Evaluation of the Occlusal Effects of the Hall Technique and Investigation of Children's Satisfaction
Condition: Dental Caries in Children
MeSH terms: Dental Caries
Study type: Observational

Summary: 
      Background: The Hall Technique (HT) is a non-invasive, easily applicable minimally invasive
      dentistry approach for managing dental caries in children. It involves placing a preformed
      metal crown over a tooth with decay, to seal it in and stop the decay from progressing.
      However, it alters the occlusion as no tooth substance is removed to make space for the
      crown.

      Objective: This study, aims to evaluate the effects of Hall Technique on occlusion in
      children, to assess whether there are any adverse effects on the temporomandibular joint and
      masseter muscles, related to changes on occlusion and to evaluate the children's perceptions
      of the crowns.

      Materials and Methods: A total of 37 children aged 5-9 years, who have not been treated with
      the Hall Technique previously and who have dentinal caries that did not reach the pulp
      (affecting the occlusal or the occluso-proximal surfaces) in their primary molars, will be
      invited to participate in the study. At the first visit, clinical examination will be carried
      out and intraoral impressions will be taken for pre-treatment evaluation. The occlusal
      vertical dimension of the teeth will be measured clinically with callipers. Temporomandibular
      joint and masseter muscles will be examined clinically. Then, the Hall Technique crown will
      be placed to treat the carious tooth, the impressions taken again, and measurements repeated.
      At one and three months following treatment with the crown, the participant will have the
      measurements repeated. The child and parent will complete a questionnaire after 3 months on
      their perception of the crown.

      In the data analysis, frequency, percentage, mean and standard deviation analyses will be
      used for demographic data and description of the clinical data. In numerical data analysis,
      t-test or Mann-Whitney U test will be used according to the data distribution. Geomagic
      software will be used to analyse sequential study models of the teeth to measure relative
      changes in the tooth positions over time.
    

Detailed description: 
      Dental caries is one of the most common chronic diseases during childhood. Due to the high
      incidence of dental caries in the primary dentition and inadequate treatments, early
      childhood caries is an important public health problem for children. The main challenge in
      paediatric dentistry, both for the clinician and the family, is to cooperate with the child
      to provide the necessary treatment successfully. Although many factors affect dental anxiety,
      research shows that the type of dental treatment can influence the child's behaviour.
      Minimally invasive dental approaches have been found to offer a more comfortable treatment
      process. The Hall Technique is a type of minimally invasive dental treatment. It has been
      used for more than 20 years to treat dental caries in children. In this technique, the
      carious lesion is sealed under a PMC to stop the progression of caries and prevent pain
      and/or infection. A crown is pressed over the tooth without local anaesthesia, tooth
      preparation/reduction, or carious tissue removal. This makes the technique less invasive and
      it can be more acceptable to children than a traditional filling involving injections and
      drilling.

      One of the drawbacks of Hall Technique is that it increases the occlusal vertical dimension
      (OVD) because the PMC is placed on the tooth without any preparation. It is possible that an
      increase in the occlusal vertical dimension could cause hyperactivity of the masticatory
      muscles, an increase in occlusal forces, bruxism, and temporomandibular joint disorders. The
      Hall Technique has reportedly temporarily increased the vertical dimension. According to
      clinical research, it takes approximately a month for the vertical dimension to return its
      pre-treatment state.

      To the best of our knowledge, none of the studies have accurately determined how the child's
      occlusion returns to its pre-treatment state after the placement of a Hall Technique
      preformed metal crown. The aim of this study is to evaluate the effects of Hall Technique on
      occlusion, temporomandibular joint, and masseter muscle in children and the child's
      perceptions of the crown.
    

Intervention name(s): Hall Technique Prefabricated Metal Crown
Intervention type(s): Device
Intervention description(s): The Hall Technique is a type of minimally invasive dental treatment. Hall Technique involves sealing the carious lesion under a Prefabricated Metal Crown to stop its progression preventing pain and/or infection.This makes the technique less invasive and it can be more acceptable to children than a traditional filling involving injections and drilling.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Potential participants will be selected and recruited from children attending for routine
        dental care at Aydin Adnan Menderes University Paediatric Dentistry Clinic.

        Children and their parents will be invited to participate and will be included in the study
        after they have the study discussed with them and they agree to participate, giving
        informed consent. Children should meet the inclusion criteria, and/or be none of the
        exclusion criteria
      
Keywords: Dental Caries; Children; Occlusion