Key Points
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Discusses evidence that the Hall Technique is an effective caries management technique for children with carious primary molars.
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Highlights that crowns placed using the Hall Technique have high success rates over the lifetime of primary teeth.
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Suggests clinicians should consider the Hall Technique for carious primary molars with approximal lesions into dentine.
Abstract
Background and aim Few paediatric dental restorative trials present outcomes for more than two years, leaving clinicians uncertain of long-term implications for their patients. This study aimed to establish the Hall Technique's success over the lifetime of primary teeth compared to conventional restorations (CR), by following up participants in the Tayside (Scotland), UK trial.
Design Following the Phase 1 prospective, split-mouth randomised control trial with 132 children (264 teeth) in 17 general practices in Scotland, 142/264 (54%) teeth had reached an endpoint of exfoliation or extraction. Through practices, Phase 2 follow-up data were collected retrospectively from case-notes, using original trial outcomes. Phase 1/ 2 outcome data were combined.
Results Data were obtained up until exfoliation/extraction for 184 teeth (73%) in matched pairs. Major failures: 16 CR; 4 HT (P = 0.0015); ARR = 0.13 (95%CI: 0.04;0.22), numbers needed to treat (NNT) 8 (95%CI: 4;25) favouring HT. Minor failures: 37 CR; 5 HT (P <0.0001); ARR = 0.35 (95%CI: 0.23;0.45) and NNT = 3 (95%CI: 2;4). Repeat failures occurred mostly in the conventional restoration arm for both major and minor failures.
Conclusions The HT continued to outperform GDP's standard restorations in primary molar teeth with significant caries involvement over the lifetime of the teeth.
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Acknowledgements
We would like to thank the children, their parents and all of the Tayside General Dental Practitioners who so assiduously took part in the original Hall Technique RCT as well as those dentists who allowed us to access their records and complete that initial piece of work. This study was supported by the University of Dundee, UK.
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Nicola Innes and Dafydd Evans received partial sponsorship in 2000, from 3M/ESPE, for the randomised control clinical trial investigating the use of preformed metal crowns to seal caries into primary molar teeth using the HT. The idea for this study, collection and analysis of Phase 2 data was supported only by the individuals' institutional funding and did not have any external funding. The other authors declare no conflict of interest. Only the authors were involved in: conceiving the study design; collection; analysis and interpretation of the data; and writing the manuscript.
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Innes, N., Stewart, M., Souster, G. et al. The Hall Technique; retrospective case-note follow-up of 5-year RCT. Br Dent J 219, 395–400 (2015). https://doi.org/10.1038/sj.bdj.2015.816
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DOI: https://doi.org/10.1038/sj.bdj.2015.816
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