Dental Caries Clinical Trial
Official title:
Checking Occlusion During Stainless Steel Crown Placement in Children Under General Anesthesia - Evaluation of a Novel Technique
Stainless steel crowns are arguably the most successful posterior restorations in primary
teeth and have been so for more than 50 years. Stainless steel crowns offer durability and
success rates in excess of 95% making them the restoration of choice for posterior primary
teeth in children treated under general anesthesia.
Failures of stainless steel crowns placed on primary teeth have been documented using
several criteria including marginal adaptation, recurrent caries, abscess formation or root
resorption, loss of the crown due to faulty retention and even perforation of the crown .
Despite the probability that factors such as root resorption and failure of endodontic
treatment could be due to traumatic occlusion, surprisingly little evidence is available in
literature on the attempts made to check or evaluate the occlusion of stainless steel crowns
placed under general anesthesia The aim of this study was to compare the time taken for
placement and the overall success of bilateral multiple stainless crowns placed under
general anesthesia using an occlusal index and compare them to crowns placed without such an
index, using a randomized control study design
A total of 60 patients (32 male and 28 female) aged between 4 and 7 years (Mean age 4.8
years, SD +/- 1.09 years) who met the inclusion criteria were recruited after obtaining
informed consent from the parent. No financial incentives were offered for participation in
the study. A total of 51 (29 male and 22 female) patients completed the six month follow up
requirement (Fig 2).
Evaluation Crowns and the Procedure All patients were evaluated at 24 hours, one week, three
months and six months post-operatively. Clinical criteria evaluated included the reporting
of pain, discomfort, difficulty in mastication or high points reported by the patient.
Tenderness on percussion, presence of premature mobility and clinical evidence of an abscess
or fistula were checked by one of the investigators (SCP). Periapical digital radiographs
were taken using a digital sensor (Schick Elite, Sirona Dental Inc. Long Island NY. USA) and
were evaluated by the same examiner for radiographic evidence of failure. In order to ensure
blinding the investigator (SCP) recording the findings was not made aware of which group the
patient belonged to. The time taken for each procedure was calculated from the time of
placement of the throat pack to the time of removal of the throat pack and was obtained from
the intra-operative anesthesiologist notes. If failure of the crown occurred at 3 months,
these teeth were excluded from the 6 month evaluation.
Statistical Analyses The parametric values of the control and case groups were compared
using the student's t test. The non-parametric values of the control and case groups were
compared using the Mann Whitney U test. All tests were conducted at p value of 0.05
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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