Zirconia crown performance in primary maxillary anterior teeth: a retrospective photographic and radiographic cohort study

Purpose: This retrospective cohort observational study evaluated marginal integrity, gingival health and aesthetics of zirconia crowns (ZC) placed on primary maxillary anterior teeth at 6- to over 30-month follow-up visits. Methods: Two independent raters evaluated radiographic and photographic findings in 131 ZC placed in 36 children aged 24.8–62.2 months (median = 40.6) who had at least one recall visit 6 months after placement. Follow-up periods were stratified into three levels: long, intermediate and short. Associations between crown performance and crown brands, follow-up periods, treatment performed under general anaesthesia or sedation and previous pulpotomy were investigated by ordinal logistic regression. Results: Follow-up ranged from 6 to 33.8 months (average: 13.5 months). Marginal integrity was highly rated in 82.4% of the teeth. No gingivitis was found in 35% of the teeth, 58% showed mild gingivitis and 7% showed moderate gingivitis (p = 0.06). Colour match and crown contour were rated very high in 55% of the cases. Marginal integrity and periodontal health differed between cases performed under general anaesthesia and those performed under sedation (p = 0.03 and p = 0.003, respectively). Pulpotomized teeth showed worse colour matching with the adjacent teeth than non-pulpotomized teeth (p = 0.03). Conclusions: Our findings suggest that ZC comprise a satisfactory treatment option for carious primary maxillary incisors, presenting good overall marginal integrity, gingival health, and aesthetics.