ABSTRACT
Background and Aim of Study: Early childhood caries is a multifactorial disease process affecting children below 71 months of age and continues to be a global health problem. Stainless steel crowns (SSCs) are widely used and are very popular in pediatric dentistry due to its superiority and durability when compared with multisurface amalgam restorations. However, one of the major disadvantages with these crowns is the poor esthetics. Parents often request for a more esthetic alternative to the SSC. Zirconia crowns are one of the tooth-colored full crown restorations currently available for use in primary teeth. These are available as both preformed and custom-made crowns and show excellent esthetics. However, these require extensive tooth preparation with a subgingival finish lines, which would cause gingival trauma and bleeding during the preparation. The present study uses intraoral scanners for making the custom-made zirconia crowns, which will avoid the conventional impressions. Currently, there are no studies available in pediatric dentistry regarding CAD-CAM crowns. Hence, there is a need for the study. Aim: The aim of this study is to clinically evaluate the performance of preformed SSCs and custom-made zirconia crowns in primary molars. To elicit parental and patient satisfaction with respect to preformed SSCs and custom made zirconia crowns and to radiographically compare the interproximal bone height for 1 year. Methods: The patients were selected with purposive sampling. The tooth of interest was prepared according to the crown it would receive. The upper and the lower arch of the tooth receiving custom-made zirconia crown was scanned using an intraoral scanner. The crowns were cemented using Type 1 glass ionomer cement (GIC) (SSC) and resin modified GIC (custom-made zirconia crown). After the crown placement, the patient and the parent's satisfaction was scaled regarding the time taken, comfort, cost of crown, appearance of crown, etc., using a 5-point Likert scale. A baseline radiograph was taken after crown placement. The patient was recalled every 3 months till 1 year for evaluation (loss of retention, loss of proximal contact, gingival inflammation, opposing tooth wear, and marginal integrity). At the end of 1 year, radiographs were taken to check the interproximal bone. Results: After 1 year evaluation of custom-made zirconia crowns and preformed SSCs in primary molars, it was shown that both SSC and zirconia crowns showed good gingival scores but zirconia crown was better than SSC in improving the gingival health. SSCs showed better results with respect to the opposing tooth wear and marginal adaptability. Parents as well as patients preferred a tooth-colored crown as a treatment option. Conclusion: Custom-made zirconia crowns are comparable to the preformed SSCs and they show better gingival scores and excellent color match.
ABSTRACT
Background: During the past decade, parental involvement for the selection of full coronal restorations for the primary anterior teeth of their children has been increased. Two most common anterior aesthetic full coronal restorations, the strip crowns and the preformed zirconia crowns, are available options. Aim: The aim of this study is to compare parental satisfaction with strip crowns and preformed primary anterior zirconia crowns over 1 year in 3–5 years old children. Materials and Methods: Forty maxillary primary incisors were restored by either strip crown or zirconia crown in 24 children. Permuted block randomization method was used for the allocation of participants. Twenty-four parents participated were recalled to fill the questionnaire over 1 year. One parent dropped out at the end of 1 year. Data were analyzed using the t-test and Chi-square test. P < 0.05 considered statistically significant. Results: Parents were satisfied with both types of restorations. Statistically significant relationship was found between overall satisfaction and durability (P = 0.004) with strip crowns and with the color (P = 0.043) in the zirconia crowns. The parents with the lower satisfaction levels with the durability of strip crowns and color of zirconia crowns rated high overall satisfaction. Conclusion: Parental overall satisfaction was higher for preformed primary anterior zirconia crowns than strip crowns. Almost equal number of parents was satisfied with all other parameters except for durability, which was more for zirconia crowns.
