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

Araujo, Mariana Pinheiro, Innes, Nicola Patricia ORCID: https://orcid.org/0000-0002-9984-0012, Bonifácio, Clarissa Calil, Hesse, Daniela, Olegário, Isabel Cristina, Mendes, Fausto Medeiros and Raggio, Daniela Prócida 2020. 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. BMC Oral Health 20 , 318. 10.21203/rs.3.rs-31623/v2

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Abstract

Background: Atraumatic 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. Methods: Children (5-10 yo) who had a primary molar with an occluso-proximal carious lesion were allocated to the ART 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). Results: One-hundred and thirty-one children (ART=65; HT=66) were included (mean age=8.1±1.2). 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 six months; and 5) teeth treated with the HT exfoliated earlier than those in the ART group (p=0.007). Conclusions: Both 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%).

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Dentistry
Additional Information:	This article is licensed under a Creative Commons Attribution 4.0 International License
Publisher:	BioMed Central
ISSN:	1472-6831
Date of First Compliant Deposit:	1 September 2020
Last Modified:	05 May 2023 01:29
URI:	https://orca.cardiff.ac.uk/id/eprint/134385

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