Module 9

Question 1

what is the hall technique

Answer 1

• method of managing carious primary molars by cementing pre-formed metal crowns, also known as stainless steel crowns, without LA, or any tooth prep

Question 2

when are hall technique used

Answer 2

• accepted restoration of choice for primary molar with caries affected more than one surface

Question 3

how does the hall technique work

Answer 3

• manipulates the plaque environment by sealing it into the tooth, separating it from the substrates it would normally receive from the host’s diet

Question 4

what needs to be done before placing crown -

Answer 4

• full history, clinical exam, including bitewing radiography

Question 5

what type of tooth condition is a hall technique used on

Answer 5

• there should be no clinical or radiographic signs of pulpal involvement
• the tooth should have sufficient sound tissue left to retain the crown

Question 6

if patient is at risk of bacterial endocarditis what do you have to do instead of hall technique

Answer 6

• restore tooth with conventional restoration

Question 7

what must child be aware of before hall technique

Answer 7

• they will have to help by biting down on crown

- the cement will taste a bit like salt and vinegar

Question 8

what instruments are essential for hall technique

Answer 8

• mirro
• straight probe
• excavator
• flat plastic
• cotton wool rolls

Question 9

what is a straight probe used for

Answer 9

• to remove separators, if used, and to remove set cement following fitting

Question 10

what is an excavator used for

Answer 10

• remove crown if necessary, and also useful for cement removal

Question 11

what other instruments may be helpful

Answer 11

• orthodontic biting stick
• band forming pliers
• gauze to protect airway and wipe off excess
• Elastoplast to secure crown for airway protection

Question 12

what are band forming pliers used for

Answer 12

• 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

Question 13

when is patient seen again after placing orthodontic separators

Answer 13

• seen 3-5 days later to remove separator

Question 14

how is the hall technique carried out

Answer 14

• 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

Question 15

how is crown size selected

Answer 15

• 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’

Question 16

what are the 2 methods of seating the crown

Answer 16

• clinician seats the crown by finger pressure

- the child seats the crown by biting on it

Question 17

what happens if crown does not seat before it sets

Answer 17

• remove it using excavator

Question 18

how long should you wait before fitting directly opposing crowns

Answer 18

• wait 3 months before fitting second one so that the child can get used to the bite of the first

Question 19

where should sprinbrack be felt

Answer 19

• widest point of the tooth

Question 20

where is caries most likely to develop

Answer 20

• base of fissures and just below the contact point of proximal surface

Question 21

which aspects of the hall crown technique ensures it is effective for managing carious primary molars

Answer 21

• dentine/pulp complex has reparative potential and a maintained seal helps plaque lose it cariogenic potential

Question 22

what is the clinical evidence you would look for to confirm caries has arrested

Answer 22

• a colour change to dark brown/black and hard to probe

Question 23

which methods are employed to enhance the safety of the hall technique

Answer 23

• place child in upright position, use gauze and secure the crown with an Elastoplast