Removing carious dentin using a polymer instrument without anesthesia versus a carbide bur with anesthesia

Area of Science:

• Dental materials science
• Minimally invasive dentistry
• Clinical dentistry

Background:

• A novel rotary polymer instrument selectively removes infected dentin.
• This instrument offers potential for cavity preparation without local anesthesia (LA).
• Previous clinical trials have not assessed patient acceptance of this technology.

Purpose of the Study:

• To evaluate patient acceptance and preference for a new polymer rotary instrument.
• To compare patient experience using the polymer instrument without LA versus a carbide bur with LA.

Main Methods:

• Open-label clinical study involving 20 subjects with Class I carious lesions.
• Randomized assignment to receive restoration with either the polymer instrument (no LA) or carbide bur (LA).
• Subjects completed questionnaires on dental history, anxiety, and pain; rated sensations during procedures; and indicated preference post-treatment and at follow-up.

Main Results:

• Subjects reported slightly increased pain, pressure, and vibration with the polymer instrument, but not increased heat, cold, or fear.
• Immediately post-procedure, 70% of subjects preferred the polymer instrument without LA for future dental work.
• This preference increased to 73.7% at 48-hour and one-week follow-ups, with only one subject requiring rescue LA.

Conclusions:

• A significant number of subjects preferred the polymer rotary instrumentation without LA over traditional carbide bur treatment with LA.
• This preference was maintained despite a slight but statistically significant increase in perceived pain and pressure.
• The polymer instrument is viable for Class I cavity preparations without LA, indicating potential for enhanced patient comfort and acceptance.