1. Do crowns in primary teeth influence periodontal health?Do crowns in primary teeth influence periodontal health?
A SYSTEMATIC REVIEWA SYSTEMATIC REVIEW
A.KoleventiA.Koleventi, D.Tsiantou, A.Arhakis, K.Arapostathis, N.Kotsanos
Department of Pediatric Dentistry Aristotle University of Thessaloniki
Searching…………………
• ElectronicElectronic
Medline, Embase, Scopus, Cochrane ,
Web of knowledge,ProQuest,TrialsCentral,
Clinical Trial, metaRegister
• Hand-searchingHand-searching
Excluded
In vitro studies, papers in other language
except English, non healthy human studies ,
histological studies, reviews , case reports.
424424 6060
potentially relevant
1212
retrieved for full report evaluation
Materials and methods
Results
CT with high level of evidence indicates that teeth restored with SSC have poorer periodontal health in comparison with conventional restorations .
esearchers didn’t use the same criteria in order to evaluate periodontal health the most common risk factor for periodontal implications is non ideal marginal
Discussion
citations were found
authorsauthors evidenceevidence nn ageage durationduration criteriacriteria resultsresults
Momen et al 2008 RCT I 160 4-7y 14mnth USPHC Spontaneous bleeding while probing in SSC significant
Leith & O’Connel 2001 Pros II 48 5y 12mths PI, MGI, PC, MA, XR Similar clinical results.
Fuks et al 1999 Pros II 22 6-9y 6mnth PI, GI,XR, MA Teeth with Esthetic crowns had significant poorer perio health
Ram et al 2005 Retro III 200 4-5y 14mnth XR, MA Periodontal ligament healthy
Sharat & Farsi 2004 Retro III 254 3-12y 38mnth PI *, GI*, XR, MA, PC Significant bone resorption when margins were non satisfactory
Einwag et al 1984 Retro III 118 2-12y 36mnth PI, SDI , XR Higher SBI values in crowned teeth but not significant
Checchio et al 1983 Retro III 50 6-11y - DI, GI, P, MA In non ideal crowns fluid flow was increased
Durr et al 1982 Retro III 101 4-12y 18mnth PI, GI, PC, MA (Myers) Positive correlations : non ideal crowns & gingivitis
Dawson et al 1981 Retro III 100 5,5y - PI, GI, PC, MA (Myers) Gingival status& plaque accumulation didn’t differ ideal-non ideal
Kupietsky et al 2005 Retro IV 145 - 35,6mnth USPHC 99% neither gingival inflammation nor marginal gingivitis
Shah et al 2004 Retro IV 46 4-8y 12mnth PI, GI, XR, MA 24% showed inflammatrion, 15% spontanuous bleeding
Kupietsiky et al 2003 Pros IV 112 - 18mnth USPHC No significant changes associated with longevity
Introduction
(1970 – 2011)Key words
•Primary teethPrimary teeth
•Decidious teethDecidious teeth
•GingivitisGingivitis
•Gingival indexGingival index
•Gingival fluidGingival fluid
•Periodontal healthPeriodontal health
•Stainless steel crowns
•Preformed crowns
•Prefabricated crowns
•(a)Esthetic crowns
•Nickel chrome crowns
•Nickel ion crowns
•Metal crowns
Aim
Concerns have aroused for the
periodontal health of the teeth
restored.
Crowns in primary teeth
are the gold standard
in restorations.
Backround
To seek evidence about the effect
of crowns in primary teeth
in periodontal health.
PI *:Green Vermillion
GI* :Gingival Index, Dental Clinic North America
XR : x-rays
PI: Loe Plaque Index
GI: Loe Gingival Index
PS :Proximal Contact evaluation
DI : Debris Index
SBI : Sulcus Bleeding Index
USPHC : United States Public Health Criteria
Papers in other
languages.
Irrelevant subjects.
In vitro studies
Histological
Studies,
permanent teeth
United states Department of Health and Human Services
I Randomized Control Trial
II Prospective studies
III Petrospective Studies with control group
IV retrospective studies without control group
Comprehensive perio
examination AAPD
Evaluate:
•the topography of the gingiva
health of the subgingival area with
measures such as
•bleeding on probing
•proximal contact relationships,
•the status of dental restorations and
•prosthetic appliances
•Occlusal examination
•satisfactory updated
diagnostic quality periapical radiographs
MGI : Modified Gingival Index
MA : Marginal Adaptation
P: Periotron: Gingival Fluid Meter
Conclusion
In view of the association between non-ideal
crowns and gingivitis the operator must be
meticulous in the placement of crowns. Errors
in adaptation should be avoided in order to
minimize irritating factors and to preserve the
periodontal health