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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (5): 907-912. doi: 10.19723/j.issn.1671-167X.2020.05.019

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Clinical performance of rensin-bonded composite strip crowns in primary incisors

Xiao-xian CHEN1,Jie ZHONG1,Wen-juan YAN1,Hong-mei ZHANG1,Xia JIANG1,Qian HUANG1,Shi-hua XUE1,Xing-gang LIU2,∆()   

  1. 1. Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
    2. Department of Prosthodontics, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing 100050, China
  • Received:2018-10-09 Online:2020-10-18 Published:2020-10-15
  • Contact: Xing-gang LIU E-mail:xinggang_liu@126.com

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Abstract:

Objective: To evaluate the clinical success of the treatment of maxillary anterior primary incisors caries with composite resin strip crowns. Methods: Children who presented with severe early childhood caries and were treated comprehensive caries under general anesthesia from January to December 2016 were enrolled in this study. Composite crowns using preformed celluloid crown (3M ESPE, USA) called as “strip crown technique” were applied to treat vital primary incisors with two or multiple surface cavities. Selective etchings of enamel, Universal Bond adhesive and 3M Z350 resin were used to make strip crowns. The patients returned at the end of 6, 12 and 18 months and received clinical and radiologic examinations. Dentists who did not attend the treatment evaluated the strip crowns clinically by modified United States Public Health Service (USPHS) criteria. Results: Four hundred eighteen restorations, placed in 127 children aged 1.17-5.75 years (average of 3.22), were evaluated. The overall retention rate was 97.8% at the end of 6 months, 93.6% at 12 months and 89.2% at 18 months. After 18 months, 28 restorations (6.7%) were totally lost and 4.1% were rated as having lost some resin material. Only four teeth (1.0%) had secondary caries at the end of 18 months and 1.4% teeth had pulpal pathology requiring root canal treatment. Composite crowns had good performance in contour and adjacent contact and improved aesthetics significantly. Twenty-nine teeth (6.9%) showed mild gingivitis and 93.1% showed healthy gingival. 11.2% of the teeth demonstrated color change because plaque accumulation and the polish could remove the stains. The complete loss of strip crowns was mainly related to eating bites. Conclusion: Strip crowns performed well for restoring primary incisors with large or multisurface caries for periods of over 18 months. The strip crowns can be a durable and aesthetic restoration for vital carious primary incisors with adequate tooth structure after caries removal. Functional movement is an important cause of complete loss. Because of the high technical sensitivity and its requirement of the cooperation of children, strip crowns are more suitable for older and cooperative children as well as children receiving dental treatment under sedation or general anesthesia.

Key words: Primary incisors, Child, Tooth crown, Dental caries

CLC Number: 

  • R783.3

Table 1

The modified USPHS criteria"

Characteristic Rating Criteria
Secondary caries A No evidence of caries contiguous with the margin of the restoration
B Caries evident contiguous with the margin of the restoration
Presence of restoration failure A Crown appears normal, no cracks, chips, or fracture
B Partly but noticeable areas of loss of material
C Complete loss of crown
Postoperative sensitivity and pulpitis A No postoperative sensitivity
C Postoperative sensitivity, spontaneous pain, pulpitis, no response to electrical activity test
Color match A No mismatch in color, shade and translucency between restoration and adjacent tooth structure
B Mismatch between restoration and tooth structure within the normal range of color, shade and translucency
C Mismatch between restoration and tooth structure outside the normal range of color, shade and translucency
Gingival health A No obvious signs of inflammation
C Marginal gingivitis

Table 2

USPHS ratings of restorations after 6, 12, and 18 months (n=418)"

Characteristic Rating 6 months, n (%) 12 months, n (%) 18 months, n (%)
Secondary caries A 418 (100.0) 417 (99.8) 414 (99.0)
B 0 (0) 1 (0.2) 4 (1.0)
Presence of restoration failure A 409 (97.8) 383 (93.6) 373 (89.2)
B 5 (1.2) 11 (1.5) 17 (4.1)
C 4 (1.0) 24 (4.9) 28 (6.7)
Postoperative sensitivity and pulpitis A 418 (100.0) 413 (98.8) 412 (98.6)
C 0 (0) 5 (1.2) 6 (1.4)
Color match A 416 (99.5) 386 (92.3) 371 (88.8)
B 2 (0.5) 32 (7.7) 47 (11.2)
C 0 (0) 0 (0) 0 (0)
Gingival health A 409 (97.8) 397 (95.0) 389 (93.1)
C 9 (2.2) 21 (5.0) 29 (6.9)

Figure 1

Strip crowns for primary incisors in a 3.5-year-old girl A, a 3.5-year-old girl, severe early childhood caries, preoperative image of anterior teeth showed multiple surfaces caries; B, preoperative maxillary full arch imaging; C, photos of composite strip crowns of #52, #51, #61, and #62 teeth taken immediately postoperatively showed good performance in crown contour, color match, and surface texture; D, maxillary full arch imaging immediately after operation; E, rating A in color match, crown contour, gingival health, and margins taken at 12-month evaluation; F, rating A in USPHS taken at 18-month evaluation. "

Figure 2

Strip crowns for primary incisors in a 4-year-old girl A, a 4-year-old girl, severe early childhood caries, preoperative image of anterior teeth showed multiple surfaces caries; B, photos of composite strip crowns of #52, #51, #61, and #62 teeth taken immediately postoperatively; C, rating A in color match and crown contour taken at 6-month evaluation, but mild marginal gingivitis; D, rating A in color match and crown contour taken at 12-month evaluation. "

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