ABSTRACT
La caries de la infancia temprana, al igual que otras formas de caries, se caracteriza por ser multifactorial, infecciosa y de rápida evolución. Puede presentarse como lesiones cavitadas o no cavitadas, se diagnostica principalmente en menores de seis años en la superficies de los dientes anterosuperiores, debido a que son los primeros órganos dentales en erupcionar y tienen mayor contacto con el estímulo cariogénico. En casos severos pueden llegar a ocasionar la pérdida de órganos dentales, influyendo en la salud general del paciente y repercutiendo en su autoestima y desarrollo psicosocial. Para devolver las características y funciones perdidas en ausencia de algún órgano dental, se recurre a sustituirlo mediante aparatología, mayormente en forma de un mantenedor de espacio funcional. Las necesidades estéticas individuales de cada caso generan diversas alternativas para adaptarnos a la situación del paciente (AU))
Early childhood caries, like other forms of caries, is characterized by being multifactorial, infectious, and rapidly evolving. It can present as cavitated or uncavitated lesions, it is mainly diagnosed in children under six years of age on the surfaces of the anterior superior teeth, because they are the first dental organs to erupt and have greater contact with the cariogenic stimulus. In severe cases they can cause the loss of dental organs, influencing the general health of the patient and impacting on their self-esteem and psychosocial development. In order to restore the lost features and functions in the absence of any dental organ, it is resorted to by means of appliances, mostly in the form of a functional space maintainer. The individual aesthetic needs of each case generate various alternatives to adapt to the patient's situation (AU)
Subject(s)
Humans , Female , Child, Preschool , Space Maintenance, Orthodontic/methods , Zirconium , Crowns , Dental Caries/therapy , Tooth, Deciduous/injuries , MexicoABSTRACT
Introduction: Different sizes of crowns may be tried on children since there is no universal crown size because of distinctions in tooth morphology from one child to other. During the process of trial and error, the crown gets contaminated which needs to be sterilized for reuse of crown. This study was carried out to evaluate the physical–mechanical outcome after the sterilization and disinfection of pediatric preformed crowns. Materials and Methods: In total, sixty crowns consisted of 20 each, stainless steel crowns (SSCs) (3M ESPE), preveneered stainless steel (Kinder Krowns), and Zirconia crowns (Kinder Krowns) which were divided into four groups. G1 in which crowns did not undergo any sterilization, G2 consisted of fast sterilization, similarly G3 was slow sterilization, and G4 underwent chemical disinfection using Korsolex Plus for 15 min. Following sterilization, all the crown samples were observed under a stereomicroscope at ×200 magnification and assessed for color change, crazing, dimensional stability, and fracturing. Post hoc Tukey test and two-way ANOVA were performed for comparison between types of crowns and sterilization methods, with a significance level was set at P < 0.05. Results: There was no color change or fracturing following sterilization among crowns in any of the groups. Highest crazing was noted in stainless steel and the least in Zirconia crowns. Preveneered stainless steel was the most dimensionally stable and SSCs was the least. Conclusion: No color changes and fracture were noted in any type of crowns. Preveneered stainless steel was most dimensionally stable followed by Zirconia and SSCs. Maximum crazing was seen in SSCs and nil in Zirconia.
