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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, 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: 18 Nov 2020 13:35
URI: http://orca.cf.ac.uk/id/eprint/134385

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