title: Clinical success of stainless steel crowns placed under general anaesthesia in primary molars: an observational follow up study.
abstract: OBJECTIVE
  Quality assessment of stainless steel crowns (SSCs) placed in primary molars of high caries risk children after 1, 3 and 5 years of service time.
  
  
  METHODS
  Out of 1149 SSCs placed 1, 3 or 5 years before the evaluation period in 558 children, 428 (37.2%) SSCs were clinically evaluated in 171 (30.6%) children aged between 1.1 and 8.6 years. Marginal adaptation, extension and proximal contacts of SSCs, plaque and gingival bleeding at SSC were assessed. Caries experience was recorded by WHO standards.
  
  
  RESULTS
  Caries experience was 7.8 dmft/18.4 dmfs before treatment. The overall success rate of SSCs was 97.2%, regardless of the extent of carious lesions or pulp treatment of the tooth. Loss of SSCs (1.9%), pathological tooth mobility (0.7%) and perforation of the crown (0.2%) were scored as clinical failures. The majority of SSCs had sealed margins and the marginal extension reached sub-gingival level. Open proximal contacts occurred mesially and distally (21.7%, 20%). All qualitative defects increased with service time. Secondary caries was not diagnosed. Of the SSCs, 46.4% were free of dental plaque. Gingival bleeding after probing was observed in 72.1% of all SSCs. Gingivitis was significantly associated with increased dmft-values (OR=1.108, 95%CI: 1.03-1.19) and plaque at SSCs (OR=0.29, 95%CI: 0.18-0.47). Children with migration background exhibited significantly more often insufficient oral hygiene and higher rates of gingival bleeding and caries experience than did German children.
  
  
  CONCLUSIONS
  SSCs are clinically successful restorations in primary molars of high caries risk children. High caries prevalence and insufficient oral hygiene were greater determining factors for the occurrence of gingivitis than the quality of the SSCs.
authors.affiliation: Department of Preventive Dentistry and Paediatric Dentistry, Jena University Hospital, Jena, Germany. Electronic address: ina.schueler@med.uni-jena.de.
authors.forename: I M
authors.initials: IM
authors.lastname: Schüler
authors.affiliation: Department of Preventive Dentistry and Paediatric Dentistry, Jena University Hospital, Jena, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hiller
authors.affiliation: Paediatric Dental Practice, Hamburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Roloff
authors.affiliation: Department of Conservative Dentistry and Periodontology, Ludwig Maximilian University, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kühnisch
authors.affiliation: Department of Preventive Dentistry and Paediatric Dentistry, Jena University Hospital, Jena, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Heinrich-Weltzien
mesh_terms: D000766:Anesthesia, Dental / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003442:Crowns / Q000592:standards*; D004245:DMF Index; D003722:Dental Alloys; D003733:Dental Caries Susceptibility; D018772:Dental Marginal Adaptation; D003774:Dental Plaque Index; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D054242:Emigrants and Immigrants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008963:Molar / Q000473:pathology*; D009911:Oral Hygiene Index; D010512:Periodontal Index; D013193:Stainless Steel; D014086:Tooth Mobility / Q000145:classification; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D003722:Dental Alloys; D013193:Stainless Steel
keywords: Caries experience; Caries risk; Carious primary molars; Gingivitis; Stainless steel crowns