Dental Crown Techniques for Tooth Decay

Overseen By Sandra Jung

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center, Houston

Disqualifiers: Medically compromised, Uncooperative behavior, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 1-2 weeks

132 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine which dental crown technique is most effective for treating tooth decay in children's baby molars. It compares the traditional stainless-steel crown method (Conventional Technique) with two newer approaches: the Hall technique and the modified Hall technique. Suitable participants are children with cavity issues in their baby molars that are not painful and who are generally cooperative during dental X-rays. The goal is to identify which technique yields better results for decaying teeth without causing complications. As an unphased trial, this study provides a unique opportunity to contribute to dental research and potentially enhance dental care for children.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these dental crown techniques are safe for treating tooth decay?

Research has shown that the Hall Technique (HT) is a well-accepted method for treating tooth decay in children. Studies have found it to be very successful and in line with guidelines for preventing cavities in baby teeth. This technique doesn't require drilling or anesthesia, making it more comfortable for kids. One study reported a 97.6% success rate for HT after 24 months, indicating its effectiveness and safety.

The Modified Hall Technique (MHT) is similar but includes some small changes. Although less research exists on MHT, it generally functions like HT. Both techniques aim to cover the decay instead of removing it, which is less invasive and causes fewer side effects.

Overall, both HT and MHT are considered safe and well-tolerated for treating cavities in children. They offer a more comfortable experience, which can make dental visits easier for kids. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about exploring different dental crown techniques for treating tooth decay. The Hall Technique (HT) is unique because it doesn't require drilling or anesthesia, making it less invasive and reducing discomfort for patients, especially children. The Modified Hall Technique (MHT) builds on this by potentially improving the seal around the tooth, aiming to enhance longevity and effectiveness. While the Conventional Technique (CT) involves more traditional methods like drilling, comparing these methods might reveal new insights into patient comfort and dental health outcomes. Ultimately, these techniques could revolutionize how we approach tooth decay treatment by focusing on patient-friendly methods.

What evidence suggests that this trial's treatments could be effective for tooth decay?

Research has shown that the Hall technique (HT), one of the treatment options in this trial, effectively treats tooth decay in baby teeth. Studies have found it to be successful and well-received by patients. This method involves placing a stainless steel crown over the tooth to seal in the decay without removing the decayed part, making it less invasive than other treatments.

The modified Hall technique (MHT), another treatment option in this trial, also shows promise. It is an improved version of the Hall technique, with early studies indicating its effectiveness in managing decay. It has been tested for both efficacy and radiographic appearance.

Overall, both the Hall and modified Hall techniques are viable options for treating decayed baby teeth. They can be especially beneficial in resource-limited settings. ^{1 6 7 8 9}

Who Is on the Research Team?

Nathanael O Salako, BDS,MSc

Principal Investigator

The University of Texas Health Science Center, Houston

Are You a Good Fit for This Trial?

This trial is for medically fit children with cooperative behavior during dental X-rays. It's for those who have primary molars with early-stage tooth decay (D1 lesions) without severe pulp damage or issues at the roots of their teeth as seen on X-rays.

Inclusion Criteria

My child is in good health.

Children who exhibit cooperative behavior at initial bitewing radiograph procedure

My teeth have surface-level cavities.

Exclusion Criteria

My child has a serious health condition.

Children with uncooperative behavior during bitewing radiograph process

I have issues with the roots of my teeth or gum disease around them.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive treatment using Hall Technique, Modified Hall Technique, or Conventional Stainless-Steel Crown restoration for primary molars with proximal caries lesions

1-2 weeks

Follow-up

Participants are monitored for biofilm, gingival health, and occlusal contact post-treatment

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Conventional Technique (CT)
• Hall Technique (HT)
• Modified Hall Technique (MHT)

Trial Overview The study compares three ways to treat cavities in kids' back teeth: the conventional method using Stainless-Steel Crowns, and two variations called Hall Technique and Modified Hall Technique, which differ in application but aim to be less invasive.

How Is the Trial Designed?

Group I: Modified Hall Technique (MHT) Experimental Treatment 1 Intervention

Group II: Hall Technique (HT) Experimental Treatment 1 Intervention

Group III: Conventional Technique (CT) Active Control 1 Intervention

Conventional Technique (CT) is already approved in European Union, United States, Canada for the following indications:

Approved in European Union as Conventional Stainless-Steel Crown Restoration for:

• Restoration of primary molars with dentinal caries
• Treatment of primary molars with proximal caries lesions

Approved in United States as Conventional Stainless-Steel Crown Restoration for:

• Restoration of primary molars with dentinal caries
• Treatment of primary molars with proximal caries lesions

Approved in Canada as Conventional Stainless-Steel Crown Restoration for:

• Restoration of primary molars with dentinal caries
• Treatment of primary molars with proximal caries lesions

Who Is Running the Clinical Trial?

The University of Texas Health Science Center, Houston

Lead Sponsor

Trials

974

Recruited

361,000+

Published Research Related to This Trial

The Hall technique for placing stainless steel crowns on primary molars does not require tooth preparation or local anesthesia, making it a less invasive option.

However, a literature review found inconclusive evidence regarding its effectiveness, suggesting that it should not be used in clinical practice at this time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Success of Hall technique crowns questioned. Nainar, SM.[2019]

The Hall technique, which involves sealing decay under preformed metal crowns without removing caries or using anesthesia, was found to be clinically effective in managing carious primary molars in 84 children aged 6-10, with no failures observed within 6 months.

