Abstract:If choosing between these three strategies for managing cavitated caries lesions in primary molars, dentists should prefer HT over NRCC or CR. This would also save costs for the healthcare payer.
“…Dentists should offer evidence‐based treatment options focusing on the preservation of hard tissues, which could help ensure that treated carious teeth remain symptomless until physiological exfoliation. The Hall Technique with its multiple advantages, including high clinical success rate, ease of use, high acceptance by children, dentists and parents, and cost‐effectiveness etc, could be a suitable technique especially for treating anxious children with specific fears (eg, injections and drilling) or as an alternative therapy for improving cooperation and building confidence.This study highlights the efficacy of Hall crowns as a long‐term, durable, and successful technique for asymptomatic carious primary molars.This study shows that the Hall Technique can be successfully used by dentists with different levels of expertise (postgraduate students/specialists) and in different treatment settings (chairside/under nitrous oxide sedation/general anaesthesia).This study enhances the evidence for the Hall Technique and recommends it to be frequently considered as a treatment option, even in cases where a radiographic pre‐treatment assessment is not possible.…”
Section: Discussionmentioning
confidence: 78%
“…Dentists should offer evidence-based treatment options focusing on the preservation of hard tissues, which could help ensure that treated carious teeth remain symptomless until physiological exfoliation. The Hall Technique with its multiple advantages, including high clinical success rate, ease of use, high acceptance by children, dentists and parents, 15,16,29 and cost-effectiveness 16,34 etc, could be a suitable technique especially for treating anxious children with specific fears (eg, injections and drilling) or as an alternative therapy for improving cooperation and building confidence.…”
Background
The Hall Technique is a less invasive caries management technique for treating carious primary molars. It has become a routine treatment at specialists’ practices.
Aim
To retrospectively evaluate the clinical success and survival rates of preformed metal crowns placed on primary molars using the Hall Technique in a Paediatric Dentistry Setting.
Design
Patient records of children receiving Hall crowns (with or without proximal slicing) between 2011 and 2017 were reviewed. Teeth with no clinical or radiographic evidence of pulp involvement at baseline and at least six months’ follow‐up were included. Kaplan‐Meier survival analyses and Mantel‐Cox statistics were carried out.
Results
In total, 181 Hall crowns performed in 2‐ to 10‐year‐olds with a mean follow‐up period of 22 months were included for analysis. Mean d3mft/D3MFT was 6.55 ± 3.48/0.18 ± 0.66. The majority of crowns were successful (92.3%; n = 167), four presented at least one minor failure (2.2%; reversible pulpitis, crown lost, or secondary caries) and ten were major failures (5.5%; irreversible pulpitis or abscess). When comparing crowns performed with no tooth preparation to crowns performed with proximal slicing, no differences were observed (P = 0.70, CI = 0.68‐0.83).
Conclusion
The survival rate and clinical efficacy of Hall crowns were high in a secondary care‐based setting. The HT is an effective and less invasive management option for asymptomatic carious primary molars.
“…Dentists should offer evidence‐based treatment options focusing on the preservation of hard tissues, which could help ensure that treated carious teeth remain symptomless until physiological exfoliation. The Hall Technique with its multiple advantages, including high clinical success rate, ease of use, high acceptance by children, dentists and parents, and cost‐effectiveness etc, could be a suitable technique especially for treating anxious children with specific fears (eg, injections and drilling) or as an alternative therapy for improving cooperation and building confidence.This study highlights the efficacy of Hall crowns as a long‐term, durable, and successful technique for asymptomatic carious primary molars.This study shows that the Hall Technique can be successfully used by dentists with different levels of expertise (postgraduate students/specialists) and in different treatment settings (chairside/under nitrous oxide sedation/general anaesthesia).This study enhances the evidence for the Hall Technique and recommends it to be frequently considered as a treatment option, even in cases where a radiographic pre‐treatment assessment is not possible.…”
Section: Discussionmentioning
confidence: 78%
“…Dentists should offer evidence-based treatment options focusing on the preservation of hard tissues, which could help ensure that treated carious teeth remain symptomless until physiological exfoliation. The Hall Technique with its multiple advantages, including high clinical success rate, ease of use, high acceptance by children, dentists and parents, 15,16,29 and cost-effectiveness 16,34 etc, could be a suitable technique especially for treating anxious children with specific fears (eg, injections and drilling) or as an alternative therapy for improving cooperation and building confidence.…”
Background
The Hall Technique is a less invasive caries management technique for treating carious primary molars. It has become a routine treatment at specialists’ practices.
Aim
To retrospectively evaluate the clinical success and survival rates of preformed metal crowns placed on primary molars using the Hall Technique in a Paediatric Dentistry Setting.
Design
Patient records of children receiving Hall crowns (with or without proximal slicing) between 2011 and 2017 were reviewed. Teeth with no clinical or radiographic evidence of pulp involvement at baseline and at least six months’ follow‐up were included. Kaplan‐Meier survival analyses and Mantel‐Cox statistics were carried out.
