Documented Failure Patterns of Prefabricated Zirconia Crowns on Pulpectomized Maxillary Primary Incisors in Children Treated Under General Anesthesia: A Retrospective Study

Background: Prefabricated zirconia crowns are used to restore extensively damaged primary incisors, including in children undergoing comprehensive dental treatment under general anesthesia. Clinical documentation of the types and timing of subsequent restoration-related complications is useful, but follow-up ascertainment must be considered when interpreting event frequencies. Objective: To describe recorded failure types and their timing among prefabricated zirconia crowns placed after pulpectomy on maxillary primary central and lateral incisors in children treated under general anesthesia. Methods: In this retrospective chart review, 113 patient records were screened. Two records contained no documented maxillary primary incisor crowns, and two further records were excluded in full because their tooth-group counts exceeded the anatomically possible number of maxillary primary incisors and could not be reconciled with source charts. The resulting analysis dataset comprised 109 children with 396 recorded eligible maxillary primary incisor crowns (205 central and 191 lateral). All included teeth underwent pulpectomy before crown placement. Documented debonding and trauma-related loss of the tooth–crown complex were distinguished. Individual dates of event-free review and censoring were unavailable, precluding valid Kaplan–Meier analysis. Results: After excluding two records with no documented eligible incisor crown and two records with irreconcilable tooth-count inconsistencies, the revised analysis includes 109 children and 396 recorded maxillary primary incisor crowns (205 central and 191 lateral). There were 48 girls and 61 boys. Five documented failures occurred within 18 months (three debondings and two trauma-related events), and two additional events occurred at 41 and 49 months. These frequencies do not establish a fixed-time risk or survival estimate. Conclusions: The available clinical records identified loss of crown retention and traumatic injury to the restored tooth–crown complex as distinct documented failure modes after zirconia crown placement on pulpectomized maxillary primary incisors. Incomplete restoration-specific follow-up records preclude reliable estimation of crown survival or cumulative failure risk. Prospective restoration-level follow-up is needed to quantify longevity.