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, 2013, 896381

Pain During Removal of Carious Lesions in Children: A Randomized Controlled Clinical Trial


Pain During Removal of Carious Lesions in Children: A Randomized Controlled Clinical Trial

Lara Jansiski Motta et al. Int J Dent.


The aim of the present study was to assess pain and the need for anesthesia during chemomechanical caries removal with Papacarie gel and the traditional method (low-speed bur) in pediatric patients. A randomized, controlled, clinical trial with a "split-mouth" design was carried out involving 20 children (10 girls and 10 boys) aged four to seven years. Forty primary teeth (two per child) were randomly allocated to either Group 1 (G1: chemomechanical caries removal with Papacarie gel) or Group 2 (G2: removal of carious dentin with low-speed bur). A face scale was used to classify the sensation of pain during the procedure (1: absence of pain; 2: mild pain; 3: moderate pain; 4: moderately intense pain; 5: intense pain; and 6: extremely intense pain). Statistical analysis of the data was performed using the Wilcoxon-Mann-Whitney (U) test. Pain scores were higher in G2, with statistically significant differences in comparison to G1 (U = 148.0; W = 358.0; P = 0.041). Chemomechanical caries removal with Papacarie provides a lesser degree of pain in comparison to conventional caries removal and does not require the use of local anesthesia. The clinical trial registration number is NCT01811420.


Figure 1
Figure 1
Flow chart of the protocol.

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Cited by 4 PubMed Central articles


    1. Balciuniene I, Sabalaite R, Juskiene I. Chemomechanical caries removal for children. Stomatologija. 2005;7(2):40–44. - PubMed
    1. Bertassoni LE, Marshall GW. Papain-gel degrades intact nonmineralized type I collagen fibrils. Scanning. 2009;31(6):253–258. - PMC - PubMed
    1. Bussadori SK, Castro LC, Galvão AC. Papain gel: a new chemo-mechanical caries removal agent. The Journal of Clinical Pediatric Dentistry. 2005;30(2):115–119. - PubMed
    1. Kumar J, Nayak M, Prasad KL, Gupta N. A comparative study of the clinical efficiency of chemomechanical caries removal using Carisolv and Papacarie—a papain gel. Indian Journal of Dental Research. 2012;23(5):p. 697. - PubMed
    1. Mickenautsch S, Yengopal V, Banerjee A. Atraumatic restorative treatment versus amalgam restoration longevity: a systematic review. Clinical Oral Investigations. 2010;14(3):233–240. - PubMed

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