Clinical success and its associated influencing factors in the placement of resin-bonded strip crowns on primary anterior teeth in children under general anaesthesia: a 1-year retrospective study

Background: Resin strip crowns (RSCs) are recommended for the restoration of primary incisors with caries. We aimed to explore the clinical outcomes and factors influencing the placement of RSCs on primary anterior teeth in children under dental general anaesthesia (DGA). Methods: We included patients who underwent RSC placement under DGA between January 2013 and December 2016. Data, including patient sex, age, arch type, tooth position, and number of carious surfaces of the tooth, were analysed. The chi-square test and logistic regression analysis were used for statistical analysis (p < 0.05). Results: A total of 63 patient files were included, with 308 restorations. At 12 months, the overall success rate of the RSCs was 87.01%. This study revealed the following: (1) The survival of RSCs placed on the teeth of patients aged >5 years was 3.61 times greater than that of RSCs placed on the teeth of patients aged ≤3 years (odds ratio (OR) = 3.61, p = 0.029). (2) The survival of RSCs placed on mandibular teeth was 2.7 times greater than that of RSCs placed on maxillary teeth (OR = 2.70, p = 0.003). (3) The survival of RSCs was 0.23 times greater for primary lateral incisors than for primary central incisors (OR = 0.23, p = 0.011) and 0.17 times greater for primary canines than for primary central incisors (OR = 0.17, p = 0.002). (4) The survival of RSCs placed on teeth with 1–2 carious surfaces was 13.5 times greater than that of RSCs place on teeth with 3–4 carious surfaces (OR = 13.5, p = 0.015). Conclusions: Patient age, arch type, tooth position, and number of carious surfaces were associated with the clinical outcomes of RSCs. For older children, RSCs may be considered a preferable treatment for the restoration of primary anterior teeth, especially teeth in the lower jaw, primary incisors and teeth with fewer carious surfaces.

Dental general anaesthesia; Primary anterior teeth; Resin-bonded strip crowns

[1] Arumugam S, Sundaramurthy N. Posts in primary teeth-past to present: a review of literature. International Journal of Clinical Pediatric Dentistry. 2021; 14: 705–710.

[2] Sarapultseva M, Sarapultsev A. 36 months’ clinical performance of primary incisors restorations depending on the type of restorative technique used: a randomized controlled trial. Dentistry Journal. 2021; 9: 126.

[3] Waggoner WF. Restoring primary anterior teeth: updated for 2014. Pediatric Dentistry. 2015; 37: 163–170.

[4] Kochhar G, Duhan H, Pandit I, Srivastava N, Gugnani N, Gupta M. Clinical comparison of various esthetic restorative options for coronal build-up of primary anterior teeth. Dental Research Journal. 2015; 12: 574.

[5] Finucane D. Restorative treatment of primary teeth: an evidence‐based narrative review. Australian Dental Journal. 2019; 64: S22–S36.

[6] Hamrah MH, Mokhtari S, Hosseini Z, Khosrozadeh M, Hosseini S, Ghafary ES, et al. Evaluation of the clinical, child, and parental satisfaction with zirconia crowns in maxillary primary incisors: a systematic review. International Journal of Dentistry. 2021; 2021: 7877728.

[7] RojaRamya K, Zulekha, Vinay C, Uloopi K, Penmatsa C, Ramesh M. Clinical performance of one shade universal composite resin and nanohybrid composite resin as full coronal esthetic restorations in primary maxillary incisors: a randomized controlled trial. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2022; 40: 159.

[8] Margolis FS. The sandwich technique and strip crowns: an esthetic restoration for primary incisors. Compendium of Continuing Education in Dentistry. 2002; 23: 1165–1169; quiz 1170.

[9] Ram D, Fuks AB. Clinical performance of resin‐bonded composite strip crowns in primary incisors: a retrospective study. International Journal of Paediatric Dentistry. 2006; 16: 49–54.

[10] Grewal N, Jha S, Kaur N. Clinical and radiographic success of resin-bonded strip crowns in primary incisors with varying extents of sound tooth structure available for bonding. International Journal of Clinical Pediatric Dentistry. 2021; 14: 454–461.

[11] Schulz-Weidner N, Schlenz MA, Jung LG, Uebereck CF, Nehls A, Krämer N. Dental Treatment under General Anesthesia in Pre-School Children and Schoolchildren with Special Healthcare Needs: A Comparative Retrospective Study. Journal of Clinical Medicine. 2022;11:

[12] Bagher SM, Sabbagh HJ, Nadhreen A, Alamoudi NM, Almushayt A, Al-Malik M, et al. Preference for comprehensive dental treatment under general anesthesia among parents with previous experience: a cross-sectional study. Children. 2023; 10: 1776.

[13] American Academy of Pediatric Dentistry; American Academy of Pediatric Dentistry Committee on Sedation and Anesthesia. Guideline on the elective use of minimal, moderate, and deep sedation and general anesthesia for pediatric dental patients. Pediatric Dentistry. 2005; 27: 110–118.

