Are pediatric preformed zirconia crowns comparable to preformed metal crowns? A real-life retrospective study

Although minimally and noninvasive caries management are advocated in pediatric dentistry, extensive caries progression often requires endodontic treatment followed by crowning of the tooth. Thus, the aim of this study was to evaluate the success of esthetic preformed zirconia crowns (PZCs) compared to the standard preformed metal crowns (PMCs) after pulpotomy in primary molars retrospectively.

Patients' digital records in a specialized pediatric clinic in Germany were analyzed to include 2- to 9-year-olds, who had received one or more PMCs or PZCs after a pulpotomy between 2016 and 2020. The main outcomes were success, minor failure (restoration loss, wear, or fracture), or major failure (need for extraction or pulpectomy).

In total, 151 patients with 249 teeth (PMC, n = 149; PZC, n = 100) were included. The mean follow-up time was (19.9 months), with 90.4% of the crowns followed for at least 18 months. The majority of the crowns were considered successful (94.4%). The differences in the success rates between PMCs (96%) and PZCs (92%) did not reach the level of statistical significance (P = .182). All minor failures (1.6%) were in the PZC group and located in the maxilla. Independent of crown type, especially first primary molars were prone to failure (7.9%; second primary molars, 3.3%).

PMCs and PZCs both show high clinical success rates as restorations of primary teeth after a pulpotomy. However, there was a tendency of greater minor or major failure in the PZC group.