Use of stainless steel crowns to restore primary molars in Germany: Questionnaire-based cross-sectional analysis

The Hall technique: knowledge, practice, and concerns of dentists in primary care settings in the State of Qatar-a questionnaire-based survey

PURPOSE

To assess the knowledge, practice, and concerns about the Hall Technique among pediatric dentists (PDs) and general dental practitioners (GDPs) working in primary care settings in the State of Qatar.

METHODS

A prospective questionnaire-based survey was distributed to all GDPs and PDs working at different Primary Health Care Corporation centers in Qatar between 1 November and 10 December 2023. Descriptive data analysis was carried out.

RESULTS

The response rate was 49% among GPDs and 100% among PDs. Approximately 85% of PDs and 48% of GDPs were familiar with the HT although only 58% of the PDs and 4% of the GDPs applied HT preformed metal crowns (HTPMCs) in their current primary care practice. Majority of both PDs and GDPs did not consider HTPMCs as the treatment of choice for restoring asymptomatic carious primary molars and preferred applying the HT for cavitated carious lesions over non-cavitated lesions. Regarding HT practices, 57.7% of PDs and 48% of GDPs always planned on taking a pre-operative radiograph before the procedure, while only 15.4% of PDs and 8% of GDPs would always consider using an orthodontic separator prior to placing an HTPMC. The main concerns among the respondents about the HT included sealing in caries (PDs 31%; GDPs 50%), high occlusion (PDs 57.7%; GDPs 53.3%), and gingival damage (27% PDs; 47% GDPs.) Endorsement by professional bodies and further research evidence were seen as ways to promote wider adoption of the HT.

CONCLUSION

The HT is recognised but not widely used among primary care dentists working in the State of Qatar. HTPMCs are often seen as secondary options for restoring carious primary molars with dentists still having a number of concerns regarding the HT.

Comparative Evaluation of Polymethyl Methacrylate and Thermoforming Crowns as Semipermanent Crowns in Primary Molars: An In Vivo Study

Aim

The present randomized clinical trial is aimed at evaluating clinical efficiency of two different types of esthetic crowns-polymethyl methacrylate crowns and vacuum formed thermoformed crown as an alternative to full-coverage coronal restoration for deciduous molars.

Materials and methods

A total of 45 primary molars in pediatric patients were selected using randomization and split into three groups based on the technique used for preparation of crowns: group I-polymethyl methacrylate crowns; group II-thermoformed crown; and group III-stainless steel crowns (SSC). All crowns were clinically and radiographically evaluated at baseline, 1st month, and 3rd month for gingival health, retention, marginal integrity, proximal contacts, occlusion, alignment, and staining.

Statistical analysis

The data was tabulated and analyzed by Statistical Package for the Social Sciences (SPSS) Version 23.0 software. The intergroup comparison was done by Kruskal-Wallis test, analysis of variance (ANOVA), and Mann-Whitney U test for continuous data. The intragroup comparison was done by Friedman test and Wilcoxon signed-rank test for categorical data. All p-values < 0.05 were considered statistically significant.

Results

With regard to the parameters of plaque score, gingival index score, occlusion, interproximal contacts, retention, alignment, and marginal adaptation, no statistical significance was noted between the three groups. However, with regard to the discoloration (staining) when the polymethyl methacrylate acrylic (PMMA) group was compared with thermoforming group, statistical significance was noted in 1st month with p-values of 0.04 and 0.03, respectively. On intragroup comparison, statistically significant values were obtained in SSC group for plaque score and thermoforming group for gingival index score.

Clinical significance

The study concluded that the PMMA and thermoforming crowns can be used as an alternative to SSC for restoring the primary molars as they showed equivalent results to that of standard SSC.

How to cite this article

Matha N, Kumar KS, Reddy BVT, et al. Comparative Evaluation of Polymethyl Methacrylate and Thermoforming Crowns as Semipermanent Crowns in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(S-1):S43-S54.

