Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting
Abstract Background Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Oral Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12903-020-01298-x |
| _version_ | 1828780489553477632 |
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| author | Mariana Pinheiro Araujo Nicola Patricia Innes Clarissa Calil Bonifácio Daniela Hesse Isabel Cristina Olegário Fausto Medeiros Mendes Daniela Prócida Raggio |
| author_facet | Mariana Pinheiro Araujo Nicola Patricia Innes Clarissa Calil Bonifácio Daniela Hesse Isabel Cristina Olegário Fausto Medeiros Mendes Daniela Prócida Raggio |
| author_sort | Mariana Pinheiro Araujo |
| collection | DOAJ |
| description | Abstract Background Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months. Methods Children (5–10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms. Primary outcome: restoration survival over 36-months (using Kaplan–Meier survival analysis, log rank test, and Cox regression). Secondary outcomes: (1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months). Results One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up. Primary outcome: restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17–0.47); HT = 93.4% (0.05; 0.72–0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007). Conclusions Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child’s tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%). Trial registration This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2. |
| first_indexed | 2024-12-11T17:18:52Z |
| format | Article |
| id | doaj.art-3cbc13b58bbc4d779e2f130a6a99aadc |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-12-11T17:18:52Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-3cbc13b58bbc4d779e2f130a6a99aadc2022-12-22T00:57:14ZengBMCBMC Oral Health1472-68312020-11-0120111810.1186/s12903-020-01298-xAtraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school settingMariana Pinheiro Araujo0Nicola Patricia Innes1Clarissa Calil Bonifácio2Daniela Hesse3Isabel Cristina Olegário4Fausto Medeiros Mendes5Daniela Prócida Raggio6Department of Paediatric Dentistry, School of Dentistry, University of São PauloSchool of Dentistry, University of DundeeDepartment of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA)Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA)Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity CollegeDepartment of Paediatric Dentistry, School of Dentistry, University of São PauloDepartment of Paediatric Dentistry, School of Dentistry, University of São PauloAbstract Background Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months. Methods Children (5–10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms. Primary outcome: restoration survival over 36-months (using Kaplan–Meier survival analysis, log rank test, and Cox regression). Secondary outcomes: (1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months). Results One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up. Primary outcome: restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17–0.47); HT = 93.4% (0.05; 0.72–0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007). Conclusions Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child’s tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%). Trial registration This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2.http://link.springer.com/article/10.1186/s12903-020-01298-xHall TechniqueAtraumatic Restorative TreatmentRestorationPrimary molarsDental cariesManagement |
| spellingShingle | Mariana Pinheiro Araujo Nicola Patricia Innes Clarissa Calil Bonifácio Daniela Hesse Isabel Cristina Olegário Fausto Medeiros Mendes Daniela Prócida Raggio Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting BMC Oral Health Hall Technique Atraumatic Restorative Treatment Restoration Primary molars Dental caries Management |
| title | Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting |
| title_full | Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting |
| title_fullStr | Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting |
| title_full_unstemmed | Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting |
| title_short | Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting |
| title_sort | atraumatic restorative treatment compared to the hall technique for occluso proximal carious lesions in primary molars 36 month follow up of a randomised control trial in a school setting |
| topic | Hall Technique Atraumatic Restorative Treatment Restoration Primary molars Dental caries Management |
| url | http://link.springer.com/article/10.1186/s12903-020-01298-x |
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