Hall Technique for Carious Primary Molars: A Review of the Literature

The high frequency of caries in primary teeth and its inadequate treatment are major public health problems during childhood. Nowadays, the Hall technique is one of the methods used for biological sealing in carious lesions in primary molars. Thus, the bacteria will be sealed from oral environment and the caries will be inactive. The objective of this article was to provide an updated search on the Hall technique description, indication, contraindication, advantages, concerns, success and failure, cost-effectiveness, acceptability, and preference in pediatric dentistry, and to compare the Hall technique with traditional crown preparation and conventional treatment options for carious primary molars. A discussion of the recently published articles on the Hall technique reveals that the Hall technique is considered a promising restorative option with high acceptability and longevity; with low failure rate for managing carious primary molars compared to conventional treatment modalities used in primary care settings. Furthermore, the survival rate of stainless steel crowns (SSCs) is considered high, whether provided using Hall technique or traditional preparation by a pediatric dentist. Thus, the Hall technique can be an effective addition to the clinician’s range of treatment options for carious primary molars. However, it should be chosen in restricted cases.

Qualitative analysis of teeth and evaluation of amalgam elements penetration into dental matrix using laser induced breakdown spectroscopy

INTRODUCTION

In this study, laser induced breakdown spectroscopy (LIBS) is used for qualitative analysis of healthy and carious teeth. The technique of laser ablation is receiving increasing attention for applications in dentistry, specifically for the treatment of teeth such as drilling of micro-holes and plaque removal.

METHODS

A quality-switched (Q-switched) Neodymium-Doped Yttrium Aluminium Garnet (Nd:YAG) laser operating at wavelength of 1064 nm, pulse energy of 90 mJ/pulse, repetition rate of 2Hz and pulse duration of 6 ns was used in this analysis. In the process of ablation a luminous micro-plasma is normally generated which may be exploited for on-line elemental analysis via laser induced breakdown spectroscopy technique. We propose laser induced breakdown spectroscopy as a rapid, in situ and easy method for monitoring drilling process.

RESULTS

The results of elemental analysis show the presence of some trace elements in teeth including P, Ca, Mg, Zn, K, Sr, C, Na, H, O and the permeability of some amalgam (teeth filling materials) elements including Hg, Ag, Cu and Sn into dental matrix.

CONCLUSION

This study addresses the ability of LIBS in elemental analysis of teeth and its feasibility in acute identification of healthy and carious teeth during drilling process for future clinical applications.

Distribution of the amelogenin protein in developing, injured and carious human teeth

Amelogenin is the major enamel matrix protein with key roles in amelogenesis. Although for many decades amelogenin was considered to be exclusively expressed by ameloblasts, more recent studies have shown that amelogenin is also expressed in other dental and no-dental cells. However, amelogenin expression in human tissues remains unclear. Here, we show that amelogenin protein is not only expressed during human embryonic development but also in pathological conditions such as carious lesions and injuries after dental cavity preparation. In developing embryonic teeth, amelogenin stage-specific expression is found in all dental epithelia cell populations but with different intensities. In the different layers of enamel matrix, waves of positive vs. negative immunostaining for amelogenin are detected suggesting that the secretion of amelogenin protein is orchestrated by a biological clock. Amelogenin is also expressed transiently in differentiating odontoblasts during predentin formation, but was absent in mature functional odontoblasts. In intact adult teeth, amelogenin was not present in dental pulp, odontoblasts, and dentin. However, in injured and carious adult human teeth amelogenin is strongly re-expressed in newly differentiated odontoblasts and is distributed in the dentinal tubuli under the lesion site. In an in vitro culture system, amelogenin is expressed preferentially in human dental pulp cells that start differentiating into odontoblast-like cells and form mineralization nodules. These data suggest that amelogenin plays important roles not only during cytodifferentiation, but also during tooth repair processes in humans.

Clinical effectiveness and cost-effectiveness of fissure sealants in children and adolescents with a high caries risk

In Germany, the application of resin-based pits and fissures sealants on the occlusal surfaces of permanent molars is part of individual prophylaxis for children and adolescents between six and 18 years. The individual prophylaxis is covered by the Statutory Health Insurance since 1993.

The report addresses questions on medical effectiveness, cost-effectiveness, as well as ethical, social, and legal implications of pit and fissure sealants in preventing dental caries for children and adolescents at high caries risk.

The results of the studies indicate a protective effect of pit and fissure sealants, particularly for children and adolescents at high caries risk. Additionally, the economic evaluation suggests a tendency for cost savings in this group. Nevertheless, a general expansion of the intervention cannot be recommended. All studies show a risk of bias in favour of pit and fissure sealing and a limited transferability to the German health care system. Studies included in the economic evaluation revealed methodological flaws. Both the economic models and primary studies do not provide reliable results.