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Objective This study aimed to evaluate the survival from fractures and risk factors of VPT-treated permanent molars restored with direct resin composites in young patients. Methods The dental records of patients aged 6 to 18 years with VPT-treated permanent molars restored with resin composites were retrospectively evaluated for the presence of fractures on these teeth. Kaplan-Meier methods were used to estimate the survival probabilities. The potential risk factors were assessed using the multivariable Cox proportional hazard model. Results A total of 234 treated molars from 189 patients were included. An overall average follow-up time was 33.34±20.54 months (ranging from 6 to 83 months). At the end of the study, 21.8% of molars had fractures with the majority of them (92.2%) were restorable. Radiographically, only 3.9% of the fractured molars had periapical lesions and considered VPT failures. The percentages of the fracture types are as follows: 54.9% natural tooth structure fracture, 27.5% restoration fracture, and 17.6% combination fracture. The most common fracture location among the 37 molars with natural tooth fracture (either alone or in combination with restoration fracture) was at the marginal ridge (59.5%), followed by the marginal ridge extending to cusp (21.6%), and the cusp itself (18.9%). The cumulative survival probabilities of these teeth decreased over time, reaching 66.02% (95% CI: 55.89–74.36) after 5 years. VPT-treated molars in the mandible had a 2.1 times higher risk of fracture than those in the maxilla. Furthermore, the molars treated with partial and coronal pulpotomy had 2.4 times and 4.6 times higher risks of fracture when compared to those with indirect pulp capping, respectively. Conclusion In VPT-treated permanent molars in young patients, more fractures were seen in mandibular teeth and in teeth with pulp roof removal (partial and coronal pulpotomy). Clinicians should plan for proper restoration on these teeth.

Background: Although stainless steel crowns (SSCs) on permanent molars are a common interim full-coverage restoration, there are few clinical studies on longevity. Aim: To evaluate the longevity of SSCs as restorations on young permanent first molars (PFMs) that have undergone vital pulp therapy (VPT) treatment and to identify factors associated with SSC treatment failure. Design: This study conducted a retrospective chart review of children who had PFMs that have undergone VPT treatment and been restored with SSCs. Data from treatment and follow-up visits were collected. The Kaplan-Meier survival analysis was used to analyse the longevity of SSCs. A multivariate Cox proportional hazards regression model was used to identify factors associated with SSC treatment failure. Results: Data from 140 SSCs were included, with an average follow-up period of 33.5 ± 21.6 (range, 6-104) months. Although none of the teeth had pulpal failure, 35.7% had SSC treatment failure. The survival probabilities of SSCs declined over time, reaching 39.6% (95% CI 27.0-51.9) after 60 months. The immediate postoperative condition of SSCs and the loss of proximal wall on the abutment tooth were significant factors associated with SSC treatment failure. Conclusion: Stainless steel crowns are suitable for use as interim restorations in PFMs that have undergone VPT treatment in children, but their longevity is limited, necessitating replacement over time. K E Y W O R D S children, permanent first molar, longevity, stainless steel crowns, vital pulp therapy How to cite this article: Chaipattanawan N, Chompu-inwai P, Nirunsittirat A, Phinyo P, Manmontri C. Longevity of stainless steel crowns as interim restorations on young permanent first molars that have undergone vital pulp therapy treatment in children and factors associated with their treatment failure: A retrospective study of up to 8.5 years.