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Dental CariesSLM2078NCT02782390

Efficacy of Hall Technique in Atypical Lesions on Primary Teeth

A study testing Dental Restoration with Stainless Crown and Dental Restoration with Composite Resin in people with Dental Caries, run by Faculty Sao Leopoldo Mandic Campinas at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Atypical carious cavities could be defined as carious lesions in more than 2 surfaces of the same tooth. Dental practitioners have shown difficulties related to material's maintenance in such type of cavities and therefore, several treatment options have been used. Read more about this study

Who is it for?
Ages 4 to 9 years
Conditions the study is for
Dental Caries
What is being tested?
Dental Restoration with Stainless Crown and Dental Restoration with Composite Resin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
364 participants
Where
1 siteBrazil
Study dates
Jun 2016to Dec 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 to 9 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • children must have at least one molar with atypical caries lesion (involving more than two surfaces);
  • parents or legal guardians accept and sign the informed consent form.

Who cannot join

  • children with special needs and/or systematic diseases with oral impairment;
  • teeth with spontaneous painful symptoms or necrotized and teeth presenting restorations, sealants, developmental enamel defects, pulp exposure or other signs related to endodontic treatment.

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Faculdade Sao Leopoldo Mandic

    Campinas, São Paulo, 13045-755

Other trials in Brazil

About this study

Official title: Efficacy of Hall Technique in Atypical Lesions on Primary Teeth: Randomized Clinical Trial

Atypical carious cavities could be defined as carious lesions in more than 2 surfaces of the same tooth. Dental practitioners have shown difficulties related to material's maintenance in such type of cavities and therefore, several treatment options have been used. However, most of them have shown a great failure percentage. A randomized clinical trial will be developed with the objective of assessing the Hall technique in comparison with the composite resin incremental technique in 364 primary molars' atypical carious lesions of children between 4 and 9 years old. Initially, two previously calibrated examiners will perform caries diagnosis by means of visual assessment and intraoral examination. Selected teeth will be randomly allocated into two groups. Teeth in the first group will be submitted to prefabricated stainless steel crowns treatment (Hall technique); and the other, to composite resin incremental technique, which will be always placed under rubber dam isolation. Lesions' clinical and radiographic follow-up will be conducted after 6 and 12 months.

Treatment's efficacy will be assessed by means of four main outcomes:

Read more
  1. Longevity, marginal adaptation, possible modification in patients' vertical dimension, and caries lesion progression;
  2. Patient-focused criteria (satisfaction, discomfort and quality of life impact);
  3. cost-efficacy; and
  4. Treatment-related parents', children' and operators' perception.

Other variables could be further analysed as secondary outcomes, such as techniques performing time among operators, impact of the socio-economic characteristics on restorations' longevity, and restorations' type impact on the antagonist tooth. Comparisons between groups will be addressed using the Kaplan-Meier survival test as well as Long-Rank test. Cox Regression will be used to enable the assessment of other variables' influence in the results. Significance value of 5% will be adopted for all analysis.

Conditions
Dental Caries
Being tested
Dental Restoration with Stainless Crown, Dental Restoration with Composite Resin
Keywords
Stainless dental crown, Composite Resin, Primary teeth
Medical subject headings
Dental Caries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dental Restoration with Stainless CrownOther

    Lesions allocated to this group will be treated with stainless dental crowns according to the Hall Technique protocol (Evans \& Innes, 2010).

  • Dental Restoration with Composite ResinOther

    Surfaces allocated to this group will be treated with composite resin (Z250, 3M ESPE, USA) according to the manufacturer's instructions.

    Initially, local anesthesia and rubber dam adaptation will be performed. Then, 37% phosphoric acid will be applied on the surface for 15 seconds, followed by spray of water/air for at least 15 seconds. Then, the adhesive system (Single Bond, 3M ESPE, USA) will be applied and light cured according to the manufacturer's instructions. Finally, composite resin (Z250, 3M ESPE, USA) will be applied and light cured according to the manufacturer's instructions.

Study groups in NCT02782390
Study groupRoleWhat they receive
Hall TechniqueExperimentalsingle placement of stainless dental crowns on atypical cavities
Receives: Other: Dental Restoration with Stainless Crown
Composite ResinActive comparatorsingle placement of composite resin on atypical cavities
Receives: Other: Dental Restoration with Composite Resin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical longevity of restoration

    The clinical evaluation will be performed by the non-blinded examiners. The examiner will use the criteria proposed by Innes et al. (2007) for both interventions.

    Measured: Change from baseline until 6 and 12 months

Secondary outcomes (16)
  1. Change in patient's vertical dimension

    The patient's vertical dimension will be measured with a probe (Williams 14, Hu-Friedy Mfg. Co., United Kingdom) according to the protocol described by van der Zee \& van Amerongen (2010).

