Parental Satisfaction with Preveneered Stainless Steel Crowns for Primary Anterior Teeth

Resident’s Name: Jessica Wilson

Article title: Parental Satisfaction with Preveneered Stainless Steel Crowns for Primary Anterior Teeth

Author(s): Champagne et al.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2007. 29:6. 465-469.

Major topic: Preveneered Stainless Steel Crowns (PVSSCs)

Overview of method of research: Survey

Purpose:
To evaluate parental satisfaction with preveneered stainless steel crowns (NuSmiles) placed on their child.

Background:
The authors reported that at the time only 4 manufacturers fabricated PVSSCs (too bad Whiter Biter, Inc. crowns are no longer available, that would be fun to say). These crowns use a composite or thermoplastic resin facing. The disadvantages of this product are a reduced retention from limited crimping, greater expense and availability in only in 2 shades.

Methods:
A questionnaire was administered by a trained assistant to 58 parents at a recall visit at least 6 months after the NuSmile crowns were placed. The questionnaire asked about durability, size, color, and shape. The crowns were placed by pediatric dental residents or private pediatric dentists and all cemented with Ketac-Cem.

Findings:
54 questionnaires were used and the average age of the patient at recall was 5 years, 2 months. A total of 238 crowns with an average of 5 crowns per child were accounted for and the crowns were present for an average of 13 months. The overall acceptance of the PVSSCs was 93% and no parents reported overall dissatisfaction. When evaluating each individual characteristic of the crowns, 97% of parents were satisfied with size, 94% shape, 89% shade and retention, 74% metal visibility and 70% durability. 80% of the parents reported that their children were satisfied with the crowns.
59% of parents said their child never reported any discomfort with the crowns and 39% reported occasional discomfort and only 1 parent said their child complained on a regular basis although they did not seek additional care for their child.
91% of parents said that they would choose the NuSmile restorations again, 7% would choose a completely different type of restoration and only 1 parent would choose extraction.
When the parents were asked if the child experienced any injury to the restored teeth, 78% reported no injury, 22% reported some injury including chipped veneers or completely dislodged crowns. Another 2 parents reported the crowns being dislodged while eating rather than injury. Upon clinical exam, only 27 of 238 crowns demonstrated any shipping/fracturing of the veneer and 6 were completely dislodged.
When comparing the level of the practitioner and the parent’s level of satisfaction, there was no statistical significance, however the parents of male patients were significantly less satisfied overall than those of female patients.

Key points/Summary:
Parental satisfaction with PVSSCs was highly positive with the highest satisfaction with size and shape and the lowest being in durability and metal visibility.
Parental satisfaction was not influenced by clinical experience or level of practitioner.

Assessment of Article:
The article was pretty straight and to the point which I appreciated. One limitation to the study the author mentioned is that there may be a doctor-patient relationship that might have prevented the parent from being more critical of the restorations. I was surprised that more parents were not more dissatisfied with the color, but thought the findings were interesting. Me likey Adam.