Pain Assessment During Chemo-Mechanical and Smart Burs Caries Removal Versus Atraumatic Restorative Treatment in Carious Primary Molars: A Randomized Clinical Trial

Background: Dental caries, a widespread condition among children. Traditional removal methods often lack precision, require anesthesia, and may harm the pulp. Minimally invasive techniques offer anesthesia-free approach that selectively removes infected dentin while preserving healthy tissue, making them especially suitable for pediatric patients.Aim: This clinical trial aimed to compare the level of pain, time required for caries removal, and the effectiveness of caries removal in carious primary molars using Chemo-Mechanical Caries Removal and Smart Burs versus Atraumatic Restorative Treatment.Materials and Methods: This study included thirty-three children with carious second primary molars. Participants were randomized equally into three groups: Intervention Group 1 (Smart Bur II), Intervention Group 2 (Chemo-Mechanical Caries Removal with Selecti-Solve gel), and Atraumatic Restorative Treatment (ART) as the Control Group. The time taken for caries removal was measured in the three approaches by minutes using a stopwatch. The effectiveness of caries removal was determined using a caries detection dye, while pain levels were assessed using the Visual Analogue Scale (VAS).Results: The results revealed no statistically significant differences in pain levels and efficacy of caries removal among the three groups. However, there was a significant difference in the time required for caries removal: Smart Bur II had the shortest mean time, followed by ART, and then Selecti-Solve was the last one. Conclusion: All three minimally invasive techniques were comparable in pain levels and efficacy of caries removal. Smart Bur II offered the greatest time efficiency, while Selecti-Solve gel was more time-consuming.