A 24-month retrospective study of preformed metal crowns: the Hall technique versus the conventional preparation method

Time to complain about pain: Children's self-reported procedural pain in a randomised control trial of Hall and conventional stainless steel crown techniques

BACKGROUND

Children's pain in dentistry has undesirable short- and long-term consequences; therefore, less invasive treatments merit consideration.

AIM

To investigate procedural pain scores for two treatments for carious primary molars in New Zealand primary care.

DESIGN

This study was a split-mouth randomised control trial, with secondary outcome analysis. Children (4-8 years) with proximal carious lesions on matched primary molars had one tooth treated with the Hall technique (HT) and one treated with a conventional stainless steel crown (CT); treatment type and order of treatment were randomly allocated (allocation concealment). The Wong-Baker self-report pain scale measured pretreatment dental pain, procedural pain at each treatment and post-operative pain.

RESULTS

Data were analysed for 103 children: 49 children had the HT first and 54 children had the CT first. Procedural pain scores did not differ by treatment type, with 71.8% and 76.7% of children reporting low pain for the HT and the CT, respectively. Fewer children reported low procedural pain for the second treatment than the first (p = .047). Most children reported low procedural pain for both treatments (58.3%), although 41.7% experienced moderate-high procedural pain with at least one treatment.

CONCLUSIONS

The HT caused pain for as many children as the CT. There is an opportunity for better dental pain management in this setting.

Hall technique versus conventional preformed metal crowns: can paediatric dentists tell the difference on radiographs?

PURPOSE

Hall technique (HT) preformed metal crowns (PMCs) are allegedly oversized compared to conventional (C) PMCs. To investigate paediatric dentists' (PDs) perception of HT-PMCs and perception/ability to identify HT or C-PMCs on bitewings radiographs.

METHODS

An online cross-sectional questionnaire including ten bitewings (five of each of HT/CPMCs) was sent to PDs across the globe. A PMC type score (from '10') was calculated. T test, Pearson's and Fischer's Chi-square, and Odd Ratios (OR) (p < 0.05).

RESULTS

A total of 476 PDs from around the world responded. Most (97%) used PMCs in their practice. Most (98.7%) knew of, and 79% used HT-PMCs. A clear opinion shift, towards supporting HT, over time was noted (OR 11.154 [95% confidence interval (CI) 6.006-20.715]. A majority (67%) thought that HT/C-PMCs were similar radiographically. Only five PMCs were identified correctly [mean score 4.9 (± 1.73)]. A minority who thought that HT/C-PMCs were dissimilar scored higher than those who thought they were similar (5.31 ± 1.22; 4.68 ± 1.9, respectively, p < 0.00001). Nobody identified all ten PMCs. HT-PMCs were 4.63 times more identifiable than C-PMCs [(OR 24.857 CI 15.059-41.028) and (OR 5.361 CI 3.089-9.304)] for HT-PMCs and CP-MCs, respectively (p < 0.0001).

CONCLUSIONS

PDs identified the PMC type in half of the bitewings. They perceived no clear radiographic difference between HT-PMCs and C-PMCs, but their chance of recognizing HT-PMCs was five times higher than C-PMCs. HT-PMC support was high.

Outcomes of preformed metal crowns placed with the conventional and Hall techniques: A systematic review and meta-analysis

BACKGROUND

Preformed metal crowns (PMCs) have been used to restore carious primary molars and have a high success and survival rate. There are two methods currently employed for PMC placement - the conventional technique (CT) and Hall technique (HT).

AIM

This systematic review aims to compare the outcomes of PMCs placed using the CT and HT.

DESIGN

This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A literature search of five databases was performed up to 23 August 2022. Clinical studies comparing carious primary molars restored with PMCs using either technique with a minimum 12-month follow-up were included. Risk of bias (RoB) assessment was performed using the National Institutes of Health Quality Assessment tool.

