What German dentists choose for their teeth: A Web-based survey of molar restorations and their longevity

Statement of problemWhich restorative material is best suited for treating the posterior molar region is unclear. As dentists presumably choose the most appropriate restoration, German dentists were asked how their own molars were treated.PurposeThe purpose of this survey study was to examine molar restorations and their durability in German dentists.Material and methodsIn the official journal of the Federal Dental Association, German dentists were asked to participate in an online survey that gathered demographic data and information on the type and durability of their molar restorations. To reduce selection bias, the data were weighted for region, sex, and age of the dentist.ResultsThe data set consisted of 1719 molars from 288 dentists. Restorations included gold inlays (25%), composite resin (24.3%), amalgam (11.8%), ceramic inlays (5.4%), glass ionomer cement or compomer (0.8%), gold crowns (21.8%), ceramic crowns (6.6%), and metal-ceramic crowns (4.3%). Notable differences were identified based on the sex, age, and region of the dentist. Women selected increased esthetic options, as did young dentists. Restorations made of gold, amalgam, and base metal had the highest longevity, at more than 20 yearsConclusionsAmong German dentists, restorations with metallic materials dominated in molars, with gold accounting for the largest share. In recent years, the proportion of tooth-colored restorations has increased, and in particular, young dentists use composite resin and ceramics.     

Interazione fra amalgama e altri metalli presenti nel cavo orale: caso clinico

ObjectivesThe aim of this study is to demonstrate, through literature review and presentation of an exemplified clinical case, the possibility of treatment of oral mucosal lesions associated with amalgam restorations.Materials and methodsThe clinical case of a patient is reported, who presented with lesions in the lateral borders of the tongue which were erythematous, bilateral and painful on palpation, and with other non-painful lesions in the posterior cheek region. On oral cavity examination, amalgam restorations in several permanent teeth and crowns in gold alloy and ceramic were found. Mucosal lesions affected areas in direct contact with amalgam restorations. The selected treatment consisted of replacing all amalgam fillings with last generation composites.ResultsOne month after the end of amalgam replacement therapies, the patient reported the total disappearance of painful symptoms. At the clinical control two months after treatment, the total disappearance of the lesions was observed.ConclusionsThe removal of amalgams from the oral cavity may represent a first successful therapeutic approach in patients with chronic oral mucosal lesions, especially if located in direct contact with the amalgams. In addition to possible toxico-allergic reactions to amalgams, it should be noted that the simultaneous presence of different types of metal restorations (often amalgam and crowns in gold alloy) may result in the formation of a high electric potential difference that can cause symptoms and lesions in the oral mucosa.     

Clinical survey on type of restoration in deciduous teeth

This study was conducted in 533 children with 1,634 treated teeth who visited the Pediatric Dentistry Department at the Chiba Hospital of Tokyo Dental College between January and December, 2003. Restorations on deciduous tooth were categorized by age of patient and tooth type. The following observations were made: Children aged 4 (17.9%) visited the clinic most frequently and this group had the highest number of deciduous restorations (21.3%). Among the 1,634 deciduous teeth restored, metal inlays were provided in 29.4% of total teeth restored, composite resin restorations in 27.2%, stainless-steel crowns in 25.7%, composite resin full crowns in 7.7%, glass-ionomer cement restorations in 6.6%, and amalgam restorations in 3.4%. By age, composite resin was most frequently used in children aged 1 to 3. In children aged 5 to 9, metal inlay was most frequently used. Those aged 4 received mostly stainless-steel crowns. Composite resin restorations were used mostly in anterior deciduous teeth, and metal inlays mostly in deciduous molars. Previous research indicated an increasing trend towards composite resin restorations and composite resin full crowns. The present study also confirmed such a trend. While the use of metal inlays and stainless-steel crowns tended to increase until 1987, the present study indicated a trend to decrease.     

Statistical analysis of fabrication of indirect single restorations]

A statistical survey based on laboratory records was performed on the number of indirect restorations fabricated at the dental hospital of Tokyo Medical and Dental University from April 1 to September 30, 1997. A comparison was also carried out with a previous survey, which had been carried out in 1986, in order to detect any change and possible alterations in the near future. Based on the results of this statistical survey, the conclusions were as follows: 1. A total of 9,126 indirect restorations were fabricated during the six month period in 1997; among them, 8,007 (87.7%) restorations were covered by health insurance and 1,119 (12.3%) restorations were not. 2. The most common restoration was the cast post and core (28.6%), followed by full crowns (18.5%) and removable partial dentures (15.6%). On the other hand, the least number were post crowns (0.03%) and resin jacket crowns (0.2%). 3. When making a comparison with the data in 1986, an increase in the number of removable partial dentures and a decrease in the number of inlays were the most distinctive features. 4. For anterior teeth, resin-veneered crowns were most common, especially for lower teeth. The percentage of restorations, which were not covered by health insurance, decreased from 45.0% (in 1986) to 12.3% (in 1997).     

