Assessing Caries Removal Efficacy and Pain Perception in Children, Using Smart Bur Versus Carbide Bur: A Randomized Clinical Study

BACKGROUND Dental caries removal is conventionally done using carbide burs, but non-metallic polymer burs have recently been developed with the aim of being more selective and causing less pain. The objective of the study is to evaluate and compare the effectiveness of caries removal, time taken, and patient compliance during restorations using smart bur and carbide burs in pediatric patients. MATERIAL AND METHODS A clinical study was designed and conducted at the Pedodontics Outpatient Department, with a focus on 40 children between 6 and 12 years old, who were split into 2 groups consisting of 20 children each: group 1, using a carbide conventional rotary bur, and group 2, using a smart bur. Efficiency of caries removal was assessed using the Ericson scale. The Face Leg Activity Cry Consolability (FLACC) and Wong-Baker FACES pain rating scale (WBS) were used to assess the intensity of pain, and the behavior of children was assessed using the Frankel behavior rating scale (FBRS). RESULTS A statistically significant difference (P<0.001) was noted in the time taken for caries excavation and Ericson scale (P=0.04), with higher scores observed in the smart bur group. The smart bur group generally reported lower WBS and FLACC scores than the carbide bur group, during caries excavation, restoration and local anesthesia administration, and this difference was very highly significant (P<0.001). CONCLUSIONS Pain perception among children was lesser and overall satisfaction was higher in smart bur group whereas caries removal efficiency was higher in conventional carbide bur group.