European Study on Three Different Approaches to Managing Class 2 Cavities in Primary Teeth
Condition: Dental Caries
MeSH terms: Dental Caries
Study type: Interventional

Summary: 
      The purpose of this randomized clinical trial is to compare the clinical effectiveness of
      three treatments involving different caries management strategies (conventional restorations,
      Hall technique, and Non-Restorative Caries Treatment) to the management of class II carious
      primary molars in children (3-8 year-old).
    

Detailed description: 
      At present, many materials and techniques are used to treat carious primary teeth. All of
      these have their proponents who claim they provide the best performance in terms of
      longevity, aesthetics, bio-compatibility, etc (Qvist, 2010; Yengopal et al., 2009). However,
      despite the great variety of techniques and materials, there is no definite evidence for the
      most effective approach when dental caries in primary molars is concerned, as yet. On the
      other hand, there is conclusive evidence that shows that glass-ionomer cement is an
      inappropriate material for class II restorations in primary teeth, due to its significant
      shorter longevity compared with other restorative materials like compomer and amalgam.

      Recently, there is re-surging interest in more biological (less-invasive) techniques: such as
      the Non-Restorative Caries Treatment (Peretz & Gluck, 2006; Gruythuysen et al., 2010) or
      stainless steel crowns with the advent of the Hall technique in Scotland (Innes et al.,
      2007). However, there is lack of comparative evidence from high quality clinical trials
      leading to uncertainty in the effectiveness of these techniques. In addition, these
      techniques are rarely compared with standard fillings.
    

Intervention name(s): Hall Technique; Non-Restorative Caries Treatment; Conventional Restoration
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Technique:
Removal of dental plaque and rest of aliments from the cavity
Selection of the SSC
If the contact points are very tight, orthodontic separator elastics could be placed through the mesial and distal contacts and the SSC has to be fitted at a subsequent appointment
Dry the crown and fill with glass-ionomer luting cement
Place the crown over the tooth
Removal of cement excesses from the crown margins
The child should be asked to keep biting on the crown until the cement has set; Technique:
A high-speed bur should be used to remove the undermined enamel and make the cavity accessible for plaque removal. Do not remove the contact area
Clean, dry the cavity and apply Duraphat® varnish fluoride (50/mg/ml)
Show the cavity to patient/parents and give them tooth-brushing instructions
Tell to parents that good plaque control is the key for this treatment
The recall interval for these patients is every 3 months.; Technique:
Local anesthesia should be used when needed
Perform complete caries removal and cavity preparation
Use a matrix band and a wedge to tightly hold the band against the tooth
Place the material (Compomer)
Check contacts and occlusion, and polish the restoration
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Class II carious primary molar; Non-Restorative Caries Treatment; Hall Technique; Conventional restorations; Children