145 - Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry: A Prospective Cohort Study

Abstract

Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry - A Prospective Cohort Study
By: Jenan Alahmad, BDS
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.
Virginia Commonwealth University, 2024
Thesis Advisor: Parthasarathy Madurantakam, DDS, MDS, PhD
Department of Pediatric Dentistry

BODY

Purpose: This prospective cohort study aimed to compare the effectiveness of restoring maxillary anterior teeth in children (aged 3-6 years) with three different materials: Zirconia Crowns (ZC), Resin Composite Crowns (RC), and Pre-veneered Stainless-Steel Crowns (PVSSC). The study aims to assess the Oral Health-Related Quality of Life (OHRQoL) in children receiving full coronal restorations in primary anterior teeth.

Methods: The study was approved by the VCU Institutional Review Board (HM #20024519). A total of 114 children diagnosed with early childhood caries were enrolled, and 79 teeth were restored with ZC, RC, or PVSSC under general anesthesia. The performance of crowns was assessed based on retention, fracture, color change, marginal integrity, mobility, and periapical pathology, The study utilized the Early Childhood Oral Health Impact Scale (ECOHIS) to evaluate OHRQoL at 0, 6, and 12 months.

Results: At 6-month follow-up, 79 crowns were evaluated, including 14 PVSSCs (18%), 15 ZCs (19%), and 50 RCs (63%), out of which 97% of crowns were debonded. Chip/fracture were observed in 13% of crowns and were not significantly associated with the crown type (P=.0925). Gingival inflammation was observed at the site of 9 crowns (11%) and was significantly more common with PVSSCs (29%) and ZC (33%) than RC (0%) (P < .0001). Child Impact scores decreased by an average of 1.6 points (95% CI: -0.75, 3.94) and Family Impact by an average of 0.40 (95% CI: 0.43, 1.22).

Conclusion: Most crowns were retained at a 6-month with minimal chips and fractures. Gingivitis was primarily observed at the site of the ZC and PVSSC crowns. Enhancement of OHRQoL was observed at the follow-ups for all crown types.