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Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial.

ABSTRACT: BACKGROUND:Providing restorations to anterior teeth in children is a challenging task due to the need for high esthetics, strength, and durability. This study was done to compare prefabricated primary zirconia with resin composite strip crowns on primary maxillary central and lateral incisors with regards to gingival health, plaque accumulation, recurrent caries, restoration failure, and opposing teeth wear over a period of 3, 6 and 12 months. METHODS:Children attending the King Abdulaziz University, Faculty of Dentistry (KAUFD) clinics who needed restorations were screened for inclusion criteria. A total of 120 teeth were treated; 60 with zirconia and 60 with strip crowns. Randomization was done by simple random allocation using SPSS software version 20.0 (Armonk, NY; IBM Corp.). A simple descriptive statistic was used for analysis by Wilcoxon Signed-Rank test and Chi-square test. Level of significance was set at (??=?0.05) and level of confidence at (95%). The presented research was registered retrospectively at ClinicalTrials.gov in 6th of August 2017, under registration number NCT03184012. RESULTS:Zirconia crowns showed significantly less gingival bleeding at the 3- and 6-months follow up periods (p?

SUBMITTER: Alaki SM

PROVIDER: S-EPMC7654025 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial.

Alaki Sumer M SM Abdulhadi Bashaer S BS AbdElBaki Medhat A MA Alamoudi Najlaa M NM

BMC oral health 20201110 1

<h4>Background</h4>Providing restorations to anterior teeth in children is a challenging task due to the need for high esthetics, strength, and durability. This study was done to compare prefabricated primary zirconia with resin composite strip crowns on primary maxillary central and lateral incisors with regards to gingival health, plaque accumulation, recurrent caries, restoration failure, and opposing teeth wear over a period of 3, 6 and 12 months.<h4>Methods</h4>Children attending the King A ...[more]

PMID: 33167954

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Project description:BACKGROUND:Clinical studies regarding zirconia implant abutments reported good survival rates in the short-term observation period. The purpose of this study was to assess the six-year clinical performance of zirconia abutments supporting all-ceramic crowns in anterior and premolar regions. METHODS:The patients received zirconia implant abutments to support all-ceramic crowns in Chang-Gung Medical Center during the period August 2010 to August 2011 were enrolled. In the following six years of observation period after the implant-crown had finished, the clinical parameters of all of the included patients were registered on a special form. The records regarding the following variables: age, gender, implant location, the condition of edentulous site before implant placement, esthetic performance at baseline, presence or absence of technical complications, and biological outcomes were registered and scrutinized for evaluation. RESULTS:Out of the 32 zirconia implant abutments and 32 all-ceramic crowns that were followed for six years. Neither abutments nor crowns were lost, yielding 100% survival rates for both zirconia abutments and crowns. The esthetic outcomes were excellent except that a score of 2 was given to two restorations. With regard to technical complications, there was one instance of abutment screw loosening, two cases of veneering ceramic chipping, one restoration with occlusal roughness, and three instances of crowns loosening. Overall, the success rates were 96.8% and 81.2% for abutments and crowns respectively. In biological performance, only 1 implant was classified in group II (satisfactory survival) in the Misch classification, while all the others were classified in group I (excellent). CONCLUSIONS:Zirconia abutments supporting all-ceramic crowns demonstrated high survival rate, good biological and esthetic results. While some technical complications were frequently observed, the complication-free rates were 96.8% for abutments and 81.2% for crowns in the medium-term observation period.

Project description:Despite the high success rates of preformed metal crowns (PMCs) in children no randomized clinical trials compare methods of placement and none describe its use in Africa. Our aim was to compare survival and cost-effectiveness of PMCs placed by conventional techniques (CT) and biological Hall techniques (HT) using a prospective randomized control trial in a general dental practice from Khartoum. One hundred and nine and 103 PMCs were placed in randomly selected children (5-8years) with 1-2 carious primary molars using HT and CT respectively and followed for 2 years. Socioeconomic status, periodontal health, occlusion, anxiety, and procedure time were compared using student t-test. Kaplan-Meier survival rates and incremental cost effectiveness ratio (ICER) were compared between CT and HT. CT and HT groups were similar for age, gender, socio-economic status. Survival rates were high (over 90%) for both study arms and not statistically different (p>0.05). Anxiety scores were significantly higher in CT arm after 12 months compared to HT (p<0.001). Clinically, gingival and plaque indices were similar between groups (p>0.05) but occlusions were raised in nearly all subjects in the HT arm (p<0.05). Periodontal health improved, and occlusions adjusted over time in both arms. There were 3 (2.7%) and 6 (5.8%) minor failures, 7 (6.4%) and 6 (5.8%) major failures in HT and CT arms respectively. Mean procedure time was lower in HT (9.1 min) than CT (33.9 min); p<0.001. Mean PMC cost was US$2.45 and US$7.81 for HT and CT respectively. The ICER was US$136.56 more for each PMC placed by CT per life year. We show that PMCs have high survival outcomes in disadvantaged populations similar to results from developed countries. As HT can be carried out by less experienced dental operators and therapists, this biological approach provides a promising cost-effective option to manage caries in developing countries with limited resources. Trial registration: The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT03640013.