The Use of Hall's Technique Preformed Metal Crown (HTPMC) by Pediatric Dentists in Malaysia

Introduction

Hall's technique preformed metal crown (HTPMC) has been used widely by pediatric dentists in developed countries as a new approach for managing decayed primary molars without local anesthesia, caries removal, and tooth preparation. Currently, inadequate information is available regarding the implementation of this technique (HTPMC) in Malaysia. This study is aimed at evaluating the implementation of HTPMC by Malaysia's pediatric dentists and identify the co-occurrence frequencies of the HTPMC implementation with the respondents' demographic profile.

Materials and Methods

A cross-sectional questionnaire-based research was conducted among 65 pediatric dentists in Malaysia. Online questionnaires were distributed to the pediatric dentists employed at public hospitals (MOH) and universities in Malaysia.

Result

It was found that over half of the respondents (65.6%) employed HTPMC. The analysis of the co-occurrence network frequency revealed that a high frequency of female pediatric dentists who were within the age group of 31-40 years old had fulfilled their postgraduation overseas and was employed in the university mainly applied HTPMC.

Conclusion

The application of HTPMC among respondent pediatric dentists in Malaysia was high. However, most respondents considered HTPMC a treatment option only to manage carious primary molar rather than a treatment of choice.

Dentists' Perception and Clinical Use of Preformed Metal Crowns to Restore Primary Molar Defects in Chengdu City, China: A Cross-Sectional Study

Background

Preformed metal crowns (PMCs), as an effective technique recommended for the enduring restoration of primary molar defects, have not been widely implemented in China as well as that in Western countries. This study is aimed at assessing the knowledge on the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China. Thus, the present study is aimed at providing the best available evidence on clinical decision-making to manage dental caries in children and the overall benefits.

Methods

The self-designed questionnaire in this study consisted of two main sections, including the sociodemographic characteristics of the respondents and their perception and use of PMCs. The anonymous questionnaire was distributed among 1000 dentists practicing in Chengdu via SO JUMP.

Results

The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty, and professional experience were associated with dentists' use of PMCs. The lack of knowledge about the PMC technique was the main obstacle to the dental practitioners' use of PMCs (41.7%). The lack of understanding of the rationale behind PMCs was the main reason for parents' acceptance of PMC restorations (43.6%). Attending continuing education programs was the main approach to learning the PMC restorative technique (59.1%).

Conclusions

The clinical use of PMCs was not very popular in Chengdu city. To promote this restorative technique, knowledge and practical training should be incorporated into routine courses of undergraduate dental education.

Stainless-steel crowns in children: Norwegian and Finnish dentists' knowledge, practice and challenges

BACKGROUND

Stainless-steel crowns (SSCs) are recommended for restorative treatment of young teeth severely affected by caries, fractures or dental developmental disorders (DDDs). However, despite recommendations and clinical evidence, SSCs are not widely used by general dentists, who favour extraction and more conventional restorations. The present study aimed to investigate the views of and use of SSCs among Norwegian and Finnish dentists.

METHODS

The present study was a cross-sectional survey among Norwegian and Finnish dentists. An electronic questionnaire was sent to Norwegian and Finnish dentists asking whether they used SSCs and on which indications. In addition, the questionnaire assessed reasons for non-use and dentists' perceptions regarding advantages and challenges in the use of SSCs, as well as the need for additional training. Distributions of background characteristics, use of and views on SSCs were calculated, and statistical significance of the associations between respondents' background and their answers were evaluated.

RESULTS

Of the 574 Norwegian and 765 Finnish respondents, only 12.0% and 12.9% reported to use SSCs, respectively. The most frequently reported barrier reported by those who did not use SSCs was lack of practical training. The most frequent challenge reported by those using SSCs was difficulties in crown adjustment followed by aesthetic issues, and the most frequently reported advantage was that SSCs maintain the function and occlusion. The majority of respondents reported a need for more information and practical training in the use of SSCs, with hands-on course as their most frequently preferred education type.

CONCLUSION

Although the value of SSCs for restoring young molars is recognized by Norwegian and Finnish dentists, SSCs are rarely used by general dentists. The majority of the respondents reported lack of training and materials and was interested in receiving more information and education.

