Postoperative Bleeding Complications after Stainless Steel Crown Placement: A Case Series.

Stainless steel crown (SSC) placement is a common pediatric restorative treatment, generally completed with minimal complications. Discussed in this case series are two patients who presented to the emergency department (ED) with moderate oral bleeding persisting more than 12 hours after oral rehabilitation under general anesthesia. Bleeding incidence after pediatric oral rehabilitation has been found to range from 20% to 40%, with most being considered mild and significantly associated with extractions. There is limited documentation regarding moderate, persistent postoperative bleeding associated with placement of preformed metal crowns. The objective of this paper is to raise awareness of postoperative bleeding following SSC placement, discuss probable causes to minimize complications in the future, and discuss the local measures that were used to obtain hemostasis.

Validation of Size Guides for Fitting Molar Bands to Stainless Steel Crowned Primary Molars.

Purpose: To create and validate size guides for fitting Denovo® plain molar bands and bands with tubes to 3M™ ESPE™ stainless steel crowned primary molars. Methods: Two size guides were created for fitting these bands to corresponding crown sizes, with an additional pre-existing guide available for comparison. Eight volunteer dentists chose their best-fit band sizes for stainless steel crowned typodont teeth, with each seeing a subset of clinical conditions as determined by a randomized factorial experiment. Comparisons of dentists' best fits and each guide individually were evaluated for over 96 fits for robustness of clinical condition in an analysis of variance and agreement using intraclass correlation. Savings in attempted fits using size guides were estimated. Results: No significant differences over clinical conditions were observed when evalua- ting size guides and dentists' best fits. Intraclass correlations between plain band, plain band with tubes, and the pre-existing plain band with tubes guides and observed fits were 0.997, 0.998 and 0.998, respectively, with corresponding expected savings of 1.1, 0.7 and 0.5 attempts per fit, respectively. Conclusion: Size guides created for fitting plain bands and bands with tubes to stainless steel crowned primary molars were validated by volunteer dentists and showed promise for decreasing waste and increasing efficiency during dental visits.).

Stainless Steel Crown Size Selection Predicted by Digital Radiographic Primary Molar Measurements.

Purpose: The purpose of this study was to evaluate whether preoperative radiographic measurements could predict the final steel crown selection size for restoration of primary molars. Methods: A retrospective chart review of children two to 10 years old receiving oral rehabbilitation between July 2019 and May 2020 was completed. Bitewing radiographs were used to obtain two linear radiographic measurements (coronal and cervical) using DEXIS™ Imaging Software (KaVo Dental). Separate models using each, along with covariates of primary first versus primary second molars, maxillary versus mandibular molars, and their interaction, were developed using linear regression analysis (N equals 225), treating the final crown size as a continuous response. Results: Final models utilizing stainless steel crown sizes of previously crowned teeth showed that predictors and all covariates were significant (P<0.001). Three cross-validation models (80 percent training sets) for each radiographic measurement showed strong agreement with the final models. Based on the final coronal model, a practitioner would achieve a correct fit using one, two, or three attempts with accuracy rates of 46 percent, 47 percent, and seven percent, respectively, with a cumulative rate through two attempts of 93 percent; for the cervical model, respective accuracy rates were 38 percent, 51 percent, 11 percent, and 89 percent. These models were used to create size fitting guides. Conclusion: This crown fitting guide has favorable clinical potential to assist providers, especially novice dentists, in selecting crown sizes, showing promise for expanded radiographic application in dentistry, specifically to education, technical efficiency, and minimization of waste.