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