Occlusal Impact of Hall Crowns in Primary Molars

NCT ID: NCT07134114

Last Updated: 2025-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-15

Study Completion Date

2026-12-15

Brief Summary

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Hall Technique is a non-invasive restorative approach for managing carious primary molars, increasingly used in pediatric dentistry due to its simplicity and patient tolerance. This study aims to evaluate and compare the occlusal changes that occur following Hall crown placement on different primary molar groups (maxillary first molar, maxillary second molar, mandibular first molar, mandibular second molar) using digital model analysis.

Detailed Description

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The aim of this clinical study is:

* to evaluate the occlusal changes that occur following the Hall Technique in different primary molar groups.
* to investigate whether the molar group (first vs. second) and jaw location (maxilla vs. mandible) influence the degree or pattern of occlusal adaptation.

A total of 60 healthy children aged between 7 and 10 years will be recruited from the Pediatric Dentistry Clinic at Ankara Yıldırım Beyazıt University, Faculty of Dentistry. Patients must have at least two primary molars requiring restorative treatment and meet all inclusion criteria.

After obtaining informed consent from parents and assent from the child, one eligible primary molar per participant will be randomly selected for Hall crown placement using a computer-generated allocation system. Based on the selected tooth, participants will be stratified into four groups: Group 1 (Maxillary first primary molar), Group 2 (Maxillary second primary molar), Group 3 (Mandibular first primary molar), and Group 4 (Mandibular second primary molar). Following group allocation, all other necessary dental treatments-including conventional restorations, endodontic procedures, and preventive interventions-will be completed to eliminate potential occlusal interferences.

One week after the completion of all dental treatments other than the Hall Technique, a baseline digital intraoral scan will be obtained using the Trios 3 scanner (3Shape, Copenhagen, Denmark), prior to crown placement on the designated primary molar. The Hall Technique will then be applied without local anesthesia or any caries removal. Debris will be gently cleared from the cavity, and airway protection will be ensured using gauze or elastoplast fixation. An appropriately sized preformed stainless-steel crown will be filled with glass ionomer cement (3M Ketac Cem) and seated on the tooth. The child will be instructed to bite firmly to ensure crown placement, or finger pressure will be used if necessary. Excess cement will be removed and interproximal contacts will be cleaned with dental floss. Digital intraoral scans will be repeated at three additional time points: immediately after crown placement (T1), at two weeks (T2), and at one month (T3) post-treatment. Superimposition and occlusal analysis will be conducted using Trios CAD (Computer-Aided Design) software to evaluate changes in occlusal parameters over time.

Following parameters will be quantitatively assessed:

* Positional change (in mm) between the mesiobuccal, distobuccal, mesiolingual/palatal, and distolingual/palatal cusp tips of the Hall-treated tooth, as well as the cusp tips of the opposing teeth in maximum intercuspation with this tooth.
* Positional change (in mm) of the cusp tip of the maxillary primary canine on the same side as the treated tooth
* Positional change (in mm) between the mesiobuccal cusp tips of all permanent first molars,
* Change in anterior occluso-vertical dimension (in mm)
* Change in posterior occluso-vertical dimension (in mm)
* Change (in mm²) in the surface area of maximum occlusal contact regions, based on digital bite registration records.

Statistical analysis will involve comparing changes in linear (mm) and surface area (mm²) measurements across the four study groups at multiple time intervals (T0-T1, T0-T2, T0-T3, T1-T2, T1-T3, and T2-T3). Data distribution will be assessed using the Shapiro-Wilk test. Group comparisons will be performed using ANOVA, Kruskal-Wallis, chi-square, and two-way mixed ANOVA or F1-LD-F1 design, as appropriate. Bonferroni correction will be applied for post hoc tests, and p ≤ 0.05 will be considered statistically significant. Analyses will be conducted using SPSS v.23 and R software.

Conditions

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Dental Caries Dental Occlusion Pediatric Dentistry

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The biostatistician performing the data analysis will be blinded to group allocation. The clinician performing treatment and model analysis will not be blinded.

Study Groups

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Maxillary First Primary Molar

A preformed metal crown will be placed and cemented on the carious maxillary first primary molar using the Hall Technique, without any tooth preparation or administration of local anesthesia.

