Stainless steel crowns reuse and decontamination techniques: a survey among Indian pediatric dentists

Comparative Evaluation of Preformed Stainless Steel Crown's Crazing at Different Autoclave Cycles

Aim

The study aimed to assess and compare the crazing of preformed stainless steel (SS) crowns at various autoclave cycles.

Materials and methods

Around 15 SS crowns were subjected to zero (unsterilized), one, three, five, and seven autoclave cycles at 121°C, 15 psi for 20 minutes. After each autoclave cycle, the mesial surface of each crown from occlusal to cervical portions was examined under a 40× stereomicroscope. Crazing was evaluated using Wickersham's criteria.

Results

One autoclave cycle does not produce any cracks, whereas the higher the number of autoclave cycles, the higher the cracks, which affects the prognosis of the SS crown treatment.

Conclusion

Surface alterations of SS crowns after different autoclave cycles were significant. So, preformed SS crowns should be discarded after sterilizing once or twice during clinical practice.

How to cite this article

Sowkarthicaa P, Mathian VM, Gawthaman M, et al. Comparative Evaluation of Preformed Stainless Steel Crown's Crazing at Different Autoclave Cycles. Int J Clin Pediatr Dent 2023;16(S-1):S77-S80.

Decontamination practices of paediatric crowns: a systematic review

Purpose

A systematic review was conducted into paediatric crown decontamination practices using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

Method

After database retrieval using predefined search terms, two reviewers independently applied the selection criteria, extracted the data, and assessed for risk of bias. From 92 potentially eligible studies, 10 were included for analysis.

Results

Steam sterilisation (autoclaving) was used as the gold standard for reducing biological contaminants on paediatric crowns across in vivo studies. However, autoclaving was associated with microstructural changes such as crazing and contour alterations. Furthermore, several tooth coloured crowns were liable to undergo colour changes from steam sterilisation.

Conclusion

Ambiguous manufacturer guidelines on protocols for reprocessing and reuse after biological exposure raises concerns regarding cross contamination and leaves practitioners open to potential litigation. A better understanding of the compatibility of paediatric crowns and decontamination practices is needed. More research into alternative chairside technologies that use low temperature, such as hydrogen peroxide gas plasma sterilisation, is warranted.

A comparison of decontamination methods of tried-in preformed metal crowns: an in-vivo study

AIM

To compare the effectiveness of different decontamination methods on tried-in preformed metal crowns (PMCs).

METHODS

Sixty unused PMCs and 90 tried-in PMCs from patients were assessed for contamination after culturing for 24 h on liquid media, solid media and differential media for identification of Streptococcus mutans, Staphylococcus aureus, and Escherichia coli. Subsequently, these PMCs were divided equally into the following six groups: autoclave (121 °C, 15 psi for 15 min), 5% sodium hypochlorite (5 min), 5% glutaraldehyde (5 min), 70% isopropyl alcohol (1 min) and normal saline (5 min). The contamination was reassessed, and the Log₁₀ counts were compared to the pre-decontamination levels using one way ANOVA and paired t-test at a significance level of p < 0.05.

RESULTS

The mean percentage reduction in colony counts was significantly more in the autoclave group compared to glutaraldehyde or sodium hypochlorite groups, glass bead, isopropyl alcohol, and normal saline in this decreasing order.

CONCLUSIONS

PMCs supplied by the manufacturer were found to be sterile and can be used directly on patients. The autoclave was the best method of sterilisation, although it did not eliminate the microbes 100%; followed by 5% glutaraldehyde and 5% sodium hypochlorite.