Çocuk Diş Hekimliğinde Hall Tekniği
Özet
Hall Tekniği (HT), süt molar dişlerdeki asemptomatik ve pulpayı etkilemeyen dentin çürüklerinin, çürük dokusu uzaklaştırılmadan ve lokal anestezi ile kavite preparasyonuna gerek duyulmadan paslanmaz çelik kronlarla (PÇK) cam iyonomer siman kullanılarak izole edilmesi esasına dayanan, biyolojik ve etkili bir tedavi seçeneğidir. Bu yöntem, karyojenik biyofilm tabakasını ağız ortamından tamamen ayırarak mikroorganizma sayısını ciddi oranda düşürür. Yapılan klinik çalışmalarda, takip sürelerinden bağımsız olarak geleneksel yöntemlere benzer şekilde %94.9 ile %98.9 arasında değişen oldukça yüksek başarı oranları bildirilmiştir. Özellikle dental anksiyete yaşayan, orta derecede uyum gösteren ya da davranışsal bozuklukları nedeniyle uzun tedavilere toleransı olmayan küçük yaştaki çocuklarda, hekim-hasta ilişkisinde güveni pekiştiren invaziv olmayan bir alternatif olarak öne çıkmaktadır. Çocuklar, aileler ve hekimler tarafından yüksek kabul edilebilirlik oranlarına sahip olan bu teknik, tedavi süresini kısaltmasının yanı sıra pulpa irritasyonu veya perforasyonu riskini tamamen ortadan kaldırır ve geleneksel dolgulara kıyasla daha düşük maliyet sunar. Uygulama aşamasında kron morfolojisi ve kontak noktaları değerlendirilir; gerekirse ortodontik seperatörlerle yer açıldıktan sonra uygun boyuttaki kron simanla doldurularak dişe oturtulur. İşlem sonrasında dikey boyutta geçici bir yükselme oluşabilse de, okluzal dengelenme birkaç hafta içinde yan etki olmaksızın kendiliğinden gerçekleşmektedir.
The Hall Technique (HT) is an effective, biologically based treatment option for asymptomatic dentin caries in primary molars without pulp involvement, where teeth are restored using stainless steel crowns (SSC) with glass ionomer cement without removing carious tissue or requiring local anesthesia and cavity preparation. This method effectively isolates the cariogenic biofilm from the oral environment, leading to a significant reduction in microorganism levels. Clinical studies report high success rates ranging from 94.9% to 98.9%, comparable to conventional methods regardless of evaluation periods. It stands out as a non-invasive alternative that reinforces doctor-patient trust, particularly for anxious children, moderately cooperative patients, or young children with behavioral disorders who cannot tolerate lengthy treatments. Demonstrating high acceptability among children, parents, and dentists, this technique completely eliminates the risk of pulp irritation or perforation, shortens treatment time, and provides lower costs compared to traditional restorations. During the clinical stages, crown morphology and contact points are evaluated, space is created using orthodontic separators if necessary, and the appropriate crown size is filled with cement and placed onto the tooth. Although a temporary increase in vertical dimension may occur after the procedure, occlusal equilibration takes place naturally within a few weeks without any adverse effects.
Referanslar
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