The paper presents the results of randomized split moth study on effectiveness of fillings and stainless-steel pediatric crowns (SSC) for primary teeth restoration. The study involved 68 children aged 1.5 to 6 years having at least two symmetrical primary molars diagnosed with chronic pulpitis (a total of 166 primary molars). After pulpotomy the teeth were randomly divided in two groups according to restoration type and restored with SCC (3MEspe) or compomer filling (Dyract XP, Dentsply). The children were examined at 3, 6, 12, 18 and 24 months after the procedure both clinically and radiologically. SCCs showed significantly better results at 24 months examination. Extraction rate in teeth restored with SCCs and fillings was 2 and 31%, correspondingly (p=0.0001). The results were much more favorable in second primary molars than in first ones: only 2 from 56 second molars and 16 from 110 first molars were extracted (p=0.02). The study results prove SCCs to be restoration of choice especially for the first primary molars in children with severe early childhood caries.