https://doi.org/10.5272/jimab.2018243.2166 Journal of IMAB Journal of IMAB - Annual Proceeding (Scientific Papers). 2018 Jul-Sep;24(3) ISSN: 1312-773X https://www.journal-imab-bg.org Review article PROSTHETIC TREATMENT WITH CROWNS AND IMPLANTS IN CHILDREN – LITERATURE REVIEW Mariana Dimova-Gabrovska1, Desislava Dimitrova2, Vladislav A. Mitronin3 1) Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University - Sofia, Bulgaria. 2) Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University - Varna, Bulgaria. 3) Department of Gnathology and Prosthetic Dentistry, Faculty of Dentistry, Moscow State University of Medicine and Dentistry, Russia. ABSTRACT: arches. These have its unfavorable effect on the child’s over- Fixed prosthetic treatment in children is indicated all well-being, self-esteem and quality of life. in cases with caries and his complications, genetic aetiol- Other reasons for the impaired integrity and loss of ogy, etc. when extensively destructed tooth structures can- teeth may be mechanical trauma, various genetic and he- not be completely restored with the methods of conserva- reditary diseases, such as ectodermal dysplasia, amelo- and tive dentistry. In these cases, prosthetic treatment is planned dentinogenesis imperfecta. [2, 3]. and performed following certain requirements, with respect In a number of cases, direct restorations with con- to age and the occurring growth changes. ventional methods of dentistry fail in primary dentition. The aim of this study is to analyse and summarize The reasons for this may include the insufficient hardiness the scientific data on the use of fixed prosthetic treatments of dental tissues that provide the retention of the restora- in children. tion, decreased resistance after pulpitis treatment, inabil- Materials and methods: An online keyword data- ity to ensure a dry operating field, etc. All of these lead to base search was performed in PubMed, Google, Lilac, the need for the development of prosthetic pediatric den- Yandex, eLibrary.ru from December 2017 to February 2018. tistry [4]. Results: Modern scientific studies have documented high functional and aesthetic results in cases of prosthetic OBJECTIVE: treatments on implants, mini-implants in children aged 3 The aim of this review is to present and analyze cur- to 17 with the presence of partial or total edentulism. Prac- rent literature data on the use of fixed prosthetic construc- tice proven method for restoring severely injured primary tions in children. teeth is the different types of performed stainless steel crowns (conventional, pre-veneered, open-face stainless MATERIALS AND METHODS: steel crowns) and aesthetic performed crowns (polycar- From December 2017 till February 2018, an elec- bonate, zirconium crowns). tronic search was conducted in the PubMed, Google, Li- Conclusion: The recovering of the masticatory and lac, Yandex, eLibrary.ru databases by using the following speech function and normal appearance is of particular im- keywords: “äåòñêî ïðîòåçèðàíå”, “èìïëàíòàòè”, “äåòñêè portance for the growth of the jaws and facial bones, the êîðîíè” and the corresponding terms in English, German, general physical development, the psyho-emotional state Russian and French: “pediatric prosthetic treatment”, “im- and the social adaptation of the children. plants”, “primary crowns”, “pädiatrische prothetische Behandlung”, “Implantate”, “Kronen für Kinder”, “ïåäè- Keywords: paediatric prosthetic treatments, im- àòðè÷åñêîå ïðîòåçèðîâàíèå”, “èìïëàíòàòû”, “êîðîíû äëÿ plants, primary crowns äåòåé”, “traitement prothétique pédiatrique”, “les im- plants”, “couronnes pour lesenfants”. The final selection INTRODUCTION: included 55 scientific researches, the data of which were Despite the efforts of preventive dentistry, caries and analyzed, summarized and presented in the main part of this its complications remain one of the most common diseases review. that affect, according to data of the World Health Organi- zation, between 60 and 90% of school-aged children [1]. RESULTS: Progression of carious lesions may lead to tooth loss and a Due to the specifics of the child’s organism and con- number of disorders that affect the masticatory function, sciousness, planning and applying of dental prosthetic speech, esthetics, and the normal development of dental constructions should be consistent with the anatomical fea- 2166 https://www.journal-imab-bg.org J of IMAB. 2018 Jul-Sep;24(3) tures, physiological changes and the emotional state of the partial dentures until the age of 21 years. The aim was to treated child. Dental prosthesis provides the opportunity preserve the structure of the alveolar bone and to create to restore the effective masticatory and speech function, to favorable conditions