Group Type EXPERIMENTAL

Hall Technique

Intervention Type PROCEDURE

Procedure: Hall Technique A preformed stainless-steel crown will be placed on a primary molar using the Hall Technique. This approach does not require local anesthesia, caries removal, or tooth preparation.

Digital Scan and Bite Registration Schedule:

* T0 (Baseline): Immediately before crown placement
* T1 (Immediate): Immediately after crown placement
* T2 (Two Weeks): Two weeks after crown placement
* T3 (One Month): One month after crown placement At each time point (T0-T3), digital scans of both the upper and lower arches will be obtained, and a bite registration will be recorded. These records will be used to generate three-dimensional digital models, which will be analyzed to assess occlusal relationships and monitor changes over time.

Maxillary Second Primary Molar

A preformed metal crown will be placed and cemented on the carious maxillary second primary molar using the Hall Technique, without any tooth preparation or administration of local anesthesia.

Group Type ACTIVE_COMPARATOR

Hall Technique

Intervention Type PROCEDURE

Procedure: Hall Technique A preformed stainless-steel crown will be placed on a primary molar using the Hall Technique. This approach does not require local anesthesia, caries removal, or tooth preparation.

Digital Scan and Bite Registration Schedule:

* T0 (Baseline): Immediately before crown placement
* T1 (Immediate): Immediately after crown placement
* T2 (Two Weeks): Two weeks after crown placement
* T3 (One Month): One month after crown placement At each time point (T0-T3), digital scans of both the upper and lower arches will be obtained, and a bite registration will be recorded. These records will be used to generate three-dimensional digital models, which will be analyzed to assess occlusal relationships and monitor changes over time.

Mandibular First Primary Molar

A preformed metal crown will be placed and cemented on the carious mandibular first primary molar using the Hall Technique, without any tooth preparation or administration of local anesthesia.

Group Type ACTIVE_COMPARATOR

Hall Technique

Intervention Type PROCEDURE

Procedure: Hall Technique A preformed stainless-steel crown will be placed on a primary molar using the Hall Technique. This approach does not require local anesthesia, caries removal, or tooth preparation.

Digital Scan and Bite Registration Schedule:

* T0 (Baseline): Immediately before crown placement
* T1 (Immediate): Immediately after crown placement
* T2 (Two Weeks): Two weeks after crown placement
* T3 (One Month): One month after crown placement At each time point (T0-T3), digital scans of both the upper and lower arches will be obtained, and a bite registration will be recorded. These records will be used to generate three-dimensional digital models, which will be analyzed to assess occlusal relationships and monitor changes over time.

Mandibular Second Primary Molar

A preformed metal crown will be placed and cemented on the carious mandibular second primary molar using the Hall Technique, without any tooth preparation or administration of local anesthesia.

Group Type ACTIVE_COMPARATOR

Hall Technique

Intervention Type PROCEDURE

Procedure: Hall Technique A preformed stainless-steel crown will be placed on a primary molar using the Hall Technique. This approach does not require local anesthesia, caries removal, or tooth preparation.

Digital Scan and Bite Registration Schedule:

* T0 (Baseline): Immediately before crown placement
* T1 (Immediate): Immediately after crown placement
* T2 (Two Weeks): Two weeks after crown placement
* T3 (One Month): One month after crown placement At each time point (T0-T3), digital scans of both the upper and lower arches will be obtained, and a bite registration will be recorded. These records will be used to generate three-dimensional digital models, which will be analyzed to assess occlusal relationships and monitor changes over time.

Interventions

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Hall Technique

Procedure: Hall Technique A preformed stainless-steel crown will be placed on a primary molar using the Hall Technique. This approach does not require local anesthesia, caries removal, or tooth preparation.

Digital Scan and Bite Registration Schedule:

* T0 (Baseline): Immediately before crown placement
* T1 (Immediate): Immediately after crown placement
* T2 (Two Weeks): Two weeks after crown placement
* T3 (One Month): One month after crown placement At each time point (T0-T3), digital scans of both the upper and lower arches will be obtained, and a bite registration will be recorded. These records will be used to generate three-dimensional digital models, which will be analyzed to assess occlusal relationships and monitor changes over time.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* No skeletal or dental anomalies,
* ASA (American Society of Anesthesiologists) physical status classification of I or II ,
* Frankl Behavior Rating Scale score of 3 or 4,
* In the mixed dentition stage,
* Fully erupted permanent first molars in occlusal contact at maximum intercuspation
* No acute dental pain or need for emergency treatment,
* Presence of at least two primary molars with carious lesions scored as 3, 4, or 5 according to the ICDAS (International Caries Detection and Assessment System),
* Presence of an antagonist tooth for the molar planned to receive Hall Technique,
* Provision of verbal and written informed consent by the participant and legal guardian after reading or listening to the consent form and fully understanding its content.


