Aronita Rosenblatt1. 1. University of Pernambuco, Brazil and The Forsyth Institute Boston, MA, USA.
Abstract
DESIGN: This was a general dental practice (GDP)-based, split-mouth, randomised controlled trial (RCT). INTERVENTION: The Hall technique, where a preformed metal crown (PMC) is cemented with no local anaesthesia, caries removal or tooth preparation, was compared with restoration with the material the GDP would normally choose. OUTCOME MEASURE: The outcomes were recorded as success; minor failure (restoration failure or reversible pulpitis, which could be managed by repair or replacement); or major failure (signs or symptoms of irreversible pulpal damage, such as dental abscess, or tooth broken down and unfeasible to repair or replace the restoration). RESULTS: A total of 128 conventional restorations were placed on 132 control teeth, and 128 PMC on 132 intervention teeth. Eighty-nine per cent of Hall PMC were rated by dentists as causing no apparent discomfort through to merely mild discomfort: for the control restorations this was 78% (not a significant difference). The Hall PMC outperformed the control restorations in terms of the number of major and minor failures (see Table 1). Preference for the Hall technique was recorded at 77% for the children, 83% for carers and 81% for dentists who expressed a preference, which this was significant (Chi square, P<0.0001). CONCLUSIONS: The Hall technique was preferred to conventional restorations by the majority of children, carers and dental practitioners. After 2 years, Hall PMC showed more favourable outcomes for pulpal health and restoration longevity than conventional restorations. The Hall technique appears to offer an effective treatment option for carious primary molar teeth.
RCT Entities:
DESIGN: This was a general dental practice (GDP)-based, split-mouth, randomised controlled trial (RCT). INTERVENTION: The Hall technique, where a preformed metal crown (PMC) is cemented with no local anaesthesia, caries removal or tooth preparation, was compared with restoration with the material the GDP would normally choose. OUTCOME MEASURE: The outcomes were recorded as success; minor failure (restoration failure or reversible pulpitis, which could be managed by repair or replacement); or major failure (signs or symptoms of irreversible pulpal damage, such as dental abscess, or tooth broken down and unfeasible to repair or replace the restoration). RESULTS: A total of 128 conventional restorations were placed on 132 control teeth, and 128 PMC on 132 intervention teeth. Eighty-nine per cent of Hall PMC were rated by dentists as causing no apparent discomfort through to merely mild discomfort: for the control restorations this was 78% (not a significant difference). The Hall PMC outperformed the control restorations in terms of the number of major and minor failures (see Table 1). Preference for the Hall technique was recorded at 77% for the children, 83% for carers and 81% for dentists who expressed a preference, which this was significant (Chi square, P<0.0001). CONCLUSIONS: The Hall technique was preferred to conventional restorations by the majority of children, carers and dental practitioners. After 2 years, Hall PMC showed more favourable outcomes for pulpal health and restoration longevity than conventional restorations. The Hall technique appears to offer an effective treatment option for carious primary molar teeth.