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Clinical and In Vitro Performance of Bioflx Crowns in Primary Teeth: A Systematic Review
Sara Faisal Hamdy1, Redhwan Saleh Al-Gabri2,3, Omer Abd Al-Aziz Al-Wahbi2
1Department of Pediatric and Preventive Dentistry and Dental Public Health, Faculty of Dentistry, Suez Canal University, Ismaillia, Egypt.
International Journal of Paediatric Dentistry
|July 20, 2026
Summary
Bioflx crowns (BFCs) offer a promising esthetic alternative for primary teeth restorations, showing high short-term survival and parental satisfaction. While stainless steel crowns (SSCs) have better retention, BFCs reduce enamel wear and improve clinical efficiency.
Area of Science:
- Pediatric Dentistry
- Dental Materials Science
- Restorative Dentistry
Background:
- Stainless steel crowns (SSCs) are standard for primary teeth, but esthetic concerns and metal hypersensitivity prompt interest in alternatives.
- Bioflx crowns (BFCs) are metal-free, flexible restorations with unproven comparative performance.
Purpose of the Study:
- Evaluate clinical and in vitro performance of Bioflx crowns (BFCs).
- Compare BFCs against stainless steel crowns (SSCs), zirconia crowns (ZrCs), and other pediatric crown systems.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched multiple databases including PubMed, Scopus, Web of Science, Cochrane, Embase, and Google Scholar.
- Included comparative clinical and in vitro studies; assessed risk of bias using Cochrane ROB-2 and modified CONSORT tools.
Main Results:
- BFCs demonstrated variable fracture resistance and favorable stress distribution.
- BFCs showed less antagonist enamel wear than ZrCs but lower cement-dependent retention than SSCs.
- Clinically, BFCs had >90% short-term survival, comparable gingival health, and higher parental satisfaction with low-to-moderate risk of bias.
Conclusions:
- Bioflx crowns show promise as an esthetic, prefabricated option for primary teeth.
- SSCs remain superior in retention with conventional cementation; Hall technique support for BFCs is unvalidated.
- BFCs offer esthetic, antagonist-preserving, and clinical efficiency advantages, but long-term RCTs are needed due to limited evidence.