Abstract / Summary
Abstract Aim To evaluate and compare the clinical and radiographic performance of size-minimized versus standard stainless-steel crowns (SSCs) as full-coverage restorations for pulpotomized mandibular primary first molars. Materials and Methods This randomized controlled clinical trial adopted a split-mouth design in 18 children aged 4–8 years, providing 36 pulpotomized mandibular first primary molars. Each child contributed one tooth to each arm: a standard SSC on the control side (Group I) and a size-minimized SSC on the contralateral side (Group II). Minimization followed the vertical-cut, re-approximation, and welding technique. Crowns were assessed immediately after placement and at 1 week, 1 month, 3 months, and 6 months using the Modified United States Public Health Service (USPHS) criteria, the Gingival Index (GI) and Plaque Index (PI) at four surfaces of both the crowned tooth and its opposing natural tooth, standardized digital bitewing radiographs, and patient/parental satisfaction. Data were analyzed with the Mann–Whitney, Kruskal–Wallis, and chi-square tests (p ≤ 0.05). Results Both groups showed a progressive, statistically significant intra-group improvement in gingival and plaque scores over the follow-up period, with no statistically significant difference between the minimized and standard crowns at any interval. All crowns in both groups retained Alpha ratings for retention, marginal adaptation, and freedom from fracture throughout (100% at every time point). Radiographic findings were normal in 100% of both groups, with no periapical or furcal pathology. Patient and parental satisfaction was uniformly high and comparable between groups (p = 0.738). Conclusion Within the limitations of this trial, size-minimized SSCs performed identically to standard crowns across gingival health, plaque accumulation, marginal adaptation, retention, fracture resistance, radiographic outcomes, and satisfaction. Crown-size minimization is a safe and clinically reliable option when a prefabricated crown is oversized relative to tooth morphology.