THE HALL TECHNIQUE IN PAEDIATRIC DENTISTRY: A REVIEW OF THE LITERATURE
AND AN “ALL HALL” CASE REPORT WITH A-24 MONTH FOLLOW UP
Pre-op
Immediate post-op
9 months post-op
24 months post-op
Figure 7. Shows clinically pre-op, immediate, 9 months and 24 months post-treatment SSCs HT. No clinical pathology
related to the SSC was noted on any of the molars (no sinuses or swellings).
5.2. Treatment
A treatment plan was arranged on our postgraduate
clinic (See Table 2). An extensive preventive
programme was instigated to improve the patient’s
very poor oral hygiene in addition to diet assessment,
analysis and advice.
Over a period of two months and following the HT
protocol, 9 the child had all his eight primary molars
fitted with SSCs and cemented with GIC. No LA
was used. The molars were fitted with elasticated
orthodontic separators in order to create space to
prepare the teeth to receive the SSC a week later.
Two molars were treated per appointment (see Table
3).
As per the standard Hall manual, 9 the following
principles were adhered to during treatment:
1) Compliance with the indications and contra
indications and selection criteria 9 for the HT
(See Table 1). Assurance of the absence of any
symptoms or signs of pulpal pathosis or sepsis
(clinical or radiographic assessments);
2) Blue elasticated orthodontic separators were
used and left in situ for one week to create
interdental spaces where required;
3) Two SSCs placed in a single appointment were
never:
a. In the same arch adjacent to each other (i.e.
never in the same quadrant);
b. On the same side in opposing arches.
4) When two crowns were placed in a single
appointment they were diagonally in opposing
arches (for example 64 and 84);
5) Appointments were at least one to two
weeks apart to allow the occlusion to settle. The
212
appointments were short; no longer than 15-20
minutes.
The SSCs crowns were placed as per the schedule
in Table 3. The patient also had simple restorations
placed (with no LA) on his upper anterior primary
incisors and canines, using simple excavation and
GIC with a view to eventually receiving composite
strip crowns. Figure 7 shows the mouth immediately
after completion of treatment. The bite appeared
open and was initially raised by approximately 1-1.5
mm. The patient was followed up six, nine, 12, 15,
18 and 24 months later. Neither he nor his parents
had any complaints whatsoever. There were no
i ssues with the occlusion, symptoms or signs of
pulpal pathosis or sepsis affecting the molars. The
bite had completely recovered (see Fig. 7). The
parents’ satisfaction in reaching a positive outcome,
without resorting to the use of GA, was very high.
Post op radiographs (Fig. 8) showed satisfactory
clown placement and no recurrent caries. The only
noticeable development was that tooth 26 became
impacted against the SSC of 65. This was also noted
on the other first permanent molars (16, 46, and 26);
however, they disengaged spontaneously without
intervention. The 26 impaction was corrected within
a week by removing the SSC of 65.
The long term treatment plan was the following:
1) Continue follow-up at 3 months intervals of all
Es and Ds clinically;
2) Close monitoring of tooth 51 for any sign of
infection. Pulpectomy or extract if symptoms;
3) Bitewing radiographs every 6 months to
monitor all Es and Ds. Interval to increase if caries
risk status changed;
Stoma Edu J. 2017;4(3): 208-217
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