Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Clinical Evaluation of Caries Removal Efficacy of

Polymer Burs Running Title: Efficacy of
Polymer Burs
Shrimahalakshmi, Nagalakshmi Chowdhary,
Postgraduate, Head of the department and Professor,
Department of Pedodontics and Preventive Dentistry, Department of Pedodontics and Preventive Dentistry,
SSAHE, Tumkur- 572107, India SSAHE, Tumkur- 572107, India

Kiran N K, Ravigna Peddi,

Former professor, Professor,
Department of Pedodontics and Preventive Dentistry, Department of Pedodontics and Preventive Dentistry,
SSAHE, Tumkur- 572107, India SSAHE, Tumkur- 572107, India

Author contributions:
Nagalakshmi Chowdhary and Kiran N K conceived the idea and guided the study;
Ravigna Peddi analyzed the data and corrected the manuscript.
Shrimahalakshmi conducted the study, collected the data, and wrote the manuscript.

We would like to submit a manuscript entitled “Clinical evaluation of caries removal efficacy of polymer burs” for
publication as an original research article in your journal. We declare that this manuscript is original, has not been published
before, and is not currently been considered for publication elsewhere.

The study was presented as a paper presentation at the 42 nd Indian society of Pedodontics and Preventive dentistry national
conference, held from 25th – 27th November 2021.

We know of no conflicts of interest associated with this publication, and there has been no significant financial support for
this work that could have influenced its outcome. As the corresponding author, I confirm that the manuscript has been read and
approved for submission by all the authors.

Thanking you

Corresponding Author
Dr. Shrimahalakshmi
Department of Pedodontics and Preventive Dentistry,
Sri Siddhartha Dental College and Hospital,
Sri Siddhartha Academy of Higher Education (SSAHE),
Tumkur- 572107, INDIA.

Abstract:- Background and objectives: The ultimate goal Conclusion: Polymer burs did not improve the efficacy
of conservative dentistry is to remove only the infected of caries removal and the pain perception was higher
portion of carious dentine and to preserve as much as when compared with ART.
possible sound tooth structure. The present study was
conducted to evaluate and compare the caries removal Keywords:- selective caries removal, polymer burs, ART,
efficacy of Polymer burs and ART. infected dentin.

Materials and methods: A total of forty children aged I. INTRODUCTION

between 4-9 years with open carious lesions were selected
for the study. They were randomly allocated to Group 1- Dental caries is a microbial disease affecting human
Polymer bur (n=40) and Group 2 – ART (n-40). The dentition since pre-historic times. It is characterized by
efficacy of caries removal was assessed using caries cavitation of enamel through a complex interaction over
detector dye (Sable and Seek). The pain perception was time between acid-producing bacteria and fermentable
assessed using the Wong-Baker faces pain rating scale. carbohydrates. As soon as caries destroy the enamel it
penetrates the dentin and destroys the dentinal tubules. [1]
Results: These results indicated no statistically
significant difference in the efficiency of caries removal Macroscopically, dentinal caries can be divided into
in both groups. Pain perception was less in ART group two layers having different microscopic and chemical
compared to the polymer bur group. structures. Superficial layer, the infected dentin, and the
deeper layer, the affected dentin.[2]Infected dentin is soft,

