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.