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Sealing caries in primary molars: randomized control trial, 5-year results
N P T Innes1, D J P Evans, D R Stirrups
1University of Dundee, Unit of Dental and Oral Health, Park Place, Dundee, DD1 4HN, UK. n.p.innes@dundee.ac.uk
Journal of Dental Research
|September 17, 2011
Summary
The Hall Technique (HT) for managing carious primary molars significantly outperformed general dental practitioners' standard restorations. HT showed substantially lower rates of major and minor failures over 60 months, demonstrating its long-term clinical effectiveness.
Area of Science:
- Pediatric Dentistry
- Restorative Dentistry
- Caries Management
Background:
- The Hall Technique (HT) offers a method for managing carious primary molars by sealing decay under pre-formed metal crowns without extensive caries removal or anesthesia.
- Conventional management by General Dental Practitioners (GDPs) often involves more invasive procedures.
Purpose of the Study:
- To compare the clinical and radiographic failure rates of the Hall Technique (HT) against standard restorations provided by GDPs in primary molars.
Main Methods:
- A split-mouth, randomized controlled trial was conducted with 132 children (aged 3-10 years) and 17 GDPs in Scotland.
- 264 carious primary molars were randomized to either HT or GDP's usual treatment.
- Annual clinical and radiographic follow-ups were performed, with a minimum follow-up of 48 months for 91 patients.
Main Results:
- At 60 months, 'Major' failures (irreversible pulpitis, loss of vitality, abscess) were significantly lower in the HT group (3%) compared to control (16.5%).
- 'Minor' failures (reversible pulpitis, restoration issues, secondary caries) were also significantly lower with HT (5%) versus control (42%).
- Overall failure rates at 60 months showed HT success rates of 95% for major failures and 95% for minor failures, significantly outperforming control restorations.
Conclusions:
- The Hall Technique is a statistically and clinically superior long-term treatment option for carious primary molars compared to standard GDP restorations.
- HT demonstrates significantly lower rates of both major and minor failures, indicating better preservation of tooth vitality and restoration integrity.
- This technique provides a highly effective and less invasive approach to managing decay in primary teeth.
