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Cited by 109Dental Health and Care UtilizationDental materials and restorationsEndodontics and Root Canal Treatments

Alternative Caries Management Options for Primary Molars: 2.5-Year Outcomes of a Randomised Clinical Trial

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Santamaría, Ruth M., Innes, N.P.T., Machiulskiene, Vita, Schmoeckel, Julian, Alkilzy, Mohammad, Splieth, Christian H.·2017·Caries Research
DOI 10.1159/000477855
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Abstract

Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458).

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Crossref · 10.1159/000477855

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33 of 33 references verified0 citation errors · 0 not checkable

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  • Gingival index was not found to be different between Hall technique and control groups in three studies.

    “Gingival index (GI) was not found to be different in three studies between HT and control groups [20], [22], [24].”

    From Hall technique for primary teeth: A systematic review and meta-analysis (2022) · cites this paper as [20]

  • Plaque index was found to be significantly better in all groups after treatment in another study.

    “and plaque index was found to be significantly better in all groups after treatment in another study [20].”

    From Hall technique for primary teeth: A systematic review and meta-analysis (2022) · cites this paper as [20]

  • Most of the included studies had pre-operative radiographic assessment, with the exception of three studies.

    “Most of the studies had pre-operative radiographic assessment with the exception of 3 studies [17], [20], [22].”

    From Hall technique for primary teeth: A systematic review and meta-analysis (2022) · cites this paper as [20]

  • A secondary publication on one of the included studies found that dentists reported less negative behaviour in the Hall technique group when compared to conventional restoration.

    “A secondary publication on one of the included studies [20] found that dentists reported less negative behaviour in the HT group when compared to conventional restoration [13].”

    From Hall technique for primary teeth: A systematic review and meta-analysis (2022) · cites this paper as [20]

  • The control groups had interventions such as conventional preformed metal crowns, conventional restorations, ART restorations, and NRCC, with two studies having two different control groups.

    “The control groups had interventions such as conventional PMCs, conventional restorations, ART restorations, and NRCC with two studies having two different control groups [18], [20].”

    From Hall technique for primary teeth: A systematic review and meta-analysis (2022) · cites this paper as [20]

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Authors
Santamaría, R. M., Innes, N. P. T., Machiulskiene, V., Schmoeckel, J., Alkilzy, M., & Splieth, C. H.
Affiliations
  • Universität Greifswald (DE)
  • University of Dundee (GB)
ORCID
Venue
Caries Research
Publisher
S. Karger AG
Published
2017
Volume
51
Issue
6
Pages
605-614
ISSN
  • 0008-6568 (ISSN-L)
  • 1421-976X
DOI
10.1159/000477855
OpenAlex
W2780486824
Cited by
109
References
33
Citations by year
2026: 5 · 2025: 8 · 2024: 6 · 2023: 9 · 2022: 13 · 2021: 13 · 2020: 33 · 2019: 12 · 2018: 9 · 2017: 1
FWCI
20.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Caries Research (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion, other-oa)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
  • Lithuanian University of Health Sciences (submittedVersion)
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
  • Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
Keywords
primary molars, caries management, Hall technique, fluoride varnish, stainless steel crowns, reversible pulpitis, irreversible pulpitis, tooth survival, restorative dentistry, children, biofilm control, compomer restorations, caries progression, secondary caries
MeSH terms
Child, Child, Preschool, Crowns, Dental Caries, Dental Restoration, Permanent, Fluorides, Topical, Follow-Up Studies, Humans, Patient Education as Topic, Pulpitis, Recurrence, Stainless Steel, Tooth, Deciduous, Biofilms, Disease Progression, Dental Restoration Failure

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