Comparison of Three Luting Cements for Prefabricated Zirconia Crowns in Primary Molar Teeth: A 36-Month Randomized Clinical Trial

Purpose: The purpose of this study was to evaluate and compare the long-term clinical retention and gingival health of prefabricated zirconia crowns (PZCs) in primary molar teeth cemented using three luting cements. Methods: Primary molar teeth restored with PZCs (n equals 30 per group) were cemented using glass ionomer cement (GIC), resin-modified GIC (BioCemim), or adhesive resin cement (APC technique: air -particle abrasion, zirconia primer, composite resin). Crown retention, plaque accumulation, and gingival status were evaluated over three years; cumulative crown survival was assessed using Kalpan-Meier analysis. Plaque gingival scores were analyzed for within and between groups using repeated measures one-way analysis of variance. Results: The survival of PZCs cemented using GIC was 76.7 percent, 70 percent for APC, and 50 percent for BioCemim after three years. The mean survival for PZC in the GIC group (35.5 months) was significantly higher than for APC (34.7 months), and BioCemim (33 months; P=0.019). Plaque accumulation around GIC-luted crowns was significantly lower (P<0.001; three-year follow-up); gingival outcomes were uniformly favorable between groups. No crown fracture was observed throughout the study period. Conclusions: Prefabricated zirconia crowns cemented using traditional glass ionomer cement have superior retention and lower plaque accumulation compared to BioCemim and APC after three years. PZCs provided long-term favorable gingival health outcomes irrespective of the cement used for luting the crowns. (Pediatr Dent 2023;45(2):115-21.E18) Received September 6, 2022 | Last Revision December 12, 2022 | Accepted December 14, 2022