Combination of Polydopamine Coating and Plasma Pretreatment to Improve Bond Ability Between PEEK and Primary Teeth

Preformed crowns are preferred to reduce the failure risk of restoration of primary teeth, but some drawback of conventional material is still a main barrier for their clinical use. Polyether etherketone (PEEK), a tooth colored, high-performance thermoplastic polymer, has been recognized as a promising alternative to manufacture the restoration of primary teeth. However, the hydrophobic surface and low surface energy of PEEK make it hard to establish a strong and durable adhesion. In this study, we have evaluated a modification method of polydopamine (PDA) coating with plasma pretreatment for the PEEK films by physical and chemical characterization, bonding properties, and biocompatibility. The surface properties of PEEK were well-characterized by scanning electron microscope (SEM) and X-ray photoelectron spectroscopy (XPS). The adhesive strength of the PEEK films was greatly improved without significant reduction of the proliferation rate of human gingival fibroblast cells in MTT and Live/Dead assays. Therefore, PDA coating with plasma pretreatment may give a new solution for effective clinical application of PEEK in primary performed crowns.

Evaluation of Clinical Effectiveness and Patient Acceptance of Hall Technique for Managing Carious Primary Molars: An In Vivo Study

Introduction

Hall technique (HT) is a biological approach where decay is sealed under preformed metal crowns without any caries removal, tooth preparation or local anesthesia. Dental caries is one of the most common prevailing chronic condition that affect both adults and children. Since children are anxious and apprehensive to dental treatment, their uncooperative behavior might cause hindrance in the treatment, which often leads to manage them in general anesthesia. To better address the dental care needs in pediatric patients, dental surgeons require some alternatives for management of caries and restorative treatment in children. The Hall technique is one such conservative treatment approach developed by Dr Norna Hall in 1980s.

Aim

The purpose of this study was to assess the clinical effectiveness and patient acceptance of Hall technique for managing carious primary molars.

Materials and methods

84 children in the age group 6–10 years with class I and class II carious lesions limited to dentin were selected for the study. Occlusal vertical dimension (OVD) was measured preoperatively, postoperatively and after 6 months. Discomfort level was assessed by facial pain rating scale and by questionnaires filled on the day of placement of SS crown, 1 week after placement and 6 months after placement.

Results

The Hall technique was found to be successful, as there was no failure clinically as well as radiographically within 6 months of placement of SS crown. The increased OVD postoperatively returned to its normal values within 6 months, the mean change in the OVD was found to be statistically significant (p = 0.02).

Conclusion

The Hall technique proved to be clinically effective and acceptable by maximum number of children.

How to cite this article

Bhatia HP, Khari PM, Sood S, et al. Evaluation of Clinical Effectiveness and Patient Acceptance of Hall Technique for Managing Carious Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2019;12(6):548–552.

Comparison of Different Cervical Finish Lines of All-Ceramic Crowns on Primary Molars in Finite Element Analysis

This study aimed to conduct a stress analysis of four types of cervical finish lines in posterior all-ceramic crowns on the primary roots of molar teeth. Four different types of finish lines (shoulder 0.5 mm, feather-edged, chamfer 0.6 mm, and mini chamfer 0.4 mm) and two all-ceramic crown materials (zirconia and lithium disilicate) were used to construct eight finite element primary tooth models with full-coverage crowns. A load of 200 N was applied at two different loading angles (0° and 15°) so as to mimic children’s masticatory force and occlusal tendency. The maximum stress distribution from the three-dimensional finite element models was determined, and the main effect of each factor (loading type, material, and finish line types) was evaluated in terms of the stress values for all of the models. The results indicated that the loading type (90.25%) was the main factor influencing the maximum stress value of the primary root, and that the feather-edged margin showed the highest stress value (p = 0.002). In conclusion, shoulder and chamfer types of finish lines with a 0.4–0.6 mm thickness are recommended for deciduous tooth preparation, according to the biomechanical analysis.