    Measured: Baseline, 30 days, 6 and 12 months

  2. Antagonist's level of intrusion

    The crown of the antagonist tooth to the treated tooth will be measured with a calliper and a ruler in cervico-occlusal direction (starting on the concave region of the gingival margin up to the center of the occlusal edge), as proposed by Miraglia et al. (2002) and Magalhaes et al. (2011).

    Measured: Baseline, 6 and 12 months

  3. Treatments' cost-efficacy

    The costs of each treatment procedure will be calculated and compared with thresholds values for intervention cost-effectiveness by region, determined by World Health Organization (http://www.who.int/choice/costs/CER_levels/en/).

    Measured: Through study completion (12 months)

  4. Clinical caries lesion progression

    Clinical examination will be performed by a blinded examiner at baseline, 6 months and 12 months after the treatment. These exams will be performed in accordance with Innes et al. (2007).

    Measured: Baseline, 6 and 12 months

  5. Impact on children's quality of life (4-5 years old)

    The oral health related to quality of life will be measured using the validated questionnaire "Early Childhood Oral Health Impact Scale" (ECOHIS) (Tesch et al., 2008) with 4-5 years old children. It will be applied immediately before the procedure and on 6 months follow-up.

    Measured: Baseline and 6 months

  6. Impact on children's quality of life (6-9 years old)

    The oral health related to quality of life will be measured using the validated questionnaire "Child Perceptions Questionnaire" (CPQ) with 6-9 years old children (Martins et al., 2009). It will be applied immediately before the procedure and on 6 months follow-up.

    Measured: Baseline and 6 months

  7. Children's perceptions about the treatment

    Children's perceptions about the treatment performed will be evaluated using the validated questionnaire "Child's and Parent's Questionnaire About Teeth Appearance" (Furtado et al., 2012). This questionnaire will be applied immediately before the procedure and on 6 and 12 months follow-up.

    Measured: Baseline, 6 and 12 months

  8. Children's satisfaction with the treatment

    The patients' satisfaction about the treatment performed will be evaluated using a scale, as performed by Mattos-Silveira et al. (2014). This scale will be applied immediately after the procedure and on 6 months follow-up.

    Measured: Baseline and 6 months

  9. Children self-reported discomfort

    The discomfort of each treatment will be evaluated using the facial scale of Wong-Baker (Wong, Baker, 1998). The patient will be asked to choose the face that is more similar to how she/he felt during the treatment.This answer should be given solely by the child, which means no parental or professional interferences.

    Measured: Baseline

  10. Marginal adaptation of the stainless steel crowns

    This outcome will be evaluated only with the patients randomized to the Hall Technique. The clinician will evaluate the marginal adaptation according to the criteria described by Sharaf \& Farsi (2004).

    Measured: Baseline, 6 and 12 months

  11. Radiographical caries lesion progression

    Radiographical examination will be performed by a blinded examiner at baseline, 6 months and 12 months after the treatment. These exams will be performed in accordance with Innes et al. (2007).

    Measured: Baseline, 6 and 12 months

  12. Biofilm retention of the stainless steel crowns

    This outcome will be evaluated only with the patients randomized to the Hall Technique. The clinician will evaluate biofilm retention according to the indice proposed by Silness \& Loe (1964), adopted to the primary dentition.

    Measured: Baseline, 6 and 12 months

  13. Caregivers' perceptions about the treatment

    Caregivers' perceptions about the treatment performed will be evaluated using the validated questionnaire "Child's and Parent's Questionnaire About Teeth Appearance" (Furtado et al., 2012). This questionnaire will be applied immediately before the procedure and on 6 and 12 months follow-up.

    Measured: Baseline, 6 and 12 months

  14. Clinicians' perceptions about the treatment

    Clinicians' perceptions about the treatment performed will be evaluated using the validated questionnaire "Child's and Parent's Questionnaire About Teeth Appearance" (Furtado et al., 2012). This questionnaire will be applied immediately before the procedure and on 6 and 12 months follow-up.

    Measured: Baseline, 6 and 12 months

  15. Caregivers' satisfaction with the treatment

    The caregivers' satisfaction about the treatment performed will be evaluated using a scale, as performed by Mattos-Silveira et al. (2014). This scale will be applied immediately after the procedure and on 6 months follow-up.

    Measured: Baseline and 6 months

  16. Clinicians' satisfaction with the treatment

    The clinicians' satisfaction about the treatment performed will be evaluated using a scale, as performed by Mattos-Silveira et al. (2014). This scale will be applied immediately after the procedure and on 6 months follow-up.

