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THE STAINLESS STEEL CROWN RESTORATION OF CARIOUS PRIMARY MOLARS WITH HALL TECHNIQUE : A CASE REPORT

Hall technique을 이용한 우식 유구치의 기성 금속관 수복 : 증례보고

  • Yu, Seong-Goo (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Jeong, Tae-Sung (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Kim, Shin (Department of Pediatric Dentistry, School of Dentistry, Pusan National University)
  • 유성구 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 정태성 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 김신 (부산대학교 치의학전문대학원 소아치과학교실)
  • Received : 2012.02.28
  • Accepted : 2012.05.17
  • Published : 2012.05.31

Abstract

Although the stainless steel crowns have been recognized as the most effective and durable form of restoration for primary molars, they have been regarded by many dentists as having definite demerits such as invasive nature of procedural complexity and behavioral aspects of children. As an alternative to conventional technique of stainless steel crown restoration, the Hall technique was first introduced in 1988, which is characterized by just pushing the pre-contoured, cement filled crown form onto the abutment molar with no local anesthesia, no caries removal, no tooth preparation. According to several reports, this can slow, arrest, or even reverse the progress of caries. In addition, its atraumatic feature gives less discomfort and stress to children than conventional one, which is thought excellent especially in younger children. Also, It has been reported to be effective and acceptable to dentist, child patients and their parents. In this case study, three children with age of 4 years 5 months, 4 years 10 months, 6 years 4 months were treated with stainless steel crowns using Hall technique on first primary molar respectively. The teeth were free from pulpal, periapical pathology. After follow up of about 3 to 6 months period, the results showed clinically successful outcomes without any marked complication in pulp, tooth or soft tissue till now. But, it should be kept in mind that this technique is not proper to every child, every carious molar, or every dentist. Thorough distinction of indicated cases and continuous follow-up check is highly required. Conclusively, Hall technique might be an effective and realistic minimally invasive alternative for the carious primary molars especially in younger or disabled children, despite potential doubts on its efficacy and some definite limitations.

비록 기성 금속관 수복이 유구치 수복 시 가장 효과적이고 내구성 있는 방법으로 인지되어 왔지만, 그것은 치과의사들에게 있어서 복합한 시술이 가지는 침습적 특징과 행동 조절 문제와 같은 명확한 단점을 가지고 있다. 전통적인 기성 금속관 수복 방법에 대한 대안으로 1988년 Hall technique이 소개되었는데, 이것은 국소마취, 우식제거, 치아삭제 없이 지대치위에 시멘트가 채워진 금속관을 합착하는 것으로 특징지어진다. 몇몇 보고들에 따르면, 그 비외상적인 특성은 전통적인 수복보다 어린이에게, 특히 저연령 어린이에게 더 적은 불편감과 스트레스를 준다. 또한 Hall technique은 치과의사, 어린이, 그리고 부모에게 효과적이고 받아들일 만 하다고 보고되어 왔다. 이 증례에서, 4세 5개월, 4세 10개월, 6세 4개월의 어린이 3명의 제1유구치를 Hall technique을 이용하여 기성 금속관 수복을 시행하였다. 3~6개월간의 정기검진 후 현재까지 치수, 치아, 또는 연조직에 명확한 합병증 없이 임상적으로 성공적인 결과를 보여주고 있다. 그러나, Hall technique이 모든 어린이, 우식 유구치, 또는 치과의사에게 적합하지는 않다는 것을 유념하고, 적응증의 엄격한 선택과 지속적인 정기 검진이 요구된다. 결론적으로, Hall technique은 효능에 대한 잠재적인 의구심과 일부 명확한 제한점에도 불구하고 특히 저연령 어린이나 장애 어린이의 우식 유구치 수복 방법에서 효과적이고 현실적인 최소침습적 대안이 될 수 있다.

