Changes in occlusal bite force following placement of preformed metal crowns on primary molars in 4–6 years old children: a 6 months’ follow-up pilot study

  • A. I. OwaisEmail author
  • A. H. Al-Battah
  • E. S. Abu Alhaija
Original Scientific Article



To evaluate the occlusal bite force (OBF) changes 6 months after placement of preformed metal crowns PMCs on primary molars in children.


Twenty-two subjects (aged 5.08 ± 0.92 years) participated and completed OBF records. Each patient received eight PMCs on their primary molars. OBF was recorded using a battery-operated portable type of OBF gauge at different time intervals: before placement, 1 week-, 1 month-, 2 months-, 3 months-, and 6 months after PMCs placement (T0–T5). A second group consisted of 22 caries-free children matched for age and gender were selected as a control sample and received no dental treatment. OBF was recorded in these subjects at T0 and T5 (6 months after).


OBF was reduced the first week after placement of PMCs. However, the OBF was restored and reached its original value at T4. At the 6-month recall visit (T5), maximum occlusal bite force (MOBF) was 148% and 136% of pre-treatment value on right and left sides, respectively. The mean MOBF difference between T5 and T0 was statistically significant (70.83N and 54.67N on the right and left sides respectively, p < 0.000).


OBF decreased 1 week after placement of PMC restoration and started to increase after 1 month reaching 136–140% of its original value after 6 months.


Preformed metal crowns Primary molar teeth Children Occlusal bite force 



This research was conducted to fulfill the master degree requirements according to the master degree regulation set by JUST University of Science and Technology. This study was supported by Deanship of Research at the Jordan University of Science and Technology (Grant Number 251/2011). We would like to express our gratitude to Dr. Haitham Owais for his help during the conduct of this study.

Compliance with ethical standards

Conflict of interest

We have no conflict of interest to declare.