Wear of resin denture teeth in partial removable dental prostheses

PurposeTo investigate occlusal wear of resin denture teeth in partial removable dental prostheses worn by partially edentulous patients.MethodsThirty patients with partial removable dental prostheses were included in the study. Thirty-two patients with complete dentures served as a reference group. Occlusal wear after two years was evaluated indirectly using gypsum casts and a three-dimensional laser-scanner device. Overall wear of complete occlusal surfaces and maximum wear of occlusal contact areas were measured. Patient and prosthesis data were analyzed using univariate and multiple linear mixed models.ResultsOverall wear of denture teeth in partial removable dental prostheses was 91 (SD 85) μm, and maximum wear of occlusal contact areas was 329 (SD 204) μm (means and standard deviations). Average and maximum wear values for teeth in complete dentures were both lower than those for teeth in partial removable dental prostheses. However, differences between wear of different types of denture did not reach statistical significance after adjustment for gender, type of tooth, dental status of the opposing jaw, and antagonist material. Statistical analysis revealed that wear was greater for denture teeth occluding with ceramic crowns and/or fixed partial dentures as antagonists.ConclusionsResin denture teeth in partial removable and complete dental prostheses are subjected to clinically important occlusal wear that might destabilize occlusion and cause further problems. Patient-related factors and dental status affect wear behavior and should be taken into consideration when treating patients with removable dentures.     

Effect of Repairing Endodontic Access Cavities on Survival of Single Crowns and Retainer Restorations

IntroductionThis retrospective study aimed to analyze the effect of repairing endodontic access cavities with composite on the survival of single crowns and retainer restorations of fixed or removable dental prostheses.MethodsDental records of patients attending a university dental clinic were retrospectively screened for single crowns and retainer restorations receiving endodontic treatment after crown placement. Survival (no further intervention) and failure (removal, loss or replacement of crown, replacement of access restoration, or recementation of restoration) of crowns and retainers with repaired endodontic access cavities were recorded. The mean annual failure rates were calculated, and the effect of individual-, tooth-, and restoration-related variables on survival was assessed by univariate log-rank tests and multivariate Cox regression analyses with shared frailty (P < .05).ResultsOne hundred eighty repaired crowns/retainers placed in 151 patients were included (4.5 ± 3.3 years follow-up). Survival after 2, 5, 7, and 10 years amounted to 82.7%, 71.5%, 67.3%, and 48.8% (mean annual failure rate = 9.0%, 6.5%, 5.5%, and 6.9%), respectively. Although tooth type, kind of restoration, endodontic irrigant, repair conditioning methods, and kind of composite affected survival in the univariate regression analyses, only the kind of restoration (single crown vs retainer restoration) remained significant in the multivariate Cox regression model.ConclusionsRepairing endodontic access cavities with composite increases the longevity of single crowns and retainer restorations.     

Amalgam--Resurrection and redemption. Part 1: the clinical and legal mythology of anti-amalgam.

Dental amalgam has come under attack for its allegedly poor physical properties and clinical performance in addition to its poor appearance. It has been claimed that the American Dental Association has a hidden agenda to protect amalgam and that other countries have banned its use. A literature search revealed that the vast majority of amalgam restorations do not cause fractured cusps or have recurrent caries. Most amalgam restorations have been shown to last longer than resin composite restorations. In addition, the materials and techniques involved in amalgam restorations have vastly improved in recent years. Like resin composite restorations, amalgam restorations can often be repaired. The American Dental Association has no vested interest in protecting amalgam. The use of amalgam has not been banned in any country in the European Union. According to the latest scientific information available, dental amalgam is a remarkably durable and long-lasting restorative material. Although its appearance is unesthetic, its clinical performance and effectiveness are unsurpassed by those of resin composite.     

