Effectiveness of zirconia crowns compared with stainless steel crowns in primary posterior teeth rehabilitation: A systematic review and meta-analysis.

BACKGROUND: The authors' aim was to evaluate the clinical and radiographic effectiveness of zirconia crowns (ZCs) compared with stainless steel crowns (SSCs) in the rehabilitation of primary posterior teeth. TYPES OF STUDIES REVIEWED: Using predefined combinations of different search terms, the authors searched the standard electronic bibliographic databases-MEDLINE, Embase, Google Scholar, The Cochrane Library, The Cochrane Central Register of Controlled Trials, and Latin American and Caribbean Health Sciences Literature-and the Trip medical database for randomized controlled trials in which the investigators evaluated the clinical and radiographic effectiveness of ZCs and SSCs. Version 2 of the Cochrane risk of bias tool for randomized trials was used for quality appraisal of the included clinical trials. Random-effects model and Mantel-Haenszel test were used for the statistical analysis of estimated effect sizes. The overall quality of evidence was assessed using GRADEpro GDT software (McMaster University and Evidence Prime). RESULTS: A total of 6 studies were included from the initial 641 results. The overall risk of bias had "low" concerns in 3 studies and "some" concerns in the remaining 3 studies. From the pooled data of the meta-analysis, the authors observed 63 clinical failure events in 497 primary teeth rehabilitated with ZCs or SSCs. Rehabilitation of primary teeth with ZCs may result in fewer clinical failures (risk ratio, 0.48; 95% CI, 0.15 to 1.52; P = .21; I2 = 62%) and probably better gingival health (mean difference, -0.32; 95% CI, -0.42 to -0.23; P < .001; I2 = 0%) than SSCs. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Primary posterior teeth rehabilitated with ZCs may have less risk of experiencing clinical failure and probably better gingival health after 12 months than SSCs. Considering the quality of available literature, no recommendations could be made regarding the effectiveness of ZCs compared with that of SSCs in the rehabilitation of primary posterior teeth. Pediatric dentists should select ZCs or SSCs according to the clinical situation for successful primary teeth rehabilitation. A protocol was registered with the International Prospective Register of Systematic Reviews (CRD42020194363).

The prevalence of traumatic dental injuries in primary teeth: A systematic review and meta-analysis.

BACKGROUND/AIMS: The varied prevalence of traumatic dental injuries (TDI) in primary teeth around the globe raises a serious knowledge gap in the available literature. The aim of this study was to evaluate the prevalence of TDI in primary teeth and also to evaluate the different factors associated with TDI in primary teeth. MATERIALS AND METHODS: Comprehensive searches were performed in PubMed, Embase, Google Scholar, and The Cochrane Central Register of Controlled Trials with predefined search criteria. The primary outcome was the prevalence of TDI in primary teeth, and the secondary outcomes were the factors associated with TDI in primary teeth. Qualitative analysis was done using the Newcastle-Ottawa scale adapted for cross-sectional studies. The random-effect model was used for meta-analysis, and meta-regression analysis was done to evaluate the heterogeneity between the included studies. Meta-analysis was done using the "meta" package of "R" language. The overall quality of evidence was assessed using GRADEpro GDT software. RESULTS: A total of 24 cross-sectional studies met the inclusion criteria representing 4876 TDIs in 22 839 children aged between 0 and 6 years old. The overall prevalence of TDI in primary teeth was 24.2% (95% CI: 18.24-31.43, P = 0, I2  = 99%). Falls contributed the highest number of TDI - 59.3% (95% CI: 41.05-76.40, P < .01, I2  = 98%) - in primary teeth. The most common type of tooth fracture in primary teeth was an enamel fracture (61.9%), and prevalence of TDI in children with incompetent lip closure was 49.4%. CONCLUSION: The prevalence of TDI in cross-sectional studies of primary teeth was 24.2% with very low quality of evidence. Falls contributed the highest number of TDI in primary teeth, accounting for 59.3%. Children with incompetent lip closure have the highest prevalence (49.4%) of TDI in primary teeth.

Evaluating the fracture resistance of fiber reinforced composite restorations - An in vitro analysis.

BACKGROUND: Laboratory reports show that fiber-reinforced composites have improved fracture resistance over traditional composites. However, limitations in the biomechanics of tests to evaluate the fracture resistance of fiber-reinforced composites need to be considered for accurate clinical applications. AIM: To assess the fracture resistance of particulate filler composites, glass fiber-reinforced composites, and polyethylene-fiber reinforced composites by analyzing the different fracture types and failure patterns. MATERIALS AND METHODS: A standardized incisal (Group I) and mesioincisal fractures (Group II) were prepared on human maxillary central incisors. The test samples were further subdivided according to the restorative material used; particulate filler composites (Filtek Z 250), glass fiber-reinforced composites (fibre splint), and polyethylene-reinforced composites (Ribbond). The type of fractures was evaluated under the stereomicroscope and the failure patterns were analyzed using the graphical output from Universal Testing Machine. STATISTICAL ANALYSIS: The Chi-square test of association was used to test the association between fiber-reinforced composites and fracture resistance of tooth restoration complex. RESULTS: No statistical association was observed between fiber-reinforced composites to the type of fractures in both incisal (P = 0.29) and mesioincisal restoration (P = 0.27). A significant association was observed between the fiber-reinforced composites to the failure patterns in both the incisal (P = 0.005) and mesioincisal restoration (P = 0.007). CONCLUSION: The glass and polyethylene fiber-reinforced composites showed improved fracture resistance properties than the traditional particulate filler composites in both incisal and mesioincisal restorations.

Variation in levels of anxiety to dental treatment among nonorphan and orphan children living under different systems.

BACKGROUND: It is essential to understand the factors influencing the level of anxiety to dental treatment among different children as it can influence seeking dental care. Here, we assessed the impact of parental loss on dental anxiety among 6-13-year-old children. MATERIALS AND METHODS: A total of 444 children within the age group 6-13 years were selected. Group 1 consisted of orphan children living in government-run orphanages, Group 2 consisted of orphan children taken care by a person with a motherly relationship, Group 3 consisted of abandoned children living in private organization and Group 4 consisted of children living with their parents. Dental anxiety was measured using children's fear survey schedule-dental subscale and modified faces version of modified child dental anxiety scale. RESULTS: The highest number of anxious children were observed in Group 4 and the difference in the anxiety levels among the four groups was found to be highly statistically significant. Children living in government-run orphanages had least dental anxiety. CONCLUSION: All the orphans may not have the same anxiety levels and the environment of upbringing the orphans plays a significant role in the development of the anxiety.