Results
In total, 181 Hall crowns performed in 2‐ to 10‐year‐olds with a mean follow‐up period of 22 months were included for analysis. Mean d3mft/D3MFT was 6.55 ± 3.48/0.18 ± 0.66. The majority of crowns were successful (92.3%; n = 167), four presented at least one minor failure (2.2%; reversible pulpitis, crown lost, or secondary caries) and ten were major failures (5.5%; irreversible pulpitis or abscess). When comparing crowns performed with no tooth preparation to crowns performed with proximal slicing, no differences were observed (P = 0.70, CI = 0.68‐0.83).
Conclusion
The survival rate and clinical efficacy of Hall crowns were high in a secondary care‐based setting. The HT is an effective and less invasive management option for asymptomatic carious primary molars.
“…In addition, HT costs were less than conventional restorations and NRCC. Thus, HT had superior cost-effectiveness than both conventional restorations and NRCC [42].…”
The high frequency of caries in primary teeth and its inadequate treatment are major public health problems during childhood. Nowadays, the Hall technique is one of the methods used for biological sealing in carious lesions in primary molars. Thus, the bacteria will be sealed from oral environment and the caries will be inactive. The objective of this article was to provide an updated search on the Hall technique description, indication, contraindication, advantages, concerns, success and failure, cost-effectiveness, acceptability, and preference in pediatric dentistry, and to compare the Hall technique with traditional crown preparation and conventional treatment options for carious primary molars. A discussion of the recently published articles on the Hall technique reveals that the Hall technique is considered a promising restorative option with high acceptability and longevity; with low failure rate for managing carious primary molars compared to conventional treatment modalities used in primary care settings. Furthermore, the survival rate of stainless steel crowns (SSCs) is considered high, whether provided using Hall technique or traditional preparation by a pediatric dentist. Thus, the Hall technique can be an effective addition to the clinician’s range of treatment options for carious primary molars. However, it should be chosen in restricted cases.
“…Cost-effectiveness analysis allows treatment comparisons in terms of both costs and effects [10]. Recent cost-effectiveness analyses of managing dental caries found the Hall Technique (HT), a method for managing carious lesions by sealing-in, to be costeffective compared to conventional restorations [11] and compared to both conventional restorations and a Non-Restorative Cavity Control approach [12]. However, these studies followed outcomes on single teeth and have focused on one type of biological approach (i.e.…”
Section: Introductionmentioning
confidence: 99%
“…The C + P strategy involved the complete mechanical removal of carious tooth tissue using local anesthesia and a drill followed by placement of a restoration alongside best practice preventive therapy and has been considered standard practice in the management of dental caries [14,15]. The B + P strategy involved sealing-in carious lesions using a variety of techniques including adhesive restorative materials or preformed metal crowns placed using the HT along with preventive therapy; Schwendicke et al's (2018, 2019) analyses focused on the HT component of B + P [11,12]. PA involved avoiding restorative intervention and using four components of preventive management; toothbrushing (with toothpaste of at least 1000ppmF concentration), dietary advice, fluoride varnish application, and fissure sealants to prevent further carious lesions.…”
Background: A three-arm parallel group, randomised controlled trial set in general dental practices in England, Scotland, and Wales was undertaken to evaluate three strategies to manage dental caries in primary teeth. Children, with at least one primary molar with caries into dentine, were randomised to receive Conventional with best practice prevention (C + P), Biological with best practice prevention (B + P), or best practice Prevention Alone (PA). Methods: Data on costs were collected via case report forms completed by clinical staff at every visit. The coprimary outcomes were incidence of, and number of episodes of, dental pain and/or infection avoided. The three strategies were ranked in order of mean cost and a more costly strategy was compared with a less costly strategy in terms of incremental cost-effectiveness. Costs and outcomes were discounted at 3.5%. Results: A total of 1144 children were randomised with data on 1058 children (C + P n = 352, B + P n = 352, PA n = 354) used in the analysis. On average, it costs £230 to manage dental caries in primary teeth over a period of up to 36 months. Managing children in PA was, on average, £19 (97.5% CI:-£18 to £55) less costly than managing those in B + P. In terms of effectiveness, on average, there were fewer incidences of, (− 0.06; 97.5% CI: − 0.14 to 0.02) and fewer episodes of dental pain and/or infection (− 0.14; 97.5% CI: − 0.29 to 0.71) in B + P compared to PA. C + P was unlikely to be considered cost-effective, as it was more costly and less effective than B + P. Conclusions: The mean cost of a child avoiding any dental pain and/or infection (incidence) was £330 and the mean cost per episode of dental pain and/or infection avoided was £130. At these thresholds B + P has the highest probability of being considered cost-effective. Over the willingness to pay thresholds considered, the probability of B + P being considered cost-effective never exceeded 75%. Trial registration: The trial was prospectively registered with the ISRCTN (reference number ISRCTN77044005) on the 26th January 2009 and East of Scotland Research Ethics Committee provided ethical approved (REC reference: 12/ES/0047).
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