Long-term evaluation of extensive restorations in permanent teeth

OBJECTIVES: The present prospective, longitudinal study assessed the outcome of posterior extensive restorations and identified risk factors for failure of the restorations. MATERIALS AND METHODS: The sample consisted of 722 amalgam restorations, 115 composite resin restorations and 89 crowns placed in 428 adults by one dentist from 1982 to 1999 in Belgium. Well-defined criteria were used for cavity preparation design, type of retention and selection of restorative material. RESULTS: At the closure of the study 48% of the restorations were well functioning, 24% were lost to lack of follow-up, and 28% had failed. The most frequent reasons for failure were fracture of restoration (8%), secondary caries (6%) and fracture of cusp (5%). Failures were more often found in premolar teeth (34%) than in molars (27%) (P=0.05) and occurred in 28% of the amalgam restorations, 30% of the resin restorations and 24% of the crowns (P=0.55). Molar restorations were more frequently repaired than replaced in contrast to premolar restorations. The highest percentage of extractions was related to complete amalgam restorations in premolars. The Kaplan-Meier median survival times were 12.8 years for amalgam restorations, 7.8 years for resin restorations, and more than 14.6 years for crowns, considering all retreatment as failures (P=0.002). The survival was influenced by extension of restoration, age of patient, pulpal vitality, 3-year period of treatment, use of base material and dentinal retentive pins. CONCLUSION: Within the limits of the study the data support the view that extensive amalgam restorations but not composite resin restorations can be used as an appropriate alternative to crowns, with due consideration to the longevity of the restorations.     

Clinical outcome of glass-fiber-reinforced crowns and fixed partial dentures: a three-year retrospective study.

OBJECTIVE: Glass-fiber-reinforced resin composites for the fabrication of esthetic single crowns and fixed partial dentures have been developed recently. However, little data on the clinical outcome of such restorations have been published. The purpose of this retrospective study was to evaluate the clinical outcome of crowns and fixed partial dentures made from the glass-fiber-reinforced resin composite material Targis/Vectris. METHOD AND MATERIALS: Between 1995 and 1997, 39 patients were treated with 67 single crowns and 83 fixed partial dentures. Twenty-five crowns and 28 fixed partial dentures were cemented with temporary cement, while 42 crowns and 55 fixed partial dentures were cemented with either zinc-phosphate cement or glass-ionomer cement. RESULTS: In September 2001, 57 restorations in 17 patients were still in function. The three-year survival rate calculated according to the Kaplan-Meier method was 58.8% for all restorations. However, after this time, it was 37.5% for crowns and 59.9% for fixed partial dentures cemented with temporary cement, and 55.1% for crowns and 67.9% for fixed partial dentures cemented with zinc phosphate or glass ionomer. The differences between the restoration groups were not statistically significant. CONCLUSION: Glass-fiber-reinforced crowns and fixed partial dentures made with the glass-fiber-reinforced resin composite material Targis/Vectris showed a lower survival rate than that published for metal-ceramic crowns and fixed partial dentures. Therefore, the use of this material for the fabrication of single crowns or fixed partial dentures as permanent restorations cannot be recommended.     

Defective restoration repair or replacement: An American Dental Association Clinical Evaluators Panel survey

BackgroundClinicians often encounter defective restorations and are faced with the difficult decision of whether to repair the existing restoration or replace it.MethodsAn electronic survey on repairing or replacing defective restorations was developed to assess how clinicians are making these decisions and the technical aspects considered when making a repair. E-mails containing the survey link were sent to the American Dental Association Clinical Evaluators (ACE) Panel on August 14, 2019, and the survey remained open for 2 weeks. Nonrespondents were sent reminders 1 week after deployment.ResultsApproximately 4 of every 5 respondents repair defective restorations. The top 3 conditions for making these repairs were noncarious marginal defects (87%), partial loss or fracture of the restoration (79%), and crown margin repair due to carious lesions (73%). Among respondents who repair defective restorations, almost all repair direct resin composite (98%), whereas approximately one-third do not repair the other restorative materials (that is, amalgam, glass ionomer, and fractured indirect all-ceramic crowns). Resin composite is used most often to repair resin direct composite restorations, and likewise, glass ionomer is used most often to repair glass ionomer restorations. Only 54% of respondents use amalgam to repair amalgam restorations. Surface treatments varied among the 3 available restorations types.ConclusionsMany dentists are actively making restoration repairs, but choosing clinical scenarios to make these repairs is material dependent.Practical ImplicationsThe repair of defective restorations is an acceptable and more conservative alternative than restoration replacement, and its success depends on proper case selection, material, and technique.     