    Measured: Baseline and 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 May 2016 (estimated)
  2. Study startJun 2016
  3. Primary completionNov 2016
  4. Study completionDec 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
364 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02782390
Sponsor's protocol ID
SLM3
Acronym
SLM2078
Status last verified
May 2022
First submitted
10 Mar 2016
Last updated
2 Jun 2022
Results posted
No
Data monitoring committee
No

Publications

  • Casagrande L, Dalpian DM, Ardenghi TM, Zanatta FB, Balbinot CE, Garcia-Godoy F, De Araujo FB. Randomized clinical trial of adhesive restorations in primary molars. 18-month results. Am J Dent. 2013 Dec;26(6):351-5.

    PubMed 24640441
  • Evans D, Innes N. The Hall Technique: A minimal intervention, child centred approach to managing the carious primary molar. A Users Manual. University of Dundee, 3. ed., 2010.

  • Innes NP, Ricketts D, Chong LY, Keightley AJ, Lamont T, Santamaria RM. Preformed crowns for decayed primary molar teeth. Cochrane Database Syst Rev. 2015 Dec 31;2015(12):CD005512. doi: 10.1002/14651858.CD005512.pub3.

    PubMed 26718872
  • van der Zee V, van Amerongen WE. Short communication: Influence of preformed metal crowns (Hall technique) on the occlusal vertical dimension in the primary dentition. Eur Arch Paediatr Dent. 2010 Oct;11(5):225-7. doi: 10.1007/BF03262751.

    PubMed 20932395
  • Miraglia SS, Freitas KB, Pinto JHN. Comparative analyze of the mesion-distal (MD) and gengivo-incisal (GI) distances of the upper central incisors with the instrument Trubyte Tooth Indicator. PGRO - Pós-Grad Rev Odontol 5(2):13-17, 2002.

  • Magalhaes JB, Zavanelli AC, Zavanelli RA. Analysis of facial proportion and its relation with dental form, rest and occlusal vertical dimension between institutionalized students. Rev Odontol UNESP 40(5): 215-221, 2011.

  • Tesch FC, Oliveira BH, Leao A. [Semantic equivalence of the Brazilian version of the Early Childhood Oral Health Impact Scale]. Cad Saude Publica. 2008 Aug;24(8):1897-909. doi: 10.1590/s0102-311x2008000800018. Portuguese.

    PubMed 18709230
  • Martins MT, Ferreira FM, Oliveira AC, Paiva SM, Vale MP, Allison PJ, Pordeus IA. Preliminary validation of the Brazilian version of the Child Perceptions Questionnaire 8-10. Eur J Paediatr Dent. 2009 Sep;10(3):135-40.

    PubMed 19761288
  • Furtado GE, Sousa ML, Barbosa TS, Wada RS, Martinez-Mier EA, Almeida ME. [Perceptions of dental fluorosis and evaluation of agreement between parents and children: validation of a questionnaire]. Cad Saude Publica. 2012 Aug;28(8):1493-505. doi: 10.1590/s0102-311x2012000800008. Portuguese.

    PubMed 22892969
  • Mattos-Silveira J, Floriano I, Ferreira FR, Vigano ME, Frizzo MA, Reyes A, Novaes TF, Moriyama CM, Raggio DP, Imparato JC, Mendes FM, Braga MM. New proposal of silver diamine fluoride use in arresting approximal caries: study protocol for a randomized controlled trial. Trials. 2014 Nov 19;15:448. doi: 10.1186/1745-6215-15-448.

    PubMed 25409545
  • Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988 Jan-Feb;14(1):9-17. No abstract available.

    PubMed 3344163
  • Sharaf AA, Farsi NM. A clinical and radiographic evaluation of stainless steel crowns for primary molars. J Dent. 2004 Jan;32(1):27-33. doi: 10.1016/s0300-5712(03)00136-2.

    PubMed 14659715
  • SILNESS J, LOE H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968. No abstract available.

    PubMed 14158464
  • Pascareli-Carlos AM, Tedesco TK, Calvo AFB, Floriano I, Gimenez T, Goncalves MDS, Calumby D, Imparato JCP. Survival rate of the Hall technique compared with resin composite restoration in multi-surface cavities in primary teeth: a 1-year randomized clinical trial. J Appl Oral Sci. 2023 Oct 9;31:e20230048. doi: 10.1590/1678-7757-2023-0048. eCollection 2023.

    PubMed 37820181

Questions about this trial

What is this clinical trial studying?

A study testing Dental Restoration with Stainless Crown and Dental Restoration with Composite Resin in people with Dental Caries, run by Faculty Sao Leopoldo Mandic Campinas at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Jun 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical longevity of restoration (time frame: Change from baseline until 6 and 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02782390, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jun 2022.

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