Full Coronal Coverage Research Articles

Esthetic Management of Child with Severe Early Childhood Caries: Two Case Reports

This case report represents the esthetic management of child with severe early childhood caries (ECC). Early loss of primary anterior teeth is caused by severe ECC. The child’s speech gets affected as it interferes with the pronunciation of consonants which could lead to the development of parafunctional habit. Two case reports are discussed with different approaches for rehabilitation of severely decayed primary anterior teeth. In Case 1, the primary anterior teeth were severely decayed. Teeth were restored with intracanal retainers followed by full coronal coverage restoration. In Case 2, one of the primary anterior tooth was mobile and rest of them were severely decayed. The tooth was extracted and fiber-reinforced bridge was placed. The other teeth were restored with intracanal retainers followed by full coronal coverage restoration. Additive effect of intracanal retainers with full coronal coverage restorations and fiber-reinforced bridge presented esthetic and functional success.

Survey on the Use of Zirconia Crowns in Pediatric Population among General Dental Practitioners

Abstract Background Pediatric zirconia crowns are metal free and more aesthetic and compatible option available for the full coronal coverage of the affected primary dentition. These crowns are not new to pediatric dentistry but usage is limited. Materials and Methods A cross-sectional, descriptive survey was conducted among 200 general dental practitioners and were requested to answer a questionnaire. The questions were framed regarding the knowledge of pediatric dental procedures, aesthetic replacement in case of full coverage restorations, and zirconia crown's features and its use in the practice, and were evaluated. Results Results were based on features of zirconia crowns according to which 81.5% participants mentioned them as stainless steel alternative and 62% as biocompatible material. Clinical aspects evaluated the amount of occlusal reduction in case of zirconia crown tooth preparation as 1 to 1.5 mm by 72.5% of the participants. Appropriate type of finish line and type of margins advocated by the participants was chamfer and subgingival finish line, respectively, according 62.0% participants. Conclusion The use of zirconia crowns for replacement of lost tooth structure and post-pulp therapy helps in creating good-looking restorations which help children and adolescents to improve their self-image.

Zirconia crowns as an esthetic alternative for oral rehabilitation in pediatric dentistry: A review

The success of rehabilitation in primary teeth may not rely only on the success of dental restoration , as esthetics is also important. As zirconia crowns combine resistance with esthetics, pediatric dentists must know the details regarding this material to be able to use it when required. To review the literature and synthesize research regarding the use of prefabricated zirconia crowns. A systematic search of the literature was carried out in PubMed, MEDLINE EBSCO, BVS, Embase, and Scopus, with the search terms: “zirconia crowns”, “zirconia crown”, “prefabricated crowns”, “pediatric crowns”, “zirconia pediatric crown”, “deciduous”,” primary teeth”, “primary tooth”, “pediatric dentistry”, “primary molar” and “primary incisors”. After the screening for inclusion and exclusion criteria, 60 eligible articles were included, in English, Spanish or Portuguese, with no restrictions on the year of publication. Zirconia crowns are indicated for primary teeth affected by early childhood caries, traumatic dental injuries and developmental defects of enamel . They present resistance, durability, higher esthetics proprieties (when compared to other materials for the full coronal coverage of primary teeth), good gingival health and biocompatibility, good parental and children's acceptance and satisfaction. However, some limitations are mentioned: higher costs, the necessity for greater amounts of tooth reduction and the impossibility of adjustments. Zirconia crowns, as no other material for the full coronal coverage of primary teeth, combine biocompatibility, resistance and ideal esthetic outcomes. This material, despite its limitations, is a great alternative for the rehabilitation of primary teeth with intense loss of structure.

Crowns for paediatric teeth: Stainless steel crown

Management of the severely destructed primary teeth poses a challenge for the paediatric dentist as three important considerations have to be kept in mind, patient’s behavioural management, preservation of the tooth structure and parental satisfaction. Various crowns have been introduced to the field of dentistry such as stainless-steel crowns and aesthetic crowns. Prefabricated stainless steel crowns (SSC) can be adapted to individual primary teeth and cemented in place to provide a definitive restoration. The SSC is extremely durable, relatively inexpensive, subject to minimal technique sensitivity during placement, and offers the advantage of full coronal coverage. SSC are often used to restore primary and permanent teeth in children and adolescents where intra-coronal restorations would otherwise fail. This article brings the update of this definitive restoration.

Extra Coronal Esthetic Restorations: Clinical Predictability in Pediatric Dentistry

A variety of esthetic restorative materials has been introduced in the past decades for restoring primary incisors. However, knowledge of the specific strengths weakness and properties of each material will enhance the clinician’s ability to make the relevant choice of selection for each individual personalized treatment plan. The objective of this review was to discuss the advancements in esthetic restorations for restoring primary incisors in a clinical situation. Individualized treatment planning and optimum professional judgement is essential for selecting the extra coronal restorations for primary dentition. Nevertheless, CAD/CAM crowns can be promising alternative options for full-coronal coverage. Moreover, long-term follow-ups and further clinical trials are required to support the evidence.

In Vitro evaluation of the wear of primary tooth enamel against different ceramic and composite resin materials.

Although there are several studies on permanent tooth wear caused by dental materials, studies concerning primary teeth are limited. To evaluate the wear of primary tooth enamel against different ceramic and composite resin materials. In vitro study. Materials and Methods: We assessed five materials (n = 10 per group): monolithic zirconia (group Z), lithium disilicate glass ceramic (group L), resin nanoceramic (group R), nanohybrid composite resin (group C), and primary tooth enamel (group E). The mesiopalatal cusps of primary maxillary second molars were used as antagonists. Wear tests were performed in a dual-axis chewing simulator, and the volume loss in the antagonist tooth was evaluated using a laser scanner and three-dimensional profiling system. Data were statistically analyzed using one-way analysis of variance with Tukey's post hoc tests (P < 0.05). Results: The maximum antagonist tooth wear was observed in group L (3.84 ± 0.7 mm3), followed by groups C (3.68 ± 0.76 mm3), R (3.48 ± 0.71 mm3), Z (2.66 ± 0.65 mm3), and E (1.66 ± 0.42 mm3). Volume loss was significantly lesser in group Z than in groups L and C (P < 0.05), whereas there were no significant differences among groups L, C, and R. Within the limitations of this in vitro study, our findings suggest that zirconia should be used for full coronal coverage in primary tooth restorations because it causes lesser antagonist tooth wear than does lithium disilicate, resin nanoceramic, and nanohybrid composite resin.

Sealing Carious Tissue in Primary Teeth Using Crowns: The Hall Technique.

In line with reducing the invasiveness of interventions in permanent teeth and changes towards more biological approaches, there have also been moves away from traditional restorative approaches to managing primary teeth where carious dentine/lesions were completely excised and a restoration placed. The Hall Technique is a method for managing carious primary molar teeth where a preformed stainless-steel crown, also known as a preformed metal crown, is seated over a tooth, sealing in, and not removing carious tissue. This chapter discusses the rationale behind the Hall Technique, an outline of the clinical procedure to carry it out, its indications and contraindications, together with the evidence supporting its use. The Hall Technique has been found to be acceptable to children and preferred to more invasive treatment options. Like all dental treatment options, it requires careful case selection, precise carious lesion and pulpal status diagnosis (clinically and radiographically), good patient management, and excellent parental cooperation. The Hall Technique has been shown to be a durable (being likely to last the lifespan of the primary molar) and economical management option for primary molars with carious lesions, which in addition offers the benefit of full coronal coverage, reducing the risk of future carious lesion development. As part of our everyday armamentarium in paediatric dentistry, the Hall Technique is an effective management option for controlling carious lesions in primary molars.

Quantitative and Qualitative Assessment of the Wear of Primary EnamelAgainst Three Types of Full Coronal Coverage

Aims: the objective of the study was to assess the wear of primary teeth against three types of crown coverage, both quantitavely and qualitatively. Methods: specimens of 30 extracted primary molars, were mounted against 10 specimens of zirconia crowns (group A), 10 specimens of preveneered stainless steel crowns (group B), and 10 extracted primary molars and 10 specimens of stainless steel crowns (group C) and were undergone in vitro wear testing using an abrasive machine. Measurement of the amount of weight loss was performed, in addition to a scanning electron microscopic examination of the worn enamel surfaces. Results: the greatest wear was recorded in zirconium specimens, and the lowest was in preveneered stainless steel crowns with a significant difference noted between the three groups (p<0.001).The micro-morphological wear characteristics revealed the most aggressive wear with complete loss of enamel structure in zirconium specimens. Conclusions: the zirconium crowns induced the most severe wear in primary molars, followed by stainless steel crowns, and the least wear was induced by preveneered stainless steel crowns.

