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

Objective: This study aimed to evaluate the success and longevity of different types of full coverage restorations for maxillary anterior primary teeth. We compared the clinical performance, esthetic outcomes including parental satisfaction of resin strip crowns (RC), pre-veneered stainless steel crowns (PVSSC), and zirconia crowns (ZC).

Methods: A prospective cohort study was conducted involving children aged 36-72 months old with carious primary maxillary anterior teeth requiring full-coverage restorations. Treatment was completed under general anesthesia by the dental surgeon. Prior to the procedure, parents or guardians were asked to fill out a pre-assessment Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire. The choice of material used for restoration was based on comfort, occlusion, age, technique sensitivity, or material availability. After completing restorations, patients were then asked to follow up for their periodic oral examinations where they were asked to complete ECOHIS questionnaires along with parental satisfaction scale as a post assessment. In order to assess the integrity of the restorations, the dental provider completed anterior crown assessments at these follow ups. Patients were followed every 6 months for up to 18 months. The data collected was entered into REDCap.

Results: A total of 41 patients were enrolled in the study and attended at least 1 follow-up appointment. The average patient age was 4.3 and 51% were male (n=21). These 41 patients received a total of 115 crowns, ranging from 1 to 6 crowns per patient. The most frequently treated teeth were D and G both at 61% of patients followed by F which was treated for 56% of patients and E for 49%. Teeth C (21%) and H (17%) were treated with crowns for 27% of the patients. The most common crown type was the composite strip crown (RC) which was used for 61 of the 115 crowns (53%). Zirconia crowns were used for 24 teeth (21%) and pre-veneered stainless steel crowns (PVSSC) for 30 (26%).

Conclusion: This study assessed the success and longevity of three types of full coverage restorations for maxillary anterior primary teeth: resin strip crowns (RC), pre-veneered stainless steel crowns (PVSSC), and zirconia crowns (ZC) over an 18-month follow-up. Results showed that nearly all crowns were intact at six months, with high parental satisfaction reported. Although minor issues like color change and fractures were noted, gingival inflammation, particularly with zirconia crowns, was the most significant concern. At the 12-month mark, PVSSCs had a higher incidence of gingival issues compared to RCs and ZCs, emphasizing the impact of crown material on soft tissue health. However, by the 18-month follow-up, clinical outcomes across all types became similar, suggesting that initial differences in gingival health may not be long-lasting. Parents completing the Early Childhood Oral Health Impact Scale indicated significant improvements in the Child Impact Score and total score at the 6-month follow-up, while subsequent follow-ups at 12 and 18 months showed improvements that were not statistically significant. Overall, parental satisfaction remained high for all restoration types, indicating that aesthetic and functional outcomes met expectations. These findings offer valuable guidance for clinicians in selecting restoration materials for young patients, balancing clinical effectiveness with parental preferences.