Zirconia crowns as a treatment option in oncology pediatric patients undergoing frequent magnetic resonance imaging: a case presentation

Background: Stainless Steel Crowns (SSC) are considered the gold standard for restoration of severely carious teeth in children. However, there are cases where they are contraindicated. The aim of this case report is to present the dental treatment of an oncology pediatric patient, in which alternative materials, that do not interfere with the magnetic field during Magnetic Resonance Imaging (MRI), were used. Case: A 5-year-old boy was referred for dental treatment. The child had been diagnosed with abdominal cancer at the age of 4 years old, and had been treated with surgery, chemotherapy and concomitant radiotherapy. At the day of presentation, he was under maintenance therapy. Clinical examination revealed severe caries on all primary teeth, and fistula on the right maxillary first primary molar. Radiographic examination showed a radiolucency on the abscessed molar, and extensive caries close to the pulp on the lower first and second primary molars. Treatment plan involved restorations of carious teeth using composite resin restorations, vital pulp therapy in teeth with lesions involving the pulp and extractions of severely carious primary teeth. On severely carious teeth, zirconia crowns were used instead of SSC as the patient is undergoing regular MRIs to control for metastasis and metal restorations are contradicted. The patient has been attending the clinic for follow up visits without presenting any new carious lesions or complications. Sealants were placed on the 2-year follow-up visit to the first permanent molars that had erupted. Conclusions: Treating patients diagnosed with a malignancy is not contraindicated but appropriate planning and choice of materials that are compatible with MRI imaging is necessary. Composite resin restorations, zirconia crowns or computer-aided design and manufacturing (CAD/CAM) materials are indicated in cancer survivors.

Pediatric patients; Composite restorations; Zirconia crowns; CAD/CAM; MRI

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