A Study Comparing the Hall Technique and Conventional Stainless-Steel Crowns in Carious Primary Molars : Clinical Outcomes, Anxiety, Time, and Cost-Effectiveness

Tooth decay is a widely experienced condition associated with the oral health of children, particularly in posterior teeth. This is attributed to their intricate texture which is commonly encountered during the oral hygiene measures . Caring for posterior teeth affected by tooth decay in children is vital to ensure stability in tooth occlusion, minimizing pain, preventing infections, and facilitating mastication and communication. However, the success of tooth restorations is questionable, particularly due to secondary decay, fracture, loss of retention, and marginal problems.

Stainless steel crowns are deemed one of the most durable and reliable treatment options in pediatric dentistry, especially for multi-surface lesions or structurally damaged molars. In a conventional approach to placing SSCs, caries needs to be removed, teeth prepared, and in most cases, local anesthesia is administered. These approaches can be quite time-consuming and may exacerbate dental anxiety in children who report previous negative dental experiences.

In the last couple of decades, there has been a gradual move toward minimal invasive dentistry (MID) in caries management. This philosophy emphasizes the importance of maintaining sound tooth structure and adopts biological methods instead of traditional operative methods . This is further consolidated by consensus guidelines that recommend either non- selective or selective caries removal methods for the purpose of minimizing patient discomfort and limiting the invasiveness of treatment. Moreover, practitioners highlight the need for early intervention and the application of less invasive methods where clinically indicated.

HT represents a biologically based, minimally invasive approach within the MID framework. This approach involves cementing a preformed metal crown over a carious posterior tooth without local anesthesia, caries excavation, or tooth preparation to seal the lesion from the oral environment. Despite several studies demonstrating favorable results of HT, there is still a lack of well-documented evidence on RCTs comparing clinical and radiographic outcomes, patient anxiety, treatment duration, and cost-effectiveness between HT and conventional SSC placement.

The aim of the study, therefore, was to establish whether the Hall Technique, compared to the conventional stainless-steel crown technique, is efficient in managing carious posterior teeth in children aged 5-8 years. Outcomes included crown survival, anxiety levels of the patient, treatment time required, and cost-effectiveness over a period of 3 months.