78 - Clinical Success of Anterior Strip Crowns: A Retrospective Study

Purpose: The purpose of this retrospective cohort study was to evaluate the clinical success of anterior strip crowns placed on primary maxillary anterior teeth affected by early childhood caries and to assess associations between treatment outcomes and provider experience, isolation technique, restorative material, treatment modality, and patient behavior.

Methods: This retrospective cohort study reviewed electronic dental records from Montefiore Pediatric Dentistry clinics for patients who received anterior strip crowns (D2335) between June and December 2023 and had a 12 months of follow-up. Clinical success was defined as the treated tooth remaining asymptomatic and functional, without clinical or radiographic pathology until exfoliation or the end of the observation period. Failure was defined as caries progression requiring retreatment or extraction due to caries, pulpal symptoms, abscess, or fistula. Independent variables included provider experience level (PGY-1 vs PGY-2), isolation technique (cotton roll, DryShield, or rubber dam), restorative material (packable composite, flowable composite, or resin-modified glass ionomer), treatment modality (chairside, operating room, or oral minimal/moderate sedation), and patient behavior assessed using Frankl behavioral ratings. Descriptive and comparative statistical analyses will be performed, with adjustment for within-patient clustering.

Results:
A total of 47 anterior strip crowns with ≥12-month follow-up were evaluated. The overall clinical success rate was 23.4% (11/47), with a failure rate of 76.6% (36/47). Higher success rates were observed among PGY-2 providers (50.0%) compared to PGY-1 providers (15.8%), and with DryShield isolation (50.0%) compared to cotton roll isolation (20.5%). Most restorations were completed using cotton roll isolation and resin-modified glass ionomer, which demonstrated a success rate of 24.4%. Procedures performed in the clinic showed higher success rates than those completed in the operating room. Due to the limited sample size, statistical comparisons were not performed.

Conclusion: Anterior strip crowns demonstrated a low overall success rate in this study, reflecting the challenges of restoring primary maxillary incisors in young pediatric patients. Outcomes appeared to improve with increased provider experience and enhanced isolation techniques, emphasizing the technique-sensitive nature of these restorations. These findings highlight the importance of careful case selection and optimal clinical conditions. Further prospective studies with larger sample sizes are needed to better evaluate factors influencing success.