Risk indicators of edentulism, partial tooth loss and prosthetic status among black and white middle-aged and older adults

OBJECTIVES: To describe the prevalence and risk indicators of edentulism; to describe the frequencies of wearing removable dentures; to describe the prevalence and risk indicators of fixed prosthetic restorations; to test the hypothesis that fixed prosthetic restorations are most likely to have been placed in persons at lower risk for dental and periodontal diseases, and to test the hypothesis that, with dental disease, dental behaviors, dental attitudes and ability to afford crowns taken into account, blacks are less likely than whites to have received crowns. METHODS: The Florida Dental Care Study is a cohort study of subjects 45 years old or older. A telephone screening interview was done as a first stage to identify 5254 subjects who met eligibility requirements and who self-reported whether they were edentulous. In a second stage, a subsample of dentate subjects was contacted after they completed their telephone screening interview. Of these, 873 subjects completed a baseline in-person interview and dental examination. RESULTS: A total of 19% of first-stage subjects were edentulous. In a single multiple logistic regression, having a poorer self-rated level of general health was significantly associated with edentulism, as were being poor, older and white. Among the second-stage participants (all of whom were dentate), several prosthetic patterns were observed. For example, a total of 64% of maxillary full denture wearers reported wearing their denture all the time. Participants had also received numerous fixed prosthodontic services. The proportion of subjects with at least one crown varied widely by subject characteristics. CONCLUSIONS: A substantial percentage of non-ideal frequencies of wearing removable prostheses was reported, as were prosthesis-related soreness and broken prostheses. Although we expected and observed an association between having a fixed prosthetic crown and periodontal status, dental fillings, dental attitudes and financial resources, a residual association with race suggests that blacks are much less likely to receive prosthetic crowns. The several possible reasons for this circumstance warrant further investigation.     

Periapical Status of Non–root-filled Teeth with Resin Composite,Amalgam, or Full Crown Restorations: A Cross-sectional Study of a Swedish Adult Population

Introduction

Experimental studies show that dental pulp cells respond unfavorably to contact with resin composite restorative material. Hypothetically, in a random population, the frequency of apical periodontitis should be higher for teeth restored with resin composite than with amalgam. Therefore, the aim was to compare the periapical status of non–root-filled teeth restored with resin composite, amalgam, or laboratory-fabricated crowns in an adult Swedish population.

Methods

The subjects comprised 440 individuals from a randomly selected sample of 1,000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all non–root-filled teeth by clinical examination and intraoral clinical photographs. Periapical status was evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed using the chi-square test and logistic regression analysis.

Results

There was no significant difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite or amalgam (1.3% and 1.1%, respectively). The frequency of AP for teeth restored with laboratory-fabricated crowns was significantly higher (6.3%). Regression analysis showed no association between AP and resin composite restorations but a significant association with laboratory-fabricated crowns.

Conclusions

The results indicate that the risk of damage to the pulp-dentin complex from exposure to resin composite material and dentin bonding agents shown in experimental studies is not reflected in the clinical setting. However, in the study sample, AP was diagnosed in a significantly higher proportion of teeth restored with laboratory-fabricated crowns.     

Oral mucosal lesions related to silver amalgam restorations

A total of 49 consecutive patients with lesions of the oral mucosa that were in contact with corroding dental amalgam restorations were subdivided into two groups. In group 1 the lesions were restricted to the contact area opposing the dental restoration, whereas the extent of the lesions in group 2 exceeded that of the contact area. Epicutaneous test for mercury allergy showed that a significantly greater proportion of the patients in group 1 had positive reactions to mercury than in group 2 (p = 0.019). The amalgam restorations were replaced by composite resin or porcelain fused to gold crowns, or contact between amalgam fillings and oral mucosa was prevented by an acrylic splint. After this treatment regression of lesions was far more pronounced in group 1 than in group 2 (p less than 0.001). On the basis of these findings, contact allergy to mercury is suggested as a possible etiologic factor of the mucosal changes in group 1, and the designation contact lesion is proposed for such lesions. The lesions of patients in group 2 seem unrelated to a contact allergy to mercury, and other causes such as lichen planus should be considered.     

