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Comparative evaluation of hybrid resin polymer, nanohybrid composite, and preformed stainless-steel crowns in primary
Irin Mariam Zachariah1, Sageena George, S Anandaraj
1Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India.
Background:
Full coronal restorations are essential for managing extensively cariouvarious primary molars. While stainless steel crowns (SSCs) remain the gold standard esthetic alternative, such as hybrid resin polymer (Bioflx) and nanohybrid composite (Edelweiss) crowns have been introduced.
Objective:
To compare the clinical performance of Bioflx, Edelweiss, and SSCs in mandibular primary second molars.
Subjects And Methods:
This randomized controlled trial included 42 children (5-9 years), each receiving one crown following pulp therapy, randomly allocated into three groups ( n = 14 each). Outcomes assessed at 3, 6, and 12 months included retention, marginal integrity, and proximal contact (United States Public Health System) criteria, gingival health and plaque (Loe and Silness index), opposing tooth wear, parental satisfaction and chairside time. Statistical analysis included analysis of variance, Fisher's exact test, and Cochran's Q test ( P < 0.05).
Results:
SSCs and Bioflx crowns showed 100% retention while Edelweiss crowns demonstrated 85.8% retention ( P = 0.37). Marginal integrity was highest in SSCs (100% at 3 and 6 months, 92% at 12 months), followed by Bioflx (85.8%) and Edelweiss (71.4%-78.5%) ( P > 0.05). Proximal contact exceeded 90% in SSC and Bioflx groups with lower values in Edelweiss ( P > 0.05). Plaque accumulation differed significantly between groups at 3 and 12 months ( P = 0.0001) with Edelweiss showing 100% plaque-free scores and SSCs the highest plaque levels. Gingival health showed a significant change overtime only in the Edelweiss group ( P = 0.02). Parental satisfaction was significantly higher for color in Edelweiss crowns ( P = 0.0001). Mean chairside time was highest for Edelweiss (1.61 ± 0.29) followed by Bioflx (0.96 ± 0.50 min) and SSCs (0.72 ± 0.20 min) with significant differences ( P = 0.0001).
Conclusion:
SSCs remain the most reliable option. Bioflx crowns offer comparable performance with improved esthetics, while Edelweiss crowns provide superior esthetics and plaque resistance but require longer chairside time and show slightly reduced retention.