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Restorative strategies for deciduous anterior teeth: A systematic review and meta-analysis

Evidence-Based Dentistry volume 26, page 149 (2025)Cite this article

Subjects

Aim

Common causes of destruction in primary anterior teeth include dental caries and trauma. This systematic review evaluated the success rate of restorative techniques for these cases.

Methods

Systematic searches were conducted in Medline (PubMed), Scopus, Web of Science, Cochrane, Embase, and ProQuest until February 2024. Randomized controlled trials and non-randomized studies of interventions with ≥12 months of follow-up were included. Exclusion criteria were: studies with >30% loss to follow-up, unclear evaluation criteria, management under general anesthesia, unhealthy patients, or lacking individual success data. A meta-analysis assessed success rates, with subgroup analyses. Risk of bias was evaluated using RoB 2 and ROBINS-I, and evidence certainty was assessed using the GRADE system.

Results

Eight studies involving 852 teeth from 271 children aged 2–9 years, with follow-ups of 3–36 months, were included. The meta-analysis revealed a 71% success rate at 12 months for all techniques. Strip crowns (79%) and zirconia crowns (70%) had the highest success rates for teeth without endodontic treatment. Intracanal posts (resin or glass fiber) achieved an 83% success rate for teeth requiring endodontic treatment. Evidence certainty was low.

Discussion

Strip crowns and zirconia crowns performed well for teeth without endodontic treatment, with strip crowns offering a simpler and less technique-sensitive option. Biological restorations had poorer outcomes due to their complexity, sensitivity, and the need for a tooth biobank, raising legal and logistical challenges. Although zirconia crowns require extensive subgingival preparation, they align less with minimally invasive principles compared to strip crowns. Intracanal posts showed high success rates for teeth needing endodontic treatment, regardless of the material used.

Conclusions

Strip crowns appear to be a suitable option for restoring primary anterior teeth that do not require endodontic treatment. For teeth requiring endodontic treatment, the use of intracanal posts combined with strip crowns seems to yield satisfactory results.

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Data availability

All data used in this systematic review are provided as supplementary material alongside this article. In addition, the authors have made the files openly accessible via the Open Science Framework (OSF) repository at osf.io/yswk2, where the study was also previously registered.

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Acknowledgements

The authors gratefully acknowledge the support of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), the Fundação Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP). Their funding and support were instrumental in facilitating the research conducted in this study.

Funding

CNPq – 140090/2022-3, CNPq – 310972/2021-3, CAPES PRINT – 88887.937441/2024-00, FAPESP - 2024/05764-3.

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Authors and Affiliations

  1. Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil

    Rodolfo de Carvalho Oliveira, Jonathan Rafael Garbim, Tamara Kerber Tedesco & Daniela Prócida Raggio

  2. Universitary Center FACENS, Sorocaba, São Paulo, Brazil

    Ana Laura Passaro

Authors
  1. Rodolfo de Carvalho Oliveira
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  4. Tamara Kerber Tedesco
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Contributions

RCO, JRG, ALP, TKT and DPR conceived the study idea and designed the study. RCO and JRG carried out the inclusion, exclusion and data extraction from the included studies. RCO and TKT carried out the risk of bias analysis and GRADE. TKT analyzed the data. All authors were involved in its revision and approved the final version.

Corresponding author

Correspondence to Daniela Prócida Raggio.

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Oliveira, R.d.C., Garbim, J.R., Passaro, A.L. et al. Restorative strategies for deciduous anterior teeth: A systematic review and meta-analysis. Evid Based Dent 26, 149 (2025). https://doi.org/10.1038/s41432-025-01144-5

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