RESULTS

Five articles met the inclusion criteria, and four were included for meta-analysis. The 12- and 24-month success and survival rates were above 85% for both groups, with no significant differences shown at 12 and 24 months. The HT requires a shorter treatment duration, is more cost-effective and has a high level of acceptability among parents when compared to the CT. Four articles were rated fair, and one article was rated good in the RoB assessment.

CONCLUSION

Greater consideration may be given towards using the HT as part of standard treatment procedures in managing carious primary molars. Future studies should standardise reporting of outcomes to facilitate a more homogeneous pool of data for future meta-analysis.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.

Impact of COVID-19 Pandemic on Dental Treatment in Children: A Retrospective Cross-Sectional Analysis in Jeddah City

Background/Purpose

The novel coronavirus disease (COVID-19) outbreak has affected individuals worldwide. Considering the nature of dental treatments and direct exposure to saliva, blood, aerosols, or droplets from infected individuals, dentists are at significant risk of COVID-19 infection. Therefore, to decrease aerosol-generating procedures, minimally invasive dentistry (MID) is recommended during this pandemic. The goal of this research was to compare the flow of patients during a pandemic at a single university hospital in Jeddah City, Saudi Arabia, and to retrospectively assess the impact of the COVID-19 pandemic on pediatric dental treatments including MID.

Materials and Methods

This study was a retrospective cross-sectional analysis of pediatric patient records, dental procedures performed, and minimally invasive techniques using the database of the King Abdul-Aziz University Dental Hospital (R4) system during the period of COVID 19 pandemic compared to the same period in the previous year.

Results

During the COVID-19 pandemic, pediatric dental patient flow included only 699 patients compared to 1151 patients during the same period in the previous year. The most common pediatric dental procedures performed during the pandemic period were simple restorative treatments, including fissure sealants, followed by dental extractions, and fluoride varnish applications. During the pandemic period, more minimally invasive treatments were performed, including the Hall technique, silver diamine fluoride, resin infiltration, and atraumatic restorative techniques.

Conclusion

Based on this data, the COVID-19 pandemic had an impact on dental patient flow and the type of dental procedures performed on children. Minimally invasive treatments that minimize air generation are recommended; however, to establish the long-term effectiveness of minimally invasive treatments in pediatric dentistry, more follow-up studies with bigger sample sizes are required. More recommendations regarding conservative pediatric dental management after the COVID-19 era are suggested.

Exploring Parent's Satisfaction and the Effectiveness of Preformed Metal Crowns Fitting by Hall Technique for Carious Primary Molars in Jeddah Region, Saudi Arabia: Findings of a Prospective Cohort Study

PURPOSE

The Hall technique (HT) is a non-invasive approach to treating carious primary teeth. Its acceptability by parents and effectiveness is not widely known in the Middle East. Therefore, we aimed to conduct this study to explore the effectiveness of preformed metal crowns (PMCs) fitting by HT and to what extent the parent's satisfaction for their children in Jeddah region.

MATERIALS AND METHODS

A prospective cohort study was conducted in the outpatient pediatric dental clinic at Jeddah Specialty Dental Center, in 2018. The cohort of children was exposed to the HT and was recalled 3 months to two years later to examine present or absence of: crown loss, open margin, signs or symptoms of reversible or irreversible pulpitis, and if the tooth exfoliated naturally. Parents who agreed to undergo the HT for their children completed a 5-point Likert questionnaire after treatment and after three months.

RESULTS

A total of 48 children (72 teeth) were initially enrolled, but only 25 children (49 teeth) completed two years of follow-up. At 2 years follow-up, one PMC was lost (2.04%) while no teeth fitted with the HT required any further intervention. Around 96% of parents were satisfied with this procedure and 92% wanted other carious teeth to be treated similarly. All parents were satisfied with this technique because it did not include local anesthesia and no drilling. It was found that parents of girls were satisfied more than parents of boys and on average their satisfaction score at the time of treatment was 3.04 units higher than parents of boys with a significant p-value of 0.02 and 95% CI for the beta coefficient to be 0.46 to 5.62.

CONCLUSION

The HT is effective as a treatment of dental caries and it was generally accepted by parents initially and during their follow-up visits.