Comparative Efficacy of Smart Burs vs Conventional Burs in Removing Infected Dentin and Preserving Affected Dentin in Primary Teeth: A Randomised Control Study

Abstract

Introduction: With the advent of time, the removal of caries has shifted from hand instruments to rotary instruments. A disadvantage of conventional burs is that they non selectively lead to over-preparation. A new polymer bur can be substituted to eliminate these undesirable effects. Aim: To compare and evaluate the efficacy of smart burs and conventional burs in removing infected dentine while preserving affected dentin in carious lesions in primary teeth. Materials and Methods: This was a double-blinded randomised controlled trial conducted in the Department of Paediatric and Preventive Dentistry at Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India over a period of three months, from August 2023 to October 2023. A total of 40 children aged 6-12 years were selected and evaluated for caries removal efficacy using visual and tactile criteria, which were further confirmed by dye application and numerically scored. Group 1 included 20 children who underwent caries excavation with smart burs, while Group 2 included 20 children who underwent the procedure with diamond points. Statistical analysis was conducted using descriptive and inferential statistics, specifically the Chi-square test. Results: A total of 40 children aged 6-12 years were divided into two groups: Group 1 comprised 11 boys and 9 girls, whereas Group 2 included 10 boys and 10 girls. Of these, 12 cases (60%) showed complete caries removal after the first application of dye, regardless of which burs was used. However, 4 cases (20%) showed some residual caries when using smart burs, while 6 cases (30%) exhibited residual caries with diamond points at the base of the cavity preparation. Additionally, there were 4 cases (20%) with caries present at the base and/or in one wall of the cavity preparation when using smart burs, compared to 2 cases (10%) with conventional burs. Nonetheless, there was no statistically significant difference between the smart burs and the conventional diamond points regarding caries removal. Conclusion: It can be concluded that smart burs are equally effective in removing soft caries compared to conventional methods. Although the results were statistically insignificant, polymer burs were found to be more convenient and can be considered a viable alternative to conventional caries removal techniques.