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Flashcards in Hall Crown Deck (20):
1

Who is the Hall technique named after?

Dr Norna Hall
GDP in Scotland

2

What material are the metal crowns made from?

Nickel Chromium
stainless steel

3

What were the problems with using pre formed metal crowns in the conventional way?

Difficult to prepare the primary teeth
Needed LA
Poor compliance
Risk of damage to the developing first permanent molar when preparing the E

4

What percentage did the pre-formed metal crowns account for restorations before the hall technique?

1%

Innes and Evans 2009

5

What are the requirements for caries?

Time
Susceptible tooth surface
Plaque
Bacteria

6

Which surfaces are most prone to caries?

Base of fissures
Just below contact points

7

Why are the bases of fissures and contact points most susceptible to caries?

Provide a very sheltered surface where an ecological niche favours cariogenic plaque maturation

8

Which bacteria within the biofilm are non-cariogenic?

Strep salivarius
Strep Oralis

9

Which bacteria within the plaque biofilm are carogenic?

Strep Mutans
Lactobacilli

10

Which acids are produced from the bacteria?

Lactic
Maleic
Proprionic

11

Which acid produced as a by product of ferment able carbohydrates has the worse affect on enamel?

Lactic

biggest molecular value therfore takes the longest to diffuse out of the plaque

12

What is the major, minor and pain failure rates for hall crown vs normal restorative material?

Major failure: abscess/irreversible pulpitis
Minor failure: Lost crown reversible pulpitis

Innes, Evans, Stirrups 2008
RCT that looked at 128 SSC and 128 conventional restprations

restoration vs Hall crown

Major failure: 15% vs 2%
Minor failure: 46% vs 5%
Pain: 11% vs 2%

13

What are the potential problems arising from Hall crowns?

Time: 13% of hall crowns need orthodontic separators
Increase in OVD

14

When should the recall time be after placing a SSC?

2 weeks to assess any problems with OVD/TMJ

15

Under which circumstances are SSC not suitable?

Innes and Evans 2009

Signs of irreversible pulpitis or signs of irreversible pulpitis
non-physiological mobility
Insufficient sound tissue to retain the crown
patient at risk from bacterial endo
Patient co-op where the clinician cannot be sure the crown can be fitted without damaging the airway
parent or child unhappy
Self-cleansing arrested carious lesion

16

When are hall crowns indicated?

Innes and Evans 2009

early to moderate class 2
active caries in D's and E's
can be used for class 1 cavities too where it is not possible to get a good peripheral seal

17

What are the 6 stages to seating a hall crown?

Innes and Evans 2009

1.Sizing
2.Fill crown with cement
3.Locate and seat
4.Wipe excess cement away
5.Seat further (let the child bite down on a cotton wool)
6.Check and clean

18

Why is it important to perform the second seating check?

Innes and Evans 2009

Because the crown can spring back a little and this can then cause some cement to be sucked back away from the gingival margin creating a breach in the seal

19

How long should you wait between fitting SSC on opposing teeth?

minimum of three months to allow occlusal equilibration

(Innes and Evans 2009)

20

What happens to the caries once the hall crown is placed?

caries progression slows or even arrests

Weerheijm 1992