In vivo study to comparatively evaluate pain threshold, efficacy and procedure time taken by various caries removal methods in children between 7-12 years of age group

Aims: To compare the pain threshold, efficacy and procedure time taken using Atraumatic restorative treatment (ART), Chemo-mechanical & Conventional restorative treatment (CRT). Design, Methods and Material: 7-12 year old pediatric patients with at least three cavitated dentinal lesions involving occlusal surface of primary or permanent teeth, without pain and pulpal involvement were randomly assigned to 3 treatment groups- Atraumatic restorative treatment (ART) using a hand instrument like a sharp spoon excavator. Conventional restorative treatment (CRT) using an airotor, round diamond bur and straight diamond fissure bur with adequate coolant. Chemo-mechanical method where carious lesions were covered with CarisolvTM gel and gently removed after 30 seconds using a sharp spoon excavator. The procedure was repeated until the gel no longer became cloudy and all cavity surfaces were hard on probing. Caries detecting dye was applied for one minute and the efficacy was compared clinically by using the scale given by Erickson et.al. At the end of each excavation, children were shown the Wong-Baker scale, and asked to point the picture best describing their feelings regarding the treatment they just received. The Modified Behavioral Pain Scale (MBPS) was used for objective evaluation of the children’s reaction during excavation of carious lesion. Procedure time was recorded from the beginning until the restoration was completed. Caries free lesions were restored using restorative Glass ionomer Cement Statistical analysis used: Statistical data was analyzed by using ANOVA, Chi Square, Tukeys post hoc and Kruskallwallis Test. Results: The highest efficacy in caries removal was exhibited by CRT. The time taken for caries removal was the maximum with Chemo-mechanical method and Pain experienced by the patients was reported to be highest with CRT Conclusions: Conventional Rotary Method showed highest efficacy in caries removal & pain response. Chemo-mechanical method exhibited least pain but required more procedure time.