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
composed of necrotic bacterial mass and bacterial products conservative approach in dentinal caries removal along with
which is dry, softened, and leathery inconsistency. Deeper instilling a positive attitude of children towards dentistry.
layer, the affected dentin is free from bacterial
contamination, partially demineralized, non-necrotic, and Various studies had been conducted to assess the
capable of physiological remineralization. [3-5] efficacy of Polymer burs. Although there are paucities in
studies comparing them. Hence, the present clinical study
In partial removal of carious dentin, the infected dentin was designed to evaluate and compare the efficacy of two
is removed whereas the affected dentin is preserved for different caries removal techniques -Polymer bur
remineralization. The rationale behind the partial removal of (SmartBurs II) and Atraumatic Restorative Treatment (ART)
caries is a proper restoration prevents the progression of for deep carious lesions involving dentin in primary molars.
carious by prohibiting external nutritional supply for the
bacteria. Subsequently, in response to caries, the II. METHODOLOGY
odontoblastic process forms calcium phosphate precipitates
(whitlockite crystals) to occlude the dentinal tubules Written informed consent was obtained from the
creating an odontoblastic reaction zone. The arrest of caries parent/ guardian after being informed about the nature of the
progression had been observed over ten years when the study. The Ethical Clearance for the study was obtained by
bacteria were isolated from the source of nutrition. [4] the Institutional Ethics and review committee.
However, a balance between tissue preservation and infected
dentin removal should be maintained to prevent caries A total of eighty primary molars were selected from
progression. children aged between 4-9 years based on the following
inclusion and exclusion criteria. The inclusion criteria were
Unfortunately, the conventional treatment of caries Cooperative children, Children with no history of any
removal using high-speed hand-piece is often inaccessible to systemic diseases, Children with at least two teeth having
most of the child population and may lead to avoidance of Class I occlusal carious lesions as confirmed by IOPA. The
dental treatment.[6, 7] Noise, vibrations, over-heating, and exclusion criteria were uncooperative children, symptomatic
pressure effects on pulp were commonly encountered during teeth (mobility, fistula, abscess), restored or fractured teeth,
cavity preparation using the classical burs that may developmental anomalies, multi-surface carious lesions.
incorporate fear and anxiety in children and their parents.
Moreover, it reduces the regenerative potential of pulp- The selected teeth were randomly allocated to two
dentin complex.[8]Anusavice et al[9] stated that the removal groups
of infected dentin does not elicit pain sensation but while  Group A (n=40) - Polymer bur group
cutting the sound healthy dentin often evoked mild pain  Group B (n=40) - ART group
sensation.
All clinical procedures were done by a single operator
Polymer bur, a single-use self-limiting bur, was first under complete isolation.
described by Boston in 2003.[10]The development of self-
A. GROUP A (POLYMER BUR GROUP):
limiting caries removal technique would be of greater
Polymer burs (Smart Bur II) were used at a slow speed
clinical importance, as it is strictly restricted to the infected
without water coolant, running in a circular motion starting
part of carious dentin, without extending into sound dentin.
from the center of the lesion to the periphery as
Hence, the possibility of pup exposure is infrequent even in
recommended by the manufacturer. Caries removal by the
deep carious lesions.[10]
bur was stopped when the polymer bur becomes abraded
The polymer burs have the potential to prepare cavities and blunted macroscopically. The number of burs used was
without the need for local anesthesia.[11] Unlike the spiral decided by the clinician.
cutting edge of conventional carbide burs, the polymer bur
B. GROUP B (ART GROUP):
has shovel-like straight cutting edges and is made up of
Caries was removed using a sterile sharp spoon
medically graded polyether ketone-ketone with a Knoop
excavator. Concurrently dentin hardness was checked and
hardness value of 50 kg/mm2 which is greater than that of
caries removal was terminated after obtaining hard dentin as
infected dentin (0 kg/mm2-30kg/mm2) and lesser than that of
detected with a probe at the base of the cavity.
healthy dentin (70 kg/mm2 - 90 kg/mm2).[11] Accordingly, on
encountering healthy dentin, the bur loses its cutting C. CLINICAL EVALUATION:
efficiency and the blades will abrade instead of abrading In both groups, the efficacy of caries removal was
health/ affected dentin. These burs are described as “dentin evaluated clinically by tactile and visual criteria. [9]In
safe” and “self-limiting burs”.[10] addition, caries removal was verified using caries detector
dye. Using an applicator tip the caries detector dye was
The bur blades are primarily designed to remove
painted into the walls and base of the cavity. The solution
carious dentin by plowing, during which carious dentin is
was rinsed off with saline after 10 seconds.The observation
first locally compressed by the blades then the compressed
was classified as complete, partial and incomplete, and
wall of softened carious dentin is pushed along the sound
numerically scored based on the criteria proposed by
dentin surface with the blades rupturing eventually at this
Munshi et al.[14].
surface level and the loosened fragments are carried to the
surface.[12, 13]Polymer bur is a more patient-friendly

