Clinical Evaluation of CAD/CAM Ceramic Endocrown Versus Prefabricated Zirconia Crown in the Restoration of Pulpotomized Primary Molars: A Two-Year Spilt-Mouth Randomized Controlled Trial

Nagwa Mohmmad Ali Khattab; Yasmine Mohamed Farouk El Makawi; Ahmad Abdel Hamid Elheeny

doi:10.1055/s-0041-1736417

European Journal of Dentistry, Table of Contents

CC BY 4.0 · Eur J Dent 2022; 16(03): 627-636
DOI: 10.1055/s-0041-1736417

Original Article

Clinical Evaluation of CAD/CAM Ceramic Endocrown Versus Prefabricated Zirconia Crown in the Restoration of Pulpotomized Primary Molars: A Two-Year Spilt-Mouth Randomized Controlled Trial

Nagwa Mohmmad Ali Khattab

¹Pediatric and Community Dentistry Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt

,

Yasmine Mohamed Farouk El Makawi

²Pediatric Dentistry Department, Faculty of Oral and Dental Medicine, Nahda University, Beni Suef, Egypt

,

Ahmad Abdel Hamid Elheeny

³Pediatric and Community Dentistry Department, Faculty of Dentistry, Minia University, Minya, Egypt

› Author Affiliations

Abstract

Objectives The current trial aimed to compare lithium disilicate (LS2) endocrowns' clinical performance, gingival health, and parental satisfaction to those of prefabricated zirconia crowns (ZCs) over a 24-month of follow-up.

Materials and Methods This study designed as a spilt-mouth randomized controlled trial. A total of 88 pulpotomized mandibular second primary molars of 44 children were assigned into two equal groups. Forty-four molars were restored with prefabricated primary ZCs (control group) and the same number were restored with LS2 endocrown (intervention group). Clinical performance and gingival status were evaluated using a modified United States Public Health Service criterion, and plaque and gingival indices. Parental satisfaction was assessed using a 5-point Likert-scale questionnaire.

Statistical Analysis Paired data were analyzed using McNemar's test, a statistical test used on paired nominal data, and paired t-tests. The significance level was set to 5% at 95% confidence interval.

Results Both restorations showed comparable gingival health status over the follow-ups. Marginal adaptation of the endocrowns and ZCs at the end of follow-up was 95.5 and 90.9%, respectively (p = 0.68). For marginal integrity and discoloration, both restorations showed similar results at the follow-ups. The overall parental satisfaction of both groups was statistically insignificant (p = 0.07). However, parents were more satisfied with the endocrown color over that of the ZC (p < 0.05).

Conclusion Endocrowns' clinical performance and gingival health were comparable to those of ZCs. For both restorations, parental satisfaction was nearly similar except for the color that showed an advantage in favor of the endocrowns.

