Hall Technique

Definition: non-invasive Treatment of baby back Teeth (For molars only)

 delay sealed under stainless steel' crown without Cavity. Prep, anesthesia,
Cavies removal or even Tooth reduction
 it's a biologically oriented strategy (biological Control of dental Cavies)

Early childhood Caries: according to pediatric dentistry it's one Tooth or more
which are

 (missed filled or decayed)

 child must be equal or less Than 71 months old about 5,899 = 6 years old
or less

Sever early Childhood Caries: 1- Move Than 3 years & there is any sign of
smooth surface Caries (anteriors)

2- At the age of 3-5 years & DMF recorded more Than his age ex: 3 years old &
DMF 4 or more ، 4 years old & DMF 5 or 6 or More

Challenges of Treatment of Pedantic Teeth

1) Thickness of primary Teeth (enamel & dentin) less than in permanent (1

ml, 1 ml) So, danger of pulp exposure is more.
2) high pulp horns rate of decay reached to pulp faster.
3) management of Pediatrics is difficult.
4) parent satisfaction ((The Most Challenging one)).
- We have shift from Conventional approach (Canes removal & restoration) To
non / less invasive biological approach (Control of the biofilm biologically) by
disruption of the decay environment & preserve the Tooth Structure.

- After one year of using Hall Technique success rate 98%

- After 2 years - 4 years of using Hall Technique success rate

95%

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By Doctor Norna Hall (2006)

She uses ST.ST Crown & sealed a delayed Tooth with glass ionomer by Finger
pressure or asking the Child to bite.

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When We Can use hall Technique. (‫)الشروط‬

a) When no signs or symptoms. or any Complain by the child from The tooth.
b) No any sign of pulp involvement & Caries is present in dentin.

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Indication (‫)امتحان‬

1) Proximal lesions (Two or more surfaces) Radiographically, a clear band of

dentin should be seen between Carious lesion & pulp, the Carious lesion
doesn't extend beyond the middle third of dentine

(no indicated ‫ لو أكتر من كده يبقى‬٣/٢ ‫ ل‬٣/١ ‫ معدى منه‬cares ‫)يعنى‬

2) Restoration of Fractured Primary molars or badly delayed.

3) Developmental problems (Localized or generalized), i.e. enamel
hypoplasia, dentinogenesis imperfecta + amelogenesis imperfecta, MAI
 4) High risk patients of developing Caries.
5) To protect & restore extensive Tooth loss due to erosion, Attrition.
6) As a support for some dental appliances ex, space Maintainers.
7) Special needs patients or Abrasion or where regular oral hygiene is
impaired lending to break down of regular direct restoration.
8) Partially submerged primary molars to maintain mesiodistal space &
occlusal vertical height.

Hall Technique not indicted When

 In Case of incipient Caries (spot prep or Conservative Tooth preparation) is

done.
 In Case of pulp involvement.
 Badly broken down Tooth & We Cannot Cover it by Crown.
 When parents not accept or approve the metal display of ST.ST Crown.

Mechanism of hall Technique

Prober seal of The Tooth (we may use smaller ST.ST Crown size or open the
Contact by elastic band).

This will separate the Caries enlivenment from the substrate & nutrition.

Changes will occur in bacterial profile of dental Caries.

Lesion will not progress.

‫ اول زيادة ونسيبه أسبوع‬elastic band ‫ﺑنﺤﻂ ال‬

embrasure ‫ الثانيﺔ فﻲ ال‬edge ‫ وال‬occlusal area ‫ ﺑتبقﻲ فوق ال‬band ‫ ﺑتاﻋﺔ ال‬upper edge

Modified Hall technique contact area ‫ﺑتﺨتﻠﻒ ﺑس اننا ﺑنﻔتﺢ‬

1- Predental Period

 Gum pads – grooves dental – gingival – lateral - transverse

 Self-limited pseudo C.II
 Bite

2- deciduous dentition period (6M-6y)

 Generalized spaces
 Primate spaces
 Normal over bite
 Terminal plane Flush ‫اﻷفﻀﻞ فﻲ المرحﻠﺔ دى انه يكون‬

‫ لو سأل ﻋن‬Normal characteristic features of (3 years old) ‫اﻻجاﺑﺔ هتكون نﻔس اﻷرﺑع نقﻂ‬

3- Mixed dentition (6 – 9) early ، (9 – 12) late

 Early & late mesial shift

 Mesial step Terminal plane
 Leeway space
Occlusion at 6 years.

Characteristics.

a) Edge to edge relation of anterior (self-limity)

occur due to

- Attrition
- Mandibular growth
b) Spacing Persists between Primary anteriors
c) Mesial step Terminal plane

occur due to

- Bodily movement growth of mandible

- Closure of primate spaces (at early mesial shift)
d) First permanent molar eruption

At (8 – 9) years

A. Deep over bite due to: eruption of upper& lower permanent incisors with
great height different between them & Primary molars
B. Ugly duckling Stage due to: Diastema between Two Permeant Centrals &
Flared letoval permanent incisors (self-limiting Condition)
C. Incisal liability due to: difference in size between large permeant Teeth
with smaller size primary teeth (self-limiting Condition)

Incisal liability is corrected by:

1- Generalized spaces 2- Inter Canine width

3- Primate spaces 4- Labial inclination

at (10 – 12) years

a) Central Diastema Closure (by eruption of Permanent Canines)

b) Correction of deep bite (by the emption of premolars)
c) Closure of leeway space (late mesial shift)