Prevalence and Association of Children Requiring Stainless Steel Crown in Maxillary First Permanent Molars
Kiruthika Patturaja1, Ganesh Jeevanandan2*, Iffat Nasim3
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
2 Reader, Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
3 Professor and HOD, Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India.
*Corresponding Author
Ganesh Jeevanandan,
Reader, Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, PH Road, Chennai
600077, Tamil Nadu, India.
Tel: 9884293869
E-mail: ganesh.sdc@saveetha.com
Received: July 30, 2021; Accepted: August 11, 2021; Published: August 18, 2021
Citation:Kiruthika Patturaja, Ganesh Jeevanandan, Iffat Nasim. Prevalence and Association of Children Requiring Stainless Steel Crown in Maxillary First Permanent Molars. Int J Dentistry Oral Sci. 2021;8(8):4101-4104. doi: dx.doi.org/10.19070/2377-8075-21000837
Copyright: Ganesh Jeevanandan©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Stainless steel crown also known as preformed metal crowns are utilized for providing full coverage to young permanent teeth and extensively used restorative material in permanent teeth. The present study aims to find the prevalence and association of children requiring stainless steel crowns in maxillary first permanent molar. A retrospective study was done by collecting required datas in University hospital between June 2019-March 2020. Datas on age, gender and tooth requiring stainless steel crown in maxillary first permanent molar were obtained after reviewing 5,000 case sheets. Descriptive statistics and chi- square test was done using SPSS statistical analyser 20.0. The prevalence rate of children requiring stainless steel crowns in maxillary permanent first molars was 1.02% (n=51). The prevalence of children requiring stainless steel crown in maxillary permanent first molar was less .There is no statistical significance association between requirement of stainless steel crown requirement with age (p=0.638) and gender (p=0.921) in children .Within the limitations of the study , there is no statistically significant association between gender, age and stainless steel crown requirement in children.
2.Introduction
3.Conclusion
4.References
Keywords
Children; Permanent Molar; Prevalence; Stainless Steel Crown.
Introduction
First permanent molars are multi-cuspid teeth erupting in the oral
cavity at around 6 years of age, forming the key to permanent
dentition having increased susceptibility to dental caries[42, 48].
First permanent molars have an influence on masticatory function
, occlusal height and vertical dimension maintenance ,serving
powerful aid for young age in planning proper health care systems
[13, 19]. Permanent molars have higher susceptibility to occlusal
caries than proximal caries in adolescents due to large pulp chambers
and proximity of pulp horns to cusp tips having increased
patency to dentinal tubules. Besides caries prevalence, permanent
molars and incisors are more susceptible to hypomineralisation
and hypoplastic which breaks down first permanent molar at a
younger age leading to challenges in treatment [46, 16, 15, 12, 55,
49].
Stainless steel crowns were the choice of final provisional restoration
as they were pre-formed, pre trimmed and pre contoured
crown with a wide range of sizes and with proven clinical efficiency
which can be adapted to individual teeth [26, 46]. Stainless steel
crowns were first introduced by “Rocky Mountain'' company and
later modified by various manufacturers. Stainless steel crowns are
used to restore multi surface caries ,fractured tooth , post endodontic
restoration in both primary and young permanent dentition
[15, 40, 22, 27, 33], restoration of developmental problems
, abutment for space maintainers and preventive restoration in
disabled children [14]. Stainless steel crowns have the advantage
of convenience, low cost, durability and longevity to protect the
tooth surface. The disadvantage of stainless steel crown is unaesthetic
appearance due to metallic look, known nickel allergy or
sensitivity and periodontal problem [45]. Stainless steel crowns
have been reported to have superior longevity when compared
to other conventional restorations. Adult stainless steel crowns
are used as interim restoration on young permanent teeth, until
permanent restoration can be placed thus providing optimal time for replacement [8, 18, 29]. Previously our team has a rich experience
in working on various research projects across multiple
disciplines [20-55]. Now the growing trend in this area motivated
us to pursue this project.
Hence the present study aims to find the prevalence and association
of children requiring stainless steel crowns in permanent first
maxillary molar.
Materials and Methods
A retrospective cross sectional study was conducted in an University
hospital .The study was employed by reviewing and analyzing
case records of 5,000 paediatric patients visiting the University
hospital between June 2019 to March 2020. A total of 51 subjects
(24 males and 27 females) below the age of 15 years who required
and underwent treatment for placement of stainless steel crown
in maxillary first permanent molar were selected as study participants.
The study protocol was approved by the Institute Review
Board under ethical approval number SDC/SIHEC/2020/DIASDATA/
0619-0320. Cross verification of datas was done from
available clinical photographs.
Data on patients' age, gender and prevalence of tooth requiring
stainless steel crown was collected and tabulated in Microsoft
Excel. Incomplete or missing datas were not considered for the
analysis. The age of the patients in the case records was categorized
for the convenience of statistical analysis such as 5-10 years,
11-15 years. The maxillary first permanent molar requiring crown
was categorized into right, left side designated by tooth number
by FDI system as 16, 26 respectively. The obtained datas were
imported to SPSS statistical analysis of version 20.0. Descriptive
statistics and chi- square tests were done for the obtained data.
