COMPARATIVE EVALUATION OF CLINICAL AND RADIOGRAPHIC OUTCOME OF STAINLESS STEEL CROWN AND A NEW ZIRCONIA CROWN IN PRIMARY MANDIBULAR MOLARS: A RANDOMIZED CONTROL SPLIT- MOUTH TRIAL
Creators: name: Vishnu, Guru
Publisher: name: figshare
Year: 2024
Subjects: classificationCode: 320309
subject: Paedodontics

description: Introduction:In pediatric dentistry, the choice between stainless steel crowns and zirconia crowns for restoring primary molars is pivotal. Stainless steel crowns have been considered as the gold standard; it offers durability and is cost-effective but may lack aesthetic appeal. Zirconia crowns, a more recent development, offer exceptional aesthetics, biocompatibility, and enhanced strength. However, they present difficulties in terms of adaptability and fracture resistance. Conducting clinical research to evaluate the relative effectiveness of stainless steel crowns compared to the new zirconia crowns is crucial for making better choices in pediatric dentistry practice based on evidence. Aim: The study aimed to assess the clinical outcome of a new zirconia crown to stainless steel crown in primary molars. Materials and methods: This study is a randomized controlled trial conducted in Chennai, India from January 2022 to January 2024. This study was designed as a split-mouth study conducted on a group of 40 children who exhibited positive Frankl's behavior and underwent pulpectomy in bilateral mandibular molars. Following pulp therapy, 80 molars were restored and categorized into two groups: Group-1 consisted of 40 molars restored with stainless steel crowns, while Group-2 consisted of 40 molars restored with zirconia crowns. These groups were then monitored at regular intervals for a duration of 1 year. The crowns were evaluated clinically using the Modified United States Public Health Service criteria, and the interproximal bone level was measured by radiographic method. A simple random sampling technique was employed to choose the samples. The analytical statistics employed the Friedman test to evaluate the parameters within each group across all timelines, and the Mann Whitney U test to compare the means of ordinal variables between the groups. The significance level was set at p&lt;0.05. Results: The new zirconia crown exhibited superior performance compared to the stainless steel crown in terms of crown wear and gingival health. At the 6th month follow-up, there was no noticeable disparity in the wear of the crowns compared to the initial condition. However, at the 9th and 12th month follow-up, the stainless steel crown exhibited evidence of wear (p=0.02*) and was considerably distinct from the new zirconia crown. During the first 6 months of observation, there was no discernible difference in the health of the gingiva. However, at the 9th and 12th month, there was slight inflammation and bleeding in stainless steel crowns (p=0.008) with no significant change in the zirconia group (p=0.40). The stainless steel crowns demonstrated greater retention compared to the new zirconia crowns. At the end of a 12-month period, all of the stainless steel crowns remained in place, but there was loss of zirconia crowns, this difference was statistically significant (p=0.002). There was no significant difference (P=0.40) in the marginal adaption between the two groups. After one year, there was no statistically significant disparity in inter-proximal bone resorption between the newly introduced zirconia crown and stainless steel crowns (p=1). Conclusion: The new zirconia crowns performed better than stainless steel crowns in terms of wear of crown and gingival health and it provided a more aesthetically pleasing and widely accepted restorative choice for primary mandibular molars. Stainless steel crows performed better in terms of retention of crowns. There was no difference between the two crowns in terms of marginal adaptation and interproximal bone loss.