[14] Kupietzky A, Waggoner WF, Galea J. The clinical and radiographic success of bonded resin composite strip crowns for primary incisors. Pediatric Dentistry. 2003; 25: 577–581.

[15] Demarco FF, Cenci MS, Montagner AF, de Lima VP, Correa MB, Moraes RR, et al. Longevity of composite restorations is definitely not only about materials. Dental Materials. 2023; 39: 1–12.

[16] van de Sande FH, Moraes RR, Elias RV, Montagner AF, Rodolpho PA, Demarco FF, et al. Is composite repair suitable for anterior restorations? A long-term practice-based clinical study. Clinical Oral Investigations. 2019; 23: 2795–2803.

[17] Srivastava V. Prevalence and pattern of caries in primary anterior teeth of preschool children: an observational study. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2020; 38: 26.

[18] Nör J, Feigal R, Dennison J, Edwards C. Dentin bonding: SEM comparison of the dentin surface in primary and permanent teeth. Pediatric Dentistry. 1997; 19: 246–252.

[19] Metz I, Rothmaier K, Pitchika V, Crispin A, Hickel R, Garcia‐Godoy F, et al. Risk factors for secondary caries in direct composite restorations in primary teeth. International Journal of Paediatric Dentistry. 2015; 25: 451–461.

[20] Antoniazzi B, Nicoloso G, Lenzi T, Soares F, Rocha RO. Selective acid etching improves the bond strength of universal adhesive to sound and demineralized enamel of primary teeth. The Journal of Adhesive Dentistry. 2016; 18: 311–316.

[21] Tichý A, Yang Y, Sayed M, Shimada Y, Hosaka K. The effect of bonding strategy and aging on adhesion to primary enamel: an in-vitro study. The Journal of Adhesive Dentistry. 2023; 25: 187–194.

[22] da Silva CL, Cavalheiro CP, Gimenez T, Imparato JCP, Bussadori SK, Lenzi TL. Bonding performance of universal and contemporary adhesives in primary teeth: a systematic review and network meta-analysis of in vitro studies. Pediatric Dentistry. 2021; 43: 170–177.

[23] van Dijken JWV, Pallesen U. Eight-year randomized clinical evaluation of class II nanohybrid resin composite restorations bonded with a one-step self-etch or a two-step etch-and-rinse adhesive. Clinical Oral Investigations. 2015; 19: 1371–1379.

[24] Soares AD, Ramos JC, Alves LC, Pereira JL, Caramelo F, Costa AL. Evaluation of the efficacy of a 2-step etch-and-rinse, 2-step self-etch and 1-step self-etch adhesive systems, in class II primary molars restorations. an one year prospective, randomized clinical trial. European Archives of Paediatric Dentistry. 2022; 23: 845–854.

[25] Lone P, Wani N, Ain Q, Heer A, Devi R, Mahajan S. Common postoperative complications after general anesthesia in oral and maxillofacial surgery. National Journal of Maxillofacial Surgery. 2021; 12: 206.

[26] Xu X, Zhu J, Mei ML, Wu H, Xie K, Wang S, et al. Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration. The Journal of Biomedical Research. 2023; 37: 138.

[27] Veneri F, Filippini T, Consolo U, Vinceti M, Generali L. Ozone treatment for the management of caries in primary dentition: a systematic review of clinical studies. Dentistry Journal. 2024; 12: 69.

[28] Bahrololoomi Z, Mehravar F. Comparison of different adhesive systems on bond strength of resin composite posts placed in primary teeth. International Journal of Dentistry. 2022; 2022: 1968781.

[29] Gill A, Garcia M, Won An S, Scott J, Seminario AL. Clinical comparison of three esthetic full-coverage restorations in primary maxillary incisors at 12 months. Pediatric Dentistry. 2020; 42: 367–372.

[30] Gupta M, Chen JW, Ontiveros JC. Veneer retention of preveneered primary stainless steel crowns after crimping. Journal of Dentistry for Children. 2008; 75: 44–47.

[31] Yepes JF, McKenna K, Jones JE, Eckert GJ, Tang Q, Downey T, et al. Longevity of primary anterior crown restorations: a retrospective dental claim analysis. Journal of Dentistry for Children. 2020; 87: 147–152.

[32] Yanover L, Waggoner W, Kupietzky A, Moskovitz M, Tickotsky N. Parental and dentist satisfaction with primary anterior zirconia crowns: a case series analysis. Children. 2021; 8: 451.

[33] Kanareli C, Balazuc-Armbruster M, Tsolakis IA, Kanarelis T, Tsolakis AI. Full mouth treatment of early childhood caries with zirconia dental crowns: a case report. Children. 2023; 10: 488.

[34] Verma RK, Srilatha V, Patel S, Dithi C, Somaraj V, Vallabhaneni SK. Assessment of parental satisfaction with various aesthetic crowns among children of various age groups: an original research. Journal of Pharmacy and Bioallied Sciences. 2023; 15: S196–S200.