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In both, the groups after complete removal of caries the IV. DISCUSSION
cavities were restored with Type IX GIC, which was mixed
according to the manufacturer’s instructions. In dentistry, caries removal is developing towards a
biologically more conservative approach. The ultimate goal
Immediately after the treatment, patients were asked to of Conservative dentistry is the selective removal of carious
choose the face that best describes their pain based on dentin which had lost the capability of remineralization
Wong-Baker faces pain rating scale (fig 1). reducing the risk of pulp exposure, preserving hard tissues
(caries-affected dentine), and inhibiting bacterial cariogenic
Scoring criteria for assessment of caries removal activity as well.[15]
efficacy[14]
Moreover, authors in the literature[16, 17]suggest that the
Score Definition affected dentin which is capable of remineralization is
0 Caries removed completely. highly impermeable to dentinal fluid transudate. If the
1 Caries present in the base of the cavity. dentinal fluid is stimulated during caries removal using
2 Caries present in the base and/or one wall. carbide bur, in turn, it stimulates the underlying nerve fibers
3 Caries present in the base and/ or two with resultant pain and sensitivity during and after the
walls. procedure.[16, 17]
4 Caries present in the base and /or more
than two walls. However, practitioners acceptance of selective caries
5 Caries present in the base, walls, and removal is still minimal, with potential harm from lingering
margins of the cavity. bacteria or the shorter lifespan of restorations placed on
carious dentin mentioned as reasons for this opposition.[16]
D. Statistical analysis:
Descriptive statistical analysis was done by the mean and The present clinical study was conducted to evaluate
standard deviation for quantitative variables and frequency and compare the caries removal efficacy of two different
and percentages for categorical variables. The association selective caries removal methods: Polymer bur (SmartBurs
between categorical variables was analyzed using the Chi- II, SS White, Lakewood, NJ, USA) and Atraumatic
square test. The data were analyzed using SPSS statistical Restorative Treatment (ART). In addition, the perception of
software version 20. treatment was evaluated in both methods.

III. RESULT Forty children aged between 4-9 years with open
carious lesions in primary molars were recruited for the
In the present clinical study, a total of 40 primary study and the selected teeth were randomly allotted to both
molars were selected from children aged between 4-9 years groups.
with a mean age of 6.1 years. Among them 12 (60%) were
girls and 8 (40%) were boys. Age distribution between the The Polymer bur was specially manufactured to
groups is shown in graph 1. The distribution of teeth perform selective removal of infected dentin, with Knoop
between the groups were shown in table 1. hardness less than that of affected dentin. There are two
Polymer burs commercially available, SmartBurs II (SS
Overall, no statistically significant differences were White, Lakewood, NJ, USA) and Polybur-1 (Komet,
registered in the efficacy of caries removal between both Mediteam, Sweden). They are available in different sizes.
groups. In the polymer bur group, 17.5% (score 0) of teeth SmartBurs II is available on 004, 006, 008, and Polybur-1 is
showed complete caries removal whereas in the ART group available on 014, 018, 023. SmartBurs II was designed to be
in 15% (score 0) of primary molars complete caries used in a micromotor handpiece at a speed of 500-800 rpm
excavation was observed. Score 1 was observed in 17.5% in whereas Polybur-1 is recommended to be used at 2000-8000
polymer bur group and 27.5% in ART group, score 2 in rpm.[20]
32.5% (group 1 and 2) and score 3 in 17.5% (group 1 and 2)
respectively. Whereas, score 4 was observed in 15% in the Carounanidy Usha and Ranjani R[20] conducted an in-
polymer bur group and 7.5% in the ART group. Table 2 and vitro study, comparing the efficacy of SmartBurs II and
graph 2 shows the comparison of caries removal in both Polybur-1 in 10 mandibular molars and concluded that both
groups. the polymer burs were equally effective in removing deep
dentinal caries. Hence, considering the speed, in our study,
In the polymer bur group, the mean value was we chose to evaluate the efficacy of Smart Burs II.
1.95±1.29 and in the ART group, it is 1.75±1.14. The values
were insignificant between the groups (table 4 and graph 4). Several studies have been conducted to evaluate the
effectiveness of Polymer burs in selective caries removal.
Significant differences were found when comparing Contradictory results have been reported about the efficacy
Wong Bakers pain rating scale. Pain experienced by the and pain perception of patients using polymer bur.
children was higher in the polymer bur group than in the
ART group. The mean value of Wong Bakers faces pain In our study, we evaluated the caries removal efficacy
rating scale is 1.80 ± 1.81 in the polymer bur group and 1.47 of both the methods using caries detector dye, and the
± 1.26 in ART which is statistically significant (graph 3). subjective pain perception was measured using Wong-Baker
The values are given in table 4 and graph 4. faces pain rating scale.

