Preformed metal crowns placed by Hall technique for restoring primary molars have an optimal survival? - a Systematic Review and Meta-analysis protocol

Background: Unsuccessful restorative treatment of carious lesions in deciduous molars remains a priority for clinicians to resolve when caring for children's dentition. However, regardless of the material or technique used, standard restorative treatments continue to fail and present low survival rates. In an effort to solve these problems, a non-invasive technique known as the Hall Technique was developed with reduced adverse effects and is being studied over the last years, presenting great success in comparison with other restorative techniques. Thus, this systematic review and meta-analysis aim to address the question concerning the survival of preformed metal crowns using the Hall Technique for restoring deciduous molars.Methods: Electronic databases and other sources, such as gray literature will be searched. Randomized controlled trials (RCTs), and Non-Randomized studies of interventions (NRSI) will be included that assess the use of preformed metal crowns using the Hall Technique on primary molars. The outcome will be the cumulative survival rate of preformed metal crowns applied according to the Hall Technique. Two independent reviewers will perform screening, study selection, data extraction, risk of bias, and certainty of evidence assessment. Any discrepancies in opinion will be resolved by a third reviewer who is considered to be an expert in the field. Assessment of the risk of bias of included studies will be evaluated by RoB 2 and ROBINS-I tools. The certainty of evidence will be determined using the GRADE tool. Methodological heterogeneity across studies will be evaluated to determine the best model for the meta-analysis.Discussion: To the best of our knowledge, no systematic review has addressed this gap directly. Findings obtained from the review will be valuable in the decision-making process regarding the use of Hall Technique preformed metal crowns for restoration of decayed primary molars.

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.

The interaction and interference of preformed metal crowns on magnetic resonance imaging: a scoping review with a systematic methodology

Purpose Preformed metal crowns are widely used to restore primary and permanent teeth. Children may require magnetic resonance imaging (MRI) for diagnosis and monitoring of diseases in the head and neck region. Metallic objects, in the field of view, may compromise the diagnostic value of an MRI. The impact on the diagnostic quality of an MRI in children who have had preformed metal crowns placed has not been assessed. The aim of this systematic review was to evaluate the impact that PFMCs have on MRI imaging quality and thus the overall diagnostic value. Methods Electronic searches of the following databases were completed: MEDLINE, EMBASE, Cochrane Library, Web of Science and Open Grey. Primary in vivo studies on children who had at least one preformed metal crown placed and required an MRI investigation were to be included. PRISMA guidelines were followed and screening/data extraction was carried out by two independent calibrated reviewers. Results A total of 7665 articles were identified. After removing duplicates, 7062 were identified for title and abstract screening. Thirty-four articles underwent full-text review, of which none met the inclusion criteria. Most common reasons for exclusion were not placing preformed metal crowns (n = 16) or in vitro studies (n = 12). Conclusion No in vivo studies were identified to establish the hypothetical impact preformed metal crowns would have on the diagnostic quality of an MRI in the head and neck region. Decision making needs to be guided on a case by case basis. Further high-quality clinical studies are required.

An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review

Purpose To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, ‘What are the treatment options for teeth in children affected by molar incisor hypomineralisation?’ Methods An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. Results Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. Conclusion The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.

Postoperative Bleeding Complications after Stainless Steel Crown Placement: A Case Series

Stainless steel crown (SSC) placement is a common pediatric restorative treatment, generally completed with minimal complications. Discussed in this case series are two patients who presented to the emergency department (ED) with moderate oral bleeding persisting more than 12 hours after oral rehabilitation under general anesthesia. Bleeding incidence after pediatric oral rehabilitation has been found to range from 20% to 40%, with most being considered mild and significantly associated with extractions. There is limited documentation regarding moderate, persistent postoperative bleeding associated with placement of preformed metal crowns. The objective of this paper is to raise awareness of postoperative bleeding following SSC placement, discuss probable causes to minimize complications in the future, and discuss the local measures that were used to obtain hemostasis.

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) are recommended for the enduring restoration of primary molar defects. However, the PMC technique is not implemented in China as well as that in Western countries. Aim: This study aimed to assess the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China.Methods: The questionnaires were distributed among 1000 dentists practicing in Chengdu via an online questionnaire platform. Data, including sociodemographic characteristics of the respondents and their perception and use of PMCs, were collected. Results: The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty and working experiences were associated with dentists’ use of PMCs. The lack of knowledge about PMCs technique was the main obstacle for the dental practitioners using PMCs (41.7%). The lack of understanding of the rationale of PMCs was the main reason for parents accepting PMC restorations(43.6%). Attending continuing education programs was the main approach to learn the PMC restorative technique(59.1%).Conclusion: The clinical use of PMCs was not very popular in Chengdu city. To promote the use of this restorative technique, the knowledge and practical training should be incorporated into routine courses of undergraduate dental education.

Floss abrasion: a cautionary tale

Background The Hall technique for placement of preformed metal crowns is widely used in the UK for the management of decayed primary molar teeth. The creation of space is achieved by the placement of orthodontic separators adjacent to the tooth requiring restoration. Highlighting the first reported case of an abrasion caused by dental floss, this communication describes the clinical findings of an 8-year-old patient following placement of orthodontic separators. Case report An 8-year old boy attended the University Dental Hospital of Manchester for placement of orthodontic separators prior to restoration URE, ULE, LLE, and LRE with preformed metal crowns using the hall technique. The following week he presented with a 2cm abrasion to his right cheek, which had been caused by dental floss used in placement of the orthodontic separators. Follow up Conservative advice was given and the lesion had resolved completely at a 2-week review. Conclusion This case is a timely reminder of the importance of adequate lip retraction and soft tissue management during placement of orthodontic separators.