A 12-month prospective randomized controlled comparative evaluation of clinical success of esthetic flexible crowns with stainless steel crowns in primary mandibular molar teeth.

This article presents a 12-month randomized controlled split-mouth trial comparing the clinical success of esthetic flexible crowns (EFCs), specifically Bioflx crowns, with stainless steel crowns (SSCs) in primary mandibular molars of 30 children aged 4 to 8 years. Using modified United States Public Health Service (USPHS) Ryge criteria, the study found that SSCs demonstrated superior resistance to staining, better surface integrity, and no major failures, whereas EFCs showed higher rates of staining, surface roughness, and two instances of crown dislodgement or fracture. Although EFCs required slightly less placement time and were preferred by parents for esthetics, their clinical performance was inferior to SSCs over the study period. The authors conclude that while EFCs may be chosen for esthetic reasons, SSCs remain the more durable option, and larger long-term trials are needed to validate improvements in esthetic crown materials.