Clinical performance of two chemomechanical caries removal agents in primary molars: a randomized controlled trial

TL;DR

This study compared two chemomechanical methods for removing tooth decay in children's molars, finding they caused less pain but took longer than traditional methods.

Contribution

The study provides new clinical evidence on the pain and time efficiency of chemomechanical caries removal agents in children.

Findings

Conventional caries removal was significantly faster than chemomechanical agents.

BRIX3000® was faster than Carie-Care™ for caries removal.

Chemomechanical agents were reported as less painful than the conventional method.

Abstract

The concept of Chemomechanical Caries Removal (CMCR) includes the selective removal of caries-infected tissue while preserving caries-affected tissue. However, studies examining its application to children are scarce. The aim was to assess pain perception and time duration of CMCR agents when removing caries in primary molars in a sample of children compared to the conventional method of caries removal using rotary burs.

A randomized controlled clinical trial with a split-mouth design with a sample of 60 children aged 4–9 years with 120 cavitated occlusal carious primary molars was equally distributed into 2 experiments: BRIX3000® vs. conventional method (Experiment 1) and Carie-Care™ vs. conventional method (Experiment 2). The time duration of caries removal was recorded. Perception of pain during caries excavation was evaluated using the “Wong-Baker FACES® Pain Rating Scale.”

Caries removal using the conventional method was significantly faster compared to CMCR agents in both experiments (P < 0.001 and P < 0.001). Caries removal using BRIX3000® was significantly faster than Carie-Care™ (P < 0.001). Caries removal with BRIX3000® or Carie-Care™ were reported less painful than the conventional method (P = 0.002 and P = 0.011, respectively).

The study concluded that although CMCR methods require more time for caries removal, they were reported to be less painful.

The study protocol was registered at www.clinicaltrials.gov under the identifier NCT05427591.

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