Comparative Success and Survival of Preformed Metal Crown Treatment Between the Hall Technique and Conventional Technique: An Umbrella Review
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Objectives
This umbrella review assessed systematic reviews and meta-analyses comparing the success and survival rates of Hall versus conventional techniques for primary teeth restored with preformed metal crowns.
Methods
A comprehensive literature search identified eligible reviews using PRISMA guidelines. Reviews were qualitatively assessed with AMSTAR 2 and quantitatively analyzed using RevMan meta-analysis. Certainty of evidence was evaluated with GRADE methodology.
Results
Of 116 articles screened, two reviews met inclusion criteria for quantitative analysis. Both had moderate AMSTAR 2 ratings. Meta-analysis found no significant difference between Hall and conventional techniques in pooled success and survival rates. Relative risk estimates were 0.99 (favoring conventional technique) and 1.01 (favoring Hall technique), with zero percent heterogeneity and low risk for publication bias. The GRADE assessment indicated moderate confidence, suggesting Hall technique may slightly reduce success rates while slightly increasing survival rates compared to conventional technique.
Conclusions
Hall and conventional techniques show comparable success and survival rates for primary molars with normal pulps or reversible pulpitis. With moderate confidence, dentists can consider Hall technique an alternative to conventional technique without additional benefit or harm related to success and survival. The Hall technique aligns with American Academy of Pediatric Dentistry guidelines as a secondary prevention method for arresting caries in children with moderate-to-high caries risk, poor cooperation, or barriers to care.