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Before the application of caries detector dye, caries human third molars and stated that Polymer burs were
removal was confirmed by tactile criteria as they are widely proved to be the most conservative method of caries
used criteria to assess complete caries removal. [21, 22] A sharp removal than steel burs and hand excavation technique.
instrument (straight probe or explorer) with gentle force is
passed on the occlusal surface of the teeth. The presence of a The incomplete removal of carious tissue in the
catch or a tug-back sensation indicates the presence of Polymer bur group might be due to its self-limiting
dental caries. The differences between infected dentin and efficiency. Every time, if the Polymer bur comes in contact
affected dentin such as the hardness, toughness, and with healthy or affected dentin, the cutting efficiency of the
resilience help us to determine the relative efficiency of bur was lost and became dull and abraded. This could be
caries excavation, clinically without the aid of additional detected macroscopically. The clinician has to check the bur
material.[22] blades repeatedly during the procedure and have to replace
the bur with a new one when it is abraded.
Kidd et al[24] in their microbiological assessment of
clinical parameters, concluded that tactile criterion is shown In clinical practice, particularly when treating children
to be sufficient for removing the majority of the infected this frequent replacement of the bur during the treatment
dentine. The major drawback of tactile criteria is that the procedure not only increases treatment duration but also the
clinician's judgment and experience are completely patient’s tolerance threshold and compliance is reduced,
responsible for the decision to remove caries. which is a primary challenge for delivering pediatric
patients.
In this study, caries removal was qualitatively assessed
using caries detector dye (Sable & Seek-Ultradent) and Preparation of carious dentin without direct access
numerically evaluated depending on the staining of the base required the use of an airotor. In small cavities, the polymer
and walls of the cavity.[14] bur readily touched the enamel and became dull, whereas in
large cavities it necessitated the use of many burs.
Rubber dam application was omitted to avoid any
possible complications related to clamp placement. In Subjective responses to pain perception, that is, those
addition, and in accordance to the manufacturer’s reported by the patients were evaluated in the study. It was
instructions, polymer bur does not necessitate complete recorded because, in children, subjective perceptions of
isolation. Allen et al[11] stated that when dentin removal is dental treatment have a significantly higher impact on future
limited to the superficial layer (infected dentin), sparing the attitudes toward dental visits and treatments. Varying levels
odontoblast reaction zone, caries removal could be of pain during treatment and varying needs to invasively
completed without the need for local anesthesia. intervene are thought to have an impact on dental anxiety. [6]

The results of this study indicated no significant Immediately after restoration, in both the groups,
difference between the caries removal efficacy of Polymer children were questioned about their pain perception. A
bur and ART in dentin caries in primary molars. In this printed Wong-Bakers faces pain rating scale was shown to
study, complete caries removal was achieved in 17.5% of each child and they were asked to choose an image that suits
teeth in the Polymer bur group and 15% in the ART group their feeling. The Wong-Baker scale consists of six smileys
but the values are insignificant. representing different emotions with numerical scores
ranging from 0 – 10. 0 refers to no pain and 10 refers to
The lower caries removal efficiency of SmartBurs II highest pain.
reported by Rima Maarouf[19] is in agreement with our
results. The study revealed that Polymer bur was less For convenience description, we classified pain
efficient in caries removal than ART. perception as no pain (score 0) mild pain (score 1& 2),
moderate pain (score 3& 4), and severe pain (5). 40% of
These findings are inconsistent with those of Celiberti children in the polymer bur group and 30% in the ART
et al[25] who evaluated the effectiveness of Polymer bur, group experienced no pain. In the polymer bur group 32.5%
laser, steel bur, and hand excavation methods for caries had mild pain and 22.5% had moderate pain whereas in the
eradication in eighty extracted primary molars. In ART group 47.5% stated mild pain and 15% stated moderate
comparison to hand excavation and chemo-mechanical pain. Severe pain was reported by 5% of children in the
procedures, Polymer bur and Er: Yag laser left the most Polymer bur group and 2.5% in the ART group.
decayed dentine. The study concluded that hand excavation
is the most suitable method for carious dentin excavation in Pain perception using Polymer burs must be due to the
primary teeth. sound, heat, vibration, and pressure encountered while using
micromotor. In ART, hand excavation offers optimal tactile
Zakirulla et al[26] compared three different techniques sensation and control as well as less discomfort to the
of caries removal (ART, smart burs, carbide burs) in patients than bur excavation. Furthermore, this procedure
primary mandibular second molars and concluded that does not produce as much heat and vibration. Thus, the ART
polymer bur exhibited greater efficiency in caries removal technique renders more efficient and self-limiting caries
than hand excavators. excavation with lower pain perception.

