Hall technique for managing carious primary molars shows good long term outcomes.

Photograph of carious teeth

There is a growing literature supporting caries management options where caries is sealed in beneath restorations or sealants. The aim of this trial to compare long-term (at 5 yrs) outcomes for carious primary molars managed by GDPs’ standard conventional restorative methods (control) with the Hall Technique in general dental practice.   The outcomes at 2 years have been reported previously ( Innes et al 2007)

This was a split-mouth randomised controlled trial involving 17 general dental practitioners. 132 (3-10 yr-old children ) with caries affecting matched pairs of asymptomatic primary molar teeth were included. were randomised with one tooth allocated to restoration with the Hall Technique, and the contralateral tooth allocated to the control (the dentists usual treatment option). Annual clinical and radiographic follow-up data were recorded. The major outcomes were: irreversible pulpitis or dental abscess requiring pulp therapy or extraction, inter-radicular radiolucency, restoration loss and tooth unrestorable, and internal root resorption.

Ninety one patients (69%) had 48 months’ minimum follow-up. there was a statistically significant increased risk of for both Major (p < 0.000488)  and minor  failures( p <0.000001) when a control restoration had been placed compared with a Hall Technique. There were only 3 major failure in teeth treated with the Hall technique ( see table).

[table id=17 /]

The authors concluded

At 60 months, for teeth with a minimum of 48 months’ follow-up, sealing-in caries by the Hall Technique statistically, and clinically, significantly outperformed the GDPs’ standard restorations.

Innes NP, Evans DJ, Stirrups DR. Sealing caries in primary molars: randomized control trial, 5-year results. J Dent Res. 2011 Dec;90(12):1405-10. Epub 2011 Sep 15. PubMed PMID: 21921249.

Innes NP, Evans DJ, Stirrups DR (2007). The Hall Technique; A randomised controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health 7:18.

 Further information on the Hall technique can be downloaded here

 

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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