Clinical efficiency of zirconia crowns over stainless steel crowns in primary posterior teeth rehabilitation: A systematic review and meta-analysis.

Purpose: To evaluate the clinical efficiency of zirconia crowns (ZCs) over stainless steel crowns (SSCs) in rehabilitation of primary posterior teeth. Methods: The randomized controlled trials (RCTs) evaluating the clinical efficiency of ZCs over SSCs were searched in the standard electronic bibliographic databases MEDLINE, EMBASE, Google Scholar, The Cochrane library, The Cochrane Central Register of Controlled Trials, LILACS, and Trip medical database using the pre-defined combinations of different keywords. The RoB 2 tool was used for the quality appraisal of the included clinical trials. The random-effect model was applied to pool the summary effect sizes and Mantel-Haenszel test was used for the statistical analysis of estimate effect sizes. The overall quality of evidence was assessed using GRADE pro GDT software. Results: The pooled data of meta-analysis results showed a total of 57 clinical failure events in 437 primary teeth rehabilitated with ZCs/SSCs. Primary teeth rehabilitation with ZCs showed less clinical failures when compared to the SSCs [Risk ratio (RR) = 0.62 (95% CI: 0.20 – 1.93), p=0.41, I2=62%]. Conclusions: The primary posterior teeth rehabilitated with ZCs have 0.62 times the risk of clinical failure than that of SSCs with 'low quality' of evidence