Cochrane · intervention · CD005512
Preformed crowns for decayed primary molar teeth
Innes, NPT, Ricketts, D, Chong, LY, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
21
current version
GRADE rated
9
No studies
9
Included studies
5
as reported
No studies 9 · 42.9%Ungraded 3 · 14.3%Very low 5 · 23.8%Low 1 · 4.8%Moderate 3 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children with at least one primary molar tooth affected by decay or developmental defects | Children aged 2 to 10 years with decayed primary molar teeth (n=438 children, 693 teeth; 5 studies) |
| Intervention | Preformed crowns of any material placed using any method (metal (PMC) or aesthetic; conventional technique or Hall Technique; with incomplete or no carious tissue removal, or any pulp therapy, prior to placement) | Preformed metal crowns: conventional technique (n=2 studies); Hall Technique (n=2 studies); aesthetic veneered stainless steel crown (n=1 study) |
| Comparison | Filling (any material; with or without complete carious tissue excavation; with or without pulp treatment); No treatment; Non-restorative caries treatment; Another crown (metal versus aesthetic); Another method of crown placement (Hall versus conventional technique) | Filling / open sandwich restoration (n=4 studies); non-restorative caries treatment (n=1 study); aesthetic crown (n=1 study) |
| Outcomes | Major failure (composite of signs/symptoms of irreversible pulpitis or periradicular periodontitis); Pain; Satisfaction with treatment (including aesthetics); Time to restoration failure/retreatment; Discomfort associated with procedure; Cost; Adverse events (e.g. bone loss, gingival inflammation) | Major failure (n=3 studies); Pain (n=2); Discomfort associated with procedure (n=2); Gingival bleeding (n=4); Bone resorption (n=1) |
| Study designs | Randomised controlled trials (RCTs), including split-mouth studies | RCTs: split-mouth (n=3); parallel group (n=1); tooth-level randomisation (n=1) |
| Timing | Short term (less than 12 months); Long term (12 months or more); discomfort at time of dental appointment or within 24 hours | 6 months to 5 years follow-up (short term <12 months; long term 12 to 48 months) |
Search date: 2015-01. Databases: Cochrane Oral Health Group Trials Register (to 21 January 2015); Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 12); MEDLINE via Ovid (1946 to 21 January 2015); EMBASE via Ovid (1980 to 21 January 2015); US National Institutes of Health Trials Register…
Questions and results
Show all 3 versionsPreformed crown (any material; conventional technique or Hall Technique) vs Filling (any material; with or without complete carious tissue excavation; with or without pulp treatment)
Population: Children with decayed primary molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cost | The studies did not measure this outcome. | 0 studies | No studies |
Adverse events: gingival bleeding Short term (up to 12 months) | RR 1.69 [0.61, 4.66] | 2 studies · 226 participants | Ungraded |
Satisfaction with treatment | Satisfaction with treatment: listed in the Summary of findings table with no data; the studies did not measure this outcome. | 0 studies | No studies |
Time to restoration failure/retreatment | The studies did not measure this outcome. | 0 studies | No studies |
Pain Long term (12 months to 24 months) | RR 0.15 [0.04, 0.67] -71 [-80, -27] fewer per 1000 | 2 studies · 312 participants | Moderate Downgraded: risk of bias |
Discomfort associated with the procedure At time of dental appointment or within 24 hours | RR 0.56 [0.36, 0.87] -105 [-153, -31] fewer per 1000 | 2 studies · 381 participants | Moderate Downgraded: risk of bias |
Major failure Short term (less than 12 months) | Short term (less than 12 months): no failures in either group; effect not estimable (Analysis 1.1.1; 76 teeth, 38 participants; one study, Hutcheson 2012). | 1 study · 76 participants | Ungraded |
Major failure Long term (12 months to 48 months) | RR 0.18 [0.06, 0.56] -92 [-105, -49] fewer per 1000 | 3 studies · 346 participants | Moderate Downgraded: risk of bias |
Pain Short term (less than 12 months) | Short term (less than 12 months): effect not estimable (Analysis 1.2.1; 64 teeth, 32 participants; one study, Hutcheson 2012). | 1 study · 64 participants | Ungraded |
Adverse events: gingival bleeding Long term (12 months) | RR 1.74 [0.99, 3.06] 116 [-1, 322] more per 1000 | 2 studies · 195 participants | Low Downgraded: risk of bias, imprecision |
Preformed crown (any material; conventional technique or Hall Technique) vs No treatment
Population: Children with decayed primary molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | Crown versus no treatment was a planned comparison (Comparison 2: crown versus no crown or filling). No study evaluated crown versus no treatment; the only study in this comparison (Santamaria 2014) used active… | 0 studies | No studies |
Preformed metal crown (fitted using the Hall Technique) vs Non-restorative caries treatment
Population: Children with decayed primary molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cost | The studies did not measure this outcome. | 0 studies | No studies |
Pain | Pain: No evidence available (Summary of findings 2). | 0 studies | No studies |
Time to restoration failure/retreatment | The studies did not measure this outcome. | 0 studies | No studies |
Major failure 12 months | RR 0.12 [0.01, 2.18] -73 [-82, 79] fewer per 1000 | 1 study · 92 participants | Very low Downgraded: risk of bias, imprecision |
Discomfort associated with the procedure Immediately after treatment | RR 1.67 [0.65, 4.25] 78 [-40, 375] more per 1000 | 1 study · 104 participants | Very low Downgraded: risk of bias, imprecision |
Satisfaction with treatment | Satisfaction with treatment: No evidence available (Summary of findings 2). | 0 studies | No studies |
Adverse events: gingival bleeding Long term (12 months) | RR 1.09 [0.42, 2.86] 13 [-85, 271] more per 1000 | 1 study · 92 participants | Very low Downgraded: risk of bias, imprecision |
Preformed metal crown (stainless steel), conventional technique vs Aesthetic crown (stainless steel with composite/white veneer), conventional technique
Population: Children with decayed primary molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse events: bone resorption Six months and four years | Bone resorption: one case at six months in a tooth treated with a veneer crown; no bone resorption at either the veneer crown or stainless steel sites at four-year follow-up (Analysis 3.2). | 1 study · 11 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events: gingival bleeding Six months and four years | At six months, none (0/11) of the PMC sites had gingival bleeding, but all (11/11) veneer sites had bleeding, 10 of which bled on probing; statistically significant (McNemar's test, P < 0.001). At four years, one case… | 1 study · 11 participants | Very low Downgraded: risk of bias, imprecision |
Preformed metal crown (fitted using the Hall Technique) vs Preformed metal crown (fitted using a conventional technique)
Population: Children with decayed primary molar teeth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | None of the included studies compared the effectiveness or safety of the Hall Technique versus the conventional technique of fitting a crown. No RCT evidence found. | 0 studies | No studies |