PEDODONTICS
Case Reports
THE HALL TECHNIQUE IN PAEDIATRIC DENTISTRY : A REVIEW OF THE LITERATURE AND AN “ ALL HALL ” CASE REPORT WITH A-24 MONTH FOLLOW UP
Batool Ghaith 1a * , Iyad Hussein 1b
1
Paediatric Dentistry Department , Hamdan Bin Mohammed College of Dental Medicine , Mohamed Bin Rashid University of Medical and Health Sciences , Dubai , UAE
a
BDS ( Dublin ), BA ( Dublin ), MFDSRCI , MSc ( MBRU ), MPaedDent RCS ( Edin ), Postgraduate Resident in Paediatric Dentistry b
DDS ( Dam ), MDentSci ( Leeds ), GDC Stat . Exam ( London ), MFDSRCPS ( Glasg ), UK Specialist in Paediatric Dentistry , Clinical Assistant Professor in Paediatric Dentistry
Received : May 02 , 2017
Revised : July 03 , 2017 Acccepted : August 01 , 2017 Published : August 02 , 2017
Academic Editor : Rodica Luca , DDS , PhD , Professor , “ Carol Davila ” University of Medicine and Pharmacy Bucharest , Bucharest , Romania
Cite this article : Ghaith B , Hussein I . The Hall Technique in paediatric dentistry : a review of the literature and an “ All Hall ” case report with a 24 month follow up . Stoma Edu J . 2017 ; 4 ( 3 ): 208-217 .
Abstract DOI : 10.25241 / stomaeduj . 2017.4 ( 3 ). art . 6
Aim : This paper highlights a non-invasive treatment option for primary molars , where decay is sealed under preformed stainless steel crowns ( SSC ). Summary : Restoring the carious primary molar in children using the “ Hall Technique ( HT )” is an internationally controversial but evidence-based new treatment modality . It started in the United Kingdom ( UK ) in 2007 where it is now considered the “ Gold Standard ” for managing the multi-surface asymptomatic carious primary molar . We review the literature and report a two year follow up of a case treated in Dubai , United Arab Emirates ( UAE ) where we restored all eight carious primary molars in a 3-year-old child by using the Hall Technique . This approach avoided the need for treatment under local analgesia general anesthesia in this very young child . It is relevant to general dental practitioners , with an interest in children ’ s dentistry in addition to specialists in pediatric dentistry . Key learning points : - SSCs placed using the HT are not suitable for all child patients with caries ; - There are selection criteria that should be assessed before considering this technique ; - There should be a clear radiolucent band between the carious lesion and pulp of the tooth intended to be restored with the HT ; - There should be no signs or symptoms of pulpal pathosis ; - All teeth treated with the HT should be followed up clinically and radiographically following the same protocols as conventional treatments . Keyword : primary molars , stainless steel crowns , caries , Hall technique .
1 . Introduction Primary molar dental caries in childhood is a disease of epidemic proportions that affects all modern societies . Despite a World Health Organization ( WHO ) pledge in 1981 to render 50 % of 5-6-year old children caries free by 2000 , 1 many developing countries remained off target to date such as the United Arab Emirates ( UAE ). A UAE survey showed that less than 84 % of 5-year old children were affected by caries 2 which echoes the dental health status of children in this region . 3 By comparison , very low levels of caries have been reported in Europe . 4 , 5 In England for example , 88 % of threeyear olds were free from obvious caries . 6 The size of decay as a problem in a society is often expressed as “ dmft ” ( decayed , missing and filled teeth ) and is well established as the key measure of caries experience in dental epidemiology . The UAE regions dmft index ranged from 3.8 to 6.6 2 whilst the England dmft range was a mere 0.48 to 0.9 . 6 This highlights countries / social inequalities where primary tooth dental caries is concerned , especially that not every child has access to a paediatric dentist . In paediatric dentistry , the carious primary molar is one clinical problem reported to have more than one solution . 7 These management options have ranged from the classical surgical treatment involving the surgical excision of dental caries ( under local analgesia - LA ) and restoring the tooth ( with restoring it with a composite for example ) and ending simply by managing the plaque ’ s biological environment employing minimal interventional techniques . 8 An example of the latter is the “ Hall Technique or HT ” 9 , 10 which involves encasing the carious lesion by “ sealing it ” from the oral environment using a stainless steel crown ( SSC ). The HT has been recommended to manage carious primary molars according to clear selection criteria and was developed in the
* Corresponding author : Dr Batool Ghaith , BDS ( Dublin ), BA ( Dublin ), MFDSRCI , MSc ( MBRU ), MPaedDent RCS ( Edin ), Paediatric Dentistry Department , Hamdan Bin Mohammed College of Dental Medicine , Mohamed Bin Rashid University of Medical and Health Sciences , Dubai , UAE Tel / Fax : + 971 523981454 , e-mail : batool . ghaith @ gmail . com
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Stoma Edu J . 2017 ; 4 ( 3 ): 208-217 http :// www . stomaeduj . com