Module 9 Flashcards
what is the hall technique
- method of managing carious primary molars by cementing pre-formed metal crowns, also known as stainless steel crowns, without LA, or any tooth prep
when are hall technique used
- accepted restoration of choice for primary molar with caries affected more than one surface
how does the hall technique work
- manipulates the plaque environment by sealing it into the tooth, separating it from the substrates it would normally receive from the host’s diet
what needs to be done before placing crown -
- full history, clinical exam, including bitewing radiography
what type of tooth condition is a hall technique used on
- there should be no clinical or radiographic signs of pulpal involvement
- the tooth should have sufficient sound tissue left to retain the crown
if patient is at risk of bacterial endocarditis what do you have to do instead of hall technique
- restore tooth with conventional restoration
what must child be aware of before hall technique
- they will have to help by biting down on crown
- the cement will taste a bit like salt and vinegar
what instruments are essential for hall technique
- mirro
- straight probe
- excavator
- flat plastic
- cotton wool rolls
what is a straight probe used for
- to remove separators, if used, and to remove set cement following fitting
what is an excavator used for
- remove crown if necessary, and also useful for cement removal
what other instruments may be helpful
- orthodontic biting stick
- band forming pliers
- gauze to protect airway and wipe off excess
- Elastoplast to secure crown for airway protection
what are band forming pliers used for
- can be useful for adjusting crowns, particularly where the primary molar has lost length messy-distally due to caries
- can increase buck-lingual width of the crown
when is patient seen again after placing orthodontic separators
- seen 3-5 days later to remove separator
how is the hall technique carried out
- gauze swab used to protect airway
- use clean Elastoplast tape to secure the crown
- dry crown and fill with GI luting cement, ensuring it is filled
- tooth dried if possible
- place crown over tooth
- once excess cement has been removed child should bite down on it for 2-3 minutes
how is crown size selected
- should aim to fit the smallest size of crown which will seat
- select one which covers all the cusps, and approaches contact points, with a slight feeling of ‘spring back’
what are the 2 methods of seating the crown
- clinician seats the crown by finger pressure
- the child seats the crown by biting on it
what happens if crown does not seat before it sets
- remove it using excavator
how long should you wait before fitting directly opposing crowns
- wait 3 months before fitting second one so that the child can get used to the bite of the first
where should sprinbrack be felt
- widest point of the tooth
where is caries most likely to develop
- base of fissures and just below the contact point of proximal surface
which aspects of the hall crown technique ensures it is effective for managing carious primary molars
- dentine/pulp complex has reparative potential and a maintained seal helps plaque lose it cariogenic potential
what is the clinical evidence you would look for to confirm caries has arrested
- a colour change to dark brown/black and hard to probe
which methods are employed to enhance the safety of the hall technique
- place child in upright position, use gauze and secure the crown with an Elastoplast
