Pain perception of children after restorative treatments: Atraumatic restorative treatment versus chemomechanical removal - A noninferiority randomized clinical trial

J Indian Soc Pedod Prev Dent. 2021 Apr-Jun;39(2):202-207. doi: 10.4103/jisppd.jisppd_426_20.

Abstract

Background: Atraumatic restorative treatment (ART) and chemomechanical removal of dental caries have been shown to be safe and effective restorative procedures. However, current literature lacks well-design studies comparing the pain perceived by infants using ART and chemo-mechanical removal techniques.

Aims: To compare pain perception of children of two techniques (ART vs. chemomechanical removal) of restorative treatments for dental caries removal.

Settings and design: A randomized clinical trial with two parallels arms (1:1) was conducted in the cities of Manaus (AM) and Uberlândia (MG), Brazil.

Methods: Children between 4 and 9 years old were selected. In both groups - ART (n = 20) and chemomechanical caries removal (Papaya® gel) (n = 20) - oximeter measurements (heart rate and blood oxygenation) were performed before the intervention and until the complete removal of the infected caries dentin. At the end of the treatment, a Wong-Baker scale was used to assess pain perception during the procedure. An independent researcher measured, in minutes, the duration of each technique.

Statistical analysis: Poisson regression analysis was used to evaluate the association between the outcome and the explicative variables.

Results: No statistical difference in pain perception between the two procedures of carious tissue removal was observed. By contrast, a lower heart rate was observed when chemomechanical removal was used (P = 0.013).

Conclusion: Children that underwent chemomechanical caries removal presented lower heart rate compared to those who underwent ART. However, both techniques showed minimal or absent perceived pain.

Keywords: Dental caries; dental restoration permanent; tooth deciduous.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Brazil
  • Child
  • Child, Preschool
  • Dental Atraumatic Restorative Treatment*
  • Dental Care
  • Dental Caries* / therapy
  • Dental Cavity Preparation
  • Dental Restoration, Permanent
  • Dentin
  • Humans
  • Pain Perception
  • Tooth, Deciduous