Clinical Outcomes for Primary Anterior Teeth Treated with Preveneered Stainless Steel Crowns

Resident’s Name: Ara Cho

Author(s): MacLean, JK et al.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2007. 29. 377-381.

Type of article: Retrospective Study.

Major topic: Anterior Primary Teeth, Early Childhood Caries, NuSmile Crowns

Purpose: To determine the clinical outcomes for a sample of NuSmile crowns used to treat anterior teeth with early childhood caries.

Overview of method of research:

Patients of either a private pediatric dentist or public health clinic and had NuSmile crowns were selected for the study. First- or second- year pediatric dental residents or a dentist in private practice placed the NuSmile crowns. The crowns were placed by 10 clinicians total. The children were evaluated at a followup appointment and three nonblinded, calibrated examiners evaluated the crowns. The parent or guardian completed a written survey to assess parental satisfaction.

Findings:

A total of 226 NuSmile crowns were evaluated in 46 patients. Mean age of crown placement was 4 years of age. Mean time of evaluation was 13 months after placement of the crowns. Each patient had an average of 5 crowns. 91% of the patients were treated under G.A., 4% with nitrous oxide, 2% with oral conscious, 2% with behavior management. 96% had positive behavior and 4% had negative behavior. 24% of patients had history of bruxism and 28% of patients had history of trauma to the crowned teeth.

91% of all patients maintained a good to excellent overall appearance after at least 6 months. NuSmile crowns are a clinically successful complete coverage restoration for anterior primary teeth as evidenced by: 86% resistance to fracture, 71% resistance to attrition, 99% retention, 99% resistance to crazing, and 99% color stability over a minimum of 6 months.

When comparing shade of the NuSmile crown to the natural teeth, only 2 patient’s shades matched. The NuSmile crown was lighter in 88% of the patients.

Key points/Summary:

1. NuSmile crowns are a clinically successful restoration for anterior primary teeth.
2. Despite some negative clinical changes, 91% of NuSmile crowns retain a good to excellent overall appearance after 6 months.
3. Canine NuSmile crowns are the least clinically successful. They are most likely to fracture, wear, and appear bulky.
4. There is an increased incidence of attrition with increased time and with bulky crowns.
5. Successful results with NuSmile crowns may be obtained by both the experienced operator and the novice.

Assessment of Article:

This article highlights the advantages of NuSmile crowns, however, does not really address the esthetic concerns of the crown. The fact that only 2 patient’s shades matched is quite significant. Only 37% of patients had excellent overall appearance; 50% had good overall appearance.