Checking Occlusion During Stainless Steel Crown Placement
Condition: Dental Caries
MeSH terms: Dental Caries
Study type: Interventional

Summary: 
      Stainless steel crowns are arguably the most successful posterior restorations in primary
      teeth and have been so for more than 50 years. Stainless steel crowns offer durability and
      success rates in excess of 95% making them the restoration of choice for posterior primary
      teeth in children treated under general anesthesia.

      Failures of stainless steel crowns placed on primary teeth have been documented using several
      criteria including marginal adaptation, recurrent caries, abscess formation or root
      resorption, loss of the crown due to faulty retention and even perforation of the crown .
      Despite the probability that factors such as root resorption and failure of endodontic
      treatment could be due to traumatic occlusion, surprisingly little evidence is available in
      literature on the attempts made to check or evaluate the occlusion of stainless steel crowns
      placed under general anesthesia The aim of this study was to compare the time taken for
      placement and the overall success of bilateral multiple stainless crowns placed under general
      anesthesia using an occlusal index and compare them to crowns placed without such an index,
      using a randomized control study design
    

Detailed description: 
      A total of 60 patients (32 male and 28 female) aged between 4 and 7 years (Mean age 4.8
      years, SD +/- 1.09 years) who met the inclusion criteria were recruited after obtaining
      informed consent from the parent. No financial incentives were offered for participation in
      the study. A total of 51 (29 male and 22 female) patients completed the six month follow up
      requirement (Fig 2).

      Evaluation Crowns and the Procedure All patients were evaluated at 24 hours, one week, three
      months and six months post-operatively. Clinical criteria evaluated included the reporting of
      pain, discomfort, difficulty in mastication or high points reported by the patient.
      Tenderness on percussion, presence of premature mobility and clinical evidence of an abscess
      or fistula were checked by one of the investigators (SCP). Periapical digital radiographs
      were taken using a digital sensor (Schick Elite, Sirona Dental Inc. Long Island NY. USA) and
      were evaluated by the same examiner for radiographic evidence of failure. In order to ensure
      blinding the investigator (SCP) recording the findings was not made aware of which group the
      patient belonged to. The time taken for each procedure was calculated from the time of
      placement of the throat pack to the time of removal of the throat pack and was obtained from
      the intra-operative anesthesiologist notes. If failure of the crown occurred at 3 months,
      these teeth were excluded from the 6 month evaluation.

      Statistical Analyses The parametric values of the control and case groups were compared using
      the student's t test. The non-parametric values of the control and case groups were compared
      using the Mann Whitney U test. All tests were conducted at p value of 0.05
    

Intervention name(s): Stainless steel crown; Occlusal Template
Intervention type(s): Other; Other
Intervention description(s): Placement of stainless steel crowns for teeth that have undergone pulpotomy for the treatment of pulpitis induced by severe early childhood caries under general anesthesia; Use of an occlusal template for the placement of stainless steel crowns under general anesthesia
Intervention MeSH terms: Salicylic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment