Placement Of Stainless Steel Crowns Research Articles

Clinical and Radiographical Outcomes of Restorative Treatment With Stainless Steel Crowns Performed by Undergraduate Dental Students in Medina, the Kingdom of Saudi Arabia.

Background and objective Stainless steel crown (SSC) placement has long been the preferred restorative treatment modality for treating multi-surface carious primary molars. This study aimed to assess the outcomes of SSC placement on primary molars performed by undergraduate dental students. Materials and methods A total of 112 children aged four to eight yearswere contacted for follow-ups 12 months after they underwent SSC restorationsby fifth- or sixth-year female dental students in 2018-2020. Clinical and radiographic examinations were performed by trained dentists to evaluate for signs of failure. Descriptive statistics were applied for categorical variables and a Chi-squared test was used to assess the relationship between failure rate and demographic variables (i.e., age, gender, and type of tooth). Results The majority of the included children were aged seven years, with females(52.7%) slightly outnumbering males (47.3%). The failure rate clinically was 17.8%, involving one or more of the following signs: pain (16.1%), poor crown adaptation (16.1%), improper marginal seal (13.4%), fistula (6.3%), and mobility (4.5%). The rate of failure as per radiological examinations was 15%, involving one or more of the following signs: furcation involvement (9.8%), periapical radiolucency (3.6%), and pathological root resorption (1.8%). No significant association was found between failure rate and age, gender, or type of tooth. Conclusions The restorative treatment of primary molars with SSCs exhibited a high success rate when performed by less experienced undergraduate dental students from different academic levels. The failure rate did not appear to be associated with the child's age and genderorthe type of tooth.

Is the traditional placement of stainless steel crowns in primary teeth more painful than the non-preparation Hall technique?

Is the anxiety level and pain experience in young children the same for the traditional method of stainless crowns placement that might require local anesthetic and excavation of decay compared to the Hall technique that requires no preparation and no anesthetic injections? A randomized controlled study of 2 groups (43 and 54) children 4-8 years old with proximal decay in primary first molars. Each child had one tooth restored with the Hall technique (HT) and the second tooth received a conventional stainless crown (CT) (with or without local anesthesia, as needed) and all crowns were cemented with a GIC resin type cement less than a month of each other. The order of the placement was reversed with the allocation randomly concealed. A visual Wong-Baker Pain Scale with six cartoon faces was used to record pain levels. Data were analyzed using SPSS (version 25). After computing univariate descriptive statistics, differences among proportions were examined using cross-tabulations and χ2 tests (α = 0.05). Analysis of variance was conducted for parametric analysis, and the Wilcoxon signed-rank test was used for within-group, and the Mann-Whitney U-test was used for between-group, nonparametric analysis. The pain scores did not differ by treatment type. The majority of children (58.3%) reported low procedural pain for both treatments leaving 47.7% reporting moderate to high procedural pain. Using local anesthetic with CT did not change the results. The pain scores were similar for both procedures. HT has been recommended as less traumatic and but this might not be true for all children.

A comparative study of conventional and Hall techniques of crown placement using finite element stress analysis.

Hall technique of crown placement causes the changes in vertical occlusal dimension; the mode of settlement of which needs to be explored. To assess and compare the changing patterns of stress distribution following placement of stainless steel crowns on primary teeth by Hall and conventional techniques using a finite element model analysis. The clinical crown heights of primary molars restored with Hall and conventional techniques and opposing teeth in contact, vertical dimension changes in the primary canine area were measured using intraoral digital scan. T-scan was used to measure the changes in bite force while the finite element analysis was used to assess deformative changes on the 2nd, 5th, 10th, and 15th days. The Hall technique of crown placement caused more stress distribution in the tooth supporting tissues that settled in 2 weeks as compared with conventional technique of crown placement in which settlement occurred in 2 days. The settling of vertical occlusal dimension as well as stress distribution in Hall technique probably takes place by intrusion of crowned tooth and opposing teeth in contact.

Conservative Management of Submandibular Space Infection in a 5-Year-Old Child: A Case Report

 Submandibular space infection is a potentially fatal infection that could arise as a result of odontogenic or non-odontogenic infections. The management should be prompt as the infection can spread rapidly leading to airway obstruction. A 5-year-old child reported with a complaint of swelling on the left side of the face for four days. On examination, patient had a diffuse swelling involving the left submandibular region with decreased mouth opening secondary to carious 75. The patient was administered intravenous (i.v) fluids, antibiotics and analgesics. Incision and drainage of the abscess was done extraorally under i.v sedation using midazolam with local anaesthesia followed by rubber drain placement. Patient responded to the treatment with progressive decrease in the swelling. Pulpectomy of 75 was performed followed by stainless-steel crown placement. This case highlights the importance of prompt appropriate treatment supplemented by salvage treatment to overcome the associated morbidity at this very young age.
  

Comparison of Bite Force and the Influencing Factors Pre- and Post-cementation of Stainless Steel Crown in Children Using T-Scan.

BackgroundIn children, stainless steel crowns (SSCs) have become an invaluable restorative option for grossly decayed primary teeth. The crowns are manufactured in different sizes with preformed anatomy which requires trimming or contouring as a necessary step to fit an individual tooth. Initially, this may produce variation in the occlusal contact points yet may not result in pain or discomfort. Little research exists regarding bite force equilibration measurements in children after placing SSC, and its influencing factors such as age and gender.Aim and objectiveTo evaluate and compare the measurements of bite force pre- and post-cementation of SSC using the conventional technique at maximal intercuspal position (MIP) on primary molars at different time intervals and whether age and gender influence bite force measurements.DesignBite force and occlusal contacts during occlusion were made using T-Scan III. Twenty children scheduled for treatment who needed SSCs were included. T-Scan measurements of the bite force and occlusal contacts of the maxilla and mandibular teeth were recorded and analyzed before and immediately after cementation of SSC later 4 weeks during the follow-up period. These measurements were correlated with age and gender influence.ResultsThere was no significant result in the percentage of bite force on the crowned tooth (placement of SSC) at different time intervals. Prematurities were present in all the groups but a significant reduction was seen on the crowned tooth from baseline to 1-month follow-up (p = 0.03). Also, a statistically significant increase in the bite force was seen in >7 years of age (p = 0.006) and no statistical significance among the gender.ConclusionFollowing the standard tooth preparation, the SSC will continue to appear clinically acceptable for many years. Our study children showed an adaptable masticatory system irrespective of age and gender during growth and development.How to cite this articleAishwarya N, Nagarathna C, Poovani S, et al. Comparison of Bite Force and the Influencing Factors Pre- and Post-cementation of Stainless Steel Crown in Children Using T-Scan. Int J Clin Pediatr Dent 2021;14(1):46–50.

The Effect of Pretreatment Conditioning by Mothers on Dental Behavior of Children: A Randomized Clinical Trial

Background: Behavior management techniques are an integral component of pediatrics dental visits. Objectives: This study aimed to evaluate the effect of child pretreatment conditioning by mothers on the dental behavior of children during dental treatment. Methods: Following a randomized clinical trial design, this study was conducted on 72 child-mother dyads, attending the pediatric dental department of Zahedan University of Medical Sciences (southeast of Iran). The children were 3 to 6 years old and required pulpotomy of one asymptomatic carious primary mandibular molar under inferior alveolar nerve block anesthesia. The dyads were randomly divided into control and intervention groups. Data on age and gender of children, mother’s age, and parents’ education were collected. Mothers in the intervention group received a brochure, containing information on how to prepare the child at home to better cope with the dental procedure. Those in the control group received no intervention. A one-month interval was set between the randomization and treatment. For both groups, an experienced pedodontist performed pulpotomy and stainless steel crown placement in a single session. The dental behavior of children during the operation was scored by a blind instructed and calibrated observer, using the Franckle behavior rating scale. Data were analyzed using the chi-square test, Fisher’s exact test, and Mann-Whitney U test in SPSS version 20 at a significance level of 0.05. Results: The child dental behavior in the intervention group was more frequently acceptable than their counterparts, and a significant difference was found between the groups (P = 0.047). The intervention was successful, regardless of the child's gender and age, mother’s age, and parents’ education (P > 0.05). Conclusions: Based on the results, dental practitioners can promote child behavior by engaging mothers to prepare their children before dental procedures.

Comparison of dental treatments performed under general anesthesia for healthy and disabled children

This study aimed to assess and compare the type of dental procedures performed under general anesthesia for healthy and disabled children. This descriptive, cross-sectional study evaluated 361 dental records of children who received dental treatments under general anesthesia in the operating room of Torabinejad Research Center during 2011-2013. Patients with mental or physical disability were categorized as disabled. The age and gender of patients, number of treated teeth, duration of general anesthesia, type of tooth, and type of dental treatment such as extraction, pulp therapy, placement of stainless steel crowns, composite restoration, preventive resin restoration (PRR), fissure sealant treatment, and fluoride therapy were separately recorded for the healthy group and patients with disability. Data were analyzed using one-way ANOVA, and independent sample t-test at P < 0.05 level of significance. Of 361 patients, 263 patients were healthy and 102 patients had disability. Of all disabled children, 48% had physical and 52% had mental disability. Among patients with physical disability, allergy (40%), followed by cardiovascular diseases (26%) were the most common. Mental retardation (54%) followed by cerebral palsy (10%) were the most common mental disabilities. Number of extracted teeth was significantly higher in disabled children (P = 0.006). Furthermore, disabled children received significantly lower PRR (P = 0.015), fissure sealant treatment (P = 0.003), fluoride therapy (P = 0.002), and pulp therapy (P < 0.001) compared with healthy children. Tooth extraction has a higher frequency in disabled children; while, attempts are made to preserve the teeth as much as possible in healthy children.

Composite core-supported stainless steel crowns enhance fracture resistance of severely damaged primary posterior teeth

Extraction of severely damaged primary teeth has been the common treatment for early childhood caries. The early loss of primary teeth results in poor oral and general health in children. To assess fracture resistance of severely damaged primary molars restored with intracoronal core with and without stainless steel crown (SSC). Eighty extracted primary molars were divided into 4 groups: Group 1 MOD cavity; Group 2 MOLi cavity; Group 3 MODLi and Group 4 MODBLi. Pulpectomy and core build-up with and without SSC placement were carried out and subjected to fracture resistance testing to examine the load to fracture and type of fracture. Fracture loads of 870–950 N were observed in the fabrication of intracoronal composite core in teeth with 1–2 remaining tooth walls whereas higher fracture load of teeth with extensive loss of all the surrounding wall following intracoronal composite core build-up was 1270 N. Following SSC placement, all groups had higher fracture load, with Group 4 being resisted to the highest force at 5500 N. Without SSC, Group 1 and Group 2 appeared to be restorable whereas Group 3 and Group 4 were non-restorable when fractured. Following SSC placement, all groups showed non-restorable fracture at the root furcation. Combined intracoronal core and SSC significantly strengthen the restored severely damaged primary molars with severe loss of coronal tooth structures. This proposed restoration method provided resistance to occlusal load that is much higher than the physiologic chewing force in children.

A Comparative Evaluation of Grades Obtained for Placement of Stainless Steel Crowns on Maxillary Molars Among Post Graduate Students

Success of any restoration depends on the material used and the skill of the operator. This study aims to compare the clinical efficiency of postgraduates of various years in placing stainless steel crowns in maxillary 1st molars and thereby finding how operator skills affect the placement by analyzing their grades. In this retrospective study the dental records of pediatric patients who had visited the dental hospital located in Chennai, Tamil Nadu, India from June 2019 to March 2020 were reviewed. Patients who underwent stainless steel crown placement of at least one primary maxillary 1st molar teeth under local or general anesthesia of 2-6 years of age by postgraduates were included in the study. Out of the 467 teeth treated 268 (57.38%) were of males and 199 (42.61%) females. The percentage of treatment done at various ages were at 2 years: 33(7.06%), 3 years: 110(23.55%), 4 years: 150(32.11%), 5 years: 102(21.84%), 6 years: 71(15.20%). The percentage of crowns placed by postgraduates of various years were 1st year postgraduates: 86(18.41%), 2nd year postgraduates: 170(36.40%), 3rd year postgraduates: 211(45.18%). Chi-square test was done and the association was found to be not significant( p-value = 0.139). The frequency of each tooth treated being primary right 1st molar: 164(35.11%), primary right 2nd molar: 56(11.99%), primary left 1st molar: 180(38.54%), and primary left 2nd molar: 67(14.34%). This data showed that the 3rd year postgraduates got the most number of high grades 211(45.18%). Chi-square test was done and the association was found to be significant (p-value = 0.000). There is a significant difference in the placement of stainless steel crowns among the various postgraduates. There was a gradual increase in the clinical performance with the 3rd years performing the best among the three years.

Digital occlusal analysis of vertical dimension and maximum intercuspal position after placement of stainless steel crown using hall technique in children.

The stainless steel crowns (SSCs) placed using the Hall technique disrupt the occlusion, but stabilization appears to occur within a short period post-placement. Negligible understanding and comprehension is presently handy about the changes in overbite and bite force after placement of stainless steel crown using the Hall technique in children. To evaluate the digital occlusal analysis of vertical dimension and maximum intercuspal position to understand the changes in overbite and bite force after placement of stainless steel crown using the Hall technique. Twenty children who needed treatment for the carious tooth with decay extending to enamel and dentin and multisurface caries were managed using the Hall technique. Following that, overbite measurement for vertical dimension was carried out clinically using digital vernier calipers. Later, the T-Scan III was used for measuring occlusal load at the maximum intercuspal position. The bite force and occlusal premature contacts were digitally analysed and recorded pre-operatively, immediately after placement of SSC and after 1month follow-up period. A significant result in the vertical dimension, bite force on crowned tooth, and significant reduction in the prematurities were seen from baseline to one-month follow-up. There was an occlusal re-equilibration attained after 1month.

Dental caries treatment completed under general anesthesia among American Indian children in a northern plains tribal community

To assess the occurrence of treatment under general anesthesia (GA) for dental caries among American Indian (AI) children from a Northern Plains tribal community. As part of a follow-up study of ECC, dental records for children age 6-8 years were evaluated. Descriptive statistics were generated, including the number of dental visits, extent of treatment, and whether the treatment was completed under GA. Data were obtained from 95 dental records. The age of dental visits varied from 15 months to 8 years. Of the 95 children, 79 (83.2%) received dental treatment under GA at least once; 24 (25.2%) did so two or more times. The majority of the treatment involved extractions and placement of stainless steel crowns. A large number of AI children received dental treatment under GA; many did so multiple times. Given the high cost of this treatment, even modestly effective preventive strategies such as silver diamine fluoride could yield cost savings.

Periodontal Assessment of Permanent Molar Teeth Restored with Stainless Steel Crown in Terms of Pocket Depth, Bleeding on Probing, Gingival Color and Inflammation.

ABSTRACTAimThis study assessed the gingival health of permanent first molars before and 6 months after restoration with stainless steel crowns (SSCs).Materials and methodsThis study was conducted on 23 children aged 6 to 12 years who required SSCs for their permanent first molars in one quadrant and had a contralateral first molar without SSC. Gingival color, inflammation, bleeding on probing (BOP), and probing pocket depth (PPD) were measured around both teeth. SSC was placed and, 6 months later, the same parameters were measured at both sides.ResultsGingival color significantly improved and PPD, BOP, and inflammation in mesiobuccal and mesiolingual areas around the first molars restored with SSC significantly decreased after 6 months (p < 0.05). However, in distobuccal and distolingual areas, no significant change occurred in these indices 6 months after placement of SSC (p > 0.05).ConclusionThe results showed that SSCs with proper fit have no adverse effect on gingiva of permanent first molars given that the patient maintains a good oral hygiene.How to cite this articleHeidari A, Shahrabi M, et al. Periodontal Assessment of Permanent Molar Teeth Restored with Stainless Steel Crown in Terms of Pocket Depth, Bleeding on Probing, Gingival Color and Inflammation. Int J Clin Pediatr Dent 2019;12(2):116–119.

Children’s Rights in their Oral Health Care

Research on children’s rights in oral health care is lacking, and this study aims to partially fill this gap. In 2015, we conducted research in one region of New Zealand using video methods to explore the rights of 22 children during a specific oral health treatment, the placement of stainless steel crowns. Our findings show that many children did not receive a professional standard of care, there were gaps in the delivery and standard of care, and there were numerous examples of children’s rights’ violations. At the same time, however, some of the children’s dental practitioners’ actions may have been acceptable practice within the profession if children’s rights have not yet fully been embedded into the practice of oral health care workers. We conclude with a discussion of the implications of our findings and suggestions for a more rights based standard of oral health care.

In vitro analysis of the marginal adaptation and discrepancy of stainless steel crowns

Aim: The purpose of the study was to assess the marginal adaptation and discrepancy of SSC’s. Differences in adaptation and discrepancy between the four surfaces (mesial, lingual, distal, and buccal) were evaluated.Methods: The placement of stainless steel crowns were completed on a phantom head in accordance with the clinical technique. The ideal tooth preparation was made and this ‘master tooth’ duplicated to achieve a sample size of 15. The stainless steel crowns were placed, trimmed, and cemented as per the clinical technique. The cemented stainless crowns were analyzed under 100× stereomicroscope magnification. The marginal adaptation and discrepancy of each specimen was measured every 2 µm.Results: All the specimens showed marginal adaptation and discrepancy. The lingual margin had a significantly better adaptation (p < .0001) over the other surfaces. The buccal surface was the only surface that had an appropriate supra-CEJ level with a significance of p < .0001.Conclusion: The marginal discrepancies occur during the trimming procedure and assessment of the gingival approximation of the SSC margin. The inspection of stainless steel crown adaptation and discrepancy is an essential clinical step.

Efficacy of Pre-Medication with Ibuprofen on Post-Operative Pain after Pulpotomy in Primary Molars.

Introduction:Pain management following dental procedures, particularly pulpotomies and extraction, is of great importance in pediatric dentistry. The aim of this study was to investigate the efficacy of pre-treatment with ibuprofen on post-operative pain following pulpotomy of primary molars. Methods and Materials: In a split mouth double-blinded randomized clinical trial, 49 children aging between 6-10 years old were given either ibuprofen or a placebo 45 min prior to the treatment. After pulpotomy and placement of a stainless steel crown (SSC), the pain level was evaluated using the Wong-Baker face visual analogue scale for up to 7 days post-treatment. McNemar and Wilcoxon tests were used for data analysis. Results:Forty-five patients were eligible to participate in this study. Pre-medication with ibuprofen significantly reduced pain during the first 24 h post-treatment (P=0.032). However, there was no significant difference in the pain levels between placebo and ibuprofen groups at 48 and 72 h post-treatment (P=0.154 and P=0.197, respectively). The number of times patients needed analgesics in ibuprofen group was significantly lower compared to that in the placebo group (P=0.008). Conclusion:Pre-medication with ibuprofen resulted in less pain following pulpotomy and SSC placement in primary teeth.

Effectiveness of audiovisual distraction with computerized delivery of anesthesia during the placement of stainless steel crowns in children with Down syndrome.

Objective:Assessing effectiveness of audiovisual (AV) distraction with/without video eyewear and computerized delivery system-intrasulcular (CDS-IS) for local anesthesia during placement of stainless steel crowns for the management of pathological tooth grinding in children with Down syndrome.Materials and Methods:This clinical study includes 22 children (13 boys and 9 girls), with mean age being 7.1 years. The study involved three sessions 1-week apart. During Session I, dental prophylaxis to the upper jaw was done while watching a movie projected on the ceiling without video eyewear whereas prophylaxis for the lower jaw and impressions of both jaws were taken while watching another movie using eyewear projection. After 1 week, during Session II/III, children had their upper and lower second primary molars which were prepared and steel crowns inserted, respectively, while watching movies which were projected using video eyewear under the effect of CDS-IS local anesthesia. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent sample t-test was used to assess significance of changes during each visit.Results:A statistically significant difference (P < 0.03) was observed in mean pulse rate between dental prophylaxis without video eyewear and during dental prophylaxis and dental impression taken while children were distracted using AV distracter with video eyewear. We observed an increase in mean pulse rate during tooth preparation use dental drills, but this does not lead to disruptive behavior as children were being distracted by AV distracter with video eyewear.Conclusion:Routine psychological (Tell-Show-Do) intervention along with visual distraction using video eyewear and use of CDS-IS system for anesthetic delivery is recommended as an effective behavior management technique for children with Down syndrome during invasive dental treatment.

Postoperative Pain following Pulpotomy of Primary Molars with Two Biomaterials: A Randomized Split Mouth Clinical Trial.

