الفهرس | Only 14 pages are availabe for public view |
Abstract With the current stage of minimally invasive restorative dentistry, developing new caries removal technique is progressing towards a more biological and conservative approach. As such, polymer bur has emerged as a self-limiting selective tool for caries removal. Polymer bur (smart bur II) is a unique rotary instrument made of a specially designed polymer material, with a particular hardness and wear resistance that, according to the manufacturer, enable it to remove only the soft caries-infected, leaving the caries affected dentin intact. Consequently polymer bur can reduce the degree of pain experienced during the dental procedures and also avoid the initiation of dental anxiety. Aim of the study: This study evaluated and compared the efficacy of polymer burs (Smart Burs II) versus conventional burs (Carbide burs) for selective removal of infected carious dentin in permanent molars through: I. Caries removal efficacy: A. Clinical evaluation. B. Volume of removed carious tissue. C. Caries removal time. II. Patient’s evaluation of the procedure. Materials and methods: A total of thirty permanent first molars in a group of children aged between 8- 11 years, with Class I occlusal caries, were selected from the outpatient clinic at the Pedodontic Department – Faculty of Dentistry – Suez Canal University with the following criteria: Clinical criteria: 1. Apparently healthy and medically-free children of both genders. 2. Co-operative children scored as positive (3) or definitely positive (4) on Frankl Behaviour Rating Scale. 3. Age ranging from 7-11 years old. 4. Children had, at least, one permanent first molar with class I (occlusal) active caries, involving dentin, with a cavity opening diameter of at least 2mm. 5. All the four walls of the tooth should be intact. Radiographic criteria: 1. Carious lesion extending up to the 2/3 thickness of the dentin. 2. Absence of periapical or inter-radicular radiolucency. Clinical procedures and grouping: Volume of the carious cavity was recorded for both groups using impression material which was inserted in calibrated insulin syringe. Then removal of carious lesions was performed for all the selected carious teeth and they were divided into two groups, according to the types of burs used for caries removal; group (A): Carbide bur group group (B): Polymer bur group After that, caries detector dye was applied on the defected teeth for both groups. After complete removal of caries, volume of the cavity was recorded. Efficiency of caries removal in both groups was numerically scored 0, 1, 2, 3, 4 and 5 using caries detector dye. Patient perception of the treatment procedure was measured using the “Facial Image Scale”. Results: 1. Results of caries removal efficiency through different parameters included; a) Volume of removed carious tissue: The statistical analysis comparison between both groups showed that there was statistical significant difference in volume of removed carious tissue between both groups, in which polymer bur was more conservative in selectively dentin caries removal than carbide bur. b) Caries removal time: The statistical analysis comparison between both groups indicated that there was statistical significant difference in caries removal time, where polymer bur was more time consuming in comparison to carbide bur. c) Remaining caries score: The statistical analysis comparison between both groups showed that scoring of remaining carious dentin between polymer bur and carbide bur was statistically non-significant. 2. Results of patient’s satisfaction of the procedures. The statistical analysis comparison between both groups revealed that smart polymer bur, used for excavating dentin caries, produced least experienced pain compared to using carbide bur which ensure more patient’s comfort. |