Survival analysis of metal crowns versus restorations in primary mandibular molars

J Am Dent Assoc. 2017 Oct;148(10):760-766. doi: 10.1016/j.adaj.2017.06.009. Epub 2017 Jul 18.

Abstract

Background: The effectiveness of stainless steel crowns (SSCs) versus direct restorations when placed in primary mandibular molars (teeth nos. L and S) is uncertain. The authors evaluated effectiveness by gauging longevity of treatment.

Methods: The authors obtained private dental insurance claims (2004-2016) from a national dental data warehouse. Paid insurance claims records (n = 1,323,489) included type of treating dentist, treatment placed, and patient age.

Results: Dentist specialty, type of treatment, and patient age were significant in predicting failure after the first restoration. The authors found high survival rates for all treatments (> 90%) after 5 years; however, as soon as within 3 years after treatment, SCCs had approximately 6% better survival.

Conclusions: Teeth nos. L and S first treated with SSCs lasted longer without new treatment compared with teeth first treated with direct restorations; the difference was small. Teeth treated by pediatric dentists had better survival rates.

Practical implications: Primary mandibular first molars initially treated with SSCs lasted longer without new treatment compared with direct restorations. Overall dental care costs of the former were considerably higher.

Keywords: Stainless steel crown; general dentist; pediatric dentist; primary teeth.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Child
  • Child, Preschool
  • Crowns* / economics
  • Dental Restoration Failure / economics
  • Dental Restoration Failure / statistics & numerical data
  • Dental Restoration, Permanent* / economics
  • Dentists / statistics & numerical data
  • Health Care Costs / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Mandible
  • Molar / surgery*
  • Stainless Steel
  • Time Factors

Substances

  • Stainless Steel