Comparison of pain and efficacy of caries removal using tungsten carbide bur versus chemomechanical agent (Brix Gel): A randomized controlled trial.

Objective: To compare the pain response and efficacy of caries removal using tungsten carbide burs with that of using Brix Gel as a chemomechanical caries removal agent. Study Design: Randomized Controlled Trial. Setting: Department of Operative Dentistry, PIMS, Islamabad. Period: November 2023 to April 2024. Methods: Conducted on 40 participants were selected using a non-probability technique. Participants aged 12 to 65 years with open occlusal carious lesions involving dentin were included. Patients with symptoms of pulpitis, caries affecting maxillary or mandibular anterior teeth, severe systemic illnesses, allergies, sensitivities, or pregnancy/lactation were excluded. Caries removal methods were randomly assigned. Pain levels were assessed using a Visual Analog Scale (VAS), and caries removal efficacy was evaluated. Statistical analysis was done using chi-square and independent samples t test. Results: Among the 40 participants, 47.50% were female, and the mean age was 36.30±15.57 years. Mandibular molars were the most commonly affected teeth (n=24, 60%). No significant difference in age or gender distribution was observed between the two groups. The chemomechanical method resulted in significantly lower pain scores compared to carbide bur (2.59 ± 1.34 vs. 4.44 ± 1.61, p < 0.001). Pain severity also differed significantly between groups, with more mild pain reported in the chemomechanical group (80.00% vs. 5.00%, p < 0.001). However, caries removal efficacy did not significantly differ between the two methods (p = 0.48). Conclusion: Chemomechanical caries removal using Brix Gel demonstrated superior pain management compared to carbide bur. While both methods showed similar efficacy in caries removal, the chemomechanical approach may offer better patient comfort during the procedure.