Is the traditional placement of stainless steel crowns in primary teeth more painful than the non-preparation Hall technique?

Clinical Question: Is the anxiety level and pain experience in young children the same for the traditional method of stainless crowns placement that might require local anesthetic and excavation of decay compared to the Hall technique that requires no preparation and no anesthetic injections?

Design: A randomized controlled study of 2 groups (43 and 54) children 4-8 years old with proximal decay in primary first molars. Each child had one tooth restored with the Hall technique (HT) and the second tooth received a conventional stainless crown (CT) (with or without local anesthesia, as needed) and all crowns were cemented with a GIC resin type cement less than a month of each other. The order of the placement was reversed with the allocation randomly concealed.

Data Analysis: A visual Wong-Baker Pain Scale with six cartoon faces was used to record pain levels. Data were analyzed using SPSS (version 25). After computing univariate descriptive statistics, differences among proportions were examined using cross-tabulations and χ2 tests (α = 0.05). Analysis of variance was conducted for parametric analysis, and the Wilcoxon signed-rank test was used for within-group, and the Mann-Whitney U-test was used for between-group, nonparametric analysis.

Results: The pain scores did not differ by treatment type. The majority of children (58.3%) reported low procedural pain for both treatments leaving 47.7% reporting moderate to high procedural pain. Using local anesthetic with CT did not change the results.

Conclusion: The pain scores were similar for both procedures. HT has been recommended as less traumatic and but this might not be true for all children.