Non-Cochrane · intervention · PM35270531
Zirconia Crowns for Primary Teeth: A Systematic Review and Meta-Analyses.
Alzanbaqi Sara Douf, Alogaiel Rakan Mishaal, Alasmari Mohammed Ali, et al. · International journal of environmental research and public health · 2022 · PubMed · doi:10.3390/ijerph19052838
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
4
current version
GRADE rated
0
No studies
0
Included studies
61
linked below
No studies 0 · 0%Ungraded 4 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%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 | Pediatric patients with primary (deciduous) teeth (special-health-care patients and pediatric patients with permanent teeth only were excluded) | Children (age range ~0-10 years) across 36 studies; the review reports 3575 teeth in total |
| Intervention | Prefabricated/ready-made zirconia crowns as permanent full-coverage crowns for primary teeth | Zirconia crowns of several brands: NuSmile (NSZ), Zirkiz (ZZC), Kinder Krown (KKZ), EZ Pedo/Spring EZ (EZP/SEC), Cheng (CCZ), CAD/CAM and generic zirconia crowns (ZC) |
| Comparison | Any other crown types or restorations, or no comparison | Stainless steel crowns (SSC), pre-veneered SSC (PVSSC), resin composite strip crowns (RCSC), glass-fiber composite crowns (GFRC), other zirconia types, or no comparator |
| Outcomes | Performance outcomes: gingival/periodontal health, parental satisfaction, color stability, crown retention, contour, fracture resistance, marginal integrity, surface roughness, recurrent caries | Assessed narratively: gingival/periodontal health (13 studies), parental satisfaction (8), color stability (9), crown retention (13), fracture resistance (11), marginal integrity (8), surface roughness (4), recurrent caries (4), crown contour (2). Meta-analyzed: crown retention and recurrent caries, each at 6 and 12 months |
| Study designs | Clinical, observational, and laboratory in vitro studies (no restriction on language or study type) | 36 studies: clinical, observational, and laboratory in vitro; 6 clinical trials contributed to the 4 meta-analyses |
| Timing | Not specified (no follow-up-time restriction) | Follow-up 1 week to 36 months; meta-analyses at 6 and 12 months |
Search date: Last search run 5 January 2022; no date or language restriction applied in the searches. Databases: Ovid, PubMed, Scopus, Web of Science
Questions and results
Prefabricated zirconia crowns (e.g., NuSmile, Zirkiz, Kinder Krown) vs Other crowns/restorations (stainless steel crowns, pre-veneered SSC, resin composite strip crowns, glass-fiber composite crowns)
Population: Children with primary (deciduous) teeth requiring full-coverage crown restoration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent caries (crowns free of recurrent caries) 6 months Recurrent caries did not differ between zirconia crowns and other restorations at 6 months (RR 1.00, 95% CI 0.97 to 1.03; 2 studies; not GRADE-rated). Source: Section 3.12 Meta-Analyses (Results); Figure 7A · same question in other reviews | RR 1.00 [0.97, 1.03] | 2 studies · 205 participants | Ungraded |
Crown retention 6 months Zirconia crowns showed no significant difference in crown retention versus other restorations at 6 months (RR 1.02, 95% CI 0.94 to 1.11; 3 studies; not GRADE-rated). Source: Section 3.12 Meta-Analyses (Results); Figure 6A · same question in other reviews | RR 1.02 [0.94, 1.11] | 3 studies · 201 participants | Ungraded |
Recurrent caries (crowns free of recurrent caries) 12 months Recurrent caries did not differ between zirconia crowns and other restorations at 12 months (RR 1.03, 95% CI 0.96 to 1.10; 2 studies; not GRADE-rated). Source: Section 3.12 Meta-Analyses (Results); Figure 7B · same question in other reviews | RR 1.03 [0.96, 1.10] | 2 studies · 203 participants | Ungraded |
Crown retention 12 months Zirconia crowns showed no significant difference in crown retention versus other restorations at 12 months (RR 1.00, 95% CI 0.94 to 1.05; 3 studies; not GRADE-rated). Source: Section 3.12 Meta-Analyses (Results); Figure 6B · same question in other reviews | RR 1.00 [0.94, 1.05] | 3 studies · 156 participants | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Partial Yes · NRSI: No | NRSI: No · RCT: Partial Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: No · RCT: Partial Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | No | no |
| 14Heterogeneity explained | Yes | No | no |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 61
