Aesthetic Crowns for Primary Anterior Teeth: A Scoping Review

There is a lack of studies comparing outcomes among various aesthetic crowns specifically for primary anterior teeth. To address this, this scoping review evaluates restoration-, tooth-, patient- and operator-related outcomes associated with aesthetic crowns. A search was conducted across four electronic databases and grey literature. Fifty-two in vitro and clinical studies (with a minimum 6-month follow-up) published from 2010 onwards were identified. Data extraction and narrative synthesis of in vitro findings, clinical success, restoration failures, periodontal, pulpal, periapical and aesthetic outcomes were performed. The success rates at 12 months were as follows: zirconia crown (ZC) >80% ( n = 6), composite resin strip crowns (CRSCs) ≤61.7% ( n = 4), pre-veneered stainless steel crowns (PVSSCs) approximately 85% ( n = 2), Figaro crowns 66.7% ( n = 1) and Pedo Jacket crowns 73.6% ( n = 1). Common reported failure modes included crown dislodgement for ZC; material fracture, secondary caries and marginal discrepancy for CRSC and poor seating and material fracture for PVSSC. ZC had better plaque and gingival outcomes than CRSC and PVSSC at 6-month follow-up. The assessment methods for aesthetics varied across studies. Secondary outcomes reported include restoration and opposing tooth wear, cost-effectiveness, post-operative discomfort and oral health-related quality of life. Common issues among the included studies were heterogeneity in defining, evaluating and reporting of outcomes. Based on the findings, suggestions were made regarding shade matching of aesthetic crowns, crown preparation, luting cement and post-treatment oral hygiene education. Furthermore, the authors advocate for standardised assessment methods for tooth, restoration and aesthetic outcomes. An Anterior–Posterior Aesthetic Crown Index is introduced to standardise the reporting of success, failure and survival rates.