for the insertion of fixed implant-sup- achieve an acceptable appearance, ensure the unimpeded ported constructions. The final result was highly appreci- growth of oral structures and normal physical, mental and ated by the patient in terms of function and esthetics. social development of the child [5, 6, 7, 8]. According to Cronin [20], dental implants inserted Fixed prosthetic treatment in childhood includes prior to completion of craniofacial growth imitate the ef- dental implant restorations and crown reconstructions. fect of ankylosing teeth. Their use in an inappropriate age Use of implants in children period, especially in the upper jaw, may lead to interrup- Insertion of intraosteal retaining structures in chil- tion of the alveolar bone development and the fall of con- dren with incomplete bone growth or lack of sufficient vol- structions into infra-occlusion. Temporary removable pros- ume of alveolar bone has a high probability of failure. Pros- thesis, prior to implant insertion, significantly increases the thetic treatment on osseointegrated implants is recom- patient’s confidence in the treatment plan and improves mended in children with partial or total tooth loss only af- cooperation [21, 22]. ter completion of bone maturation [9, 10]. Subject of interest is the study of Heuberer et al. [23], Valle et al. [11] and Worsaae et al. [12] suggest the which aims to find a lasting treatment that addresses the use of implants as an effective method of restoring the mas- problems associated with growth changes, multiple miss- ticatory and speech function in children aged 17 years and ing teeth, underdeveloped alveolar bones, and the younger over. age of patients. As a suitable method for restoring subtotal Mishra et al. [13] explore the possibilities of suc- tooth loss, Onplants(individually made titanium discs with cessful prosthesis with dental implants in adolescents and a thickness of 3.3 mm and a diameter of 7.7 mm) for the summarize the following main factors: implantation should upper jaw and traditional implants with a conical, root- be performed after completion of the skeletal growth; the shaped geometry for the lower jaw were presented. After exact inverse age of each child should be subjected to a the final osseo-integration, removable partial dentures were cephalometric study with orthodontic monitoring; the mini- made, which were separated along the line of the bone su- mum age for treatment is 15 years for girls and 18 years ture to ensure the unimpeded development of the upper jaw. for boys; the only possible site for prosthesis before reach- For additional retention of the lower dentures, implant-sup- ing the skeletal maturation is the lower frontal area, due to ported telescopic crowns were used. the lowest number of registered changes in this area. Use of mini-implants in the prosthetic treatment of These findings are also confirmed by the studies by children Balut et al. [14] and Kramer et al. [15]. The authors have Due to the partial success with regard to the reten- found that the insertion of implants during jaw develop- tion of removable dentures in children, it is necessary to ment may lead to trauma of dental follicles, impaired tooth include alternative methods of prosthetic restoration. Mello eruption and delayed development of orofacial structures. et al. [24] and Sfeir et al. [25] recommend the insertion of However, there are data available in the literature on mini-implants in the lower canines of children. The the use of the implant-supported treatment in the case of supraosseous part is used for additional retention of the re- incomplete growth, outside the recommended area. This is movable constructions or as replacements of the missing the case presented by Durstberger and Watzek [16] of a 10- teeth, with fixed constructions made on them. Patients’ sat- year-old boy with oligodontia, where implants were inserted isfaction with this type of prosthesis has been reported to for the purposes of prosthetic restoration with a fixed pros- be higher compared to that with conventional dentures [26]. thetic construction. During the procedure of surgical ex- Apart from cases of systemic and genetic diseases, a ploration, a cranial movement of the insertedintraosteal re- cause for the loss of deciduous or permanent teeth may be taining devices was observed as a result of growth. Fre- different types of mechanical injury. Traumas may often quently, this is considered an obstacle in achieving opti- lead to expulsion and premature tooth loss. In these situa- mal esthetic results. tions, methods of re-implantation are generally applied, in Of particular interest is the report of Guckes et al. most cases, unsuccessfully. This requires the search for al- [17], where the