A 12-month prospective randomized controlled comparative evaluation of clinical success of esthetic flexible crowns with stainless steel crowns in primary mandibular molar teeth.

Abstract

Objective: To compare the clinical success of esthetic flexible crowns with stainless steel crowns in primary molars over 12 months.

Methods and materials: In this randomized split-mouth pilot study, 30 children each received one SSC and one esthetic flexible crown. Clinical parameters were evaluated using modified USPHS Ryge criteria at baseline, one week, one month, three months, six months, and twelve months. Procedural time was recorded, and parental satisfaction was assessed at twelve months.

Results: Based on Ryge criteria, SSCs showed significantly better resistance to staining and superior surface integrity at both 6 and 12 months (p = 0.001 and p = 0.011, respectively). At 12 months, two esthetic crowns failed, while no SSC failures were recorded. None of the other evaluated clinical parameters showed statistically significant differences between the two crown types over the 12-month follow-up. The mean time required was 12.3 ± 1.53 minutes for SSCs and 10.32 ± 1.48 minutes for esthetic crowns (p < 0.001). However, this approximately two-minute difference was not clinically significant. Parental preference favored esthetic crowns for appearance.

Conclusion: SSCs outperformed esthetic flexible crowns in key clinical parameters, and failures occurred only in esthetic crowns. While parental preference for esthetics was high, these findings suggest esthetic crowns may have higher failure rates. This pilot study highlights the need for larger, long-term trials to further assess their clinical performance.