The purpose of this clinical trial was to assess the clinical performance of primary molar zirconia crowns with a glass fiber-reinforced composite crown (GFRC) in primary molar teeth. This trial was designed as a prospective, randomized, bilateral split-mouth study. A total of 66 crowns were placed in 30 children, ages four to nine years, from October 2018 until January 2019. Assessment of the clinical performance was done at one week and at three, six, 12, and 18 months. Several criteria, such as color match, time taken for the clinical procedure, resistance to dislodgement prior to cementation, crown retention, occlusal wear, staining, gingival health, plaque retention, and parental satisfaction, were evaluated. Result: At 18 months, 58 crowns were analyzed: 30 ZR crowns and 28 GFRC crowns. There was a statistically significant difference (P<0.05) between staining, occlusal wear, gingival health, plaque retention, and parental satisfaction between groups at 18 months, with the zirconia crowns outperforming the GFRC crowns in all those categories. The only areas where GFRC crowns performed better than ZR crowns were the time required to place them and the resistance to dislodgement before cementation. Conclusion: This study demonstrated that primary molar zirconia crowns had highly acceptable and significantly better clinical performance than glass fiber-reinforced composite crowns after 18 months.

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