The Clinical Performance of Laboratory-Fabricated Crowns: Placed on First Permanent Molars with Developmental Defects

Abstract

Young permanent molars with developmental enamel defects commonly are treated with stainless steel crowns. However, allergic reactions to nickel and chromium have been reported by some patients. The literature contains no evaluations of alternative treatments. In a retrospective study, the authors evaluated the clinical performance of cast gold crowns and tooth-colored composite or ceramic crowns placed on first permanent molars with developmental defects in children 6 to 8 years of age. A total of 41 molars were prepared. After crown preparation, an impression was made, and crowns of cast gold, Artglass (J.F. Jelenko & Co.) composite or Empress (Ivoclar) leucite-containing ceramic were fabricated and clinically evaluated every six months for a period ranging from two to five years postoperatively (mean three years). After two to five years, all crowns were fully retained. The marginal adaptation of 39 of the 41 crowns was rated excellent, and the marginal adaptation of the remaining two crowns (both gold) received acceptable ratings. In two cast gold crowns, the margins were subgingival at cementation; the remaining 39 crowns had supragingival margins at the time of luting. By the end of the second year, all margins were supragingival. All teeth were vital and asymptomatic at all evaluation points. No secondary caries was recorded. Neither gingival inflammation nor loss of vertical dimension was recorded in any case. All crowns were well-accepted by the patients and their parents. Laboratory-fabricated crowns can be used for the treatment of young permanent molars with developmental defects. Cast gold, composite or ceramic crowns can be used successfully to treat developmental defects of first permanent molars in children.