Ferraz et al[27] evaluated the effectiveness of steel bur, These results were coherent with a study conducted by
hand excavation, and Polymer burs in thirty extracted sound Maarouf et al[19] The study revealed that pain experienced in

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
the ART group was lesser when compared with the Polymer pressure plays in pulpal response. J Am Dent Assoc
bur group. They selected children with at least one carious 1960; 61: 450-56.
primary molar. The study did not evaluate both the [9.] Anusavice KJ, Kincheloe JE. Comparison of pain
techniques in the same children. In our study, we have associated with mechanical and chemomechanical
selected children with at least two decayed primary molars removal of caries. J Dent Res 1987;66:1680-3.
so that pain perception in both techniques could be [10.] Boston DW. New device for selective dentin caries
compared. removal. Quintessence Int 2003;34:678‑85.
[11.] Allen KL, Salgado T, Janal M, Thompson V.
Soni H K et al[18] assessed pain perception of children Removing carious dentin using a polymer instrument
using visual analog scale and verbal pain scale. The study without anesthesia versus a carbide bur with
concluded that Carisolv and Polymer burs were the least anesthesia. J Am Dent Assoc 2005;136:643- 651.
painful methods than hand instruments and airotor. [12.] Freedman G &Goldstep F (2003) Polymer preparation
instruments. A new paradigm in selective dentin
Duman et al [29] compared Brix 3000 and Polymer burs removal Dentistry Today 22(4) 58-61.
in young permanent molars. No patient preferences was [13.] Hauman CH, Kuzmanovic DV. An evaluation of
found. polymer rotary instruments ability to remove healthy,
The major drawback of this self-limiting bur in the non-carious dentin. Eur J ProsthodontRestor Dent
clinician’s aspect is its cost, because, it is a single-use bur 2007; 15: 77-80.
and the number of burs used to remove carious lesions is not [14.] Munshi AK, Hegde AM, Shetty PK. Clinical
limited to one. In the patient’s aspect, it is an advantage as it evaluation of carisolv in the chemo mechanical
reduces the chances of cross-infection. removal of carious dentin. The Journal of Clinical
Limitations of the study include low sample size, Pediatric Dentistry. 2001;26(1):49-54.
unequal distribution of teeth between the groups. However, [15.] Santos TM, Bresciani E, de Souza Matos F, Camargo
further studies need to be conducted, comparing the polymer SE, Hidalgo AP, Rivera LM, de Macedo Bernardino Í,
bur with other minimally invasive techniques. Microbial and Paranhos LR. Comparison between conventional and
also long-term follow-up studies to assess the longevity of chemomechanical approaches for the removal of
the restoration placed after caries excavation with these carious dentin: an in vitro study. Scientific reports.
recently introduced materials. 2020 May 15;10(1):1-0.
[16.] Basting RT, Serra MC. Occlusal caries: diagnosis and
V. CONCLUSION non-invasive treatment. Quintessence Int 1999
Mar;30(3):174-178.
Within the limitations of the study, we could conclude [17.] McComb D. Systematic review of conservative
that the polymer bur effectively preserved the affected operative caries management strategies. J Dent Educ
dentin similar to Atraumatic Restorative Treatment. 2001;65:1154-1161.
[18.] Soni HK, Sharma A, Sood PB. A comparative clinical
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[3.] Pashley EL, Talman R, Horner JA, Pashley DH. [20.] Carounanidy, Ranjani. Comparative evaluation of two
Permeability of normal versus carious dentin. Endod commercially available polymer burs dentistry for their
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[4.] Mertz-Fairhurst EJ, Curtis Jr JW, Ergle JW, using polarized light microscopy. Jour of Scientific
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[25.] Celiberti P. Francescut A. Lussi. Performance of four [28.] Aswathi, K.K., Rani, S.P., Athimuthu, A., Prasanna, P.,
Dentine excavation methods in deciduous teeth. Caries Patil, P. and Deepali, K.J. Comparison of efficacy of
Res 2006;40:117–123. caries removal using polymer bur and
[26.] Zakirulla M, Uloopi KS, Reddy VV. In vivo chemomechanical caries removal agent: A clinical and
comparison of reduction in bacterial count after caries microbiological assessment-An in vivo study. J Indian
excavation with 3 different techniques. Journal of Soc PedodPrev Dent. 2017;35:6-13.
Dentistry for children. 2011 Apr 15;78(1):31-5. [29.] Duman C, Kalauglu E, Capan BS, Edibe EG.
[27.] Camila Ferraz, Patrícia Lima The et al., Effectiveness Comparison of two aerosol-free caries removal
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50(2): 56-62 jun 2014.

