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

<bold>Background: </bold>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.<bold>Aims: </bold>To compare pain perception of children of two techniques (ART vs. chemomechanical removal) of restorative treatments for dental caries removal.<bold>Settings and Design: </bold>A randomized clinical trial with two parallels arms (1:1) was conducted in the cities of Manaus (AM) and Uberlândia (MG), Brazil.<bold>Methods: </bold>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.<bold>Statistical Analysis: </bold>Poisson regression analysis was used to evaluate the association between the outcome and the explicative variables.<bold>Results: </bold>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).<bold>Conclusion: </bold>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. [ABSTRACT FROM AUTHOR]