Introduction: the objective of this systematic review was to determine the predisposing factors for gingival inflammation produced by steel crowns, compared to unrestored temporary teeth in the pediatric population. Methods: a systematic literature review by searching scientific articles in these databases: Pubmed, Elsevier, Embase, Cochrane, and Lilacs using the following terms: stainless steel crowns, pediatric crowns, gingivitis, pediatric dentistry, clinical parameters, and child, and reducing the search with eligibility criteria with no language distinction. This search included analytic observational studies, clinical trials, and systematic reviews. The studies’ quality and validity after final filtration were evaluated with two checklists: CONSORT (clinical trials) and STROBE (cross-sectional analytical observational studies). They were later classified according to levels of evidence and degrees of recommendation, according to the parameters of the Scottish Intercollegiate Guidelines Network. Results: once the process of reading and information analysis was completed, 1450 articles were identified in the period of study (1970-2012) and 10 were selected as they met the inclusion criteria. Duplicates were discarded as well as those that did not meet the specifications required to answer the research question. Finally, 2 articles were chosen as they met the previously set requirements. Conclusions: the scientific evidence was not enough to support the fact of steel crowns adaptation being one of the predisposing factors for gingival disease in the pediatric patients, nor does it prove the alteration of periodontal tissue by invading biological thickness due to the over-extension of steel crowns. The variable related to excessive cement material has not been widely documented. While a clinical study showed that gingival health is affected by steel crowns in the presence of dental biofilm, the literature is not conclusive regarding the behavior of gingival tissue in the pediatric population.