Ultrastructure and properties of primary carious molars treated using the Hall Technique

Abstract

Background The Hall Technique (HT) is a method of restoring decayed primary teeth using stainless steel crowns (SSCs) without tooth preparation, caries removal, or local anaesthetic. Aim To investigate the ultrastructural, biomechanical, and chemical characteristics of teeth managed with the Hall Technique in comparison with conventional SSC (controls). Design Twelve HT‐treated primary molars and four controls were analysed. Teeth were dehydrated in ethanol, embedded in methylmethacrylate, mesio‐distally sectioned, X‐rayed, mounted, and polished. Biomechanical, ultrastructural, and chemical characterisation was performed for carious lesion and sound areas of each specimen. Results Pre‐treatment and post‐treatment X‐rays showed evidence of little to no caries progression over time. In carious lesions, mean hardness and elastic modulus values were lower in HT‐treated teeth than in controls. In both controls and HT‐treated teeth, carious lesions had the lowest %wt of Ca and P of all tissues sampled. Conclusions Although the retained carious tissue was biomechanically more compromised in HT‐treated teeth, the Ca and P values were higher than reported elsewhere for carious lesions in primary molars, suggesting remineralisation may have occurred in caries in HT‐treated teeth. Future investigations will help elucidate the processes involved with carious lesion arrest under SSC.

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

“…Further, there was a lower mean hardness in HT-treated teeth than in controls. 15 Similarly, another study conducted in India found that children are free of any signs and symptoms of mandibular joint dysfunction following this technique, and any changes in the occlusion are settled four weeks after employing the HT. 16 Likewise, findings from one systematic review and meta-analysis showed that randomized controlled trials and quasi-experimental studies favored the HT in comparison to other approaches.…”

“…Pre- and post-treatment X-rays revealed little to no caries progression over time, and Ca and P values were higher than previously reported for carious lesions in primary molars, implying that remineralization may have occurred in caries in HT-treated teeth. 15 …”

“…Patient Preference and Adherence 2022:16 2504 little to no caries progression over time, and Ca and P values were higher than previously reported for carious lesions in primary molars, implying that remineralization may have occurred in caries in HT-treated teeth. 15 Since the Hall technique does not involve occlusal preparation, placing the preformed crown may cause an increase in the occlusal vertical dimension (OVD). In this study, 96% did not complain to their parent about their bite after treatment.…”

Comparison of the Hall Technique and Conventional Compomer Restorations: A 60-Month Follow-up

“…Since the bacteria cannot produce acids, the cariogenicity of biofilm becomes less (5). In addition, when primary molars were treated with Hall Technique, it has been observed that although the hardness and elastic modulus of tissue was low, the calcium and phosphorus values to support remineralization were higher than the amount in the carious tissue without treatment (24).…”

Postoperative pain following hall technique versus pulpotomy in primary molars with deep caries

“…The Hall Technique embraces changing concepts of managing dental caries, moving from the concept requiring its complete surgical excision, even at the expense of cavity size and pulpal health, to better understanding that caries in dentine can be slowed, arrested, and possibly even reversed, within a meticulously sealed environment. Owing to its non-invasive design, acceptance by patients, and rate of restoration longevity, the Hall technique may be an improved treatment option to increase access to care, decrease rates of untreated caries and provide a restoration that will allow for natural tooth exfoliation (6 ). Thus, the present study aimed to determine the efficiency of Hall Technique versus Formecresol Pulpotomy Technique regarding postoperative pain.…”