Who wears the crown? Comparing 3D-printed resin crowns to preformed stainless steel crowns for restoring primary molars

Q3 Dentistry
Lucy Tiplady, Sadie Karia
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Abstract

A multi-centre randomised controlled trial was conducted with paediatric patients requiring crowns after pulp therapy. Participants were randomly divided into two groups: Stainless Steel Crown (SCC) (n = 28) and Resin Crown (RC) (n = 28). RCs were fabricated using a 3D printer with a standardised manufacturing process. The assessment was through periapical radiographs, photographs, quantitative light-induced fluorescence, impressions, and clinical assessment. Quigley-Hein plaque index (QHI), gingival index (GI), occlusal wear, and survival were evaluated. Participants were selected from two departments of paediatric dentistry at Yonsei University and Kyung Hee University of Dental College. Patients were between 4–7 years old. The tooth must require pulp therapy and crown, be in place for at least 2 years, and be in stable occlusion. Those with systemic illness, disability, poor cooperation, temporomandibular joint disorder, and bruxism were excluded. Analysis was performed at 1 week, 3 months, 6 months and 12 months. QHI and GI were compared between the two groups. Shapiro-Wilk test was used to analyse the normal distribution of occlusal wear. Comparison was completed using Mann-Whitney U and independent t-tests. Survival rates were assessed using Kaplan-Meier analysis and log-rank tests. Fifty-six teeth were included initially, with follow-up on 23 RCs and 25 SSCs due to failure or lack of attendance. RCs exhibited a statistically significant increase in wear, with mean root mean square (RMS) values of 0.064 (+/−0.02) at 3 months, 0.079 (+) at 6 months, and 0.125 (+/−0.05) at 12 months. Whereas SSCs demonstrated minimal wear, with mean RMS values ranging from 0.021 (+/−0.01) to 0.025 (+/−0.01). The QHI scores indicated no significant difference, except at 1 week where RC exhibited increased plaque. The GI scores for RCs were significantly higher at 12 months. The survival rate of RCs was significantly lower (82.1%) compared to SSCs (100%). While RCs offer improved aesthetics over SSCs, they exhibit lower wear resistance and higher plaque accumulation and gingival inflammation. The survival rate of RCs is significantly lower due to fractures. The clinical effectiveness of RCs has not yet been established.
谁戴牙冠?比较三维打印树脂冠和预制不锈钢冠修复初级臼齿的效果。
设计对牙髓治疗后需要牙冠的儿科患者进行多中心随机对照试验。参与者被随机分为两组:不锈钢牙冠(SCC)(n = 28)和树脂牙冠(RC)(n = 28)。树脂冠采用标准化生产工艺,使用 3D 打印机制作。通过根尖周X光片、照片、定量光诱导荧光、印模和临床评估进行评估。对Quigley-Hein牙菌斑指数(QHI)、牙龈指数(GI)、咬合磨损和存活率进行评估:参与者选自延世大学和庆熙大学牙科学院的两个儿童牙科系。患者年龄在 4-7 岁之间。患者的牙齿必须需要牙髓治疗和牙冠,至少已植入 2 年,且咬合稳定。排除患有全身性疾病、残疾、合作能力差、颞下颌关节紊乱和磨牙症的患者:数据分析:分别在 1 周、3 个月、6 个月和 12 个月时进行分析。对两组患者的 QHI 和 GI 进行比较。采用 Shapiro-Wilk 检验分析咬合磨损的正态分布。比较采用曼-惠特尼 U 检验和独立 t 检验。采用 Kaplan-Meier 分析和对数秩检验评估存活率:最初共纳入 56 颗牙齿,其中 23 颗 RC 和 25 颗 SSC 因失败或缺席而未接受随访。从统计学角度看,RC 的磨损程度明显增加,3 个月时的平均均方根值为 0.064 (+/-0.02),6 个月时为 0.079 (+),12 个月时为 0.125 (+/-0.05)。而 SSCs 的磨损很小,平均 RMS 值为 0.021 (+/-0.01) 到 0.025 (+/-0.01)。QHI 评分显示,除 1 周时 RC 显示斑块增加外,其余时间无明显差异。12 个月时,RC 的 GI 评分明显更高。RC的存活率(82.1%)明显低于SSC(100%):结论:虽然 RC 比 SSC 更美观,但耐磨性较差,牙菌斑累积和牙龈炎症较高。由于断裂,RC 的存活率明显较低。RC 的临床效果尚未确定。
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来源期刊
Evidence-based dentistry
Evidence-based dentistry Dentistry-Dentistry (all)
CiteScore
2.50
自引率
0.00%
发文量
77
期刊介绍: Evidence-Based Dentistry delivers the best available evidence on the latest developments in oral health. We evaluate the evidence and provide guidance concerning the value of the author''s conclusions. We keep dentistry up to date with new approaches, exploring a wide range of the latest developments through an accessible expert commentary. Original papers and relevant publications are condensed into digestible summaries, drawing attention to the current methods and findings. We are a central resource for the most cutting edge and relevant issues concerning the evidence-based approach in dentistry today. Evidence-Based Dentistry is published by Springer Nature on behalf of the British Dental Association.
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