{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:03:19Z","timestamp":1784545399838,"version":"3.55.0"},"reference-count":75,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Paed Dentistry"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stainless steel crowns (SSCs) are the standard for restoring severely damaged primary teeth, but esthetic concerns and metal hypersensitivity have driven interest in alternatives. Bioflx crowns (BFCs) are flexible, metal\u2010free restorations with uncertain comparative performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the clinical and in\u00a0vitro performance of BFCs versus SSCs, zirconia crowns (ZrCs), and other pediatric crown systems (Figaro, PEEK, Edelweiss, and graphene\u2010based).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This PRISMA\u2010based systematic review searched PubMed\/MEDLINE, Scopus, Web of Science, Cochrane, Embase, and Google Scholar. Comparative clinical and in\u00a0vitro studies were included. Risk of bias was assessed using Cochrane ROB\u20102 and modified CONSORT tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010six studies (nine clinical and 17 in\u00a0vitro) were included. BFCs showed variable fracture resistance, favorable stress distribution, and less antagonist enamel wear than ZrCs, but lower, cement\u2010dependent retention compared with SSCs. Clinically, BFCs demonstrated high short\u2010term survival (&gt;\u200990%), comparable gingival health, and higher parental satisfaction, with an overall low\u2010to\u2010moderate risk of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bioflx crowns show promising short\u2010term performance as an esthetic prefabricated option for primary teeth. Although SSCs remain superior in retention with conventional cementation, and Hall technique support is not yet validated for BFCs, BFCs offer esthetic, antagonist\u2010preserving, and clinical efficiency advantages. Evidence remains limited, warranting cautious interpretation and long\u2010term RCTs.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration<\/jats:bold>\n                    <\/jats:p>\n                    <jats:p>This systematic review was prospectively registered in PROSPERO (CRD420251083036)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ipd.70111","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:12:46Z","timestamp":1784542366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and In\u00a0Vitro Performance of Bioflx Crowns in Primary Teeth: A Systematic Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2250-1799","authenticated-orcid":false,"given":"Sara Faisal","family":"Hamdy","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry and Dental Public Health, Faculty of Dentistry Suez Canal University  Ismaillia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5962-6907","authenticated-orcid":false,"given":"Redhwan Saleh","family":"Al\u2010Gabri","sequence":"additional","affiliation":[{"name":"Prosthodontics Department, Faculty of Dentistry Ibb University  Ibb Yemen"},{"name":"Prosthodontics Department, Faculty of Dentistry National University  Ibb Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Abd Al\u2010aziz","family":"Al\u2010wahbi","sequence":"additional","affiliation":[{"name":"Prosthodontics Department, Faculty of Dentistry Ibb University  Ibb Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-6381","authenticated-orcid":false,"given":"Abeer","family":"Sharafuddin","sequence":"additional","affiliation":[{"name":"Oral Medicine, Oral Diagnosis, Periodontology and Oral Radiology Department, Faculty of Dentistry Sana'a University  Sana'a Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mokhtar","family":"Al\u2010Domeni","sequence":"additional","affiliation":[{"name":"Prosthodontics Department, Faculty of Dentistry Ibb University  Ibb Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman","family":"Fadag","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry Ibb University  Ibb Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadeq","family":"Altayyar","sequence":"additional","affiliation":[{"name":"Prosthodontics Department, Faculty of Dentistry Ibb University  Ibb Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan Omar","family":"AboAlrejal","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Radiology Department, Faculty of Dentistry Ibb University  Ibb Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husam","family":"Alofi","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, College of Dentistry Taibah University  Madinah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6536-8269","authenticated-orcid":false,"given":"Ahmed Yaseen","family":"Alqutaibi","sequence":"additional","affiliation":[{"name":"Prosthodontics Department, Faculty of Dentistry Ibb University  Ibb Yemen"},{"name":"Department of Substitutive Dental Sciences (Prosthodontics), College of Dentistry Taibah University  Madinah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"112","article-title":"Zirconia vs. Stainless Steel Pediatric Crowns: A Literature Review","volume":"70","author":"Ludovichetti F. 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