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

Author(s)

Araujo, Mariana Pinheiro ^{[1, 2]} ; Innes, Nicola Patricia ^{[2, 3]} ; Bonifacio, Clarissa Calil ^[4] ; Hesse, Daniela ^[4] ; Olegario, Isabel Cristina ^[5] ; Mendes, Fausto Medeiros ^[1] ; Raggio, Daniela Procida ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Dent, Dept Paediat Dent, Sao Paulo - Brazil

^[2] Univ Dundee, Sch Dent, Dundee - Scotland

^[3] Cardiff Univ, Sch Dent, Heath Pk, Cardiff CF14 4XY - Wales

^[4] Acad Ctr Dent Amsterdam ACTA, Dept Paediat Dent, Amsterdam - Netherlands

^[5] Trinity Coll Dublin, Dublin Dent Univ Hosp, Dept Publ & Child Dent Hlth, Dublin - Ireland

• Document type: Journal article
• Source: BMC ORAL HEALTH; v. 20, n. 1 NOV 11 2020.
• Web of Science Citations: 0

Abstract

BackgroundAtraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol 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.MethodsChildren (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). ResultsOne-hundred and thirty-one children (ART=65; HT=66) were included (mean age=8.11.2). 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<0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p=0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p=0.007).ConclusionsBoth ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child's tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%).Trial registration This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Techniqu e+Atraumatic+Rest orative+Treatment\&draw=2\&rank=2. (AU)

• FAPESP's process: 15/18098-2 - Atraumatic restorative treatment versus Hall technique in occluso-proximal cavities in primary molars: a randomized clinical trial
• Grantee: Mariana Pinheiro de Araújo
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)