PMC Survival Rates in First permanent Molars.pptx

PMC Survival Rates in First permanent Molars

1. PMC Survival Rates in First Molars

2. PMC Survival Rates in First Molars Introduction Importance of First Permanent Molars Why Preformed Metal Crowns (PMCs)? Study Overview and Methodology Survival Rates Breakdown Common Causes of PMC Failure Key Risk Factors Affecting PMC Survival Kaplan-Meier Survival Analysis Impact of Proximal Contacts on PMC Success Influence of Pulp Treatment on PMC Survival

3. PMC Survival Rates in First Molars Clinical Recommendations for PMC Placement Comparison with Similar Studies Discussion on Failures and Improvements Conclusion Limitations and Future Research References

4. Introduction Research Paper Overview: This retrospective study assesses long-term durability of PMCs in pediatric permanent molars. Authors and Contribution: Authored by Nayoung Oh, Soonhyeun Nam, Jaesik Lee, and Hyunjung Kim, exploring clinical applications. Primary Objective: Aim is to evaluate PMC survival rates and influential factors in pediatric dental settings. Photo by Bhavesh Jain on Pexels

5. Importance of First Permanent Molars Importance of First Permanent Molars: First permanent molars significantly influence dental arch development, occlusion, and overall oral functions. Common Dental Issues: Caries or developmental conditions like MIH, DI, and AI frequently cause damage to these teeth. Impact on Treatment Choices: These damages necessitate effective restoration strategies such as PMCs to ensure longevity and function. Photo by Photo Source Kaboompics.com on Pexels

6. Why Preformed Metal Crowns (PMCs)? Comprehensive Protection: PMCs provide complete coverage, protecting damaged molars from further decay and restoring functionality. Established Clinical History: A longstanding success rate in pediatric dentistry validates PMCs as reliable restorations for compromised teeth. Durability as Interim Solutions: PMCs prove effective interim options, maintaining tooth integrity until permanent restorations can be implemented.

7. Study Overview and Methodology Retrospective Analysis Details: Analyzed 115 PMCs in first permanent molars across 82 patients under 15 years old. Inclusion Criteria Overview: Included children required follow-ups with both preoperative and postoperative radiographic evaluations. Patient Follow-up Requirements: Follow-up assessments ensured minimum one-year evaluation with clinical and radiographic documentation.

8. Survival Rates Breakdown One-Year Survival Rate: A remarkable 97.4% survival rate for PMCs was achieved within the first year post-placement. Five-Year Performance Insights: At five years, the survival rate of PMCs drops to 82.8%, indicating longevity but also significant challenges. Failure Analysis Overview: Out of 115 PMCs, an overall failure rate of 15.7% identified common issues leading to restoration complications.

9. Common Causes of PMC Failure Defective Restorations: Marginal adaptation issues often contribute to microleakage, jeopardizing crown integrity and leading to failures. Debonding Concerns: Improper seating during placement frequently results in debonding, compromising the crown's functional stability over time. Mechanical Wear Factors: Perforations from mechanical wear indicate longevity issues, signaling a need for timely clinical evaluations and interventions.

10. Key Risk Factors Affecting PMC Survival Risk of Distal Cavities: Distal cavities significantly increase the failure rate of PMCs by 9.225 times, indicating vulnerability. Mandibular Molars Vulnerability: Mandibular molars exhibit a 12.925 times higher failure rate in PMC applications compared to maxillary counterparts. Clinical Considerations: Understanding these risks is vital for optimizing treatment strategies and improving dental outcomes with PMCs. Photo by Pixabay on Pexels

11. Kaplan-Meier Survival Analysis Kaplan-Meier Curve Overview: The Kaplan-Meier curve illustrates survival rates of PMCs based on pulp involvement and proximal contact. Impact of Pulp Involvement: Differential survival rates are observed with regards to pulp treatment types influencing PMC longevity. Proximal Contacts Analysis: Number of proximal contacts crucially affects survival; fewer contacts correlate with increased failure rates.

12. Impact of Proximal Contacts on PMC Success Intact Proximal Contacts: Two-wall contacts exhibit an impressive survival rate of 92.5%, affirming their stability over time. Distal Cavity Outcomes: Survival rates drop to 52% for distal cavities, highlighting the challenges in restoration sustainability. Encouraging Results for Mesial Cases: Notably, mesial cavity and broken-down wall cases achieved a remarkable 100% survival rate. Photo by Mikhail Nilov on Pexels

13. Influence of Pulp Treatment on PMC Survival Pulp Treatment Success Rates: No pulp treatment shows 88.6%, pulpectomy achieves 90%, but pulpotomy has a lower success rate. Importance of Pulp Involvement: Understanding pulp treatment types is crucial for optimizing recommendations and enhancing PMC longevity. Clinical Implications: Emphasizing successful pulp treatments could improve overall PMC performance and patient outcomes significantly.

14. Clinical Recommendations for PMC Placement Ensure Proper Crown Seating: Careful and accurate seating of PMCs optimizes fit, thus enhancing their longevity and effectiveness. Radiographic Confirmation: Performing pre-cementation radiographs can verify crown fit, minimizing risk of subsequent failures in placement. Focus on Distal Cavities: Prioritizing distal cavities is crucial, as they present significantly heightened risks for PMC failure rates.

15. Comparison with Similar Studies Literature Comparison: Present study's 82.8% five-year survival aligns closely with Chen et al.'s and Discepolo & Sultan's findings. Success Rate Consistency: Chen et al. (2013) report 96% success at 52 months; our findings reinforce long-term viability of PMCs. Previous Study Validation: Studies by Discepolo & Sultan (2017) document an 88% success rate, supporting results of our analysis. Photo by Jens Johnsson on Pexels

16. Discussion on Failures and Improvements Faulty Margins: Poor marginal adaptation increases microleakage risk, jeopardizing restoration longevity, necessitating meticulous crown fitting. Operator Experience: In-depth training for dental practitioners enhances placement accuracy, reducing failure rates and ensuring successful outcomes. Regular Evaluations: Periodic radiographic checks and clinical evaluations are essential to identify issues early and optimize PMC longevity. Photo by Miguel Cuenca on Pexels

17. Conclusion Overall Success Rate: Preformed Metal Crowns demonstrate an 82.8% survival rate at five years, affirming their effectiveness. Identified Risk Factors: Distal cavities and mandibular placements significantly elevate failure risks, necessitating careful clinical consideration. Crown Placement Importance: Meticulous crown positioning during application is essential for optimizing PMC longevity and overall success. Photo by Nina Uhlikova on Pexels

18. Limitations and Future Research Retrospective Design Limitations: The study's retrospective design constrains the precision of failure assessments and introduces potential biases. Call for Prospective Trials: Future research should promote prospective randomized trials to substantiate findings and enhance clinical reliability. Sample Size Constraints: Small sample sizes limit the generalizability of results, underscoring the need for larger-scale investigations. Photo by Naro K on Pexels

19. References Comprehensive References: References encompass studies by Chen, Discepolo, and others, assessing PMC longevity and performance. Key Literature Insights: Cited literature highlights PMC success rates and effectiveness across various pediatric dental contexts. Contribution to Practice: References inform clinical guidelines, aiding practitioners in optimizing implementation of PMCs in dentistry. Photo by Engin Akyurt on Pexels