Survival Rates of Stainless Steel Crowns and Multi-Surface Composite Restorations Placed by Dental Students in a Pediatric Clinic

Purpose: This study examined survival rates of multi-surface composite restorations and stainless steel crowns (SSCs) placed by students in a pediatric dental clinic as well as the length of time it takes for restorations to be replaced with stainless steel crowns. Study design: Data from electronic dental records for all children with at least one 2-surface composite restorations or SSCs on a primary first or second molar from January 1, 2007 to September 30, 2015 were analyzed. The primary outcome was the time to a new restoration or SSC on the same tooth, with time to a crown as a secondary outcome. Descriptive statistics were obtained and the cumulative incidence of the event of interest was estimated using 95% confidence intervals and compared between groups using Fine-Gray regression. Results: A total of 6,288 teeth from 2,044 children were analyzed. Three years after the initial procedure, 1.5% of SSCs and 21% of 2 and 3 surface composite restorations failed and needed a replacement (Hazard Ratio [HR]= 14; 95% Confidence interval [CI] 9–22, p<0.001). Also, 6.8% of composite restorations needed replacement with SSCs' (HR=4; 95% CI: 3–7). Conclusions: The study demonstrates that stainless steel crowns had a higher survival rate than multi-surface composite resins placed by students at a pediatric dental clinic in primary molars of children.

Children, stainless steel crowns, survival rates and composite restoration

1. Çolak H, Dülgergil CT, Dalli M, Hamidi MM. Early childhood caries update: A review of causes, diagnoses, and treatments. J Nat Sci Biol Med 4(1): 29–38, 2013

2. US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General— Executive Summary . Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.

3. Seow WK. Biological mechanisms of early childhood caries. Community Dent Oral Epidemiology 26 (supplement 1): 8-18, 1998.

4. Henzi D, Davis E, Jasinevicius R. North American Dental students’ Perspectives about Their Clinical Education. J. Dent. Educ 70(4): 361- 377, 2006.

5. Donly KJ, Garcias-Godoy F. The use of resin-based composites in chil-dren: an update. Pediatr Dent 37: 136-143, 2015.

6. Seale NS, Randall R. The use of stainless steel crowns: a systematic liter-ature review. Pediatr Dent 37: 147-162, 2015.

7. Einwag J, Dunninger P. Stainless steel crown versus multisurface amalgam restorations: an 8-year longitudinal clinical study. Quintessence Int 27(5): 321-323, 1996.

8. Messer LB, Levering NJ. The durability of primary molar restorations: II. Observations and predictions of success of stainless steel crowns. Pediatr Dent 10: 81-85, 1988.

9. Levering NJ, Messer LB. The durability of primary molar restorations: I. Observations and predictions of success of amalgams. Pediatr Dent 10: 74- 80, 1988.

10. Eidelman E1, Faibis S, Peretz B.A comparison of restorations for children with early childhood caries treated under general anesthesia or conscious sedation. Pediatr Dent 22(1): 33-37, 2000.

11. Bohaty BS, Ye Q, Misra A, Sene F, Spencer P. Posterior composite resto-ration update: focus on factors influencing form and function. Clinical, Cosmetic and Investigational Dentistry 5: 33-42, 2013.

12. Drummond BK, Davidson LE, Williams SM, Moffat SM, Yers KM. Outcomes two, three and four years after comprehensive care under general anesthesia. NZ Dent J 2:32-37, 2004.

13. Fuks AB, Ram D, Eidelman E. Clinical performance of esthetic posterior crowns in primary molars: a pilot study. Pediatr Dent 21 (7): 445-448, 1999.

14. Milsom KM, Kearney-Mitchell PI, Shahid S, Threlfall A, Blinkhorn A, Tickle M. The treatment of primary molar teeth presenting with two surface caries: a review of care delivered by the Personal Dental Services in Bradford. Int J Health Promo Educ 44: 141-144, 2006.

15. Papathanasiou AG, Curzon MEJ, Fairpo CG. The influence of restorative material on the survival rate of restorations in primary molar. Pediatr Dent 16: 282-288, 1994.

16. Derkson GD, Richardson AS, Waldman R: Clinical evaluation of composite resin and amalgam posterior restorations: three year results. J Can Dent Assoc 50: 478-480, 1984.

17. Deprá MB, de Almeida JX, da Cunha Tde M, Lon LF, Retamoso LB, et al. Effect of saliva contamination on bond strength with a hydrophilic composite resin. Dental Press J Orthod 18(1): 63-68, 2013.

18. Furuse AY, Fernandes Da Cunha L, Benetti AR. et al. Bond Strength Of Resin-Resin Interfaces Contaminated With Saliva And Submitted To Different Surface Treatments. J Appl Oral Sci 15(6): 501–505, 2007.