pediatric dental care.

Purpose of the Study:

• To compare the clinical outcomes of multisurface caries treatment in primary molars using intracoronal restorations versus SSCs.
• To evaluate the survival rates and success of these two restorative approaches over time.
• To identify patient age groups where one treatment modality demonstrates superior efficacy.

Main Methods:

• A retrospective split-mouth study design was employed.
• Dental records of 988 primary molars were analyzed, comparing intracoronal restorations with SSCs.
• Follow-up extended until tooth exfoliation, loss to follow-up, or treatment failure, with a mean follow-up of 22 months.

Main Results:

• SSCs demonstrated significantly higher survival probabilities (95.5% at 1 year, 92.8% at 2 years) compared to intracoronal restorations (92.0% at 1 year, 80.0% at 2 years) (P<0.001).
• The superior success of SSCs was particularly pronounced in children aged four years and younger (P<0.001).
• No statistically significant difference in survival was observed for children aged five years and older (P=0.10).

Conclusions:

• Stainless steel crowns offer a more durable and successful treatment option for multisurface caries in primary molars compared to intracoronal restorations.
• For children aged four years and younger, early and more aggressive treatment with SSCs should be considered to minimize the need for subsequent retreatment.
• Conservative restorative approaches for multisurface caries in young children may lead to higher failure rates and increased retreatment demands.