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Zirconia crowns show higher retention and lower failure rates than composite strip crownsZirconia crowns show better durability for children with tooth decay

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Key Takeaway
Note that zirconia crowns offer superior retention and lower failure rates than composite strip crowns at 12 months.

This meta-analysis compared the clinical performance of zirconia crowns and composite strip crowns for treating decayed primary incisors in children. The study evaluated outcomes including crown retention, restoration failure, gingival health, plaque accumulation, color stability, and opposing tooth wear over a 12.0 months follow-up period.

Zirconia crowns demonstrated significantly higher odds for crown retention (OR 7.549) and lower odds for restoration failure (OR 0.158) compared to composite strip crowns. Additionally, zirconia crowns showed favorable trends in gingival health, plaque accumulation, color stability, and parental satisfaction. Conversely, zirconia crowns were associated with significantly higher odds for opposing tooth wear (OR 6.640).

The authors noted several limitations, including wide uncertainty in the pooled estimate for parental satisfaction and some measures being comparable between the two crown types. Certain outcomes were not statistically significant or were imprecise. Clinically, while both types perform adequately at 12 months, zirconia crowns generally show more favorable clinical outcomes, though practitioners should note the increased risk of opposing tooth wear.

How this fits prior evidence

This meta-analysis addresses the management of dental caries in children, a condition driven by dietary sugars and biofilm formation. While previous coverage highlighted the role of sugar as a pivotal ecological factor in dental caries and the potential of bioactive components like dairy products and berberine for protection, this study focuses on the restorative outcomes of zirconia versus composite crowns for primary incisors.

When a child has a cavity in a front tooth, the choice of a protective crown is a big decision for parents. Doctors must decide between different materials to ensure the tooth stays healthy and the child stays happy. This analysis looked at how zirconia crowns compared to composite strip crowns over a 12-month period.

Zirconia crowns showed several advantages in this comparison. They were much more likely to stay in place and were less likely to fail than composite strips. The study also found that zirconia crowns led to better gum health and less plaque buildup. Additionally, zirconia crowns maintained their color better over the year. While both types of crowns can work well in practice, zirconia showed stronger trends in these clinical areas.

There is one important trade-off to consider. The study found that zirconia crowns were more likely to cause wear on the opposing tooth. Also, while parents tended to prefer the zirconia option, the data for their satisfaction was not very precise. Because some measurements were similar between the two types, you should talk to a dentist to see which option fits your child's specific needs.

What this means for you:
Zirconia crowns stay in place better and offer better gum health than composite strips for children's teeth.

Common questions

How long do zirconia crowns last compared to composite strips?

Zirconia crowns showed significantly higher odds of staying in place compared to composite strip crowns over a 12-month period. They also had lower odds of restoration failure, making them a durable option for children with decayed primary incisors.

Are there any risks to using zirconia crowns?

While zirconia crowns perform well in many areas, the study found they had significantly higher odds of causing wear on the opposing tooth. You should discuss this specific trade-off with your dentist to decide the best path for your child.

How do these two types of crowns compare for gum health?

Zirconia crowns were found to be significantly better for gum health and resulted in lower plaque accumulation than composite strip crowns. Both options can perform adequately, but zirconia showed more favorable trends in these clinical outcomes.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up12.0 mo
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Zirconia and composite strip crowns are considered as restorative options for decayed primary incisors in children. Zirconia crowns are preferred for their durability and natural appearance, while composite strip crowns are valued for their cost-effectiveness and ease of use. However, differences in their long-term clinical outcomes and parental satisfaction remain a key consideration in pediatric dentistry. AIM: The aim of this systematic review and meta-analysis was to compare the effectiveness and evaluate long-term outcomes of zirconia and composite strip crowns for restoring primary incisors. MATERIALS AND METHODS: The data were explored through advanced searches and databases for articles published between 2013 and 2026 to identify studies investigating the long-term outcomes of zirconia and composite strip crowns for restoring primary incisors. RESULTS: Eight randomized controlled trials and 1 non-randomized prospective study were included. Zirconia crowns demonstrated significantly better gingival health, lower plaque accumulation, higher crown retention, reduced restoration failure, and superior color stability compared with composite strip crowns at ≥12 months. Meta-analysis showed significantly higher odds of crown retention (OR 7.549), lower restoration failure (OR 0.158), and improved gingival outcomes for zirconia crowns. However, zirconia crowns were associated with significantly higher odds of opposing tooth wear (OR 6.640). Parental satisfaction tended to favor zirconia crowns, though the pooled estimate showed wide uncertainty. CONCLUSIONS: The observed clinical acceptability of all crowns used to treat primary anterior teeth at the 12 months mark indicates that both zirconia crowns and composite strip crowns can perform adequately in practical applications. Parental reports suggest higher satisfaction with preformed primary anterior zirconia crowns compared to strip crown. Across several outcomes, zirconia crowns generally demonstrated favorable trends, including clinical retention, lower plaque and gingival index values, enhanced color match, and lower rates of restoration failure; however, some measures were comparable between the 2 crown types, and pooled estimates for certain outcomes were not statistically significant or were imprecise.
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