Pediatric Preformed Metal Crowns - An Update

Stainless Steel crowns (SSC) were introduced in 1947 by the Rocky Mountain Company and popularized by Humphrey in 1950. Prefabricated SSC can be adapted to individual primary teeth and cemented in place to provide a definitive restoration. The SSC is extremely durable, relatively inexpensive, subject to minimal technique sensitivity during placement, and offers the advantage of full coronal coverage. SSC are often used to restore primary and permanent teeth in children and adolescents where intracoronal restorations would otherwise fail. This article brings the update of this definitive restoration.

Orthograde endodontic retreatment of teeth with individual cast posts: Report of two cases

The failure of primary endodontic treatment is manifested by various clinical symptoms following endodontic therapy or, more frequently, by the development of chronic inflammatory process in the apex region without any subjective symptoms. In case of unfavorable outcome of the primary endodontic treatment, orthograde endodontic retreatment is the method of choice for a prolonged therapy. Two female patients, 47 and 44 years old, were presented at the Dental Clinic of Vojvodina for endodontic retreatment of teeth 22, 23 and 13, within the repeated prosthetic restoration. Intraradicular individual cast posts were removed using ultrasonic instruments. Remains of gutta-percha were removed by engine driven rotary re-treatment files, root canals were shaped and cleaned using the crown-down technique, and obturated with gutta-percha and epoxy-resin-based sealer using the lateral compaction technique. When there are metal posts or broken instruments in the root canal, the use of ultrasonic instruments is considered a safe method characterized by negligible tooth substance loss and minimal root damage causing fractures and perforations, and the entire procedure is effective and predictable. Non-surgical orthograde endodontic retreatment, when properly performed in accessible and penetrable root canals, achieves a high cure rate, good and lasting results and eliminates the need for radical procedures, such as apical surgery or tooth extraction. When nonsurgical endodontic retreatment is done, treated teeth must be restored by full coronal coverage as soon as possible, to prevent coronal leakage or fracture.

Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralisation (MIH): A systematic review

This was to review the literature concerning the treatment of permanent teeth with molar-incisor hypomineralised enamel (MIH), comment about possible shortcomings and propose areas of future research. A search of MedLine, Scopus, ResearchGate, Isis and Google Scholar databases was conducted using all terms relevant to the subject. Relevant papers published in English were identified after a review of their titles, abstracts or full reading of the papers. Of 189 references initially found, 66 papers were included; 34 directly relevant to the subject. From the latter, only 14 concerned laboratory or clinical studies dealing with treatment for MIH. Since 2000 11 reviews evaluated, to a certain extent, treatment options for affected teeth. Analysis of the proposed treatment modalities indicated options for prevention, restorations, and adhesion to hypomineralised enamel, full coronal coverage and extraction followed by orthodontics. Based on these findings, a treatment decision plan is proposed. Although treatment approaches for MIH have started to be clearer, long-term clinical trials, supported by laboratory studies, should be conducted to further facilitate the clinical management of this dental defect.

Endodontic Treatment Outcomes in a Large Patient Population in the USA: An Epidemiological Study

Outcome assessment of endodontic treatment is critical for appropriate case selection and treatment planning. However, reports on outcomes of nonsurgical endodontic treatment vary considerably. Epidemiological studies done in a large patient population and over a long follow-up period can provide the clinician with useful tools for clinical decision-making and assessment of tooth prognosis. In this study, outcomes of initial endodontic treatment done in 1,462,936 teeth of 1,126,288 patients from 50 states across the USA was assessed over a period of 8 yr. Treatment was done by private general practitioners and endodontists participating in the Delta Dental Insurance plan that insures approximately 14 million individuals in the USA. Overall, 97% of teeth were retained in the oral cavity 8 yr after initial nonsurgical endodontic treatment. The combined incidence of untoward events such as retreatments, apical surgeries, and extractions was 3% and occurred mostly within 3 yr from completion of treatment. Analysis of the extracted teeth revealed that 85% had no full coronal coverage. A significant difference was found between covered and noncovered teeth for all tooth groups tested (p < 0.001). In conclusion, it appears that initial nonsurgical endodontic treatment is a predictable procedure with high incidence of tooth retention after 8 yr.

Xerostomia (Sjögren's syndrome) associated with unusual dental caries: Report of a case

A case of Sjögren's syndrome exhibiting aptyalism with a marked dental caries pattern has been presented. Attention is drawn to the absence of salivary calculus in those areas exhibiting the most extensive earious attack. Treatment by means of full coronal coverage is suggested.