Project description:OBJECTIVE:It is unclear if brachio-basilic vein fistula should be performed as a primary or staged procedure, particularly for smaller basilic veins. Our aim was to report on a randomized controlled trial comparing these two techniques. METHODS:Sixteen patients with a basilic vein ?2.5?mm were randomized into primary transposed brachio-basilic vein (TBBV) fistula (n?=?9) and staged TBBV fistula (n?=?7). Patients with basilic veins enlarged by previous arteriovenous fistulas were excluded. Baseline characteristics of the two study groups, including vein size, were comparable (median basilic vein diameter 3.5?mm, range 2.8-4.1?mm). The staged group had a brachio-basilic vein fistula performed first followed by the transposition procedure performed at least 6?weeks later to allow the basilic vein to enlarge. TBBV fistula maturation at 10?weeks, primary, assisted-primary, and secondary patency were the primary outcome measures. Early failures were included in the calculation of patency rates. RESULTS:Transposed brachio-basilic vein fistula maturation rate after primary procedures (3/9, 33%) was lower compared to maturation rate after staged procedures (7/7, 100%, P?=?0.011, Fisher's exact test), which led to premature termination of the trial. Time to hemodialysis [median (interquartile range)] of primary and staged procedures was 54 (51.5-113.5)?days and 97 (93-126)?days, respectively (P?=?0.16). One-year primary and assisted-primary patency rates of primary and staged procedures were equivalent (44 vs 57%, P?=?0.76 and 44 vs 71%, P?=?0.29, respectively); however, there was a trend toward a better 1-year secondary patency after staged procedures (86 vs 44% for primary procedures, P?=?0.09). CONCLUSIONS:Among candidates for TBBV fistula with a small basilic vein, staged transposition achieves higher maturation rates compared to primary procedures, a difference reflected in long-term secondary patency. TRIAL REGISTRATION:www.ClinicalTrials.gov, identifier NCT01274117.

Project description:The optimal management of croup--a common respiratory illness in young children--is well established. In particular, treatment with corticosteroids has been shown to significantly reduce the rate and duration of intubation, hospitalization, and return to care for on-going croup symptoms. Furthermore treatment with a single dose of corticosteroids does not appear to result in any significant adverse outcomes, and yields overall cost-savings for both families and the health care system. However, as has been shown with many other diseases, there is a significant gap between what we know and what we do. The overall aim of this study is to identify, from a societal perspective, the costs and associated benefits of three strategies for implementing a practice guideline that addresses the management of croup.We propose to use a matched pair cluster trial in 24 Alberta hospitals randomized into three intervention groups. We will use mixed methods to assess outcomes including linkage and analysis of administrative databases obtained from Alberta Health and Wellness, retrospective medical chart audit, and prospective telephone surveys of the parents of children diagnosed to have croup. The intervention strategies to be compared will be mailing of printed educational materials (low intensity intervention), mailing plus a combination of interactive educational meetings, educational outreach visits, and reminders (intermediate intensity intervention), and a combination of mailing, interactive sessions, outreach visits, reminders plus identification of local opinion leaders and establishment of local consensus processes (high intensity intervention). The primary objective is to determine which of the three intervention strategies are most effective at lowering the rate of hospital days per 1,000 disease episodes. Secondary objectives are to determine which of the three dissemination strategies are most effective at increasing the use of therapies of known benefit. An economic analysis will be conducted to determine which of the three intervention strategies will most effectively reduce total societal costs including all health care costs, costs borne by the family, and costs stemming from the strategies for disseminating guidelines.

Dataset Information

Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial.

Publications

Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial.

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