Based on Clinical Examination:

* No history of prolonged pain in response to thermal or chemical stimuli, or spontaneous pain suggestive of irreversible pulpitis,
* No sensitivity to percussion or palpation,
* Absence of both pathological and physiological mobility,
* No signs of swelling, fistula, or discoloration,
* Sufficient remaining tooth structure to retain a preformed stainless steel crown.

Based on Radiographic Examination:

* Radiolucent lesion associated with dental caries located within the outer one-third to two-thirds of the dentin, with a visible band of normal dentin between the lesion and the pulp,
* At least two-thirds of root length present,
* No signs of internal or external pathological or physiological root resorption,
* Intact lamina dura and normal periodontal ligament space,
* No periradicular bone loss surrounding the roots,
* No calcified masses in the pulp chamber.

Exclusion Criteria

* Individuals with serious systemic or psychological conditions
* Participants who fail to attend follow-up appointments
* Those who exhibit excessive fear or anxiety reactions and are unable to cooperate during treatment
Minimum Eligible Age

7 Years

Maximum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ankara Yildirim Beyazıt University

OTHER

Sponsor Role lead

Responsible Party

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AYŞE IŞIL CİHAN

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ayşe I. Cihan, Professor

Role: STUDY_CHAIR

Ankara Yıldırım Beyazit University Faculty of Dentistry

Locations

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Ankara Yıldırım Beyazıt University Faculty of Dentistry

Ankara, Keçiören, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Ayşe I. Cihan, Professor

Role: CONTACT

+905325095961

Eylül Ü. Aykan

Role: CONTACT

+905342820608

Facility Contacts

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Ayşe Işıl Cihan, Professor

Role: primary

+90 532 509 59 61

References

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Akyildiz BM, Al-Yaseen W, Innes N, Zhurov A, Tas A, Sonmez I. Longitudinal observational digital analysis of occlusion in Hall Technique. J Dent. 2025 Feb;153:105547. doi: 10.1016/j.jdent.2024.105547. Epub 2024 Dec 30.

Reference Type BACKGROUND
PMID: 39743130 (View on PubMed)

Joseph RM, Rao AP, Srikant N, Karuna YM, Nayak AP. Evaluation of Changes in the Occlusion and Occlusal Vertical Dimension in Children Following the Placement of Preformed Metal Crowns Using the Hall Technique. J Clin Pediatr Dent. 2020;44(2):130-134. doi: 10.17796/1053-4625-44.2.12.

Reference Type BACKGROUND
PMID: 32271658 (View on PubMed)

Kaya MS, Kinay Taran P, Bakkal M. Temporomandibular dysfunction assessment in children treated with the Hall Technique: A pilot study. Int J Paediatr Dent. 2020 Jul;30(4):429-435. doi: 10.1111/ipd.12620. Epub 2020 Feb 12.

Reference Type BACKGROUND
PMID: 31991506 (View on PubMed)

Gallagher S, O'Connell BC, O'Connell AC. Assessment of occlusion after placement of stainless steel crowns in children - a pilot study. J Oral Rehabil. 2014 Oct;41(10):730-6. doi: 10.1111/joor.12196. Epub 2014 Jun 10.

Reference Type BACKGROUND
PMID: 24913609 (View on PubMed)

van der Zee V, van Amerongen WE. Short communication: Influence of preformed metal crowns (Hall technique) on the occlusal vertical dimension in the primary dentition. Eur Arch Paediatr Dent. 2010 Oct;11(5):225-7. doi: 10.1007/BF03262751.

Reference Type BACKGROUND
PMID: 20932395 (View on PubMed)

Other Identifiers

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E2-25-11969

Identifier Type: -

Identifier Source: org_study_id

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