Restoration of badly decayed primary incisors is challenging. Esthetics crowns present a solution to this problem. Pompedo esthetic crown is made of polyoxymethylene. The clinical performance of Pompedo crowns have not been tested before. Thus, the aim of this study is to compare the effectiveness of Pompedo (PC) versus NuSmile zirconia crowns (NSZ) in terms of retention, discoloration and fracture. Methods: Records from a private practice was screened for children conforming with eligibility criteria. Twelve children in both groups were recalled for follow-up. Two assessors examined the children and the records. Consensus resolved differences between examiners. Results: The relative risk for crown dislodgement was 1.25 (95% CI: 0.4 to 3.8), with no significant statistical difference (P<0.05). The relative risk for crown discolouration was 2.43 (95%CI: 0.67 to 8.85) with one and a half time more chance for crown discolouration in PC compared to NSZ, but this result is not statistically significant (P<0.05). Finally, the risk of crown fracture in the NSZ was 8% (95% CI: 3 to 18), while none of the PC was broken. Conclusion: In conclusion, both NSZ and PC showed good clinical performance with NSZ slightly better in resisting colour changes and PC being better in resisting crown fracture. PC can be recommended for use as an aesthetic replacement for zirconia crowns in primary teeth due to its lower cost and comparable clinical performance over two years post placement
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