Introduction:The aim of this randomized clinical trial split-mouth study was to compare the postoperative pain following use of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as pulpotomy agents in carious primary molars. Methods and Materials:Forty-seven children aged between 6-10 years old were enrolled in this study. Each child had two cariously involved primary molar in need of pulpotomy. After caries removal and preparing access cavity in one of the carious teeth, either MTA or CEM cement was randomly used as the pulpotomy agent, while the other cariously involved primary molar tooth was capped with the other material in a separate visit. After covering the radicular pulp with one of the capping materials the teeth were permanently restored with stainless steel crown (SSC). Postoperative pain was recorded by using Wong-Baker faces pain rating scale (Wong-Baker FPRS) up to seven days following the treatment. Data was analyzed using the Wilcoxon, McNemar, and chi square tests. Results:Forty-five patients fulfilled the treatment procedure and returned the Wong-Baker FPRS forms. Overall 65.6% of the patients reported pain irrespective of the pulpotomy agents used. There was no significant difference in postoperative pain between the teeth that received either MTA or CEM cement as pulpotomy agents in the first, second and the third day (P=0.805, P=0.942, P=0.705, respectively) following the procedure. The trend of the pain scores showed decreasing manner during the study period for the teeth in either groups of MTA or CEM cement. There was no significant difference between the two groups in the number of analgesics used following the treatment (P>0.05).Conclusion:The findings of the present study showed that a majority of the children felt pain following pulpotomy and SSC placement; however, there was no significant difference in pain reported when either MTA or CEM cement was used as pulpotomy agents.

A novel technique to check the occlusion during the placement of stainless steel crowns under general anesthesia

Stainless steel crowns are the restoration of choice for the treatment of badly decayed posterior teeth under general anesthesia. The evaluation of occlusion after the placement of these crowns, however, remains a difficult task. This paper outlines a technique to evaluate the occlusion of stainless steel crowns placed under general anesthesia using a specially designed tray and a fast setting polyvinyl siloxane bite registration material (Regisil® PB™, Dentsply, Surrey UK).

Assessment of occlusion after placement of stainless steel crowns in children - a pilot study.

Many stainless steel crowns (SSCs) disrupt the occlusion in children, but stabilisation appears to occur within a short period post-placement. The extent and mechanism of these short-term occlusal changes in children are unknown. This study sought to determine whether placement of a SSC changes the maximum intercuspation position (MIP) in children, whether the MIP returns to normal within 4weeks and whether local anaesthesia had an effect on the child's ability to achieve MIP. The T-Scan(®) III was used for the measurement of occlusal contacts. Reliability and reproducibility of the system was determined using a calibration exercise where MIP recordings were taken of eleven children not undergoing any dental treatment. For the main study, the percentage of total occlusal force on each tooth was recorded in 20 children preoperatively, after local anaesthesia, after SSC placement and 4weeks postoperatively. There was no significant difference in MIP (P=0·435) preoperatively and post-administration of local anaesthesia. There was a significant difference between the preoperative force on a tooth and the reading after crown placement (P=0·0013, Wilcoxon test). By 4weeks, there was no significant difference overall between post-SSC placement and the preoperative value for the tooth (P=0·3). Administration of local anaesthesia did not affect the ability of a child to attain MIP. Maximum intercuspation position was disturbed by the placement of a SSC in seven of 20 cases. When MIP was disturbed, in most cases, it returned to preoperative status within 4weeks of crown placement.

Ready for practice? A study of confidence levels of final year dental students at Cardiff University and University College Cork

The aim of this study was to describe the self-reported confidence levels of final year students at the School of Dentistry, Cardiff University and at the University Dental School & Hospital, Cork, Ireland in performing a variety of dental procedures commonly completed in primary dental care settings. A questionnaire was distributed to 61 final year students at Cardiff and 34 final year students at Cork. Information requested related to the respondents confidence in performing a variety of routine clinical tasks, using a five-point scale (1=very little confidence, 5=very confident). Comparisons were made between the two schools, gender of the respondent, and whether or not a student intended completing a year of vocational training after graduation. A response rate of 74% was achieved (n=70). The greatest self-reported confidence scores were for 'scale and polish' (4.61), fissure sealants (4.54) and delivery of oral hygiene instruction (4.51). Areas with the least confidence were placement of stainless steel crowns (2.83), vital tooth bleaching (2.39) and surgical extractions (2.26). Students at Cardiff were more confident than those at Cork in performing simple extractions (Cardiff: 4.31; Cork: 3.76) and surgical extractions (Cardiff: 2.61; Cork: 1.88), whilst students in Cork were more confident in caries diagnosis (Cork: 4.24; Cardiff: 3.89) fissure sealing (Cork: 4.76; Cardiff: 4.33) and placement of preventive resin restorations (Cork: 4.68; Cardiff: 4.22). Final year students at Cardiff and Cork were most confident in simpler procedures and procedures in which they had had most clinical experience. They were least confident in more complex procedures and procedures in which they had the least clinical experience. Increased clinical time in complex procedures may help in increasing final year students' confidence in those areas.