Survival of direct resin composites versus stainless-steel crowns as coronal restorations following pulpotomy in young permanent first molars: a retrospective cohort study using propensity score-matched analysis.

Purpose: This retrospective cohort study using propensity score matching aimed to compare the 7-year survival probabilities of direct resin composites (DRCs) and stainless-steel crowns (SSCs) in young permanent first molars treated with either partial or coronal pulpotomy.

Methods: To evaluate the presence of restorative failures, the efficacy research with a retrospective cohort design was conducted by reviewing electronic dental records of patients aged 6-16 years who received pulpotomy and attended recall programs between September 2012 and December 2021. To reduce confounding bias associated with treatment indications and contraindications, one-to-one matching of comparison groups was conducted using propensity scores. Kaplan-Meier analysis and log-rank test were performed to estimate and compare survival probabilities between groups. Cox proportional hazards regression was used to estimate hazard ratio (HR) and its confidence interval (CI) for failures.

Results: From 136 children, 156 treated molars were initially included. Finally, a total of 56 molars were matched for analysis (28 molars in each group). The 7-year cumulative survival probability of SSCs (87.4%) was significantly (p < 0.05) higher than that of DRCs (35.5%). Moreover, the molars restored with DRCs had a 7.6 times higher risk of failure compared to those restored with SSCs (HR 7.64, 95% CI 1.88-31.01, p < 0.05).

Conclusion: Compared to DRCs, SSCs demonstrated a significantly higher survival probability for coronal restorations following pulpotomy in young permanent first molars over a period of up to 7 years.