ABSTRACT
Objective: This study aimed to assess the fracture resistance of primary molars restored with endocrowns compared to prefabricated zirconia crowns. Material and Methods: Twelve sound, defect-free primary second molars were selected and divided into two groups: group I included 6 molars restored with zirconia crowns, while group II included 6 teeth restored with endocrowns. For both groups access cavity was prepared for the teeth to open pulp chamber. Fracture resistance of both groups was tested using a universal testing machine. Results: Zirconia crown showed statistically significantly higher mean fracture resistance than Endocrown (P-value = 0.001, Effect size = 2.72). Conclusion: Pulpotomized primary molars restored with Zirconia crowns showed significantly higher mean fracture resistance compared to primary molars restored with endocrowns, meanwhile both restorations have shown higher mean fracture resistance than the maximum biting force in children. (AU)
Objetivo: Este estudo teve como objetivo avaliar a resistência à fratura de molares decíduos restaurados com endocrowns em comparação com coroas de zircônia pré-fabricadas. Material e Métodos: Doze segundos molares decíduos hígidos e livres de defeitos foram selecionados e divididos em dois grupos: o grupo l incluiu 6 molares restaurados com coroas de zircônia, enquanto o grupo ll incluiu 6 dentes restaurados com edocrowns. Para ambos os grupos, foi preparada uma cavidade de acesso à câmara pulpar. A resistência à fratura de ambos os grupos foi testada em uma máquina de ensaio universal. Resultados: A coroa de zircônia apresentou resistência média à fratura estatisticamente significativa maior do que endocrown (p=0,001, Tamanho do efeito = 2,72). Conclusão: Molares decíduos pulpotomizados restaurados com coroas de zircônia apresentam resistência média à fratura significativamente maior em comparação aos molares decíduos restaurados com endocrowns, entretanto, ambas as restaurações mostraram maior média à fratura do que a força máxima de mordida em crianças (AU)
Subject(s)
Composite Resins , Crowns , Flexural StrengthABSTRACT
The purpose of this study was to provide clinical recommendations for restoration with selection of the most similar zirconia crown by 3-dimensional analysis of the shape of the maxillary primary central and lateral incisors in Korean individuals and prefabricated zirconia crowns.The average shape of the sound maxillary primary central and lateral incisors in 300 children was reproduced by 3-dimensional scanning. Zirconia crowns of 4 manufacturers (NuSmile ZR® Crown, Cheng Crowns®, Kinder Krowns®, and EZ Pedo® Crown) were scanned 3-dimensionally, and coordinates for comparison of the shape were measured to evaluate the similarity between the teeth and crowns. The most similar crowns were selected by comparing the mesiodistal length, crown height, crown shape ratio, distance between the same coordinates of a tooth and crown, the radius of curvature of the labial surface, and the volume.As a result of analysis, Cheng Crowns® size 3 and NuSmile ZR® Crown size 2 were the most similar crowns in the maxillary primary central and lateral incisors, respectively. Scanning the inner surface of the crowns and evaluating the amount of tooth reduction required suggested that an overall lesser amount of tooth reduction compared to that presented by the manufacturer's guidelines should be performed.
Subject(s)
Child , Humans , Crowns , Incisor , Radius , ToothABSTRACT
PURPOSE: To compare the accuracy of marginal and internal adaptation of zirconia (Zr) copings fabricated on anatomic (A), semi-anatomic (SA) and non-anatomic (NA) occlusal surface preparations. MATERIALS AND METHODS: 45 extracted bicuspid teeth were prepared for receiving zirconia crowns, with different occlusal preparation designs A=15, SA=15 & NA=15. The Zr copings were fabricated by using CAD4DENT, CAD/CAM. The copings were adjusted, cemented and were cross sectioned centrally from buccal cusp tip to lingual cusp tip into mesial and distal halves. The copings were examined under electron microscope at x200 magnification and the measurements were recorded at 9 predetermined areas in micrometers. RESULTS: Overall mean gap values for the three groups was found to be 155.93+/-33.98 microm with Anatomical Occlusal preparation design having the least gap value of 139.23+/-30.85 microm showing the best adaptation among the groups. Post Hoc Tukey's test showed a statistically significant difference (P=.007) between the means of gap for A & NA preparation designs. Measurements recorded at 9 predetermined points showed variations for the three groups. CONCLUSION: Anatomical occlusal preparation designs resulted in better marginal and internal adaptation of Zr copings. There is a considerable variation between the measured marginal and internal gap values for the Zr copings fabricated by the (CAD4DENT-CAD/CAM). This variation may be associated with the lack of standardization of the preparation of teeth, computerized designing of the coping for each tooth, cement used, uniform pressure application during the cementation of the copings, sectioning of the copings and the microscopic measurements.