Procedural Pain, Hall Technique Crowns and Separators: A Randomized Controlled Clinical Pilot Feasibility Study

Area of Science:

• Pediatric Dentistry
• Orthodontics
• Pain Management

Background:

• The Hall Technique (HT) for stainless steel crowns (SSCs) involves elastomeric orthodontic separators (EOSs).
• Recent studies indicate that HT procedures can cause significant procedural pain.

Purpose of the Study:

• To evaluate procedural pain associated with bilateral HT EOSs and SSCs.
• To assess the efficacy of benzocaine 20% topical anesthetic gel (BZG) in mitigating child-perceived pain after EOSs placement.

Main Methods:

• A randomized controlled, split-mouth, single-blinded pilot feasibility trial was conducted.
• Children received BZG or placebo before EOSs placement, with pain assessed using the Wong-Baker FACES Pain Rating Scale (WBFS).
• Pain scores were recorded post-EOSs placement and SSC cementation.

Main Results:

• Bilateral SSC placement caused less pain than bilateral EOSs placement (p=0.001).
• BZG significantly reduced pain when four EOSs were placed per child (p=0.045), but not with two EOSs.
• Higher numbers of EOSs per tooth correlated with increased pain perception.

Conclusions:

• Procedural pain in HT-SSCs is mainly linked to EOSs placement, not SSC cementation.
• BZG demonstrates effectiveness in reducing immediate pain perception when multiple EOSs are used.
• Findings support further investigation in a larger clinical trial.