A p-value or less than 0.05 was considered to be statistically significant.
Results & Discussion
From the total of 5000 case sheets reviewed, 51 subjects (24 males
and 27 females ) required stainless steel crown in maxillary first
permanent molar .The prevalence rate of children with stainless
steel crown requirement in maxillary first permanent molar was
1.02%. Figure 1 shows the age distribution of children requiring
stainless steel crown in maxillary first permanent molar. 15.7%
of subjects were between the age group of 5-10 years and 84.3%
were between 10-15 years .Figure 2 shows the gender distribution
of children requiring stainless steel crown. Based on gender
distribution 47% were males and 53% were females who required
stainless steel crowns in maxillary first permanent molar. Figure
3 shows age distribution based on teeth requiring stainless steel
crown, of the total population 54.9% had stainless steel crown in
the right permanent maxillary first molar (tooth number 16) while
45.1% had stainless steel crown in left permanent maxillary first
molar (tooth number 26) .Chi-square test shows there is no statistical
significance for association between age and stainless steel
crown requirement in permanent maxillary first molar p= 0.638.
Figure 4 shows distribution of gender based on prevalence of
stainless steel crown, about 53% of females had higher prevalence
of stainless steel crown requirement than males 47% .Chi-square
test for association of gender and prevalence of stainless steel
crown shows that there is no statistically significant association
between gender and stainless steel crown requirement p=0.921 .
The present study has yielded results on prevalence and association
of stainless steel crown requirement in children based on age
and gender.
The present study findings show that females are more prevalent
and require stainless steel crowns than males, but there was
no statistical significance. Similar findings , Page et al analysis on
attitude of children for stainless steel crown on primary molar
found no statistical significance for gender [31] . Madi et al, found
females having pulpally involved caries in permanent teeth more
than males [1]. These findings suggest the females have earlier
eruption of tooth than males due to early onset of growth spurt
and have more liability to complain to get treatment for their
tooth [50].
Present study findings show that children between the age group
of 10-15 years have a higher incidence of stainless steel crown
than lower age group. Szymaczh found higher caries prevalence with enamel hypoplasia in children of 6-8 years of age [28]. Dicepolo
et al , children of 12 years or older groups have increased risk
of failure of stainless steel crown due to changes in occlusion and
found younger groups to be more successful and benefited [7].
It has been reported that overhanging margins with poor adaptation
of stainless steel crown in primary tooth may lead to
impaction of permanent first molar [6]. Stainless steel crown as
interim restoration has been found to perform satisfactorily in
young adults in severely compromised teeth [7]. Stainless steel
crown however is recognised for its cost-effectiveness, efficiency
in terms of durability and longevity in the majority of the cases.
However potential limitations may have an impact on the outcome
of the results such as limited sample size, geographic location
and limited data variables for comparison. Further research
to be done on a large scale to find the prevalence of stainless steel
crown requirement in young permanent tooth. There should be
increased awareness on maintenance of oral hygiene and regular
dental checkups among parents and caregivers such that early innervations
on caries control by fluoridation and sealants will prevent
progression of caries in children .Long term follow up to be
done for tooth treated with interim restoration so as to improve
the prognosis . Our institution is passionate about high quality
evidence based research and has excelled in various fields [20-55].
We hope this study adds to this rich legacy.
Figure 1. Bar graph showing age distribution of the children. X axis represents the age group 5-10 years (red) ,11-15 years (pink) and Y axis represents the total number of children requiring stainless steel crown in maxillary first permanent molar .Frequency of stainless steel crown requirement is more prevalent in the age group of 11-15 years.
Figure 2. Bar graph shows distribution of gender in children requiring stainless steel crown in maxillary first permanent molar. X-axis represents the gender distribution females (red), males (orange) and Y axis represents the total number of children requiring stainless steel crown. Prevalence of stainless steel crown requirement is more among females.
Figure 3. Bar graph showing association between age and stainless steel crown requirement in maxillary first permanent molar. X axis represents the age of the children and Y axis represents the children requiring stainless steel crown in maxillary first permanent molar. Higher prevalence of stainless steel crown requirement in 16 (violet) than 26 (yellow) in the age group of 11-15 years. The association between age and teeth requiring stainless steel crown was found to be statistically insignificant p value of 0.638, p>0.05 (Chi square test).
Figure 4. Bar graph showing association of gender and stainless steel crown requirement in maxillary first permanent molar. X axis represents gender of the children and Y axis represents the children requiring stainless steel crown in maxillary first permanent molar. Higher prevalence of stainless steel crown requirement in 16 (violet) than 26 (yellow) among females. The association between gender and teeth requiring stainless steel crown was found to be statistically insignificant p value of 0.921, p>0.05 (Chi square test).
Conclusion
Within the limitations of the study, there is no statistically significant
association between gender, age and stainless steel crown
requirement in children. The prevalence rate of children requiring
stainless steel crown in maxillary permanent molars was significantly
less. Early innervations and preventive measures of treatment
should be promoted to prevent future complications.
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