Stainless steel crown versus modified open-sandwich restorations for primary molars: a 2-year randomized clinical trial

Int J Paediatr Dent. 2008 Sep;18(5):325-32. doi: 10.1111/j.1365-263X.2007.00900.x. Epub 2008 Mar 6.


Objective: The aim of this study was to investigate the clinical performance and survival of stainless steel crown (SSC) restoration and modified open-sandwich technique using resin-modified glass ionomer cement.

Design: Randomized clinical trial.

Setting: General dental practice.

Materials and methods: A total of 87 children aged 4-7 years at baseline with one or more primary molars that have undergone pulp therapy were randomly assigned to receive either SSC or modified open-sandwich restoration. One hundred and sixty restorations were placed and evaluated after 6, 12, 18, and 24 months using the Ryge criteria.

Results: Comparable survival rates were observed for both SSC and modified open-sandwich restoration. With only four SSCs and six modified open-sandwich restorations failing over 24 months, the survival rates were high for both materials (2-year survival rate: 95.0% for SSCs and 92.5% for modified open-sandwich restorations). Significantly better gingival health (P < 0.05) was observed for the modified open-sandwich restorations compared with SSCs, as only one modified open-sandwich restoration was rated Charlie compared to 13 SSCs. No significant differences were observed between the two materials for marginal integrity, proximal contact, occlusion, or recurrent caries.

Conclusion: The 2-year results indicated that the modified open-sandwich restoration is an appropriate alternative to SSC in extensive restorations, particularly where aesthetic considerations are important.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Crowns*
  • Dental Care for Children / methods
  • Dental Caries / therapy*
  • Dental Marginal Adaptation
  • Dental Restoration Failure
  • Dental Restoration Wear
  • Dental Restoration, Permanent / methods*
  • Female
  • Fluorides / administration & dosage
  • Glass Ionomer Cements / chemistry
  • Glass Ionomer Cements / therapeutic use*
  • Humans
  • Longitudinal Studies
  • Male
  • Molar
  • Pulpotomy
  • Resin Cements / chemistry
  • Resin Cements / therapeutic use*
  • Stainless Steel
  • Survival Analysis
  • Tooth, Deciduous
  • Tooth, Nonvital / therapy
  • Treatment Outcome


  • Glass Ionomer Cements
  • Resin Cements
  • Stainless Steel
  • Fluorides