169 - Trends in Prefabricated Zirconia Crown Usage: A Dental Claims Review

Purpose: The purpose of this project is to investigate how prefabricated zirconia crowns (PZC) are being used in the United States.

Methods: Proportional usage of PZC in primary teeth were compared to other full coverage options. Other variables investigated include: dental specialty, location in the mouth, geographic location and concurrent pulpal therapy. The financial cost of placing prefabricated zirconia crowns vs other options was also investigated. The data for this study was obtained in conjunction Fluent, a private dental insurance claims database, through a partnership agreement with Indiana University. A retrospective analysis of dental claims made from January 1st, 2013 to December 31st, 2022 was completed. Data was extracted using CDT codes, with associated data including date, tooth number, cost, patient information and dental provider information. CDT codes included PZC (D2929), SSCs (D2930), resin window SSCs (D2933), preveenered SSCs (D2934), resin-based composite crowns (D2390), pulpotomy (D3220) and pulpectomy (D3221). Data was analyzed using Chi-square analysis and multinomial logistic regression.

Results: 6.4 million full coverage restoration claims. 74,000 pulpotomy/pulpectomy claims found to correlate the 6.4 million claims. ~ 1% of the time a pulpal therapy is completed prior to full coverage restoration placement. PZCs were placed more by pediatric dentist and in the anterior region of the mouth. In 2017 PZCs were the second most placed full coverage pediatric crown.

Conclusions: Pulpal therapy was not routinely associated with full coverage restorations. Pediatric dentists place more PZCs (and all other pediatric full coverage crowns) versus general dentists. PZCs usage has increased every year since 2013 and is now the second most placed pediatric full coverage crown placed based of the data in this study. Limitations are Medicaid insurance claims or self-pay patients not included database and reason for the treatment of choice is not available in the dental claims for analysis.