The influence of stainless steel crowns placed on primary teeth on biochemical parameters in GCF: A systematic review

Objective: The aim of this systematic review was to investigate, identify, and summarize the existing literature on the levels of proinflammatory cytokines and chemokines present in gingival crevicular fluid (GCF) of primary teeth restored with stainless steel crowns (SSC) versus control teeth. Materials and methods: The systematic review was registered in the Open Science Framework (ID): 10.17605/OSF.IO/39U4D. In addition, it was prepared following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Five electronic databases were used to identify studies for this systematic review: PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar, from January 10, 1999, to September 15, 2024. The risk of bias in the included studies was assessed using Joanna Briggs Institute (cross-sectional studies) and the Cochrane Risk of Bias for Randomized Trials (RoB 2.0) in randomized clinical trials. Results: The review includes four studies (two cross-sectional and two randomized clinical trials). A total of 75 children aged 3 to 10 years were studied. GCF samples were taken from 98 upper and lower molars rehabilitated with SSC and control teeth (without SSC). ELISA analyzed all samples. This way, the levels of four proinflammatory cytokines and chemokines, IL-1β, IL-6, MIP-1α, and MIP-1β, were determined. The studies reported significant differences between both study groups: IL-1β: 27.30 versus 23.56 p < 0.05; MIP-1α: 682.55 versus 197.60 p < 0.05; and MIP-1β: 884.35 versus 287.85, p < 0.05. Conclusions: This systematic review provides a comprehensive and current overview of the concentrations of proinflammatory cytokines and chemokines present in GCF, providing new insights into the pathogenesis of gingival inflammation in children with SSC. IL-1β, MIP-1α, and MIP-1β levels increased in the GCF of upper and lower molars rehabilitated with stainless steel crowns compared to control primary teeth.