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Alaki 2020 matched by author and year (probable) | 1 other review | not stated | not extracted yet | not extracted yet |
| Alaki et al. 2020 Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial. PMID:33167954 | 1 other review | Recurrent caries (crowns free of recurrent caries) | not extracted yet | not extracted yet |
| Al Shobber 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Al Shobber et al. 2017 Fracture resistance of different primary anterior esthetic crowns. PMID:29033529 | this review only | not stated | not extracted yet | not extracted yet |
| Alhaj 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Alhaj et al. 2019 In vitro comparison of marginal and internal fit between stainless steel crowns and esthetic crowns of primary molars using different… DOI:10.4103/1735-3327.270783 | this review only | not stated | not extracted yet | not extracted yet |
| Alhissan 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Alhissan et al. 2021 Factors Influencing the Survival of Preformed Zirconia Crowns in Children Treated under General Anesthesia. PMID:33833801 | this review only | not stated | not extracted yet | not extracted yet |
| Azab 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Azab et al. 2020 Influence of luting cement on the clinical outcomes of Zirconia pediatric crowns: A 3‐year split‐mouth randomized controlled trial DOI:10.1111/ipd.12607 | this review only | not stated | not extracted yet | not extracted yet |
| Donly et al. 2018 matched by author and year (probable) | this review only | Recurrent caries (crowns free of recurrent caries) | not extracted yet | not extracted yet |
| El Makawi 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| El Makawi et al. 2019 In Vitro Comparative Analysis of Fracture Resistance of Lithium Disilicate Endocrown and Prefabricated Zirconium Crown in Pulpotomized… PMID:32165959 | this review only | not stated | not extracted yet | not extracted yet |
| El Shahawy 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| El Shahawy et al. 2016 Successful Restoration of Severely Mutilated Primary Incisors Using a Novel Method to Retain Zirconia Crowns – Two Year Results DOI:10.17796/1053-4628-40.6.425 | this review only | not stated | not extracted yet | not extracted yet |
| Gill et al. 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Hanafi 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Hanafi et al. 2021 Evaluation and comparison two types of prefabricated zirconia crowns in mixed and primary dentition: A randomized clinical trial. PMID:33665422 | this review only | not stated | not extracted yet | not extracted yet |
| Holsinger et al. 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Jing et al. 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kessler 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kessler et al. 2020 Two-body wear and fracture behaviour of an experimental paediatric composite crown in comparison to zirconia and stainless steel crowns… DOI:10.1016/j.dental.2020.11.010 | this review only | not stated | not extracted yet | not extracted yet |
| Kist 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Kist et al. 2019 Fracture load and chewing simulation of zirconia and stainless‐steel crowns for primary molars DOI:10.1111/eos.12645 | this review only | not stated | not extracted yet | not extracted yet |
| Lin et al. 2021 Comparison of Fracture Strengths among different Commonly Placed Anterior Esthetic Restorations for Primary Dentition: An <i>in vitro</i>… DOI:10.17796/1053-4625-45.3.5 | this review only | not stated | not extracted yet | not extracted yet |
| Mathew 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Mathew et al. 2020 Evaluation of adhesion of Streptococcus mutans, plaque accumulation on zirconia and stainless steel crowns, and surrounding gingival… DOI:10.1007/s00784-020-03204-9 | this review only | not stated | not extracted yet | not extracted yet |
| Mathew et al. 2020 Evaluation of Clinical Success, Parental and Child Satisfaction of Stainless Steel Crowns and Zirconia Crowns in Primary Molars. PMID:32509626 | this review only | Crown retention | not extracted yet | not extracted yet |
| Mohn 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Mohn et al. 2021 Wear and marginal quality of aesthetic crowns for primary molars DOI:10.1111/ipd.12852 | this review only | not stated | not extracted yet | not extracted yet |
