Esthetic and functional rehabilitation of hypomineralized first permanent molars using prefabricated versus custom made zirconia crowns: a 12-month follow-up study

Sakshi Rawal, Nikhil Srivastava, Vivek Rana, Noopur Kaushik


Background: Molar incisor hypomineralisation is defined as “hypomineralisation of systemic origin, presenting as demarcated, qualitative defects of the enamel of one to four first permanent molars frequently associated with affected incisors. MIH is also considered as a public health issue since it leads to pain, poor esthetics and has a negative impact on the quality of life. Thus, managing patients with MIH requires a variety of patient management approaches, materials, and techniques ranging from Intracoronal to extracoronal full or partial coverage restorations. To evaluate the efficacy of prefabricated zirconia crowns and custom-made zirconia crowns used on hypomineralised molars and to compare their efficacy in terms of gingival health, surface integrity, retention, parental satisfaction, time and cost over a time period of baseline (1day), 3, 6, 9 and 12 months.

Methods: Twenty-six hypomineralized first permanent molars from children aged 7-12 years indicated for full coverage restorations were randomly selected from the Out Patient Department. The selected teeth (molars) were then randomly allocated into two groups (13 each) according to the type of crown used, namely Group A-prefabricated zirconia crowns (n=13) and group B-custom-made zirconia crowns (n=13). Tooth preparation was done according to the crown selected and all the crowns were cemented using resin-based cement. Patients were recalled and the follow-up was done by single trained examiner.

Results: Clinical success for both the crowns were similar with no statistical difference between them.

Conclusions: Both the crowns proved to be clinically successful.


Molar inciosr hypomineralusation, First permanent molars, Developmental defects of enamel

Full Text:



Ravindran R,Saji AM,Prevalence of the developmental defects of the enamel in children aged 12-15 years in Kollam district. J Int Soc Prev Community Dent. 2016;6(1):28-33.

Elfrink MEC, Cate JM ten, Jaddoe VWV , Moll HA, Veerkamp JSJ, Deciduous molar hypomineralisation, its nature and nurture. J Dent Res. 2012;91:551.

Mittal R, Chandak S, Chandwani M, Singh P, Pimpale J. Assessment of association between molar incisor hypomineralization and hypomineralized second primary molar. JISPPD. 2016;6(1):34-8.

Krishnan R, Ramesh M. Molar incisor hypomineralisation: A review of its current concepts and management. SRM J Res Dent Sci. 2014;5(4):248-52.

Laisi S, Ess A, Sahlberg P, Arvio P, Lukinmaa P-L, Satu A. Amoxicillin may cause molar incisor hypomineralization. J Dent Res. 2009;88(2):132-6.

Allazzam SM, Alaki SM, El Meligy OA. Molar incisor hypomineralization, prevalence, and etiology. Int J Dent. 2014;2014:23.

William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent. 2006;28(3):224-32.

Garg V, Panda A, Shah J, Panchal P. Crowns in Pediatric Dentistry: A review. J Adv Med Dent Scie Res. 2016;4(2):41-6.

An SY, Shim YS. Esthetic restoration of deciduous teeth using prefabricated zirconia crown in children with early childhood caries: a report of three cases. J Dent Hyg Sci. 2018;18(3):194-200.

Al-Atyaa ZT , Majeed MA. Comparative evaluation of the marginal and internal fitness of monolithic CAD/CAM zirconia crowns fabricated from different conventional techniques and digital impression using silicone replica technique (An in vitro study. Biomed Pharmacol J. 2018;11(1):45-9.

Yang JN, Mani G ,Crowns for primary anterior teeth. Int J Pedod Rehabil. 2016;1:75-8.

Nu S. Product Profile: NuSmile ZR zirconia pediatric crown system. J Multidiscip Care Dent. 2019;32:45-9.

Kinder Krowns. Available at: Accessed on 20 November 2022.

Kids-e-dental crowns. Available at: Brochure.pdf. Accessed on 20 November 2022.

Signature crowns. Available at: http://signature Accessed on 20 November 2022.

Instructions for use and general information. Available at: Widgets.FAQ.Vinformatix/Content/FAQ/FAQ CategoryFiles/IFU%2005%20ZR%20Technical%20Guide%20(Eng)%20Rev%208.pdf. Accessed on 20 November 2022.

Peter S. Essentials of preventive and community dentistry. 4th ed. New Delhi: Arya Medi Publishing House Pvt Ltd; 2010.

Orkin DA, Reddy J, Bradshaw D. The relationship of the position of crown margins to gingival health. J Prosthet Dent. 1987;57(4):421-4.

Dhanraj M, Benita PBDS, Varma A, Jain AR. Effect of subgingival margins influencing periodontal health: a systematic review and meta analysis. Biomed Pharmacol J. 2017;10(20):45-9.

Jones JC. The success rate of anterior crowns. Br Dent J. 1972;132:399-403.

Srivastava N. How efficacious are stainless steel crown luting cements: an ex vivo comparative study. EC Dent Sci. 2018;4:1887-98.

Zmener O, Pameijer CH, Hernandez S. Resistance against bacterial leakage of four luting agents used for cementation of complete cast crowns. Am J Dent. 2014;27(1):51-5.

Waggoner WF. Restoring primary anterior teeth: updated for 2014. Pediatr Dent. 2015;37(2):163-7.

The science behind. Available at: “http://www. nceBasedDesign”. Accessed on 20 June 2021.

Hmaidouch R, Müller WD, Lauer HC, Weigl P. Surface roughness of zirconia for full-contour crowns after clinically simulated grinding and polishing. Int J Oral Sci. 2014;6(4):241-6.

Hojat M, Louis DZ, Maxwell K, Markham FW, Wender RC, Gonnella JS. A brief instrument to measure patients' overall satisfaction with primary care physicians. Fam Med. 2011;43(6):412-7.

Mathew MG, Roopa KB, Soni AJ, Khan MM, Kauser A. Evaluation of clinical success, parental and child satisfaction of stainless steel crowns and zirconia crowns in primary molars. J Family Med Prim Care. 2020;9(3):1418-23.

Khan S, Togoo RA, Mustafa M, Kaushik N. Questionnaire inventory about clinical knowledge and awareness of molar‒incisor hypo mineralization (MIH) among dental specialist, interns and students, at college of dentistry, King Khalid university, Abha Saudi Arabia. Int Ed Res J. 2017;3(5):673-6.

Pruthi T, Srivastava N, Rana V, Kaushik N, Kaur N. A recent update on Silver Diamine Fluoride. J Adv Med Dent Sci Res. 2021;9(4):88-92.