Patient acceptance of the Hall technique was high, as indicated by low discomfort levels reported by children during follow-up assessments, making it a promising alternative for treating dental caries in pediatric patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of Clinical Effectiveness and Patient Acceptance of Hall Technique for Managing Carious Primary Molars: An In Vivo Study. Bhatia, HP., Khari, PM., Sood, S., et al.[2022]

The Hall Technique (HT) is widely recognized among dentists in East China, with 91.4% of surveyed dentists aware of it, but only 40.2% have actually used it, indicating a gap between knowledge and practice.

Concerns about potential complications, such as pulp inflammation or necrosis, are a significant barrier to the adoption of the HT, highlighting the need for more systematic training to increase its utilization in pediatric dentistry.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of the Hall Technique by dentists in East China: A questionnaire-based cross-sectional survey. Ding, N., Ding, Q., Sheng, K., et al.[2023]

The Hall technique (HT) for restoring primary carious molars was found to be significantly more successful than conventional dental restorations, based on a systematic review of five studies involving 1775 teeth, with 1325 treated using HT.

Meta-analysis results showed a risk ratio of 5.55 favoring HT over traditional methods, indicating a strong preference for HT in achieving successful restorations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Hall Technique for Primary Carious Molars: A Systematic Review and Meta-analysis. Badar, SB., Tabassum, S., Khan, FR., et al.[2022]

In a study of 65 children, both Conventional and Hall Technique (HT) Preformed Metal Crowns (PMCs) showed high success rates at 24 months, with 97.6% for conventional PMCs and 93.5% for HT PMCs.

While there was no significant difference in success rates at 12 months, the HT PMCs demonstrated a statistically significant higher success rate at 24 months, indicating that HT may offer a slight advantage in long-term outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A 24-month retrospective study of preformed metal crowns: the Hall technique versus the conventional preparation method. Binladen, H., Al Halabi, M., Kowash, M., et al.[2022]

In a study of 39 healthy children aged 5-9 years treated with the Hall technique for carious primary teeth, there was no significant increase in temporomandibular dysfunction (TM-D) signs or symptoms over a 12-month follow-up period.

Only a few children exhibited TM-D signs or symptoms, and the overall findings suggest that the Hall technique does not appear to be associated with the development of TM-D in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Temporomandibular dysfunction assessment in children treated with the Hall Technique: A pilot study. Kaya, MS., Kınay Taran, P., Bakkal, M.[2022]

The Hall Technique (HT) is a non-invasive treatment for carious primary molars in children aged 3-7, which involves sealing carious lesions with a stainless steel crown without the need for local anesthesia or removal of carious tissue.

This study aims to evaluate the clinical effectiveness, acceptability, and cost-effectiveness of HT over a 24-month period, with a target sample size of 220 children, to determine its potential for widespread use in managing dental caries in young patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Protocol for the Hall Technique study: A trial to measure clinical effectiveness and cost-effectiveness of stainless steel crowns for dental caries restoration in primary molars in young children. Tonmukayakul, U., Martin, R., Clark, R., et al.[2019]

The Hall Technique (HT) for treating decayed primary teeth using stainless steel crowns showed little to no progression of caries over time, indicating its effectiveness in managing dental decay without traditional preparation methods.

While HT-treated teeth exhibited lower hardness and elastic modulus in carious lesions compared to conventional treatments, they also showed higher calcium and phosphorus levels, suggesting potential remineralization of the retained carious tissue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrastructure and properties of primary carious molars treated using the Hall Technique. Loch, C., Jansen van Vuuren, L., Duncan, WJ., et al.[2021]

The Hall Technique (HT) for managing carious primary molars showed significantly lower rates of both major and minor failures compared to standard restorations by General Dental Practitioners, with only 3% major failures in HT versus 16.5% in controls after 60 months.

In a study involving 132 children and 264 teeth, HT demonstrated a remarkable advantage in long-term outcomes, with only 5% minor failures compared to 42% in standard restorations, indicating that sealing caries without removal is a highly effective treatment method.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sealing caries in primary molars: randomized control trial, 5-year results. Innes, NP., Evans, DJ., Stirrups, DR.[2012]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7229363/

Effectiveness of Hall Technique for Primary Carious Molars The objective of the present systematic review was to assess the outcomes of Hall technique (HT) on primary carious molars and compared it with the ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07186673

Hall Technique vs Conventional Crown Restoration in ... The aim of this study is to compare the clinical and radiographic success of stainless steel crowns placed using the Hall Technique versus ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S1882761622000217

Hall technique for primary teeth: A systematic review and ... Comparison of the treatment outcomes of the conventional stainless steel crown restorations and the hall technique in the treatment of carious primary molars.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7229388/

Evaluation of Clinical Effectiveness and Patient ... The purpose of this study was to assess the clinical effectiveness and patient acceptance of Hall technique for managing carious primary molars.

5. journals.lww.com journals.lww.com/njcp/fulltext/2021/24040/comparison_of_the_treatment_outcomes_of_the.19.aspx

Comparison of the Treatment Outcomes ... The Hall Technique appears to offer an effective treatment option for managing dental caries in primary molar teeth especially in a resource challenged ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/33723119/

Evaluation of success of stainless steel crowns placed ... HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations.

7. mdpi.com mdpi.com/2304-6767/8/1/11

Hall Technique for Carious Primary Molars: A Review of ... Using the Hall technique, the crown is placed without local anesthesia, caries removal, or tooth preparation. An appropriate size of PMC should ...

8. medrxiv.org medrxiv.org/content/10.1101/2025.05.18.25327863v1.full-text

Comparative Success and Survival of Preformed Metal ... The Hall technique aligns with American Academy of Pediatric Dentistry guidelines as a secondary prevention method for arresting caries in ...

9. clinicaltrials.gov clinicaltrials.gov/study/NCT06453005

NCT06453005 | Comparative Evaluation of SMART Hall ... Comparison of the treatment outcomes of the conventional stainless steel crown restorations and the hall technique in the treatment of carious primary molars.