TOOTH NUMBER FREQUENCY (%)

54 5(12.5)
55 4(10)
64 5(12.5)
65 5(12.5)
POLYMER BUR GROUP
74 7(17.5)
75 5(12.5)
84 3(7.5)
85 6(15)
54 3(7.5)
55 4(10)
64 3(7.5)
65 9(22.5)
ART GROUP
74 7(17.5)
75 5(12.5)
84 6(15)
85 3(7.5)
Table 1: Distribution of teeth between the groups

Caries removal
Chi-square value Significance
0 1 2 3 4
Polymer
7(17.5) 7(17.5) 13(32.5) 7(17.5) 6(15)
bur
1.966 0.742(N.S)
ART 6(15) 11(27.5) 13(32.5) 7(17.5) 3(7.5)
Total 13(16.3) 18(22.5) 26(32.5) 14(17.5) 9(11.3)
Table 2: Comparison of Caries removal efficacy in Polymer bur group and ART group

Wong Bakers face scores Chi square

Sig.
value
0 1 2 3 4 5

Polymer 16(40) 1(2.5) 12(30) 1(2.5) 8(20) 2(5)

ART 12(30) 7(17.5) 14(35) 5(12.5) 1(2.5) 1(2.5) 13.670 0.018(S)

Total 28(35) 8(10) 26(32.5) 6(7.5) 9(11.3) 3(3.8)

Table 3: Comparison of pain perception in Polymer bur group and ART group

Mean Standard deviation t Sig.

Polymer 1.7500 1.70595
Wong bakers face 0.820 0.032(S)
ART 1.4750 1.26060
Polymer 1.9500 1.29990
Caries removal 0.729 0.634(N.S)
ART 1.7500 1.14914
Table 4: Pain perception and caries excavation in Polymer bur group and ART group

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
AGE DISTRIBUTION, 9 AGE DISTRIBUTION, 4
YEARS, 5%, 5% YEARS, 12.50%, 13%
AGE DISTRIBUTION, 8
YEARS, 12.50%, 13%

AGE DISTRIBUTION, 5
YEARS, 22.50%, 24%
AGE DISTRIBUTION, 7
YEARS, 17.50%, 19%

AGE DISTRIBUTION, 6
YEARS, 30%, 30%
4 YEARS 5 YEARS 6 YEARS 7 YEARS 8 YEARS 9 YEARS

Graph 1: Age distribution of study population

SCORE 2, POLYMER,
35.00% 32.50% SCORE 2, ART, 32.50%

30.00% SCORE 1, ART, 27.50%

25.00%
SCORE 1, POLYMER,
17.50% SCORE 3, POLYMER,
SCORE 0, POLYMER,
20.00% 17.50% 17.50% SCORE 3, ART, 17.50%
SCORE 4, POLYMER, 15%SCORE 0, ART, 15%
15.00%

10.00% SCORE 4, ART, 7.50%

5.00%

0.00%
POLYMER ART

SCORE 0 SCORE 1 SCORE 2 SCORE 3 SCORE 4

Graph 2: Comparison of Caries excavation in Polymer bur group and ART group

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
40%
40%
35%
35%
30% 30%
30%

25%
20%
20% 17.50%

15% 12.50%

10%
5% 2.50%
5% 2.50% 2.50% 2.50%

0%
POLYMER
SCORE 0 SCORE 1 SCORE 2 SCORE 3ART SCORE 4 SCORE 5

Graph 3: Evaluation of pain perception in Polymer bur group and ART group

1.95
2 1.75 1.75
1.8
1.475
1.6
1.4
1.2
1
0.8
0.6
0.4
0.2
0
WONG BAKERS CARIES REMOVAL

POLYMER ART

Graph 4: Pain perception and caries excavation in Polymer bur group and ART group

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