Keywords

References

  1. Humphrey W : Uses of chrome steel in children's dentistry. Dent. Survey, 26:945-949, 1950.
  2. Kindelan SA, Day P, Nichol R, et al. : UK National Clinical Guidelines in Paediatric Dentistry: Stainless steel preformed crowns for primary molars. Int J Paediatr Dent, 18:Suppl 1:20-28, 2008. https://doi.org/10.1111/j.1365-263X.2008.00935.x
  3. 이선경, 김종철, 이광수 : 기성금속관수복 유구치의 변연 적합도에 관한 연구. 대한소아치과학회지, 26(2):389-400, 1996.
  4. Threlfall AG, Pilkington L, Milsom KM, et al. : general dental practitioners views on the use of stainless steel crowns to restore primary molars. Br Dent J, 199(7):453-455, 2005. https://doi.org/10.1038/sj.bdj.4812746
  5. Randall RC : Preformed metal crowns for primary and permanent molar teeth: review of the literature. Pediatr Dent, 24(5):489-500, 2002.
  6. N. Sue Seale : The use of stainless steel crowns. Pediatr Dent, 24(5):501-505, 2002.
  7. 배익현, 정태성, 김신 : 제2유구치 기성금속관 수복에 따른 제 1대구치의 의원성 손상. 대한소아치과학회지, 31(2):153-158, 2004.
  8. Innes NP, Stirrups DR, Evans DJ, et al. : A novel technique using preformed metal crowns for managing carious primary molars in general practice - a retrospective analysis. Br Dent J, 200(8):451-454, 2006. https://doi.org/10.1038/sj.bdj.4813466
  9. Innes NP, Stirrups DR, Evans DJ, Hall N, et al. : The Hall technique: a pilot trial of a novel use of preformed metal crowns for managing carious primary teeth. Br Dent J, 200(8):451-454, 2006. https://doi.org/10.1038/sj.bdj.4813466
  10. Innes NP, Evans DJ, Stirrups DR : The Hall Technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health, 7:18, 2007. https://doi.org/10.1186/1472-6831-7-18
  11. Innes N, Evans D, Hall N : The Hall technique for managing carious primary molars. Dent Update, 36(8):472-474, 477-478, 2009.
  12. Innes N, Evans D : The Hall Technique: A user manual. http://www.scottishdental.org/index.aspx?o=2802.
  13. Rahimtoola S, van Amerongen E, Maher R et al. : Pain related to different ways of minimal intervention in the treatment of small caries lesions. ASDC J Dent Child, 67(2):123-127, 2000.
  14. van Bochove JA, van Amerongen WE : The influence of restorative treatment approaches and the use of local analgesia, on the children's discomfort. Eur Arch Paediatr Dent, 7(1):11-16, 2006.
  15. 대한소아치과학회 : 소아치과학 교과서. 신흥인터네셔날, 서울, 2007.
  16. Marsh PD : Dental plaque as a microbial biofilm. Caries Res, 38(3):204-211, 2004. https://doi.org/10.1159/000077756
  17. Ricketts DN, Kidd EA, Innes N, et al. : Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev, 2006.
  18. Fejerskov O, Kidd EAM : Dental Caries. The Disease and its Clinical Management. Blackwell Munksgaard, Denmark, 267-291, 2003.
  19. Luther F : TMD and occlusion part II. Damned if we don't? Functional occlusal problems: TMD epidemiology in a wider context. Br Dent J, 202(1):1-6, 2007. https://doi.org/10.1038/bdj.2006.130
  20. Croll TP : Preformed stainless steel crowns: an update. Compend Contin Educ Dent, 20:89-92, 94-96, 98-100, 1999.
  21. Croll TP, Epstein DW, Castaldi CR : Marginal adaptation of stainless steel crowns. Pediatr Dent, 25(3):249-252, 2003.
  22. 우주형, 장철호, 김정욱 등 : 유구치 기성 금속관의 변연 적합도에 관한 연구. 대한소아치과학회지, 34(1):27-35, 2007.