Reasons for Crown Failures in Primary Teeth: Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Understanding long-term retention rates and complications associated with different materials for fabricating pediatric crowns for primary teeth is crucial for material selection and optimizing clinical outcomes. objectives: This systematic review aimed to descriptively analyze the crown-retention rates and complications associated with crown retention, as well as the biological and technical complications of pediatric crowns, for primary teeth. The meta-analysis reported herein was performed to estimate long-term (3-year and 5-year) retention rates of these pediatric crowns fabricated using various materials. Methods: Using the PICOS (Population, Intervention, Comparison, Outcomes, and Study design) paradigm, a systematic search was conducted between July and August 2023 in the Cochrane, Embase, and PubMed databases to identify randomized controlled trials (RCTs) and clinical (prospective and retrospective) studies reporting retention rates, complications of crown retention, and biological and technical complications. After selecting studies with a predefined set of selection criteria, data from included studies were used for a systematic review aimed at a descriptive analysis of factors associated with the failure of crowns for primary teeth. Data from the included RCTs were used for meta-analysis, wherein 3-year and 5-year crown-retention rates were estimated using Poisson regression models. Results: This systematic review included 13 RCTs and 5 clinical studies on dental crowns for primary teeth, involving 454 children (1172 crowns) in RCTs and 810 children (2667 crowns) in clinical studies. The median follow-up durations were 12 months for RCTs and 20.8 months for clinical studies, with a 10.6% (124/1172) dropout rate in RCTs. Meta-analysis of pooled 5-year retention rates for different crown materials revealed the following retention rates: 88.90% for compomer crowns, 92.18% for composite resin crowns, 90.30% for resin-modified glass ionomer cement (RMGIC) crowns, and 97.88% for stainless steel crowns. Additionally, strip crowns exhibited a retention rate of 83.48%, while zirconia crowns had a retention rate of 97.09%. Poisson regression estimated 3-year and 5-year crown-retention rates, indicating good outcomes across materials. Complications included secondary caries (up to 21.8% in zirconia crowns) and marginal adaptation issues (up to 22.2% in compomer crowns). These findings highlight material-specific considerations necessary for optimizing outcomes in pediatric dental crown treatments. Conclusions: While retentive complications such as chipping, material loss, and fractures do occur across materials, compomer, composite resin, stainless steel, strip, and zirconia crowns all have clinically acceptable retention rates. However, the differences in biological and technical complications between materials may provide insights for selecting appropriate materials for pediatric crowns based on clinical considerations.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.028 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.008 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".