Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars;
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RESEARCH ARTICLE
Open Access
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 Mariana Pinheiro Araujo1,2, Nicola Patricia Innes2,3* , Clarissa Calil Bonifácio4, Daniela Hesse4, Isabel Cristina Olegário5, Fausto Medeiros Mendes1 and Daniela Prócida Raggio1
Abstract Background: Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, nonaerosol 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 0.5 mm) Restoration loss—tooth can be re- restored Reversible pulpitis—can be managed without the need of pulpotomy or extraction
Crown perforation Crown loss—tooth can be re-restored Reversible pulpitis—can be managed without the need of pulpotomy or extraction
Major failures
Irreversible pulpitis, dental abscess or fistula—requires pulpotomy or extraction Restoration loss—tooth cannot be re- restored Tooth fracture
Irreversible pulpitis, dental abscess or fistula—requires pulpotomy or extraction Crown loss—tooth cannot be re- restored Tooth fracture
Araujo et al. BMC Oral Health
(2020) 20:318
• generally cooperative behaviour that could be managed by the operators in the school setting; and • no known medical conditions. Children eligible to participate in this study received an envelope to take home for their parents/carers containing an information sheet about the trial and a parents/carers’ informed consent form. If parents/carers were interested in their children taking part in the trial, they sent the consent form signed back to the school before the child’s treatment commencement. At the time of the treatment, children whose parents/carers agreed to take part in this trial received an assent form asking if they also agreed to take part. In cases where the child had more than one cavity eligible for inclusion in the study, only one c
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