Evaluation of Papacárie in ART restorations using Visual Analog Scale

Objectives: To evaluate by faces pain scale Visual Analog Scale (VAS) the applicability and acceptability of chemicalmechanical caries removal using Papacarie vs hand excavation during atraumatic restorative treatment (ART).  Methods: The sample consisted of 182 permanent molars with cavities selected from 103 children (44 female, 59 male) aged 6-15 years. Caries were removed by two calibrated operators by mechanical method, hand excavation (N=88) and Papacárie, a papain based gel (N=94). The time spent for the removal of caries in Papacárie system and in hand excavation method was (10.9±4.46 min) and (7.87±2.92 min), respectively (p>0.05). Each cavity depth was measured by a periodontal probe. Before filling with glass-ionomer cement using ART, each patient was asked to indicate the amount of pain being experienced on the patient's pain scale using the slidable indicator. The score (0 to 5) was represented by the face pain scale in crescent order. Mann-Whitney test (p<0.05) was used. Results: The mean of cavity depth was 1.9mm. No relation was found between cavity depth and VAS in both caries removal technique (p>0.05). The scores indicated by VAS are presented in the following table:

Caries Removal Technique	Hand Excavation (Control group)		Chemo-Mechanical Method (Papacárie)
Score	N	%	N	%
0	56	63.7	68	72.3
1	25	28.4	19	20.2
2	3	3.4	5	5.4
3	4	4.5	2	2.1
4	0	-	0	-
5	0	-	0	-

The operators related that Papacárie was the easiest way to remove caries in all cases. Conclusion: There is no evidence that Papacárie on ART restorations make this technique less sensitive, but it allows easier caries removal than conventional hand excavation. Supported by Fórmula&Ação and FUNADESP.