Quality of extensive fixed prosthodontics after five years

A group of 150 patients who had received extensive restorative treatment 5 years prior to this study was selected at random from the Swedish Dental Insurance System records in Malmo. Of the 133 respondents to a questionnaire, 109 participated in a clinical evaluation of 891 restorations including 498 crowns, 232 pontics, 6 removable partial dentures, and 155 adjacent or opposing metallic restorations. The clinical evaluation was performed by two trained examiners by means of the CDA quality evaluation for dental care. Ninety percent of the crowns and pontics, 80% of the adjacent or opposing metallic restorations, and all six partial dentures were rated satisfactory. Twenty-three percent of the crowns, 49% of the pontics, 17% of the adjacent or opposing restorations, and half the partial dentures rated in the range of excellence. Not acceptable ratings for crowns included 3.4% T ratings and 6.6% V ratings. For pontics, the corresponding percents were 9.5% and 0.4%, respectively. T ratings were in most cases indicative of overcontouring, whereas V ratings for crowns were usually given because of secondary caries. Marginal periodontitis was mainly associated with not acceptable ratings but was also observed in connection with satisfactory restorations. Only 2% of the restorations had been lost during the 5-year period after insertion.     

北京口腔医院技工中心11年修复体加工情况的统计分析

目的客观评估不同种类修复体的应用情况,为临床应用、资源优化配置和科研课题选择等提供参考信息。方法收集首都医科大学附属北京口腔医院技工中心2002-2012年的工作月报和制作数据,以299953件修复体为研究对象,统计冠桥固定修复体、种植固定修复体、可摘局部义齿、全口义齿等主要修复体类别的数量,分析发展趋势。结果活动类修复体构成比呈逐年下降趋势,固定类修复体逐年成为主要修复类型。全口义齿与胶连活动义齿缓慢减少,4种铸造支架活动义齿均增长。贵金属烤瓷固定义齿的制作量增长速率较快,种植体固定修复体一直呈稳定增长趋势,全瓷固定修复体制作量自开展后加速增长。贵金属全冠修复体制作量呈整体增长,成为铸造全冠修复体主要材料类型,而普通钴铬全冠修复体制作量则持续缓慢降低。结论固定类修复体占主导地位,活动类修复体逐年降低,各种材料修复体均有不同程度的起伏,但都有各自的临床需求,其中贵金属、全瓷、种植类需求量增长最为明显,预示未来修复体发展的方向。     

Treatment options for large posterior restorations: a systematic review and network meta-analysis

BackgroundThe best treatment option for large caries in permanent posterior teeth is still a matter of uncertainty in dental literature. The authors conducted a network meta-analysis to address the challenges related to rehabilitation of these teeth.Types of Studies ReviewedThe authors selected prospective and retrospective studies that compared at least 2 different treatment alternatives for permanent teeth with a minimum of 5 years of follow-up. The authors searched databases from MEDLINE, Scopus, Cochrane Library, and Web of Science in October 2019 without language or year of publication restrictions.ResultsFrom 11,263 studies identified, 43 studies fulfilled the eligibility criteria and were included in the final review. Only 13 studies were randomized controlled trials and were classified as low risk of bias. Gold (annual failure rate of 0.29%) and metal ceramic (annual failure rate of 0.52%) crowns performed better for indirect restorations and direct resin composite performed better for direct restorations (annual failure rate of 2.19%). The most substantial comparisons were between feldspathic and glass ceramics, followed by direct resin composite and amalgam; there were no statistically significant differences between these interventions. Results of the pairwise meta-analysis showed mainly glass ionomer as significantly more prone to failure than amalgam and direct composite resin.Conclusions and Practical ImplicationsReference standard direct and indirect materials except for glass ionomer can be used for restorations of large posterior caries.     

Clinical evaluation of reasons for replacement of amalgam vs composite posterior restorations

BackgroundThe aim of the present study is to evaluate the most common reasons for replacing posterior amalgam and resin composite restorations in patients attending the university dental restorative clinics.MethodsA total of 318 restorations which needed to be replaced were clinically and radiographically evaluated in a period of nine months. The frequencies of reasons for replacing posterior amalgam and resin composite restorations were calculated; secondary caries, restoration/tooth fracture, marginal discoloration/ditching, proximal overhang/open margin, loss of anatomy, pain/sensitivity, and esthetics.ResultsThe sample population comprised of 191 females and 106 males. The majority of the sample population fell in the age group of 40–50 years (n = 110). 318 restorations (n = 318) were examined in this study. 82% of examined teeth were restored with amalgam (n = 261), while posterior composite restorations comprised 18% of the examined teeth (n = 57). Among all restorations demanded to be replaced by the patients (n = 318), aesthetic need was the most common reason (n = 98), followed by Ditching or discoloration (n = 64), secondary caries (n = 57), and fracture (n = 44). Loss of anatomy was the least common cause to replace both amalgam and resin composite restorations (n = 5). The different reasons of failure were all significant between amalgam and resin composite restorations as shown in (Fig. 1) (p < 0.005). The most common reason for amalgam replacement was aesthetic. The most common reason for composite replacement was secondary caries and marginal ditching.ConclusionBoth amalgam and composite had different reasons for replacement. Amalgam had lesser risk of developing secondary caries and higher longevity than composite.     