| Nischal 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Nischal et al. 2020 Clinical Comparison of Three Tooth-colored Full-coronal Restorations in Primary Maxillary Incisors. PMID:33976486 | this review only | not stated | not extracted yet | not extracted yet |
| Padmanabh 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Padmanabh et al. 2021 The effect of sterilization and disinfection on the physical-mechanical properties of preformed crowns DOI:10.4103/jisppd.jisppd_508_20 | this review only | not stated | not extracted yet | not extracted yet |
| Pani 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Pani et al. 2016 Esthetic Concerns and Acceptability of Treatment Modalities in Primary Teeth: A Comparison between Children and Their Parents. PMID:27446212 | this review only | not stated | not extracted yet | not extracted yet |
| Ravindran 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Ravindran et al. 2020 Prevalence of usage of stainless steel crown, strip crown and zirconia in anterior teeth for paediatric dental patients in different age… DOI:10.26452/ijrps.v11ispl3.3468 | this review only | not stated | not extracted yet | not extracted yet |
| Ravindran et al. 2020 Use of stainless steel crowns and zirconia crowns in posterior primary teeth for children in different age groups DOI:10.26452/ijrps.v11ispl3.3473 | this review only | not stated | not extracted yet | not extracted yet |
| Sabbah 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sabbah et al. 2020 Fracture Resistance of Primary Molars Restored with Endocrowns Versus Zirconia Crowns (An in Vitro Study) DOI:10.14295/bds.2021.v24i4.2626 | this review only | not stated | not extracted yet | not extracted yet |
| Salami 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Salami et al. 2015 Comparison of Parental Satisfaction with Three Tooth-Colored Full-Coronal Restorations in Primary Maxillary Incisors DOI:10.17796/1053-4628-39.5.423 | this review only | not stated | not extracted yet | not extracted yet |
| Sharma 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Sharma et al. 2021 Evaluation and comparison of strip crowns and primary anterior zirconia crowns in 3–5 years old children at one year DOI:10.1016/j.pdj.2021.02.001 | this review only | not stated | not extracted yet | not extracted yet |
| Talekar et al. 2021 matched by author and year (probable) | this review only | Crown retention | not extracted yet | not extracted yet |
| Taran et al. 2018 matched by author and year (probable) | this review only | Crown retention | not extracted yet | not extracted yet |
| Theriot et al. 2017 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Townsend 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Townsend et al. 2014 Scientific article DOI:10.1016/0090-4295(93)90520-k | this review only | not stated | not extracted yet | not extracted yet |
| Vaishali 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Vaishali et al. 2019 Possible role of dopamine-beta-hydroxylase in the regulation of norepinephrine biosynthesis in rat brain. PMID:201940 | this review only | not stated | not extracted yet | not extracted yet |
| Walia 2019 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Walia 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Walia et al. 2014 matched by author and year (probable) | this review only | Crown retention | not extracted yet | not extracted yet |
| Walia et al. 2019 Comparative evaluation of surface roughness of posterior primary zirconia crowns DOI:10.1007/s40368-018-0382-4 | this review only | not stated | not extracted yet | not extracted yet |
| Walia et al. 2021 Retention Force of Glass Ionomer Based Luting Cements with Posterior Primary Zirconium Crowns – A Comparative <i>in Vitro</i> Study DOI:10.17796/1053-4625-45.4.7 | this review only | not stated | not extracted yet | not extracted yet |
| Yanover 2020 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Yanover 2021 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Yanover et al. 2020 Zirconia crown performance in primary maxillary anterior teeth: a retrospective photographic and radiographic cohort study DOI:10.1007/s40368-020-00571-5 | this review only | not stated | not extracted yet | not extracted yet |
| Yanover et al. 2021 Parental and Dentist Satisfaction with Primary Anterior Zirconia Crowns: A Case Series Analysis. PMID:34073572 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp therapy: a systematic review. (2022) | 2 | 0.02 |