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A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan
Despite the high success rates of preformed metal crowns (PMCs) in children no randomized clinical trials compare methods of placement and none describe its use in Africa. Our aim was to compare survival and cost-effectiveness of PMCs placed by conventional techniques (CT) and biological Hall techni...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546341/ https://www.ncbi.nlm.nih.gov/pubmed/31158253 http://dx.doi.org/10.1371/journal.pone.0217740 |
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author | Elamin, Fadil Abdelazeem, Nihal Salah, Isra Mirghani, Yousra Wong, Ferranti |
author_facet | Elamin, Fadil Abdelazeem, Nihal Salah, Isra Mirghani, Yousra Wong, Ferranti |
author_sort | Elamin, Fadil |
collection | PubMed |
description | Despite the high success rates of preformed metal crowns (PMCs) in children no randomized clinical trials compare methods of placement and none describe its use in Africa. Our aim was to compare survival and cost-effectiveness of PMCs placed by conventional techniques (CT) and biological Hall techniques (HT) using a prospective randomized control trial in a general dental practice from Khartoum. One hundred and nine and 103 PMCs were placed in randomly selected children (5-8years) with 1–2 carious primary molars using HT and CT respectively and followed for 2 years. Socioeconomic status, periodontal health, occlusion, anxiety, and procedure time were compared using student t-test. Kaplan–Meier survival rates and incremental cost effectiveness ratio (ICER) were compared between CT and HT. CT and HT groups were similar for age, gender, socio-economic status. Survival rates were high (over 90%) for both study arms and not statistically different (p>0.05). Anxiety scores were significantly higher in CT arm after 12 months compared to HT (p<0.001). Clinically, gingival and plaque indices were similar between groups (p>0.05) but occlusions were raised in nearly all subjects in the HT arm (p<0.05). Periodontal health improved, and occlusions adjusted over time in both arms. There were 3 (2.7%) and 6 (5.8%) minor failures, 7 (6.4%) and 6 (5.8%) major failures in HT and CT arms respectively. Mean procedure time was lower in HT (9.1 min) than CT (33.9 min); p<0.001. Mean PMC cost was US$2.45 and US$7.81 for HT and CT respectively. The ICER was US$136.56 more for each PMC placed by CT per life year. We show that PMCs have high survival outcomes in disadvantaged populations similar to results from developed countries. As HT can be carried out by less experienced dental operators and therapists, this biological approach provides a promising cost-effective option to manage caries in developing countries with limited resources. Trial registration: The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT03640013 |
format | Online Article Text |
id | pubmed-6546341 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65463412019-06-17 A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan Elamin, Fadil Abdelazeem, Nihal Salah, Isra Mirghani, Yousra Wong, Ferranti PLoS One Research Article Despite the high success rates of preformed metal crowns (PMCs) in children no randomized clinical trials compare methods of placement and none describe its use in Africa. Our aim was to compare survival and cost-effectiveness of PMCs placed by conventional techniques (CT) and biological Hall techniques (HT) using a prospective randomized control trial in a general dental practice from Khartoum. One hundred and nine and 103 PMCs were placed in randomly selected children (5-8years) with 1–2 carious primary molars using HT and CT respectively and followed for 2 years. Socioeconomic status, periodontal health, occlusion, anxiety, and procedure time were compared using student t-test. Kaplan–Meier survival rates and incremental cost effectiveness ratio (ICER) were compared between CT and HT. CT and HT groups were similar for age, gender, socio-economic status. Survival rates were high (over 90%) for both study arms and not statistically different (p>0.05). Anxiety scores were significantly higher in CT arm after 12 months compared to HT (p<0.001). Clinically, gingival and plaque indices were similar between groups (p>0.05) but occlusions were raised in nearly all subjects in the HT arm (p<0.05). Periodontal health improved, and occlusions adjusted over time in both arms. There were 3 (2.7%) and 6 (5.8%) minor failures, 7 (6.4%) and 6 (5.8%) major failures in HT and CT arms respectively. Mean procedure time was lower in HT (9.1 min) than CT (33.9 min); p<0.001. Mean PMC cost was US$2.45 and US$7.81 for HT and CT respectively. The ICER was US$136.56 more for each PMC placed by CT per life year. We show that PMCs have high survival outcomes in disadvantaged populations similar to results from developed countries. As HT can be carried out by less experienced dental operators and therapists, this biological approach provides a promising cost-effective option to manage caries in developing countries with limited resources. Trial registration: The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT03640013 Public Library of Science 2019-06-03 /pmc/articles/PMC6546341/ /pubmed/31158253 http://dx.doi.org/10.1371/journal.pone.0217740 Text en © 2019 Elamin et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Elamin, Fadil Abdelazeem, Nihal Salah, Isra Mirghani, Yousra Wong, Ferranti A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan |
title | A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan |
title_full | A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan |
title_fullStr | A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan |
title_full_unstemmed | A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan |
title_short | A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan |
title_sort | randomized clinical trial comparing hall vs conventional technique in placing preformed metal crowns from sudan |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546341/ https://www.ncbi.nlm.nih.gov/pubmed/31158253 http://dx.doi.org/10.1371/journal.pone.0217740 |
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