THE HALL TECHNIQUE IN PAEDIATRIC DENTISTRY: A REVIEW OF THE LITERATURE
AND AN “ALL HALL” CASE REPORT WITH A-24 MONTH FOLLOW UP
210
a
b
Figure 2. The Hall Technique: tooth 84 with orthodontic
separators mesially and distally. They are left in situ for 3-5 days. Figure 3. The Hall technique: tooth 84 before (a) and after (b)
orthodontic separator removal. Notice the space thus created.
Figure 4. The SSC is tried on tooth 84 using adhesive tape and
patient in the supine position. Figure 5. The patient bites down on the crown using a cotton roll.
The patient bites on a cotton wool roll to allow the SSC to “snap”
on tooth number 84. A click is occasionally heard.
B. Hall Technique: Appointment 2
1) Removal of separators: 3-7 days after the first
appointment, the patient returns for the removal of
the orthodontic separators. Space is created mesially
and distally that will negate the need for crown
preparation (see Figs. 3 a & b).
2) SSC selection and placement: The patient is sat
up in the supine position and the operator selects
the correct SSC in terms of tooth number and size.
After selecting the correct SSC, it is tried passively on
the tooth to make sure that it fits with gentle pressure
applied to the SSC over the contact points but not
completely through. For safety purposes the crown is
stuck to the operator’s finger (See Fig. 4), while trying
out the size, using an adhesive tape/elastoplast.
The SSC should be neither too loose nor too tight.
The crown should “spring back” from the contact
points while trying it on the tooth at this stage. After
crown selection, the crown should then be filled with
a self- curing glass ionomer cement and positioned
over and on the tooth. The operator then digitally
presses the crown through the contact points so that
the crown flexibly “clicks” on the tooth and fits snugly.
The patient is then asked to bite on a cotton wool roll
to finish off its correct positioning (see Fig. 5). The
excess of the glass ionomer cement is wiped off. The
crown should be level with the occlusal plane and
blanching of the gingivae will be noticed buccally
and lingually indicating an adequate seal (see Fig. 6).
The patient may feel a little tightness; however that and the gingival blanching disappear within an hour
if not less. Equated to the tightness of a brand new
pair of shoes around feet, it resolves spontaneously
after a while. Occasionally the bite may be raised
by a millimeter. Multiple SSCs using the HT could
be placed in one patient over several appointments
without any LA or drilling; however it is possible to
place two SSC using the HT in one appointment. 11
This is possible in: a) contra-lateral primary molars
in the same arch, for example placement of two SSC
on upper Es (teeth 55 and 65) or lower Ds (74, 84).
b) diagonal teeth in opposing arches, for example,
placement of SSCs on tooth 55 and 75, or placement
of SSCs on 65 and 85.
C. Hall Technique: Follow-up appointments
All teeth treated with the HT should be followed
up clinically and radiographically following the
same protocols as conventional treatments. 9 The
tooth should be assessed for pain, sinuses, swelling
and radiographically for signs of interradicular
radiolucency or root resorption. The bite usually
resolves spontaneously due to dento-alveolar
compensation within a week or two (see below).
4. Can the Hall technique be used to restore all Ds
and Es in one patient?
Restoring multi surface carious primary molars using
conventional SSCs (i.e.; all Ds and Es in one child)
after preparing them with a high speed drill has been
the standard for many years. However, this is not the
Stoma Edu J. 2017;4(3): 208-217
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