Dental Caries in Primary Molars in Children
Conditions
Keywords
Atraumatic Restorative Treatment,Gentle Hand Burs,Smart Burs,Minimally Invasive Dentistry,Primary Molar Caries removal,Paediatric Dentistry
Brief summary
This study compared three gentle ways of removing tooth decay in children's primary molars:Gentle hand burs(new hand held rotary instrument used withot electricity),Smart burs (polymer burs used in a slow speed hand piece) and Atraumatic Restorative Treatment(removal with hand spoon excavator).Ninety children aged 5-11 years with a decayed occlusal surface on a primary molar were randomly assigned to one of the three methods.The study measured how completly decay was removed,how long removal took,how anxious the child was during treatment and how much pain the child reported afterwards.
Detailed description
Conventional high speed rotary caries removal can remove sound tooth structure,generate heat and aerosols and cause anxiety in children due to noise and vibration.Minimally invasive alternatives include Atraumatic Restorative Treament(ART) using hand excavators,self limiting polymer smart burs,and the recentl introduced Gentle Hand Burs ,which have an aluminium handle and long-shank carbide bur and need no electricity. This single center,parallel group,randomised controlled trial was conducted in the Department of paediatric and preventive dentistry,Meghna Institute of Dental sciences,Mallaram,Nizamabad,Telangana,India.Ninety children aged 5-11 years with occlusal caries lesions {ICDAS 4-6} in asymptomatic primary molars without pulpal involvement were allocated 1:1:1 by lottery method to ART,Gentle Hand Burs or Smart burs(30 per group).Sample size were calculated with alpha 0.05 and power 95%. Under rubber dam isolation, a caries-indicator dye was applied for 10 seconds and rinsed .Caries was removed by a single operator ; the end point was no catch with a straight explorer and no dye staining.Efficacy was scored with ericson's criteria,time was recorded,behaviour was rated by two examiners with the Sound,Eye,Motor(SEM) scale, and pain was self reported with the Wong Baker FACES Scale after treatment.Glass Ionomer Cement Restoration placed after excavation.
Interventions
DEVICEGentle Hand Burs
Caries removal done by manually operated instrument which is an aluminium handle and long shank carbide bur,without electricity or handpiece( Gerry Bueachmin,USA).
PROCEDUREAtraumatic Restorative Treatment
Caries removal with sharp spoon excavator without rotary instruments.
DEVICESmart Burs(polymer bur)
Self limiting polymer bur used in a slowspeed contra angle hand piece ,replaced when blunted.
Sponsors
Sathiraju Hema Sai Niharika
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to 11 Years
Healthy volunteers
No
Inclusion criteria
1. Children aged 5 to 11 years 2. Atleast one active carious lesion on the occlusal surface of an asymptomatic primary molar 3. ICDAS score 4 to 6 4. Radiographic evidence of enamel and dentin involvement without pulpal involvement. 5. Written consent form from parent/guardian of child. -
Exclusion criteria
1)Pulpal exposure or bleeding during excavation 2)Tenderness to percussion 3)Non vital or grossly decayed teeth 4)Devlopmental anomalies such as fusion,gemination,dilaceration or amelogenesis imperfecta. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time taken for caries removal (efficiency) | During the procedure (single visit) | Time in minutes from the start of excavation to the clinical end-point ( no catch with explorer and no dye staining ), recorded with a stopwatch. |
| Efficacy of caries removal | Immediately after excavation (single visit) | Completeness of caries removal scored with Ericson's criteria (0 to 5;0=caries completly removed). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Child behaviour during treatment | During the procedure (single visit). | Sound,Eye,Motor (SEM) scale scores recorded by two calibrated examiners; higher scores mean more discomfort. |
| Pain perception | Immediately after the procedure( sinle visit ). | Wong Baker FACES Pain Rating Scale (0 to 10) self reported by the child;higher scores mean more pain. |
Countries
India
Contacts
PRINCIPAL_INVESTIGATORSathiraju Hema Sai Niharika post graduate in paediatric and preventive dentistry, MDS
Meghna Institute of Dental Sciences
Outcome results
None listed