Abstract
AIM: The present study aims to compare the gingival health, plaque accumulation, clinical performance and parental satisfaction of stainless steel crowns (SSCs) and fiber-reinforced composite (FRC) crowns in a split-mouth design. MATERIALS AND METHODS: Thirty-five children aged 4-7 years requiring full-coverage restorations for both primary mandibular second molars were included. Each child received an SSC and an FRC crown on the contralateral molars. Clinical performance was assessed using the United States Public Health Service (USPHS) criteria, along with the Gingival Index and Plaque Index, at 3, 6, and 9 months. Parental satisfaction was assessed at 9 months. Data were analyzed using paired tests, and survival analysis was performed using the Kaplan-Meier method with the log-rank test. RESULTS: SSCs demonstrated significantly better gingival health and lower plaque scores compared to FRC crowns at all follow-up intervals. Restoration survival was higher for SSCs. Kaplan-Meier survival analysis demonstrated a significantly higher survival probability for SSCs compared to FRC crowns over the 9-month follow-up (p < 0.001). Parental satisfaction scores were higher for SSCs; however, the difference was not statistically significant (p = 0.185). CONCLUSION: Stainless steel crowns demonstrated better clinical performance and longevity compared to fiber-reinforced composite crowns in primary molars. Although FRC crowns offer improved esthetics, their clinical outcomes were comparatively less favorable over the study period. CLINICAL SIGNIFICANCE: The findings of this study may help guide clinicians in selecting appropriate full-coverage restorations for primary molars by considering both functional performance and esthetic requirements.