Periodontal health at first permanent molars adjacent to primary molar stainless steel crowns Guelmann M, Matsson L and Bimstein E: Periodontal health at first permanent molars adjacent lo primary molar stainless steel crowns. J Ctin Periodontol 1988: 15: 531-533. Abstract. The present investigation was designed to study the effect of stainless steel crowns (SSC), placed on second primary molars, on the periodontal tissues of neighbouring first pennanent molars. 36 children (9-12 years old) with an SSC on a second primary molar on one side of the mouth only, were selected for the study. A clinical and radiographic examination was performed at the mesial surface of the first permanent molar, adjacent to the SSC, and at the corresponding area on the contraiateral side of the mouth. The ciinicai examination included gingival and plaque index scores and probing depth measurements. In the radiographic examination, the marginal bone level was assessed. No statistically significant differences in plaque index scores, gingival index scores and probing pocket depth were noted between the mesial surface of first permanent molars and the contraiateral control area. Nor were any significant differences in bone level seen. The present findings suggest that the presence of a well-adapted SSC on a second permanent molar does not affect the periodontal health of the neighbouring first permanent molar.
The Stainless steel crown (SSC). manufactured as a metal shell with the preformed anatomy of the occiusal surface, is mostly used for the semi-permanent restoration of badly decayed primary teeth. Its retention is based on margins that extend beyond the prepared portion of the tooth, adapted to the individual tooth by being trimmed, contoured and crimped (Mink & Bennet 1968, USDOHEW 1977), The adaptation of the SSC is limited and its possible deleterious effect on the surrounding gingival tissues of the tooth has been the subject of several studies (Webber 1974, Myers 1975. Sarafanov 1979, Ashraphi et a l 1981. Machen et al, 1981), Most of these investigations detected an increase in gingival irritation associated with SSC (Meyrs 1975, Sarafanov 1979, Ashraphi et al. 1981. Machen et al. 1981). This finding, and the fact that the mesial surface of the first permanent molars has been identified as a "risk area" for the early development of periodontal disease (Hugoson et al. 1981, Gjermo et al. 1984). led
to the hypothesis that an SSC placed ona second primary molar may have a deleterious effect on the mesial periodontal tissues of the first pennanent molar. The purpose of the present study was therefore to describe the effect of a second primary molar SSC on the periodontal tissues of the mesial surface of the first permanent molars.
Material and Methods The dental records of 280 children, aged 9-12 years, from a mixed socio-economic suburb of .Jerusalem, who received dental treatment at the Haddassah Health Community Center, were reviewed for cases in which an SSC had been applied to a second primary molar on one side of the mouth only. 40 cases were found that fulfilled these criteria. Of these, 36 (15 boys and 21 girls), in which the SSC and its contraiateral control tooth were still present in the mouth, were examined. Each child
Marcio Guelmann', Lars Matston' and Enrique Bimstein' 'Department ot Pediatric Dentistry, Haddassati Faculty of Dental Medicine, Hebrew University In Jerusalem, Israel, and 'Department ol Pedodontics, University of Umea, Sweden
UBRARY
Key words: periodontal disease steel crowns; pedodontics. Accepted for publication 28 November 1987
contrib uted with one SSC and one control tooth. The length of time that the SSC had been in the mouth was recorded. The age of the patients selected was chosen to represent the end stage of the functional period of the primary molars, A clinica] and radiographic examination was performed of the area at the mesial surface of the first permanent molar adjacent to the primary molar with an SSC and at the corresponding area on the contraiateral side of the mouth. All examinations were performed by one of the authors (MG). In each child, two bite-wing radiographs (Kodak Ultra Speed D) were taken using an X-ray unit equipped with a long cone (Philips Oralix CHF). The central ray was directed at the mesial surface of the first permanent molars. The radiographs were also used for diagnosis of caries disease and appointments for treatment were given to children who required treatment. The clinical examination included: (i) gingival index and plaque index scores