  1. Abu Alhaija E, Al Zo’ubi I, Al Rousan M, Hammad M. Maximum occlusal bite forces in Jordanian individuals with different dentofacial vertical skeletal patterns. Eur J Orthod. 2010;32(1):71–7.CrossRefGoogle Scholar
  2. Atieh M. Stainless steel crown versus modified open-sandwich restorations for primary molars: a 2-year randomized clinical trial. Int J Paediatr Dent. 2008;18(5):325–32.CrossRefGoogle Scholar
  3. Babic J, Panduric J, Jerolimov V et al. Bite force in subjects with complete dentition. Coll Antropol. 2002;26:293–302.Google Scholar
  4. Bakke M, Møller E, Thorsen N. Occlusal contact and maximal muscle activity in natural mandibular position. J Dent Res. 1980;59:892.Google Scholar
  5. Castelo PM, Gavião MB, Pereira LJ, Bonjardim LR. Masticatory muscle thickness, bite force, and occlusal contacts in young children with unilateral posterior crossbite. Eur J Orthod. 2007;29:149–56.CrossRefGoogle Scholar
  6. English JD, Buschang PH, Throckmorton GS. Does malocclusion affect masticatory performance? Angle Orthod. 2002;72:21–7.PubMedGoogle Scholar
  7. Gallagher S, O’Connell BC, O’Connell AC. Assessment of occlusion after placement of stainless steel crowns in children—a pilot study. J Oral Rehabil. 2014 Oct;41(10):730–6.CrossRefGoogle Scholar
  8. IBM Corporation. IBM SPSS statistics for windows, version 22.0. Armonk: IBM Corp; 2013.Google Scholar
  9. Kindelan S, Day P, Nichol R, Willmott N, Fayle S. UK National Clinical Guidelines in Paediatric Dentistry: stainless steel preformed crowns for primary molars. Int J Paediatr Dent. 2008;18(1):20–8.CrossRefGoogle Scholar
  10. Koc D, Dogan A, Bek B. Bite force and influential factors on bite force measurements: a literature review. Eur J Dent. 2010;4(2):223–32.PubMedPubMedCentralGoogle Scholar
  11. Magalhaes IB, Pereira LJ, Marques LS, Gameiro GH. The influence of malocclusion on masticatory performance. A systematic review. Angle Orthod. 2010;80:981–7.CrossRefGoogle Scholar
  12. Mountain G, Wood D, Toumba J. Bite force measurement in children with primary dentition. Int J Paediatr Dent. 2011;21(2):112–8.CrossRefGoogle Scholar
  13. Ohira A, Ono Y, Yano N, Takagi Y. The effect of chewing exercise in preschool children on maximum bite force and masticatory performance. Int J Paediatr Dent. 2012;22(2):146–53.CrossRefGoogle Scholar
  14. Oliveira LB, Sheiham A, Bonecker M. Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children. Eur J Oral Sci. 2008;116(1):37–43.CrossRefGoogle Scholar
  15. Oueis H. Factors affecting masticatory performance of Japanese children. Int J Paediatr Dent. 2009;19(3):201–5.CrossRefGoogle Scholar
  16. Owais I, Shaweesh M, Abu Alhaija E. Maximum occusal bite force for children in different dentition stages. Eur J Orthod. 2013;35(4):427–33.CrossRefGoogle Scholar
  17. Owens S, Buschang P, Throckmorton G, Palmer L, English J. Masticatory performance and areas of occlusal contact and near contact in subjects with normal occlusion and malocclusion. Am J Orthod Dentofac Orthop. 2002;121(6):602–9.CrossRefGoogle Scholar
  18. Rentes A, Gaviao M, Amaral J. Bite force determination in children with primary dentition. J Oral Rehabil. 2002;29(12):1174–80.CrossRefGoogle Scholar
  19. Roldán SI, Restrepo LG, Isaza JF, Vélez LG, Buschang PH. Are maximum bite forces of subjects 7 to 17 years of age related to malocclusion? Angle Orthod. 2016;86(3):456–461.CrossRefGoogle Scholar
  20. Seale N. Stainless steel crowns improve success rate of root canal treatment in primary teeth. J Evid Based Dent Pract. 2005;5(4):205–6.CrossRefGoogle Scholar
  21. Seale N, Randall R. The use of stainless steel crowns: a systematic review. Pediatr Dent. 2015;37(2):147–62.Google Scholar
  22. Serra M, Gambareli F, Gaviao M. A 1-year intraindividual evaluation of maximum bite force in children wearing a removable partial dental prosthesis. J Dent Child. 2007;74(3):171–6.Google Scholar
  23. Sonnesen L, Bakke M, Solow B. Bite force in pre-orthodontic children with unilateral crossbite. Eur J Orthod. 2001;23:741–9.CrossRefGoogle Scholar
  24. Su C, Yang Y, Hsieh T. Relationship between oral status and maximum bite force in preschool children. J Dent Sci. 2009;4(1):32–9.CrossRefGoogle Scholar
  25. Tortopidis D, Lyons M, Baxendale R, Gilmour W. The variability of bite force measurement between sessions, in different positions within the dental arch. J Oral Rehabil. 1998;25(9):681–6.CrossRefGoogle Scholar
  26. Tsai H. Maximum bite force and related dental status in children with deciduous dentition. J Clin Pediatr Dent. 2004;28:139–42.CrossRefGoogle Scholar
  27. van Gemert-Schriks MC, van Amerongen WE, ten Cate JM, Aartman IH. The effect of different dental treatment strategies on the oral health of children: a longitudinal randomised controlled trial. Clin Oral Investig. 2008;12(4):361–8.CrossRefGoogle Scholar
  28. van der Zee V, van Amerongen WE. Influence of pre-formed metal crowns (Hall technique) on the occlusal vertical dimension in the primary dentition. Eur Arch Paediatr Dent. 2010;11:110–2.Google Scholar
  29. Wong HM, Mcgrath CP, King NM, Lo EC. Oral health related quality of life in Hong Kong preschool children. Caries Res. 2011;45(4):370–6.CrossRefGoogle Scholar
  30. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  • A. I. Owais
    • 1
    Email author
  • A. H. Al-Battah
    • 2
  • E. S. Abu Alhaija
    • 3
  1. 1.Division of Paediatric Dentistry, Department of Preventive Dentistry, Faculty of DentistryJordan University of Science and TechnologyIrbidJordan
  2. 2.Department of Preventive Dentistry, Faculty of DentistryJordan University of Science and TechnologyIrbidJordan
  3. 3.Division of Orthodontics, Department of Preventive Dentistry, Faculty of DentistryJordan University of Science and TechnologyIrbidJordan

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