Treatment of carious primary molars with the Hall technique versus Atraumatic Restorative Treatment (ART) in Surinam: Survival after Six Months

Huijser van Rheenen, A. (2009) Treatment of carious primary molars with the Hall technique versus Atraumatic Restorative Treatment (ART) in Surinam: Survival after Six Months. thesis, Dentistry.

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Abstract

Introduction: Many children in the inlands of Surinam deal with untreated dental caries in primary teeth. Although ART (Atraumatic Restorative Treatment) has shown to be an effective treatment technique in underdeveloped countries with limited acces to dental care, survival rates in Surinam were extremely low for both one-surface and two-surface ARTrestorations. The Hall technique is a simplified technique for managing caries in primary molars using PMCs (Preformed Metal Crowns). The PMCs are filled with glass-ionomer cement and pushed onto the tooth without any tooth preparation, caries removal or local anaesthesia. Several studies have shown promising treatment results with the Hall technique, and because with this approach electrically driven equipment is not necessary, it might be of potential use in the inlands of Surinam. A study was set up by the ACTA to compare the treatment of carious primary molars with the Hall technique and the ART-technique in the inlands of Surinam. Three ACTA-students started the study from October until December 2007 in two villages in the inlands of Surinam, namely Drietabbetje and Pikinslee. Two RUGstudents evaluated those restorations after six months, from April until July 2008. This study aimed to compare the survival of both treatment techniques after these first six months. Methods: Children from 5-7 years old were randomly divided in two treatment groups, namely the Hall-group and MZ-group. In the Hall-group, Hall PMCs were placed on carious primary molars which had at least two surfaces left. In the MZ-group only occlusal cavities into the dentine were treated with an ART-restoration, approximal cavities were made accessible and were kept under supervision. In total, 114 Hall PMCs and 39 ART-restorations were placed and evaluated after one month by the ACTA-students. After six months two RUG-students evaluated these restorations again. When pain, an abscess or a fistula was present or the restoration was lost or needed repair, the restoration was considered as a failure. Results: 111 Hall PMCs and 38 ART-restorations were evaluated. 4 Hall PMCs had to be extracted because of the presence of mobility/pain, pus coming out of the sulcus and a fistula. No failures were seen with the ART-restorations. The survival rate of the ARTrestorations was therefore 100% and of the Hall PMCs 94.7% (including 2 earlier failures reported by the ACTA-students after one month). This difference is not statistically significant. Restorations made on occlusal cavities in both treatment groups had a survival rate of 100%. A relation between the survival rates and the size of the cavity or number of decayed tooth surfaces could not be found. The overbite of the children who were treated with Hall PMCs became propped open directly after treatment, in the MZ-group this was not seen. At the one-month evaluation the overbite was almost regulated to its initial position. After six months the RUG-students measured a deeper overbite in both the Hall-group and MZ-group. Significantly less plaque was present on the Hall crowns compared to its contralateral control teeth. With the ART-restorations there was no difference in plaque score compared to its control teeth. Conclusion: It is too early to assume that one of the treatment techniques is more effective than the other, but the prospects for Hall PMCs are promising. This trial will be followed up for at least three years and results of further evaluation visits (each after six months) have to be awaited.

Item Type:	Thesis (Thesis)
Supervisor name:	Parree, Drs. J.W.F. and Blanksma, Dr. N.G. and Department of Dentistry and Oral Hygiene, University of Gron
Supervisor name:	Amerongen, Dr. W.E. van and Department of Pediatric Dentistry, Academic Centre of Dentis and Poots, Drs. M.A.S. and Foundation Medical Mission Primary Health Care Surinam, loca
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:52
Last Modified:	25 Jun 2020 10:52
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1322

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