In vitro dentin demineralization inhibition effects of an experimental fluoridated HEMA and water wetting agent

The ability of fluoride-releasing resins to inhibit dentin demineralization remains controversial. The purpose of this study was to evaluate the caries inhibition of resin composite restorations with an experimental fluoridated hydroxyethyl methyl methacrylate (HEMA) and water wetting agent. Standardized Class V preparations were placed in 40 molars, the gingival margin placed below the cementoenamel junction. Two dentin primers (sodium fluoride, HEMA and water; HEMA and water) were placed in equal numbers of 20 preparations, then One-Step Dental Adhesive (Bisco) was applied as recommended by the manufacturer, followed by the placement of a resin composite restoration. Amalgam restorations with no primer/adhesive were placed in 10 preparations and 10 preparations were restored by placing One-Step Dental Adhesive, then resin composite. All teeth were subjected to an artificial caries challenge (pH 4.4) for 5 days. Results demonstrated the mean areas (microm2 +/- s.d.) of demineralization 100 microm from the restoration/dentin margin to be: amalgam 5,570 +/- 873; One-Step 7,038 +/- 2,099; HEMA and water 6,126 +/- 634; fluoridated HEMA and water 3,411 +/-593. ANOVA and Duncan's test (P < 0.05) demonstrated the fluoridated HEMA and water wetting agent to have significantly less adjacent dentin demineralization than the other three groups. Eighty percent of HEMA and water wetting agent, 80% of One-Step Dental Adhesive and 100% of amalgam restorations demonstrated wall lesions. One hundred percent of restorations with fluoridated HEMA and water wetting agent demonstrated inhibition zones in adjacent dentin.     

Composite resins to restore mutilated teeth

This technique has been used successfully in over 300 restorations, with few problems. It is not the purpose of this paper to advocate the use of composite resin restorations in place of amalgam. In this technique, the composite resin is covered with either gold, porcelain-on-gold, or porcelain crowns. All the teeth had bases placed in them which protected the pulpal tissue. As a result of the easy manipulation of composite resin, our “resurrection cases” are made much simpler and the results are satisfying.     

Stainless steel crowns as a restoration for permanent posterior teeth in people with special needs: A retrospective study

BackgroundLimited information exists regarding the use of stainless steel crowns (SSCs) in permanent teeth. The objective of this retrospective cohort study was to present the long-term clinical outcomes of the SSC compared with those of amalgam and composite resin restorations and the SSC radiographic outcomes in a special-needs population.MethodsThis study included 271 patients with at least 1 SSC restoration from the Mount Sinai Hospital Dentistry Clinic for Persons with Special Needs in Toronto, Ontario, Canada. A total of 2,621 posterior permanent tooth restorations were documented: 766 SSCs, 1,651 amalgam restorations, and 204 composite resin restorations. Clinical analysis included patient demographics, treatment parameters, and outcome assessments for each restoration recorded. Radiographic analysis of SSC restorations included 127 bite-wing radiographs and 118 periapical radiographs, measurement of interproximal bone loss, and assessment of periapical status using the Periapical Index Scale.ResultsThe 10-year survival rates for new SSC and amalgam restorations were 79.2% and 63.5%, respectively. The 91 SSC failures included 2 recementations, 33 replacements, and 56 extractions. Primary diagnoses at the time of failure included chronic periodontal disease (25) and loose or lost SSCs (24). Of the 528 failed conventional restorations that were replaced, 60% were replaced with SSCs. The mean alveolar bone loss from mesial and distal sites was 1.36 millimeters and 1.40 mm, respectively. Therefore, 93% of the sites recorded were less than 2 mm and classified as healthy. All pre-SCC and post-SSC periapical radiographs had healthy Periapical Index Scale scores (1 or 2) recorded over an average duration of 8.4 years (1-29.1 years).ConclusionsSSCs are a durable treatment option for the restoration of the posterior permanent dentition.Practical ImplicationsPosterior permanent teeth restored with stainless steel crowns can be expected to last for 10 years and represent a viable treatment choice for severely carious or fractured posterior permanent teeth.