Zirconia crown performance in primary maxillary anterior teeth: a retrospective photographic and radiographic cohort study.

PURPOSE: This retrospective cohort observational study evaluated marginal integrity, gingival health and aesthetics of zirconia crowns (ZC) placed on primary maxillary anterior teeth at 6- to over 30-month follow-up visits. METHODS: Two independent raters evaluated radiographic and photographic findings in 131 ZC placed in 36 children aged 24.8-62.2 months (median = 40.6) who had at least one recall visit 6 months after placement. Follow-up periods were stratified into three levels: long, intermediate and short. Associations between crown performance and crown brands, follow-up periods, treatment performed under general anaesthesia or sedation and previous pulpotomy were investigated by ordinal logistic regression. RESULTS: Follow-up ranged from 6 to 33.8 months (average: 13.5 months). Marginal integrity was highly rated in 82.4% of the teeth. No gingivitis was found in 35% of the teeth, 58% showed mild gingivitis and 7% showed moderate gingivitis (p = 0.06). Colour match and crown contour were rated very high in 55% of the cases. Marginal integrity and periodontal health differed between cases performed under general anaesthesia and those performed under sedation (p = 0.03 and p = 0.003, respectively). Pulpotomized teeth showed worse colour matching with the adjacent teeth than non-pulpotomized teeth (p = 0.03). CONCLUSIONS: Our findings suggest that ZC comprise a satisfactory treatment option for carious primary maxillary incisors, presenting good overall marginal integrity, gingival health, and aesthetics.

The incidence and nature of complaints against dentists for the treatment of children in Israel from 1992-2011.

OBJECTIVES: Medical literature lacks information about complaints against dentists who treat children. The present study aimed to evaluate the reports filed to Medical Consultant International (MCI) regarding paediatric dentistry in 1992-2011. BASIC RESEARCH DESIGN: Most dentists in Israel (85%) are obliged by their professional liability insurance policy to report adverse events to MCI. Reports were analysed using a structured form that included demographic details of the treating dentist, patients and parents, type of treatment, the result and the dentist's attitude. MCI dental consultants' decisions were evaluated by two specialists in paediatric dentistry. RESULTS: The number of complaints per year is increasing. Complaints involved maltreatment (33%), case mismanagement (25%) and complications that required additional treatment (26%). Communication was problematic in 60% of cases. Only 16.7% of complaints developed into an actual lawsuit. Most complaints were against female general practitioners and against dentists who worked in community dental clinics located in peripheral areas. Treating permanent teeth increased to 3.6 times the probability of developing into a lawsuit. 59% of event records had missing data. Seventy-five percent of the cases rose from elective treatments while 25% concerned emergency treatments. One third of the cases required additional treatment in a hospital i.e. abscess drainage, foreign body swallowing or other physical damages. CONCLUSIONS: Better case selection and documentation, better training of dentists who treat children and more appropriate attitude toward patients and parents, are likely to reduce the number of complaints.