The Use of Stainless Steel Crowns: a Systematic Literature Review

Purpose: The purpose was to review the published literature on stainless steel crowns (SSCs) from 2002 to the present as an update to an earlier review published in 2002.

Methods: Included were published papers on clinical studies, case series, and laboratory testing on SSCs (including esthetic SSCs and the Hall technique) in peer-reviewed journals. Study quality and strength of evidence presented were assessed for papers reporting clinical results for SSCs as a primary study outcome using a list of weighting criteria.

Results: Sixty-one papers fulfilled the inclusion criteria (24 papers on 22 clinical studies, three case reports, 21 reviews and surveys, and 13 laboratory testing reports on SSCs and esthetic preformed metal crowns for primary and permanent molar teeth). Ten clinical studies achieved weighting scores ranging from 68 percent to 26 percent, with the two highest scoring studies (68 percent and 63 percent) considered good quality.

Conclusions: Within the confines of the studies reviewed, primary molar esthetic crowns and SSCs had superior clinical performance as restoratives for posterior primary teeth, and the Hall technique was shown to have validity. No clinical studies were available on zirconia crowns. Further well-designed prospective studies on primary molar esthetic crowns and the Hall technique are needed.