Influence of luting cement on the clinical outcomes of Zirconia pediatric crowns: A 3‐year split‐mouth randomized controlled trial

Abstract

Background:There is no scientific evidence supporting the choice of luting cement for cementation of zirconia crowns. Aim: The purpose of this split-mouth study was to compare the efficacy of using bioactive cement versus packable glass ionomer for cementation of posterior pediatric zirconia crowns. Design: Fifty first mandibular primary molars were restored by zirconia crowns and were randomly divided to be luted with either (a) bioactive cement or (b) packable glass ionomer. Crowns' retention, fracture, and gingival condition were evaluated at 1 week, and 1-, 3-, 6-, 9-, 12-, 18-, 24-, and 36-month intervals. Statistical analysis was carried out using Fisher's exact test, Kaplan-Meier survival analysis, and Wilcoxon signed rank test. Results: At 3-to 36-month follow-ups, there were statistically significant (P = .009-≤.001) less debonded crowns in packable glass ionomer group. There were no fractured crowns for either cements. There was no statistically significant difference between gingival index scores. Conclusions: Packable glass ionomer is more retentive than bioactive cement when used for cementing zirconia pediatric crowns. Posterior zirconia pediatric crowns have high fracture resistance after 36 months of clinical performance, irrespective of luting cement. Luting cement for zirconia pediatric crowns has no apparent effect on gingival condition around crowns. K E Y W O R D Sbioactive cement, cementation, packable glass ionomer, pediatric crowns, zirconia | 315 AZAB et Al.

Guidelines for reporting randomized controlled trials in paediatric dentistry based on the CONSORT statement

“…At 3‐month follow‐up, two patients dropped out due to relocation, another could not be contacted, and a patient missed it due to illness. At 9‐month follow‐up, another patient missed the follow‐up due to illness” 20 …”

“…Molars should have sound cervical margins, not hypoplastic or hypocalcified. Molars with malocclusion, active periodontal condition, or with no opposing functioning teeth were excluded from study” 20 …”

“…Example: “Participants, legal guardians, and operator were not blinded due to difference in mode of application of each cement. Statistician was blinded” 20 …”

“…Example: “Zirconia pediatric crowns showed higher mean bond strength when cemented with NuSmile BioCem than when cemented with conventional glass ionomer cement. There are, however, apparently no clinical trials to test the clinical performance of the cement up to date… So, this study was carried out to compare retention and fracture of posterior zirconia pediatric crowns, and gingival condition around them when cemented with bioactive cement versus when cemented with packable glass ionomer” 20 …”

Factors Influencing the Survival of Preformed Zirconia Crowns in Children Treated under General Anesthesia

“…ere has been an increased demand for aesthetic anterior restorations in children with both parents and children showing increased need for aesthetics [3,6]. Over the past decade, the introduction of preformed zirconia crowns has radically altered the way pediatric dentists view aesthetic dentistry [3,[7][8][9][10]. ere have been several studies documenting the use of zirconia crowns in badly destructed primary teeth [9,10].…”