296 - Child‑Centered Chemomechanical Caries Removal: A Split‑Mouth Evaluation of Two Minimally Invasive Agents.

Abstract:

Purpose: Minimal invasive dentistry prioritizes minimal tooth structure loss. Chemomechanical caries removal (CMCR) is a minimal and painless intervention that benefits uncooperative and fearful children with phobia of needles and or dental procedures.

Methods: A split‑mouth In Vivo study design was used to compare two different commercially available papain-based CMCR agents using both clinical and microbiological parameters, and their acceptance during caries excavation procedure in children. A total of 40 primary teeth from 20 children aged 6-9 years were included. A bio-encapsulation technology-based material (Group I) and a commonly used blue colored papain-based gel containing endoproteins (Group II) that selectively degraded caries-affected dentin were applied on contralateral sides in a split-mouth design. Caries removal time, microbial load reduction before and after caries excavation, and patient acceptance using Visual Analogue Scale were recorded and compared. Inter- and intragroup analyses were performed using independent and paired t-tests, respectively, while acceptance scores were evaluated using the chi-square test.

Results: Group II required longer working time. Statistically significant reductions in microbial load were observed before and after excavation with both the groups. Patient acceptance was similarly significant for both groups with P < .05

Conclusion: Caries excavation was effective with both agents; however,Group I yielded better clinical and microbiological outcomes.
This study supports the adoption of minimal intervention approach as an effective alternative in pediatric dental practice, for caries removal, that preserves healthy tissues and fosters a positive dental attitude, especially in children, by reducing dental fear and anxiety, contrasting with traditional "drill-fill-bill" practices.

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