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.