Keywords

adhesive - pediatric dentistry - aesthetic - crowns - gingivitis

Full Text

References

References
1 Holan G, Fuks AB, Ketlz N. Success rate of formocresol pulpotomy in primary molars restored with stainless steel crown vs amalga. Pediatr Dent 2002; 24 (03) 212-216
2 Walia T, Salami AA, Bashiri R, Hamoodi OM, Rashid F. A randomised controlled trial of three aesthetic full-coronal restorations in primary maxillary teeth. Eur J Paediatr Dent 2014; 15 (02) 113-118
3 Seale NS. The use of stainless steel crowns. Pediatr Dent 2002; 24 (05) 501-505
4 Lopez Cazaux S, Hyon I, Prud'homme T, Dajean Trutaud S. Twenty-nine-month follow-up of a paediatric zirconia dental crown. BMJ Case Rep 2017; 2017: bcr-2017-219891
5 Ram D, Fuks AB, Eidelman E. Long-term clinical performance of esthetic primary molar crowns. Pediatr Dent 2003; 25 (06) 582-584
6 Clark L, Wells MH, Harris EF, Lou J. Comparison of amount of primary tooth reduction required for anterior and posterior zirconia and stainless steel crowns. Pediatr Dent 2016; 38 (01) 42-46
7 Donly KJ, Méndez MJC, Contreras CI, Liu JA. Prospective randomized clinical trial of primary molar crowns: 36-month results. Am J Dent 2020; 33 (03) 165-168
8 Donly KJ, Sasa I, Contreras CI, Mendez MJC. Prospective randomized clinical trial of primary molar crowns: 24-month results. Pediatr Dent 2018; 40 (04) 253-258
9 Abdulhadi B, Abdullah M, Alaki S, Alamoudi N, Attar M. Clinical evaluation between zirconia crowns and stainless steel crowns in primary molars teeth. J Paediatr Dent 2017; 5 (01) 21-21
10 Taran PK, Kaya MS. A comparison of periodontal health in primary molars restored with prefabricated stainless steel and zirconia crowns. Pediatr Dent 2018; 40 (05) 334-339
11 Sun J, Ruan W, He J. et al. Clinical efficacy of different marginal forms of endocrowns: study protocol for a randomized controlled trial. Trials 2019; 20 (01) 454
12 Bindl A, Mörmann WH. Clinical evaluation of adhesively placed Cerec endo-crowns after 2 years–preliminary results. J Adhes Dent 1999; 1 (03) 255-265
13 Zarone F, Di Mauro MI, Ausiello P, Ruggiero G, Sorrentino R. Current status on lithium disilicate and zirconia: a narrative review. BMC Oral Health 2019; 19 (01) 134
14 Baldissara P, Llukacej A, Ciocca L, Valandro FL, Scotti R. Translucency of zirconia copings made with different CAD/CAM systems. J Prosthet Dent 2010; 104 (01) 6-12
15 Guo Y, Pandis N. Sample-size calculation for repeated-measures and longitudinal studies. Am J Orthod Dentofacial Orthop 2015; 147 (01) 146-149
16 Guo Y, Logan HL, Glueck DH, Muller KE. Selecting a sample size for studies with repeated measures. BMC Med Res Methodol 2013; 13: 100
17 Elheeny AAH. Articaine efficacy and safety in young children below the age of four years: an equivalent parallel randomized control trial. Int J Paediatr Dent 2020; 30 (05) 547-555
18 Edelhoff D, Ahlers MO. Occlusal onlays as a modern treatment concept for the reconstruction of severely worn occlusal surfaces. Quintessence Int 2018; 49 (07) 521-533
19 Santos MJ, Mondelli RF, Navarro MF, Francischone CE, Rubo JH, Santos Jr GC. Clinical evaluation of ceramic inlays and onlays fabricated with two systems: five-year follow-up. Oper Dent 2013; 38 (01) 3-11
20 Elheeny AAH. Oral health status and impact on the oral health-related quality of life of Egyptian children and early adolescents with type-1 diabetes: a case-control study. Clin Oral Investig 2020; 24 (11) 4033-4042
21 Holsinger DM, Wells MH, Scarbecz M, Donaldson M. Clinical Evaluation and Parental Satisfaction with Pediatric Zirconia Anterior Crowns. Clinical evaluation and parental satisfaction with pediatric zirconia anterior crowns. Pediatr Dent 2016; 38 (03) 192-197
22 Kupietzky A, Waggoner WF. Parental satisfaction with bonded resin composite strip crowns for primary incisors. Pediatr Dent 2004; 26 (04) 337-340
23 Choi JW, Bae IH, Noh TH. et al. Wear of primary teeth caused by opposed all-ceramic or stainless steel crowns. J Adv Prosthodont 2016; 8 (01) 43-52
24 Smaïl-Faugeron V, Fron-Chabouis H, Courson F, Durieux P. Comparison of intervention effects in split-mouth and parallel-arm randomized controlled trials: a meta-epidemiological study. BMC Med Res Methodol 2014; 14: 64
25 Biacchi GR, Mello B, Basting RT. The endocrown: an alternative approach for restoring extensively damaged molars. J Esthet Restor Dent 2013; 25 (06) 383-390
26 Tzimas K, Tsiafitsa M, Gerasimou P, Tsitrou E. Endocrown restorations for extensively damaged posterior teeth: clinical performance of three cases. Restor Dent Endod 2018; 43 (04) e38
27 Peter S. Essentials of Preventive and Community Dentistry. New Delhi: Arya Publishing House; 2004
28 Fasbinder DJ, Dennison JB, Heys D, Neiva G. A clinical evaluation of chairside lithium disilicate CAD/CAM crowns: a two-year report. J Am Dent Assoc 2010; 141 (Suppl. 02) 10S-14S
29 Schmitt J, Holst S, Wichmann M, Reich S, Gollner M, Hamel J. Zirconia posterior fixed partial dentures: a prospective clinical 3-year follow-up. Int J Prosthodont 2009; 22 (06) 597-603
30 Forster A, Ungvári K, Györgyey Á, Kukovecz Á, Turzó K, Nagy K. Human epithelial tissue culture study on restorative materials. J Dent 2014; 42 (01) 7-14
31 Tezulas E, Yildiz C, Kucuk C, Kahramanoglu E. Current status of zirconia-based all-ceramic restorations fabricated by the digital veneering technique: a comprehensive review. Int J Comput Dent 2019; 22 (03) 217-230
32 Salami A, Walia T, Bashiri R. Comparison of parental satisfaction with three tooth-colored full-coronal restorations in primary maxillary incisors. J Clin Pediatr Dent 2015; 39 (05) 423-428

Supplementary Material

Supplementary Material