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Reasons for Crown Failures in Primary Teeth: Systematic Review and Meta-Analysis.

Stephan Lampl1, Deepa Gurunathan1, Deepak Mehta2,3

  • 1Department of Pediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, 162, Poonamallee High Rd, Velappanchavadi, Chennai, 600077, India.

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|May 1, 2025
PubMed
Summary
This summary is machine-generated.

Stainless steel and zirconia crowns show high retention rates for primary teeth. While all materials have acceptable retention, differences in complications like secondary caries and marginal adaptation guide pediatric crown material selection.

Keywords:
biological complicationschildrencomplicationcrowndentaldentistmeta-analysisoralpediatricsprimary teethreview methodssearchsurvival ratessynthesissystematictechnical complications

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Area of Science:

  • Pediatric Dentistry
  • Dental Materials Science
  • Restorative Dentistry

Background:

  • Selecting appropriate materials for pediatric crowns on primary teeth is essential for long-term success and minimizing complications.
  • Understanding the retention rates and potential issues associated with different crown materials is critical for clinical decision-making.

Purpose of the Study:

  • To descriptively analyze retention rates and complications of pediatric crowns for primary teeth.
  • To estimate long-term (3- and 5-year) retention rates of various pediatric crown materials through meta-analysis.

Main Methods:

  • A systematic review and meta-analysis were conducted using data from randomized controlled trials (RCTs) and clinical studies.
  • Searches were performed in Cochrane, Embase, and PubMed databases (July-August 2023) following the PICOS paradigm.
  • Poisson regression models were used to estimate 3- and 5-year retention rates.

Main Results:

  • Meta-analysis of 5-year retention rates: Stainless steel (97.88%), Zirconia (97.09%), Resin-modified glass ionomer cement (RMGIC) (90.30%), Composite resin (92.18%), Compomer (88.90%), and Strip crowns (83.48%).
  • Complications observed included secondary caries (up to 21.8% with zirconia) and marginal adaptation issues (up to 22.2% with compomer).
  • Estimated 3- and 5-year retention rates indicated good outcomes across all evaluated materials.

Conclusions:

  • All evaluated pediatric crown materials demonstrate clinically acceptable retention rates.
  • Differences in biological and technical complications among materials offer guidance for selecting the most suitable pediatric crown based on clinical needs.
  • Material-specific considerations are vital for optimizing outcomes in pediatric dental crown treatments.