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Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial

  • Abdul Khalek AMG1
  • Elkateb MA1,2
  • Abdel Aziz WE1
  • El Tantawi M3

1Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

2College of Dentistry, Princess Nourah Bint Abdulrahman University, Saudi Arabia

3Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia

DOI: 10.17796/1053-4628-41.3.219 Vol.41,Issue 3,May 2017 pp.219-224

Published: 01 May 2017

*Corresponding Author(s): El Tantawi M E-mail:


Objective: To compare the effect of Papacarie and Atraumatic Restorative Treatment (ART) on pain and discomfort during caries removal among children. Study Design: Fifty healthy, 4–8 year-old children were equally and randomly allocated to Papacarie and ART to remove caries from decayed primary teeth. A randomized, controlled, blinded, two parallel-arms clinical trial was conducted in the clinic of the Pediatric Dentistry and Dental Public Health Department, Alexandria University, Egypt in March 2014. Pain and discomfort were assessed blindly by two independent investigators watching videotaped treatment sessions using the Sound, Eye and Motor scale (SEM). Their reliability was assessed using Kappa statistics. The effect of caries removal methods, time spent to remove caries and other confounders on SEM score was assessed using regression analysis. Results: Mean time to remove caries using Papacarie and ART was 5.8 and 4.8 minutes, P= 0.005. Median Paparie and ART scores for the S, E and M components were 1, 1, 1 and 3, 2, 3. Adjusted mean SEM score= 3.6 and 7.8, P <0.0001. Method of caries removal was the only factor significantly affecting pain and discomfort. Conclusion: Papacarie is associated with minimal pain during caries removal from primary teeth compared to ART, although it has longer working time.


Papacarie, Alternative Restorative Treatment, Pain, Caries

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Abdul Khalek AMG,Elkateb MA,Abdel Aziz WE,El Tantawi M. Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial. Journal of Clinical Pediatric Dentistry. 2017. 41(3);219-224.


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