Biological responses to pediatric stainless steel crowns

Abstract

A systematic review was conducted to identify the biological responses, allergic reaction, hypersensitivity, toxicity, and ion release profile associated with pediatric stainless steel crowns (SSCs) in the existing literature. A systematic search was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The inclusion criteria consisted of patients younger than 20 years of age with SSC placement on primary or permanent teeth and in vivo and in vitro exposure to SSCs. Outcomes measures included adverse oral/mucosal effects; removal/failure/replacement of the SSC; type of allergic reaction; nickel (Ni) or other ion levels in bodily fluids, cellular, genotoxic, cytotoxic, mutagenic or carcinogenic effects related to the SSC. After an initial search of 764 studies in the database, 17 articles were included in the analysis. Evidence of allergic reactions to SSCs in children is limited and obtained from mostly low-quality research. Some studies showed that the amount of Ni detected was less than the amount ingested in the daily diet. In contrast, other studies reported a significantly higher release of Ni occurred into the saliva in acidic environments. There is some concern about the leaching of metal ions such as Ni from SSCs in children at high risk for caries. Further long-term studies are required to investigate this phenomenon.

Zirconia Crowns for Primary Teeth: A Systematic Review and Meta-Analyses

“…Studies have evaluated the performance of stainless steel crowns in comparison to other restoration methods and found that stainless steel crowns showed a higher lifespan and durability [ 15 , 16 , 17 , 18 ]. The stainless steel crowns have reasonable costs and are less technique sensitive during placement [ 11 , 19 ].…”

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“…Depending on the degree of corrosion that metal undergoes, its carcinogenesis ability varies. The symptoms can appear at distance from metal alloy [173][174][175].…”

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“…In addition, the more SSC appeared, the more nickel ions were released. Based on this research, the release of nickel ions was not influenced by how much nickel ion content was in the SSC but rather by the level of resistance of SSC to electrochemical corrosion by saliva [17,[22][23][24][25]. The research was also conducted to see the nickel lysis of the trimming process when adjusting the stainless-steel crown.…”

“…If these impacts arise, they will require countermeasures. Therefore, this literature review would discuss studies related to SSC materials and their contents as well as hypersensitivity reactions that can be caused by a metal content in SSC and actions that must be taken before and after restoration considering that SSC will be in the oral cavity for a long time, about 8-9 years until the permanent replacement tooth erupts [15].…”