Deep Caries Clinical Trial
Official title:
Influence of Luting Cement on the Clinical Outcomes of Zirconia Pediatric Crowns. A 3 Year Split-Mouth Randomized Controlled Trial
The purpose of this split-mouth study was to compare the efficacy of using Bio-active cement versus Packable glass ionomer for cementation of posterior zirconia pediatric crowns.
Restoration of pulp treated or badly broken down deciduous teeth with full coverage
restoration have shown superior success rate to all other restorative materials.
Restoration of deciduous teeth with esthetic full coverage restoration has been a challenging
aim especially for the more functionally loaded posterior teeth. Due to the continuous
increase in socio-economic standards; restoring posterior teeth with esthetic restoration is
on high demand nowadays.
The recently introduced zirconia pediatric crowns have been very promising in terms of
strength and toughness. Clinical trials on maxillary incisors have shown very high success
rates in terms of retention and gingival health.
The problem of restoring posterior deciduous teeth with pre-fabricated zirconia crowns is
that its retention is only and totally dependent on luting cement, in addition to the problem
of the deteriorated gingival condition around crowns in general.
Being recently introduced to the market; there have not been any clinical trials studying
retention of zirconia posterior pediatric crowns published yet.
Recently introduced bio-active cement [NuSmile® BioCem™] is claimed by the manufacturer to be
the solution of this problem due to the shock absorbing effect, bioactive components, and
antimicrobial effect making it tougher than traditional cements and more gingival friendly.
Also, experienced clinicians have found that packable glass ionomer gives very acceptable
results for retention of zirconia pediatric crowns. This may be due to the fact that,
pre-fabricated pediatric crown is not well adapted to the prepared tooth creating a greater
gap between the prepared tooth and the crown, resulting in a greater film thickness of luting
cement, which may benefit from the stronger, tougher and less soluble packable glass ionomer
rather than the conventional glass ionomer cement for cementation of zirconia crowns.
There is no clear evidence whether it's better to cement zirconia based crowns with
conventional or adhesive cement; and to the investigator's knowledge, there is no data
available for the best clinical practice in cementation of zirconia pediatric crowns; and so,
this study was carried out to compare the effectiveness of bio-active cement with packable
glass ionomer when used for cementation of zirconia pediatric crowns.
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