Bacterial Adhesion in Pediatric Crowns: A Systematic and Meta-Analytical Review

Stainless steel crowns (SSC) have long been the standard choice due to their durability, ease of use, and cost-effectiveness. Other esthetic crowns, known for their superior esthetic properties and biocompatibility, have emerged as a popular option in recent years. A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library, up to June 2024. The population under study was primary teeth, with the intervention being the application of aesthetic crowns. These were compared against SSC, with the primary outcome being the level of microbial adhesion on the crowns in primary teeth. Data extraction and quality assessment were performed independently by two reviewers. Meta-analyses were conducted using random-effects models to estimate pooled differences in microbial adhesion levels. A total of five studies were included in the review. The meta-analysis revealed a statistically significant difference in microbial adhesion between esthetic and SSC, with esthetic crowns showing lower levels of bacterial colonization. Specifically, the mean difference in colony-forming units (CFU). Esthetic crowns exhibit significantly lower microbial adhesion compared to SSC in pediatric patients, suggesting a potential advantage in reducing the risk of secondary caries and other microbial-related complications. However, further long-term clinical studies are warranted to confirm these results and assess their clinical implications.